Registration Form of Pollution Discharge from Stationary Pollution Sources (Fill in Sample Version)
Fixed Pollution Source Pollution Registration Form(Fill in the template)
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Unit Name (1) |
the business license (e. g. Huizhou **** Co., Ltd.) |
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Registered Address (5) |
business license registered company address (e. g. No. **Town, Huicheng District, Huizhou City) |
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production and business premises (6) |
the actual production and operation address of the enterprise (if consistent with the business license, the same) |
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Industry Categories (7) |
enterprises operate (e. g., engaged inplastic partsindustry, fill inplastic parts and other plastic products; If it is not possible to determine the expression of the industry category, it can be expressed in detail in words) |
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Other Industry Categories |
(if the company is engaged in two industries, fill in the same as the above table, if not, fill in "/") |
Unified Social Credit Code (8) |
(number of business license registration) |
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Legal representative/actual person in charge (12) |
(name of legal person registered with business license) |
Contact Information |
(mobile phone number of person in charge of legal person or enterprise) |
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Production Process Name (13) |
Major Products (14) |
main product capacity |
Unit of measurement |
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(detailed product process flow, if there are multiple products and the process of each product is different, fill in separately, and indicate which process corresponds to which product) |
(product name) |
(annual output) |
(name of unit) |
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Fuel Usage Information£have□None(insert "None" if not present) |
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Fuel Name |
(such as liquefied petroleum gas, light diesel oil, biomass pellets, etc.) |
Annual Consumption (ton) |
annual usage |
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involvedVOCsexcipients (use involvesVOCsAccessories1tons/years to fill)(15) □ Yes□None(insert "None" if not present) |
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Name |
(e. g. coatings, inks, adhesives, paints, organic solvents, etc.) |
Annual Consumption (ton) |
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exhaust gas□ Organized discharge□ Unorganized discharge□None(insert "None" if not present) |
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Exhaust Gas Name |
(waste gas generated in the process) |
Treatment Facilities |
what equipment to deal with (such as: activated carbon, water spray, bag dust, etc.) |
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Exhaust Gas Name |
Treatment Facilities |
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Name of discharge port |
(fill in with or without exhaust pipe) |
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waste water□ Yes□None(insert "None" if not present) |
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Type of wastewater |
(e. g. production wastewater or domestic sewage) |
emission destination |
(such as: into the municipal pipe network, park sewage treatment facilities) |
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Industrial solid waste□have□ None |
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Industrial solid waste name |
is hazardous waste |
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(such as: waste activated carbon, waste oil, spray waste water, waste ink, waste paint, waste bucket) |
□ Yes□No (insert "None" if not present) |
□storage: □ this unit/□to supplier □ Disposal: □ Unit/□ Delivery □ Incineration/□ Landfill/□ Disposal by Other Methods □ Utilization: □ Unit/□ Delivery |
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EIA Approval Document No. |
(please fill in the correct document number of the approval, for example: Huishihuan (Huicheng) Jian [2020]**) |
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