Anticipated Activities In The Coming Year
ADVERTISEMENT
1
2as of 4 June, 2002
*** Please complete this form in English and in block letter
Form S1-2
Trade and Industry Department
Government of the Hong Kong Special Administrative Region
Report on Schedule 1 Chemical –
Chemical Weapons (Convention) Ordinance, Cap. XX
Anticipated Activities in the Coming Year
Submit this form for each Schedule 1 chemical anticipated to be produced at the declared facility in the next calendar year. This form must be submitted to
st
the Trade and Industry Department not later than 31
July of the year immediately before the year in which the anticipated activities take place.
Facility Name :
Permit Number :
IUPAC Chemical Name (see Note 1) :
CAS Registry No. :
It's structural formula :
Year of Activities Anticipated in this Form (hereunder referred to as
"reporting year") (must be a calendar year) :
Item 1
a.
Anticipated production (see Note 2) quantity :
b.
Anticipated time period for the production –
_______ grams
Start date (dd/mm/yy) : __________________
End date (dd/mm/yy) : __________________
* □ Research □ Medical □ Pharmaceutical □ Waste Disposal □ Production of other Schedule 1 chemicals
c.
Purpose(s) :
□ Other (please specify)_______________________________________________________________________
* please check the applicable one
Item 2
a.
Anticipated production quantity :
b.
Anticipated time period for the production –
_______ grams
Start date (dd/mm/yy) : __________________
End date (dd/mm/yy) : __________________
* □ Research □ Medical □ Pharmaceutical □ Waste Disposal □ Production of other Schedule 1 chemicals
c.
Purpose(s) :
□ Other (please specify)_______________________________________________________________________
* please check the applicable one
Item 3
a.
Anticipated production quantity :
b.
Anticipated time period for the production –
_______ grams
Start date (dd/mm/yy) : __________________
End date (dd/mm/yy) : __________________
* □ Research □ Medical □ Pharmaceutical □ Waste Disposal □ Production of other Schedule 1 chemicals
c.
Purpose(s) :
□ Other (please specify)_______________________________________________________________________
* please check the applicable one
For additional information on anticipated activities, please use additional Form S1-2 and indicate the number of Form S1-2 submitted.
- Total number of Form S1-2 (including this page) submitted : __________ page
Any anticipated changes at the declared facility and its relevant plant during the reporting year compared to previously submitted detailed technical
descriptions of the facility (i.e. Form S1) :
* Yes / No (* please delete if inappropriate)
Please support this declaration with a duly completed Form S1 containing updated information on the technical description of the facility or its
relevant parts, including inventories of equipment and detailed diagrams, if the answer above is "Yes".
I, the undersigned, hereby declare to the best of my knowledge and belief, that all information provided in this
For official use only
form and in any sheet attached to this form is true and correct. I also declare that, in submitting this form, I
fully understand that the Trade and Industry Department reserves at all times the right to release the above
Date of receipt :
information and any information relates to this report, including particulars of the undersigned, to third parties
for purposes stated in section 28(2) of the Chemical Weapons (Convention) Ordinance, Cap. XXX.
Remarks :
Name of the Permit Holder of the Registered Facility :
Signature of the Permit Holder and Company Chop :
Date :
[Form S1-2-c.DOC]
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business