Mu s: B11.

1
HNG DN LP BO CO TNH HNH THC HIN
GIY PHP X NC THI VO NGUN NC
(i vi trng hp ngh gia hn giy php x nc thi vo ngun nc)
1. Thng tin chung v c s x nc thi (Tn, a ch, fax, s giy php x nc thi
c cp.)
2. Tnh hnh x nc thi vo ngun nc:
- Ngun nc tip nhn nc thi:
- V tr ni x nc thi:
Thnx/phng.qun/huyn...tnh/thnh ph.
Ta v tr x thi (VN2000): X.
Y
- Phng thc x nc thi: (bao gm c ch v phng thc x)
- Lu lng nc thi:
- Thng s, nng cht nhim c php x thi:
Thng s
n v
Gi tr
Ghi ch
3. Tnh hnh thc hin ngha v ca ch giy php:
- Tnh hnh thc hin trch nhim v yu cu ca c quan cp php ghi trong ni dung
giy php.
- Tnh hnh thc hin cc ngha v khc c lin quan: