Section 10:

10. State whether the factory building is new ............................. Signature of applicant: ........................................................ Name: .............................................................................. Status: ............................................................................. Date: ................................................................................ FOR OFFICE USE ONLY The application is— *(a) Approved with conditions for period ........................... to ...................... *(b) Approved without conditions for period ....................... to ...................... *(c) Not approved. O2 – 89 [Issue 1] Occupational Safety and Health Act FIFTEENTH SCHEDULE—continued Date: ...................................... ......................................................... for Director, Occupational Safety and Health *Delete whichever is not applicable. II III Rs cs Registration Fee: ...................... Factory Building Permit Fee: Rs. ............ (already paid) Surcharge (50%): ..................... Receipt No.: ....................................... TOTAL: ................................... Certificate No.: ................................... Date of issue: ..................................... File No.: ............................................. Receipt No.: ........................................ Certificate No.: ................................... Date of issue: ..................................... Date of expiry: .................................... ............................................... .......................................................... Signature of Issuing Officer for Director, Occupational Safety and Health Date: ...................................... Date: ..................................... SIXTEENTH SCHEDULE [Section 29] THE OCCUPATIONAL SAFETY AND HEALTH ACT [Section 29] APPLICATION FORM FOR REGISTRATION TO PRACTISE AS A SAFETY AND HEALTH OFFICER