Kewajiban Memiliki Sertifikat Hapus Serangga bagi Pesawat Udara
Kewajiban Memiliki Sertifikat Hapus Serangga bagi Pesawat Udara
Kewajiban Memiliki Sertifikat Hapus Serangga bagi Pesawat Udara
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Jl. VETERAN No. 219 Telp : (061) 6941343<br />
BELAWAN 20411 FAX : (061) 6941343<br />
Kode<br />
Reg. Merk<br />
Pemilik/ Operator<br />
Owner/ Operator<br />
Nomor Penerbangan<br />
Flight Number<br />
: ………………………………………………………………………………………….<br />
: ………………………………………………………………………………………….<br />
: ………………………………………………………………………………………….<br />
Datang dari<br />
Arrival from<br />
: …………………………………..............<br />
Jam<br />
Time<br />
: _______ WIB<br />
Berangkat ke<br />
Destination<br />
Jam<br />
: ……………………………………………… : _______ WIB<br />
Time<br />
Date of provious Sertificate<br />
Tanggal <strong>Sertifikat</strong> yg lama<br />
: ……………………………….<br />
Issued at<br />
Diterbitkan di<br />
: ……….……………….<br />
No.<br />
1.<br />
2.<br />
3.<br />
4.<br />
5.<br />
6.<br />
7.<br />
8.<br />
9.<br />
Yang diperiksa<br />
Items<br />
Kabin Penumpang<br />
Pax Cabin<br />
Fasilitas Toilet<br />
Toilet Facilities<br />
Ruangan Penyimpanan Makanan<br />
Galley<br />
Palka<br />
Cargo Compartement<br />
Ruang Roda<br />
Wheel wells<br />
Peti Kemas<br />
Containers<br />
Pembuangan Kotoran Cair<br />
Excreta Disposal<br />
Pembuangan Sampah <strong>Pesawat</strong><br />
Aircraft refuse disposal<br />
Rekomendasi & Tindakan<br />
Recomendation & Measures<br />
Binatang Pengganggu<br />
Pest Infestation<br />
Mosquitoes Flies Cockroachs Rodents Other<br />
Indikasi Kehidupan <strong>Serangga</strong><br />
Insect Indication<br />
Discovered, Treated, Insect Dead , None *)<br />
Discovered, Treated, Insect Dead , None *)<br />
Discovered, Treated, Insect Dead , None *)<br />
Discovered, Treated, Insect Dead , None *)<br />
Discovered, Treated, Insect Dead , None *)<br />
Discovered, Treated, Insect Dead , None *)<br />
Discovered, Treated, Insect Dead , None *)<br />
Discovered, Treated, Insect Dead , None *)<br />
……………………………………………………………………………………………………………………………………………....<br />
……………………………………………………………………………………………………………………………………………....<br />
Signature, Name and seal<br />
Capt. Pilot<br />
Medan, …………………………. 2007<br />
Signature, Name and seal<br />
Inspector<br />
( ………………………………………….. )<br />
( ………………………………………….. )<br />
NIP : ……………………..
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