1. | Applicant's Name | : | ............................................................... |
Applicant's Calling | : | ............................................................... | |
Applicant's Address | : | ............................................................... | |
2. | Full Name & Postal Address of the factory | : | ............................................................... |
3. | Situation of the Factory | : | ............................................................... |
Province | : | ............................................................... | |
District | : | ............................................................... | |
Town or village | : | ............................................................... | |
Nearest Police Station | : | ............................................................... | |
Nearest Railway Station or Steamer Ghat | : | ............................................................... | |
4. | Particulars of Plant to be installed | : | ............................................................... |
Signature of Applicant | |
Date …………....……... | |
NOTE:- This Application shall be accompanied by the following documents: | |
(a) | A flow chart of the manufacturing process supplemented by a description of process in its various stages. |
(b) | Plans, in duplicate drawn to scale, showing:- |
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(c) | Such other particulars as the Chief Inspector may require. |