Pedoman Pengawasan Lingkungan TTU

PENGAWASANPEDOMAN LINGKUNGAN TEMPAT – TEMPAT UMUM (TTU )

I.

PENJELASAN UMUM

1.

Temp Tempat at Tem Tempa patt Umum Umum ( TTU TTU ) aa! aa!a" a" #a$ #a$a% a%aa &a%' &a%' # #e ea*a a*a% % +!e" +!e" ,a ,aa% a% – ,a ,aa% a% Peme$%ta"a%- Peme$%ta"a% Dae$a"- Sa#ta atau Pe$#e+$a%'a% &a%' me%'"a#!*a% Se#utu u%tu* atau &a%' !a%'#u%' !a%'#u%' apat pe$'u%a*a% pe$'u%a*a% +!e" umum.

/.

Pe%& Pe%&e" e"at ata% a% TTU TTU aa! aa!a" a" #e'a #e'a!a !a upa& upa&aa u%t u%tu* me% me%%' %'*a *at* t*a% a% a% a% meme! eme!"a$ "a$a *e#e"ata% *e#e"ata% !%'*u%'a% !%'*u%'a% TTU a!am $a%'*a meu0u*a% meu0u*a% e$a0at *e#e"ata% ma#&a$a*at &a%' +ptma!- me!put *e'ata% a% pe%'e%a!a% $#*+ – $#*+ *e#e"ata% a*,at *u$a%' te$pe%u"%&a *e#e"ata% a#a$- e%'a% 0a!a% pe%%'*ata% #a%ta# !%'*u%'a% ,a* paa !%'*u%'a% tempat%&a maupu% te$"aap ,e%tu* atau u0u #u,#ta%t%&a &a%' ,e$upa #*- *ma *ma a% ,+!+'# ,+!+'# te$ma#u* te$ma#u* pe$u,a"a% pe$!a*u. pe$!a*u.

II.

MAKSUD DAN TUJUAN

2

Ma*#u 3

Me%%'*at*a% Me%%'*at*a% "&'e%e #a%ta# !%'*u%'a% !%'*u%'a% #a$a%a #a$a%a a% ,a%'u%a% umum a'a$ ma#&a$a*at ma#&a$a*at apat mema%aat*a%%&a e%'a% ama% a% te$"%a$ a$ $#*+ pe%u!a$a% pe%&a*t.

2

Tu0ua% 3

Te$#e!e%''a$a%&a upa&a pe%'e%a!a% a*t+$ $#*+ !%'*u%'a% ( 45L ) a% a*t+$ $#*+ pe$!a*u ( 45P ) te$"aap *e'ata% TTU.

1

III.

7

KE6IJAKAN DAN ST5ATEGI

KE6IJAKAN

1.

Te$p Te$pa au u e%'a e%'a% % !%t !%ta# a# p$+' p$+'$a $am m a% a% L%t L%ta# a# #e*t #e*t+$ +$

/.

Kemt$ Kemt$aa% aa% e%'a% e%'a% +$'a% +$'a%#a# #a# p$+e# p$+e# ma#&a$ ma#&a$a*a a*att- +$um+$um- a#+#a a#+#a# #

8.

Da$a" Da$a"*a% *a% paa pe%%'*a pe%%'*ata% ta% mutu mutu #a$a #a$a%a %a a% ,a%'u%a ,a%'u%a% % a'a$ a'a$ meme%u" meme%u" pe$#&a pe$#&a$at $ata% a% *e#e"ata% !%'*u%'a% a% pe$u,a"a% pe$!a*u

7

ST5ATEGI

1.

Me%'em Me%'em,a%' ,a%'*a% *a% 0a$%' 0a$%'a% a% e%'a% e%'a% !%ta# !%ta# #e*t+$ #e*t+$a! a! a% !%ta# !%ta# p$+'$a p$+'$am m

/.

Me% Me%%' %'*at *at*a *a% % *ua! *ua!ta ta## Sum,e$ Sum,e$ a&a a&a ma%u# ma%u#a a ( SDM SDM )

8.

Mema Mema#& #&a$ a$*a *at* t*a% a% pe$! pe$!a* a*u u "u "up p #e"at #e"at

I9.

LANDASAN :UKUM

La%a#a% La%a#a% "u*um &a%' me%'atu$ #a$a%a tempat – tempat tempat umum- &atu 3

1.

UU N+. N+. /8 Ta"u% Ta"u% 1;;/ 1;;/ Te%t Te%ta% a%' ' Ke#e" Ke#e"at ata% a% Pa#a Pa#a!! => #e$ta #e$ta ?1 Te%t Te%ta% a%' ' Pem,a Pem,a%' %'u% u%a% a% Ke#e"ata% aa!a" u%tu* me%%'*at*a% *e#aa$a%- *emaua% a% *emampua% ,a' #etap +$a%' a'a$ te$u0u e$a0at *e#e"ata% &a%' +ptma!.

/.

UU N+. /8 Ta"u% 1;;? Te%ta%' Te%ta%' Pe%'e!+! Pe%'e!+!aa% aa% L%'*u%'a% L%'*u%'a% :up.

8.

PP N+. /? Ta"u% 1;;; Te%ta%' Te%ta%' AMDAL

@.

Pe$me%*e# N+. ;/BMe%*e#BPe$BIB1;;= Te%ta%' AMDAL 6a%' Ke#e"ata%

=.

Kepme%*e# Kepme%*e# N+. 1@=BMe%*e#B 1@=BMe%*e#BSKBI SKBIB// B// Te%ta%' Te%ta%' Pe$#&a$a*at Pe$#&a$a*at Ke#e"ata% Ke#e"ata% L%'*u%'a L%'*u%'a% % Ke$0a Pe$*a%t+$a% a% I%u#t$.

>.

Pe$a Pe$a N+. N+. 1 Ta"u% Ta"u% /1 Te%t Te%ta% a%' ' Ta$ Ta$ Pe!a Pe!a&a &a%a% %a% Ke#e"a Ke#e"ata ta% % paa paa U%t U%tBI BI%# %#ta ta!a !a# #

/

Ke#e"ata% Peme$%ta" Ka,upate% 6a%u%' !ua$ 5uma" Sa*t

9.

SASA5AN KEGIATAN

Da!am pe%'aa#a% tempat – tempat umum- #a#a$a% *e'ata%%&a- me!put 3 1.

5uma" #a*t

/.

:+te!

8.

K+!am $e%a%'

@.

Pema%a% umum

=.

6+#*+p

>.

Geu Geu%' %' pe$ pe$tu%0 u%0u*a% u*a%

?.

Pa#a$

.

Pu#a Pu#att pe$, pe$,e! e!a% a%00aa% aa%

;.

Sa$a%a a%'*ut *uta%

1.

Pa%'* %'*a# 5am,ut

11. 11.

Sa!+ Sa!+% % Kea Kea%t %t* *a% a%

1/.

Pe#a%t$e%

18. 18.

Se*+ Se*+!!a" a#a a#a$ $

1@.

O,&e* #ata

1=. 1=.

Pe$* Pe$*a% a%t+ t+$a $a% %

1>.

I%u#t$

9I.

KEGI KE GIAT ATAN AN POKO POKOK K P5OG P5OG5A 5AM M PEN PENE: E:AT ATAN AN TE TEMP MPAT AT – TE TEMPA MPAT T UMUM

Aapu% Aapu% *e'ata *e'ata% % p+*+* p+*+* &a%' "a$u# "a$u# !a*u* !a*u*a% a% a!am a!am p$+'$a p$+'$am m pe%&e"a pe%&e"ata% ta% tempat tempat – tempat umum- &atu 3



Pe%ataa% tempattempat umum 8



Pe%'aa#a% a% Pem,%aa% *ua!ta# !%'*u%'a% tempattempat umum- me!put 3



I%#pe*# #a%ta# "+te!



+

I%#pe*# #a%ta# *+!am $e%a%'

+

I%#pe*# #a%ta# pema%a% umum

+

I%#pe*# #a%ta# ,+#*+p

+

I%#pe*# #a%ta# tempat pe$,aata%

+

I%#pe*# #a%ta# pe#a%t$e%

+

I%#pe*# #a%ta# #e*+!a"

+

I%#pe*# #a%ta# #a!+%- tempat pema%'*a# $am,ut

+

I%#pe*# #a%ta# pa#a$

+

I%#pe*# #a%ta# pu#at pe$,e!a%0aa%

+

I%#pe*# #a%ta# te$m%a!- #ta#u% KA

+

I%#pe*# #a%ta# +,0e* #ata

+

I%#pe*# #a%ta# %u#t$

+

I%#pe*# #a%ta# pe$*a%t+$a% Pe%'am,!a% Pe%'am,!a% a% pe%'$m pe%'$ma% a% #ampe! #ampe! a$ a$ ,e$#",e$#"- U#ap a!ata% a!ata% U#ap U#ap u,u$  tempat tempat tempat umum



Pem,e$a% ta%a te$ata$ Pem,e$a% #e$t*at !a* #e"at (6e*e$0a #ama e%'a% Tm Pe$%a% )

@

9II.

MAAM – MAAM TEMPAT – TEMPAT UMUM

1. 5UMA: SAKIT

Pe%'e$ta%

5uma" #a*t aa!a" #a$a%a #a$a%a upa&a *e#e"ata% &a%' me%&e!e%''a$ me%&e!e%''a$a*a% a*a% *e'ata% pe!a&a%a% *e#e *e#e"a "ata ta% % #e$t #e$taa apat apat ,e$u ,e$u%' %'# # #e,a #e,a'a 'a temp tempat at pe% pe% *a *a% % te%a te%a'a 'a *e#e *e#e"a "ata ta% % a% pe%e!ta%.

Tu0ua%

1.

Meu0u*a% mutu utu *e# *e#e"ata ata% !%'*u%' u%'a% 5S &a%' a%' ,e$#" a% te$t, #e"%''a me%%'*at*a% t$a 5S.

/.

Me!% Me!%u%' u%' pa#e pa#e%%- pe%'u pe%'u%0u %0u%' %' a% a% *a$& *a$&aa aa% % #e$t #e$taa ma#&a ma#&a$a* $a*at at #e*ta #e*ta$$ 5S 5S te$" te$"% %a$ a$ a$ a$ #e'a!a *emu%'*%a% 'a%''ua% B $e#*+ &a%' ,e$a#a! a$ *e'ata% 5S- #e"%''a te$apa e$a0at *e#e"ata% &a%' +ptma!.

2

Da#a$ Pe!a*#a%aa% Pe!a*#a%aa% *e'ata% *e#e"ata% *e#e"ata% !%'*u%'a% !%'*u%'a% 5uma" Sa*t

1.

UU Ke#e Ke#e"a "ata ta% % 5I N+. N+. /8 ta"u ta"u% % 1;;/ 1;;/ te%t te%ta% a%' ' Ke#e Ke#e"a "ata ta%. %.

/.

Kepme%*e Kepme%*e## 5I NO. 1/@ 1/@ B Me%*e# Me%*e#BPe BPe$B/ $B/@ @ te%ta% te%ta%' ' Pe$#&a Pe$#&a$at $ata% a% Ke#e"at Ke#e"ata% a% L%'*u% L%'*u%'a% 'a% 5uma" Sa*t.

8.

Pe$me Pe$me%* %*e# e# 5I N+. ?1BMe ?1BMe%*e %*e#B #BPe Pe$B $BI IB1 B1;? ;? te%ta te%ta%' %' Ke,# Ke,#%'a %'a% % &a%' &a%' ,e$"u, ,e$"u,u% u%'a% 'a% e%'a% *e#e"ata%.

@.

Pe$me% Pe$me%*e# *e# N+. @1>BPe @1>BPe$BI $BIB1 B1;; ;; te%ta% te%ta%' ' S&a$ S&a$at at #&a$at #&a$at  pe%' pe%'aa aa#a% #a% Kua!t Kua!ta# a# A$. A$.

=.

Keput Keputu# u#a% a% Me%t Me%te$ e$ L%'* L%'*u%' u%'a% a% :u :up p N+. =BM =BMEN ENL: L:B1 B1/B /B1; 1;;= ;= te%t te%ta%' a%' 6a* 6a*u u Mutu Mutu =

Lm,a" a$ 6a' Ke'ata% 5S

I.

Petu%0u* Pe%'#a% 4+$mu!$ 5uma" Sa*t

1.

K+mp+%e% &a%' %!a ( K+!+m @ ) Apa,!a *e%&ataa% &a%' aa ta* meme%u" pe$#&a$ata% #e,a'ama%a te$a%tum paa *+mp+%e% &a'  %!a- ma*a %!a%&a aa!a"  ( %+! )- #e,a!*%&a apa,!a meme%u" pe$#&a$ata% ma*a %!a%&a aa!a"" #e,e#a$ %!a &a%' te$a%tum paa *+!+m =.

/.

9a$a,e! Upa&a ( K+!+m / ) Setap ,a'a% atau *e'ata% a$ a$a,e! upa&a mem!* %!a a%ta$a  ( %+! ) #ampa e%'a% 1.

8.

S*+$e ( K+!+m > ) S*+$e aa!a0 pe$*a!a% a%ta$a ,+,+t ( *+!+m 8 ) e%'a% %!a &a%' pe$+!e" ( *+!+m = ).

@.

9a$a,e! upa&a e%t!a# ( 6ut$ 1. 8 ) K"u#u# u%tu* a$a,e! upa&a e%t!a# p!" #a!a" #atu 0e%# e%t!a# &a%' #e#ua e%'a% *e%&ataa% &a%' aa a% !+*a# peme$*#aa% m%ma! paa $ua%' tu%''u pe$aata%- p+!*!%* a% pe$*a%t+$a% B am%#t$a#.

=.

9a$a,e! upa&a $ua%' $a+!+' a% pe$!%u%'a% $aa# ( ,ut$ 11= a% ,ut$ I ) 6a' $uma" #a*t &a%' ta* mem!* a#!ta# $ua%' $a+!+'& ( ,+,+t -= ) a% pe$!%u%'a% $aa# ( ,+,+t /- ) ma*a #*+$ ma*#ma! $uma" #a*t te$#e,ut ( 1. ) "a$u# *u$a%' %!a #e,e#a$ Q ( -= R 1 ) ( /- R1 ) Q /= p+%t

>.

9a$a,e! upa&a &a%' #e$a"*a% B !a*#a%a*a% p"a* !ua$ 6a' $uma" #a*t &a%' me%&e$a"*a% #e,a'a% *+mp+%e% &a%'  %!a ( *+!+m @ ) &a%' >

te$a%tum paa a$a,e! upa&a ( *+!+m / ) *epaa p"a* !ua$ a%  *e$0a*a%  !ua$ !%'*u%'a% $uma" #a*t- ma*a u%tu* a$a,e! upa&a te$#e,ut ta* te$ma#u* a!am pe%!aa% %- #e"%''a #*+$e ma*#ma! ( 1. ) "a$u# *u$a%' e%'a% #*+$e #e,a'a% *e'ata% paa a$a,e! upa&a &a%' #e$a"*a% *epaa p"a* !ua$ te$#e,ut. ?.

9a$a,e! upa&a &a%' ta* !a*u*a% peme$*#aa% U%tu* *+mp+%e% &a%' %!a ( *+!+m @ ) paa a$a,e! upa&a (*+!+m / ) &a%' ta* !a*u*a% peme$*#aa% atau pe%!aa% a!am %#pe*# $uma" #a*t. I% #e,a,*a% *a$e%a ta* te$#ea%&a a!at &a%' memaa atau petu'a# &a%' mampu me!a*#a%aa% pem$*#aa% atau *a$e%a #e,a, – #e,a, !a%%&a- ma*a u%tu* *+mp+%e% &a%' %!a te$#e,ut ta* te$pe%u" - #e"%''a #*+$e ma*#ma! ( 1. )  *u$a%' e%'a% #*+$ ma*#ma! *+mp+%e% &a%' %!a te$#e,ut.

.

9a$a,e! upa&a u%t B %#ta!a# 5.S ( 6ut$ I ) K"u#u# u%tu* a$a,e! upa&a u%t B %#ta!a# $uma" #a*t p!" #a!a" #atu *+mp+%e% &a%' %!a ( *+!+m @ ) &a%' #e#ua e%'a% *+%# $uma" #a*t &a%' pe$*#a.

1.

5uma" #a*t %&ata*a% meme%u" pe$#&a$ata% *e#e"ata% !%'*u%'a% ( M.S ) apa,!a mempe$+!e" #*+$ "a#! pe%!aa% *e#e"ata% !%'*u%'a%- #e,a'a ,e$*ut 3

a.

Se*u$a%' – *u$a%'%&a ?=  a$ #*+$ ma*#ma! &a%' aa B &a%' pe$*#a u%tu* 3 

5S Peme$%ta"- 6UMNB 6UMD Ke!a# A a% 6

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5S A65I Ke!a# I a% II

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5S Sa#ta# Ke!a# Utama a% Ma&a

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Se*u$a%' – *u$a%'%&a >=  a$ #*+$ ma*#ma! &a%' aa B &a%' pe$*#a u%tu* 3 

5S Peme$%ta"- 6UMN B 6UMD Ke!a# 

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5S A65I Ke!a# III

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5S Sa#ta Ke!a# p$atama

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Se*u$a%' – *u$a%'%&a >  a$ #*+$ ma*#ma! &a%' aa B&a%' pe$*#a u%tu* 3 

5S Peme$%ta"a% - 6UMN B 6UMD Ke!a# D

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5S A65I Ke!a# I9. ?

De'a% atata% #*+$e m%ma! u%tu* ma#%' – ma#%' a$a,e! upa&a aa!a" #epe$t te$#e,ut paa ta,e! ,e$*ut 3 TPE KELAS 5S

SKO5E MINIMAL DA5I MASING – MASING UPAA9A5IA6EL DALAM (  ) I

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Kete$a%'a% 3 ) T&pe 5S &a%' #et%'*at

/. Ke#mpu!a% "a#! pe%!aa% te$#e,ut  ata# ta* te$ma#u* a$a,e! – a$a,e! upa&a #e,a' ,e$*ut 3

a.

9a$a,e! upa&a VVVVVVVVVVVVVVVVVVVVVVVV atau &a%' me!put *+mp+%e% &a%' %!a (VV)VVVVVVVVVVVVVVVVta* "a$u# !a*u*a% peme$*#aa% atau pe%!aa% *a$e%aVVVVVVVVVVVVVVV..

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9a$a,e! upa&a VVVVVVVVVVVVVVVVVVVVVVVVVVV..atau &a%' me!put *+mp+%e% &a%' %!a (VV..) VVVVVVVVVVVVVV.ta* "a$u# !a*u*a% peme$*#aa% atau pe%!aa% *a$e%aVVVVVVVVVVVVVVV..

.

9a$a,e! upa&a VVVVVVVVVVVatau &a%' me!put *+mp+%e% &a%' %!a

A

(VV..) VVVVVVVVVVVVVVV*a$e%aVVVVVVVVVVVVV. Kete$a%'a% 3 (VV) # %+m+$ a$a,e! upa&a atau *+mp+%e% &a%' %!a - tetap ta* !a*u*a% !ap+$a% pe%!aa%.

8. Sa$a% – #a$a% atau $e*+me%a# a)VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVVVVVVVVVVVVVVVVVV ,)VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVVVVVVVVVVVVVVVVV.. )VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVVVVVVVVVVVVVVVVVV. #tVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVVVVVVVVVVVVVVVVV.

*e#mpu!a% "a#! pe%!aa% peme$*#aa% *e#e"ata% !%'*u%'a% $uma" #a*t me$upa*a% !ap+$a% &a%' "a$u# ta%a ta%'a% +!e" Kepa!a D%a# Ke#e"ata% P$+%# Ka,upate% B *+ta.

;

/. INDUST5I

Pe%'e$ta% 

I%u#t$ aa!a" #etap ,e%tu* u#a"a &a%' mempe$*e$0a*a% pe*e$0a e%'a% me%a$ !a,a atau ta*- ,a* m!* #a#ta maupu% m!* Ne'a$a.

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Da!am

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me!,at*a%

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ma%u#a

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a*tta#

p$+u*tta#%&a- &a%' #e,ut te%a'a *e$0a- Te%a'a Ke$0a aa!a" #etap +$a%' &a%' mampu me!a*u*a% pe*e$0aa%%&a ,a* a!am maupu%  !ua$ "u,u%'a% *e$0a- 'u%a me%'"a#!*a% 0a#a atau ,a$a%' u%tu* meme%u" *e,utu"a% ma#&a$a*at%&a

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Tempat Ke$0a aa!a" tap $ua%'a% B !apa%'a%- te$tutup B te$,u*a- ,e$'e$a* atau tetapatau &a%' #e$%' ma#u* te%a'a *e$0a u%tu* *epe$!ua% #uatu u#a"a a% ma%a #um,e$ atau #um,e$ #um,e$ ,a"a&a%&a.

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NA6 ( N!a Am,a%' 6ata# ) aa!a" #ta%a$ a*t+$ – a*t+$ !%'*u%'a%*e$0a &a%' a%0u$*a%  tempat *e$0a a'a$ te%a'a *e$0a ma#" apat me%e$ma%&a ta%pa me%'a*,at*a% pe%&a*t atau 'a%''ua% *e#e"ata%- a!am pe*e$0aa% #e"a$ "a$ u%tu* a*tu ta* me!e,"  0am #e"at atau @ 0am #em%''u

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APD aa!a" a!at pe!%u%' $ #e,a'a pe$!e%'*apa% &a%' 'u%a*a% u%tu* me!%u%' te%a'a *e$0a a$ ,a"a&a !%'*u%'a% *e$0a ,a$upa 3 tutup "u%'- mu!ut$e#p$at+$- *aa mata- pa*aa% *e$0a *"u#u# te$ma#u* #epatu- #a$u%' ta%'a%- tutup *epa!a a% !a% – !a%.

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P$+u*# 6e$#" aa!a" pe%e$apa% +%t%ue #t$ate' pe%'e!+!aa% !%'*u%'a% &a%' ,e$#at p$ee%t a% te$%te'$a# paa p$+#e# a% p$+u* #e"%''a m%'u$a%' $#*+ 1G

te$"aap ma%u#a a% !%'*u%'a% ( e+!+'a! a!ue ae ).

Tata La*#a%a Ke#e"ata%  L%'*u%'a% I%u#t$

a.

A$ 6e$#" 

A$ ,e$#" u%tu* *epe$!ua% %u#t$& apat pe$+!e" a$ PAM- #um,e$ a$ ta%a" atau #um,e$ !a%%&a &a%' te!a" +!a" #e"%''a meme%u" #&a$at *e#e"ata%

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Te$#ea%&a a$ ,e$#" u%tu* *e,utu"a% *a$&aa% #e#ua e%'a% pe#&a$ata% *e#e"ata%

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D#t$,u# a$ ,e$#" a% #a$a%a a$ ,e$#" "a$u# ,e,a# a$ pe%ema$a% #um,e$ #* *ma a% ,a*te$+!+'#

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D!a*u*a% pe%'am,!a% #amp!e a$ ,e$#" paa #um,e$- ,a* pe%ampu%'a% a% paa *$a% te$0au" pe$*#a  !a,+$at+$um m%ma! / *a! #eta"u%- &atu paa mu#m *ema$au a% mu#m "u0a%.

,.

Ua$a 5ua%'a%

1.

Su"u a% Ke!em,a,a%

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T%'' !a%'t – !a%'t a$ !a%ta /-= m

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6!a #u"u ua$a n 8 o  pe$!u me%''u%a*a% a!at pe%ata ua$a #epe$t A- Kpa# a%'%- !!.

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6!a #u"u ua$a !ua$  1o pe$!u me%''u%a*a% a!at pema%a# $ua%' ( "eate$ )

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6!a !eme,a,a% ua$a $ua%' *e$0a n ;=  pe$!u me%''u%*a% a!at e"ume$

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6!a *e!em,a,a% ua$a $ua%' *e$0a  >= pe$!u me%''u%a*a% "ume$- m#a!%&a 3 me#% pem,e%tu* ae$+#+!.

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De,u

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Paa #um,e$ !e%'*ap e%'a% pe%a%'*ap e,u

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U%tu* me%a%'*ap e,u &a%' tm,u! a*,at p$+#e# p$+u*#- pe$!u pa#a%' e%t!a# !+a! ( !+a! eR"au#te$ ) &a%' "u,u%'*a% e%'a% e$+,+%' a% !e%'*ap e%'a% 11

pe%&a$%' e,u ( !te$ ) 

5ua%' p$+#e# p$+u*# pa#a%' !u# e%t!a# ( mema#u**a% ua$a #e'a$ )

8.

Pe$tu*a$a% ua$a

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Mema#u**a% ua$a #e'a$ u%tu* me%apa pe$#&a$ata% NA6 e%a% me%''u%a*a% e%t!a# B A

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Ke,utu"a% #up!a& ua$a #e'a$ 1 !t B +$a%' B et*

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Mem,e$#"*a% #a$%' B !te$ ua$a A #ea$a pe$+ #e#ua *ete%tua% pa,$*.

@.

Ga# Pe%ema$

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Paa #um,e$ pa#a%' "++ ( pe%a%'*ap 'a# ) &a%' "u,u%'*a% e%'a% !+a! eR"au#te$ a% !e%'*ap e%'a% !te$ pe%a%'*ap 'a#

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Me!e%'*ap $ua%' p$+#e# p$+u*# e%'a% pe%a%'*ap 'a#

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D!e%'*ap e%'a% #u!a& ua$a #e'a$

=.

M*$+,a

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U%tu* %u#t$& &a%' ,e$p+te%# me%ema$ ua$a e%'a% m*$,a- a'a$ !e%'*ap e%'a% e%t!a# B A e%'a% ##tm #a$%'a% ua$a ,e$t%'*at u%tu* me%a'*ap m*$+,a atau upa&a e#%e*# e%'a% #%a$ u*t$a +!et atau ,a"a% *ma.

.

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Meme!"a$a #&#tem e%t!a# a'a$ ,e$u%'# e%'a% ,a*

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Meme!"a$a #&#tem A #e%t$a!.

Lm,a"

1.

Lm,a" Paat



Me!a*u*a% e%tta# #um,e$ !m,a" a% pe%'e!+mp+**a%%&a

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Lm,a" $a+a*t *e!+!a #e#ua pe$atu$a% pe$u%a%'a% &a%' ,e$!a*u

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Lm,a" paat apat ma%aat*a% *em,a! e%'a% pe%'+!a"a% au$ u!a%' a% 1/

pema%aata% #e,a'a% aa$ p#a"*a% e%'a% !m,a" paat &a%' %+% 68 

Lm,a" 68 *e!+!a *e tempat pe%'+!a"a% !m,a" 68 #e#ua e%'a% pe$atu$a% pe$u%a%'a% u%a%'a% &a%' ,e$!a*u- a$a pe%&mpa%%&a 3 2

68 ,e$#at #ta,! 0a ta* ,+!e" #mpa% ,e$#ama #ama e%'a% atau ,e$e*ata% e%'a% *+mp+%e% #a%a

2

Pe%&mpa%a% 68 e*at e%'a% p$+#e#- 0a &a%' ,e$,ea #at B &a%' apat ,e$ea*# "a$u# 0au"*a%

2

Waa" 68 "a$u# #e!a!u te$tutup "a$u# e* #ea$a te$atu$

2

5ua%'a% pe%&mpa%a%%&a "a$u# #e!a!u #e0u*- mempu%&a e%t!a# &a%' u*up- 0au" a$ pe$*a% ap

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Pem,e$a% !a,e! a% #&m,+! !m,a" 68

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Lm,a" a$

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Me!a*u*a% e%t*a# #um,e$ !m,a" a$

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Me!a*u*a% a%a!#a !a,+$at+$um B pema%taua% #e#ua #ta%a$- +*ume% UKL  UPL

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Sa!u$a% !m,a" a$ "a$u# *eap a$- te$tutup- !m,a" a$ apat me%'a!$ e%'a% !a%a$ a% ta* mem,u!*a% ,au



Semua !m,a" a$ "a$u# !a*u*a% pe%'+!a"a% #*- *ma- atau ,+!+'# #e#ua *e,utu"a%

.

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Me%'u$a%' !m,a" a$ #um,e$%&a

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Me!ap+$*a% UKP  UPL *epaa %#ta%# te$*at

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Pe%a"a&aa%

Pe%a"a&aa% a!am maupu% ,uata% upa&a*a% a'a$ ta* me%m,u!*a% *e#!aua% a% mem!* %te%#ta# #e#ua e%'a% pe$u%tu*a%

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K+%t$a# #e#ua *e,utu"a%- "%a$*a% te$0a%&a *e#!aua% atau ,a&a%'a%

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U%tu* $ua%' *e$0a &a%' me%''u%a*a% !ampu %e+%

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Pe%empata% ,+!a !ampu apat me%'"a#!*a% pe%&%a$a% &a%' +ptmum a% ,!a !ampu #e$%' ,e$#"*a%

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6+!a !ampu &a%' mu!a ta* ,e$u%'# e%'a% ,a* #e'e$a ' a%t 18

e.

Ke,#%'a%



Pe%'atu$a% tata !eta* "a$u# #eem*a% $upa a'a$ te$"%a$ a$ *e,#%'a%

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Sum,e$ ,#%' apat *e%a!*a% e%'a% a$a me$eam- me%&e*at- pem%a"a% peme!"a$aa%- pe%a%ama% p+"+%- pe%%''a% tem,+*- mem,uat ,u*t ,uata%- !!.

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5e*a&a#a pe$a!ata%



D"%a$ e%'a% a$a ta"a% B *u$a%' a$ #um,e$%&a- apat me%''u%a*a pe%a"a% ,u%& ( ,a$$e$ ) pe%&e$ap ,u%&- pe$eam ,$a#- pe%'#+!a# ,$a# a% pe%a"a% ,u%&. Me!%u%' pe%e%'a$a% a$ *e,#%'a%.



.

Geta$a%



Me!e%'*ap $ua%'a% *e$0a e%'a% pe$eam 'eta$



Mempe$,a* a% meme!"a$a #&#tem pe%a"a% 'eta$a%



Me%'u$a%' 'eta$ paa #um,e$%&a e%'a% mem,e$ ,a%ta!a% paa #um,e$%&a



Me%''u%a*a% pe$a!ata% *e$0a &a%' $e%a" %te%#ta# 'eta$a%%&a ( !e%'*ap e%'a% amp%' B pe$eam ) Ma%am," B me%&#p*a% amp%' a%ta$a ta%'a% a% aat- m#a!%&a mem,a!ut



pe'a%'a% a!at e%'a% *a$et Pe%'u$a%'a%- papa$a% apat !a*u*a% e%'a% me%''u%a*a% #a$u%' ta%'a% &a%'



te!a" !e%'*ap e%'a% #a$u%' ta%'a% &a% te!a" !e%'*ap e%'a% pe$eam 'eta$ ( ,u#a )

'.

5aa#



Pe%e'a"a% te$"aap $aa# mea% !#t$*



Me$a%a%' %#ta!a# &a% #e#ua e%'a% pe$atu$a% pe$u%a%'a% &a%' ,e$!a*u



Me%&ea*a% a!at pe!%u%' ( #+!a# ) $aa# paa #um,e$



Pe%e'a"a% te$"aap $aa# mea% !#t$*

1@

".



9e*t+$ Pe%&a*t

Pe%'e%a!a% #ea$a #* 3 +

K+%#t$u*# ,a%'u%a% ta* memu%'*%*a% ma#u* a% ,e$*em,a%' ,a*%&a et+$ a% $e#e$+$ pe%&a*t *ea!am $ua%' *e$0ae%'a% mema#a%' a!at &a%' apat me%e'a" ma#u*%&a #e$a%''a a% t*u#

+

Me%0a'a *e,e$#"a% !%'*u%'a%- #e"%''a ta* te$0a pe%umpu*a% #mapa" a% ##a ma*a%a%

+

Me%0a'a *e,e$#"a% !%'*u%'a%- #e"%''a ta* te$0a pe%umpu*a% #ampa" a% ##a ma*a%a%



+

Pe%a'tu$a% pe$a!ata% a% a$#p #ea$a te$atu$

+

Me%aa*a% tempat pe$%u*a% #e$a%''a a% t*u#

Pe%'e%a!a% e%'a% ,a"a% *ma &atu me!a*u*a% pe%&emp$+ta%- pe%'a#apa%mema#a%' umpa%- mem,u,u"*a% a,ate paa tempat pe%ampu%'a% a$



Pe%'ea!a% pe%0amu e%'a% !#t$* $e*ue%# t%''



a$a me*a%* e%'a% mema#a%' pe$a%'*ap

.

5ua%'  6a%'u%a%

a.

Ke,e$#"a% pa,$* apat t%'*at*a% e%'a% me!a*u*a% pe%'aa#a% te$"aap #etap p$+#e# pe%'e$0aa% a'a$ ta* te$0a pe%umpa"a% at – at *ma- a% pem,uata% !a$uta% &a%' ,e$!e,"a%

,.

Ke,e$#"a% pa,$* 0u'a pe$a%a% pe%t%' a!am me%'u$a%' ,e,a% pe%ema$a% #amp%' apat me%'u$a%' pem,+$+#a%.

.

Dpe$*$a*a% ,a"a *e,e$#"a% pa,$* &a%' ,a* apat me%'u$a%' pe%ema$a% #ampa =  1.

.

U%tu* mempe$mua" me%e$ap*a% "+u#e *eep%' ( e#e%# *e$0a- p$+u*tta# *e$0a pem,+$+#a%- *ua!ta# *e$0a- *e#e!amata% *e$0a )-  !%'*u%'a% *e$0a- *+%#ep = 5 ( $%'*a#- $ap- $e#*- $aat a% $a0% ).

1=

0.

T+!et

T+!et "a$u# ,e$#"*a% m%ma! / *a! #e"a$ a% ta* me%0a tempat ,e$*em,a%' ,a*%&a #e$a%''a atau t*u#.

*.

I%#ta!a#

a.

I%#ta!a# u%tu* ma#%' – ma#%' pe$u%tu*a% #e,a*%&a me%''u%a*a% *+e a$%a a% !a,e!

,.

Dupa&a*a% a'a$ ta* te$0a "u,u%'a% #!a%' a% a!$a% ,a!* a%ta$a 0a$%'a% #t$,u# a$ !m,a" e%'a% a$ ,ae$#" #e#ua e%'a% *ete%tua% &a%' ,e$!a*u.

.

Ja$%'a% %#ta!a# a'a$ tata #eem*a% $upa a'a$ meme%u" #&a$at e#tet*a- ta* me%0a tempat pe$%u*a% #e$a%''a a% t*u#

.

Pe%'+pe$a#a% %#ta!a# #e#ua e%'a% p$+#eu$ tetap &a%' te!a" te%tu*a%

e.

K+%#t$u*# %#ta!a# upa&a*a% a'a$ #e#ua e%'a% #ta%a$ e#a% &a%' ,e$!a*u.

PE5ALATAN

Pe$a!ata% &a%' 'u%a*a% a!am *e'ata% % aa!a" #e,a'a ,e$*ut 3 NO

NAMA ALAT

4UNGSI

1

Te$m+mete$

A!at pe%'u*u$ #u"u ua$a

/

:&'$+mete$

A!at pe%'u*u$ *e!em,a,a% ua$a

8

LuRmete$

A!at pe%'u*u$ pe%Ja"a&aa%

@

N+#e L+''%' e#mete$

A!at pe%'u*u$ *e,#%'a%

=

Se%te$

A!at ,a%tu pe%e$a%'a% peme$*#aa% 0e%t*

>

ame$a

A!at u*ume%ta#

?

4+$mat aut #a%ta#

T++!# u%tu* aut #a%ta# %u#t$



4+$mat $e*aptu!a#

Me%Jatat "a#! pe%'u*u$a% *ua!ta# !%'*u%'a% ,e$a#a$*a% tt* !+*a#

1>

5INIAN KEGIATAN 1.

Pe$#apa%

2

Pem,uata% #u$at tu'a#.

2

Pe%''a%aa% +$m %#pe*# #a%ta# %u#t$ a% +$mat+$mat pe!e%'*ap ( SPJ9#um- 4+$mat "a#! pe%'u*u$a%- !ap+$a% "a#! peme$*#aa% #eme%ta$a- 6e$ta Aa$a Pe%+!a*a%).

2

Pe$#apa% a!at pe%'u*u$a% *ua!ta# !%'*u%'a% ( te$m+mete$- "&'$+mete$- S+u% Lee!mete$- LuRmete$) a% +*ume%ta#.

/.

2

Pem,uata% #u$at pem,e$ta"ua% *e %u#t$ a% Pu#*e#ma#.

2

Pe%&u#u%a% 0aa! *e'ata%.

2

Pe%&aa% pem,e$ta"ua% $e%a%a *e'ata% *e %u#t$ a% Pu#*e#ma#.

2

Pe!a*#a%aa%

Aut #a%ta# me%''u%a*a%

4+$m / I% #e#ua

1@=BMe%*e#BSKBIB/?

te%ta%'

Keputu#a% Me%te$ Ke#e"ata% N+m+$ 3

Pe$#&a$ata%

Ke#e"ata%

L%'*u%'a%

Ke$0a

Pe$*a%t+$a% a% I%u#t$ (+$m te$!amp$).

2

Aut #a%ta# aa!a" *e'ata% u%tu* me%!a *eaaa% #uatu #a$a%a #a%ta# a#a$ atau !%'*u%'a% %u#t$ ,a* #*- *ma maupu% ,+!+' 'u%a me%'eta"u ,e$apa ,e#a$ *emu%'*%a% #a$a%a atau !%'*u%'a% te$#e,ut pe%'a$u" +!e" !%'*u%'a%%&a #e"%''a a*a% me%'a*,at*a% *e#e"ata% ma#&a$a*at me%u$u% a% apat mem,e$*a% %+$ma# #e% mu%'*% pe%ema$a% &a%' #e,a,*a% +!e" *e'ata% ma%u#a atau ma"*!u* !a%%&a

2

I%u#t$ %&ata*a% meme%u" pe$#&a$ata% *e#e"ata% !%'*u%'a% (MS) apa,!a mempe$+!e" #*+$e "a#! pe%!aa% peme$*#aa% *e#e"ata% !%'*u%'a% #e*u$a%' 1?

*u$a%'%&a  (e!apa% pu!u" pe$#e%) e%'a% pe$+!e"a% #*+$e m%ma! paa ma#%'ma#%' a$a,e! upa&a #e,a'a ,e$*ut 3

NO 1 / 8 @ = > ?  ; 1 11 1/ 2

9A5IA6EL UPAA L%'*u%'a% !ua$B"a!ama% 5ua%' ,a%'u%a% Pe%&e"ata% a$ ,e$#" Pe%&e"ata% uaa$a $ua%' Pe%'e!+!aa% #ampa"  !m,a" Pe%Ja"a&aa% Ke,#%'a% paa $ua%' *e$0a Geta$a%  $ua%' *e$0a 5aa#  $ua%' *e$0a Pe%'e%a!a% e*t+$ pe%&a*t I%#ta!a# Peme!"a$aa% t+!et

SKO5E MINIMAL (? T) > >  ? ? > 1 1 ?=  ? =

D!a*u*a% pe%'u*u$a% *ua!ta# !%'*u%'a% ,e$a#a$*a% *eputu#a% Me%te$ Ke#e"ata% 5epu,!* I%+%e#a N+m+$3 1@=BMENKESBSKBIB// te%ta%' Pe$#&a$ata% Ke#e"ata% L%'*u%'a% Ke$0a Pe$*a%t+$a% a% I%u#t$- &atu Su"u*e!em,a,a%- *e,#%'a% a% pe%a"a&aa%

2

8. 2

Pe%'+!a"a% ata

Pe!ap+$a%

Pe%&u#u%a% !ap+$a% "a#! *e'ata%.

1A

8. :OTEL

a. Pe%'e$ta% :+te! :+te! aa!a" 0e%# a*+m+a# &a%' mempe$'u%a*a% #e,a'a% atau #e!u$u" ,a'u%a% u%tu* me%&ea*a% 0a#a pe!a&a%a% pe%'%apa%- &a%' *e!+!a #ea$a *+me$#! &a%' me!put "+te! me!at a% "+te! ,e$,%ta%'.

,. Je%# :+te! 2

:+te! ,e$,%ta%' aa!a" 0e%# a*+m+a# &a%' mempe$'u%a*a% #e,a'a% atau #e!u$u" ,a%'u%a% u%tu* me%&ea*a% 0a#a pe!a&a%a% pe%'%apa%- ma*a%- m%um #e$ta 0a#a !a% ,a' umum.

2

:+te! me!at aa!a" 0e%# a*+m+a# &a%' mempe$'u%a*a% #e,a'a% atau #e!u$u" ,a%'u%a% &a%' *"u#u# #ea*a% u%tu* mempe$+!e" 0a#a pe!a&a%a% pe%'%apa%.

. Pe$a!ata%

NO

NAMA ALAT

4UNGSI

1

Te$m+mete$


/

:&'$+mete$


8

LuRmete$

A!at pe%'u*u$ pe%a"a&aa%

@

N+#e L+''%' e#mete$

A!at pe%'u*u$ *e,#%'a%

=

Se%te$


>

ame$a


?


T++!# u%tu* aut #a%ta# "+te!




Me%atat "a#! pe%'u*u$a% *ua!ta#

1;

/G

PETUNJUK

PENGISIAN

4O5M

DAN

PENETUAN

LAIK

SE:AT

:OTEL

6E56INTANG

1. K+mp+%e% &a%' %!a ( *+!+m @ ) Apa,!a *e%&ataa% &a%' aa ta* meme%u" pe$#&a$ata% #e,a'ama%a te$a%tum paa *+mp+%e% &a%' %!a- ma*a %!a%&a aa!a"  ( %+! )- #e,a!*%&a apa,!a meme%u" pe$#&a$ata% ma*a %!a%&a aa!a" #e,e#a$ %!a &a%' te$a%tum paa *+!+m =.

/. 9a$a,e! Upa&a ( *+!+m / ) Setap ,a'a% atau *e'ata% a$ a$a,e! upa&a mem!* %!a a%ta$a ( %+! ) #ampa e%'a% 1.

8. S*+$e ( *+!+m > ) S*+$e aa!a" pe$*a!a% a%ta$a ,+,+t ( *+!+m 8) e%'a% %!a &a%' pe$+!e" ( *+!+m = ).

KESIMPULAN :ASIL PENILAIAN PEME5IKSAAN KESE:ATAN LINGKUNGAN :OTEL 6E56INTANG

1. :+te! ,e$,%ta%' %&ata*a% LAIK SE:AT apa,!a mempe$+!e" %!a #e*u$a%' – *u$a%'%&a ?=  e%'a% atata% #*+$e m%ma! u%tu* ma#%' – ma#%' a$a,e! u%tu* ma#%' – ma#%' a$a,e! upa&a aa!a" #epe$t ta,e! ,e$*ut % 3

I

9A5IA6EL UPAA II III

I9









/1

PETUNJUK PENGISIAN 4O5M DAN PENENTUAN LAIK SE:AT :OTEL MELATI

1. K+mp+%e% &a%' %!a ( K+!+m @ ) Apa,!a *e%&ataa% &a%' aa ta* meme%u" pe$#&a$ata% #e,a'ama%a te$a%tum paa *+mp+%e% &a%' %!a- ma*a %!a%%&a aa!a"  (%+! )- #e,a!*%&a apa,!a meme%u" pe$#&a$ata% ma*a %!a%&a aa!a" #e,e#a$ %!a &a%' te$#%tum paa *+!+m =.

/. 9a$a,e! upa&a ( *+!+m /q) Setap ,a'a% atau *e'ata% a$ a$a,e! upa&a mem!* %!a a%ata$a ( %+! ) #ampa e%'a% 1.

8. S*+$e ( *+!++m > ) S*+$e aa!a" pe$*a!a% a%ta$a ,+,+t ( *+!+m 8 ) e%'a% %!a &a%' pe$+!e" ( *+!+m = )

KESIMPULAN

:ASIL

PENILAIAN

PEME5IKSAAN

KESE:ATAN

LINGKUNGAN :OTEL MELATI

1. :+te! ,e$,%ta%' %&ata*a% LAIK SE:AT apa,!a mempe$+!e" %!a #e*u$a%' – *u$a%'%&a ?= e%'a% atata% #*+$e m%ma! u%tu* ma#%' – ma#%' a$a,e! upa&a aa!a" #epe$t ta,e! ,e$*ut 3

I


I9









//

@. KOLAM 5ENANG DAN PEMANDIAN UMUM

. Pe%'e$ta% K+!am 5e%a%' a% Pema%a% Umum

2

K+!am $e%a%' aa!a" #uatu u#a"a ,a' umum &a%' me%&ea*a% tempat u%tu* ,e$e%a%'- ,e$e*$ea#- ,e$+!a" $a'a- #e$ta 0a#a pe!a&a%a% !a%%&a- me%''u%a*a% a$ ,e$#" &a%' te!a" +!a" .

2

Pema%a% Umum aa!a" #uatu u#a"a ,a' umum &a%' me%&ea*a% tempat u%tu* ma%- ,e$e*$ea#- ,e$+!a" $a'a #e$ta 0a#a pe!a&a%a% !a%%&a- me%''u%a*a% a$ ta%pa pe%'+!a"a% te$!e," a"u!u atau ta* te$ma#u* u%tu* pe%'+,ata%.

.

Pe$a!ata%

NO

NAMA ALAT

4UNGSI

1

Te$m+mete$


/

:&'$+mete$


8

LuRmete$


@

N+#e L+''%' e#mete$

A!at pe%'u*u$ *e,#%'a%

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T++!# u%tu* aut #a%ta# *+!am $e%a%' pema%a% umum

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Me%atat "a#! pe%'u*u$a% *ua!ta# !%'*u%'a% ,e$a#a$*a% tt* !+*a#

A. 5%a% Ke'ata%

1. Pe$#apa%

/8

'.


". Pe%''a%aa% +$m %#pe*# #a%ta# *+!am $e%a%' pema%a% umum a% +$mat

+$mat pe!e%'*ap ( SPJ- 9#um- 4+$mat "a#! pe%'u*u$a%- !ap+$a% "a#! peme$*#aa% #eme%ta$a- 6e$ta Aa$a Pe%+!a*a%). (.


0.

Pem,uata% #u$at pem,e$ta"ua% *e *+!am $e%a%'  pema%a% umum a% Pu#*e#ma#.

*.


!.

Pe%&aa% pem,e$ta"ua% $e%a%a *e'ata% *e *+!am $e%a%'pema%a% umum a% Pu#*e#ma#.

/. Pe!a*#a%aa% 2 2

Aut #a%ta# me%''u%a*a% (+$m te$!amp$). Aut #a%ta# aa!a" *e'ata% u%tu* me%!a *eaaa% #uatu #a$a%a #a%ta# a#a$ atau !%'*u%'a% *+!am $e%a%'B pema%a% umum ,a* #*- *ma maupu% ,+!+' 'u%a me%'eta"u ,e$apa ,e#a$ *emu%'*%a% #a$a%a atau !%'*u%'a% te$#e,ut pe%'a$u" +!e" !%'*u%'a%%&a #e"%''a a*a% me%'a*,at*a% *e#e"ata% ma#&a$a*at me%u$u% a% apat mem,e$*a% %+$ma# #e% mu%'*% pe%ema$a% &a%' #e,a,*a% +!e" *e'ata% ma%u#a atau ma"*!u* !a%%&a.

8. Pe%utup 2

Pe%&u#u%a% !ap+$a% "a#! *e'ata%

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=. 6IOSKOP  GEDUNG PE5TUNJUKAN

a. Pe%'e$ta% 6+#*+p a% Geu%' Pe$tu%0u*a%

2

6+#*+p aa!a" #uatu tempat te$ma#u* a#!ta#%&a ma%a umum apat me%*mat pe$tu%0u*a%  tempat te$#e,ut.

2

Geu%' pe$tu%0u*a% aa!a" #uatu tempat te$ma#u* a#!ta#%&a ma%a umum apat me%*mat pe$tu%0u*a%  tempat te$#e,ut.

,. Pe$a!ata%

NO

NAMA ALAT

4UNGSI

1

Te$m+mete$


/

:&'$+mete$


8

LuRmete$


@

N+#e L+''%' e#mete$

A!at pe%'u*u$ *e,#%'a%

=

Se%te$


>

ame$a


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T++!# u%tu* aut #a%ta# ,+#*+p

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A. 5%a% Ke'ata%

1. Pe$#apa% J.


. Pe%''a%aa% +$m %#pe*# #a%ta# ,+#*+p a% +$mat+$mat pe!e%'*ap ( SPJ-

/=

9#um- 4+$mat "a#! pe%'u*u$a%- !ap+$a% "a#! peme$*#aa% #eme%ta$a- 6e$ta Aa$a Pe%+!a*a%). e.


.

Pem,uata% #u$at pem,e$ta"ua% *e ,+#*+p

'.


". Pe%&aa% pem,e$ta"ua% $e%a%a *e'ata% ,+#*+p

/. Pe!a*#a%aa% 2

Aut #a%ta# me%''u%a*a% (+$m te$!amp$).

2

Aut #a%ta# aa!a" *e'ata% u%tu* me%!a *eaaa% #uatu #a$a%a #a%ta# a#a$ atau !%'*u%'a% ,+#*+p ,a* #*- *ma maupu% ,+!+' 'u%a me%'eta"u ,e$apa ,e#a$ *emu%'*%a% #a$a%a atau !%'*u%'a% te$#e,ut pe%'a$u" +!e" !%'*u%'a%%&a #e"%''a a*a% me%'a*,at*a% *e#e"ata% ma#&a$a*at me%u$u% a% apat mem,e$*a% %+$ma# #e% mu%'*% pe%ema$a% &a%' #e,a,*a% +!e" *e'ata% ma%u#a atau ma"*!u* !a%%&a.

8. Pe%utup 2

Pe%&u#u%a% !ap+$a% "a#! *e'ata%

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PETUNJUK PENGISIAN 4O5MULI5 DAN PENENTUAN LAIK SE:AT 6IOSKOP

1. K+mp+%e% &a%' %!a ( *+!+m @ ) Apa,!a *e%&ataa% &a%' aa ta* meme%u" pe$#&a$ata% #e,a'ama%a te$a%tum paa *+mp+%e% &a%' %!a- ma*a %!a%&a aa!a"  ( %+! )- #e,a!*%&a meme%u" pe$#&a$ata% ma*a %!a%&a aa!a" #e,e#a$ %!a &a%' te$a%tum paa *+!+m =.

/. 9a$a,e! Upa&a ( *+!+m /) Setap ,a'a% atau *e'ata% a$ a$a,e! upa&a mem!* %!a a%ta$a ( %+! ) #ampa e%'a% 1.

8. S*+$e ( *+!+m > ) S*+$e aa!a" pe$*a!a% a%ta$a ,+,+t ( *+!+m 8 ) e%'a% %!a &a%' pe$+!e" ( *+!+m = )

KESIMPULAN :ASIL PENILAIAN PEME5IKSAAN KESE:ATAN LINGKUNGAN 6IOSKOP 1. 6+#*+p %&ata*a% LAIK SE:AT apa,!a mempe$+!e" %!a #e*u$a%' – *u$a%'%&a ?=

e%'a% atata% #*+$e m%ma! u%tu* ma#%' – ma#%' a$a,e! upa&a aa!a" #epe$t ta,e! ,e$*ut % 3

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>. PASA5

a. Pe%'e$ta% pa#a$

Pa#a$ aa!a" #uatu tempat te$te%tu e%'a% #e'a!a a#!ta#%&a #e,a'a tempat ,e$temu%&a a%ta$a pe%0ua! e%'a% pem,e! ma%a pe%0ua! apat mempe$a'a*a% a% me%0ua! ,a$a%' a'a%'a%%&a.

,. Pe$a!ata% NO

NAMA ALAT

4UNGSI

1

Te$m+mete$


/

:&'$+mete$


8

LuRmete$


@

N+#e L+''%' e#mete$

A!at pe%'u*u$ *e,#%'a%

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ame$a


>


T++!# u%tu* aut #a%ta# pa#a$

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. 5%a% Ke'ata%

1. Pe$#apa%

a.


,. Pe%''a%aa% +$m %#pe*# #a%ta# pa#a$ a% +$mat+$mat pe!e%'*ap ( SPJ- 9#um-

4+$mat "a#! pe%'u*u$a%- !ap+$a% "a#! peme$*#aa% #eme%ta$a- 6e$ta Aa$a Pe%+!a*a%). J.

Pe$#apa% a!at pe%'u*u$a% *ua!ta# !%'*u%'a% ( te$m+mete$- "&'$+mete$- S+u%

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Lee!mete$- LuRmete$) a% +*ume%ta#. . Pem,uata% #u$at pem,e$ta"ua% *e pe%'e!+!a pa#a$ e.


.

Pe%&aa% pem,e$ta"ua% $e%a%a *e'ata% *e pe%'e!+!a pa#a$

/. Pe!a*#a%aa% 2


2

Aut #a%ta# aa!a" *e'ata% u%tu* me%!a *eaaa% #uatu #a$a%a #a%ta# a#a$ atau !%'*u%'a% pa#a$ ,a* #*- *ma maupu% ,+!+' 'u%a me%'eta"u ,e$apa ,e#a$ *emu%'*%a% #a$a%a atau !%'*u%'a% te$#e,ut pe%'a$u" +!e" !%'*u%'a%%&a #e"%''a a*a% me%'a*,at*a% *e#e"ata% ma#&a$a*at me%u$u% a% apat mem,e$*a% %+$ma# #e% mu%'*% pe%ema$a% &a%' #e,a,*a% +!e" *e'ata% ma%u#a atau ma"*!u* !a%%&a.

8. Pe%utup 2

Pe%&u#u%a% !ap+$a% "a#! *e'ata%

/;

PETUNJUK PENGISIAN 4O5MUL5 DAN PENENTUAN LAIK SE:AT PASA5

1. K+mp+%e% &a%'  %!a ( *+!+m @ )

Apa,!a *e%&ataa% &a%' aa ta* meme%u" pe$#&a$ata% #e,a'ama%a te$a%tum paa *+mp+%e% &a%' %!a- ma*a %!a%&a aa!a"  ( %+! )- #e,a!*%&a apa,!a meme%u" pe$#&a$ata% ma*a %!a%&a aa!" #e,e#a$ %!a &a%' te$a%tum paa *+!+m = ( !ma ).

/. 4e$ea,e! Upa&a ( K+!+m / ) Setap #e,a'a% atau *e'ata% a$ a$a,e! upa&a mem!* %!a a%ta$a  ( %+! ) #ampa e%'a% 1 ( #e$atu# ).

8. S*+$e ( *+!+m > ) S*+$e aa!a" pe$*a!a% a%ta$a ,+,+t ( *+!+m 8 ) e%'a% %!a &a%' pe$+!e" ( *+!+m = ).

KESIMPULAN :ASIL PENILAIAN PEME5IKSAAN KESE:ATAN LINGKUNGAN PASA5

Pa#a$ %&ata*a% !a* #e"at apa,!a mempe$+!e" %!a #e*u$a%' – *u$a%'%&a >  e%'a% atata% #*+$e m%ma! u%tu* ma#%' – ma#%' a$a,e! upa&a aa!a" #epe$t ta,e! ,e$*ut 3

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9A5IA6EL UPAA II

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?. PUSAT PE56ELANJAAN

a. Pe%'e$ta% pu#at pe$,e!a%0aa%

Pu#at pe$,e!a%0aa% aa!a" #uatu tempat ma%a +$a%' B umum at%' u%tu* ,e$,e!a%0ama%a ,e%tu* *e'ata% pa#a$ *e!+!a +!e" #atu ,aa%- #epe$t Depa$teme% #t+$eSupe$ma$*et !!.

,. Pe$a!ata% NO

NAMA ALAT

4UNGSI

1

Te$m+mete$


/

:&'$+mete$


8

LuRmete$


@

N+#e L+''%' e#mete$

A!at pe%'u*u$ *e,#%'a%

=

#e%te$

U%tu* peme$*#aa% 0e%t*

>

ame$a

A!at +*ume%ta#

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T++!# u%tu* aut #a%ta# pu#at pe$,e!a%0aa%

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. 5%a% Ke'ata%

1. Pe$#apa%

a.


,. Pe%''a%aa% +$m %#pe*# #a%ta# pu#at pe$,e!a%0aa% a% +$mat+$mat pe!e%'*ap

( SPJ- 9#um- 4+$mat "a#! pe%'u*u$a%- !ap+$a% "a#! peme$*#aa% #eme%ta$a- 6e$ta Aa$a Pe%+!a*a%).

81

J.


. Pem,uata% #u$at pem,e$ta"ua% *e pe%'e!+!a pu#at pe$,e!a%0aa% e.


.

Pe%&aa% pem,e$ta"ua% $e%a%a *e'ata% *e pe%'e!+!a pu#at pe$,e!a%0aa%

/. Pe!a*#a%aa% 2


2

Aut #a%ta# aa!a" *e'ata% u%tu* me%!a *eaaa% #uatu #a$a%a #a%ta# a#a$ atau !%'*u%'a% pu#at pe$,e!a%0aa% ,a* #*- *ma maupu% ,+!+' 'u%a me%'eta"u ,e$apa ,e#a$ *emu%'*%a% #a$a%a atau !%'*u%'a% te$#e,ut pe%'a$u" +!e" !%'*u%'a%%&a #e"%''a a*a% me%'a*,at*a% *e#e"ata% ma#&a$a*at me%u$u% a% apat mem,e$*a% %+$ma# #e% mu%'*% pe%ema$a% &a%' #e,a,*a% +!e" *e'ata% ma%u#a atau ma"*!u* !a%%&a.

8. Pe%utup 2

Pe%&u#u%a% !ap+$a% "a#! *e'ata%

8/

. SA5ANA DAN P5ASA5ANA ANGKUTAN UMUM

a. Pe%'e$ta% Sa$a%a a% P$a#a$a%a A%'*uta% Umum

2

Sa$a%a a%'*uta% umum aa!a" #e'a!a 0e%# *e%a$aa% a% #emua a#!ta#%&a &a%' pe$'u%a*a% u%tu* umum.

2

P$a#a$a%a a%'*uta% umum aa!a" #uatu tempat a#!ta#%&a ma%a ma#&a$a*at e%'a% tu0ua% ma#%' – ma#%' ,e$*umpu! u%tu* me%u%''u- %a* a% tu$u% *e%a$aa%.

,. Pe$a!ata%

NO

NAMA ALAT

4UNGSI

1

Te$m+mete$


/

:&'$+mete$


8

LuRmete$


@

N+#e L+''%' e#mete$

A!at pe%'u*u$ *e,#%'a%

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#e%te$


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T++!# u%tu* aut #a%ta# #a$a%a a%'*uta% umum

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88

. 5%a% Ke'ata%

1. Pe$#apa% a.


,. Pe%''a%aa% +$m %#pe*# #a%ta# #a$a%a a%'*uta% umum a% +$mat+$mat

pe!e%'*ap ( SPJ- 9#um- 4+$mat "a#! pe%'u*u$a%- !ap+$a% "a#! peme$*#aa% #eme%ta$a- 6e$ta Aa$a Pe%+!a*a%). J.


. Pem,uata% #u$at pem,e$ta"ua% *e pe%'e!+!a #a$a%a a%'*uta% umum e.


.

Pe%&aa% pem,e$ta"ua% $e%a%a *e'ata% *e pe%'e!+!a #a$a%a a%'*uta% umum

/. Pe!a*#a%aa% 2


2

Aut #a%ta# aa!a" *e'ata% u%tu* me%!a *eaaa% #uatu #a$a%a #a%ta# a#a$ atau !%'*u%'a% #a$a%a a%'*uta% umum ,a* #*- *ma maupu% ,+!+' 'u%a me%'eta"u ,e$apa ,e#a$ *emu%'*%a% #a$a%a atau !%'*u%'a% te$#e,ut pe%'a$u" +!e" !%'*u%'a%%&a #e"%''a a*a% me%'a*,at*a% *e#e"ata% ma#&a$a*at me%u$u% a% apat mem,e$*a% %+$ma# #e% mu%'*% pe%ema$a% &a%' #e,a,*a% +!e" *e'ata% ma%u#a atau ma"*!u* !a%%&a.

8. Pe%utup 2

Pe%&u#u%a% !ap+$a% "a#! *e'ata%

8@

;. PANGKAS 5AM6UT B SALON

a. Pe%'e$ta% Pa%'*a# 5am,ut a% Sa!+%

2

Pa%'*a# $am,ut aa!a" tempat – tempat umum &a%' me%etap ma%a #ea*a% #e'a!a a#!ta#%&a u%tu* me!a&a% pema%'*a#a% B pem+t+%'a% $am,ut ,a' umum

2

Sa!+% Kea%t*a% aa!a" #a$a%a pe!a&a%a% umum u%tu* peme!"a$aa% *ea%t*a% *"u#u#%&a

meme!"a$a

a%

me$aat

*e#e"ata%

*u!t-

$am,ut-

e%'a%

me%''u%a*a% *+#met* #ea$a ma%ua!- p$epa$ate a% e*+$at ta%pa t%a*a% +pe$a#.

,. Pe$a!ata%

NO

NAMA ALAT

4UNGSI

1

Te$m+mete$


/

:&'$+mete$


8

LuRmete$


@

N+#e L+''%' e#mete$

A!at pe%'u*u$ *e,#%'a%

=

#e%te$


>

ame$a


?


T++!# u%tu* aut #a%ta# pa%'*a# $am,utB #a!+%





8=

. 5%a% Ke'ata%

1. Pe$#apa%

a. Pem,uata% #u$at tu'a#. ,. Pe%''a%aa% +$m %#pe*# #a%ta# pa%'*a# $am,utB #a!+% a% +$mat+$mat pe!e%'*ap ( SPJ- 9#um- 4+$mat "a#! pe%'u*u$a%- !ap+$a% "a#! peme$*#aa% #eme%ta$a- 6e$ta Aa$a Pe%+!a*a%). J.


. Pem,uata% #u$at pem,e$ta"ua% *e pem!* pa%'*a# $am,utB #a!+% e.


.

Pe%&aa% pem,e$ta"ua% $e%a%a *e'ata% *e pem!* pa%'*a# $am,utB #a!+%

/. Pe!a*#a%aa% 2


2

Aut #a%ta# aa!a" *e'ata% u%tu* me%!a *eaaa% #uatu #a$a%a #a%ta# a#a$ atau !%'*u%'a% pa%'*a# $am,ut B #a!+% ,a* #*- *ma maupu% ,+!+' 'u%a me%'eta"u ,e$apa ,e#a$ *emu%'*%a% #a$a%a atau !%'*u%'a% te$#e,ut pe%'a$u" +!e" !%'*u%'a%%&a #e"%''a a*a% me%'a*,at*a% *e#e"ata% ma#&a$a*at me%u$u% a% apat mem,e$*a% %+$ma# #e% mu%'*% pe%ema$a% &a%' #e,a,*a% +!e" *e'ata% ma%u#a atau ma"*!u* !a%%&a.

8. Pe%utup 2

Pe%&u#u%a% !ap+$a% "a#! *e'ata%

8>

PETUNJUK PENGISIAN 4O5MULI5 DAN PENENTUAN LAIK SE:AT SALON B PANGKAS 5AM6UT

1. K+mp+%e% &a%' %!a ( K+!+m @ )

Apa,!a *e%&ataa% &a%' aa ta* meme%u" pe$#&a$ata% &a%' %!a- ma*a %!a%&a aa!a"  ( %+! )- #e,a!*%&a apa,!a meme%u" pe$#&a$ata% ma*a %!a%&a aa!a" #e,e#a$ %!a &a%' te$a%tum paa *+!+m = .

/. 9a$a,e! Upa&a ( *+!+m / )

Setap ,a'a% atau *e'ata% a$a,e! upa&a mem!* %!a a%ta$a ( %+! ) #ampa e%'a% 1.

8. S*+$e ( *+!+m > )

S*+$e aa!a" pe$*a!a% a%ta$a ,+,+t ( *+!+m 8 ) e%'a% %!a &a%' pe$+!e" ( *+!+m= )

KESIMPULAN

:ASIL

PENILAIAN

PEME5IKSAAN

KESE:ATAN

LINGKUNGAN SALON B PANGKAS 5AM6UT

1. Sa!+% B pa%'*a# $am,ut %&ata*a% LAIK SE:AT apa,!a mempe$+!e" %!a #e*u$a%'*u$a%'%&a >=  e%'a% atata% #*+$e m%ma! u%tu* ma#%'ma#%' a$a,e! upa&a aa!a" #epe$t ta,e! ,e$*ut

8?

I

II

9A5IA6EL UPAA III

==

?=

?

I9

9

>

1

1. PESANT5EN

a. Pe%'e$ta% Pe#a%t$e%

Pe#a%t$e% aa!a" #uatu tempat te$ma#u* a#!ta#%&a &a%' pe$'u%a*a% u%tu* me%&e!e%''a$a*a% pe%*a% a'ama I#!am

,. Pe$a!ata%

NO

NAMA ALAT

4UNGSI

1

Te$m+mete$


/

:&'$+mete$


8

LuRmete$


@

N+#e L+''%' e#mete$

A!at pe%'u*u$ *e,#%'a%

=

#e%te$


>

ame$a


?


T++!# u%tu* aut #a%ta# pe#a%t$e%





. 5%a% Ke'ata%

1. Pe$#apa% J.


. Pe%''a%aa% +$m %#pe*# #a%ta# pe#a%t$e% a% +$mat+$mat pe!e%'*ap ( SPJ-

8A

9#um- 4+$mat "a#! pe%'u*u$a%- !ap+$a% "a#! peme$*#aa% #eme%ta$a- 6e$ta Aa$a Pe%+!a*a%). e.


.

Pem,uata% #u$at pem,e$ta"ua% *e pe#a%t$e%

'.


". Pe%&aa% pem,e$ta"ua% $e%a%a *e'ata% *e pe#a%t$e%

/. Pe!a*#a%aa%

2


2

Aut #a%ta# aa!a" *e'ata% u%tu* me%!a *eaaa% #uatu #a$a%a #a%ta# a#a$ atau !%'*u%'a% pe#a%t$e% ,a* #*- *ma maupu% ,+!+' 'u%a me%'eta"u ,e$apa ,e#a$ *emu%'*%a% #a$a%a atau !%'*u%'a% te$#e,ut pe%'a$u" +!e" !%'*u%'a%%&a #e"%''a a*a% me%'a*,at*a% *e#e"ata% ma#&a$a*at me%u$u% a% apat mem,e$*a% %+$ma# #e% mu%'*% pe%ema$a% &a%' #e,a,*a% +!e" *e'ata% ma%u#a atau ma"*!u* !a%%&a.

8. Pe%utup

2

Pe%&u#u%a% !ap+$a% "a#! *e'ata%

8;

11. SEKOLA: DASA5

a. Pe%'e$ta% Se*+!a" Da#a$

Se*+!a" a#a$ aa!a" #uatu tempat te$ma#u* a#!ta#%&a &a%' pe$'u%a*a% u%tu* me%&e!e%''a$*a% pe%*a% pe%*a% a#a$ te$utama *epaa a%a*a%a*.

,. Pe$a!ata%

NO

NAMA ALAT

4UNGSI

1

Te$m+mete$


/

:&'$+mete$


8

LuRmete$


@

N+#e L+''%' e#mete$

A!at pe%'u*u$ *e,#%'a%

=

#e%te$


>

ame$a


?


T++!# u%tu* aut #a%ta# #e*+!a" a#a$





. 5%a% Ke'ata%

1. Pe$#apa%

@G

a. Pem,uata% #u$at tu'a#. ,. Pe%''a%aa% +$m %#pe*# #a%ta# #e*+!a" a#a$ a% +$mat+$mat pe!e%'*ap (SPJ- 9#um- 4+$mat "a#! pe%'u*u$a%- !ap+$a% "a#! peme$*#aa% #eme%ta$a6e$ta Aa$a Pe%+!a*a%). . Pe$#apa% a!at pe%'u*u$a% *ua!ta# !%'*u%'a% ( te$m+mete$- "&'$+mete$- S+u% Lee!mete$- LuRmete$) a% +*ume%ta#. . Pem,uata% #u$at pem,e$ta"ua% *e #e*+!a" a#a$ e. Pe%&u#u%a% 0aa! *e'ata%. . Pe%&aa% pem,e$ta"ua% $e%a%a *e'ata% *e #e*+!a" a#a$

/. Pe!a*#a%aa%

2


8. Pe%utup

2

Pe%&u#u%a% !ap+$a% "a#! *e'ata%

@1

1/. PUSKESMAS

a. Pe%'e$ta% Pu#*e#ma#

Pu#*e#ma# aa!a" #uatu tempat a% #emua a#!ta#%&a #e,a'a pu#at pe!a&a%a% *e#e"ata%&a%' me!put upa&a pe%'+,ata%- pe%e'a"a%- pe%%'*ata% *e#e"ata% a% pemu!"a% *e#e"ata% #ea$a te$pau *epaa ma#&a$a*at  *eamata% #e,a'a !a&a" *e$0a%&a.

,. Pe$a!ata%

NO

NAMA ALAT

4UNGSI

1

Te$m+mete$


/

:&'$+mete$


8

LuRmete$


@

N+#e L+''%' e#mete$

A!at pe%'u*u$ *e,#%'a%

=

#e%te$


>

ame$a


?


T++!# u%tu* aut #a%ta# Pu#*e#ma#





. 5%a% Ke'ata%

@/

1. Pe$#apa% a. Pem,uata% #u$at tu'a#. ,. Pe%''a%aa% +$m %#pe*# #a%ta# Pu#*e#ma# a% +$mat+$mat pe!e%'*ap (SPJ- 9#um- 4+$mat "a#! pe%'u*u$a%- !ap+$a% "a#! peme$*#aa% #eme%ta$a6e$ta Aa$a Pe%+!a*a%). . Pe$#apa% a!at pe%'u*u$a% *ua!ta# !%'*u%'a% ( te$m+mete$- "&'$+mete$- S+u% Lee!mete$- LuRmete$) a% +*ume%ta#. . Pem,uata% #u$at pem,e$ta"ua% *e p"a* Pu#*e#ma# e. Pe%&u#u%a% 0aa! *e'ata%. . Pe%&aa% pem,e$ta"ua% $e%a%a *e'ata% *e p"a* Pu#*e#ma#

/. Pe!a*#a%aa%

2


8. Pe%utup

2

Pe%&u#u%a% !ap+$a% "a#! *e'ata%

@. Te*%# Pe%!aa% Pu#*e#ma#

Se,e!um me!a*#a%a*a% Pe%!aa% Pe!a*#a%aa% Pu#*e#ma# 6e$#" Te$t, (PP6T)- pa$a petu'a# B pe%a%''u%' 0aa,  T%'*at P$+p%# a% K+ta Ma&a B Ka,upate% a% Pu#*e#ma# "a$u# me%'e$t a% mema"am te$!e," a"u!u petu%0u* Te*%# Pe%!aa% Pe!a*#a%aa% Pu#*e#ma# 6e$#" Te$t,. Petu%0u* Te*%# Pe%!aa% Pe!a*#a%aa% Pu#*e#ma# 6e$#" Te$t, a!am "a! %mem,e$*a% pe%0e!a#a% a$a pe%'#a% a% me%e%tu*a% N!a :a#! paa 9a$a,e! Upa&a Ke#e"ata% L%'*u%'a% te$utama a$ K+mp+%e% – K+mp+%e% a%' D%!a- &a%' te$apat a!am %#t$ume%t Pe%!aa% Pe!a*#a%aa% Pu#*e#ma# 6e$#"

@8

Te$t, ( PP6T ). Pe%e%tua% N!a :a#! ma*#u "a%&a !a*#a%a*a% te$"aap a$a,e! – a$a,e! 3 6a'u%a% Lua$- 6a%'u%a% Da!am- a% 4a#!ta# Sa%ta#. Sea%'*a%- u%tu* a$a,e! Ma%a'eme% a% 5ua%' tam,a"a% %!a "a#! pe$+!e"

#e,a'ama%a te$a%tum paa %!a #ta%a$ apa,!a meme%u" pe$#a&a$ata% a$ *+mp+%e% pe%!aa%- a% #e,a!*%&a apa,!a ta* meme%u" pe$#&a$ata% %!a "a#! aa!a"  ( %+! ). Sa#a$a%

Pe%!aa%

Pe!a*#a%aa%

Pu#*e#ma#

6e$#"

Te$t,

me%''u%a*a%

%#t$ume%t pe%!aa% a% *ete$a%'a% #e,a'a ,e$*ut 3

a. I%t$ume% PP6T pa*a u%tu* pe%!aa% #a$a%a Pu#*e#ma# e%'a% Pe$aata% ( DPT ) Pu#*e#ma# *ete$a%a'a% #e,a'a ,e$*ut 3

2

I%#t$ume% PP6T pa*a u%tu* pe%!aa% #a$a%a Pu#*e#ma# e%'a% Pe$aata% ( DPT ) Pu#*e#ma# a% Pu#*e#ma# Pem,a%tu. 

U%tu* Pu#*e#ma# DPT

3 te$$ = %+m+$ e%'a% 88= *+mp+%e% pe%!aa%



U%tu* Pu#*e#ma#

3 te$$ = %+m+$ e%'a% 8?1 *+mp+%e% pe%!aa%



U%tu* Pu#tu

3 *+mp+%e% &a%' %!a paa a$a,e! &a% %!a paa

+!ume *e'ata% &a%' aa- #e"%''a *+mp+%e% &a%' %!a a$ 81? *+mp+%e% *u$a%' a$a,e! upa&a &a%' ta* aa. M%ma! &a%'  %!a paa ,a'a% II 6a%'u%a% Da!am #epe$t 5ua%' Kepa!a Pu#*e#ma# Pem,a%tu (Pu#tu ) B 5ua%' peme$*#aa%- 5ua%' Tata u#a"a B Am%#t$a# a% 5ua%' Tu%''u.

,. K+mp+%e% a%' D%!a

Apa,!a *e%&ataa% ta* meme%u" pe$#&a$ata% #e,a'ama%a te$a%tum paa *+mp+%e% &a%' %!a- ma*a %!a%&a  ( %+! )- #e,a!*%&a apa,!a meme%u" pe$#&a$ata% ma*a %!a%&a #e,e#a$ %!a #ta%a$ #e,a'ama%a *+!+m =. N!a "a$u# #epe%u"%&a #e$a"*a% *epaa *epe*aa% # pe%!a e%'a% #e +,&e*t mu%'*%.

. 9a$a,e! Upa&a

@@

Setap ,a'a% atau *e'ata% a$ a$a,e! upa&a mem!* %!a a%ta$a  (%+!) #amap e%'a% 1.

. S*+$e

S*+$e aa!a" pe$*a!a% a%ta$a ,+,+t e%'a% %!a "a#! e. N!a :a#!

N!a "a#! aa!a" %!a &a%' apat*a% B pe$+!e" a$ "a#! pe%'amata% B peme$*#aa%  !apa%'a% #e,e#a$ a%ta$a %!a  ( %+! ) #amap e%'a% #e,e#a$ %!a #ta%a$ #e,a'ama%a te$a%tum  a!am pe+ma% petu%0u* te*%# pe%!aa%.

.

N!a Ma*#ma! aa!a" Pe%0um!a"a% t+ta! #+$e



N!a ma*#ma! u%tu* Pu#*e#ma# DPT

3 8.1;.



N!a ma*#ma! u%tu* Pu#*e#ma#

3 /.>@



N!a ma*#ma! u%tu* Pu#tu

3pe%!aa% #ama e%'a% pe%!aa% Pu#*e#ma#

e%'a% ,e,e$apa "a! #e#ua*a% e%'a% *+%# +!ume *e'ata% Pu#*e#ma# Pem,a%tu- ma*a %!a ma*#ma! paa pu#*e#ma# Pem,a%tu ( Pu#tu ) Q /.>@ – (*+mp+%e% &a%' ta* te$ma#u* a!am pe%!aa%).

'. Pe%e%tua% $te$a ,a*- #ea%' a% *u$a%' aa!a" #e,a' ,e$*ut

 6 a*



3 r?=  a$ %!a ma*#ma!- u%tu*

s

Pu#*e#ma# DPT

3 /8;/- =

s

Pu#*e#ma#

3 /18@- =

s

Pu#*e#ma# Pem,a%tu

3

Sea%' s s

3 r =  ?=  a$ #*+$e ma*#ma! u%tu*

Pu#*e#ma# DPT Pu#*e#ma#

3

3

3 r 1=;> –/8;1-= 3r 1@/@ – /188- =

@=

s



Pu#*ema# Pem,a%tu

Ku$a%'

3

3  = a$ #*+$e ma*#ma! u%tu*

s

Pu#*e#ma# DPT

3  1=;=

s

Pu#*e#ma#

3  1@/8

s

Pu#*e#ma# Pem,a%tu

3

3

Pe!ap+$a% PP6T

1. T%'*at Pu#*e#ma#

Pe!ap+$a% a$ pu#*e#ma# *e Dat II !a*#a%a*a% #etap > ,u!a% &atu paa ,u!a% Ja%ua$ a% ,u!a% Ju%

/. T%'*at Dat II Pe!ap+$a% a$ Dat II *e P$+%# !a*#a%a*a% #etap > ,u!a% &atu paa ,u!a% 4e,$ua$ a% 6u!a% A'u#tu#.

@>

18. O6EK WISATA

a. Pe%'e$ta% O,&e* W#ata

O,&e* W#ata aa!a" #uatu tempat &a%' #ea*a%- e%'a% #e'a!a a#!ta#%&a &a%' pe$'u%a*a% +!e" ma#&a$a*at umum u%tu* ,e$e*$ea# B ,e$ama#ata.

,. Pe$a!ata%

NO

NAMA ALAT

4UNGSI

1

Te$m+mete$


/

:&'$+mete$


8

LuRmete$


@

N+#e L+''%' e#mete$

A!at pe%'u*u$ *e,#%'a%

=

#e%te$


>

ame$a


?


T++!# u%tu* aut #a%ta# O,&e* W#ata





. 5%a% Ke'ata%

@?

1. Pe$#apa% a. Pem,uata% #u$at tu'a#. ,. Pe%''a%aa% +$m %#pe*# #a%ta# +,&e* #ata a% +$mat+$mat pe!e%'*ap (SPJ- 9#um- 4+$mat "a#! pe%'u*u$a%- !ap+$a% "a#! peme$*#aa% #eme%ta$a- 6e$ta Aa$a Pe%+!a*a%). . Pe$#apa% a!at pe%'u*u$a% *ua!ta# !%'*u%'a% ( te$m+mete$- "&'$+mete$S+u% Lee!mete$- LuRmete$) a% +*ume%ta#. . Pem,uata% #u$at pem,e$ta"ua% *e pe%'e!+!a +,&e* #ata e. Pe%&u#u%a% 0aa! *e'ata%. . Pe%&aa% pem,e$ta"ua% $e%a%a *e'ata% *e p"a* O,&e* #ata.

/. Pe!a*#a%aa%

2


8. Pe%utup

2

Pe%&u#u%a% !ap+$a% "a#! *e'ata%

@A

PETUNJUK PENGISIAN 4O5MULI5 DAN PENETUAN LAIK SE:AT O6EK WISATA ( PENINGGALAN SEJA5A:- TAMAN 5EK5EASI- WISATA ALAM- DLL )

1. K+mp+%e% &a%' %!a ( *+!+m @ )

Apa,!a *e%&ataa% &a%' aa ta* meme%u" pe$#&a$ata% #e,a'ama%a te$a%tum paa *+mp+%e% &a%' %!a- ma*a %!a%&a aa!a"  ( %+! )- #e,a!*%&a apa,!a meme%u" pe$#&a$ata% ma*a %!a%&a aa!a" #e,e#a$ %!a &a%' te$a%tum paa *+!+m =.

/. 9a$a,e! Upa&a ( *+!+m / )

Setap #e,a'a% atau *e'ata% a$ a$a,e! upa&a mem!* %!a a%ta$a ( %+! ) #ampa e%'a% 1

8. S*+$e ( *+!+m > )

S*+$e aa!a" pe$*a!a% a%ta$a pe$*a!a% a%ta$a ,+,+t ( *+!+m 8 ) e%'a% %!a &a%' pe$+!e" ( *+!+m = ).

KESIMPULAN :ASIL PENILAIAN PEME5IKSAAN KESE:ATAN LINGKUNGAN O6EK WISATA ( PENINGGALAN SEJA5A:- TAMAN 5EK5EASI- WISATA ALAM- DLL )

1. O,&e* #ata %&ata*a% La* Se"at apa,!a mempe$+!e" %!a #e*u$a%' – *u$a%'%&a >=  e%'a% atata% #*+$e m%ma! u%tu* ma#%'  ma#%' a$a,e! upa&a aa!a" #epe$t ta,e! ,e$*ut 3 @;

I ?

9A5IA6EL UPAA II >=

III >

1@. PE5KANTO5AN

a. Pe%'e$ta% Pe$*a%t+$a%

Pe$*a%t+$a% aa!a" #uatu tempat a% #e'a!a a#!ta#%&a me!put $ua%'a%- "a!ama%a% a$ea #e*e!!%'%&a &a%' me$upa*a% ,a'a% atau &a%' ,e$"u,u%'a% e%'a% tempat *e$0a atau *e'ata% pe$*a%t+$a%.

,. Pe$a!ata%

NO

NAMA ALAT

4UNGSI

1

Te$m+mete$


/

:&'$+mete$


8

LuRmete$


@

N+#e L+''%' e#mete$

A!at pe%'u*u$ *e,#%'a%

=

#e%te$


>

ame$a


?


T++!# u%tu* aut #a%ta# pe$*a%t+$a%





. 5%a% Ke'ata%

1. Pe$#apa% a. Pem,uata% #u$at tu'a#. =G

,. Pe%''a%aa% +$m %#pe*# #a%ta# pe$*a%t+$a% a% +$mat+$mat pe!e%'*ap (SPJ- 9#um- 4+$mat "a#! pe%'u*u$a%- !ap+$a% "a#! peme$*#aa% #eme%ta$a- 6e$ta Aa$a Pe%+!a*a%). . Pe$#apa%

a!at

pe%'u*u$a%

*ua!ta#

!%'*u%'a%

(

te$m+mete$-

"&'$+mete$- S+u% Lee!mete$- LuRmete$) a% +*ume%ta#. . Pem,uata% #u$at pem,e$ta"ua% *e pe$*a%t+$a% &a%' a*a%  pe$*#a e. Pe%&u#u%a% 0aa! *e'ata%. . Pe%&aa% pem,e$ta"ua% $e%a%a *e'ata% *e p"a* pe$*a%t+$a%.

/. Pe!a*#a%aa%

2


8. Pe%utp

2

Pe%&u#u%a% !ap+$a% "a#! *e'ata%

=1

PETUNJUK :ASIL PENILAIAN PEME5IKSAAN KESE:ATAN LINGKUNGAN KE5JA PE5KANTO5AN ( KANT. 1 )

1. Umum

a. Ke!+mp+* &a%' %!a ( *+!+m @ )

Apa,!a *e%&ataa% &a%' aa ta* meme%u" pe$#&a$ata% #e,a'ama%a te$a%tum paa *+mp+%e% &a%' %!a- ma*a %!a%&a aa!a"  (%+!) #e,a!*%&a apa,!a meme%u" pe$#&a$ata% ma*a %!a%&a aa!a" #e,e#a$ %!a &a%' te$a%tum paa *+!+m =.

,. 9a$a,e! Upa&a ( *+!+m / )

Setap ,a'a% atau *e'ata% a$ a$a,e! upa&a mem!* %!a  ( %+! ) #amp e%'a% 1.

. S*+$e ( *+!+m > ) S*+$e aa!a" pe$*a!a% a%ta$a ,+,+t ( *+!+m 8 ) e%'a% %!a &a%' pe$+!e" ( *+!+m 8 ) e%'a% %!a &a%' pe$+!e" ( *+!+m = ).

. 9a$a,e! upa&a &a%' ta* !a*u*a% peme$*#aa% U%tu* *+mp+%e% &a%' %!a ( *+!+m @ ) paa a$a,e! upa&a ( *+!+m / ) &a%' ta* !a*u*a% peme$*#aa% atau pe%!aa% a!am I%#pe*# Sa%ta# L%'*u%'a% Ke$0a I%u#t$ % #e,a,*a% *a$e%a ta* te$#ea a!at &a%' memaa atau petu'a# &a%' mampu u%tu* me!a*#a%a*a% peme$*#aa% atau *a$e%a #e,a, – #e,a, !a%%&a- ma*a u%tu* *+mp+%e% &a%' %!a te$#e,ut ta* te$ma#u* a!am pe%!aa%- #e"%''a #*+$e =/

ma*#ma! ( 1.) *u$a%' e%'a #*+$e ma*#ma! *+mp+%e% &a%' %!a te$#e,ut.

/. KESIMPULAN

:ASIL

PENILAIAN

PEME5IKSAAN

KESE:ATAN

LINGKUNGAN KE5JA PE5KANTO5AN

a. Ka%t+$ %&ata*a% meme%u" pe$#&a$ata% *e#e"ata% !%"*u%'a% ( MS ) apa,!a mempe$+!e" #*+$e "a#! pe%!aa% peme$*#aa% *e#e"ata% !%'*u%'a% #e*u$a%' – *u$a%'%&a ? e%'a% pe$+!e"a% #*+$e m%ma! paa ma#%' – ma#%' a$a,e! upa&a #,, 3

=8

(VVV) # %+m+$ a$a,e! upa&a atau *+mp+%e% &a%' %!a- tetap ta* !a*u*a% peme$*#aa% B pe%!aa%.

8. Sa$a% – #a$a% atau $e*+me%a# 3 a)VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV ,)VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV.. J)VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV.

=@

1=. MASJID B LANGGA5 B SU5AU

a. Pe$a!ata%

NO

NAMA ALAT

4UNGSI

1

Te$m+mete$


/

:&'$+mete$


8

LuRmete$


@

N+#e L+''%' e#mete$

A!at pe%'u*u$ *e,#%'a%

=

#e%te$


>

ame$a


?


T++!# u%tu* aut #a%ta# ma#0





@. 5%a% Ke'ata%

1. Pe$#apa% a. Pem,uata% #u$at tu'a#. ,. Pe%''a%aa% +$m %#pe*# #a%ta# ma#0 a% +$mat+$mat pe!e%'*ap (SPJ9#um- 4+$mat "a#! pe%'u*u$a%- !ap+$a% "a#! peme$*#aa% #eme%ta$a- 6e$ta Aa$a Pe%+!a*a%). . Pe$#apa% a!at pe%'u*u$a% *ua!ta# !%'*u%'a% ( te$m+mete$- "&'$+mete$- S+u% Lee!mete$- LuRmete$) a% +*ume%ta#. . Pem,uata% #u$at pem,e$ta"ua% *e ma#0 &a%' a*a%  pe$*#a e. Pe%&u#u%a% 0aa! *e'ata%. . Pe%&aa% pem,e$ta"ua% $e%a%a *e'ata% *e p"a* ma#0.

==

Pedoman Pengawasan Lingkungan TTU

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