Hong Kong Regulations

QUARRIES (SAFETY) REGULATIONS - SCHEDULE 1

1.	I .............................................................., of ............................................................. (full name) (address) hereby apply to be approved as a supervisor/deputy supervisor(1) of the ............................ .............................................................................................Quarry/a quarry(1) situated at ................................................................................................................................ (address of quarry)
2.	I submit the following information in support of this application:- (a) Date of birth: ........................................................................................................ (b) Identity Card Number: ........................................................................................... (c) Practical experience in work in quarries: ................................................................. ............................................................................................................................. ............................................................................................................................. ............................................................................................................................. (d) Qualifications(2): ..................................................................................................... .............................................................................................................................
3.	I am already an approved supervisor/approved deputy supervisor(1) of the following quarry under these regulations(2): .............................................................................................
4.	I specify ................................................................................ as the date before which I do not desire the approval of this application, if granted, to come into effect.(2)(4)
5.	I attach the written consent of the proprietor(s)(1) of the quarry to my approval as a supervisor/deputy supervisor(1) of the quarry(3).
	Photograph of Applicant	Date: .................................................. Signature of applicant: .............................................
Note: (1) Delete whichever is inapplicable. (2) Delete if inapplicable. (3) Delete if applicant is sole proprietor of quarry. (4) Date specified must not be more than 3 months later than date of application.

Date and time of inspection	Equipment inspected	Report	Supervisor on duty by whom inspected	Signature of supervisor on duty by whom inspected

Date and time of inspection	Place inspected	Report	Supervisor on duty by whom inspected	Signature of supervisor on duty by whom inspected

Date	Hours during which work carried on in quarry	Supervisor on duty	Signature of supervisor on duty