城市排水许可申请表(空).pdf
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1、学习文档仅供参考申请编号：受理编号：申请时间：受理时间：城镇污水排入排水管网许可申请表申请单位章中山市腾格电子排水户中山市腾格电子填 表 日 期申 请 类 别：首次申请 变更申请 延期申请学习文档仅供参考填写说明1、本表一式两份，申请人一份，归档一份。2、表格使用黑色钢笔或签字笔填写，也可用电脑打印，字迹工整，不得涂改，申请表封面应加盖申请单位公章。3、本表“一、基本情况”和“二、排水管网情况”、“三、排水水质情况”的内容由排水户申请单位真实、准确、完整、全面地填写。“申请编号”、“申请时间”、“受理编号”、“受理时间”等内容由发证机关填写。4、本表一律用中文填写，数字均使用阿拉伯数字。5、本
2、表封面的“申请类别”一栏，申请人如果是首次申请，请在“首次申请”后的方括号内打勾；如果是由于排水口数量和位置、排水量、污染物项目或浓度等许可内容变更重新申请，请在“变更申请”后的方括号内打勾；如果是延期申请，请在“延期申请”后的方括号内打勾。“基本情况”部分“用水量”、“排水量”需提供相关依据，“污水预处理方式”如是委托处理，在相应的方框内打勾即可，如是自行处理，还需注明污水处理工艺。6、“排水管网情况”需填写所有排水口设置情况，雨水排放口不需要填写“排水量”及“有无在线监测装置及检测项目类型”项。7、“排水水质情况”应按照由具有计量认证资质的排水监测机构出具的排水水质检测报告填写；拟排放污水
3、的新排水户应附水质、水量预测报告。8、本表在填写时如需加页，一律使用A4 型纸。9、复印件需加盖公章或法人签名。文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10
4、S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P
5、2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2
6、Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z
7、10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R
8、4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2
9、X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3学习文档仅供参考一、基本情况申请单位单位地址邮 编营业执照注册号组织机构代码法定代表人电 话手 机联系人电 话手 机排水户排水户业务类型排水户地址用水量
10、 m3/日排水量 m3/日总用水量其中自来水量其中自备水量总排水量其中生产(含餐饮)污水量其中生活污水量无无预处理方式中打“”自行处理预处理工艺委托处理排水户用地面积(m2)总建筑面积(m2)生产区面积(m2)住宅面积(m2)商业面积(m2)办公面积(m2)餐饮面积(m2)主要产品或服务：主要原料：主要生产工艺及水污染物产生流程框图，可附图：污水预处理工艺流程框图，可附图：备注：文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R
11、7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S
12、3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2
13、R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q
14、5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z1
15、0S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4
16、P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X
17、2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3学习文档仅供参考二、排水管网情况排水口编号连接管排水口管径 mm排水量m3/日排水去向道路名称有无在线监测装置及检测项目类型排水管网平面示意图可附图：备注：文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S
18、3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2R9B9 HU8J2X2Q5R7 ZC3S9X7Z10S3文档编码:CG1R4P2
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