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Declaration Format

The industrial unit declares that it has submitted a request for RTDMS connectivity for analyzers monitoring various parameters at multiple stations. It declares that the analyzers, their installation, operation, and measurement principles conform to CPCB guidelines and that the industry will be liable for any non-compliance. The declaration is signed and sealed by an authorized representative of the industry.

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Ashish Singh
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94 views1 page

Declaration Format

The industrial unit declares that it has submitted a request for RTDMS connectivity for analyzers monitoring various parameters at multiple stations. It declares that the analyzers, their installation, operation, and measurement principles conform to CPCB guidelines and that the industry will be liable for any non-compliance. The declaration is signed and sealed by an authorized representative of the industry.

Uploaded by

Ashish Singh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Annexure – II

SELF DECLARATION
(TO BE SUBMITTED ON OFFICIAL LETTERHEAD OF THE INDUSTRY)

We, M/s {{name of the industrial unit}}, located at {{complete address of the industry as per CTO}},
hereby declare that we have submitted RTDMS Connectivity request for the following:

S. No. Station Name Parameter Make and Model of Serial Number of the
Name Analyzer Analyzer
1 … … … …
2 … … … …
3 … … … …
We hereby declare that the analyzer, its installation, working, and measurement principle strictly
conforms to the CPCB Guidelines, and we will be liable for action in case of any deviation from the
guidelines.

(Seal of the authorized representative of the industry) :

(Signature of the authorized representative of the industry):

(Name of the authorized representative of the industry) :

(Email ID) :

(Contact Number) :

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