TNAG-1617-FCO40-2225-Executive-Council-of-Hong-Kong-memoranda-and-minutes-of-meet-1987 — Page 251

FORM 5

NOTICE OF OBJECTION TO THE GRANTING OR RENEWAL OR VARIATION OR TRANSFER* CF A LICENCE OR VARIATION OR CANCELLATION

OF A TERM OR CONDITION OF AN EXEMPTION PURSUANT TO SECTION 14/16/18/18A/23* OF THE AIR POLLUTION CONTROL ORDINANCE

eg.19

To: The Authority

1.

Full Name of Objector:

2.

Home Address of Objector:

Cffice Address of Objector:

Occupation:

Telephone No.:

3. Details of the Application Under Objection:

Registration No.:

Name of Applicant:

Purpose of the Application:

Address of the Premises Where the Specified Process Is To Be Conducted:

4. Relevant Air Quality Objective(s) being Threatened:

5. The grounds for this objection are: (set them out in full)

Dated this

4

day of

(Signature)

Objector

of 19

Copy to the Secretary for Health and Welfare

* Delete if not applicable