Form 44

{see sub-rule (11) of rule 115}

Certificate of Approval of site-plan of factory

From,

…………………

…………………

To,

…………………..

…………………..

Site plan no.: F/plan/lic: Date:

Subject: Regarding approval of new extension and revision of factory building plans and stability certificate.

Sir/Madam,

Please refer to your on-line application regarding approval of the site-plan of new/ extension and

revision of factory building plans and stability certificate dated …………. submitted to Chief Inspector-

cum-Facilitator or …………………….. (mention Licencing Authority).

Your aforesaid application if forthwith approved under the following conditions/ reasons

according to the provisions of occupational safety health and working conditions code 2020 and rules made

there under:

Conditions/ remarks-1:

Conditions/ remarks-2:

Conditions/ remarks-3:

Conditions/ remarks-4:

Over all conditions/ remarks:

As well as the stability certificate dated ………… which is signed by ………………. and work

room number/ as has been shown in the factory plans number ………………….. is approved for the use of

………….. horsepower electricity/ ………………… horsepower diesel/ oil engine, total ………………….

horsepower for use is approved. Besides this your attention is sought towards the provisions of these rules

according to that before starting the work with the help of power, it shall be compulsory to issue and get the

approval of the stability certificate.

Enclosed:

1. Plans

2. Site plans

3. Questionnaires

4. Form- 42

5. Flow chart

6. Certificate of Stability (Form- 43)

Your’s

……………….

……………….