Profile

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Nama Perusahaan :*

Alamat Lengkap Perusahaan : *

Kode Pos :*

Nomor Tlp/HP : *

Fax :

E-mail :*

Jenis Industri : *

Contoh :

  • Industri pengolahan pangan
  • Industri pelayanan kesehatan

Jenis Limbah :*

Butuh Jasa Penglolahan dan Pemanfaatan:

Butuh Jasa Pengangkutan:

Alamat Pengangkutan:

Sumber Informasi:

Rekanan

Internet

Sumber Informasi Lainnya

Kelengkapan Penagihan/Urusan Keuangan

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Alamat Pengiriman Tagihan:*

Nama PIC bagian keuangan:*

No HP PIC bagian keuangan:*

No NPWP:*

File NPWP:*

File SPPKP:*

Contact PIC Order

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Nama:*

Bagian:*

No. Telp:*

Keterangan/Catatan

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Catatan/Keterangan Tambahan:


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