12
"FIRST SCHEDULE.
[reg. 22.]
HONG KON
香 襻
FORM I.
13
(8) Are you in possession of detonator crimpers?
(9) For which of the following do you require a Mine Blasting
Certificate to be issued—
海桥第一款
MINES (SAFETY) REGULATIONS.
Application for a Mine Blasting Certificate.
鼷壩燃煤
(This form to be submitted to the Superintendent of Mines with fee
1
of $5.00. In the case of a Government employee the fee is waived under 公轄員,則可慨攮櫈例第二十 款第(三)段之規定琵齉
regulation 22(3) ).
-
{}
For surface or opencast workings
(甲)
Mining operations underground
(2)
(10) Are you going to use electrical shot-firing when blasting?
星镰電力燃故?
1
1 hereby certify that this is a true statement of the particulars herein 以 上所收吝断四脚媒實無
(1) Full name of applicant-keskkremaskinen
(2) Address
(2) de 址
(3) Year of birth
Met forth.
凸
Date
19.
一九年月
Signature.
器
(8)
出生年低
籟
(4) Nationality
14) 2
(3) Tdentity Card No.
身份推號碼
(0) (0) 做
Have you previously made application in Hong Kong for 台端前時是否在香港按閎热特鳏 the issue of a blasting certificate under the Buildings Ordin-
ance, Chapter 123, or a Mine Blasting Certificate under these 證譽 雕
regulations?
If so, when?
+
符合申請者、體註明申請日期心
If the application was granted state the number, year and
reason for now acquiring another
以及現顫申灣另一証睿之理由
(7) Have you ever held a blasting certificate or a Mine Blasting
Certificate which has at any time been suspended or revoked?
If so, give particulars womeça
如有者,斷證明详细情形
Hong Koni
茂 洮
FORM 10. 海二
MINES (SEETY) REOULATIONS.
Mine Blasting Certificate.
Original to granice.
正本交持人收数
Duplicate 10 Superintendent of Mines,
This is to certify that----
证明下關心
(1) Nama
(2) Address
做她
年齡