D 14

[Subsidiary]

CAP. 358] Water Pollution Control (General)

Regulations

[1988 Ed.

SECTION A. GENERAL INFORMATION

OFFICIAL USE ONLY

AL.

Date received

Land status checked

Further info. sought

Sampling point approved

Date confirmed

In Register

ISIC No.

CODE

WPCO/E/1/

Variation date

Variation code

Remarks

A2.

A3.

NOTIFIER

Full name

Name in Chinese characters (if any)

ID Card No./Business Registration No.

Address for correspondence

Telephone No.

Capacity in which making notification

INDUSTRIAL PREMISES IN WHICH DISCHARGE OR DEPOSIT ORIGINATES

Name and location of building in which premises are situated

Name and location of premises (specify floor no. if in multi-storey building)

Postal address of premises (if different from above)

Beneficial owner of building in which premises are situated

ISIC category number and name of industrial process carried on on the premises

Product(s) of the industrial process

INDUSTRIAL ENTERPRISE CARRYING ON THE INDUSTRIAL PROCESS ON THE PREMISES

Name of enterprise

Address and Business Registration No. of enterprise

Full name and capacity of manager of enterprise

ID Card No.

Address for correspondence

Telephone No.

SECTION B. DETAILS OF INDUSTRIAL PROCESS AND OF DISCHARGE OR DEPOSIT

B1.

B2.

Describe industrial process from which discharge or deposit arises. Attach flow chart or diagram if necessary.

State at how many points the discharge or deposit from the premises enters—

(a) the waters of Hong Kong;

(b) a public drain or public sewer.

B3. In respect of each discharge point give particulars of the point at which the discharge or deposit enters the waters of Hong Kong or a public drain or public sewer.

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