FORM 'J'
Application for the Inspection of Boilers and Steam Pipes under the
Indian Boilers Act.1923 (Act V 1923)
(Vide Rule 26 of Karnataka Boiler Rules,1982)
Registered No. of Name of the Date of Description of
Where situated inspection
Boilers/S.P.L Owner or Agent Boiler & Age
desirable
.
Mullugudde-57621 ..
kAVRADI
Karkala Type:Small Industrial ..
KTK-S-4087 Sri Durga Renuka 2019-04-18 Rating:8.09 Sq. mt.
Cashew Industries UDUPI Place and Year of
Make: Kanyana 2012
576211
Mob: 9448348554
Phone:
Email Id:
BANASHANKARIEN ..
I hereby, submit application to The Assistant Director of Boilers,Mangalore ..
for inspection and the grant of a certificate for the Boiler above named,together with
the treasury receipt in original obtained on payment of the prescribed fee specified
above.
Fee paid at ONLINE PAYMENT Rs 1900(Rupees) One Thousand Nine ..
CR0419023000871072 and date 2019-04-10. This 10th Day of April 2019.
Signature of Owner or Agent