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[接上页] AIR POLLUTION CONTROL (SPECIFIED PROCESSES) REGULATIONS APPLICATION FOR RENEWAL OF A LICENCE PURSUANT TO SECTION 16 OF THE AIR POLLUTION CONTROL ORDINANCE To: The Authority 1. I/We* the undersigned, being the licence holder of the undermentioned licence, hereby apply under Section 16 of the Air Pollution Control Ordinance for the renewal of a licence for the conduct of the undermentioned specified process. I/We* hereby declare that the particulars of the undermentioned specified process, including any chimney and relevant plant, nature and emission of any air pollutant, the fuel usage, raw materials and products are substantially unchanged and that the following particulars provided are correct. Dated this ........................ day of .................................. 19 ........... Signature of Applicant .................................................................. Name ......................................................................................... 2. Details of Owner(s) + Name of the Owner(s) (Surname First) Status Correspondence Address Telephone Number Identity Card/Certificate of Incorporation* Number English Chinese * Delete if not applicable. + Including the applicant. 3. Premises where the specified process is conducted Name of Premises (if any) Address Telephone Number English Chinese Contact Person in the Premises (Surname First) Title or Position Correspondence Address Telephone Number English Chinese Business Registration No. Certificate of Incorporation No. No. of Employees in the Premises Area of the Premises (m2) Land Status Nature of Tenure Name of Air Control Zone in which the Premises are Located 4. Nature of Work Existing Licence No. Expiry Date Classification of Specified Process under Application Mode of Operation (Continuous/Batch) Installed/ Processing* Capacity Silo Capacity (for Cement Works Only) Total No. of Emission Points 5. Notes Any person who provides information which he knows to be incorrect in a material respect or recklessly makes any statement which is incorrect in a material respect or knowingly omits any material particular commits an offence and is liable to a fine of $50000. * Delete if not applicable. (L.N. 311 of 1993; L.N. 212 of 1996) FORM 3 [regulation 4] AIR POLLUTION CONTROL (SPECIFIED PROCESSES) REGULATIONS APPLICATION FOR VARIATION OF A LICENCE PURSUANT TO SECTION 18, OR VARIATION OR CANCELLATION OF ANY TERM OR CONDITION OF AN EXEMPTION PURSUANT TO SECTION 23, OF THE AIR POLLUTION CONTROL ORDINANCE To: The Authority 1. I/We* the undersigned, being the licence/exemption* holder of the undermentioned licence/exemption*, hereby apply under Section 18/23* of the Air Pollution Control Ordinance for the variation of a licence/variation or cancellation of a term or condition of an exemption* for the conduct of the undermentioned specified process and I/we* hereby declare the following particulars and the additional information, if any, provided are correct and the relevant plans and specifications are prepared by the qualified engineer(s)/authorized person(s) listed in paragraph 3 of this application. I/We* enclose the application fee of $ ......... as prescribed in the Third Schedule to these regulations. This application, including plans and specifications, comprises ........... pages. Dated this ........................ day of .............................. 19 ............. . Signature of Applicant ................................................................. Name ........................................................................................ 2. Details of Owner(s)+ Name of the Owner(s) (Surname First) Status Correspondence Address Telephone Number Identity Card/ Certificate of Incorporation* Number English Chinese * Delete if not applicable. + Including the applicant. 3. Qualified Engineer/Authorized Person Name of Qualified Engineer/Authorized Person (Surname First) Correspondence Address Telephone Number Material+ Prepared 4. Premises where the specified process is conducted Name of Premises (if any) Address Telephone Number English Chinese Contact Person in the Premises (Surname First) Title or Position Correspondence Address Telephone Number English Chinese Business Registration No. Certificate of Incorporation No. No. of Employees in the Premises Area of the Premises (m2) Land Status Nature of Tenure Name of Air Control Zone in which the Premises are Located + Including the plans and specifications mentioned in paragraphs 5 and 6. 5. Details of Variation in Respect of which Approval is Sought (1) Nature of Works Existing Licence/ Exemption* No. Expiry Date (if applicable) Classification of Specified Process under Application Mode of Operation (Continuous/Batch) Installed/Processing* Capacity Existing Licence/ Exemption* Proposed Variation Existing Licence/ Exemption* Proposed Variation |