10 -
SECOND SCHEDULE
FORM 1
AIR POLLUTION CONTROL (SPECIFIED PROCESSES) REGULATIONS 1987
regs. 4, 10, 11, 12 & 157 [reg. 47
APPLICATION FOR A LICENCE PURSUANT TO SECTION 14 OF THE AIR POLLUTION CONTROL ORDINANCE
To: The Authority
I/We* the undersigned hereby apply under Section 14 of the Air Pollution Control Ordinance for a licence for the conduct of the undermentioned specified process and I/we* hereby declare that the following particulars and the additional information, if any, provided are correot and the relevant plans and specifications are prepared by the qualified engineer(s)/ authorized person(s) listed in paragraph 3 of the application.
1.
I/We enolose the application fee of $100.
This application, including plans and specifications, comprises
of 19
pages.
Dated this
Signature of Applicant
Name
2.
Details of Owner(s)*
Name of the Owner(s)
(Surname First)
English
day of
Status
Correspondence Address
Telephone
Number
Chinese
* Delete if not applicable
Tuakad dva ce
Identity Card/ Certificate of Incorporation*
Number