环境影响自检表 FINAL(2007.3).docVIP

项目类别：工业、三产、其它 收件日期：__________ 编 号：__________ 苏 州 工 业 园 区 SUZHOU INDUSTRIAL PARK 建设项目环境影响自检表 ENVIRONMENTAL IMPACTS SELF EVALUATION FORM OF PROPOSED PROJECT 项目名称: 元素六金刚石（苏州）有限公司扩建项目 Name of proposed project 建设单位： 元素六金刚石（苏州）有限公司 Developer(seal) (盖 章) 填报日期: 2007 年 3 月 5 日 Date of application 2007 yy 3 mm 5 dd 苏州工业园区环保局制 Suzhou Industrial Park Environmental Protection Bureau 建设项目环境影响自检表填报说明 How to fill in Environmental Impacts Self- Evaluation Form of Proposed Project 一、填表要求 ⅠRequirements 1、一式二份均须用不褪色墨水笔填写，涂改无效。 Tow copies of the forms needed, please fill in with ink pens without amendment, 2、须如实申报，规范填写，不得瞒报和虚报。若有涂改，涂改处须经项目法人代表签字或加盖法人章确认。 Please apply according to the facts, no hidden facts and no making a false report. All the amendments should be confirmed by Legal Representative’s signature or seal. 3、所有内容须经项目法人代表审阅后签字认可或加盖法人章。如委托签字须附法人代表的授权委托书。 All the blanks should be filled in upon project legal representative’s confirmation by signature or seal. Power of Attorney should be attached if signed by authorized person. 4、位于园区周边镇区的项目填写本表后须经当地镇政府环保办初审后方可报园区环保局。 Local township environmental offices have to pre-approve projects registered in townships before submitting to SIP Environmental Bureau. 二、附件资料 ⅡAttachments 1、本表须附申报项目选址的定位图，中新合作区内项目由一站式服务中心提供定位底图，园区周边地区的项目可向所在地镇政府环保办索取定位底图。 1 Site Location Map of Proposed Project should be attached. Proposed projects registered in the central area could request site location map from One Stop Service center, while those registered in the townships could request from local environmental office. 2、新设立生产性企业须提交工商名称预核准通知书复印件。 Copy of Approval of Business Name issued by ICB is required upon new proposed manufacturing project. 3、租用厂房的生产性企业须提交该厂房环保验收合格通知书复印件。 Manufacturing projects renting the factory should offer copy of Notification on Environmental Approval of Factory. 三、填表指南 Ⅲ Guide 1、? 封面右上角，仅供环保部门填写。 Top right