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T.D. 26

T.D. 89

V.E. 24

F .S . 251

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SAMPLE

TRANSPORT DEPARTMENT E %I 33

Motor Vehicle Certificate of Roadworthiness %&ESB%ef&s=s a 5

The above vehicle having been examined under Section 78 of the Road Traffic Ordinance Cap. 374. 1 hereby certify that on the day of examina.l:ion .the requirements prescribed by the Road

Traffic (Construction and Maintenance of Vehicles) Regulations, Cap. 374 have been complied with in relation to the said vehicle.

k~S$%#3Ei&F,~%~%#~l%3Zk+~~ZBFBi%@1%k+1~iR~9+&4R &AggktSU~ttS$Hfi @9&*&2 a mE?3&%*&fid%5Zk+asZf82B ( S$@@EBl%S 1 BfidFhY4&2i%i+ O

Date ------------------------------------------------------------.-------------- ---------.----.-------.---.---------------------------------------------------------------------

m!l M.V.E. & $3 Z i 3

Model Registration Mark

S$RE@

For the purpose of licensing, this certificate must be presented within 4 months from the date of issue.

ktBS9Bfi+%%Z El EZt miaH m rn&ZB2iF%$RM2H O

SBE%?EG / S$R%PRE@

Class of Vehicle New or Used Vehicle Examination Centre

S$RRE'J %fiSSES

Make

%%

Serial No.

iiG%

SAMPLE NEW KOWLOON BAY VEHICLE EXAMlNATlOlN CENTRE

%fih88BJ%$ + 1 Li 8 TSUl HlNC STREET, KOWLOON BAY, KOWLLON Exam. Report No

h88BS%@jjiE &&+BE%% Telephone ZE& : 2751-8862 XX

VEHICLE EXAMINATION REPORT AND REPAIR ORDER 3 $fi t& Zfi! 4% E & E EZ 5% 23 %U %-

Vehicle Reg. Mark @QB%2M?iE Class %811 Chassis No. VIN &%/@%3PR%% Exam. Date .&@Ex4

Make E%

Time @ Fa7

Appointment No. ER%% Model ?&!% Year o f Manufacture %E%tfl Lane No. k%@#$%

Upon passing the Overall Examination Evaluation, this report is required for vehicle relicensing and is only valid for this purpose within 4 months from the date of issue. BEB8!38f&Gf&f& SQBRW9B*%1K;dES% L'LEgSCRR 1H;OES%8%% B&itDiB!H F9GB The above vehicle having been examined in accordance with the Road Traffic Ordinance Cap. 374 (Section 83 & 85) was found to have the defects listed above. You are hereby required to rectify these defects and produce the vehicle for a further inspection within one month of the date given above. ~ ~ + E B B B ~ P J ~ Z B L + ~ ~ ~ B Z ~ ~ ~ B Y ( ~ A + Z E A + E ~ ~ ) t m z t m k z m $ g B R ~ Z ~ E ~ S S ~ M ~ E B G %?&&L'Lkt8Z El E!--irnH rn%8SZ%@& - For descriptions of items numbers to Visual Inspection & Under Carriage Inspection, please refer to overleaf for details. R$3SB%mWEIUUm%ZffE3M IW%d?&R

Axle Weights (t) 1. (

RESULTS $692

ITEM JBH

1) VISUAL INSPECTION % ETi $& )%

Unsatisfactory Items F%E%€i Skipped lterns WB&*@JB €i

2) SIDE SLIP TEST IN :@ %I 24 3) BRAKE TEST %!I %J ?HI 8

Land Supervisor ,&S#2ZE

Brake Force (Kg) Wlj a A Front Axle i C NI Rear Axle f& NI Park brake Axle $,Q@$!l@NI Total Axle Weight f

4) SPEEDOIVETER TEST s 33 @ ?!!I 8 5) TAXIIVETER TEST 09 k Zt fZ' % ?F!U 24 6) HEAD LAMP TEST s @ fz? ?F!U 3 7) EXHAUST SMOKE TEST l# $3 $11 8 8) LlblDER CARRIAGE INSPECTION ,E & t& ,%

Unsatisfactory lterns F%%JPB€i Skipped lterns @2B&*%XB €i

9) OVERALL EXAMINATION EVALUATION @#8!I?&s@i

Left Wheel &$i$ Right Wheel &$I$

SAMPLE X XXXXXXXX

FSD Ref. : ................................ ME&%%

FIRE SERVICE (INSTALLATIONS AND EQUIPMENT) REGULATIONS Sffi (EBE%f i )%@j

(Regulation 9(1)) (3% h I€% (1) 3 )

CERTIFICATE OF FOR SERVICE INSTALLAITONS AND EQUIPMENT SffiiEBE%IE4BS

Name of Client : Bib&% Address Name of Building @FgR %ht

St. No. BY R M !& Street I Road Name %fj 3% tikj Town Lot & No. $ fj ,@ E 3% 6

FlaVRoom B Block E Floor I District I Area Lg 53

PART I

PART 2

Comment on Condition #3mai

The works listed in Part 1 above were completed ~ - ~ f i p ~ & l r @ ~ ~ ........................ .... ..... .+ on .............................. .. ............. and the above ......................... fl ............................. ElZE installations I equipment have tested and found to be in Z$!!S& SWEfiEBH R~NB&&ETE!+G~&J@{E efficient working order in accordance with the Code of IFIENffiEEE%E3R!!@%% 3?BG%H?!!fi%-3 Practice for Minimum Fire Service Installations and Equipment published from time to time by the Director of Fire Services. Exception listed in Part 2.

Nature of Work Carried out REtitIl?rn@

Item No. %HlM

Item No. %H%M

Date HfgJ ................................................................................. for ............................................................... (Firm's Name) (fiq%@)

Type of Installation

F.S. 251

Outstanding Defects %@SF&

Comment on Defects SF&AZ

?aAEt%% Fire Extinguisher Lable

Registration Number 3#@3% Maintenance Date +%%Elm Valid Unit *%am FS 251 Serial Number

HF%mR%%

XXXXXXXX

XX-XX-XX

XX-XX-XX

XxxxxXXX

XXXXXXXX

FORM 3 %%3

THE GOVERNMENT OF THE HONG KONG SPECIAL ADMINISTRATIVE REGION %BRBrJE&E&R

GAS SAFETY (GAS SUPPLY) REGULATIONS CAP. 51 BB%rn% 51 S%B%* (%BE@ %a

NEW APPLICATION / RENEWAL FOR PERMIT FOR CONVEYANCE OF LPG CYLINDERS ON GAS VEHICLE %$3 1 #HEH%HSWZS6B%%rn3~3

To the Gas Authority : B : %%WEB@

Note : This application form is used for *NEW application I RENEWAL for permit t o convey LPG cylinders on gas vehicle. i Z 9 : &+ZirjS%i%*%+IW 1 HB!~M%ESQ-I3;6a%%~R?jJStM

The applicant should complete all sections of this application form in BLOCK letter and SIGN the form. +?3AELXiE&%%$%%&M %EG%%k%S - The fee for the issue of permit should be paid by the applicant at the time of collection of the permit (see Application & Payment Instruction No. 3) +%hEG%@A~sW&2B%~T?jJsRM - (38M@3%&3.Z& 3 )

I I We hereby apply for a permit to convey LPG cylinders on gas vehicle and I I We declare that all particulars, statements and documents submitted herein and with this application form are true and correct.

$A 1 %ffS+i i r jEM%#SW~Z;6~%%~BT~~ ,$A 1 %iP'l%%a8Ek+iirjS+%%?E~-WBH , M&RW;fkfFJ%14EWBf %It

Date : Signature of Applicant : El#@ +%A%S

Sectlon A : Particulars of Gas Vehlcle A 3 %ES%BH

(1) Vehicle Registration Number : (2) Make: S%BSZB%G u Ex% I l l l l l j l I I I I / I I I I I

(3) Engine Number : (4) Chassis Number : 5 I%%% a SBEi%G% I I I I / I I I I I I I / I I

( 5 ) Trailer Number (if applicable) : #ESE@ (4OBR ) /IIII/IIII/II

Section B : Particulars of Owner of the gas vehicle / Applicant* B 3 11S~S4.1 @lirjh*W#

(1) Name: ??kg

(English)

(Chinese) ($2)

(2) Identity Document Number BM'd;la82!4%%

(* Delete where not applicable) (B#$%H1Wlll)

EMSDlGS0103 (REV. ID)

(3) Postal Address : B%%ht

(4) Telephone Number : %S%3 u u

(5) Authorization : (if you are authorizing another person to apply for a permit t o convey LPG cylinders on your vehicle please sign below.)

%2@ : (tU%2lNAltB+IWIER%HSW3Z.fia%%&3"IS , ~ S E ~ ; E I % ~

I /We hereby authorize on my / our behalf t o apply for a permit t o convey $A I %ffTB@(Name of Applicant + % A & Q ) I t S $ A I ftifflEQ;mH%@SQS2;Ei%%%&B4qS - $A 1 ftiff'1

LPG cylinders on my / our vehicle registration number Srn&BiZ%GB

Date : BE4

Signature of Vehicle Owner : S*%t

Section C : Particular ot Applicant authorized by the owner ot the gas vehicle (it authorized in Section B(5)) C 3 B%#S$%S*B@&EQBWA3W ( $LIE?@$? B ( 5 ) 3 )

(1) Name : #Q

(English) (Kg)

(Chinese) I 2) ldentity Document Number : ( + Z ) &lAlsBZl+%% u

(4) Telephone Number : %SEG u u

(3) Postal Address :

M o m D : Pha(ocoplr of documants submltbd In support of *la appllutloa D dB : WIEQRf K $ l R S SsBatJXRaEP$ (see attached notes and the Application & Payment Instructions No. 3) (3PHK$16t i r2BEQW#t3ES 3)

# #

%3%ht

(a) Hong Kong ldentity Card(s) - owner / authorized applicant S%%BB* - SX 1 #!?@@%A

I

0 (b) Certificate of Incorporation /L?qsfWg$?9

(c) Certificate of Particulars of Vehicle (T.D. 61(c)) EtBEZrnrnirla89

(d) Vehicle Registration Document (T.D. 26) *MBeatr

(e) Certificate of Roadworthiness (TD 89) UUF*&Mg&Bi

(f) Vehicle Examination Report and Repair Order (VE24) SQUU~LESBEWB~I~

0 (g) Certificate of Fire Sewice Installations and Equipment (F.S. 251) HEBBBSRBi

0 (h) Registered Gas Supply Company's Approval Letter Zrn%E!EE/L? aK&9

# Please tick as appropriate

3GaP9BhUlJE t Owner I authorized applicant can voluntarily provide a copy

SZ 1 Bl*%AqBmsBBKgu$

Notes MZ3

This application form is used for new application / renewal for a permit to convey LPG cylinders on a gas vehicle. kt@%%?&i% *%$% 1 aBiEm%BsmB36?m%EmZTqB2H

The applicant should provide one photocopy of the documents stated in Section D to support this application. $%AEEf% D ~bFfiagf%%EP*LxfFB%

For renewal of permit, the applicant should make vehicle examination appointment within 3 months before the permit expiry date. Where the permit has already expired, a new permit will be issued in accordance with regulation 26(1). 91@,@$BZTqZB $ $BAEBR6ZTqZB6%B@%$ 3 fH H F!gF%)ES ZR6ZTqZB6BBEE@ F!U@ E% 26( 1 )f&%B%mgTqZB

Appointment for vehicle examination could be arranged with Fire Services Department on 2733 7607 between 11:OO a.m. and 12:OO noon or 2:30 p.m. and 3:30 p.m. from Monday to Friday. 9nsgFgqEs SEER-SS~~T I I B ~ S ~ E T 12 @ ~ T T 2 ~3 30 f i ~ 3 E+ 30 f i & ~ 2733 7607 W ~ E @B%@rH7

LPG cylinder wagon examination could only be arranged on Tuesday and Thursday (excluding Public Holiday). 6a%%sm&s@Fm7RPEEBm:Ws%m (!iXEErnB9+ )

Application & Payment Instruction No. 3 EQ;~@#&~$z~ 3

The fee for the issue of permit for the conveyance of LPG cylinders on gas vehicle is 82,420 (new application and 8600 (permit renewal) but may be subject to periodic revision. %,%$3@H%Bs@B36%%%mZTqBmRH%$2,420 ( % $ZB ) W $600 ( ZTqiB,@% ) ZXRqilX% RZkt3%

This application form should be posted to Gas Standards Office, 3 Kai Shing Street, Kowloon, Hong Kong unless otherwise advised by Gas Standards Office. $SSESGB%hEiHE% 3 %%%&@%BE B9F%BB@SB@Z6tEZ

Payment of fee should be made in person by the applicant, or representative, at the Registration and Collection Office, Ground Floor, the Electrical and Mechanical Services Department Headquarters, 3 Kai Shing Street, Kowloon, Hong Kong. $3A$ZSf-t% * E?i2!JBBhEHE% 3 % B % I + ~ S ~ % ~ & T Z ~ W 4 2 S A B ~ ~ ~ H

HOURS OF COLLECTION : Monday to Friday 9:00 a.m. to 4:30 p.m 42SAB3Ba'l BB-ES5 kTh@iESTTFl@Z+fi

Saturday EBk

9:00 a.m. to 12:OO noon kThB3iES$T+X%E

Cheques, Drafts and Cashier Orders should be made payable to the "The Government of the Hong Kong Special Administrative Region" and crossed. They must not be made payable to any individual officer. Post-dated cheque will not be accepted. Ffi&&% - E%E$%B&~%%54&!$ @&%ZUf?&E&R, MJnS!#& t?~@%B&!$g-@3 B%+@ %f++B#fl

EMSDlGS0103 (REV. 1 D)