1954-HKRS30-8-44_Part02 — Page 44

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SCHEDULE.

HONG KONG,

FORM 1.

MINES (SAFETY) REGULATIONS, 1954.

Application for a Mine Blasting Certificate.

{rog. 22

(This form to be submitted to the Superintendent of Mines with fee of $6.00. In the case of a Government employee the fee is waived under regulation 22(4))

29

HONG CÔNG

FORM II

MINES (SAFETY) REGULATIONS, 1954. Mine Blasting Certificate,

Original to grantee.

Duplicate to Superintendent of Mines, Triplicate to Commissioner of Police,

This is to certify that-la

(1)

Fall name of applicant

(2)

Address

(3)

Year of birth

(4)

Nationality

(8)

Identity Card No.

(6)(0) Have you previously made application in Hong Kong for the issue of a blasting certificate under the Buildings Ordinance, Chapter 129, or A Mine Blasting Certificate under these regulations?

Lf so when?

(5) If the application was granted slate the number, year and

reuden for now acquiring another

перницы в

(1)

Name

(2)

Address

(3)

Age

(4)

Nationality

(6)

Identity Card No.

is qualified to use explosives for blasting in prospecting or mining

operations-

(a)

Surface and opencast workings.

(5)

Mining operations underground.

(e)

Qualified to use electrical shot-firing equipment.

Issued

(The issuing officer must cross out the words not required.)

this

day of

19.....

(7)

Have you ever held a blasting certificate or a Mine Blasting Certificate which hus at any time been suspended or revoked? If so, give particulars

(8)

Are you in possession of detonator crimpers?

(9)

For which of the following do you require a Bline Blasting Ccrtificate to be insued-

PHOTO

(a) For surface or opencast workings (5) Mining operations underground

(10)

Are

going

ta use electrical

ahot-firing when

bleating?

I hereby cariify that this is a true statement of the particulars

herein set forth.

Signature

(Signature of holder)

of Mines.

COUNCIL CHAMBER,

Date

18......

12th October, 1954- (Secretariat 22/3231/54)

Signature,

Deputy Clerk of Councils.