The Notification Of Cooling Towers And Evaporative Condensers Regulations 1992

1. Name and address of premises where cooling tower/evaporative condenser is to be situated

Name of Premises ^*

Business Address Line 1 ^*

Business Address Line 2

Business Address Line 3

Postcode ^*

2. Person(s) in control of premises:

(NB: This information is required to enable access to be gained at all times to the notifiable device)

If there is more than 1 person, please use the ADD button

Title

First Name

Surname

Company Name

Address Line 1

Address Line 2

Postcode

Telephone Number

3. How many cooling towers or evaporative condensers are at the address shown at 1.?

4. Please give brief location of each piece of equipment being registered at this time: (ie. Main Building, South East Corner of 3rd Floor Roof, etc).

I confirm that the details contained in this application form were completed by me and that the details contained in the application form are correct to the best of my knowledge and belief

Name Of Person For Correspondence	DateDay	Position
Name Of Person For Correspondence	DateMonthYear	Position

Please forward your form to us by using the Submit button.

For any queries please telephone (01472) 324770 or e-mail environmental.health@nelincs.gov.uk

DATA PROTECTION NOTICE
North East Lincolnshire Council is a Data Controller for the purposes of the Data Protection Act 1998. Any personal information supplied on this form will be processed in accordance with the principles of the Act. If you want to find out more about your rights under the Act, you can contact the Office of the Information Commissioner (tel: 01625 545 700 / http://www.dataprotection.gov.uk) or the Director of Law and Democratic Services on 01472 313131.



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