3.
4.
Qualified Engineer/Authorized Person
Name of Qualified
Engineer/Authorised
Person (Surname First)
+
Correspondence Address
Telephone
Material
Number
Prepared
Fremises where the specified process is to be conducted
Name of the Promisos (if any)
English
Chinese
Contact Person in the Premisea
(Surname First)
Title or Position
English
Chinese
Address
Correspondence Address
Business Registration No.
Certificate of Incorporation No.
No. of Employoos in the Fromisos
Nature of Tonure
Area of the
Premises (m2)
Name of Air Control Zone in which the Promises are Located
+ Including the plans and specifications mentioned in paragraphs 5 to 9.
Telephone
Number
Telephone
Number
Land Status
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