FORMULIR PENILAIAN KERUSAKAN BANGUNAN
ra Seon ‘uk MEER! 1 SUPIOR!
ara Banga _BANGUNAN KELAS TEXWK MES
{. MORIDO RAYA DESA MARSRAM DISTRI SUPIORI TUR KABUPATEN SUPIOR!
‘suP!oR! Proves! PAPUA,
1 2 i at :
no omen sunvononen —saruan amas | : 3 ‘ & "WOKAT ERUSANA
7 a z == = x = 3 72
+ PoNoASH Pot oto Penrnen era pac coh ers barren 2% amv angen
2 ermuxrun ro nn a0 00 on]
ae 200 009 BN cm 0m reateemtenteepentan
eo on 00 00 om |
2 Aw * 000 99 5
7 rR = a pos ae | eae
a, eases a 9 os 090 | ocx ox margarita angi n
ios = “000. 000 900 | ono
= ci ca _ [_ cS
fen = 00 a a0 | sae
7a engi ne = 000 ow ose | Se
7 ae es ‘Seeger torpor prank ncn ental maton ete | a
‘sincramanre noo orga bya pan nt £0 tte he
ian me acs nin oe
Drainase Limbah mo 1 000 0.00 0,00 900 G00 | oom
3 FSH ring aaa 808089909 0a sat
Feira Ora * 90099 0m 009 eo 00 | Hae
Ft Rene = 0 0 00 ‘300600400 | aa
5.0% Ruvak Beret