公共场所卫生许可证申请书

公共场所卫生许可证申请书 公共场所卫生许可证 申 请 书 申请单位:,,,,,,,,,,, 申请日期:,,,,年,,月,,日 东莞市卫生局制 methods of the poker vibrator vibrating, steel reinforcement in Foundation pit West of a steel processing plant concentrates production templates using large pieces of shaped steel formwork and bamboo glue formwork methods. Bridge jacking of 500t hydraulic top picks, roof is complete, edge angle wall, railing, cable channel, u-channel and other ancillary works construction. 3.1.4. the construction process (see the construction process flow chart) construction process flow chart3.2. construction site layout 3.2.1. construction site layout 1, layout according to the construction design requirement, Foundation placed in the North of the line. Construction site layout as shown in Figure 1. construction general layout. 2, temporary works combined with the devoted section personnel and machinery equipment, the actual situation, in accordance with the specification requirements, established in the site layout construction and management required from near, and to meet the normal production and life in the Office, housing and steel processing facilities, warehouse and storage and the template field, and fire facilities as required. Separation of work zones, work area, living area settings, and set wall closed. 3, construction water water in situ dewatering wells, water tanks and bottled water. 4, the construction of electricity given this project of welded steel and concrete construction 填 写 说 明 一、申请书需保持整洁，不得折叠;申请书用黑色或蓝色钢笔填写，内容应完整、准确，字迹工整清晰，不得涂改。 二、本申请书适用于公共场所卫生许可证的申请，下列公共场所需办理公共场所卫生许可证: (一)宾馆、酒店、旅店、招待所、度假村等住宿场所; (二)桑拿、浴室、洗浴中心、足浴、温泉浴、SPA休闲中心等沐浴场所; (三)理发店、美容店(不含医疗美容)、美甲店等美容美发场所; (四)影剧院、歌舞厅、音乐厅、录像厅、卡拉OK、游艺厅(室)、咖啡馆、酒吧、茶座等文化娱乐场所; (五)体育场(馆)、游泳场(馆)、健身室等体育场所; (六)展览馆、博物馆、美术馆、图书馆等文化交流场所; (七)营业面积在1万平方米以上或使用集中空调的商场、超市、书店等购物场所; (八)候车(含地铁)室、候船室等公共交通等候场所。 三、单位名称栏:应与工商行政管理等部门核准的一致。 四、单位地址栏:按经营场所的详细地址填写。 五、法定代表人(或负责人)栏，根据公共场所经营者的性质，在“法定代表人(或负责人)”栏后填写法定代表人或负责人姓名，其中属法人的，填写法定代表人姓名;属法人分支机构或者其他组织的，填写负责人姓名。 六、从业人员数:指参与正常经营服务活动的工作人员总数。 七、所附文字资料必须采用A4规格纸张打印，并逐页加盖公章，如企业未有公章，法人代表(或负责人)必须逐页签字，并在申请表中“备注”一栏注明。 y given this project of welded steel and concrete constructionlosed. 3, construction water water in situ dewatering wells, water tanks and bottled water. 4, the construction of electricitall cand the template field, and fire facilities as required. Separation of work zones, work area, living area settings, and set w ear, and to meet the normal production and life in the Office, housing and steel processing facilities, warehouse and storagefrom ntion, in accordance with the specification requirements, established in the site layout construction and management required tion general layout. 2, temporary works combined with the devoted section personnel and machinery equipment, the actual situanstruconstruction design requirement, Foundation placed in the North of the line. Construction site layout as shown in Figure 1. cort) construction process flow chart3.2. construction site layout 3.2.1. construction site layout 1, layout according to the cchannel and other ancillary works construction. 3.1.4. the construction process (see the construction process flow cha-e channel, und bamboo glue formwork methods. Bridge jacking of 500t hydraulic top picks, roof is complete, edge angle wall, railing, cablproduction templates using large pieces of shaped steel formwork amethods of the poker vibrator vibrating, steel reinforcement in Foundation pit West of a steel processing plant concentrates 2 ?新建 ?许可证复核 ?改建 ?更正地址 项 目 类 别 ?扩建 ?许可证延续 ?变更 ?遗失补证 单 位 名 称 单 位 地 址 法定代表人 单 位 电 话 (或负责人) 从业人员数 人 已体检人数 人 ?国有 ?个人独资 ?有限责任公司 单 位 性 质 ?集体 ?外商独资 ?股份有限公司 ?合伙 ?中外合资 ?中外合作 ?其它 注 册 资 金 万元 所属镇(区) 总建筑面积 平方米 使 用 面 积 平方米 联 系 人 联 系 电 话 是否星级(或预备星级)酒店:? 是 ? 否 ? 一星级(或预备一星级) ? 二星级(或预备二星级) ? 三星级(或预备三星级) ? 四星级(或预备四星级) ? 五星级(或预备五星级) city given this project of welded steel and concrete constructionlectriet wall closed. 3, construction water water in situ dewatering wells, water tanks and bottled water. 4, the construction of eage and the template field, and fire facilities as required. Separation of work zones, work area, living area settings, and sd stored from near, and to meet the normal production and life in the Office, housing and steel processing facilities, warehouse antuation, in accordance with the specification requirements, established in the site layout construction and management requiral siconstruction general layout. 2, temporary works combined with the devoted section personnel and machinery equipment, the actu e construction design requirement, Foundation placed in the North of the line. Construction site layout as shown in Figure 1.struction process flow chart3.2. construction site layout 3.2.1. construction site layout 1, layout according to thchannel and other ancillary works construction. 3.1.4. the construction process (see the construction process flow chart) con-able channel, uing, cormwork and bamboo glue formwork methods. Bridge jacking of 500t hydraulic top picks, roof is complete, edge angle wall, railent in Foundation pit West of a steel processing plant concentrates production templates using large pieces of shaped steel fmethods of the poker vibrator vibrating, steel reinforcem3 ?宾馆 ?酒店 ?旅店 ?A.住宿场所 ?招待所 ?度假村 ?其他( ) ?桑拿 ?浴室 ?洗浴中心 ?B.沐浴场所 ?足浴 ?温泉浴 ?SPA休闲中心 ?其他( ) ?理发店 ?美容店(不含医疗美容) ?C.美容美发场所 ?美甲店 ?其他( ) ?影剧院 ?歌舞厅 ?音乐厅 ?录像厅 ?卡拉OK ?游艺厅 申 请 ?D.文化娱乐场所 ?游艺室 ?咖啡馆 ?酒吧 许 可 ?茶座 ?其他( ) 项 目 ?体育场 ?体育馆 ?游泳场 ?E.体育场所 ?游泳馆 ?健身室 ?其他( ) ?展览馆 ?博物馆 ?美术馆 ?F.文化交流场所 ?图书馆 ?其他( ) ?商场 ?超市 ?书店 ?G.购物场所 ?其他( ) ?候车(含地铁)室 ?候船室 ?H.公共交通等候场所 ?其他( ) 已 批 准 许可项目 卫生许可证号 发 证 日 期 有 效 期 年 月 日至 年 月 日 y given this project of welded steel and concrete constructionlosed. 3, construction water water in situ dewatering wells, water tanks and bottled water. 4, the construction of electricitall cand the template field, and fire facilities as required. Separation of work zones, work area, living area settings, and set w ear, and to meet the normal production and life in the Office, housing and steel processing facilities, warehouse and storagefrom ntion, in accordance with the specification requirements, established in the site layout construction and management required tion general layout. 2, temporary works combined with the devoted section personnel and machinery equipment, the actual situanstruconstruction design requirement, Foundation placed in the North of the line. Construction site layout as shown in Figure 1. cort) construction process flow chart3.2. construction site layout 3.2.1. construction site layout 1, layout according to the cchannel and other ancillary works construction. 3.1.4. the construction process (see the construction process flow cha-e channel, und bamboo glue formwork methods. Bridge jacking of 500t hydraulic top picks, roof is complete, edge angle wall, railing, cablproduction templates using large pieces of shaped steel formwork amethods of the poker vibrator vibrating, steel reinforcement in Foundation pit West of a steel processing plant concentrates 4 申报 材料 关于××同志的政审材料调查表环保先进个人材料国家普通话测试材料农民专业合作社注销四查四问剖析材料 (请在所提供材料前的?内打“?”) 编号 材 料 名 称 页 数 ? 1 企业名称预先核准通知书或营业执照复印件 ( )页 ? 2 法定代表人或负责人身份 证明 住所证明下载场所使用证明下载诊断证明下载住所证明下载爱问住所证明下载爱问 复印件 ( )页 ? 3 公共场所地址方位示意图、平面图和卫生设施平面布局( )页 图 ? 4 公共场所、集中空调通风系统卫生检测或者评价报告复( )页 印件 ? 5 从业人员的名单、健康合格证明和卫生知识培训合格证( )页 明，以及卫生管理人员卫生培训合格证明 ? 6 公共场所卫生管理 制度 关于办公室下班关闭电源制度矿山事故隐患举报和奖励制度制度下载人事管理制度doc盘点制度下载 ( )页 ? 7 建设项目竣工卫生验收认可书 ( )页 ? 8 卫生行政部门依法要求提供的其它资料 ( )页 ? 9 卫生许可证原件 ( )页 ? 10 卫生许可证复印件 ( )页 ? 11 变更申请 ( )页 ? 12 更正地址申请 ( )页 ? 13 当地居委会证明 ( )页 ? 14 遗失补证申请 ( )页 ? 15 登报原件 ( )页 申请单位保证书 本申请书中所申报的内容和所附资料均真实、合法，所提交的文件、证件及有关证明是真实有效的，复印件与原件是一致可信的。如有不实之处，本单位愿负相应法律责任，并承担由此造成的一切后果。 法定代表人(或负责人)签名: (申请单位盖章) 年 月 日 备注: city given this project of welded steel and concrete constructionlectriet wall closed. 3, construction water water in situ dewatering wells, water tanks and bottled water. 4, the construction of eage and the template field, and fire facilities as required. Separation of work zones, work area, living area settings, and sd stored from near, and to meet the normal production and life in the Office, housing and steel processing facilities, warehouse antuation, in accordance with the specification requirements, established in the site layout construction and management requiral siconstruction general layout. 2, temporary works combined with the devoted section personnel and machinery equipment, the actu e construction design requirement, Foundation placed in the North of the line. Construction site layout as shown in Figure 1.struction process flow chart3.2. construction site layout 3.2.1. construction site layout 1, layout according to thchannel and other ancillary works construction. 3.1.4. the construction process (see the construction process flow chart) con-able channel, uing, cormwork and bamboo glue formwork methods. Bridge jacking of 500t hydraulic top picks, roof is complete, edge angle wall, railent in Foundation pit West of a steel processing plant concentrates production templates using large pieces of shaped steel fmethods of the poker vibrator vibrating, steel reinforcem5 各 场 所 名 称 楼名、楼层 空 调 设 备 卫生设施:(有下列设施的请在?内打“?”) ? 1 专用清洗消毒间:?消毒柜 ?给排水设施 ?清洗消毒过水“三联池” ? 2 专用消毒设施:?非一次性拖鞋消毒设施 ?修脚专用工具消毒设施 ?理发、美容专用工具消毒设施 ?技师手部清洗消毒设施 ?桑拿浴室配备浴池水净化消毒设施和通风排气装置 ?游泳场所配备池水净化消毒设施，有消毒药品存放间 ? 3 机械通风、排气设施:?空调系统 ?新风系统 ?抽风系统 ?排气扇 ? 4 集中空调通风系统:?空气净化消毒装置 ?有应急关闭回风和新风的装置 ?供风管系统清洗消毒用的可开闭窗 ? 5 专用布草间:?布草柜 ?日用品柜 ?布草车 ? 6 自洗布草:?给排水设施 ?消毒池 ?洗衣机 ?干衣机 ? 7 果盘、果汁制作间:?预进间 ?洗手设施 ?消毒设施 ?更衣设施 ?非手动式的水龙头 ?食品冷藏设施 ?紫外线消毒灯 ? 8 水冲式公共卫生间:?洗手设施 ?机械排风装置 ? 9 卫生防护设施:?防蚊 ?防蝇 ?防蟑螂 ?防鼠 ? 10 废弃物存放设施密闭或带盖 ? 11 室内公共场所禁烟标志 y given this project of welded steel and concrete constructionlosed. 3, construction water water in situ dewatering wells, water tanks and bottled water. 4, the construction of electricitall cand the template field, and fire facilities as required. Separation of work zones, work area, living area settings, and set w ear, and to meet the normal production and life in the Office, housing and steel processing facilities, warehouse and storagefrom ntion, in accordance with the specification requirements, established in the site layout construction and management required tion general layout. 2, temporary works combined with the devoted section personnel and machinery equipment, the actual situanstruconstruction design requirement, Foundation placed in the North of the line. Construction site layout as shown in Figure 1. cort) construction process flow chart3.2. construction site layout 3.2.1. construction site layout 1, layout according to the cchannel and other ancillary works construction. 3.1.4. the construction process (see the construction process flow cha-e channel, und bamboo glue formwork methods. Bridge jacking of 500t hydraulic top picks, roof is complete, edge angle wall, railing, cablproduction templates using large pieces of shaped steel formwork amethods of the poker vibrator vibrating, steel reinforcement in Foundation pit West of a steel processing plant concentrates 6 受理、审核、发证 受 理 人 受 理 日 期 年 月 日 卫生监督员意见: 量化分级评分: 卫生信誉度等级: 签名: 年 月 日 审核许可项目: 签名: 年 月 日 科室负责人意见: 签名: 年 月 日 单位领导意见: 签名: 年 月 日 经办人意见: 打印日期: 发 年 月 日 证 情 签名: 证号: 况 年 月 日 经办人签名: 领证人签名: 年 月 日 city given this project of welded steel and concrete constructionlectriet wall closed. 3, construction water water in situ dewatering wells, water tanks and bottled water. 4, the construction of eage and the template field, and fire facilities as required. Separation of work zones, work area, living area settings, and sd stored from near, and to meet the normal production and life in the Office, housing and steel processing facilities, warehouse antuation, in accordance with the specification requirements, established in the site layout construction and management requiral siconstruction general layout. 2, temporary works combined with the devoted section personnel and machinery equipment, the actu e construction design requirement, Foundation placed in the North of the line. Construction site layout as shown in Figure 1.struction process flow chart3.2. construction site layout 3.2.1. construction site layout 1, layout according to thchannel and other ancillary works construction. 3.1.4. the construction process (see the construction process flow chart) con-able channel, uing, cormwork and bamboo glue formwork methods. Bridge jacking of 500t hydraulic top picks, roof is complete, edge angle wall, railent in Foundation pit West of a steel processing plant concentrates production templates using large pieces of shaped steel fmethods of the poker vibrator vibrating, steel reinforcem7