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D 30

CAP. 358]

Water Pollution Control (General) Regulations

[1988 Ed.

[Subsidiary]

GOVERNMENT OF HONG KONG

FORM 3

WATER POLLUTION CONTROL ORDINANCE

(Chapter 358)

Section 18

Application to vary an exemption

To the Water Pollution Control Authority,

OFFICIAL USE

ONLY

Date received

SECTION A. GENERAL INFORMATION

A1. APPLICANT

Full name

Name in Chinese characters (if any)

ID Card No./Business Registration No.

Address for correspondence

Telephone No.

Capacity in which making application

ISIC No. (if any)

Control Zone.

Further info. sought

Public notification

Date accepted/refused

In Register

Fee received

A2. Name of industrial premises or domestic sewage treatment plant to which application refers

CODE WPCO/EV/..../......

A3. Location of industrial premises or domestic sewage treatment plant to which application refers

Variation date

Variation code

A4. Code number of original notification- WPCO/E/.....

Remarks

A5. Date of original notification

A6.

A7.

A8. Type of discharge or deposit to which application refers-

Discharge or deposit from industrial premises

Discharge or deposit from domestic sewage treatment plant

If discharge or deposit is from industrial premises, state ISIC category number and name of industrial process carried on there.

Has exemption been varied previously?

YES

NO

If yes, state code number and date of most recent variation:

Code number: WPCO/EV/.....

Date

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