POLITEKNIK CALTEX RIAU
BAGIAN PENGELOLAAN LABORATORIUM
Jl. Umban Sari No. 1 Rumbai, Pekanbaru - Riau 28265 | Telp: (0761) 53939
FORMULIR PEMINJAMAN
No: #3025
SURAT PERMOHONAN PEMINJAMAN LABORATORIUM
Level 1 (Reguler / Praktikum Mandiri)
| Tanggal Pengajuan | : | 06 March 2019 |
| Laboratorium & Ruangan | : | Jaringan Telekomunikasi 1 (Ruang 236) |
| Tanggal Pelaksanaan | : | 06 March 2019 s/d 08 March 2019 |
| Waktu / Jam Pelaksanaan | : | Pukul 07.00 s/d 16.00 WIB |
| Keperluan / Nama Kegiatan | : | Pengambilan data TA |
| Ketua Kegiatan | : | Syahrunni |
| No. Kontak / HP | : | Hidden |
| Daftar Anggota / Peserta | : | Syahrunni Nurul Azanna Asniyati Trifandi Wibowo Ody Rifandi Spektrum Analyzer (Ed Laboratory) : JT1/INS/SA1/2012/01, Kabel Power (Syahrunni , Nurul, Asniyati, Trifandi, Ody) Magnetic Probe : JT1/EQP/M2/2007/05-02 (Syahrunni ) Magnetic Probe : JT1/EQP/M2/2007/04-02 (Syahrunni) Konektor N to SMA 2 pcs (Nurul Azanna, Asniyati,Syahrunni) EMC Demo Board : JT1/EQP/EDB/2007/05-09(Nurul Azanna, Asniyati) Electronic Probe : JT1/EQP/E2/2007/05-05 (Asniyati) Magnetic Probe : JT1/EQP/M1/2007/05-01(Nurul Azanna) PABX : JT1/EQP/PABX/2011/04 (Nurul, Asniyati) LISN: JT1/EQP/LISN/2015/01 (Ody) Osiloskop Digital: JT1/DSO/2010/03 (Ody) Probe Osiloskop 2 pcs, Kabel Power 1 pc (ody) Fitting Lampu (Ody) Kabel N to N 2 Pcs (Trifandi Wibowo) Kabel BNC to N 1 pcs (Nurul, Asniyati) |
| Pekanbaru, 06 March 2019 | ||
| Ketua Kegiatan, | Laboran, | Kepala Laboratorium, |
| ( Syahrunni ) | ( Risky Amelia ) | ( _________________________ ) |