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    Surat Bebas Pelayananan Departemen

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    Husnan Abiyyu H.
    This document is a certificate stating that a student named Husnan Abiyyu Haris from the Department of Geological Engineering at Universitas Gadja Mada has no outstanding debts or obligations for any facilities at the department's library, laboratories, or other service units. The certificate is signed by officials from 12 different facilities, including the library, laboratories for sedimentology, environmental geology, exploration geophysics, and more. The certificate is provided to meet the student's graduation requirements from their undergraduate or graduate program in geological engineering.

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    Surat Bebas Pelayananan Departemen

    Uploaded by

    Husnan Abiyyu H.
    22 views2 pages
    This document is a certificate stating that a student named Husnan Abiyyu Haris from the Department of Geological Engineering at Universitas Gadja Mada has no outstanding debts or obligations for any facilities at the department's library, laboratories, or other service units. The certificate is signed by officials from 12 different facilities, including the library, laboratories for sedimentology, environmental geology, exploration geophysics, and more. The certificate is provided to meet the student's graduation requirements from their undergraduate or graduate program in geological engineering.

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    This document is a certificate stating that a student named Husnan Abiyyu Haris from the Department of Geological Engineering at Universitas Gadja Mada has no outstanding debts or obligations for any facilities at the department's library, laboratories, or other service units. The certificate is signed by officials from 12 different facilities, including the library, laboratories for sedimentology, environmental geology, exploration geophysics, and more. The certificate is provided to meet the student's graduation requirements from their undergraduate or graduate program in geological engineering.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    22 views2 pages

    Surat Bebas Pelayananan Departemen

    Uploaded by

    Husnan Abiyyu H.
    This document is a certificate stating that a student named Husnan Abiyyu Haris from the Department of Geological Engineering at Universitas Gadja Mada has no outstanding debts or obligations for any facilities at the department's library, laboratories, or other service units. The certificate is signed by officials from 12 different facilities, including the library, laboratories for sedimentology, environmental geology, exploration geophysics, and more. The certificate is provided to meet the student's graduation requirements from their undergraduate or graduate program in geological engineering.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    UNIVERSITAS GADJAH MADA - FAKULTAS TEKNIK

    UNIVERSITAS GADJAH MADA – FACULTY OF ENGINEERING


    DEPARTEMEN TEKNIK GEOLOGI
    DEPARTMENT OF GEOLOGICAL ENGINEERING
    Jl.Grafika No.2 Kampus UGM, Yogyakarta 55281 Indonesia Telp. (0274) 513668 Fax (0274) 546039
    Website: http://geologi.ugm.ac.id | E-mail: jtg.ft@ugm.ac.id

    Form 3
    SURAT KETERANGAN BEBAS PINJAM FASILITAS
    FACILITIES INDEBTEDNESS FREE FORM

    Dengan ini menerangkan bahwa mahasiswa S-1/S-2 di bawah ini :


    The undersigned below hereby certifies that the following Undergraduate/Master

    Nama : Husnan Abiyyu Haris


    Name
    NIM : 16/395080/TK/44372
    Student No.

    Telah bebas pinjam fasilitas Perpustakaan, Laboratorium dan Bagian Sarana Prasarana DepartemenTeknik Geologi, Fakultas Teknik, UGM.
    Do not have any indebtedness of facility at the library, laboratory and general facility unit in Department of Geological Engineering
    Department, Faculty of Engineering, UGM.

    No. Unit Pelayanan Fasilitas No. Agenda Seksi/Lab Nama Petugas Tanda Tangan
    (Service Fasilities Unit) (Officer Name) (Signature)
    1. Perpustakaan W.58/BP/Perp/VI/2022 Junaedi 1 √
    (Library)
    2. Sarana Prasarana W.058/BP/SP/TGL/V/2022 Riyantono 2 √
    (General facility service unit)
    3. Sedimentologi W.058/LSD/BP/VI/2022 Rizki Yudha Perdana 3 √
    (Sedimentology Lab.)
    4. Geologi Tata Lingkungan W.058/LGTL/BP/VI/2022 A. Chandra Widihermawan 4 √
    (Environmental Geology Lab.)
    5. Geofisika Eksplorasi W.058/LGFE/BP/VI/2022 Muh. Fatih Fauzi 5 √
    (Exploration Geophysics Lab.)
    6. Bahan Galian W.058/LBG/BP/VI/2022 A. Chandra Widihermawan 6 √
    (Mineral Resource Lab.)
    7. Paleontologi W.058/LPL/BP/VI/2022 Adesti Audina 7 √
    (Paleontology Lab.)
    8. Geologi Dinamik W.057/LGD/BP/VI/2022 Dwi Indriyati 8 √
    (Dynamics Geology Lab.)
    9. Geo Optik W.062/LGO/BP/VI/2022 Sariyanto 9 √
    (Optical Geology Lab.)
    10. Geokimia W.058/LGK/BP/VI/2022 Margaretha Aditya Kurnia P. 10 √
    (Geochemistry Lab.)
    11. Pusat Geologi W.058/LPG/BP/VI/2022 Margaretha Aditya Kurnia P. 11 √
    (Central Geology Lab.)
    12. Keuangan - Nanang Yuli P. 12 √
    (Finance )

    Keterangan ini diberikan untuk memenuhi persyaratan yudisium sarjana/pascasarjana di Departemen Teknik Geologi FT. UGM. Apabila di
    kemudian hari ternyata ada kesalahan maka surat keterangan ini akan ditinjau kembali.
    This information is given to meet the requirements of graduation judicium in Department of Engineering Geology FT. Should there be any
    revision, this certificate will be reviewed.

    Yogyakarta, 13 Juni 2022


    Mengetahui,
    Acknowledged,
    Ketua Departemen
    (Head of Department)

    Dr.Eng. Ir. Agung Setianto, S.T., M.Si., IPM.


    NIP.197412032002121001
    Lampiran: Histori alur persetujuan
    No Jabatan Nama Jenis Tanggal Disetujui
    KoUr Pendidikan dan RM. Pentatok Kuncoro Sri
    1 Paraf Senin, 13 Juni 2022 14:21
    Kemahasiswaan Dept. Teknik Geologi Setiyoaji, S.T. M.Sc.
    Dr.Eng. Ir. Agung Setianto,
    2 Ketua Departemen Teknik Geologi Tanda Tangan Selasa, 14 Juni 2022 05:34
    S.T., M.Si., IPM.

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