TNAG-1617-FCO40-2225-Executive-Council-of-Hong-Kong-memoranda-and-minutes-of-meet-1987 — Page 210

SECOND SCHEDULE

FORM 1

rogo. 4, 10, 11, 12 & 157

[reg. 47

AIR POLLUTION CONTROL (SPECIFIED PROCESSES) REGULATIONS 1987

APPLICATION FOR A LICENCE PURSUANT TO SECTION 14 OF THE AIR POLLUTION CONTROL ORDINANCE

To: The Authority

1.

I/We* the undersigned hereby apply under Section 14 of the Air Pollution Control Ordinance for a licence for the conduct of the undermentioned specified process and I/we* heroby declare that the following particulars and the additional information, if any, provided are correot and the relevant plans and specifications are prepared by the qualified engineer(s)/ authorized person(s) listed in paragraph 3 of the application.

I/We enolose the application fee of $100.

This application, including plans and specifications, comprises

Dated this

day of

of 19

pages.

2.

Signature of Applicant

Name

Details of Owner(s)+

Name of the Owner(s) (Surname First)

English

Status

Correspondence Address

Telephone

Number

Identity Card/

Certificate of Incorporation"

Chinese

Number

Delete if not applicable

+ Including the applicant

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