cnc application form
DESCRIPTION
1TRANSCRIPT
1. Name of the Project
Ensuring Community Safety through Installation of Street Lights
2. Project Location
Street/Sitio/BarangayBrgy. Pinatuad
Zone Classification (i.e. industrial, residential)
City/MunicipalityNabas
ProvinceAklan
RegionVI
3. Proponent Name
Barangay Council
4. Proponent Address
Barangay Pinatuad
5. Contact Person Name
Lydia D. MerecidioDesignationBSPMC
6. Proponent Means of Contact
Landline No.N/A
Fax No.N/A
Mobile No.09195130779
7. Project Type/Undertaking
Consumer Product Laboratory
8. Project Size Fill up only relevant parameters.Capacity/Others(i.e. MW, m3, heads)
Space Allocation/Area(i.e. km, ha, sqm)
Quantity to be Processed(i.e. MT of raw material)
Others:
Production Rate(i.e. MT/year)
9. Description of Project Activities (i.e. during pre-construction, construction, operation and abandonment)
(See Attached POW)
Prepared/Submitted by:
LYDIA D. MERECIDIO
Concurred/Approved by:
FERDINAND S. NAPATSignature over Printed Name Owner’s/Proponent’s Signature over
Printed Name
CERTIFICATE OF NON-COVERAGE (CNC)1-Page Application Form