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[接上页] (第358章) 牌照申请书/牌照续期/更改牌照申请书 .............................................................. 水质管制区。 A栏申请人 A1.申请人必须填写本栏。 姓名或名称(英文) ...................................................................................................... 姓名或名称(中文) ...................................................................................................... 身分证号码,如申请人为商号,则商业登记号码 ................................................. 通讯地址 ..................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... 电话号码 ..................................................................................................................... 申请人以什么身分提出申请? ................................................................................. (例如:“拥有人”、“占用人”、“经理”、“董事”、“代理人”) ______________________________________________________________________ A2.如为商业处所、工业处所或机构处所(包括供多于一个住户单位占用的处所,不论租作假日宿处或作其他用途),或为住宅污水处理装置提出申请,请填写本栏。 企业名称 ..................................................................................................................... 登记地址 ..................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... ...................................................................................................................................... 经理姓名 ..................................................................................................................... 经理的身分证号码 ..................................................................................................... 经理的业务用电话号码 ............................................................................................. B栏流出物 B1.申请人必须填写本栏。 作出的排放或沉积所来自的处所的名称及详细地址。 ...................................................................................................................................... ...................................................................................................................................... 在何日已开始或将开始排放或沉积? ...................................................................................................................................... ______________________________________________________________________ B2.有厕所、浴室或厨房废水的申请人必须填写本栏。 (1)厕所废水排放到那裹(请加上“ˇ”号)? (a) 化粪池□ (b) 其他处理设施□ (c) 用以输送脏水的公用污水渠或排水渠□ (d) 其他地方,例如水道□(如属(b)或(d),请指明 .................................................................................... ) 述明与所涉处所有关的设施的位置 .............................................................................................................................. .............................................................................................................................. (2)厨房及浴室废水排放到那裹(请加上“ˇ”号)? (a) 化粪池□ (b) 其他处理设施□ (c) 用以输送脏水的公用污水渠或排水渠□ (d) 其他地方,例如水道□(如属(b)或(d),请指明 .................................................................................... ) 述明与所涉处所有关的设施的位置 .............................................................................................................................. .............................................................................................................................. ______________________________________________________________________ B3.如为商业处所、工业处所或机构处所提出申请,请填写本栏。 (1)述明─(a) 在该处所进行的工业、行业、业务或其他工作 |