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[]
[null,null,"PT. TJB POWER SERVICES",null,null,null,null,"PT PLN (PERSERO)"]
[null,null,"Power Plant 2x660 MW CFPP",null,null,null,null,"PEMBANGKITAN TANJUNG JATI B"]
[null,null,"Tanjung Jati \"B\" - JEPARA"]
["TJB-BM-1201-02-F01 R00"]
["ID CARD REQUEST FORM"]
[]
[]
[]
[null,"APPLICANT NAME (IN BLOCK CAPITALS)",null,null,null,": "]
[null,"NAMA PEMOHON DENGAN HURUF BALOK"]
[]
[null,null,null,null,null,null," MALE",null," FEMALE"]
[null,null,null,null,null,null," LAKI-LAKI",null," PEREMPUAN"]
[]
[null,"PLACE & DATE OF BIRTH",null,null,null,": "]
[null,"TEMPAT DAN TANGGAL LAHIR"]
[]
[null,"BLOOD TYPE",null,null,null,":"]
[null,"GOLONGAN DARAH"]
[]
[null,"HOME ADDRESS",null,null,null,": "]
[null,"ALAMAT RUMAH"]
[]
[null,"EMERGENCY PHONE NUMBER",null,null,null,": "]
[null,"NO. TELEPON DARURAT"]
[]
[null,"KTP NO. (COPY IS ATTACHED)",null,null,null,": "]
[null,"NO. KTP (FOTO COPY TERLAMPIR)"]
[]
[null,"COMPANY NAME",null,null,null,": "]
[null,"NAMA PERUSAHAAN"]
[]
[null,"POSITION",null,null,null,": "]
[null,"POSISI"]
[]
[null,"COMPANY ADDRESS",null,null,null,":"]
[null,"ALAMAT PERUSAHAAN"]
[]
[null,"TELEPHONE NO.",null,null,null,": "]
[null,"NO. TELEPON"]
[]
[]
[]
["COMPANY MANAGEMENT",null,null,"RESPECTIVE USER",null,"APPROVED BY",null,null,"ACKNOWLEDGED BY"]
["(MANAJEMEN PERUSAHAAN)",null,null,"(PEMAKAI JASA)",null,"(TJB POWER SERVICES)",null,null,"( PLN )"]
[]
[]
[]
[]
["SIGN",null,null,"SIGN",null,"SIGN",null,null,"SIGN"]
["NAME :  HARIYANTO",null,null,"NAME : ",null,"NAME : GOTOT SETIJONO",null,null,"NAME : "]
["TITLE :  SITE MANAGER",null,null,"TITLE :  ",null,"TITLE : EHS MANAGER",null,null,"TITLE : HR & F MANAGER"]
["DATE :  21 / 03 / 2017",null,null,"DATE : ",null,"DATE :",null,null,"DATE : "]
[]
[null,"CARD TYPE (FILLED BY EHS DEPARTMENT):"]
[null,"TIPE KARTU (DIISI OLEH DEPARTEMEN EHS)"]
[]
[null,null,"  PERMANENT PASS ",null,null,null,"  TEMPORARY PASS "]
[]
[]
[null,"* Please attach with valid Police Record (SKCK)"]

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[]
[null,null,"    PT. AZATHA DUTA MAXIMA"]
[null,null,"    MAINTENANCE PLTU TJB JEPARA JAWA TENGAH UNIT 1 & 2"]
[]
[null,"LIST MANPOWER "]
[null,"Safety Induction "]
[null,"NO.","NAME","GENDER ",null,"PLACE & DATE OF THE BIRTH","BLOOD TYPE","HOME ADDRESS","EMERGENCY PHONE NUMBER","KTP NO. (COPY IS ATTACHED)","COMPANY NAME","POSITION","COMPANY ADDRESS","TELEPON"]
[null,null,null,"MALE","FEMALE"]
[null,1,"ERDA KISWANTO","√",null,"JEPARA 12 JUNI 1987",null,"KANCILAN RT 02 / RW 05 KEMBANG ",null,"33201412068700004","PT. AZATHA DUTA MAXIMA","SKILL MECHANICAL","PLTU TAJUNG JATI B JEPARA"]
[null,2,"MURDIANTORO","√",null,"JEPARA 29 APRIL 1980",null,"JERUKWANGI RT 03 / RW 08 BANGSRI",null,"33200829048000002","PT. AZATHA DUTA MAXIMA","SKILL MECHANICAL","PLTU TAJUNG JATI B JEPARA"]
[null,3,"SELAMET SUPRIYADI","√",null,"JEPARA 17 SEPTEMBER 1973",null,"BONDO RT 04 / RW 08 BANGSRI",null,"3320081709730003","PT. AZATHA DUTA MAXIMA","SKILL MECHANICAL","PLTU TAJUNG JATI B JEPARA"]
[null,4,"ISTIYANTO","√",null,"JEPARA 24 OKTOBER 1969",null,"BONDO RT 04 / RW 08 BANGSRI",null,"3320082410690001","PT. AZATHA DUTA MAXIMA","SKILL MECHANICAL","PLTU TAJUNG JATI B JEPARA"]
[null,5,"TONI HERMAWAN","√",null,"JEPARA 04 FEBRUARI 1996",null,"TUBANAN RT 06 / RW 07 KEMBANG",null,"3320140402960002","PT. AZATHA DUTA MAXIMA ","SKILL MECHANIC","PLTU TANJUNG JATI B JEPARA "]
[null,6,"YUSAK ","√",null,"JEPARA 13 FEBRUARY 1994",null,"BONDO RT 04 / RW 08 BANGSRI",null,"3320081302940004","PT. AZATHA DUTA MAXIMA ","SKILL MECHANIC","PLTU TANJUNG JATI B JEPARA "]
[null,7,"SUGIYAN ","√",null,"JEPARA 12 JUNI 1969",null,"KALIAMAN RT 03 / RW 04 KEMBANG JEPARA",null,"3320141206690003","PT. AZATHA DUTA MAXIMA ","SKILL MECHANIC","PLTU TANJUNG JATI B JEPARA "]
[null,8,"SUPRIADI","√",null,"JEPARA 19 SEPTEMBER 1975",null,"PONJONG RT 03 / RW 011 PADANGAN ",null,"3403101909750001","PT. AZATHA DUTA MAXIMA ","SKILL MECHANIC","PLTU TANJUNG JATI B JEPARA "]
[null,9,"RIAN BUDI PRASETYO","√",null,"JEPARA 23 OKTOBER 1989 ",null,"TUBANAN RT 01 / RW 07 KEMBANG",null,"3320142310890156","PT. AZATHA DUTA MAXIMA ","SKILL MECHANIC","PLTU TANJUNG JATI B JEPARA "]
[null,10,"YUNANTO","√",null,"JEPARA 13 JUNI 1981",null,"TUBANAN RT 05 / RW 06 JEPARA",null,"3320141306810001","PT. AZATHA DUTA MAXIMA ","WELDER","PLTU TANJUNG JATI B JEPARA ","085216197989"]
[null,11,"DWIK WALUYO","√",null,"JEPARA 18 SEPTEMBER 1989",null,"TUBANAN RT 04 / RW 06 JEPARA",null,"3320141809890002","PT. AZATHA DUTA MAXIMA ","SKILL MECHANIC","PLTU TANJUNG JATI B JEPARA "]
[null,12,"KUSWANTO","√",null,"JEPARA 06 NOVEMBER 1998",null,"TUBANAN RT 04 / RW 06 JEPARA",null,"3320140611980001","PT. AZATHA DUTA MAXIMA ","SKILL MECHANIC","PLTU TANJUNG JATI B JEPARA "]
[null,13,"BAYU EKO SUNU ","√",null,"JEPARA 08 OKTOBER 1995",null,"TUBANAN RT 01 / RW 07 KEMBANG",null,"3320140810950003","PT. AZATHA DUTA MAXIMA ","SKILL MECHANIC","PLTU TANJUNG JATI B JEPARA "]
[null,14,"ANDI IRAWAN ","√",null,"JEPARA 29 APRIL 1999",null,"TUBANAN RT 01 / RW 07 KEMBANG",null,"3320142904990003","PT. AZATHA DUTA MAXIMA ","SKILL MECHANIC","PLTU TANJUNG JATI B JEPARA "]
[null,15,"EDUIN ANJIS NUGROHO","√",null,"JEPARA 11 SEPTEMBER 1997",null,"TUBANAN RT 01 / RW 07 KEMBANG",null,"3320141109970003","PT. AZATHA DUTA MAXIMA ","SKILL MECHANIC","PLTU TANJUNG JATI B JEPARA "]
[null,16,"BAGAS WORO","√",null,"JEPARA 15 DESEMBER 1998",null,"TUBANAN RT 01 / RW 07 KEMBANG",null,"3320141512980004","PT. AZATHA DUTA MAXIMA ","SKILL MECHANIC","PLTU TANJUNG JATI B JEPARA "]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,"Reported By,"]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"( HERU H )"]