Hong Kong Regulations
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WATER POLLUTION CONTROL (GENERAL) REGULATIONS - SCHEDULE 2
GOVERNMENT OF HONG KONG
[regulations 2 & 17]
FORM A For Official Use
Code No.
WPCO/ / /
GOVERNMENT OF HONG KONG
WATER POLLUTION CONTROL ORDINANCE
(Chapter 358)
Application for a licence/Application for renewal/variation of a licence
...........................................................................
........... Water Control Zone.
SECTION A. The Applicant. A1. All applicants must complete this section. Your
name in English
...........................................................................
......................... Your name in Chinese
...........................................................................
....................... Your identity card number, OR, if the applicant is a
firm, your business registration number
...........................................................................
............................................. Your correspondence address
...........................................................................
............
...........................................................................
..........................................................
...........................................................................
..........................................................
...........................................................................
.......................................................... Your telephone
number ............................................................ In what
capacity are you making this application?
............................................................
(for example, "owner", "occupier", "manager", "director", "agent")
---------------------------------------------------------------------------
-------------------------------------- A2. Complete this section if the
application is for commercial, industrial or institutional premises (including
premises occupied by more than one household unit whether rented as holiday
accommodation or otherwise), or a domestic sewage treatment plant.
Name of the enterprise
...........................................................................
....................... Registered address
...........................................................................
.............................
...........................................................................
..........................................................
...........................................................................
..........................................................
...........................................................................
.......................................................... Name of the manager
...........................................................................
......................... Manager's identity card number
...........................................................................
.......... Manager's business telephone number
........................................................................... .
SECTION B. The Effluent. B1. All applicants must complete this section. Give
the name and full address of the premises from which the discharge or deposit
is made.
...........................................................................
...............................................
...........................................................................
.......................................................... On what date did or
will the discharge or deposit begin?
...........................................................................
..........................................................
---------------------------------------------------------------------------
-------------------------------------- B2. Applicants with toilet, bathroom or
kitchen wastewater must complete this section.
(1) Where does toilet wastewater discharge to (please tick)?
(a) Septic tank □
(b) Other treatment facilities □
(c) Communal sewer or drain for the carriage of foul water □
(d) Elsewhere, for example, a watercourse □ (If (b) or (d), please
specify
...........................................................................
..) State the location of the facility in relation to the premises
...........................................................................
.............................................
...........................................................................
.............................................
(2) Where do the kitchen and bathroom wastewaters discharge to (please tick)?
(a) Septic tank □
(b) Other treatment facilities □
(c) Communal sewer or drain for the carriage of foul water □
(d) Elsewhere, for example, a watercourse □ (If (b) or (d), please
specify
...........................................................................
.) State the location of the facility in relation to the premises
...........................................................................
.............................................
...........................................................................
.............................................
---------------------------------------------------------------------------
-------------------------------------- B3. Complete this section if
the application is for commercial, industrial or
institutional premises.
(1) State-
(a) the industry, trade, business or other work carried on at the premises
...........................................................................
.....................................
...........................................................................
.....................................
(b) the number of staff
...........................................................................
........
(c) the number of working hours per day
...........................................................................
.....................................
(d) the number of working days per week
...........................................................................
..................................... If fluctuation in any of the
above is expected, please elaborate
...........................................................................
.............................................
...........................................................................
.............................................
(2) If the business is manufacturing, state-
(a) what is made
...........................................................................
.................
(b) the raw materials used
...........................................................................
...
(c) any streams of wastewater produced
...........................................................................
.....................................
(d) water account number(s)
..........................................................................
(e) the information shown in the last received water bill(s) as-
(i) the billing period
...........................................................................
.............................
(ii) the water consumption (in cubic metres)
...........................................................................
.............................
(f) the information shown in the next-but-last received water bill(s) as-
(i) the billing period
...........................................................................
.............................
(ii) the water consumption (in cubic metres)
...........................................................................
.............................
---------------------------------------------------------------------------
-------------------------------------- B4. If the application
is for discharges from domestic premises, omit this section.
(1) What is the maximum daily flow rate of the discharge(s) or deposit(s)?
...........................................................................
............................................. Besides tap water, any other
sources of water used?
...........................................................................
............................................. If yes, please specify (for
example, well, stream or recycled water)
...........................................................................
............................................. and its total daily consumption
...........................................................................
(2) If the effluent is treated before it leaves your premises show by ticking
the boxes what treatment processes are used-
Screening Temperature control
Settlement Biological treatment
Chemical precipitation what kind?
.................................................
Ion exchange Other process
pH adjustment what kind? .................................................
Provide a layout plan and schematic diagram of the treatment plant if one is
available.
(3) Where does the effluent discharge to?
...........................................................................
.............................................
(for example surface water drain, foul sewer, treatment plant, river, stream
or sea); draw a sketch plan of the discharge in section C.
SECTION C. Plan If the application is for discharges from domestic premises,
omit this section. If the application is other than for discharges from
domestic premises, draw or attach in this section a sketch plan showing the
following details-
(1) the location of the premises;
(2) the location of the discharge points;
(3) the places where samples of the effluent may be taken.
SECTION D. Renewal or Variation. Complete this section if you are applying to
vary or renew an existing licence.
(1) Existing licence number
...........................................................................
...............
(2) Date licence expires
...........................................................................
.................... If the application is for a variation of conditions,
state the variation sought and the reasons for it-
...........................................................................
..................................................................
...........................................................................
..................................................................
...........................................................................
..................................................................
...........................................................................
..................................................................
...........................................................................
..................................................................
...........................................................................
..................................................................
SECTION E. Declaration. All applicants must complete this section. I hereby
certify that the particulars provided in this form are, to the best of my
knowledge and belief, correct.
Signed .................................................. (Applicant)
Date ....................................................
Note: 1. Please use a separate sheet of paper where the space provided in the
form is not sufficient. 2. The information given in this application, and the
result of the application, will be recorded in a register open for public
inspection. If an applicant wishes to withhold certain information from public
notification, a separate application under section 43 of the Ordinance will be
required. 3. The issue of a licence is subject to payment of a prescribed fee,
details of which are provided in a leaflet attached to this application form.
A demand note for the fee, specifying the date by which it should be paid,
will be sent to the applicant. A licence will not be issued unless the fee is
paid by the due date.
WARNING: Regulation 17 of the Water Pollution Control (General) Regulations
makes it an offence punishable with a maximum fine of $10000 for a person in
completing the form to knowingly or recklessly make a statement or give an
estimate which is incorrect in a material particular or knowingly omit a
material particular. (L.N. 375 of 1990; L.N. 324 of 1994; L.N. 80 of 1997)
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