Form 41

Made under The Occupational Safety, Health and Working Conditions Code, 2020Notification No. 962/XXXVI-03-2026-1903305, 27 Aug 2026

Official text

Open in the official PDF (p. 523)

Tables and forms lose their layout when extracted; the PDF is the authoritative version.

{See sub-rule (2) of rule 115}

Form of Approval of plans and permission for site.

1- Name of the factory …………………………………….

2- Location of the factory …………………………………(if possible geo-mapping)

3- Name of the employer ………………………………….

4- Address, telephone number and E-mail Id of the employer …………………………………

5- Name and Address, telephone number and E-mail Id of the Occupier

………………………………..

6- Name and Address, telephone number and E-mail Id of the Manger

…………………………………………….

7- Activity or proposed activity as per national industrial classification ………………………

8- Detail of selected NIC code ………………………………………………………………..

9- Number of the workers employed or to be employed …………………………………………

10- Details of power used or to be used ………………………………………………………

Signature

(Name and

Address)

Source: The Uttar Pradesh Occupational Safety, Health and Working Conditions Rules, 2026, Notification No. 962/XXXVI-03-2026-1903305 — Uttar Pradesh Gazette Extraordinary, 27 August 2026, p. 523 of the PDF. Open our copy at p. 523 · official download · all sources

The rules were made in Hindi. The English text is the translation published by order of the Governor under clause (3) of Article 348 of the Constitution, which makes it the authoritative text in English. Rule headings are printed as marginal notes.