Name of unit (seal)

Fill in the name approved by the legal person registration or the administrative department for industry and commerce. The name of the unit shall be consistent with the name used in the official seal of the unit.

2. Reporting year

Is the year of the reference date.

3. The reporting entity legal person code

Fill in the code on the code certificate of legal entity issued by the technical supervision department.

4. Legal representative

Signature and approval of the legal representative. Individual industrial and commercial households shall be signed and sealed by the owners.

5. Company address

Refers to the address of the reporting unit, which should be specific to the township (town), street (village) and house number.

6. Enterprise scale

Fill in the name according to the enterprise scale code table. Including large, medium and small.

7. Registration type

Fill in the names according to the registration type code table, such as state-owned enterprises, collective enterprises, self-employed, individuals and others.

8. Join

Including provinces, cities, counties, streets, neighborhood committees and so on.

9. Original value of fixed assets

Refers to the original value of fixed assets used for production and operation, which is filled in according to the data in the financial statements of the previous year.

10. Bank and account number

Fill in the financial basic account information of the reporting unit.

1 1. Business hours

Refers to the date when the reporting unit is put into production, use and operation.

12. Number of employees at the end of the year

Refers to the actual total number of employees at the end of last year.

13. Industry category/code

Fill in the industry name and code according to the Code Table of National Economy Industry (GB/T4754-2002). Such as: catering industry /67, bathing industry /825, accommodation industry /66, barber, massage, beauty salon industry code 82, car wash industry /83, etc.

14. Data source

"Water fee" is filled in the list of "Water fee of XXX Water Supply Group Co., Ltd.", and no "other" is filled in.

15. sewage discharge characteristic value

According to the corresponding items in the table, it should correspond to the industry. Among them, the catering industry mainly reports the business area, the bathing industry reports the shower nozzle, the hotel industry reports the bed, the barber/massage/beauty/hairdressing industry reports the seat (bed), and the car wash industry reports the parking space.

16. Fuel name

Refers to the name of the main fuel coal, fuel oil and gas.

17. Annual consumption (tons or cubic meters)

According to the actual consumption of coal, oil and gas last year, this year's quantity is predicted, in which the unit of coal and oil is tons and gas is cubic meters.

18. Main combustion equipment

Refers to boilers, tea stoves, stoves and other combustion equipment, but also the main equipment to produce atmospheric pollutants.

19. Discharge of water pollutants and air pollutants this year

Combined with the actual situation of last year and the declaration of this year's production and operation plan, the unit is kg.

20. Monthly emission of boundary noise

Whether it exceeds the standard or not, the name of the noise source in [corresponding noise source and number] shall be filled in.

2 1. Additional explanation

Explain the data sources of water pollutants and air pollutants and the calculation method of emissions.

22. Fill in the blanks

Signed by the person who filled out the report.

23. Date of offer

Fill in the report and date it.