Tel.

: 2429 6500 Fax: 2418 1387

Application for Welding Works

燒焊工作申請

Shop No. 商舖號碼 ：__________________ Shop Name 商舖名稱 ：_____________________

Applicant Name 申請人姓名 ：__________________ Title 職位 ：_____________________
Tel. No. 聯絡電話 ：__________________ Mobile No. 手提電話 ：_____________________
Fax No. 傳真號碼 ：__________________
E-mail Address 電郵地址 ：______________________________________________________________
Duration for welding work 燒焊工作日期：From 由 to 至

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Note 備註：
1) Welding work can only be proceeded with the presence of the duly signed copy of this application form and shall be shown to our
Management Services Office if required anytime.
燒焊公司/負責人獲此雙方已簽署的副本後方可進行燒焊工作，並須隨時在服務處要求下出示此副本。
2) Re-submission of application is required, if the date for welding work is expired.
如超出上述燒焊日期，必須重新申請。
3) Welding work shall be suspended if the equipments or working procedure cannot comply with the “Code of Practice of Welding
and Cutting Safety”.
如發現工具不足或不遵守「焊接及割切安全須知」將會被禁止燒焊工作。
4) Management Services Office reserves the right to hold over the grant of approval for welding work at any time if deemed
necessary.
服務處保留隨時禁止任何燒焊工作的權利。
5) In case of any dispute on interpretation on this form, English version shall prevail.
如有任何因解釋此表發生爭議，一切以英文版本為準。

We hereby submit the application for the welding work at the above location for the said duration and confirm to observe and monitor
all workers to comply with the “Code of Practice of Welding and Cutting Safety” from the Labour Department.
本人/公司現申請在上述單位/ 地方及上述日期進行燒焊工作，並願意遵守及監督燒焊工人遵守香港勞工處印製的「焊接及割
切安全須知」。
We understand that the welding work can only be proceeded if equipped with necessary equipment and facilities and with the signed
copy of this application form from the Management Services Office.
本人/公司明白需要提供及採用足夠的燒焊工具及設備，並獲取服務處簽批准的「燒焊工作申請」副本才開工。
We (including the undersigned company’s in-charge and Tenant) undertake all the loss and damages and liabilities arising from the
welding work.
本人/公司(包括以下署名的燒焊公司負責人及商戶)明白需要對燒桿工作(包括意外)所引起的一切 法律責任及賠償負全責。

Approved by 批核:

____________________________ _______________________________
Signature & Co. Chop Signature & Co. Chop
Welding Company / Applicant Management Services Office
燒焊公司/ 負責人蓋印及簽名 服務處蓋印及代表簽名
Date 日期：_________________ Date 日期：____________________

The information we collected will be used for processing all matters relating to the relevant application, daily operation and /or any follow up actions. We
will keep your personal data only for as long as necessary to fulfill the purpose for which it is collected
我們所收集之資料將用作處理有關申請、日常管理及/或任何跟進事宜。我們只會在有需要的時間內，為了達到收集個人資料的目的而保存閣下的個人資料。