D 68

CAP. 358]

Water Pollution Control (General) Regulations

[1988 Ed.

[Subsidiary]

GOVERNMENT OF HONG KONG

FORM 11

WATER POLLUTION CONTROL ORDINANCE

(Chapter 358)

Section 23

Application for renewal of a licence for a discharge or deposit of sewage other than from a domestic sewage treatment plant

To the Water Pollution Control Authority,

SECTION A. GENERAL INFORMATION

OFFICIAL USE ONLY

Date received

AL

Further info. sought

APPLICANT

Public notification

Date granted/
refused

In Register

Fee received

CODE WPCO/

Variation date

Full name

Name in Chinese characters (if any).

ID Card No./Business Registration No.

Address for correspondence

Telephone No.

Capacity in which making notification

Variation code

Remarks

A2.

Location of facility to which licence relates...

A3.

Code number of original licence-
WPCO

A4.

Date of original application

A5.

Control Zone.

Has original licence been varied or renewed previously?

YES

NO

If yes, state code number and date of most recent variation or renewal-

Code number: WPCO/

Date

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