1988 Ed.]
Water Pollution Control (General) Regulations
[CAP. 358
D 73
[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 provided on Form 10.
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
(Block letters)
Date
APPLICANT
MANAGER OF FACILITY (If not the applicant)
C3. The fee prescribed in the Third Schedule to the Water Pollution Control (General) Regulations should accompany this application.
* Delete if inapplicable.