SI Dan Kontraktor Non Tambang 2018-050918

TOTAL MINE PERMIT DAN DATA TIDAK
NO Instansi SIMPPER YANG DIAJUKAN LENGKAP (NA)

1 PT. SEMEN INDONESIA 181 0
2 PT. SWABINA GATRA 55 15
3 PT. KWSG 25 0
4 PT. MARGO MULYO MAKMUR 20 0
5 PT. AJIZ JAYA ABADI 5 5
6 PT. MULYA DEWI 2 0
7 PT. TRIATA 15 0
8 PT. TEKNOTAMA LINGKUNGAN INTERNUSA 102 0
9 PT. CITRA DUTA MUDA 7 0
10 PT. PERWIRA JAYA PERKASA 16 0
11 PT. KITA MANDIRI ABADI 43 0
12 PT. AMAKO REZEKI UTAMA 10 0
13 PT. SETYAWAN MAHAKARYA PRIMA 2 0
14 PT. VARIA USAHA 29 0
15 PT. KMCB 48 13
16 PT. PANCASAKA NATHA PERSADA 9 0
17 PT. LEWIND 20 0
18 PETANI GREEN BELT 271 0
19 PT. SURYA BUANA SENTOSA 20 0
20 PT. SURYA WIJAYA MEGAH 11 0
21 PT. ANT 25 0
22 PT. BUMI ANUGERAH ABADI 8 0
23 PT. JAYA SAKTI LINGKUNGAN HIDUP 9 0
24 PT. BANTENG MUDA TRANS 7 0
25 PT. METATU NUSANTARA JAYA 14 0
TOTAL 860 33
UPDATE MINE PERMIT DAN SIMPPER SI & KONTRAKTOR
MINE PERMIT / SIMPPER PROSES MINE PERMIT YANG MENDEKATI DAN SUDAH, HABIS MASA B
YANG TELAH DI TERBITKAN PENERBITAN VALID WARNING
58 123 83 0
11 29 0 0
17 8 6 0
20 0 9 0
0 0 0 0
2 0 0 0
15 0 0 0
96 6 82 0
7 0 0 0
15 1 0 0
35 8 41 0
9 1 0 0
2 0 0 0
25 4 0 0
11 24 31 1
0 9 9 0
20 0 20 0
248 23 271 0
0 20 17 0
11 0 11 0
20 5 11 0
0 8 11 0
9 0 8 0
7 0 5 0
0
591 236 552 1
TOR
DAN SUDAH, HABIS MASA BERLAKU SIM & SIO YANG MENDEKATI DAN SUDAH, HABIS MASA BERLAKU
EXPIRED VALID WARNING EXPIRED
98 DETAIL 98 4 33
36 DETAIL 20 2 23
11 DETAIL 7 0 10
21 DETAIL 8 1 7
0 DETAIL 0 0 0
2 DETAIL 1 0 1
15 DETAIL 13 2 4
20 DETAIL 58 6 34
7 DETAIL 1 0 1
15 DETAIL 1 0 0
3 DETAIL 12 0 5
9 DETAIL 3 0 6
2 DETAIL 0 0 1
26 DETAIL 4 0 22
3 DETAIL 10 0 4
0 o 0 0 2
0 DETAIL 12 1 6
0 DETAIL 0 0 0
0 DETAIL 0 0 0
0 DETAIL 0 0 0
0 DETAIL 0 0 0
0 DETAIL 0 0 0
2 DETAIL 4 0 1
2 DETAIL 2 0 0
DETAIL
268 248 16 159
MASA BERLAKU
KETERANGAN
DETAIL
DETAIL
DETAIL
DETAIL
DETAIL
DETAIL WARNA MERAH UNTUK SIMPPER
ATAU MINE PERMIT YANG SUDAH
DETAIL MASA BERLAKU SUDAH HABIS
DETAIL (EXPIRED)
MERAH
DETAIL
DETAIL
DETAIL WARNA KUNING UNTUK SIMPPER
DETAIL ATAU MINE PERMIT YANG
MENDEKATI HABIS MASA
DETAIL BERLAKUNYA 60 HARI (WARNING)
DETAIL
DETAIL
DETAIL
DETAIL KUNING
DETAIL
DETAIL
DETAIL
DETAIL
DETAIL
DETAIL
DETAIL
BACK
NO NIK NAMA
SECTION
1 1754 KHOIRUL ANWAR RAW MATERIAL PRODUCTION

2 1368 YANISMANSYAH RAW MATERIAL PRODUCTION
3 1085 SUNAWAN RAW MATERIAL PRODUCTION
4 1203 AKHMAD BUSIRI RAW MATERIAL PRODUCTION
5 1391 TRI PRASETYO RAW MATERIAL PRODUCTION
6 1240 EKO PURWADI RAW MATERIAL PRODUCTION
7 6364 AGUS SALIM RAW MATERIAL PRODUCTION
8 6994 M. ARDY ZAILANI RAW MATERIAL PRODUCTION
9 6954 ENDAR DRIANTO RAW MATERIAL PRODUCTION
10 1996 MOCH. KHALIK H RAW MATERIAL PRODUCTION
11 1905 DARUL SETYAWAN RAW MATERIAL PRODUCTION
12 1913 REZA FABIAN MIFFANTO RAW MATERIAL PRODUCTION
13 6334 AULIAWAN TRI BARTA RAW MATERIAL PRODUCTION
14 1313 SUYANTO RAW MATERIAL PRODUCTION
15 6355 ARFEN TRIYUNARTO RAW MATERIAL PRODUCTION
16 1964 MUKHAMMAD YUNUS RAW MATERIAL PRODUCTION
17 6321 EKO PURNOMO RAW MATERIAL PRODUCTION
18 955 LAURENSIUS SLAMET MARTONO RAW MATERIAL PRODUCTION
19 1075 TAUFIQ SUSANTO RAW MATERIAL PRODUCTION
20 6327 AGRIFA TARIGAN RAW MATERIAL PRODUCTION
21 7276 MUHAMMAD MUCHTAR ARIFIN RAW MATERIAL PRODUCTION
22 594 RACHMAD SOLIKIN RAW MATERIAL PRODUCTION
23 1581 NUR ANAS QOMARI RAW MATERIAL PRODUCTION
24 1388 AGUNG WIDODO RAW MATERIAL PRODUCTION
25 1499 JUWANTO RAW MATERIAL PRODUCTION
26 1346 HERY SYAFI'I RAW MATERIAL PRODUCTION
27 1728 MUHAMMAD FARID RAW MATERIAL PRODUCTION
28 1588 SUDIYONO RAW MATERIAL PRODUCTION
29 610 EDI DWIANTORO RAW MATERIAL PRODUCTION
30 1815 ARIE EKO WIBIONO RAW MATERIAL PRODUCTION
31 1350 ABDUR ROHMAN RAW MATERIAL PRODUCTION
32 1981 OKJU VIONO RAW MATERIAL PRODUCTION
33 1219 SUGIANANG RAW MATERIAL PRODUCTION
34 6995 ARIFIANTO RAW MATERIAL PRODUCTION
35 1847 BAGUS BUDI MUZAMMIL RAW MATERIAL PRODUCTION
36 1596 M. ROCHIMIN RAW MATERIAL PRODUCTION
37 592 EDY PURWANTO RAW MATERIAL PRODUCTION
38 1839 M. NUR SAID RAW MATERIAL PRODUCTION
39 823 NGUDI CATUR PRIYANTO RAW MATERIAL PRODUCTION
40 6307 ANGGORO LAILY BUDIONO RAW MATERIAL PRODUCTION
41 1167 IRWAN DARMANTO RAW MATERIAL PRODUCTION
42 7003 INDRA AGUSTIAN RAW MATERIAL PRODUCTION
43 7078 IRWAN NU'MAN HADI RAW MATERIAL PRODUCTION
44 7210 FUKA YUDHA PRADITYA RAW MATERIAL PRODUCTION
45 7264 BAYU WAHONO PUTRA RAW MATERIAL PRODUCTION
46 7216 DANAR ADISURYA RAW MATERIAL PRODUCTION
47 7244 AGUNG WAHYU WIBOWO RAW MATERIAL PRODUCTION
48 7249 EDGAR FASTIAN LEKSONO RAW MATERIAL PRODUCTION
49 7225 ABDUL GOVAR RAW MATERIAL PRODUCTION
50 1778 OKTORIA MASNIARI M RAW MATERIAL PRODUCTION
51 6294 JOIN TRIMOR DAMANIK RAW MATERIAL PRODUCTION
52 6371 ASWAMEDDHIKA RAW MATERIAL PRODUCTION
53 1382 ALLEN SUSETYO RAW MATERIAL PRODUCTION
54 743 DIDIK SUWARYANTA RAW MATERIAL PRODUCTION
55 1595 DEBBY TARUNA VIRGO RIANA RAW MATERIAL PRODUCTION
56 7036 FRIDA WAHYU RAW MATERIAL PRODUCTION
57 1492 EDY LUKMAN FAUZI RAW MATERIAL PRODUCTION
58 7117 VESTI HERLINA RAW MATERIAL PRODUCTION
59 1419 SULISTYONO RAW MATERIAL PRODUCTION
60 1247 DARMANTO RAW MATERIAL PRODUCTION
61 1593 HERUTO RAW MATERIAL PRODUCTION
62 1356 SAMSURI RAW MATERIAL PRODUCTION
63 1573 MAMAK JUNAIDI PURNOMO RAW MATERIAL PRODUCTION
64 1244 MUGIYONO RAW MATERIAL PRODUCTION
65 1674 SLAMET BUDIONO RAW MATERIAL PRODUCTION
66 1158 AGUS MARIANTO RAW MATERIAL PRODUCTION
67 1201 SUGENG YUDI ARYANTO RAW MATERIAL PRODUCTION
68 889 CANDRA PRABONDO SARI RAW MATERIAL PRODUCTION
69 1535 FIRIS DIANTO RAW MATERIAL PRODUCTION
70 1217 DWI PURWANTO RAW MATERIAL PRODUCTION
71 1561 AGUNG SUPRIYANTO RAW MATERIAL PRODUCTION
72 1546 AGUS HADI ISMANTO RAW MATERIAL PRODUCTION
73 1938 KANANG ALI MUKTAR RAW MATERIAL PRODUCTION
74 1950 SAMSUL HADI RAW MATERIAL PRODUCTION
75 6366 BIMA SEPTIAN A. R RAW MATERIAL PRODUCTION
76 1994 ARDHO RINALDY RAW MATERIAL PRODUCTION
77 1329 ALI MUHTAR RAW MATERIAL PRODUCTION
78 1489 YULI IHWAN PURNOMO RAW MATERIAL PRODUCTION
79 1147 MUTTAQIN RAW MATERIAL PRODUCTION
80 1974 MOHAMMAD EDI WIJAYA RAW MATERIAL PRODUCTION
81 1333 SOENOE DIHARJO RAW MATERIAL PRODUCTION
82 983 PARDIONO RAW MATERIAL PRODUCTION
83 1340 DEDDY PRIHANTORO RAW MATERIAL PRODUCTION
84 1562 DJOKO PURNOMO RAW MATERIAL PRODUCTION
85 1902 RENDRA SEPTA KUSUMA RAW MATERIAL PRODUCTION
86 1975 NARKO RAW MATERIAL PRODUCTION
87 1998 TAUFIQ YUNUS RAW MATERIAL PRODUCTION
88 1962 DEDY IRAWAN RAW MATERIAL PRODUCTION
89 1539 EKO WAHYUDI RAW MATERIAL PRODUCTION
90 7138 OKKY IBRAHIM WIBISONO RAW MATERIAL PRODUCTION
91 6373 MIFTAH FAHMI ANSOLIH RAW MATERIAL PRODUCTION
92 1403 KUKUH PRIASMORO RAW MATERIAL PRODUCTION
93 1389 ACHMAD KOMARI RAW MATERIAL PRODUCTION
94 1910 HANDIKA SETYAWAN RAW MATERIAL PRODUCTION
95 1921 ARIP WISAR MANDA RAW MATERIAL PRODUCTION
96 1545 ACHMAD FATONI RAW MATERIAL PRODUCTION
97 1544 ELYA ACHMAD RAW MATERIAL PRODUCTION
98 7134 WAHYU ARDIANTO RAW MATERIAL PRODUCTION
99 1337 MOH. KHOLIL RAW MATERIAL PRODUCTION
100 1540 PRASETIAWAN SIGIT W RAW MATERIAL PRODUCTION
101 1417 NURDIONO RAW MATERIAL PRODUCTION
102 1916 HARI TRIANGGONO RAW MATERIAL PRODUCTION
103 1883 ACHMAD TAUFIQUR ROHMAN RAW MATERIAL PRODUCTION
104 1936 WIYOTO RAW MATERIAL PRODUCTION
105 1334 AHMAD AINUROFIQ RAW MATERIAL PRODUCTION
106 7073 MUADZ HAZMI RAW MATERIAL PRODUCTION
107 647 JUWARI RAW MATERIAL PRODUCTION
108 1562 DJOKO PURWONO RAW MATERIAL PRODUCTION
109 1202 HERY SUPRASTIYO RAW MATERIAL PRODUCTION
110 1173 MOCHAMMAD ARIF NASRUDIN RAW MATERIAL PRODUCTION
111 7258 AGUS SUPRIYANTO RAW MATERIAL PRODUCTION
112 708 YULI YASTORO QHSE
113 881 EKO AGUS SETYAWAN QHSE
114 1059 DWI PURWANTO QHSE
115 6343 TRI SUSENO QHSE
131 1073 PURNOMO QHSE
132 1629 M. ARIS SYUKRIYANTO, ST. QHSE
133 1072 JATMIKO QHSE
134 6949 MIRZA IMESYA NIALDA, S.Stat. QHSE
135 1088 UNTUNG SUGIHARTONO QHSE
136 6342 MOCH. SYAHRIAL RAMADANI QHSE
137 1051 RUDDY ARIYANTO QHSE
138 1086 JUNAIDI TRI UTOMO QHSE
139 6315 ARIES MUCHLIS HUDIN QHSE
140 1081 CHOIRUL INSAN QHSE
141 1971 EBY MARDIYANSYAH QHSE
142 1922 ANJAR PRIBADY QHSE
143 1968 HARTONO QHSE
144 1900 IRFAN HIDAYAT QHSE
145 1963 WARSITO UTOMO QHSE
146 1897 JUNI CAHYO WIBISONO QHSE
147 1931 HERU SUSANTO QHSE
148 1296 ALI SODIKIN COMUNICATION & GA
149 907 ALI MUHTAR COMUNICATION & GA
150 914 ABDUL MUNIF EFENDI COMUNICATION & GA
151 1129 HARI SUSILO COMUNICATION & GA
152 1077 KUSNIADI, ST. COMUNICATION & GA
153 813 KUSWANDI, SH. COMUNICATION & GA
154 6969 YENI INDAH LESTARI, S.Sos. COMUNICATION & GA
155 1146 MOCHAMMAD SANI YUWONO, SE. COMUNICATION & GA
156 926 IVAN SETYABUDIE, SE. COMUNICATION & GA
157 1341 EDI SULEMAN COMUNICATION & GA
158 1242 SISWANTO, ST. COMUNICATION & GA
159 969 HARI SISWOYO COMUNICATION & GA
160 943 UMU KHOIRIYAH COMUNICATION & GA
161 1227 ARIF RULLIYANTORO COMUNICATION & GA
162 1138 ARIF SANTOSO COMUNICATION & GA
163 1302 ANDIK SUTIKNO, SH. COMUNICATION & GA
164 1966 DONI RIZAL IBRAHIM COMUNICATION & GA
165 1258 DWI AGUS WIDODO RAW MATERIAL PRODUCTION
166 1263 MANSUR TAMIN RAW MATERIAL PRODUCTION
167 1267 WAHYUDI SUMARNO RAW MATERIAL PRODUCTION
168 7011 SYAHRIAL RAMADHAN RAW MATERIAL PRODUCTION
169 1681 RUDI HERMAWAN RAW MATERIAL PRODUCTION
170 642 TALKAH MARDWI RAW MATERIAL PRODUCTION
171 1256 MOKHAMAD SOLEH RAW MATERIAL PRODUCTION
172 1318 MOCHAMAD ATHOK DINA RAW MATERIAL PRODUCTION
173 1746 HATTA MUDZAKIR RAW MATERIAL PRODUCTION
174 1829 EKO WAHYU ARI ERMANTO RAW MATERIAL PRODUCTION
175 1917 PRADANA RAW MATERIAL PRODUCTION
176 7042 DICKY INDRAMANTO RAW MATERIAL PRODUCTION
177 1348 MOHAMAD ALI DIMYATI RAW MATERIAL PRODUCTION
178 7066 GINANJAR WIHARNO PUTRO RAW MATERIAL PRODUCTION
179 6292 KOKOH ADICARAKA RAW MATERIAL PRODUCTION
180 1319 AGUNG DANI SULISTIAWAN RAW MATERIAL PRODUCTION
181 1622 JOKO MALIS RAW MATERIAL PRODUCTION
MINE PERMIT STATUS ID CARD
TELAH
REGU NO ID ACCESS VALID UNTIL KET DICETAK
MINING OPERATION 101-001 FULL 1-Dec-2020 VALID Y

MINING PLANNING & MONITORING 101-013 FULL 1-Dec-2020 VALID Y
MINING PLANNING & MONITORING 101-014 FULL 1-Dec-2020 VALID Y
MINING PLANNING & MONITORING 101-015 FULL 24-Jan-2023 VALID
MINING PLANNING & MONITORING 101-016 FULL 15-Aug-2022 VALID
LAND RECLAMATION 101-017 FULL 1-Dec-2020 VALID Y
CRUSHER MACHINE MAINTENANCE 101-022 NON 1-Dec-2020 VALID Y
MINING OPERATION 101-044 FULL 1-Jan-2020 VALID Y
MINING OPERATION 101-045 FULL 1-Jan-2020 VALID Y
MINING PLANNING & MONITORING 101-046 FULL 1-Jan-2020 VALID Y
MINING PLANNING & MONITORING 101-047 FULL 1-Jan-2017 EXPIRED Y
MINING PLANNING & MONITORING 101-048 FULL 1-Jan-2017 EXPIRED Y
LAND RECLAMATION 101-049 FULL 1-Jan-2017 EXPIRED Y
101-050 FULL 1-Jan-2017 EXPIRED Y
PROCESS EVALUATION 101-051 FULL 1-Jan-2017 EXPIRED Y
PROCESS EVALUATION 101-052 FULL 1-Jan-2017 EXPIRED Y
PROCESS CONTROL 101-053 FULL 1-Jan-2017 EXPIRED Y
HEAVY EQUIPMENT 101-065 NON 1-Jan-2017 EXPIRED Y
CRUSHER OPERATION 101-077 NON 1-Jan-2017 EXPIRED
CRUSHER OPERATION 101-078 NON 1-Jan-2017 EXPIRED Y
CRUSHER OPERATION 101-108 NON 2-Feb-2021 VALID
CRUSHER MACHINE MAINTENANCE 101-109 NON 2-Feb-2021 VALID
HEAVY EQUIPMENT 101-110 NON 2-Feb-2021 VALID
HEAVY EQUIPMENT 101-111 NON 2-Feb-2021 VALID
ENVIROMENTAL MONITORING 102-001 FULL 1-Dec-2016 EXPIRED Y
TUBAN HYGIENE 102-020 NON 1-Dec-2016 EXPIRED Y
TUBAN HYGIENE 102-021 NON 2-Feb-2021 VALID
TUBAN SAFETY 102-022 FULL 2-Feb-2021 VALID
SECRETARIAT & PROTOCOL 103-001 FULL 1-Dec-2016 EXPIRED Y
SECRETARIAT & PROTOCOL 103-002 FULL 21-Apr-2023 VALID Y
SECRETARIAT & PROTOCOL 103-003 FULL 17-Apr-2021 VALID Y
SECRETARIAT & PROTOCOL 103-004 FULL 9-Feb-2021 VALID Y
SECRETARIAT & PROTOCOL 103-005 FULL 2-Feb-2021 VALID
PR COMMUNICATION & DEVELOPMENT 103-006 FULL 2-Feb-2021 VALID
PR COMMUNICATION & DEVELOPMENT 103-007 FULL 2-Feb-2021 VALID
TUBAN PUBLIC RELATION 103-008 FULL 2-Feb-2021 VALID
TBN COMMUNITY & DEVELOPMENT 103-011 FULL 2-Feb-2021 VALID
CRUSHER ELECTRIC INSTRUMEN MAINTENAN 104-001 FULL 1-Jun-2017 EXPIRED Y
CRUSHER ELECTRIC INSTRUMEN MAINTENAN 104-017 FULL 2-Feb-2021 VALID
STATUS ID CARD
NILAI
DOK
TELAH SIM-POL NO SIM-POL
TULIS PRAKTEK LV
DITERIMA F FT K
Y √ √ √ A 820215470686 92 17-Feb-2018
Y √ √ √ A 710115470136 100 6-Jan-2018
Y √ √ √ A 740515470113 86 30-May-2019
Y √ √ √ A 740615470347 94 24-Jun-2018
Y √ √ √ A 761115470207 92 18-Nov-2019
Y √ √ √ A 730215470214 100 14-Feb-2018
Y √ √ √ A 900815470440 7-Aug-2018
Y √ √ √ A 910211200122 3-Feb-2017
Y √ √ √ A 880825261551 100 21-Aug-2019
Y √ √ √ A 910615460351 100 20-Jun-2016
Y √ √ √ A 901014490708 100 24-Oct-2017
Y √ √ √ A 910215350684 78 14-Feb-2019
Y √ √ √ A 891014520705 98 2-Oct-2016
Y √ √ √ A 770115470231 94 27-Jan-2019
√ √ √ A 900114520975 90 24-Jan-2023
√ √ √ A 890815280557 96 15-Aug-2022
Y √ √ √ C 880711190245 92
Y √ √ √ A 740615470243 18-Jun-2020
Y √ √ √ A 731215470202 12-Dec-2018
Y √ √ A 880915470482 20-Sep-2021
Y √ √ √ A 790217140867 2-Feb-2020
Y √ √ √ A 690815470272 70 5-Aug-2017
Y √ √ √ A 770815470754 68 2-Aug-2020
Y √ √ √ A 761115470402 68 1-Nov-2016
Y √ √ A 771115470565 13-Nov-2020
Y √ √ A 751015470144 13-Oct-2016
Y √ √ √ A 790415470711 10-Apr-2017
Y √ √ √ A 771015470526 82 20-Oct-2019
Y √ √ √ A 700515470435 24-May-2018
Y √ √ √ A 830415540671 64 17-Apr-2017
Y √ √ √ A 760215470254 54 10-Feb-2020
Y √ √ √ A 901015470302 12-Oct-2017
Y √ √ √ A 760215470047 80 3-Feb-2019
Y √ √ A 910315140270 88 6-Mar-2018
Y √ √ √ A 901114390209 70 22-Nov-2017
Y √ √ √ A 790115470438 31-Jan-2016
Y √ √ √ A 690515540366 1-May-2020
Y √ √ √ A 881014360572 13-Oct-2016
Y √ √ √ A 680915470186 86 26-Sep-2016
Y √ √ √ A 870914410686 64 15-Sep-2019
Y √ √ √ A 750315470368 58 5-Mar-2017
Y √ √ A 910817140247 24-Aug-2017
Y √ √ C 910315481075
Y √ √ C 920415460168
Y √ √ C 970915460177
Y √ √ C 930415460403
Y √ √
Y √ √ C 960114520038 96
Y √ √ C 931015460181
√ √
√ √
√ √
Y √ √ A 760615140269 20-Jun-2018
Y √ √ A 730715470225 13-Jul-2016
Y √ √ A 780915470130 3-Sep-2020
√
Y √ √ √ A 770815470323 26-Aug-2017
√
Y √ √ √ A 771015470243 1-Oct-2014
√ √
Y √ √ A 780415470197 27-Apr-2016
√ √
Y √ √ A 770415470310 4-Apr-2019
Y √ √ A 740415470420 30-Apr-2015
√ √
√ √
√ √
√ √
√ √
√ √
√ √
√ √
√ √
√ √
√ √
√ √
√ √ A 720915470348 2-Sep-2016
√ √ A 770715470772 28-Jul-2016
√ √ A 751215470297 12-Dec-2016
√ √ A 900615470505 6-Jun-2019
√ √ A 730415470261 5-Apr-2016
√ √ BI 730415470684 4-Apr-2019
√ √ A 740815470292 26-Aug-2018
√ √
√ √ C 900915360315
√ √ A 900615470507 21-Jun-2019
√ √ C 911115470310
√ √ C 890615470340
√ √ A 761115540389 1-Nov-2017
√ √ A 93101205971574 1-Oct-2020
√ √ C 910313270186
√ √ A 770515470686 4-May-2016
√ √ A 761115470167 6-Nov-2017
√ √ A 910115350686 10-Jan-2017
√ √ A 910715360676 1-Jul-2019
√ √ A 780515470516 20-May-2018
√ √ A 780415540510 19-Apr-2016
√ √ A 930814440538 13-Aug-2020
√ √ A 731215470208 12-Dec-2018
√ √ A 770115470486 7-Jan-2018
√ √ A 770915540518 4-Sep-2020
√ √ C 910415360462
√ √ A 891015350781 2-Oct-2018
√ √ A 851015470648 18-Oct-2020
√ √ A 730515470601 14-May-2017
54
60
√
√
√
√
√ √ A 710715540038 1-Jul-2020
√ √ A 720815540886 7-Aug-2017
√ √ A 730115470246 24-Jan-2014
√ √ A 890514410591 15-May-2017
√ √
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√ √ A 750915470053 6-Sep-2017
Y √ √ A 670415470379 21-Apr-2018
Y √ √ A 700415470376 17-Apr-2020
Y √
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√ A 760415470603 30-Apr-2017
√ BI 770715479849 12-Jul-2017
√ A 920415540203 1-Apr-2020
√ A 821015340825 8-Oct-2020
√ A 660315540348 2-Mar-2016
√ A 750615470525 3-Jun-2017
√ A 770515470197 27-May-2020
√ A 811015470564 29-Oct-2019
√ C 890315470211
√ C 910515639127
√ A 891215143472 8-Dec-2020
√ A 751115470191 9-Nov-2017
√ C 901115540263
√ A 850915481020 22-Sep-2018
√ A 770715470245 4-Jul-2017
√
DRIVER LICENSE VALID DATE
LV DUMP TRUCK Crane Trailer Motorcycle
EXPIRED F
EXPIRED F
EXPIRED F
EXPIRED F
VALID F
EXPIRED F
EXPIRED F
EXPIRED F
WARNING F
EXPIRED F
EXPIRED F
EXPIRED F
EXPIRED F
EXPIRED F
VALID F
VALID F
VALID F
EXPIRED F
VALID F
VALID F
EXPIRED N
VALID N
EXPIRED N
VALID N
EXPIRED N
EXPIRED N
VALID N
EXPIRED N
EXPIRED N
VALID N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
VALID N
EXPIRED N
EXPIRED N
VALID N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
VALID N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
VALID N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
VALID N
EXPIRED N
VALID N
EXPIRED N
EXPIRED N
VALID N
EXPIRED N
VALID N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
VALID N
EXPIRED N
EXPIRED N
VALID N
VALID N
EXPIRED N
VALID N
EXPIRED N
VALID N
VALID N
EXPIRED N
EXPIRED N
EXPIRED N
SIMPPER
Dump Truck Excavato

CWB Scania PC 750
25-May-2020 VALID F 25-May-2020 VALID F
25-May-2020 VALID F
25-May-2020 VALID F
25-May-2020 VALID F 25-May-2020 VALID F 25-May-2020 VALID F

F
F


25-May-2020 VALID F 25-May-2020 VALID F 25-May-2020 VALID F
SIMPPER
OPERATOR LICENSE VALID D
Excavator Wheel Loader
Breaker
PC 400 PC 300 PC 200 WA 500
25-May-2020
F F

F F
25-May-2020
25-May-2020
25-May-2020

OPERATOR LICENSE VALID DATE
Dozer Motor Forklif
D 155 D 85 Grader
F 25-May-2020 VALID F
F 25-May-2020 VALID 25-May-2020 VALID
F
F
Rock Drill Machine
Surface Blaster
HCR 1500 ROC F7 Sandvic ROC T35 Miner
28-May-2020 VALID F
22-Jun-2017 EXPIRED
28-May-2020 VALID F
28-May-2020 VALID F
28-May-2020 VALID F
31-Jul-2016 EXPIRED
28-May-2020 VALID F
28-May-2020 VALID F
1-Jul-2016 EXPIRED
STATUS MINE PERMIT STATUS SIMPPER
VALID WARNING EXPIRED VALID WARNING EXPIRED

Compactor
83 0 98 98 1 3
UNIT KERJA
NO NIK NAMA BACK
INSTANSI BAGIAN
1 857097 AHMAD HERI PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE

2 827088 ANDANI PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
3 917094 ARI MAULANA PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
4 827085 ASEP WIBOWO PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
5 827438 CHOIRINNAS EKA HANDOYO PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
6 807100 CIPTO TEGUH BUDI U PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
7 917431 DARWANTO PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
8 787077 DWI JUJUK MARDIANTO PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
9 897435 EDI PURWANTO PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
10 897183 ERNAWATI PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
11 927084 HARIYONO PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
12 727096 HASAN BISRI PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
13 947081 HENDRI PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
14 777089 KARSIMAN PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
15 721223 KUS INDRATNO PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
16 767095 KUSMINDAR PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
17 737079 KUSNADI PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
18 867428 LAMSIONO PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
19 887086 LASMURI PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
20 721219 LILIK AGUSTYANTO PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
21 867430 LILIK WAHYUDI PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
22 897087 M. EFENDI PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
23 687078 MARSAID PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
24 897093 MUH. BAHTIAR AFANDI PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
25 897098 MUHAMMAD KIROM PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
26 847092 MUIN PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
27 877083 NURKAZI PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
28 937090 PRIYO SANTOSO PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
29 867437 SAIFUDIN PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
30 857434 SANTO PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
31 887073 SATRIO PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
32 697091 SETYO BUDI PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
33 747076 SISWO PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
34 740116 SLAMET MALIKI PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
35 897080 SUPRIHADI PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
36 767082 SUYANTO PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
37 747074 TASRAN PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
38 877432 TRI SETIAWAN PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
39 787071 WANTO PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
40 907072 WIDODO PRAYITNO PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
41 867075 YULIANA WIRAWAN PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
42 A. KHAMID PT. SWABINA GATRA TUBAN HYGIENE
43 781523 BAMBANG EDI S PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
44 650032 PRANOTO PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
45 790498 NAFI PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
46 660847 DWI CIPTO PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
47 700248 MASMAUN PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
48 731280 MARDINTO PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
49 680074 SUKAERI PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE
50 650807 SAKRUN PT. SWABINA GATRA CRUSHER OPERATION
51 8774455 ACHMAD RAFIK PT. SWABINA GATRA CRUSHER OPERATION
52 97B565 AHMAD SAIPUDDIN PT. SWABINA GATRA OPERASI TAMBANG
53 92B566 EDI RUDIANTO PT. SWABINA GATRA OPERASI TAMBANG
54 96B567 SELAMET WIJANARKO PT. SWABINA GATRA OPERASI TAMBANG
55 95B568 KURNIAWAN PT. SWABINA GATRA OPERASI TAMBANG
DOK
TELAH TELAH SIM-POL
NO ID ACCESS VALID UNTIL KET DICETAK DITERIMA F FT K
202-007 NON 1-Dec-16 EXPIRED Y √ √

202-009 NON 1-Dec-16 EXPIRED Y √ √ A
202-011 NON 1-Dec-16 EXPIRED Y √ √ C
202-012 NON 1-Dec-16 EXPIRED Y Y √ √ BII
202-016 NON NA √
202-019 NON 1-Dec-16 EXPIRED Y Y √ √
202-021 NON 1-Dec-16 EXPIRED Y Y √ √ C
202-025 NON NA √
202-026 NON NA √ A
202-031 NON NA √
202-040 NON NA √
202-044 NON 1-Dec-16 EXPIRED Y √ √ BI
202-067 NON NA √
202-075 NON NA √ A
202-076 NON NA √ A
202-077 NON NA √ A
202-078 NON NA √ A
202-079 NON NA √ A
202-080 NON NA √ A
202-081 NON NA √ A
202-082 NON NA √ C
202-083 NON NA √ A
202-084 FULL 22-Dec-20 VALID √ √
202-085 FULL 22-Dec-20 VALID √ √ C
202-086 FULL 22-Dec-20 VALID √ √
202-087 FULL 22-Dec-20 VALID √ √ C
A DRIVER LICENSE
NO SIM-POL
TULIS PRAKTEK LV Dump Truck
911215470344 8-Dec-2018 EXPIRED N
820315470451 10-Mar-2016 EXPIRED N

800815470767 88 5-Aug-2018 EXPIRED N
780315470222
68
68
60
720915470530 66
720815470233 76 17-Aug-2019 WARNING N

860715470219
681015470264 42
86
42
68
690715470055
740715460582 56
68
60
740815470708 52
870315470511 13-Mar-2019 EXPIRED N
780715470406
780315470598 27-Mar-2016 EXPIRED N
850415470805 23-Apr-2020 VALID N
790615470153 24-Jun-2018 EXPIRED N
660315470099 4-Mar-2018 EXPIRED N
700715470603 23-Jul-2016 EXPIRED N
730815470608 5-Aug-2017 EXPIRED N
681115470081 7-Nov-2020 VALID N
650715470231
870315470532 30-Mar-2019 EXPIRED N
920315470091
960815470298
SIMPPER
Dump Truck Crane Trailer Motorcycle Service Truck
8-Dec-2016 EXPIRED N
10-Mar-2019 EXPIRED N
6-Sep-2017 EXPIRED N
17-Aug-2019 WARNING N
4-Jul-2017 EXPIRED N
20-Oct-2020 VALID N
12-Jul-2018 VALID N
1-Aug-2020 VALID N
23-Apr-2020 VALID N
24-Jun-2019 EXPIRED N
23-Jul-2019 WARNING N
5-Aug-2020 VALID N
7-Nov-2017 EXPIRED N
24-Mar-2020 VALID N
17-Aug-2020 VALID N
SIMPPER
OPERATOR LICENS
Dump Truck Excavator
Breaker
CWB Scania PC 750 PC 400 PC 300 PC 200
Wheel Loader Dozer Motor Rock Drill Machine
Forklif
WA 500 D 155 D 85 Grader HCR 1500 ROC F7 ROC T35
Surface Compactor
Miner
UNIT KERJA
BACK
NO NIK NAMA
INSTANSI
1 130661 EDI KUNCORO KWSG

2 130662 KASLAN KWSG
3 130663 ROCHMAD NUR AGUS Z KWSG
4 130658 SUPATMAN KWSG
5 130659 YOYOK DWI ANANTO KWSG
6 740415470803 TARMUJI NOTO RAHARJOKWSG
7 760415470547 GUNAWAN KWSG
8 760715540382 BADRUN KWSG
9 770515470722 IMAM SYARIFUDIN KWSG
10 770615540419 ACHMAD YUSUF KWSG
11 780815541099 EKO SUSANTO KWSG
12 790415381007 SUDARTO KWSG
13 811215540078 WOKO BUDI SANTOSO KWSG
14 830714390455 NGAINUL MARZUKIN KWSG
15 830814390276 SODIKUN KWSG
16 730115470143 BUDI HARIYANTO KWSG
17 721015481013 KHOIRUL ANAM KWSG
18
19
20
21
22
23
24
25
UNIT KERJA MINE PERMIT STATUS ID CARD
TELAH TELAH
DEPARTEMEN NO ID ACCESS VALID UNTIL KET DICETAK DITERIMA
COMMUNICATION & GA 203-001 FULL 1-Dec-16 EXPIRED Y Y

QHSE 203-006 FULL 1-Jun-17 EXPIRED Y Y
QHSE 203-007 FULL 1-Jun-20 VALID Y Y
NILAI
DOK
SIM-POL NO SIM-POL
TULIS PRAKTEK LV
F FT K
√ √ √ A 720715470260 6-Jul-2017
√ √ √ BI 710115470152 82 20-Jan-2021
√ √ √ BI 921215470266 89 11-Dec-2018
√ √ √ A 830215470199 3-Feb-2018
√ √ √ BII UMUM 780215470458 89 3-Feb-2020
√ √ √ BII UMUM 740415470803
√ √ √ BII UMUM 760415470547
√ √ √ A 760715540382 6-Jul-2020
√ √ √ BII UMUM 770515470722
√ √ √ BII UMUM 770615540419
√ √ √ BII UMUM 780815541099
√ √ √ BII UMUM 790415381007
√ √ √ BII UMUM 811215540078
√ √ √ BII UMUM 830714390455
√ √ √ BII UMUM 830814390276
√ √ √ BII UMUM 730115470143
√ √ √ BII UMUM 721015481013
LV Truck Ringan Crane Trailer Motorcycle Service Truck
EXPIRED
VALID
EXPIRED
EXPIRED
VALID
4-Apr-19 EXPIRED
2-Apr-21 VALID
VALID
16-May-16 EXPIRED
15-Jun-20 VALID
11-Aug-17 EXPIRED
18-Apr-16 EXPIRED
2-Dec-20 VALID
8-Feb-21 VALID
27-Aug-18 EXPIRED
20-Jan-19 EXPIRED
27-Oct-18 EXPIRED
SIMPPER

CWB Scania PC 750 PC 400 PC 300
avator Wheel Loader Dozer
Breaker
PC 200 WA 500 D 155
Dozer Motor Rock Drill Machine
Forklif Surface
D 85 Grader HCR 1500 ROC F7 ROC T35 Miner
Compactor
BACK UNIT KERJA
NO NIK NAMA
INSTANSI
7 TAHIR PT. MARGO MULYO MAKMUR

3 SLAMET PT. MARGO MULYO MAKMUR
1 BISRUL KAFI PT. MARGO MULYO MAKMUR
9 TRIWI HANTONO PT. MARGO MULYO MAKMUR
6 SUNARYO PT. MARGO MULYO MAKMUR
4 SUMARNO PT. MARGO MULYO MAKMUR
8 TARMONO PT. MARGO MULYO MAKMUR
5 SUMIHARSO PT. MARGO MULYO MAKMUR
2 HARIYANTO PT. MARGO MULYO MAKMUR
18 RUSTAM PT. MARGO MULYO MAKMUR
10 TARMUJI PT. MARGO MULYO MAKMUR
11 MAT BENI PT. MARGO MULYO MAKMUR
12 NUR PAKIH PT. MARGO MULYO MAKMUR
13 SUHADAK PT. MARGO MULYO MAKMUR
14 SUWARNO PT. MARGO MULYO MAKMUR
15 LASMINAR PT. MARGO MULYO MAKMUR
26 SUTRISNO PT. MARGO MULYO MAKMUR
16 KAWAN DIDIK MULYADI PT. MARGO MULYO MAKMUR
17 KACUNG PT. MARGO MULYO MAKMUR
19 NARTADI PT. MARGO MULYO MAKMUR
TELAH TELAH
TUBAN GENERAL FACILITY M 204-007 FULL 1-Dec-16 EXPIRED Y Y

LAND RECLAMATION 204-019 NON 15-Dec-17 VALID Y Y
LAND RECLAMATION 204-010 NON 15-Dec-17 EXPIRED Y Y
LAND RECLAMATION 204-020 NON 15-Dec-17 EXPIRED Y Y
NILAI
DOK
SIM-POL NO SIM-POL
TULIS PRAKTEK LV
F FT K
√ √ √ A 690915470099 79 6-Sep-16
√ √ √ BI 641215470063 66 6-Dec-16
√ √ √ A 830115470510 20-Jan-17
√ √ √ BII 870215470367 15-Feb-18
√ √ √ A 780215470545 21-Feb-18
√ √ √ A 860415470525 82 15-Apr-18
√ √ √ BI 910615470480 59 17-Jun-19
√ √ √ A 640814510265 82 1-Aug-19
√ √ √ BI 680115470093 16-Jan-20
√ √ √ A 650715470246 1-Jul-20
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √ C 650815470516
√ √ √
√ √ √
LV Truck Ringan Crane Trailer Motorcycle
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
EXPIRED N
WARNING N
VALID N
VALID N
7-Aug-21 VALID N
c

Service Truck
CWB Scania PC 750 PC 400
Excavator Wheel Loader Dozer
Breaker
PC 300 PC 200 WA 500 D 155
DATE
Dozer Backhoe Loader Motor Rock Drill Machine
Forklif
D 85 Grader HCR 1500
Rock Drill Machine
Surface Compactor
ROC F7 ROC T35 Miner
UNIT KERJA MINE PERMI
BACK
NO NIK NAMA
INSTANSI DEPARTEMEN NO ID
1 1502064 BAKRUN PT. AZIS JAYA ABADI EMISSION CONTROL 205-001

2 1502073 DAIM PT. AZIS JAYA ABADI EMISSION CONTROL 205-002
3 1502090 DARSAM PT. AZIS JAYA ABADI EMISSION CONTROL 205-003
4 1502071 DASRAN PT. AZIS JAYA ABADI EMISSION CONTROL 205-004
5 1502065 TRINOTO PT. AZIS JAYA ABADI EMISSION CONTROL 205-005
DOK
TELAH TELAH SIM-POL
ACCESS VALID UNTIL KET DICETAK DITERIMA F FT K
FULL NA √
FULL NA √
FULL NA √
FULL NA √
FULL NA √
NILAI DRIVER LICENSE VALID DATE
NO SIM-POL
TULIS PRAKTEK LV Truck Ringan Crane Trailer Motorcycle
c

Motorcycle Service Truck
Breaker
PC 300 PC 200 WA 500 D 155
Forklif Surface Compactor
UNIT KERJA MINE PE
BACK
NO NIK NAMA
1 MIFTAKHUL ANAM PT. MULIA DEWI SEJA CRUSHER OPERATION 208-001

2 NURKASAN PT. MULIA DEWI SEJA CRUSHER OPERATION 208-002
DOK
TELAH TELAH
NON 01-Feb-17 EXPIRED Y Y √ √

NON 01-Feb-17 EXPIRED Y Y √ √
NILAI DRIVER LICENSE VALI
SIM-POL NO SIM-POL
TULIS PRAKTEK LV Truck Ringan
C 831115470340 64
C 830115470513 59
Dump Truck
Truck Ringan Crane Trailer Motorcycle Service Truck
CWB
16-Nov-20 VALID
17-Jan-17 EXPIRED
c
OP
Scania PC 750 PC 400 PC 300 PC 200
Wheel Loader Dozer
Breaker
WA 500 D 155 D 85
Motor Rock Drill Machine Surface Compacto
Forklif
Grader HCR 1500 ROC F7 ROC T35 Miner r
UNIT KERJA
BACK
NO NIK NAMA
INSTANSI DEPARTEMEN
1 ACHMAD SUNARDI PT. TRIATA MULIA INDONESIA QHSE

2 AMININ PT. TRIATA MULIA INDONESIA QHSE
3 HARTONO JUNI SANTOSO PT. TRIATA MULIA INDONESIA QHSE
4 HENDRIK HARDIANTOK PT. TRIATA MULIA INDONESIA QHSE
5 MOCHAMAD CHOIRUL ANAM PT. TRIATA MULIA INDONESIA QHSE
6 PURWANTO PT. TRIATA MULIA INDONESIA QHSE
7 RIFA'I PT. TRIATA MULIA INDONESIA QHSE
8 SLAMET EDI MULYONO PT. TRIATA MULIA INDONESIA QHSE
9 SUGONDO PT. TRIATA MULIA INDONESIA QHSE
10 SUWANAN PT. TRIATA MULIA INDONESIA QHSE
11 SUWARNO PT. TRIATA MULIA INDONESIA QHSE
12 WIDODO PT. TRIATA MULIA INDONESIA QHSE
13 HADI PT. TRIATA MULIA INDONESIA QHSE
14 MUZAMILIN PT. TRIATA MULIA INDONESIA QHSE
15 MUSTOFA PT. TRIATA MULIA INDONESIA QHSE
DOK
TELAH TELAH
209-001 FULL 1-Jun-17 EXPIRED Y Y √ √ √

SIM-POL NO SIM-POL
TULIS PRAKTEK LV DUMP TRUCK
BII 720215620150 66 9-Feb-21 VALID N

BII 720815145063 44 17-Aug-20 VALID N
BII 791215351804 34 31-Dec-16 EXPIRED N
BI 881115147117 3-Nov-21 VALID N
BII 781015620127 11-Oct-21 VALID N
BII 810715460569 42 8-Jul-19 WARNING N
BII 750215620132 16-Feb-21 VALID N
BII 760315620062 3-Mar-19 EXPIRED N
BII 790115620074 13-Jan-19 EXPIRED N
BII 780515620148 15-May-21 VALID N
BI 780615620017 21-Jun-19 EXPIRED N
BII 800715620081 1-Jul-19 WARNING N
BI 840315560911 5-Mar-20 VALID N

BI 761215620042 9-Dec-19 VALID N
c
Dump Truck
Crane Trailer Motorcycle Service Truck
CWB Scania
c
Breaker
PC 750 PC 400 PC 300 PC 200
ERATOR LICENSE VALID DATE
Forklif
WA 500 D 155 D 85 Grader HCR 1500
Rock Drill Machine
Surface Compactor
BACK UNIT KERJA
NO NIK NAMA
INSTANSI
1 SRI WIDODO PT. TEKNOTAMA LINGKUNGAN INTERNUSA

2 DARYONO PT. TEKNOTAMA LINGKUNGAN INTERNUSA
3 EKO BUDI PURWANTO PT. TEKNOTAMA LINGKUNGAN INTERNUSA
4 SHOLEH PT. TEKNOTAMA LINGKUNGAN INTERNUSA
5 TANTO PT. TEKNOTAMA LINGKUNGAN INTERNUSA
6 AGUS ROSNANDI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
7 SURADI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
8 BAMBANG YUDHA PT. TEKNOTAMA LINGKUNGAN INTERNUSA
9 KARNEN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
10 KUNAWI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
11 SUKA PT. TEKNOTAMA LINGKUNGAN INTERNUSA
12 SOLEMAN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
13 EMAK MAKSUDI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
14 UDIN SYAMSUDIN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
15 MAKMUN BIN ILYAS PT. TEKNOTAMA LINGKUNGAN INTERNUSA
16 ADE WARSIDI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
17 FUAD BIN JAYADI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
18 SUKIMIN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
19 MUNASIR ARAFAT PT. TEKNOTAMA LINGKUNGAN INTERNUSA
20 MAMAN NURKIMAN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
21 ASEP NURDIANA PT. TEKNOTAMA LINGKUNGAN INTERNUSA
22 MOCH DJAMALUDIN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
23 HARUN ALHAFIDZ PT. TEKNOTAMA LINGKUNGAN INTERNUSA
24 ANWAR PT. TEKNOTAMA LINGKUNGAN INTERNUSA
25 LILIK MUHALI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
26 WAWAN RIDWAN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
27 INFRON ROSYADI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
28 NANA SUPRIATNA PT. TEKNOTAMA LINGKUNGAN INTERNUSA
29 MUHAMAD SOLIHIN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
30 SARBANI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
31 OHING SOLIHIN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
32 ALI MUCKSIN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
33 ABDULLAH PT. TEKNOTAMA LINGKUNGAN INTERNUSA
34 KUSNO SUPRIYANTO PT. TEKNOTAMA LINGKUNGAN INTERNUSA
35 MOH. TOHA PT. TEKNOTAMA LINGKUNGAN INTERNUSA
36 DIDI SUHARDI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
37 SANGSA RUKMADI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
38 SUHARTONO PT. TEKNOTAMA LINGKUNGAN INTERNUSA
39 MAMAN SUMANTRI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
40 WAHYU PT. TEKNOTAMA LINGKUNGAN INTERNUSA
41 TARLI YARIP PT. TEKNOTAMA LINGKUNGAN INTERNUSA
42 SANTOSO PT. TEKNOTAMA LINGKUNGAN INTERNUSA
43 SUWANDI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
44 BAYU RULI SEPTIAN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
45 SUTARMO PT. TEKNOTAMA LINGKUNGAN INTERNUSA
46 ACEP GUNAWAN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
47 AANG KUNAEFI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
48 AGUNG YONIAR PT. TEKNOTAMA LINGKUNGAN INTERNUSA
49 YAYAT SUDRAJAT PT. TEKNOTAMA LINGKUNGAN INTERNUSA
50 SUNARTO PT. TEKNOTAMA LINGKUNGAN INTERNUSA
51 TRI PRIHATNOLO PT. TEKNOTAMA LINGKUNGAN INTERNUSA
52 RUDIYANTO PT. TEKNOTAMA LINGKUNGAN INTERNUSA
53 ASEP SUTENDA PT. TEKNOTAMA LINGKUNGAN INTERNUSA
54 DEDE GUNAWAN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
55 MUSRONI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
56 DJAYADI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
57 NUR IHSAN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
58 SANTANU PT. TEKNOTAMA LINGKUNGAN INTERNUSA
59 TOTO SUDIANTO PT. TEKNOTAMA LINGKUNGAN INTERNUSA
60 SARMIDI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
61 BADRUDIN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
62 YOGA YOGASWARA PT. TEKNOTAMA LINGKUNGAN INTERNUSA
63 SODIKIN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
64 NANA SUPRIATNA PT. TEKNOTAMA LINGKUNGAN INTERNUSA
65 SUSWAN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
66 BUDIJANTO PT. TEKNOTAMA LINGKUNGAN INTERNUSA
67 ROCHEDI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
68 JITU BERMAN PURBA PT. TEKNOTAMA LINGKUNGAN INTERNUSA
69 SUTARYONO PT. TEKNOTAMA LINGKUNGAN INTERNUSA
70 UMAR PT. TEKNOTAMA LINGKUNGAN INTERNUSA
71 NUR WAHID PT. TEKNOTAMA LINGKUNGAN INTERNUSA
72 FIVIC NURDIANSYAH PT. TEKNOTAMA LINGKUNGAN INTERNUSA
73 SUMANDUN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
74 LUKMAN FIRMANSYAH PT. TEKNOTAMA LINGKUNGAN INTERNUSA
75 YAYAT SUPRIYATNA PT. TEKNOTAMA LINGKUNGAN INTERNUSA
76 ARIF MUJIONO PT. TEKNOTAMA LINGKUNGAN INTERNUSA
77 AGUS MUJIARTO PT. TEKNOTAMA LINGKUNGAN INTERNUSA
78 MUSTOFA PT. TEKNOTAMA LINGKUNGAN INTERNUSA
79 TARSILAN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
80 SUTADJI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
81 HARDIANTO PT. TEKNOTAMA LINGKUNGAN INTERNUSA
82 HADI ROMADHON PT. TEKNOTAMA LINGKUNGAN INTERNUSA
83 HELMI EFENDI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
84 AMIN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
85 NANDA AIRLANGGA PT. TEKNOTAMA LINGKUNGAN INTERNUSA
86 NURKHOLIS PT. TEKNOTAMA LINGKUNGAN INTERNUSA
87 WARSIM PT. TEKNOTAMA LINGKUNGAN INTERNUSA
88 CAHYONO EDI SAPUTRA PT. TEKNOTAMA LINGKUNGAN INTERNUSA
89 MUHERI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
90 ALI MURTADHO PT. TEKNOTAMA LINGKUNGAN INTERNUSA
91 ANEN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
92 JOHAN WAHYUDI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
93 ALIMIN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
94 AYUS NUGRAHA PT. TEKNOTAMA LINGKUNGAN INTERNUSA
95 CASIM PT. TEKNOTAMA LINGKUNGAN INTERNUSA
96 UJANG RAHMAT PT. TEKNOTAMA LINGKUNGAN INTERNUSA
97 DIDI RASADI PT. TEKNOTAMA LINGKUNGAN INTERNUSA
98 NABIR PANE PT. TEKNOTAMA LINGKUNGAN INTERNUSA
99 UDIN NURDIN PT. TEKNOTAMA LINGKUNGAN INTERNUSA
### SUGIYONO PT. TEKNOTAMA LINGKUNGAN INTERNUSA
### ANDRI H F PT. TEKNOTAMA LINGKUNGAN INTERNUSA
### PRIYOTO PT. TEKNOTAMA LINGKUNGAN INTERNUSA
RJA MINE PERMIT STATUS ID CARD
TELAH TELAH
LITBANG 210-001 FULL 1-Jun-20 VALID Y Y

LITBANG 210-002 FULL 4-May-21 VALID
LITBANG 210-010 FULL 1-Jun-17 EXPIRED Y Y
LITBANG 210-017 FULL 2-Mar-20 VALID Y Y
LITBANG 210-023 FULL 16-Nov-20 VALID Y Y
LITBANG 210-027 FULL 25-Jan-19 EXPIRED Y Y
LITBANG 210-050 FULL 10-Oct-20 VALID Y Y
LITBANG 210-059 FULL 18-Jan-22 VALID Y Y
LITBANG 210-063 FULL 26-Jan-21 VALID Y Y
LITBANG 210-065 FULL 23-Mar-19 EXPIRED
LITBANG 210-072 FULL 20-Aug-20 VALID Y Y
LITBANG 210-088 NON 1/27/2021 VALID Y Y
LITBANG 210-099 NON 4/10/2022 VALID Y
NILAI
DOK
SIM-POL NO SIM-POL
TULIS PRAKTEK LV
F FT K
√ √ √ A 740315470629 75 2-Mar-20 VALID

√ √ √ BII 800515470604 50
√ √ √ 70
√ √ √ 65
√ √ √ 45
√ √ √ BII 750513390050 70
√ √ √ BII 711113370485 45
√ √ √ BII 630113390089 30
√ √ √ BII 520213370267 65
√ √ √ BII 600513390145
√ √ √ BII 730313380074 35
√ √ √ BII 781013390503 40
√ √ √ BII 621113390064 55
√ √ √ BII 831013370548 100
√ √ √ BII 771113370530
√ √ √ BII 690913310024 50
√ √ √ BII 760313370622 65
√ √ √ BII 401133200636 25
√ √ √ BII 641214230396 45
√ √ √ BII 640113320063 40
√ √ √ BII 761113390130 50
√ √ √ BII 731014230057 35
√ √ √ BII 821013370159 35
√ √ √ BII 680613379882 40
√ √ √ BII 770813370730 60
√ √ √ BII 700613390088 75
√ √ √ BII 840113370709 70
√ √ √ BII 820413390515 30
√ √ √ BII 700513360055 25
√ √ √ BII 771113370554 80
√ √ √ BII 740613390811 55
√ √ √ BII 771113379372
√ √ √ BII 740213370560 90
√ √ √ BII 810313370890 30
√ √ √ BII 730413370801 30
√ √ √ BII 810113390420 80
√ √ √ BII 670513390081
√ √ √ BII 790213370220 70
√ √ √ BII 730613390097 55
√ √ √ BII 700613390033 35
√ √ √ BII 641013370512 55
√ √ √ BII 700915340185 25
√ √ √ BII 840713341082 40
√ √ √ BII 880913390315 70
√ √ √ BII 760213380504 30
√ √ √ BII 690513370802 45
√ √ √ BII 740813390623 85
√ √ √ BII 860713390386 75
√ √ √ BII 651013390244 60
√ √ √ BII 791013370473 60
√ √ √ BII 810814250475
√ √ √ BII 700313360022 60
√ √ √ BII 630813390475 30
√ √ √ BII 770513371005
√ √ √ BII 720313370904 45
√ √ √ BII 591013380309
√ √ √ BII 650825262064 65
√ √ √ BII 710113390349 30
√ √ √ BII 781013390284 80
√ √ √ BII 700214140764 45
√ √ √ BII 710713371168 20
√ √ √ BII 750813390094 75
√ √ √ BII 800814231280
√ √ √ BII 800513390723
√ √ √ BII 700314140018 65
√ √ √ BII 711213370783
√ √ √ BII 741114230198 25
√ √ √ BII 760825262593 50
√ √ √ BII 660513390007 65
√ √ √ BII 820713370588 65
√ √ √ BII 820525281841 65
√ √ √ BII 860915470571
√ √ √ BII 700314390062
√ √ √ BII 820213390631
√ √ √ BII 801113370992
√ √ √ BII 730415340993
√ √ √ BII 840715470728
√ √ √ BII 870615470595
√ √ √ BII 721215470481
√ √ √ BII 720615470915
√ √ √ BII 720315470145
√ √ √ BII 850315470670
√ √ √ BII 771213390351
√ √ √ BII 740313371238
√ √ √ BII 901013450332
√ √ √ BII 820613371377
√ √ √ BII 901013450334
Y Y Y
Y Y Y BII 890913340018
Y Y Y BII 770513380886
Y Y Y BII 740113390298
Y Y Y BII 780513371468
Y Y Y BII 690513390077
Y Y Y BII 820413390692
Y Y Y BII 780313390635
Y Y Y BII 760113370741
Y Y Y BII 751013390295
Y Y Y BII 740725262505
Y Y Y BII 800413390770
Y Y Y BII 750113370949
Y Y Y BII 840113390492
Y Y Y BII 770515470736
Dump Truck
V DUMPU TRUCK Crane Trailer Motorcycle Service Truck
CWB
N
4-May-21 VALID N
18-May-21 VALID N
10-Nov-19 VALID N
22-Jan-21 VALID N
5-Feb-19 EXPIRED N
25-May-17 EXPIRED N
9-Mar-20 VALID N
12-Oct-16 EXPIRED N
14-Nov-21 VALID N
24-Oct-19 VALID N
18-Nov-21 VALID N
23-Sep-20 VALID N
2-Mar-20 VALID N
26-Jun-18 EXPIRED N
23-Dec-19 VALID N
28-Jan-20 VALID N
10-Nov-19 VALID N
29-Oct-19 VALID N
7-Oct-21 VALID N
13-Apr-20 VALID N
11-Aug-20 VALID N
3-Jun-21 VALID N
25-Jan-19 EXPIRED N
5-Apr-20 VALID N
16-May-19 EXPIRED N
13-Nov-17 EXPIRED N
10-Jun-21 VALID N
23-Nov-19 VALID N
12-Feb-21 VALID N
14-Mar-18 EXPIRED N
8-Apr-21 VALID N
2-Jan-20 VALID N
16-May-20 VALID N
8-Feb-19 EXPIRED N
11-Jun-22 VALID N
5-Jun-21 VALID N
14-Oct-16 EXPIRED N
12-Sep-21 VALID N
1-Jul-17
EXPIRED N
29-Sep-18 EXPIRED N
6-Feb-14EXPIRED N
13-May-20 VALID N
8-Aug-19WARNING N
29-Jul-16
EXPIRED N
31-Oct-20 VALID N
10-Oct-20 VALID N
15-Aug-19 WARNING N
29-Mar-18 EXPIRED N
13-Aug-19 WARNING N
5-May-22 VALID N
23-Mar-21 VALID N
EXPIRED
5-Oct-16 N
1-Aug-17EXPIRED N
7-Jan-19
EXPIRED N
18-Jan-22 VALID N
9-Feb-20 VALID N
3-Jul-19
WARNING N
9-Aug-20 VALID N
25-Aug-21 VALID N
20-May-19 EXPIRED N
23-Mar-19 EXPIRED N
28-Dec-17 EXPIRED N
10-Nov-17 EXPIRED N
18-Aug-19 WARNING N
31-May-18 EXPIRED N
8-Jul-18
EXPIRED N
5-May-21 VALID N
16-Sep-19 VALID N
16-Mar-21 VALID N
17-Feb-20 VALID N
18-Nov-22 VALID N
4-Apr-22 VALID N
EXPIRED
15-Jul-18 N
EXPIRED
3-Jun-19 N
12-Dec-19 VALID N
25-Jun-21 VALID N
28-Mar-19 EXPIRED N
10-Mar-18 EXPIRED N
18-Dec-19 VALID N
8-Mar-22 VALID N
7-Oct-21VALID N
4-Jun-22VALID N
9-Oct-21VALID N
NA
1-Sep-21 VALID N
25-May-18 EXPIRED N
1-Jan-19 EXPIRED N
5-May-21 VALID N
5-May-19 EXPIRED N
28-Apr-19 EXPIRED N
2-Mar-17 EXPIRED N
21-Jan-21 VALID N
27-Oct-18 EXPIRED N
19-Jul-19 WARNING N
4/10/2022 VALID N
1/2/2020 VALID N
1/23/2021 VALID N
5/29/2023 VALID N
c
OP
Wheel Loader Dozer
Breaker
WA 500 D 155 D 85
Motor Rock Drill Machine
Grader HCR 1500 ROC F7 ROC T35 Miner
UNIT KERJA
BACK
NO NIK NAMA
INSTANSI DEPARTEMEN
1 FITRAH ASEP KUSMANAPT. CITRA DUTA MUDA RAW MATERIAL PRODUCTION

2 SUYONO PT. CITRA DUTA MUDA RAW MATERIAL PRODUCTION
3 PANDI PT. CITRA DUTA MUDA RAW MATERIAL PRODUCTION
4 SUYOTO PT. CITRA DUTA MUDA RAW MATERIAL PRODUCTION
5 RUSWANTO PT. CITRA DUTA MUDA RAW MATERIAL PRODUCTION
6 WINARTO PT. CITRA DUTA MUDA RAW MATERIAL PRODUCTION
7 AGUS SUPONTO PT. CITRA DUTA MUDA RAW MATERIAL PRODUCTION
DOK
TELAH TELAH
NO ID ACCESS VALID UNTIL KET DICETAK DITERIMA F FT
211-001 FULL 1-Jun-17 EXPIRED Y Y √ √

NILAI DRIVER LICEN
DOK
SIM-POL NO SIM-POL
K
√ C 800915470623
√ C 870615470277
√
√
√
√
√
Dump Truck
CWB Scania
20-Sep-19 VALID N
5-Jun-19 EXPIRED N
SIMPPER
OPERATOR L
Excavator
Wheel Loader Dozer Motor
Breaker
WA 500 D 155 D 85 Grader
Rock Drill Machine
HCR 1500 ROC F7 ROC T35 Miner
PT. PERWIRA JAYA PERKASA
UNIT KERJA MINE PERMIT

BACK
NO NIK NAMA
1 KARSAM PT. PERWIRA JAYA PERKASA LAND RECLAMATION 212-001

2 SHOLIHIN PT. PERWIRA JAYA PERKASA LAND RECLAMATION 212-002
3 HARDI RIYADI PT. PERWIRA JAYA PERKASA LAND RECLAMATION 212-003
4 ABU SOLEH PT. PERWIRA JAYA PERKASA LAND RECLAMATION 212-004
5 SOKIP PT. PERWIRA JAYA PERKASA LAND RECLAMATION 212-005
6 BENY ARISTA PT. PERWIRA JAYA PERKASA LAND RECLAMATION 212-006
7 MOH ROZIQIN PT. PERWIRA JAYA PERKASA LAND RECLAMATION 212-007
8 KASTUNGGAL PT. PERWIRA JAYA PERKASA LAND RECLAMATION 212-008
9 SLAMET PT. PERWIRA JAYA PERKASA LAND RECLAMATION 212-009
10 PARIS PT. PERWIRA JAYA PERKASA LAND RECLAMATION 212-010
11 DASMARI PT. PERWIRA JAYA PERKASA LAND RECLAMATION 212-011
12 SAMPAN PT. PERWIRA JAYA PERKASA LAND RECLAMATION 212-012
13 SUMIAN PT. PERWIRA JAYA PERKASA LAND RECLAMATION 212-013
14 SUPRIANTO PT. PERWIRA JAYA PERKASA LAND RECLAMATION 212-014
15 SURIPTO PT. PERWIRA JAYA PERKASA LAND RECLAMATION 212-015
DOK
TELAH TELAH SIM-POL
FULL 01-Jun-17 EXPIRED Y Y √ √ √ A

FULL 01-Jun-17 EXPIRED Y Y √ √ √
NO SIM-POL
TULIS PRAKTEK LV Truck Ringan Crane Trailer
770215470531 3-Feb-21 VALID N

c
ALID DATE
Dump Truck Excavato
Motorcycle Service Truck
Breaker
PC 300 PC 200 WA 500 D 155
Forklif Surface
Compactor
UNIT KERJA MINE
BACK
NO NIK NAMA
1 SULIYANTO PT. KITA MANDIRI ABADI LITBANG 213-001

2 REGA RAMADHANY PT. KITA MANDIRI ABADI LITBANG 213-002
3 DEDI KRISTIANTO PT. KITA MANDIRI ABADI LITBANG 213-003
4 PURNOKO PT. KITA MANDIRI ABADI LITBANG 213-004
5 TURMUDI PT. KITA MANDIRI ABADI LITBANG 213-005
6 NUR FATTAH PT. KITA MANDIRI ABADI LITBANG 213-006
7 IMAM SYAFII PT. KITA MANDIRI ABADI LITBANG 213-007
8 DAVILITO WINDARA PUTROPT. KITA MANDIRI ABADI LITBANG 213-008
11 ENDRYANTO PT. KITA MANDIRI ABADI LITBANG 213-009
10 SLAMET TRIMO PT. KITA MANDIRI ABADI LITBANG 213-010
11 DENI BAYU P PT. KITA MANDIRI ABADI LITBANG 213-011
12 SUGIANTO PT. KITA MANDIRI ABADI LITBANG 213-012
13 ZAINUDIN PT. KITA MANDIRI ABADI LITBANG 213-013
14 NUR WIDAYAT PT. KITA MANDIRI ABADI LITBANG 213-014
15 AHMAD NUKIN PT. KITA MANDIRI ABADI LITBANG 213-015
16 MASHURI PT. KITA MANDIRI ABADI LITBANG 213-016
17 SUYAKBIANTO PT. KITA MANDIRI ABADI LITBANG 213-017
18 MOH. IMRON ROSYADI PT. KITA MANDIRI ABADI LITBANG 213-018
19 AGUNG NUGROHO PT. KITA MANDIRI ABADI LITBANG 213-019
20 M. HERMANSYAH PT. KITA MANDIRI ABADI LITBANG 213-020
21 DIDIK MEI IRAWAN PT. KITA MANDIRI ABADI LITBANG 213-021
22 SUIWAN PT. KITA MANDIRI ABADI LITBANG 213-022
23 NURACHMAN PT. KITA MANDIRI ABADI LITBANG 213-023
24 KHOIRUL ANAM PT. KITA MANDIRI ABADI LITBANG 213-024
25 SYAMSUL HUDA PT. KITA MANDIRI ABADI LITBANG 213-025
26 SUPARDI PT. KITA MANDIRI ABADI LITBANG 213-026
27 DHORI PT. KITA MANDIRI ABADI LITBANG 213-027
28 YULIANTO PT. KITA MANDIRI ABADI LITBANG 213-028
29 AMININ PT. KITA MANDIRI ABADI LITBANG 213-029
30 IWAN VIBRIANTO PT. KITA MANDIRI ABADI LITBANG 213-030
31 ANDI YULIYANTO PT. KITA MANDIRI ABADI LITBANG 213-031
32 SRIWANTO PT. KITA MANDIRI ABADI LITBANG 213-032
33 KARYONO PT. KITA MANDIRI ABADI LITBANG 213-033
34 WINOTO PT. KITA MANDIRI ABADI LITBANG 213-034
35 CIPTO HADI PT. KITA MANDIRI ABADI LITBANG 213-035
36 SAMSUL HIDAYAT PT. KITA MANDIRI ABADI LITBANG 213-036
37 MASMUR PT. KITA MANDIRI ABADI LITBANG 213-037
38 HERI BIANTORO PT. KITA MANDIRI ABADI LITBANG 213-038
39 SLAMET HARIANTO PT. KITA MANDIRI ABADI LITBANG 213-039
40 DIAN NURUL HIDAYAT PT. KITA MANDIRI ABADI LITBANG 213-040
41 WAHYU NUR RUDDIN PT. KITA MANDIRI ABADI LITBANG 213-041
42 MUCH. SUBANDI PT. KITA MANDIRI ABADI LITBANG 213-042
43 RICKI IRAWAN PT. KITA MANDIRI ABADI LITBANG 213-043
AGUS PURNOMO PT. KITA MANDIRI ABADI LITBANG 213-044
DOK
TELAH TELAH
NON 01-Jun-20 VALID Y Y √ √ √

NON 01-Jun-17 EXPIRED Y Y √ √ √
NON 09-Dec-20 VALID Y Y √ √ √
NON 5-Apr-20 VALID Y Y Y Y
NON 5-Apr-20 VALID Y Y Y Y Y
NON 09-Dec-20 VALID Y Y Y Y Y
NON 02-Aug-23 VALID Y 13-Jun-18 Y Y Y
NON 28-Dec-20 VALID Y 13-Jun-18 Y Y Y
NON 19-Jul-22 VALID Y 13-Jun-18 Y Y Y
NON 26-Jul-23 VALID Y 13-Jun-18 Y Y Y
NON 23-May-21 VALID Y 13-Jun-18 Y Y Y
NON 18-Aug-22 VALID Y Y Y
SIM-POL NO SIM-POL NILAI DRIVER LICENSE VALID DATE
TULIS PRAKTEK
LV DUMP TRUCK
BII 700115532228 67 01-Jan-18

BI 920315531496 70.3 11-Nov-15
BI 880615351277 76.9 27-Jun-20
BII 880615470617 86.8 04-Jun-21
BII 860115470547 80.2 02-Jan-19
BII 761215532404 67 04-Dec-15
50.5
76.9
63.7
BI 940815531179 25-Nov-20
BI 780615532441 01-Jun-18
BI 680515532915 19-May-20
BII 800615533053 30-Jun-22

BII 720815145063 17-Aug-20
09-Dec-20
BII 810815532834 02-Aug-23
BII 841215540721 28-Dec-20
BII 810715541111 19-Jul-22
BI 780715541241 26-Jul-23
BII UMUM 850820280613 10-Aug-22
Crane Trailer Motorcycle
DUMP TRUCK Truck Ringan
EXPIRED N
EXPIRED N
VALID N
VALID N
EXPIRED N
EXPIRED N
VALID N
EXPIRED N
VALID N
VALID N
VALID N
VALID N
VALID N
VALID N
VALID N
VALID N
NA N
NA N
NA N
NA N
VALID N
NA N
SIMPPER
Service Truck Dump Truck Excavator
Breaker Wheel Loader Dozer
PC 300 PC 200 WA 500 D 155
Motor Grader ForklifRock Drill Machine
D 85 HCR 1500 ROC F7 ROC T35
Surface
Miner Compactor
UNIT KERJA
NO NIK NAMA BACK
INSTANSI DEPARTEMEN
1 WARCA PAUL PT. AMAKO REZEKI UTAMA LITBANG

2 RIKI BIN SOPIAN PT. AMAKO REZEKI UTAMA LITBANG
3 ACH. FIRDAUS PT. AMAKO REZEKI UTAMA LITBANG
4 ADE SOBANDI PT. AMAKO REZEKI UTAMA LITBANG
5 SUYADI PT. AMAKO REZEKI UTAMA LITBANG
6 KOMARUDIN PT. AMAKO REZEKI UTAMA LITBANG
7 ACHBRAMANTYO SETYA PT. AMAKO REZEKI UTAMA LITBANG
8 AMIR MUMININ PT. AMAKO REZEKI UTAMA LITBANG
9 MAMAN KUSYAWAN PT. AMAKO REZEKI UTAMA LITBANG
DOK
TELAH TELAH
NO ID ACCESS VALID UNTIL KET DICETAK DITERIMA F FT
214-001 NON 1-Jun-17 EXPIRED Y Y √ √

NILAI DRIVER LICENSE
DOK
SIM-POL NO SIM-POL
K
√ BII 670713300231 10-Jul-18

√ BII 810813281763 10-Aug-21
√ BI 730915540361 50 9-Sep-17
√ BII 670713281092 12-Jul-21
√ BII 740615541413 55 6-Jun-19
√ BII 660613280264 50 5-Jun-18
√ BII 670915140472 55 13-Sep-21
√ BII 620313380398 50 2-Mar-14
√ BII 620913300076 55 1-Sep-16
Dump Truck
CWB Scania
EXPIRED N
VALID N
EXPIRED N
VALID N
EXPIRED N
EXPIRED N
VALID N
EXPIRED N
EXPIRED N
c
OPERATOR LICE
Excavator
Breaker
Rock Drill Machine
UNIT KERJA
NO NIK NAMA BACK
INSTANSI DEPARTEMEN
1 DEDY SETIAWAN PT. SETYAWAN MAHAKARYA PRIMA LITBANG

6 IMAM SETIA WIBOWO PT. SETYAWAN MAHAKARYA PRIMA LITBANG
DOK
TELAH TELAH
215-001 NON 1-Jun-17 EXPIRED Y Y √ √ √

215-002 NON 1-Jun-17 EXPIRED Y Y √ √ √
SIM-POL NO SIM-POL
TULIS PRAKTEK LV Truck Ringan Crane
A 931215142369 12-Dec-16 EXPIRED N

c
R LICENSE VALID DATE
Dump Truck
Trailer Motorcycle Service Truck
CWB Scania PC 750
c
Breaker
PC 400 PC 300 PC 200 WA 500
DATE
Forklif
D 155 D 85 Grader HCR 1500 ROC F7 ROC T35
Surface Compactor
Miner
NO NIK NAMA BACK
1 MOHAMAD JAUHARI PT. VARIA USAHA LITBANG 216-001

2 HADI PT. VARIA USAHA LITBANG 216-002
3 HARNOKO PT. VARIA USAHA LITBANG 216-003
4 SUJONO EFENDI PT. VARIA USAHA LITBANG 216-004
5 HAIRUDIN PT. VARIA USAHA LITBANG 216-005
6 NIKO KURNIAWAN PT. VARIA USAHA LITBANG 216-006
7 NYAMAN PT. VARIA USAHA LITBANG 216-007
8 MUHAJIR PT. VARIA USAHA LITBANG 216-008
9 TAMANI PT. VARIA USAHA LITBANG 216-009
10 AHMAT SUBAKIR PT. VARIA USAHA LITBANG 216-010
11 MUSTOFA PT. VARIA USAHA LITBANG 216-011
12 MOCHAMMAD NADIR PT. VARIA USAHA LITBANG 216-012
13 AGUS BAGIO PT. VARIA USAHA LITBANG 216-013
14 SUHARDI PT. VARIA USAHA LITBANG 216-014
15 ZAINAL ARIFIN PT. VARIA USAHA LITBANG 216-015
16 ZAENAL ABIDIN PT. VARIA USAHA LITBANG 216-016
17 DARSONO PT. VARIA USAHA LITBANG 216-017
18 AGUNG SATRIYANTO PT. VARIA USAHA LITBANG 216-018
19 SLAMET HADI PT. VARIA USAHA LITBANG 216-019
20 M. ALFAN LUBIS PT. VARIA USAHA LITBANG 216-020
21 SUMITO PT. VARIA USAHA LITBANG 216-021
22 FAIZIN PT. VARIA USAHA LITBANG 216-022
23 IMAM SAFI'I PT. VARIA USAHA LITBANG 216-023
24 NANANG EKA SUKWANTO PT. VARIA USAHA LITBANG 216-024
25 SUGITO PT. VARIA USAHA LITBANG 216-025
26 LEROY WIDHA PRATAMA PT. VARIA USAHA LITBANG 216-026
27
28
29
DOK
TELAH TELAH SIM-POL
NON 01-Jun-17 EXPIRED Y Y √ √ √ B II

NON 01-Jun-17 EXPIRED Y Y Y Y Y B II
NON 1-Jun-17 EXPIRED Y Y Y B II
NO SIM-POL
750314390232 14-Mar-16 EXPIRED N

820614390093 15-Jun-16 EXPIRED N
780515470070 10-Jun-16 EXPIRED N
900425540574 90 28-Apr-18 EXPIRED N
700925470402 11-Sep-13 EXPIRED N
880315470406 20-Mar-17 EXPIRED N
790315470684 95 13-Mar-18 EXPIRED N
760925470558 14-Sep-18 EXPIRED N
841215470364 65 11-Dec-16 EXPIRED N
841215470502 85 7-Dec-18 EXPIRED N
870615470595 3-Jun-19 EXPIRED N
640615480381 12-Jun-17 EXPIRED N
670915481538 18-Sep-19 VALID N
770615470042 5-Jun-15 EXPIRED N
771015470067 12-Oct-20 VALID N
830715470483 12-Jul-20 VALID N
650915470061 90 18-Sep-15 EXPIRED N
850815470744 30-Aug-19 VALID N
650815470297 70 15-Jun-17 EXPIRED N
780615470089 25-Jun-17 EXPIRED N
690415470060 75 10-Apr-17 EXPIRED N
800214390052 95 3-Feb-18 EXPIRED N
830915470350 23-Sep-15 EXPIRED N
720115470058 31-Jan-17 EXPIRED N
651015470002 15-Oct-18 EXPIRED N
900915600126 90 27-Sep-18 EXPIRED N
c
VER LICENSE VALID DATE
Dump Truck
CWB Scania PC 750
c
Breaker
PC 400 PC 300 PC 200 WA 500
NSE VALID DATE
Forklif
D 155 D 85 Grader HCR 1500 ROC F7
ck Drill Machine
Surface Compactor
ROC T35 Miner
BACK
NO NIK NAMA
1 DARSONO PT. KMCB RAW MATERIAL PRODUCTION

2 TARMADI PT. KMCB RAW MATERIAL PRODUCTION
3 RAEKAN PT. KMCB RAW MATERIAL PRODUCTION
4 WANDIK PT. KMCB RAW MATERIAL PRODUCTION
5 SULISTIONO PT. KMCB LAND RECLAMATION
6 WASTONO PT. KMCB LAND RECLAMATION
7 M. ROZIKIN PT. KMCB LAND RECLAMATION
8 SUYADI PT. KMCB LAND RECLAMATION
9 DARSANI PT. KMCB LAND RECLAMATION
10 TASMANI PT. KMCB LAND RECLAMATION
11 HANDOKO PT. KMCB LAND RECLAMATION
12 ERVAN PT. KMCB LAND RECLAMATION
13 DARMUJI PT. KMCB LAND RECLAMATION
1 AMIN THOHARI PT. KMCB OPERASI TAMBANG 217-001
2 LUTHFI BAYU PERMANA PT. KMCB OPERASI TAMBANG 217-002
3 RUSMIN PT. KMCB LAND RECLAMATION 217-003
4 TASMIN PT. KMCB LAND RECLAMATION 217-004
5 LATIP PT. KMCB LAND RECLAMATION 217-005
6 RAEKAN PT. KMCB LAND RECLAMATION 217-006
7 HARDIANSYAH DWI PUTRA PT. KMCB LAND RECLAMATION 217-007
8 M.ROZIKIN PT. KMCB LAND RECLAMATION 217-008
9 DARMAN PT. KMCB LAND RECLAMATION 217-009
10 SUYADI PT. KMCB LAND RECLAMATION 217-010
11 SULISTIONO PT. KMCB LAND RECLAMATION 217-011
12 DARSONO PT. KMCB LAND RECLAMATION 217-012
13 TARMADI PT. KMCB LAND RECLAMATION 217-013
14 DARMUJI PT. KMCB LAND RECLAMATION 217-014
15 WANDIK PT. KMCB LAND RECLAMATION 217-015
16 M KHOIRUL ANWAR PT. KMCB LAND RECLAMATION 217-016
17 IMAM HANAFI PT. KMCB LAND RECLAMATION 217-017
18 M DAVID KURNIAWAN PT. KMCB LAND RECLAMATION 217-018
19 SUNANDAR PT. KMCB LAND RECLAMATION 217-019
20 ABDUSSALAM PT. KMCB LAND RECLAMATION 217-020
21 FAIZAL PAIDIN PT. KMCB LAND RECLAMATION 217-021
22 ABDUL WAKHID PT. KMCB LAND RECLAMATION 217-022
23 EFENDI PT. KMCB LAND RECLAMATION 217-023
24 MUSTAKIM PT. KMCB LAND RECLAMATION 217-024
25 RACHMAT PT. KMCB LAND RECLAMATION 217-025
26 MAHFUD PT. KMCB LAND RECLAMATION 217-026
27 MOCH. SOKHIRUL KHITAM PT. KMCB LAND RECLAMATION 217-027
28 HANDRIONO PT. KMCB LAND RECLAMATION 217-028
29 DARMAJI PT. KMCB LAND RECLAMATION 217-029
30 SATIR PT. KMCB LAND RECLAMATION 217-030
31 ZAKARIYA PT. KMCB LAND RECLAMATION 217-031
32 MAJU PT. KMCB LAND RECLAMATION 217-032
33 WINARKO PT. KMCB LAND RECLAMATION 217-033
34 DASMANI PT. KMCB LAND RECLAMATION 217-034
35 SUNARTO PT. KMCB LAND RECLAMATION 217-035
NILAI
DOK
TELAH TELAH
ACCESS VALID UNTIL KET DICETAK DITERIMA TULIS
F FT K
NON NA √ √ √
NON NA Y Y √ √ √ 86
NON NA Y Y √ √ 56
NON NA √ √ √
NON NA Y Y √ √ √ 64
NON NA Y Y √ √ √ 58
NON NA Y Y √ √ √ 48
NON NA Y Y √ √ √
NON NA Y Y √ √ √ 50
NON NA Y Y √ √ √ 72
NON NA Y Y √ √ √ 38
NON NA Y Y √ √ √ 70
NON NA Y Y √ √ √
FULL 21-Apr-21 VALID Y 7-Jun-18 √ √ √
FULL 2-Nov-19 VALID Y 7-Jun-18 √ √ √
NON 20-May-21 VALID Y 7-Jun-18 √ √ √
FULL 2-Jun-21 VALID Y 7-Jun-18
FULL 27-Feb-22 VALID Y 7-Jun-18
FULL 1-Jul-22 VALID Y 7-Jun-18
FULL 7-Dec-22 VALID Y 7-Jun-18
FULL 4-Apr-20 VALID Y 7-Jun-18
NON 7-Dec-18 EXPIRED Y 7-Jun-18
FULL 25-Aug-20 VALID Y 7-Jun-18
FULL 10-Sep-18 EXPIRED Y 7-Jun-18
FULL 1-Sep-18 EXPIRED Y 7-Jun-18
FULL 10-Feb-22 VALID Y 7-Jun-18
FULL 11-Jul-21 VALID Y 7-Jun-18
FULL 6-Dec-21 VALID Y Y Y Y
FULL 30-Jun-19 WARNING Y Y Y Y
FULL 20-Jul-20 VALID Y Y Y Y
PRAKTEK SIM POL NO SIM POL LV DUMP TRUCK Crane
1-Feb-14 EXPIRED F
BII 750415470718 10-Apr-21 VALID N

NA
A 870415470338 21-Apr-21 VALID F
A 901115470376 2-Nov-19 VALID F
A 770223230372 27-Feb-22 VALID F

BI 900715470654 1-Jul-22 VALID F
BII 751215470499 7-Dec-22 VALID F
BII 680415470601 4-Apr-20 VALID F
BII 641215470324 7-Dec-18 EXPIRED N
BII 1790815470192 25-Aug-20 VALID F
BII 750915470096 10-Sep-18 EXPIRED F
BI 700915470382 1-Sep-18 EXPIRED F
BII 890215470288 10-Feb-22 VALID F
BI 870715470828 11-Jul-21 VALID F
BII 630615470421
BI 680715470655
A 971214390233
SIMPPER
SE VALID DATE
Dump Truck Exc
CWB Scania PC 750
SIMPPER
Breaker
PC 400 PC 300 PC 200 WA 500
SE VALID DATE
Forklif
D 155 D 85 Grader HCR 1500 ROC F7
ock Drill Machine
Surface Compactor
ROC T35 Miner
UNIT KERJA
NO NIK NAMA BACK
INSTANSI
1 SUWANDI PT. PANCASAKA NATHA PERSADA

2 TARI PT. PANCASAKA NATHA PERSADA
3 SADUK PT. PANCASAKA NATHA PERSADA
4 BANDIONO PT. PANCASAKA NATHA PERSADA
6 HARI PT. PANCASAKA NATHA PERSADA
8 TAMSIDIN PT. PANCASAKA NATHA PERSADA
9 SUTRISNO PT. PANCASAKA NATHA PERSADA
11 ANANG FAJAR SETYAWAN PT. PANCASAKA NATHA PERSADA
14 ANIS AIR GIRI PT. PANCASAKA NATHA PERSADA
TELAH TELAH
LAND RECLAMATION 218-001 NON 10-May-21 VALID Y 7-Jun-18

LAND RECLAMATION 218-008 NON 15-Dec-17 VALID Y 7-Jun-18
NILAI
DOK
SIM-POL NO SIM-POL
TULIS PRAKTEK LV
F FT K
√ √ √
√ √ √
√ √ √
Y Y √
√ √ √
√ √ √
√ √ √
√ √ √ C 810315470078
√ √ √ C 781215470349
LV Truck Ringan Crane Trailer Motorcycle Service Truck
4-Dec-14 EXPIRED N
22-Dec-18 EXPIRED N
SIMPPER

Breaker
PC 200 WA 500 D 155
Forklif Surface
Compactor
UNIT KERJA
NO NIK NAMA BACK
INSTANSI
1 AGUS SUGIANTO PT. LEWIND

2 ACHMAD KARTUBI PT. LEWIND
3 DODIK EFENDI PT. LEWIND
4 DONNY PT. LEWIND
5 MOCH IMRON PT. LEWIND
6 SAMSUL ARIF PT. LEWIND
7 SOLIKIN PT. LEWIND
8 SUTAJI PT. LEWIND
9 WURI DARMONO PT. LEWIND
10 SUWANTO PT. LEWIND
11 ABDUL AZIS PT. LEWIND
12 EKO SUPRAYITNO PT. LEWIND
13 RUBIYANTO PT. LEWIND
14 FERRY FAJAR SUKMONO PT. LEWIND
15 RENDRA AGUS SETIAWAN PT. LEWIND
16 SLAMET PAMUDJI PT. LEWIND
17 MUHAMAD JAMAL PT. LEWIND
18 RIFA'I PT. LEWIND
19 DWI CANDRA IRAWAN PT. LEWIND
20 ADJIB SUGIARTO PT. LEWIND
TELAH TELAH
LITBANG 219-001 NON 15-May-20 VALID Y Y

DOK
NILAI BACK
SIM-POL NO SIM-POL
TULIS PRAKTEK LV
F FT K
√ √ √ BII 710115532366 78
√ √ √ BII 670315532033 22
√ √ √ BI 801215440166 56
√ √ √ BII 701215571680 52
√ √ √ BII 800315142930 70
√ √ √ BII 700415550377 32
√ √ √ BII 820314390451
√ √ √ BII 750615525612 44
√ √ √ BII 760915531926 58
√ √ √ BII 670415380828 36
√ √ √ BII 921115531362
√ √ √ BII 820815532568
√ √ √ BII 900415531808
√ √ √ BII 900815143224
√ √ √ BII 920815531456
√ √ √ BII 690315532784
√ √ √ BII 700115532785
√ √ √ BII 700715281254
√ √ √ BII 880615532114
√ √ √ BII 730615281390
BACK DRIVER LICENSE VALID DATE
LV DUMP TRUCK Crane Trailer Motorcycle Service Truck
1-Jan-19 EXPIRED N
1-Mar-18 EXPIRED N
1-Dec-18 EXPIRED N
28-Dec-18 EXPIRED N
26-Mar-22 VALID N
4-Apr-22 VALID N
23-Mar-21 VALID N
6-Jun-18 EXPIRED N
7-Sep-18 EXPIRED N
9-Nov-21 VALID N
2-Aug-20 VALID N
1-Apr-21 VALID N
1-Aug-19 WARNING N
17-Aug-20 VALID N
15-Mar-22 VALID N
1-Jan-20 VALID N
13-Jul-22 VALID N
28-Jun-22 VALID N
15-Jun-21 VALID N
SIMPPER

Breaker
PC 200 WA 500 D 155
Forklif Surface Miner
D 85 Grader HCR 1500 ROC F7 ROC T35
Surface Miner Compactor
NO NIK NAMA
BACK
1 ANA PUTRI RAHAYU PETANI GREEN BELT LAND RECLAMATION 220-001

2 BAKRUN PETANI GREEN BELT LAND RECLAMATION 220-002
3 DAKLAN 2 PETANI GREEN BELT LAND RECLAMATION 220-003
4 DAKLAN PETANI GREEN BELT LAND RECLAMATION 220-004
5 DARKUP PETANI GREEN BELT LAND RECLAMATION 220-005
6 DARMAWAN PETANI GREEN BELT LAND RECLAMATION 220-006
7 DEWI MUKTI PETANI GREEN BELT LAND RECLAMATION 220-007
8 HADI SUWITO PETANI GREEN BELT LAND RECLAMATION 220-008
9 KAMIT PETANI GREEN BELT LAND RECLAMATION 220-009
10 KAMSINAH PETANI GREEN BELT LAND RECLAMATION 220-010
11 KARSADI PETANI GREEN BELT LAND RECLAMATION 220-011
12 LAJI PETANI GREEN BELT LAND RECLAMATION 220-012
13 LASMURI PETANI GREEN BELT LAND RECLAMATION 220-013
14 MARSIT PETANI GREEN BELT LAND RECLAMATION 220-014
15 NUR QOMAR PETANI GREEN BELT LAND RECLAMATION 220-015
16 SAMAN PETANI GREEN BELT LAND RECLAMATION 220-016
17 SAMIN PETANI GREEN BELT LAND RECLAMATION 220-017
18 SARI PETANI GREEN BELT LAND RECLAMATION 220-018
19 SARKAM PETANI GREEN BELT LAND RECLAMATION 220-019
20 SUMADI PETANI GREEN BELT LAND RECLAMATION 220-020
21 TAMBANG PETANI GREEN BELT LAND RECLAMATION 220-021
22 TARIP PETANI GREEN BELT LAND RECLAMATION 220-022
23 TARMUJI PETANI GREEN BELT LAND RECLAMATION 220-023
24 TARNI PETANI GREEN BELT LAND RECLAMATION 220-024
25 WAJIB PETANI GREEN BELT LAND RECLAMATION 220-025
26 DJANADJI PETANI GREEN BELT LAND RECLAMATION 220-026
27 JOKO PURNOMO PETANI GREEN BELT LAND RECLAMATION 220-027
28 KATIRAN PETANI GREEN BELT LAND RECLAMATION 220-028
29 LASAN PETANI GREEN BELT LAND RECLAMATION 220-029
30 LASIYATIN PETANI GREEN BELT LAND RECLAMATION 220-030
31 LASTRI PETANI GREEN BELT LAND RECLAMATION 220-031
32 MENENG PETANI GREEN BELT LAND RECLAMATION 220-032
33 RASIT PETANI GREEN BELT LAND RECLAMATION 220-033
34 RUMIATI PETANI GREEN BELT LAND RECLAMATION 220-034
35 SAEPAN PETANI GREEN BELT LAND RECLAMATION 220-035
36 SAMPIT PETANI GREEN BELT LAND RECLAMATION 220-036
37 SASI PETANI GREEN BELT LAND RECLAMATION 220-037
38 SUKUR PETANI GREEN BELT LAND RECLAMATION 220-038
39 TAMIN PETANI GREEN BELT LAND RECLAMATION 220-039
40 TARNO PETANI GREEN BELT LAND RECLAMATION 220-040
41 TARSIDIN PETANI GREEN BELT LAND RECLAMATION 220-041
42 TARYONO PETANI GREEN BELT LAND RECLAMATION 220-042
43 WARDJO PETANI GREEN BELT LAND RECLAMATION 220-043
44 WARSIH PETANI GREEN BELT LAND RECLAMATION 220-044
45 DARJI PETANI GREEN BELT LAND RECLAMATION 220-045
46 HARI PETANI GREEN BELT LAND RECLAMATION 220-046
47 HUSLAN PETANI GREEN BELT LAND RECLAMATION 220-047
48 JERMAN PETANI GREEN BELT LAND RECLAMATION 220-048
49 KASMAN PETANI GREEN BELT LAND RECLAMATION 220-049
50 NIRMAN PETANI GREEN BELT LAND RECLAMATION 220-050
51 SUPARDI PETANI GREEN BELT LAND RECLAMATION 220-051
52 SUSIATI NINGSIH PETANI GREEN BELT LAND RECLAMATION 220-052
53 TADJI PETANI GREEN BELT LAND RECLAMATION 220-053
54 TARWI PETANI GREEN BELT LAND RECLAMATION 220-054
55 TASAN PETANI GREEN BELT LAND RECLAMATION 220-055
56 WAHYU LININGSIH PETANI GREEN BELT LAND RECLAMATION 220-056
57 WARSAM PETANI GREEN BELT LAND RECLAMATION 220-057
58 DASMUNI PETANI GREEN BELT LAND RECLAMATION 220-058
59 GUNOMAT PETANI GREEN BELT LAND RECLAMATION 220-059
60 KAJIRAH PETANI GREEN BELT LAND RECLAMATION 220-060
61 KARNAWI LUGITO PETANI GREEN BELT LAND RECLAMATION 220-061
62 KASIRI PETANI GREEN BELT LAND RECLAMATION 220-062
63 KUSWATI PETANI GREEN BELT LAND RECLAMATION 220-063
64 SARMADI PETANI GREEN BELT LAND RECLAMATION 220-064
65 SHOHI FATULUMMAH PETANI GREEN BELT LAND RECLAMATION 220-065
66 SRIPAH PETANI GREEN BELT LAND RECLAMATION 220-066
67 SULASTRI PETANI GREEN BELT LAND RECLAMATION 220-067
68 SUNARTI PETANI GREEN BELT LAND RECLAMATION 220-068
69 TASRIP PETANI GREEN BELT LAND RECLAMATION 220-069
70 TAWAR PETANI GREEN BELT LAND RECLAMATION 220-070
71 WANISRI PETANI GREEN BELT LAND RECLAMATION 220-071
72 WARKAM PETANI GREEN BELT LAND RECLAMATION 220-072
73 WARSILAN PETANI GREEN BELT LAND RECLAMATION 220-073
74 YUNARTI PETANI GREEN BELT LAND RECLAMATION 220-074
75 BASAR PETANI GREEN BELT LAND RECLAMATION 220-075
76 CIPTO PETANI GREEN BELT LAND RECLAMATION 220-076
77 DARMIN PETANI GREEN BELT LAND RECLAMATION 220-077
78 DARWATI PETANI GREEN BELT LAND RECLAMATION 220-078
79 DASRUN PETANI GREEN BELT LAND RECLAMATION 220-079
80 DOYO PETANI GREEN BELT LAND RECLAMATION 220-080
81 HARUM PETANI GREEN BELT LAND RECLAMATION 220-081
82 JUWOK PETANI GREEN BELT LAND RECLAMATION 220-082
83 KACUNG PETANI GREEN BELT LAND RECLAMATION 220-083
84 KARNAWI PETANI GREEN BELT LAND RECLAMATION 220-084
85 LAYI PETANI GREEN BELT LAND RECLAMATION 220-085
86 PAIMAN PETANI GREEN BELT LAND RECLAMATION 220-086
87 PARNI PETANI GREEN BELT LAND RECLAMATION 220-087
88 SADIK PETANI GREEN BELT LAND RECLAMATION 220-088
89 SARJU PETANI GREEN BELT LAND RECLAMATION 220-089
90 SUKRI PETANI GREEN BELT LAND RECLAMATION 220-090
91 SUYONO PETANI GREEN BELT LAND RECLAMATION 220-091
92 TASLIM PETANI GREEN BELT LAND RECLAMATION 220-092
93 WARNO PETANI GREEN BELT LAND RECLAMATION 220-093
94 WARSAN PETANI GREEN BELT LAND RECLAMATION 220-094
95 WARSINI PETANI GREEN BELT LAND RECLAMATION 220-095
96 WARTONO PETANI GREEN BELT LAND RECLAMATION 220-096
97 ATIK PETANI GREEN BELT LAND RECLAMATION 220-097
98 CAWI PETANI GREEN BELT LAND RECLAMATION 220-098
99 CONDRO PETANI GREEN BELT LAND RECLAMATION 220-099
100 EMI YULIARINI PETANI GREEN BELT LAND RECLAMATION 220-100
101 KAMAR PETANI GREEN BELT LAND RECLAMATION 220-101
102 KARTINI PETANI GREEN BELT LAND RECLAMATION 220-102
103 KASMUJI PETANI GREEN BELT LAND RECLAMATION 220-103
104 KUSNAN PETANI GREEN BELT LAND RECLAMATION 220-104
105 MUNDAKIR PETANI GREEN BELT LAND RECLAMATION 220-105
106 MUNTORIB PETANI GREEN BELT LAND RECLAMATION 220-106
107 RADIMIN PETANI GREEN BELT LAND RECLAMATION 220-107
108 RASIDAN PETANI GREEN BELT LAND RECLAMATION 220-108
109 RUSKUMIATI PETANI GREEN BELT LAND RECLAMATION 220-109
110 SAMONAH PETANI GREEN BELT LAND RECLAMATION 220-110
111 SUBANDRYO PETANI GREEN BELT LAND RECLAMATION 220-111
112 SUKADI PETANI GREEN BELT LAND RECLAMATION 220-112
113 SUKIRAN PETANI GREEN BELT LAND RECLAMATION 220-113
114 SUNARYO PETANI GREEN BELT LAND RECLAMATION 220-114
115 SUWARDI PETANI GREEN BELT LAND RECLAMATION 220-115
116 SUWARNI PETANI GREEN BELT LAND RECLAMATION 220-116
118 TARSINAH PETANI GREEN BELT LAND RECLAMATION 220-118
119 TUTIK PETANI GREEN BELT LAND RECLAMATION 220-119
120 WARIS PETANI GREEN BELT LAND RECLAMATION 220-120
121 WINTIN PETANI GREEN BELT LAND RECLAMATION 220-121
122 ABDUL KODIR PETANI GREEN BELT LAND RECLAMATION 220-122
123 ABU CHOERI PETANI GREEN BELT LAND RECLAMATION 220-123
124 ANSHORI PETANI GREEN BELT LAND RECLAMATION 220-124
125 DANMARI PETANI GREEN BELT LAND RECLAMATION 220-125
126 DARMIN PETANI GREEN BELT LAND RECLAMATION 220-126
127 DARMINI PETANI GREEN BELT LAND RECLAMATION 220-127
128 DARSAM PETANI GREEN BELT LAND RECLAMATION 220-128
129 DARSILAN 2 PETANI GREEN BELT LAND RECLAMATION 220-129
130 DARSILAN PETANI GREEN BELT LAND RECLAMATION 220-130
131 DARSO 2 PETANI GREEN BELT LAND RECLAMATION 220-131
132 DARSO PETANI GREEN BELT LAND RECLAMATION 220-132
133 KARDI PETANI GREEN BELT LAND RECLAMATION 220-133
134 KANSAR PETANI GREEN BELT LAND RECLAMATION 220-134
135 LASMIRAN PETANI GREEN BELT LAND RECLAMATION 220-135
136 LASRI PETANI GREEN BELT LAND RECLAMATION 220-136
137 LELES PETANI GREEN BELT LAND RECLAMATION 220-137
138 MASIRAN PETANI GREEN BELT LAND RECLAMATION 220-138
139 MUJIRAN PETANI GREEN BELT LAND RECLAMATION 220-139
140 NAWI PETANI GREEN BELT LAND RECLAMATION 220-140
141 NIKNINGSIH PETANI GREEN BELT LAND RECLAMATION 220-141
142 NURSAM PETANI GREEN BELT LAND RECLAMATION 220-142
143 RASMADI PETANI GREEN BELT LAND RECLAMATION 220-143
144 REBYENG PETANI GREEN BELT LAND RECLAMATION 220-144
145 ROSLAN PETANI GREEN BELT LAND RECLAMATION 220-145
146 RUS SUTARMAN PETANI GREEN BELT LAND RECLAMATION 220-146
147 RUSTAM PETANI GREEN BELT LAND RECLAMATION 220-147
148 SARJI PETANI GREEN BELT LAND RECLAMATION 220-148
149 SUMAR PETANI GREEN BELT LAND RECLAMATION 220-149
150 SUTO PETANI GREEN BELT LAND RECLAMATION 220-150
151 SUYASMI PETANI GREEN BELT LAND RECLAMATION 220-151
152 TARSONO PETANI GREEN BELT LAND RECLAMATION 220-152
153 TARSIN PETANI GREEN BELT LAND RECLAMATION 220-153
154 URI PETANI GREEN BELT LAND RECLAMATION 220-154
155 WANI PETANI GREEN BELT LAND RECLAMATION 220-155
156 WANTO PETANI GREEN BELT LAND RECLAMATION 220-156
157 WARNAJI PETANI GREEN BELT LAND RECLAMATION 220-157
158 WARSANI PETANI GREEN BELT LAND RECLAMATION 220-158
159 WARSIMO PETANI GREEN BELT LAND RECLAMATION 220-159
160 WARSUMI PETANI GREEN BELT LAND RECLAMATION 220-160
161 COWEK PETANI GREEN BELT LAND RECLAMATION 220-161
162 DARSINAH PETANI GREEN BELT LAND RECLAMATION 220-162
163 DARWATI PETANI GREEN BELT LAND RECLAMATION 220-163
164 DASURI PETANI GREEN BELT LAND RECLAMATION 220-164
165 JIMAN PETANI GREEN BELT LAND RECLAMATION 220-165
166 KARIM M PETANI GREEN BELT LAND RECLAMATION 220-166
167 KARDI PETANI GREEN BELT LAND RECLAMATION 220-167
168 KATINI PETANI GREEN BELT LAND RECLAMATION 220-168
169 MASIYAH PETANI GREEN BELT LAND RECLAMATION 220-169
170 MUNTARI PETANI GREEN BELT LAND RECLAMATION 220-170
171 MURTI PETANI GREEN BELT LAND RECLAMATION 220-171
172 RADI PETANI GREEN BELT LAND RECLAMATION 220-172
173 RADIMO PETANI GREEN BELT LAND RECLAMATION 220-173
174 SAJIB PETANI GREEN BELT LAND RECLAMATION 220-174
175 SITI HENIK PETANI GREEN BELT LAND RECLAMATION 220-175
176 SUKARDI PETANI GREEN BELT LAND RECLAMATION 220-176
177 SUKARNO PETANI GREEN BELT LAND RECLAMATION 220-177
178 SUPRIHADI PETANI GREEN BELT LAND RECLAMATION 220-178
179 SUTARTI PETANI GREEN BELT LAND RECLAMATION 220-179
180 SUWARNI PETANI GREEN BELT LAND RECLAMATION 220-180
181 SUWARTI PETANI GREEN BELT LAND RECLAMATION 220-181
182 SUYONO PETANI GREEN BELT LAND RECLAMATION 220-182
183 TAMAJI PETANI GREEN BELT LAND RECLAMATION 220-183
184 TAMAT RIFAI PETANI GREEN BELT LAND RECLAMATION 220-184
185 TAMSARI PETANI GREEN BELT LAND RECLAMATION 220-185
186 TARIMIN PETANI GREEN BELT LAND RECLAMATION 220-186
187 TARMINI PETANI GREEN BELT LAND RECLAMATION 220-187
188 WARNI PETANI GREEN BELT LAND RECLAMATION 220-188
189 WARSITI PETANI GREEN BELT LAND RECLAMATION 220-189
190 ARIS PETANI GREEN BELT LAND RECLAMATION 220-190
191 CARI PETANI GREEN BELT LAND RECLAMATION 220-191
192 DARMAJI PETANI GREEN BELT LAND RECLAMATION 220-192
193 DARSO PETANI GREEN BELT LAND RECLAMATION 220-193
194 JUMANI PETANI GREEN BELT LAND RECLAMATION 220-194
195 KARSO PETANI GREEN BELT LAND RECLAMATION 220-195
196 KUASAIN PETANI GREEN BELT LAND RECLAMATION 220-196
197 LASIMIN PETANI GREEN BELT LAND RECLAMATION 220-197
198 LASMANI PETANI GREEN BELT LAND RECLAMATION 220-198
199 MUNAWAR PETANI GREEN BELT LAND RECLAMATION 220-199
200 RAJI PETANI GREEN BELT LAND RECLAMATION 220-200
201 ROKIM PETANI GREEN BELT LAND RECLAMATION 220-201
202 SANADI PETANI GREEN BELT LAND RECLAMATION 220-202
203 SAPRAN PETANI GREEN BELT LAND RECLAMATION 220-203
204 SARDI PETANI GREEN BELT LAND RECLAMATION 220-204
205 SARIAN PETANI GREEN BELT LAND RECLAMATION 220-205
206 SARMAN PETANI GREEN BELT LAND RECLAMATION 220-206
207 SUKARMIN PETANI GREEN BELT LAND RECLAMATION 220-207
208 SUMIT PETANI GREEN BELT LAND RECLAMATION 220-208
209 TAJI PETANI GREEN BELT LAND RECLAMATION 220-209
210 TARJI PETANI GREEN BELT LAND RECLAMATION 220-210
211 TARUM PETANI GREEN BELT LAND RECLAMATION 220-211
213 WONDO PETANI GREEN BELT LAND RECLAMATION 220-213
214 ASMIN PETANI GREEN BELT LAND RECLAMATION 220-214
215 KARSUN PETANI GREEN BELT LAND RECLAMATION 220-215
216 MARSITAH PETANI GREEN BELT LAND RECLAMATION 220-216
217 MURJI PETANI GREEN BELT LAND RECLAMATION 220-217
218 NGASRI PETANI GREEN BELT LAND RECLAMATION 220-218
219 RAJANI PETANI GREEN BELT LAND RECLAMATION 220-219
220 RASMONAH PETANI GREEN BELT LAND RECLAMATION 220-220
221 RIYANTO PETANI GREEN BELT LAND RECLAMATION 220-221
222 SUMARSONO PETANI GREEN BELT LAND RECLAMATION 220-222
223 SUTARNO PETANI GREEN BELT LAND RECLAMATION 220-223
224 SUYASMI PETANI GREEN BELT LAND RECLAMATION 220-224
226 TARSIMAN PETANI GREEN BELT LAND RECLAMATION 220-226
227 TASIRAN PETANI GREEN BELT LAND RECLAMATION 220-227
228 TAUTI KHOTIJAH PETANI GREEN BELT LAND RECLAMATION 220-228
229 TUTI'ATUN PETANI GREEN BELT LAND RECLAMATION 220-229
230 WARDI HAMAD PETANI GREEN BELT LAND RECLAMATION 220-230
231 WINARDI PETANI GREEN BELT LAND RECLAMATION 220-231
232 WIWIK PETANI GREEN BELT LAND RECLAMATION 220-232
233 AJAM MULYADI PETANI GREEN BELT LAND RECLAMATION 220-233
234 DASMULAN PETANI GREEN BELT LAND RECLAMATION 220-234
235 KACUNG PETANI GREEN BELT LAND RECLAMATION 220-235
236 KASIYO PETANI GREEN BELT LAND RECLAMATION 220-236
237 KASNO PETANI GREEN BELT LAND RECLAMATION 220-237
238 KOWIYATI PETANI GREEN BELT LAND RECLAMATION 220-238
239 LASMANI PETANI GREEN BELT LAND RECLAMATION 220-239
240 MARKASIM PETANI GREEN BELT LAND RECLAMATION 220-240
241 PASIMAN PETANI GREEN BELT LAND RECLAMATION 220-241
242 RAKIDIN PETANI GREEN BELT LAND RECLAMATION 220-242
243 SARKAN PETANI GREEN BELT LAND RECLAMATION 220-243
244 SUMADI PETANI GREEN BELT LAND RECLAMATION 220-244
245 TARMU PETANI GREEN BELT LAND RECLAMATION 220-245
246 TARSUMI PETANI GREEN BELT LAND RECLAMATION 220-246
247 TASLAN PETANI GREEN BELT LAND RECLAMATION 220-247
248 WARSITO PETANI GREEN BELT LAND RECLAMATION 220-248
249 DARMADI PETANI GREEN BELT LAND RECLAMATION 220-249
250 DASRUN PETANI GREEN BELT LAND RECLAMATION 220-250
251 GUNO PETANI GREEN BELT LAND RECLAMATION 220-251
252 JASMARI PETANI GREEN BELT LAND RECLAMATION 220-252
253 KARMONO PETANI GREEN BELT LAND RECLAMATION 220-253
254 KARMU PETANI GREEN BELT LAND RECLAMATION 220-254
255 KASMAN PETANI GREEN BELT LAND RECLAMATION 220-255
256 KASWADI PETANI GREEN BELT LAND RECLAMATION 220-256
257 KUSINI PETANI GREEN BELT LAND RECLAMATION 220-257
258 KUSMIATI PETANI GREEN BELT LAND RECLAMATION 220-258
259 LUMANDAR PETANI GREEN BELT LAND RECLAMATION 220-259
260 RANJI PETANI GREEN BELT LAND RECLAMATION 220-260
261 RASIDIN PETANI GREEN BELT LAND RECLAMATION 220-261
262 SUNOTO PETANI GREEN BELT LAND RECLAMATION 220-262
263 SURATMIN PETANI GREEN BELT LAND RECLAMATION 220-263
264 TARIMIN PETANI GREEN BELT LAND RECLAMATION 220-264
265 TASIRAN PETANI GREEN BELT LAND RECLAMATION 220-265
266 TRIMO PETANI GREEN BELT LAND RECLAMATION 220-266
268 WANI PETANI GREEN BELT LAND RECLAMATION 220-268
269 WARIJAN PETANI GREEN BELT LAND RECLAMATION 220-269
270 WARJI PETANI GREEN BELT LAND RECLAMATION 220-270
271 WATI PETANI GREEN BELT LAND RECLAMATION 220-271
DOK
TELAH TELAH SIM-POL

NON 30-Jun-20 VALID √ √ √
NO SIM-POL
TULIS PRAKTEK LV Truck Ringan Crane
c
IVER LICENSE VALID DATE
Dump Truck
CWB Scania
c
OPERATOR LICENSE VALID
Excavator
Breaker
PC 750 PC 400 PC 300 PC 200
Rock Drill Machine
BACK
NO NIK NAMA
NGASIYO PT. SURYA BUANA SENTOSA LITBANG 221-001

AJI BRAMANTA PT. SURYA BUANA SENTOSA LITBANG 221-002
FIRMAN ADI HERMANTO PT. SURYA BUANA SENTOSA LITBANG 221-003
SATUJI PT. SURYA BUANA SENTOSA LITBANG 221-004
SUDARSONO PT. SURYA BUANA SENTOSA LITBANG 221-005
DARIANTO PT. SURYA BUANA SENTOSA LITBANG 221-006
SOLIKAN PT. SURYA BUANA SENTOSA LITBANG 221-007
ATIM PT. SURYA BUANA SENTOSA LITBANG 221-008
MIFTAHUL UDIN PT. SURYA BUANA SENTOSA LITBANG 221-009
MAT JALIL PT. SURYA BUANA SENTOSA LITBANG 221-010
GALIH WIBISONO PT. SURYA BUANA SENTOSA LITBANG 221-011
MOH. DUHAN PT. SURYA BUANA SENTOSA LITBANG 221-012
RIANTO PT. SURYA BUANA SENTOSA LITBANG 221-013
IMAM SYAFI'I PT. SURYA BUANA SENTOSA LITBANG 221-014
NUR ROHMAN PT. SURYA BUANA SENTOSA LITBANG 221-015
RUSMAN PT. SURYA BUANA SENTOSA LITBANG 221-016
EKO PT. SURYA BUANA SENTOSA LITBANG 221-017
CATUR SETIAWAN PT. SURYA BUANA SENTOSA LITBANG
M. RUDY IKSANI PT. SURYA BUANA SENTOSA LITBANG
AHMAD BASUNI PT. SURYA BUANA SENTOSA LITBANG
DOK
TELAH TELAH
NON 22-Jul-20 VALID Y Y Y

SIM-POL NO SIM-POL
LV DUMP TRUCK Crane
BII 751015470466 16-Oct-17 EXPIRED N

BII 781015290581 31-Oct-17 EXPIRED N
BII 850415534636 16-Apr-18 EXPIRED N
BII 740415561450 28-Apr-18 EXPIRED N
BII 840510385767 5-May-18 EXPIRED N
BII 750715460643 5-Jul-18 EXPIRED N
BII 101215561640 3-Dec-18 EXPIRED N
BII 660415470228 15-Apr-19 EXPIRED N
BII 810515564861 6-May-19 EXPIRED N
BII 691215480298 7-Dec-19 VALID N
BII 930815550511 28-Aug-20 VALID N
BII 850716554841 1-Jul-21 VALID N
BII 750811532700 20-Sep-21 VALID N
BII 780415470710 6-Apr-17 EXPIRED N

BII 800615532282 13-Jun-17 EXPIRED N
BII 770815551210 3-Aug-17 EXPIRED N
c
VALID DATE
Dump Truck
CWB Scania PC 750
c
Breaker
PC 400 PC 300 PC 200
Wheel Loader Dozer Motor Forklif
Rock Drill Machine
Surface Compactor
BACK
NO NIK NAMA
INSTANSI DEPARTEMEN NO ID ACCESS
1 JUWARI PT. SURYA WIJAYA MEGAH LITBANG 222-001 NON

2 JULIADI PT. SURYA WIJAYA MEGAH LITBANG 222-002 NON
3 HADI SUPRIYATNO PT. SURYA WIJAYA MEGAH LITBANG 222-003 NON
4 DINO VALENTINO PT. SURYA WIJAYA MEGAH LITBANG 222-004 NON
5 RATNO WIBOWO PT. SURYA WIJAYA MEGAH LITBANG 222-005 NON
6 SUEBBURHAN PT. SURYA WIJAYA MEGAH LITBANG 222-006 NON
7 AGUS RIYADIN PT. SURYA WIJAYA MEGAH LITBANG 222-007 NON
8 MAHFUD PT. SURYA WIJAYA MEGAH LITBANG 222-008 NON
9 HARRY SOEBOWO PT. SURYA WIJAYA MEGAH LITBANG 222-009 NON
10 MOKHAMMAD PT. SURYA WIJAYA MEGAH LITBANG 222-010 NON
11 JAINUL MUSTOFA PT. SURYA WIJAYA MEGAH LITBANG 222-011 NON
DOK
TELAH TELAH SIM-POL NO SIM-POL
VALID UNTIL KET DICETAK DITERIMA F FT K
20-Aug-20 VALID Y Y Y Y Y BII 590315540224

2-Oct-20 VALID Y Y Y Y Y BII 701215620208
TULIS PRAKTEK LV DUMP TRUCK Crane
30-Dec-18 EXPIRED N
30-Jun-22 VALID N
10-Apr-21 VALID N
27-Dec-19 VALID N
15-Dec-21 VALID N
30-Sep-20 VALID N
9-Dec-19 VALID N
1-Jan-21 VALID N
18-Aug-21 VALID N
10-Apr-22 VALID N
1-Dec-22 VALID N
c
TE
Dump Truck
CWB Scania PC 750
Breaker
PC 400 PC 300 PC 200 WA 500
DATE
Forklif
Surface Compactor
Miner
NO NIK NAMA BACK
1 MOCH. YUSUF PT. ANT LITBANG 223-001 NON

2 ARIK LESTIAWAN PT. ANT LITBANG 223-002 NON
3 JUNAEDI PT. ANT LITBANG 223-003 NON
4 MOKHAMMAD IMRON PT. ANT LITBANG 223-004 NON
5 ARIS MAULANA PENI PT. ANT LITBANG 223-005 NON
6 SURO MULJO SEDJATI PT. ANT LITBANG 223-006 NON
7 NURHADI PT. ANT LITBANG 223-007 NON
8 YUNUS PRAWONO PT. ANT LITBANG 223-008 NON
9 M. SUWITO PT. ANT LITBANG 223-009 NON
10 SYAFUL ARIFIN PT. ANT LITBANG 223-010 NON
11 HARI SUSANTO PT. ANT LITBANG 223-011 NON
12 PUTRO AGUNG LUKI PURWANTO PT. ANT LITBANG 223-012 NON
13 BAMBANG HARMANTO PT. ANT LITBANG 223-013 NON
14 TONO PT. ANT LITBANG 223-014 NON
15 KARYONO PT. ANT LITBANG 223-015 NON
16 DARYONO PT. ANT LITBANG 223-016 NON
17 POKIM PT. ANT LITBANG 223-017 NON
18 SUHAN PT. ANT LITBANG 223-018 NON
19 HENDRIK PT. ANT LITBANG 223-019 NON
20 BAMBANG PT. ANT LITBANG 223-020 NON
21 DIDIK HARIADI PT. ANT LITBANG 223-021 NON
22 YANTO PT. ANT LITBANG 223-022 NON
23 KHOIRUL ANWAR PT. ANT LITBANG 223-023 NON
24 M. YUSUF EFENDI PT. ANT LITBANG 223-024 NON
25 MUHAMMAD USMAN PT. ANT LITBANG 223-025 NON
DOK

16-Jan-21 VALID Y Y Y Y Y
3/7/2021 VALID Y Y Y Y BII 760315532646
5/1/2022 VALID Y Y Y Y BII 760515620257
4/22/2019 EXPIRED Y Y Y Y BII 920415531281
1/15/2023 VALID Y Y Y Y BII 820115550676
13-011-2022 VALID Y Y Y Y BII 731115551104
17-Apr-22 VALID N
10-Sep-20 VALID N
14-May-18 EXPIRED N
27-Jul-22 VALID N
12-May-21 VALID N
10-Jan-19 EXPIRED N
14-Aug-20 VALID N
27-Oct-20 VALID N
10-Aug-19 WARNING N
22-Mar-22 VALID N
3-Mar-19 EXPIRED N
28-Jan-18 EXPIRED N
30-Jul-21 VALID N
3/7/2021 VALID N
5/1/2022 VALID N
4/22/2019 EXPIRED N
1/15/2023 VALID N
### VALID N
c
SE VALID DATE
Dump Truck
CWB Scania
c
OPERATOR LICENSE VALID D
Excavator
Breaker
PC 750 PC 400 PC 300 PC 200
Rock Drill Machine
NO NIK NAMA
BACK INSTANSI DEPARTEMEN NO ID
1 MOCH. YUSUF PT. BUMI ANUGERAH ABADI LITBANG 224-001

2 ARIK LESTIAWAN PT. BUMI ANUGERAH ABADI LITBANG 224-002
3 JUNAEDI PT. BUMI ANUGERAH ABADI LITBANG 224-003
4 MOKHAMMAD IMRON PT. BUMI ANUGERAH ABADI LITBANG 224-004
5 MUJIADI PT. BUMI ANUGERAH ABADI LITBANG 224-005
6 JUNIANTO PT. BUMI ANUGERAH ABADI LITBANG 224-006
7 SUGIONO PT. BUMI ANUGERAH ABADI LITBANG 224-007
8 AGUS WIDODO PT. BUMI ANUGERAH ABADI LITBANG 224-008
DOK
TELAH TELAH SIM-POL
NON 28-Nov-20 VALID Y Y Y BII

NO SIM-POL
STATUS
810915551170 10-Sep-20 VALID N
830915551198 10-Sep-20 VALID N
800515550967 14-May-18 EXPIRED N
680715551508 27-Jul-22 VALID N
680815551403 16-Aug-20 VALID N
700615551492 26-Jun-20 VALID N
670515623842 5-May-18 EXPIRED N
810915551170 10-Sep-20 VALID N
c
Dump Truck
CWB Scania
c
Breaker
PC 750 PC 400 PC 300 PC 200
Forklif
WA 500 D 155 D 85 Grader HCR 1500
Rock Drill Machine
Surface Compactor
NO NIK NAMA
1 PUJO AGUNG LUKI PURWANTO PT. JAYA SAKTI LINGKUNGAN HI LITBANG 225-001
2 NURHADI PT. JAYA SAKTI LINGKUNGAN HI LITBANG 225-002
3 SORO MULJO SEDJATI PT. JAYA SAKTI LINGKUNGAN HI LITBANG 225-003
4 SAIFUL ARIFIN PT. JAYA SAKTI LINGKUNGAN HI LITBANG 225-004
5 BAMBANG HERMANTO PT. JAYA SAKTI LINGKUNGAN HI LITBANG 225-005
6 YUNUS PRAWONO PT. JAYA SAKTI LINGKUNGAN HI LITBANG 225-006
7 ALI MUSTOFA PT. JAYA SAKTI LINGKUNGAN HI LITBANG 225-007
8 SUPRAPTO PT. JAYA SAKTI LINGKUNGAN HI LITBANG 225-008
9 MIRAN PT. JAYA SAKTI LINGKUNGAN HI LITBANG 225-009
YUSUF PRAWOTO PT. JAYA SAKTI LINGKUNGAN HI LITBANG 225-010
DOK
TELAH TELAH SIM-POL
NON 5-Feb-21 VALID Y Y Y Y Y BII

NON 14-Aug-20 VALID Y Y Y Y Y BII
NON 10-Jan-19 EXPIRED Y Y Y Y Y BII
NON 22-Mar-22 VALID Y Y Y Y Y BII
NON 30-Jul-21 VALID Y Y Y Y Y BII
NON 27-Oct-20 VALID Y Y Y Y Y BII
NON 20-Jun-21 VALID Y Y Y Y Y BII
NON 10-Apr-19 EXPIRED Y Y Y Y Y BII
NON 13-Apr-21 VALID Y Y Y
NO SIM-POL
STATUS
920116260495 28-Jan-18 EXPIRED N
830915551198 14-Aug-20 VALID N
810115143801 10-Jan-19 EXPIRED N
850315560991 22-Mar-22 VALID N
870715147099 30-Jul-21 VALID N
771015148992 27-Oct-20 VALID N
660615561196 20-Jun-21 VALID N
690415141507 10-Apr-19 EXPIRED N
830715352046 1-Jul-22 VALID N
c
Dump Truck
CWB Scania
c
Breaker
PC 750 PC 400 PC 300 PC 200
Forklif
WA 500 D 155 D 85 Grader HCR 1500
Rock Drill Machine
Surface Compactor
NO NIK NAMA
1 SURADAL BASUKI PT. BANTENG MUDA TRANS LITBANG 226-001

2 MOCHAMMAD EKO MULYANTO PT. BANTENG MUDA TRANS LITBANG 226-002
3 DEDY HALIMI PT. BANTENG MUDA TRANS LITBANG 226-003
4 FATKHURIAWAN PT. BANTENG MUDA TRANS LITBANG 226-004
5 PRASETYO HADI PT. BANTENG MUDA TRANS LITBANG 226-005
6 AHMAD KUSWANTO PT. BANTENG MUDA TRANS LITBANG 226-006
7 SUPRIYONO PT. BANTENG MUDA TRANS LITBANG 226-007
DOK
TELAH TELAH SIM-POL
NON 5-Feb-21 VALID Y Y Y Y Y

NON 14-Aug-20 VALID Y Y Y Y Y BII
NON 27-Jan-21 VALID Y Y Y Y Y BII
NON 06-10-2021 VALID Y Y Y Y Y BII
NON 14-Jun-18 EXPIRED Y Y Y Y Y BII
NON 4-Apr-19 EXPIRED Y Y Y BI
NO SIM-POL
STATUS
28-Jan-18 EXPIRED N
14-Aug-20 VALID N
570714380378 10-Jan-19 EXPIRED N
910114380583 22-Mar-22 VALID N
741014380590 30-Jul-21 VALID N
790614380171 27-Oct-20 VALID N
700414380058 20-Jun-21 VALID N
c
Dump Truck
CWB Scania
c
Breaker
PC 750 PC 400 PC 300 PC 200
Forklif
WA 500 D 155 D 85 Grader HCR 1500
Rock Drill Machine
Surface Compactor
NO NIK NAMA
1 NUR ANHAR PT. MJS Bag. Opera227-001

2
3
4
5
6
7
DOK
TELAH TELAH SIM-POL
FULL 3-Mar-22 VALID Y Y Y Y A

NO SIM-POL
STATUS
1514170805402 3/3/2022 VALID FULL
c
RIVER LICENSE VALID DATE
Dump Truck
CWB Scania
c
Breaker
PC 750 PC 400 PC 300 PC 200
Forklif
WA 500 D 155 D 85 Grader HCR 1500
Rock Drill Machine
Surface Compactor
NO NIK NAMA
1 MOCH ZAINI PT. METATU NUSANTARA JAYA LITBANG 228-001

2 SAMSUL ARIFIN PT. METATU NUSANTARA JAYA LITBANG 228-002
3 SUPARDI PT. METATU NUSANTARA JAYA LITBANG 228-003
4 AHMAD LADI PT. METATU NUSANTARA JAYA LITBANG 228-004
5 AHMAD ANSORI PT. METATU NUSANTARA JAYA LITBANG 228-005
6 MASKAN HADI PT. METATU NUSANTARA JAYA LITBANG 228-006
7 ABDUL ROHIM PT. METATU NUSANTARA JAYA LITBANG 228-007
8 MOCH HERMAN PT. METATU NUSANTARA JAYA LITBANG 228-008
9 AMANAT BERLIANTO PT. METATU NUSANTARA JAYA LITBANG 228-009
10 MUJIONO PT. METATU NUSANTARA JAYA LITBANG 228-010
11 SISWANTO PT. METATU NUSANTARA JAYA LITBANG 228-011
12 KARSONO PT. METATU NUSANTARA JAYA LITBANG 228-012
13 SUPARDI PT. METATU NUSANTARA JAYA LITBANG 228-013
14 KHOIRIL PT. METATU NUSANTARA JAYA LITBANG 228-014
DOK
TELAH TELAH SIM-POL
NON N Y Y Y
NON 9-Oct-23 N Y Y Y BII
NON 10-Oct-21 N v 5/5/2018 Y Y Y BII
NON 1-Jan-20 N v 5/5/2018 Y Y Y BII
NON 7-Jan-21 N v 5/5/2018 Y Y Y BII
NON 24-Dec-22 N v 5/5/2018 Y Y Y BII
NON 29-May-22 N Y Y Y BII
NON 16-Jul-18 N Y Y Y BII
NON 17-May-20 N Y Y Y BI
NON 9/19/2020 N Y Y Y BI
NON 5/11/2023 N Y Y Y BI
NON 7/6/2022 N Y Y Y BII
NO SIM-POL
STATUS
3/3/2022 VALID NON NA
1514180506741 9-Oct-23 VALID N
621015540186 NA
650115560747 NA
830115481324 NA
601215481727 NA
830415144201 29-Apr-22 VALID N
910515481327 12-May-20 VALID N
820715481010 16-Jul-18 EXPIRED N
790515380671 31-May-17 EXPIRED N
800515541075 17-May-20 VALID N
790915481253 9/19/2020 VALID N
790515541195 5/11/2023 VALID N
750715481421 7/6/2022 VALID N
NA
c
Dump Truck
CWB Scania
c
Breaker
PC 750 PC 400 PC 300 PC 200
Forklif
WA 500 D 155 D 85 Grader HCR 1500
Rock Drill Machine
Surface Compactor
NO NIK NAMA
1 JAUHARUDIN MUSTOFA PT. SINAR PELITA DUNIA LITBANG 229-001

2 ABDUL RACHMAN PT. SINAR PELITA DUNIA LITBANG 229-002
3 AGUS EKA CAHYONO PT. SINAR PELITA DUNIA LITBANG 229-003
4 AFUK ZAELANI PT. SINAR PELITA DUNIA LITBANG 229-004
SUYATMAN PT. SINAR PELITA DUNIA LITBANG 229-005
YULIANTO PT. SINAR PELITA DUNIA LITBANG 229-006
EKO SETIAWAN PT. SINAR PELITA DUNIA LITBANG 229-007
DOK
TELAH TELAH SIM-POL
NON 27-Oct-20 Y Y Y BII

NON Y Y Y
NON Y Y Y
NON 2-Mar-19 Y Y Y BII
NON 27-Feb-21 BII
NON 28-Jul-20 BII
NON 22-Sep-23 BII
NO SIM-POL
STATUS
89101555743 27-Oct-20 VALID N
810315551422 2-Mar-19 EXPIRED N

730215620140 27-Feb-21 VALID N
810715531821 28-Jul-20 VALID N
810915541067 22-Sep-23 VALID N
c
Dump Truck
CWB Scania
c
Breaker
PC 750 PC 400 PC 300 PC 200
Forklif
WA 500 D 155 D 85 Grader HCR 1500
Rock Drill Machine
Surface Compactor
BACK
NO NIK NAMA
1 MOCHAMAD NOERI PT. NATBOUR RESOURCES SURA LITBANG 230-001 NON

2 ANDRIK PT. NATBOUR RESOURCES SURA LITBANG 230-002 NON
3 MULJONO PT. NATBOUR RESOURCES SURA LITBANG 230-003 NON
4 NURKAN PT. NATBOUR RESOURCES SURA LITBANG 230-004 NON
5 DIDIK SUDARYANTO PT. NATBOUR RESOURCES SURA LITBANG 230-005 NON
6 TONIK PT. NATBOUR RESOURCES SURA LITBANG 230-006 NON
7
8
9
10
11
DOK
20-Mar-19 Y Y Y BII 680315140314

21-Feb-19 Y Y Y BII 840215147046
29-Apr-23 Y Y Y BII 660415147901
10-Nov-23 Y Y Y BII 591115142299
7-Jul-23 Y Y Y BII 830715144618
1-Mar-23 Y Y Y BI 900315149689
20-Mar-19 EXPIRED N
21-Feb-19 EXPIRED N
29-Apr-23 VALID N
10-Nov-23 VALID N
7-Jul-23 VALID N
1-Mar-23 VALID N
c
TE
Dump Truck
CWB Scania PC 750
Breaker
PC 400 PC 300 PC 200 WA 500
DATE
Forklif
Surface Compactor
Miner

SI Dan Kontraktor Non Tambang 2018-050918

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TOTAL MINE PERMIT DAN DATA TIDAK

NO Instansi SIMPPER YANG DIAJUKAN LENGKAP (NA)

1 1754 KHOIRUL ANWAR RAW MATERIAL PRODUCTION

MINING OPERATION 101-001 FULL 1-Dec-2020 VALID Y

LV DUMP TRUCK Crane Trailer Motorcycle

Dump Truck Excavato

25-May-2020 VALID F 25-May-2020 VALID F

25-May-2020 VALID F 25-May-2020 VALID F

25-May-2020 VALID F 25-May-2020 VALID F

25-May-2020 VALID F 25-May-2020 VALID F

25-May-2020 VALID F 25-May-2020 VALID F

25-May-2020 VALID F 25-May-2020 VALID F 25-May-2020 VALID F

25-May-2020 VALID F 25-May-2020 VALID F

25-May-2020 VALID F 25-May-2020 VALID F

25-May-2020 VALID F 25-May-2020 VALID F

25-May-2020 VALID F 25-May-2020 VALID F

25-May-2020 VALID F 25-May-2020 VALID F

25-May-2020 VALID F 25-May-2020 VALID F

25-May-2020 VALID F 25-May-2020 VALID F

25-May-2020 VALID F 25-May-2020 VALID F

25-May-2020 VALID F 25-May-2020 VALID F

25-May-2020 VALID F 25-May-2020 VALID F

25-May-2020 VALID F 25-May-2020 VALID F

25-May-2020 VALID F 25-May-2020 VALID F

VALID WARNING EXPIRED VALID WARNING EXPIRED

1 857097 AHMAD HERI PT. SWABINA GATRA CRUSHER MACHINE MAINTENANCE

202-007 NON 1-Dec-16 EXPIRED Y √ √

911215470344 8-Dec-2018 EXPIRED N

820315470451 10-Mar-2016 EXPIRED N

720815470233 76 17-Aug-2019 WARNING N

Dump Truck Crane Trailer Motorcycle Service Truck

1 130661 EDI KUNCORO KWSG

COMMUNICATION & GA 203-001 FULL 1-Dec-16 EXPIRED Y Y

LV Truck Ringan Crane Trailer Motorcycle Service Truck

Dump Truck Excavator

7 TAHIR PT. MARGO MULYO MAKMUR

TUBAN GENERAL FACILITY M 204-007 FULL 1-Dec-16 EXPIRED Y Y

LV Truck Ringan Crane Trailer Motorcycle

Dump Truck Excavator

1 1502064 BAKRUN PT. AZIS JAYA ABADI EMISSION CONTROL 205-001

Dump Truck Excavator

1 MIFTAKHUL ANAM PT. MULIA DEWI SEJA CRUSHER OPERATION 208-001

NON 01-Feb-17 EXPIRED Y Y √ √

1 ACHMAD SUNARDI PT. TRIATA MULIA INDONESIA QHSE

209-001 FULL 1-Jun-17 EXPIRED Y Y √ √ √

BII 720215620150 66 9-Feb-21 VALID N

BI 840315560911 5-Mar-20 VALID N

1 SRI WIDODO PT. TEKNOTAMA LINGKUNGAN INTERNUSA

LITBANG 210-001 FULL 1-Jun-20 VALID Y Y

√ √ √ A 740315470629 75 2-Mar-20 VALID

1 FITRAH ASEP KUSMANAPT. CITRA DUTA MUDA RAW MATERIAL PRODUCTION

211-001 FULL 1-Jun-17 EXPIRED Y Y √ √

UNIT KERJA MINE PERMIT

1 KARSAM PT. PERWIRA JAYA PERKASA LAND RECLAMATION 212-001

FULL 01-Jun-17 EXPIRED Y Y √ √ √ A

770215470531 3-Feb-21 VALID N

1 SULIYANTO PT. KITA MANDIRI ABADI LITBANG 213-001

NON 01-Jun-20 VALID Y Y √ √ √

BII 700115532228 67 01-Jan-18