3.
4.
11
Qualified Engineer/Authorized Person
Name of Qualified Engineer/Authorised
Person (Surname First)
Correspondence Address
Telephone
Number
Premises where the specified process is to be conducted
Name of the Premises (if any)
English
Chinese
Contact Person in the Premises
(Surname First)
English
Chinese
Title or Position
Address
Correspondence Address
Business Registration No.
Certificate of Incorporation No.
No. of Employees in the Fremises
Nature of Tenure
Area of the
Premises (m2 )
Name of Air Control Zone in which the Premises are Located
+ Including the plans and specifications mentioned in paragraphs 5 to 9.
Material* Prepared
Telephone
Number
Telephone
Number
Land Status