borough of poole - hambleton district · web viewplease give details, including location, of the...
TRANSCRIPT
BOROUGH OF POOLE
HAMBLETON DISTRICT COUNCIL
NOTIFICATION OF COOLING TOWERS
AND EVAPORATIVE CONDENSERS REGULATIONS 1992
1
Address where the alterations are being carried out - continue overleaf if necessary
Name of Premises
Address
2
Person(s) in control of premises – please continue overleaf if necessary
Name of person
Company name
Address
Telephone Number
NB - This information is required to enable access to be gained at all times to a notifiable device.
3
How many cooling towers or evaporative condensers are at the address shown in box 1?
4
Please give details, including location, of the amendments/alterations for each piece of equipment you are intending to carry out and the date of completion of these works. If you are sending a plan of the alterations please state this here. Please continue overleaf if necessary.
Declarations
Signed by
PositionDate
Please indicate if you require a receipt YES/NO
Acknowledgement tear off - for Local Authority Use
THE NOTIFICATION OF COOLING TOWERS AND EVAPORATIVE CONDENSERS REGULATIONS
To
Name of person(s) in control
Address
Date of registration
Number of cooling towers registered
Reference number in case of query
y:\environmental health\general\ehs quality management system\health & safety\forms\h.f.7 - cooling tower change application.docx