Premises where the specified process is conducted

Name of the Premises (if any)

English

Chinese

Contact Person in the Premises (Surname First)

Chinese

Title or Position

Address

Correspondence Address

Telephone Number

F 36 CAP. 311] Air Pollution Control (Specified Processes) Regulations [1987 Ed. [Subsidiary]

Area of the Premises (m2)

Land Status

Name of Air Control Zone in which the Premises are Located

Business Registration No.

Certificate of Incorporation No.

No. of Employees in the Premises

English

4. Nature of Work

Existing Licence No.

Expiry Date

Classification of Specified Process under Application

Mode of Operation (Continuous/Batch)

Installed/Processing* Capacity

Silo Capacity (for Cement Works Only)

Total No. of Emission Points

Nature of Tenure

(1) The prescribed fee for application is NOT refundable.

(2) Any person who provides information which he knows to be incorrect in a material respect or recklessly makes any statement which is incorrect in a material respect or knowingly omits any material particular commits an offence and is liable to a fine of $5,000.

* Delete if not applicable.

5. Notes

Page 35

Page 36

表格 4

空氣污染管制(指定工序)規例

根據空氣污染管制條例第18A條呈遞的轉讓牌照申請書

【規例第4條】

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