No.

Criteria

1.

Setting and Infrastructure

(SI)
Campus Setting (letak / lokasi
kampus)

1.1

1.2

1.3

1.4
1.5

1.6

Type of Higher education

institution (jenis kampus /
perguruan tinggi)
Number of campus sites
(jumlah letak kampus jika
terdapat lokasi yang terpisah)
Total campus area (luas total
kampus)
Total ground floor area of
buildings (total luas lantai
bawah gedung)
Number of students (jumlah

Indicative Performance Measured

Answer
(if indicative Performance
Measured in 1 cell, select indicative
that suitable to your campuss, and if
indicative performance measured
in more than 1 cell, so we need your
campuss data for describe your
campuss)

Points for
each
indicator

Total Points
for each
Category

1600

Rural (pedesaan)
Sub urban (pinggir kota)
Urban (kota)
In city center / high rise building (pusat
administrasi kota)

Comprehensive (semua jenis)

Specialized higher education institution
(kampus khusus)
(Provide number)

(meter square provide number)

(meter square provide number)

(provide number)

1.7

1.8

1.9

mahasiswa)
(include both part time and
full time students)
Number of academic and (provide number)
administrative staff (jumlah
pegawai
akademis
dan
administratif kampus)
Roof insulation (description that what kinds
Building (bangunan)
of roof insulation generally)
Wall insulation (description that what kinds
of roof insulation generally)
Ventilation system (description that what
kinds of roof insulation generally)
Control panel safety (description that what
kinds of roof insulation generally)
Plumbing utilization (description that what
kinds of roof insulation generally. What
kinds of pipe that drain the black water and
grey water in a building?)
Drainage system (description that what
kinds of roof insulation generally.
Decentralization or centralization, where did
end drainage throw take place? )
Types of room in kind of Class room, discussion room, class meeting,
building in each faculty
and office room (provide number of each
room type)
Computer room (provide number of room
and number of computer in a room)

1.10
1.11

1.12

1.13

1.14

Laboratorium (provide number of room and

kind of laboratorium)
Storage room (provide number of room in
each building)
Healthy care room or center (provide
number of room in a campus or number of
healthy care center in a campus - also
distance of others building)
Others (provide number of each building
and kind of room)
Total Parking area of each (provide number and percentage)
faculty or building
Area on campus covered in (provide as percentage of total site area)
vegetation in the form of
forest
Area on campus covered in (provide as percentage of total site area)
planted vegetation (include
lawns, gardens, green roofs,
internal planting)
Retention:
non-retentive (percentage)
surface
on
campus
as
percentage of total area (where
non-retentive
surfaces
including earth, grass, conblock etc, and retentive
surfaces including concrete,
tarmac) for water absorption.
Percentage
of
university (percentage)

1.15
1.16

2.
2.1

2.2

2.3

budget for sustainability effort

Fire prevention (prevention
action when fire happened)
Total length of street in your campuss
Public access
(provide number)
Width of street in your campuss (provide
number)
Position of security
Campuss near from public infrastucture
(such as bus terminal, mall, market, and
others)
Energy and Climate Change
(EC)
Conventional
Energy efficient appliances
Partly replaced
usage (extent to which energy
Fully employed
efficient appliances / lighting
Smart building
fixtures, low watt light bulbs
are replacing conventional
appliances)
Renewable energy usage None
policy (select one or more of Bio diesel
the given energy sources used Clean biomass
Solar power
on your campus)
Geothermal
Wind power
(provide
number)
Electricity usage per year (for
lighting, heating, cooling, etc)
(total KWH)

2000

2.4

2.5

Energy
conversation
program (formalized effort in
encouraging members of the
campus community to reduce
energy use)
Green team

2.6

2.7

Energy modelling for control

program per year

Green building (elements of

green building implementation
as reflected in all construction
and renovation policy) (select
one or more that apply)

No policy
Policy preparation
Policy in initial implementation
Policy implemented with some
problems
Policy in full implement
No team formation
Team formation preparation
Team
formation
in
initial
implementation
Team formation implemented with
some problems
Team formation in full implement
None
Modelling preparation
Modelling in initial implementation
Modelling in implementation with
some problems
Modelling in full implementation
None
Natural ventilation
Full day-lighting
Building efficiency: less than 35% for
circulation
Number of floor
Types of plumbing drain
Using lift or stairs (option)
Water resources from


2.8

Material Green Building

2.9

2.10

Climate change adaptation and

mitigation program (current
stage of institutional effort)

Greenhouse
gas
reductions policy

emission

3.
3.1

Waste Stream Management

(WSM)
Recycling
program
for

Kind of water conservation (if

provided)
Life cycle impacts (menjelaskan
bagaimana siklus material yang
digunakan dalam pembangunan gedung
dan fasilitas di lingkungan kampus,
dimulai dari pengadaan material hingga
akhirnya bersisa dan tidak terpakai lagi
menjadi sampah padat konstruksi)
Kinds of material that using for
building robustness (menyebutkan
jenis material yang digunakan dalam
ketahanan bangunan)
No program
Program preparation
Program in initial implementation
Program implemented with some
problems
Program in full implementation
No policy
Policy preparation
Policy in initial implementation
Policy implemented with some
problems
Policy in full implementation
1800

None

3.2

3.3

university waste (policy led

effort to encourage staff and
students to recycle waste)
Toxic
waste
recycling
(whether toxic waste is dealt
with separately, for example by
classifying and recycling it)
Organic waste treatment
(garbage, discarded vegetable
and plant matter)

3.4

Inorganic waste treatment

(rubbish,
trash,
discarded
paper, plastic, metal, etc.)

3.5

Sewerage disposal (primary

method of treatment of
sewerage)

3.6

Policy to reduce the use of

papers and plastics in campus

Partial
Extensive

Not treated
Partly treated in some places
Fully treated

Taken off campus to a dump site

Dumped in open
Partly composted
Fully composted
Burned in open
Taken off campus to a dump site
Partially recycled
Fully recycled
Flows into river or waterway
Piped to septic tank
Treated before disposal
Treated for reuse
No policy
Policy preparation
Policy in initial implementation
Policy implemented with some
problems
Policy in full implementation

4
4.1
4.2

Water Management (WRM)

Water conservation program
Piped water

1200
(systematic, formalized program)
(water consumed from utility or piped

system as a percentage of all sources of

water including, ground or well water)
Ground water (air tanah-sumur bor)
Develop Government water (air yang
dikelola oleh pemerintah setempatPDAM)
Number of water use in a campuss
(jumlah kebutuhan penggunaan air
dalam kampus)
and (provide number of maintenance and control
program)

4.3

Water consumption

4.4

Water leak detection

prevention
Transportation (TR)
Number of vehicles owned by
your institution (buses and
cars)
Number of cars entering the
university daily (average based
on
balanced
sample,
considering term and holiday
periods)
Number of bicycles that are
found on campus on an
average day (include both
those owned by the university
and privately owned bikes)
(provide number)
Transportation policy designed
to limit the number of motor
vehicles used on campus

5
5.1

5.2

5.3

5.4

1400
(provide number)

(provide number)

(provide number)

No policy
Policy preparation

5.5

5.6

5.7

6.
6.1

6.2
6.3

6.4

(expressed
as
stage
of Policy in initial implementation
implementation of that policy) Policy implemented with some problems
Policy in full implementation
Transportation policy designed No policy
to limit or decrease the parking Policy preparation
area on campus
Policy in initial implementation
Policy implemented with some problems
Policy in full implementation
Campus buses (the availability Not available
of buses for journeys within Available (paying service)
the campus whether free or Available (free service)
paid)
Bicycle and pedestrian policy Bicycle use not possible or practical
on campus (reflects the extent No policy but use not discouraged
to which bicycle use or Bicycle provide by university
walking is supported)
Bicycle way
Pedestrian way
Education (ED)
Number of courses related to (provide number)
environment and sustainability
offerred
Total number of courses (provide number)
offerred
Total research funds dedicated (provide number)
to
environmental
and
sustainability research (in US
Dollars, average per annum
over the last 3 years)
Total research funds (in US (provide number)

1400

6.5

6.6

6.7

Dollars, average per annum

over the last 3 years)
Number of scholarly evets
related to environment and
sustainability (average per
annum over the last 3 years)
Number
of
student
organizations
related
to
environment and sustainability
Existence of a university-run
sustainability website

7.
7.1

Pollution Monitoring (PM)

Impact of cooler room

7.2

Surface water run-off

(provide number)

(provide number)

Not Available
In progress
http://www. (mention it)
500

Moisture room average daily (room

generally)
Particulate matter in room (room
generally)
Temperature and pH in room (room
generally)
Drainage
form:
pipe
drained
(mengatur pengaliran air permukaan
dengan
beberapa
pipa
dan
mengarahkannya
ke
badan
air
permukaan kembali)
Drainage form: concrete drained
(bentukan saluran dari beton dan
sejenisnya dan mengarahkannya ke
badan air permukaan kembali)

7.3

Reduction of night-time light

pollution

8.

Monitoring and Maintenance

Building and Environmental
(MM)

100

Total Points Achieved

None
Reduction night-light in number of
building (provide number of building
that reducing of night-time light)

None
Weekly
Monthly
Yearly
Others