1988 Ed.]

Water Pollution Control (General) Regulations

[CAP. 358

D 61

[Subsidiary]

B2. Reason for variation.

B3.

B4. Is requested variation to be temporary or permanent?

Temporary

Permanent

If temporary, specify period during which variation will be needed;

from

to

Any other changes from the particulars notified on Form 8.

B5. Any additional information relevant to the application.

SECTION C. DECLARATION

C1.

C2. *I/We hereby certify that the particulars given above are, to the best of *my/our knowledge and belief, correct.

*I/We do not intend to apply to the Secretary under section 43 of the Ordinance to withhold from public notification or other public access the information contained in this Form, except those in sections-

Signature/s

Name/s

APPLICANT

MANAGER OF FACILITY

(If not the applicant)

C3 (Block letters)

Date

The fee prescribed in the Third Schedule to the Water Pollution Control (General) Regulations should accompany this application.

• Delete if inapplicable.

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