FORM 3.B.

3 RUMAH TERLAYANI SPAM

KABUPATEN/KOTA :

KELURAHAN/ JUMLAH KONDISI EKONOMI SUDAH TERLAYANI

NO. NAMA KEPALA KELUARGA NO KK NIK ANGGOTA KELUARGA
DESA RUMAH
MBR NON MBR JP BJP
1 2 3 4 5 6 7 8 9 10

1 RIBI 7304100112110034 7304103010760001 10 1

2 NURDIN 7304103011270001 12 1
3 MALING 7304100112110070 7304100810700001 5 1
4 RAMLI 7304100112110048 7304103012700001 7 1
5 MALLU DG RAJA 7304100112110049 7304103112840361 4 1
6 HAMSAH 7304100112110054 7304101012850001 9 1
7 DANDI 7304101107170001 7304101603030001 8 1
8 SUHERMAN 7304100411130002 7304100808880001 11 1
9 MANRA 7304100112110055 7304103012610001 2 1
10 NASO 7304102409100004 7304103112510148 4 1
11 NURU 7304100112110063 7304103112660038 3 1
12 MUSTARI 7304103011110074 7304100703850001 4 1
13 YUPA DG.LILI 7304103107120075 7304103112500145 5 1
14 MASIN 7304102105180002 7304103112810508 4 1
15 HARIS 7304100112110028 7304102512710002 5 1
16 MAUDU 7304102408100002 7304103112610092 4 1
17 SYAMSUDDIN 7304100112110122 7304100512730001 2 1
18 BONGGO 7304100112110093 7304103112550102 6 1
19 TARI 7304100112110133 7304103112850317 6 1
20 JAMALUDDIN 7304102705200001 730410040600001 8 1
21 H. RAMLI 7304100112110072 7304100703690002 4 1
22 UDIN 7304100610100002 7304100311880001 5 1
23 HJ. BINA 7303011202180007 7303015211430001 8 1
24 HJ. SITTI HASNAH 7304102405110004 7304106868660001 5 1
25 AGUS 7304102408170002 7371140302720012 6 1
26 BASIR 7304100401180001 7371142604670001 4 1
27 TINA 7304100112110154 7304101005550001 4 1
28 SAHAKING 7304101206170003 7471040302720001 4 1
29 SUMA 7304100112110152 7304100508730002 4 1
30 DAHLAN 7304100112110090 7304100510800001 4 1
31 SUBUH 7304100112110084 7304103112770030 6 1
32 BASINONG 7304100112110075 7304103112560133 4 1
33 SAMADING 7304100112110078 7304103112810473 5 1
34 PONO 7304101011110003 7304103112480055 7 1
35 SIRAJANG 7304100509170002 7304103112790402 2 1
36 LAHA 7304100112110051 7304101005800003 5 1
37 SABAN 7304102606190004 7303050206720001 5 1
38 MANAI 7304102308170002 73041006003910002 7 1
39 BOLANI 7304100112110053 7304101005520001 9 1
40 ULIK 7304100704170001 7304101708920003 8 1
41 JANNANG 7304100112110058 7304101312800001 4 1
42 NORO BELLA 7304100112110023 7304103112580123 4 1
43 SUDIRMAN 7304100112110042 7304101501890001 11 1
44 HAMDAN 7304100112110099 7304100501730001 9 1
45 TAJUDDIN DG. TOTO 7304102601150003 7304102508800003 4 1
46 RASIDO 7304100112110062 7304103012710001 4 1
47 IRWAN DG TOMPO 7304102007160001 7304100510740003 11 1
48 KULLE 7304100112110135 7304103112500121 6 1
49 SIMBANG 7304100112110045 7304101003800002 4 1
50 DAMING 7304100112110068 7304102708540001 6 1
51 RIBI 7304100112110034 7304103010760001 5 1
52 JUMARANG 7304101210100001 7304103112860182 2 1
53 SUMARLIN 7304100/812200001 7371032307800006 3 1
54 JANNANG 7304081304150001 7304103112940228 5 1
55 NYINGKI 7304100112110087 7304103112650403 3 1
56 SUAJI 7304100607210002 7307072307880002 4 1
57 SAHARUDDIN 7304101511100007 7304103112830322 8 1
 JARAK SUMBER AIR
BELUM KE PENAMPUNGAN
TERLAYANI PENGOTOR/LIMBAH KET
> 10 M < 10 M
11 12 13 14

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
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1
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1
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1
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1
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1
1
1
 FORM 3.B.3 RUMAH TERLAYANI SPAM
KABUPATEN/KOTA :

KELURAHAN/ JUMLAH KONDISI EKONOMI SUDAH TERLAYANI

NO. NAMA KEPALA KELUARGA NO KK NIK ANGGOTA KELUARGA
DESA RUMAH
MBR NON MBR JP BJP
1 2 3 4 5 6 7 8 9 10

1 DAHLAN 73041030111100004 73041025005600001 6 1

2 SAIDO 73041000112110077 73041025057100001 5 1
3 JINDA 730410200071200006 7304107112480011 4 1
4 SUUBUH 73040102707120004 7304101510700002 5 1
5 ABD HAMID 73041030111100055 73041014003640002 5 1
6 NURDIN 7304100112110064 7304103112780353 3 1
7 RAMING 7304100112110130 73041003126800001 1 1
8 KASIM 7304101812100160 7304101001920001 3 1
9 RUMBI 7304100410120005 7304107112530155 3 1
10 SUANDI 7304101121000100 7371130211720001 4 1
11 HJ. SUBAEDAH 7303011012100065 7304107112560106 2 1
12 JAMALUDDIN 7304100905140001 7304100508770001 2 1
13 JANONG 7304100112110106 7304102503670001 4 1
14 EVAN DG TINGGI 7304100803940001 3 1
15 RAMLI 7304100112110089 7304101003750001 3 1
16 JUMALI DG RATE 7304101408120031 7304103112650449 3 1
17 KARIM 7304100112110712 7304100810680001 8 1
18 TINTANG 7304103011110122 7304105002710003 3 1
19 RAFIUDDIN 7304102707120003 7304102811840001 6 1
20 SAMSIAH 7304100112110136 7304107112650306 3 1
21 ABD MUIN 7304100302100003 7304101504660001 3 1
22 HASNA 7304100112110118 7304105110590002 4 1
23 SAIRI 7304103011110257 7304103112750440 1 1
24 TUNI 730410 7304105210700001 9 1
25 FATMAWATI 7304108051070002 7304107112790418 4 1
26 KASIRI 7304100112110115 7304102405790001 5 1
27 M. SAID 7304103011110047 7304103112610111 6 1
28 SISI 7304100112110126 7304101027600002 2 1
29 FAIZAL 730410048140001 7304100608830001 3 1
30 MARSUKI 7304102402150001 7304102005970001 2 1
31 SAING 7304100112110100 7304102712730001 4 1
32 PUDDING 7304103011110072 7304102505610002 2 1
33 MUH. ARIFIN S.Pd 7304101607120030 7304100208840003 2 1
34 SATTU 7304100112110097 7304101585730002 4 1
35 YARU 7304103011110050 7304102705490001 2 1
36 MAKAWANG 730410011211094 7304101808700002 2 1
37 SAHARING 7304100112110127 7304103112780355 4 1
38 UDIN 730410110520005 7304103112830351 2 1
BAHARING 7304103112510173 1
39 7304102908120037 5
YUPA 7304102705680002 1
40 7304103011110193 4
SAING 7304101005880001 1
41 7304100112110103 4
SITTI 7304105212620004 1
42 7304100609210001 8
BALE 7304103112830331 1
43 7304103011110096 5
ASRI 7304103112740131 1
44 7304100112110109 3
SALAEMAN 7304102711170004 6473033010950005 1
45 5
TAHANG 7304103011110289 7304100510600004 1
46 1
ARIFING 7304103011110120 7304102712800003 1
47 7
MANSYUR 7304101112170004 73041071009790005 1
48 4
SANAI 7304103011110284 7304102302840001 1
49 4
DUDDING 730410112170003 73710717018000012 1
50 2
RAMLI 7304103011110217 7304100805760001 1
51 4
SARIALANG 7304100504190002 7304106012760001 1
52 5
JUMADING 7304103011110279 7304103112680137 1
53 5
MAIDA 7304103011110094 7304106811540001 1
54 4
 DG RINGGI 7304102109210001 737107726101012 1
55 2
BULU 7304103011110278 7304100809680001 1
56 9
ISMAIL 7304101705160002 7304051507830004 3 1
57
H. HADING OPA 7304101901090001 7304103112490001 4 1
58
PINDO 730410451110002 7304101805540001 2 1
59
SALIMA 7304103011110082 7304106704560001 1 1
60
 JARAK SUMBER AIR
BELUM KE PENAMPUNGAN
TERLAYANI PENGOTOR/LIMBAH KET
> 10 M < 10 M
11 12 13 14

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
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1
1
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1
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 FORM 3.B.3 RUMAH TERLAYANI SPAM
KABUPATEN/KOTA :

KELURAHAN/ JUMLAH KONDISI EKONOMI SUDAH TERLAYANI

NO. NAMA KEPALA KELUARGA NO KK NIK ANGGOTA KELUARGA
DESA RUMAH
MBR NON MBR JP BJP
1 2 3 4 5 6 7 8 9 10
1 BUNDU "7304103011110181 "7304102010760004 3 1
2 AMNCU "7304103121110002 "730410311290382 3 1
3 RIBI "7304105012550001 "730410050345001 6 1
4 CAKE "7304103011110117 "7304101811590001 4 1
5 TATI "7304103012190003 "7304106603750001 4 1
6 CAMPA BALI "7304103105950002 "7304101603500001 10 1
7 SAMSUDDIN "7304103011110176 "7304101806690001 5 1
8 TIJA "7304100306080002 "7304107112600454 6 1
9 RUMA "7304103011110202 "7304100807500001 5 1
10 TEPU "7304103011110212 "7304101001760002 4 1
11 JUSMAN "7304103011110245 "7304102706840001 5 1
12 HAMA "7304103011110237 "7304101308660001 5 1
13 HJ NURAENI "7304104511110002 "730410506680001 4 1
14 SAING "7304103011110173 "7304100270570001 1 1
15 MANGAUPA "7304102507200004 "7304100271570002 9 1
16 ARIFING " "7304100710690001 3 1
17 SASA "7304100410002 "7304100502500001 3 1
18 BULU LALANG "7304103011110167 "7304103112460070 3 1
19 SUARDI "7304102010100001 "7304100707820001 4 1
20 SYAHARUDDIN "7304100705180006 "7304100206830001 5 1
21 ASARA "7304103011110233 "7304103112680136 5 1
22 NUR ABDUL RAHMAN "73104102704860001 2 1
23 HARIFING "7304102808180003 "7304100712900001 4 1
24 MANGSA "7304103011110165 "730410111700002 3 1
25 SEWANG "73204103011110136 "7304102706890001 3 1
26 SANAI "7304103011110078 "7304102505820001 3 1
27 RIMBU "7304103011110228 "7304103112660037 8 1
28 RYAN MEIRANDI "7304100504160001 "7304041305970001 3 1
29 SATIPA "7304101507120073 "7304107112610227 6 1
30 BAHARUDDIN "7304102007130013 "7304103112580133 3 1
31 MUH BASRI "7304101703150001 "7304100608930003 3 1
32 BASO "7304103011110130 "7304102806740001 4 1
33 RABELLA "7304103011101621 "7304101911840001 1 1
34 CU'LA "7304103011110220 "7304100507860002 9 1
35 NURDIN "7304103011110160 "7304101106820001 4 1
36 BASRI "7304103011110153 "7304101302760001 5 1
37 SALA "7304103011110098 "7304103106840004 6 1
38 KAMMISI "7304103011110282 "7304103112350441 2 1
39 UMAR "7304103011110248 "73041010086500002 3 1
40 SYAMSUDDIN "7304102011111002 "7304102701830001 2 1
41 DG CI'NO "7304103008130003 "7304107112500107 4 1
42 NASIA "7304103011110245 "7304104805130001 2 1
43 SATENG "7304101010170003 "7303012505840003 2 1
44 MUSTAFA "7304102011111002 "7304103012780001 4 1
45 SAIRI "7304102007120001 "7304103112660002 6 1
46 JUMASING "7304100809700001 "7304100809700001 4 1
47 SALASIA "7304101111060155 "7304100305500001 6 1
48 YUSUF "7304103011110251 "7304103112810472 5 1
49 SUTTARA "7304102002120003 "7304103112550104 2 1
50 NAWANG "7304103011110283 "7304101505600001 3 1
51 ARDIANSYAH "7304101007190003 "7315726068500001 5 1
52 ILAS "7304103011110124 "730410505900003 3 1
53 MUNIR "7304101812140004 "7304101810950002 4 1
54 YUSUF "7304103112910330 "7304102308180003 8 1
55 DG PATI "7304103011110099 "7304105011400001 6 1
56 BAHTIAR "7304100909080002 "7304102707720001 5 1
57 KAMMISI "7304100202200001 "7304100807720001 4 1
58 SABI "7304103011110263 "7304102505700002 5 1
59 NADI "7304100788620002 "7304101700860001 5 1
60 SABAJI "7304102210200002 "7304106510500001 3 1
61 RUSLI FENDI "7304103011110255 "7304101005860003 1 1
62 SUTTARA "7304102007120013 "73041015005640001 3 1
63 AMIR "7304103011110039 "7304102104890001 3 1
64 LEPU "73041031125100166 1
"7304101207120007 4
65 HAMMA "7304103112830329 1
"7304102304140001 2
66 NODDIN "7304101708500002 1
"7304103011110024 2
67 KIKI AMELIA "730410620710001 1
4
68 YUDDI "7304101608700001 1
"7304103011110040 4
69 SUNGGU "7304105003720001 1
4
70 ANDI FAIZAL "7304100401120003 1
6
71 BAHARU "7304101505550002 1
"7304103011110065 4
72 LOPO "7304105012500002 5 1
73 ANI "7304105708000003 7 1
74 SAHARUDDIN "7304103011110252 "730410121740001 2 1
75 BASRI "730410007150004 "7304105050790002 5 1
76 MISI "7304103011110143 "7304102311880002 5 1
77 HAMID "7304103011110088 "7304101501720001 7 1
78 RUDI "7304103011110059 "7304102505900002 9 1
79 JUSRIADI "7304105011110001 "7304102505850002 8 1
80 INDRA "7304103011110031 "7304101012880004 4 1
81 KHAIRUL "730410210910004 "7304102305800001 4 1
82 USMAN "7304102610200005 "7322103112700041 11 1
83 RAZENG "730410651111001 "7304101007820001 9 1
84 LIBA "730410301110036 "7304101003540002 3 1
 JARAK SUMBER AIR
BELUM KE PENAMPUNGAN
TERLAYANI PENGOTOR/LIMBAH KET
> 10 M < 10 M
11 12 13 14

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
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1
1
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1
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1
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 FORM 3.B.3 RUMAH TERLAYANI SPAM
KABUPATEN/KOTA :

KELURAHAN/ JUMLAH KONDISI EKONOMI SUDAH TERLAYANI

NO. NAMA KEPALA KELUARGA NO KK NIK ANGGOTA KELUARGA
DESA RUMAH
MBR NON MBR JP BJP
1 2 3 4 5 6 7 8 9 10
1 YUPA 730410301111004 7304103112600118 3 1
2 SUPRIADI 7204102509100001 7304101610940002 3 1
3 DG KANANG 7304103001090006 7304107112660298 4 1
4 DG LA'LANG 7304103011110049 7304103112660031 6 1
5 SUDDING 7304103011110064 7304103112780349 3 1
6 KARIM 7304103011110069 7304103112570112 3 1
7 RUDDING DG NGAWING 7304102707120058 7304101810500001 2 1
8 MANA 7304101408120026 7304103112660067 4 1
9 MAING 7304102407120076 7304102009034001 3 1
10 MANAI 7304100501100001 7304103112110009 4 1
11 SODDING 7304103011110029 7304103112760440 8 1
12 SODDING 7304103011110056 7304103112650401 5 1
13 DADANG DG LALLO 7304100207120034 7304100105820002 7 1
14 DADI DG CI'NONG 7304105207500001 '7304105207500001 4 1
15 HAMSAH DG TOMPO 7304102607120131 7304103112730169 1 1
16 HARIPUDDIN 7304020806860002 '7304020806860002 2 1
17 ZAINUDDIN DG TINGGI 7304103011110044 7304103112770025 6 1
18 RAMANG 7304103011110077 7304103112610470 4 1
19 H. LOLO 7304103011110045 7304103112520010 3 1
20 MUHAMMAD 7304103011110003 7304101403470002 7 1
21 YUPA 7304103011110005 730401302650001 6 1
22 YABBASA 7304103011110035 7304103112700524 5 1
23 NAWIR 7304100607170003 7304103112993101 9 1
24 PATI 7304100905160002 7304107112600481 3 1
25 MRAMLI 7304103007120028 7304101210700002 3 1
26 SIDO 7303061309130001 7306071608740003 3 1
27 RAMLI NGEWA 7304103011110022 7304103112810469 5 1
28 BAHARUDDIN 7304103011110025 7304103112650400 8 1
29 M SYAWAL 7314103011110106 7304100701490002 9 1
30 BAJI NGAI 7304102109120006 7304104203500001 3 1
31 ROHANI 7304106208790002 3 1
32 RAHIM 7304100304810001 1
7304100503200001 6
33 SAMPARA 1
7304103112730152 7304103112730152 2
34 RATIA 7304105010500001 1
730410301110060 10
35 SUTING 7606032505830001 1
7304101103200002 3
36 TASBI 1
7307113240579003 7307113240579003 2
37 SAMPARA 1
7304103122660007 7304103122660007 3
38 SAMPARA MANGE 1
7304101411540001 7304101411540001 3
39 MA'DO' TUNRU 1
7304103112410012 7304103112410012 6
40 SIORO 7304107112600407 1
7304103011110018 8
41 CU'LA' 7304100204830001 1
7304103011110060 5
42 PODDING 1
7304103112760470 7304103112760470 4
43 LIPO 7304107112600910 1
7304103011110132 5
44 SIMBUNG 7304103112736154 1
7304103011110180 3
45 DORO 7304102110660001 1
7304102907120019 5
46 JABBAR 7304103112670159 1
7304103011110142 6
47 BACO' 7304103011110010 7304103112700521 5
48 SALENG 7304103112650399 1
7304103011110007 4
49 HAKIM 7304103112870044 1
7304103011110137 2
50 YUDDIN 7304103112930190 1
7304100401220001 2
51 MICHLIS 73041051010830002' 1
7304101501140001 5
52 ALES 730410311284356 1
7304103011110017 7
53 RABANI 7304100912740001 1
7304103011110204 3
54 TAMA 730410311260079 1
7304103011110014 2
55 KOSONG 4
56 NUHUNG 7304103112640646 1
7304103011110144 2
57 MASUD 7304100505770001 1
7304103011110152 2
58 SAMA 7304103112560132 1
7304103011110123 5
59 KUMI LAU 7304103112790397 1
7304103011110174 4
60 M.SIKKI 7304103112770049 1
7304102408120006 10
61 ILYAS 7304101202190004 7372030107760171 1
4
62 1
PAKKA DG LALLO 7304101705100001 7304103112600351 5
63 1
SALLENG 7304103011110114 7304103112610114 5
64 1
DG NGAI 5
65 SAING SITA 730410301111078 7304102506680002 1
3
66 1
H.NAPI DG TINGGI 7304102506100001 7304103112740119 4
67 JAPA 704103011110183 7304103112590144 1
2
68 1
MINANG DGNGADA 7304100804190001 7304107112460169 6
69 1
SYARIFUDDIN 7304103011110095 7304103112740128 5
70 1
SAIN 7304103011110175 7304103112780351 2
71 1
KARIM 7304101500120053 7304103112670133 1
72 SALIM 7304103011110010 7304107112760388 3 1
73 ARDI 7304100308200002 7371072212930008 6 1
74 HASANUDDIN 7304101408120037 7304101907850003 7 1
75 SARIPUDDIN 2 1
76 SALI 7304102411210002 7304107112960179 4 1
77 ARIFIN 7304103011110093 7304103011800002 3 1
78 SULTAN 7304103011110203 7304103112710304 4 1
79 PANNU 7304100104430002 7304100104430002 4 1
80 SUARDI 4 1
81 BAHARUDDIN 7304103011110187 7304100408780001 4 1
82 MAU 7304103011110180 7304100505680001 5 1
83 SUDIRMAN S.Pd 7304101008120056 7304102407850003 3 1
84 KOSONG 3
85 HARUDDIN 7304100811130000 7304103010930001 5 1
86 SATI 7304103011110195 7304107112710255 7 1
87 ABD RAHIM 7304103011110191 7304100201880002 4 1
 88 NAWI 7304103011110169 7304107112600412 2 1
89 PAMMA 7304103011110075 7304103112660032 2 1
90 ARDI 7304102808180001 7304102106880004 4 1
91 SYAMSUDDIN 7304103011110171 7304103112790396 2 1
92 SAHARUDDIN 7304100209150001 7304103112890247 7 1
93 TAJUDDIN 7304103007120028 7304103010910001 5 1
94 RUMAH KOSONG 2
95 HAFID DG RANI 7304103011110098 7304103112610113 7 1
96 BARRANG DG BOMBANG 7304101508122272 7304107112630219 3 1
97 HAWANG DG BAU 7304100310110004 7304044402640001 7 1
98 KANDIRI 73041030111110119 7304103112590149 5 1
99 SAING S.Pd.I 7304103011110197 7304100910760002 3 1
100 H. KALUMA 7304103011110164 7304103112450170 5 1
101 AMIN 7304103112790401 7304103112790401 9 1
102 SYAMSIR 7304103011110080 7304101512800001 4 1
103 AMIR 7304103011110161 7304103112760443 2 1
104 ISMAIL 7304103112760470 7304103112760470 3 1
105 IRWAN 7304102504120007 7304102911830002 1 1
106 SALASA 7304103011110166 7304103112640147 2 1
107 HAKIM 7304102308120011 7304102010650002 4 1
 JARAK SUMBER AIR
BELUM KE PENAMPUNGAN
TERLAYANI PENGOTOR/LIMBAH KET
> 10 M < 10 M
11 12 13 14

1
1
1
1
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1
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1
1
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1
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 FORM 3.B.3 RUMAH TERLAYANI SPAM
KABUPATEN/KOTA :

KELURAHAN/ JUMLAH KONDISI EKONOMI SUDAH TERLAYANI

NO. NAMA KEPALA KELUARGA NO KK NIK ANGGOTA KELUARGA
DESA RUMAH
MBR NON MBR JP BJP
1 2 3 4 5 6 7 8 9 10
1 BA'DU 7304103011110276 7304102106590000 5 1
2 EDI 7304102202180003 7304100509830002 2 1
3 HABA 7304101306650001 7304101306650001 4 1
4 HAMSA 7304102307190003 7304101003890002 5 1
5 MAWANG 7304103011110221 7304101311600001 4 1
6 SAMA 7304102106620002 7304102106620001 5 1
7 RANONG 7304107103610001 3 1
8 YUSUF 7304103112880470 730410312860470 11 1
9 MILI 7304103112690001 4 1
10 CABA 7304102906710001 7304102906710001 3 1
11 HAMID 7304103011110223 7304102612750002 2 1
12 ASI LIRA 7304102308120046 7304103112790441 4 1
13 BASRI 7304103011110229 7304103112680030 2 1
14 MANTANG 730410 7304101906790001 2 1
15 M. ILYAS 7304101807160003 7304102005880001 3 1
16 BISU 730410301110230 7304101605710001 6 1
17 SUDI 73041001908920001 7304101908920001 2 1
18 SANIASA 7304103011110236 7304106308870002 4 1
19 RAMLI 7304101608170001 7304100101940001 6 1
20 JUFRI 7304101203850001 7304101203850001 7 1
21 JUMADI 7304102721603331 7304102712600001 2 1
22 SEHA 730410301110268 7304102007680003 4 1
23 TURU 7304101406690002 7304100911910001 2 1
24 NUMI 7304107112640146 73041007112640001 4 1
25 AHMAD 7304103011110244 7304103112860001 5 1
26 YAMA 7304102308120038 7304100107670008 1 1
27 SALE 7304103112610123 7304103112610134 7 1
28 ABD. LATIF 73041031126600410 7304103112650410 7 1
29 SAMSUDDIN 7304103011110249 7304101001760003 3 1
30 MASE 7304102104740001 4 1
31 SATTANI 7304100309120026 7304101001890002 4 1
32 LENTENG 7304103011110250 7304103112630001 3 1
33 MAPPA 7304103011110254 ,7304101203630001 6 1
34 BAHARUDDIN 7304103011110266 73041031112700531 5 1
35 MISENG 730410301111246 7304101806830001 8 1
36 TUMANG 7304103011110262 7304101702830002 4 1
37 AMIN 7304103011110240 7304101212750001 6 1
38 AMIRUDDIN 7304103011110240 7304103112880488 4 1
39 BORA 730410 7304101010720001 3 1
40 SANO' 730410 7304102006860001 2 1
41 MAING 730410 7304102110920002 4 1
42 RASENG 7304102110110002 7304103112700514 11 1
43 ANDI 7304101810160002 73041080309940001 4 1
44 TEPPO 730410 7304102412580001 4 1
45 BANGGU 7304103011110258 7304101304640001 8 1
46 ACA 730410 730410103730001 8 1
47 SAMA 730410 7304102106620001 4 1
48 KANANG 730410 730410200888001 6 1
 JARAK SUMBER AIR
BELUM KE PENAMPUNGAN
TERLAYANI PENGOTOR/LIMBAH KET
> 10 M < 10 M
11 12 13 14
 FORM 3.B.3 RUMAH TERLAYANI SPAM
KABUPATEN/KOTA :

KELURAHAN/ JUMLAH KONDISI EKONOMI SUDAH TERLAYANI

NO. NAMA KEPALA KELUARGA NO KK NIK ANGGOTA KELUARGA
DESA RUMAH
MBR NON MBR JP BJP
1 2 3 4 5 6 7 8 9 10
1 Fattahuddin 7304103011110177 7304102112700528 3 1
2 Yusuf 7304103011110110 730410311264014 3 1
3 Ismail 7304102804210000 7306032311870001' 4 1
4 Kane 7304100112110080 7304103112750442 6 1
5 Tumang 7304103011110196 '7304101203660002 3 1
6 Bia Dg Lo'mo 7304101508120010 7304104301740000 3 1
7 Nele 7304103011110028 7304103112560131 2 1
8 Nyenggo 7304103011110200 7304103112710303 4 1
9 Haruna Rowa 7304103011110033 7304103112400137 3 1
10 Sainuddin 7304102103130003 7304100501820006 4 1
11 Iksan Kr Ranca 7304102510110029 7304103112860194 8 1
12 Manai 7304101608100000 7304103112760426 5 1
13 Mantari 7304103011110208 7304103112760445 7 1
14 Bulu 7304103011110209 7304103112600384 4 1
15 Saharuddin 7304102408120001 7304103112630203 1 1
16 Samad 7304103011110210 7304103112760446 1 1
17 Yaling 7304103011110214 7304103112610115 5 1
18 Syamsuddin 7304103011110210 7304103112700530 4 1
19 Samsud 7304100210120016 730410028810001 5 1
20 Bsao 7304103005090094 7304100502760001 4 1
21 Jaipa 734103008120005 7304107112480010 4 1
22 Abd.Haris 7304103011110159 7304103112710300 3 1
23 Hasen 7304103011110163 7304103112830333 4 1
24 Basinong 7304103011110168 7304103112540011 5 1
25 Saing 7304102605100002 7304103112750103 4 1
26 Saipa 7304103011110179 7304107112740197 6 1
27 Yanto 7304102107090005 7304102606820001 4 1
28 Siswadi 7304101508130003 7304101006900002 4 1
29 Baharuddin 7304103011110148 7304100310600001 3 1
30 Nasrul '7304102103160001 7304030705880001 7 1
31 Marang '7304103003170001 '7304100605730001 4 1
32 Sarong 7304103011110134 '7304103112450169 3 1
33 Saeni 7304103011110131 7304103112700526 5 1
34 Sa'alla 7304101706100004 7304100204500001 5 1
35 Kamaruddin 7304100807110001 7304103112870329 2 1
36 Amiluddin, S.Pd.I 7304102812160002 7304100801890001 3 1
37 Rustam 7304103011110151 7304102107810001 4 1
38 Irwan Kr. Lagu 7304100207120028 7304103012780002 4 1
39 Raba 7304103011110073 7304107112710553 7 1
40 Sangka 7304103011110021 7304103112710297 3 1
41 Daming 7304103011110172 7304103112740131 3 1
42 Siang 7304100901190002 7371114504780009 5 1
43 Muhammad Riswan 7304102101200002 7304100809940001 1 1
44 Sauma 7304102812160001 7304107112660299 5 1
45 Saeru 7304100507180002 7304103112700525 3 1
46 Sudding 7304103011110076 7304103112680134 4 1
47 Hamsar 7304011512110008 7304010508770002 5 1
48 Manai 7304103011110038 7304103112690231 4 1
49 Sanuddin 7304103112710298 1
7304103011110054 2
50 Muhammad Asri 7305090949420001 1
7304102805180002 3
51 Sugi 7304104211480001 1
7304102409120020 4
52 Dg Lette 7304100905420001 1
7304102308120026 5
53 Kammisi 7304103112670158 1
7304103011110042 4
54 Tiang 7304103112720211 1
7304103011110058 3
55 Sampara 7304103112780350 1
7304102409120019 2
56 Rusman 7304101008880001 1
7304102407140005 3
57 Yasi 7304103112760478 1
7304101809190002 4
58 Nuru Tompo 7304103112740127 1
7304103011110051 5
59 Juga 7304103112750488 1
7304100210120021 2
60 Manong 7304107112560301 1
7304103011110109 3
61 Hamid 7304103112750490 1
7304101308130007 3
62 Sanudding 7304103112780352 1
7304103011110192 4
63 Misi 7304103112610112 1
7304103011110097 2
64 Yati 7304107112680274 1
7304102002120002 3
65 Sangki 7304103112660033 1
7304103011110091 3
66 Baso 7304103112710299 1
7304103011110079 4
67 Sappari 7304103112740129 1
7304103011110105 3
68 Iwan 7304103112880520 1
7304101408120030 5
69 Hasem 7304050607820003 1
7304101102000002 6
70 Mondo Dg Buang 7308053112510005 1
7304100705210002 4
71 Nurdin 7304052202990001 1
7304101007190004 4
 JARAK SUMBER AIR
BELUM KE PENAMPUNGAN
TERLAYANI PENGOTOR/LIMBAH KET
> 10 M < 10 M
11 12 13 14

1
1
1
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1
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1
1
 FORM 3.B.3 RUMAH TERLAYANI SPAM
KABUPATEN/KOTA :

JUMLAH KONDISI EKONOMI SUDAH TERLAYANI

NO. KELURAHAN/DESA NAMA KEPALA KELUARGA NO KK NIK ANGGOTA KELUARGA
RUMAH
MBR NON MBR JP BJP
1 2 3 4 5 6 7 8 9 10
1 Aci dg.ngawing 7304100609120009 7304102107890003 6 1
2 H.sangki 7304100112110026 7304102706400001 3 1
3 Saharuddin 7304100112110070 7304103112840360 3 1
4 Hamma 7304100112110041 7304103112870347 5 1
5 Mansyur 7304101612110002 7304103112860318 3 1
6 Risal DG.Makka 7304102306210006 7304103112800630 2 1
7 Suhardi 7304100104190005 7304102101940001 4 1
8 Mina 7304101208090009 7304105206560001 2 1
9 Tepu 7304101228010004 7304103112870340 3 1
10 Muhammad Dg.Rola 7304101612100050 7304100305870001 2 1
11 Yunus 730410061100050 7304199999999999 3 1
12 Rustan Dg.Sirua 7304107806820001 7304101806820001 2 1
13 Herman 7304100112110014 7304101705840002 5 1
14 Misa 7304100011310011 73041006903810001 3 1
15 Ludding 7304103112880001 3 1
16 H.Hading 7304100602230004 7304102103590001 4 1
17 Talle 7304100502220001 7304106111690001 2 1
18 Sonda 7304100112110076 3 1
19 Ramisa 7304100112110076 7304103112800010 4 1
20 Ngali 7304000112110079 7304103112600368 2 1
21 Mustari Buang 7304102232110002 7304103112610117 4 1
22 Malang 7304102103120001 7304106106830001 4 1
23 Bisu 7304103008120003 7304101206840003 1 1
24 Dg.Golla 7304100112110088 7303112600389003 5 1
25 Do'ding 7304100112110029 7304103010680001 4 1
26 Soda Dg.Sita 7304101308130005 7304103112720243 5 1
27 Yasang 7304103008120004 7304100104790001 4 1
28 DG.Bau 7304103008120003 7304103112480021 4 1
29 Rabasing 7304100112110155 7304102810750001 3 1
30 Sajeng 7304103008120002 7304103112770050 4 1
31 Rani Dg.Tumpu 7304101508080001 7304103112770009 5 1
32 Ramang 7304103011110277 7304101310500001 4 1
33 Rusli 7304103008120001 7304103112890276 6 1
34 Somba 7304100112110134 7304107112720289 4 1
35 Kr.Mamang 7304100112110131 7300926071112680 4 1
36 Supriadi 7304102501160001 7304101105950004 3 1
37 Banong 7304100112110125 7304105506470001 7 1
38 Herman Kr.Bonto 7304106411140000 7304100103720002 4 1
39 Kr.Baso 7304100112110123 7304100307640002 3 1
40 H.Andi Jaya 7304100112110113 7304102008750003 5 1
41 Kr.Musu 7304100112110138 7304103112650404 5 1
42 Sampara 7304100112110143 7304103112600391 2 1
43 Basing 7304100112110110 7304102108830001 3 1
44 Muh.Nasir 7304100112110142 7304103112890248 4 1
45 Momong 7304102012130004 7304102105800002 4 1
46 Sandi 7304100801200001 7304102310940003 7 1
47 Anto 7304102503190006 730410 3 1
48 Ardi Saangaji 7304101609200004 730410 3 1
49 Nasir 7304100112110086 7304103112480216 1
5
50 Riswan 7304102207190003 7304103112010285 1
1
51 Asri 7304101208090009 7304103112800010 1
5
52 Saharuddin 7304100112110140 7304100712770003 1
3
 JARAK SUMBER AIR
BELUM KE PENAMPUNGAN
TERLAYANI PENGOTOR/LIMBAH KET
> 10 M < 10 M
11 12 13 14

1
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 FORM 3.B.4 RUMAH TERLAYANI SPALD
KABUPATEN/KOTA :

AKSES
KONDISI DASAR/
AKSES
EKONOMI TANPA AKSES LAYAK AKSES LAYAK AKSES AMAN SPALD-S AKSES AMAN SPALD-T
KELUARGA PERDESAA
N
NAMA KEPALA JUMLAH
NO. KEL/DESA KELUARGA NO KK NIK ANGGOTA
RUMAH
TANGKI TANGKI TANGKI IPALD
CUBLUK TANGKI IPALD KAWASA IPALD
MBR NON BABS (PERKOTA CUBLUK SEPTIK SEPTIK MCK SEPTIK SEPTIK PERMUKI N PERKOT
MBR AN) INDIVIDU KOMUNA INDIVIDU KOMUNAL MAN TERTENT AAN
AL L AL U

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Total *)