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The Water (Prevention and Control of Pollution) Rules, 1975

FORM XII - CENTRAL POLLUTION CONTROL BOARD
Notice of intention to have sample analysed
(See Rule 31)

To

_______________________________

Take notice that it is intended to have analysed the sample of water/sewage effluent/trade effluent which is being taken today the _________day of ___________ 19__ from (1)

____________________________________

Name and designation of the person
who takes the sample

(I) Here specify the stream, well, plant, vessel or place from where the sample is taken.

To
_________________________________
_________________________________
_________________________________

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