Application for Safety Production License for Hazardous Chemicals Manufacturing Enterprises

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Application for Safety Production License for Hazardous Chemicals Manufacturing Enterprises
Application Number: Su An Wei Hua (Sheng) Shen Zi No. ______
Application Date: Year Month Day
Receipt Number: Su An Wei Hua (Sheng) Shou Zi No. ______
Receipt Date: Year Month Day

Application for Safety Production License for Hazardous Chemicals Manufacturing Enterprises
Applicant: Changzhou City Gas Co., Ltd.
Entity to Obtain the License: Changzhou City Gas Co., Ltd.
Person in Charge: ______
Contact Phone Number: ______
Mailing Address: Changzhou City Gas Co., Ltd.
Date of Filling out: March 15, 2007
Issued by the Jiangsu Provincial Work Safety Supervision Bureau

Instructions for Filling out the Application:
1. This application should be filled out using a pen or signature pen, or printed out with a printer; the handwriting must be clear and neat. II. The “Application Number,” “Application Date,” “Acceptance Number,” and “Acceptance Date” on the cover of this application form shall be filled in by the accepting party, while all other fields shall be filled in by the applying enterprise. Among them, “handler” refers to the person designated by the applying enterprise to handle the application matters ； “\"Contact number\" refers to the handler’s phone number. III. In this application, the fields for “affiliated enterprise,” “applying entity,” and “certifying entity” shall be filled in as follows: 1. For hazardous chemical manufacturing enterprises with legal person status applying for a work safety license, fill in the fields for “applying entity” and “comments from the applying entity.” ； If there is a affiliated company, the “Affiliated Company” field also needs to be filled in. 2. Hazardous chemicals manufacturing enterprises that do not have legal person status applying for a work safety license shall fill in the fields for \"Applying Entity\", \"License-issuing Entity\", \"Comments from the Applying Entity\", and \"Comments from the License-issuing Entity\" ； If the applying entity has affiliated companies, it is also necessary to fill in the “Affiliated Companies” field. 3. For group companies directly under central government administration, head offices, as well as branches and subsidiaries of listed companies applying for a work safety license, fill in the fields for “Applying Entity”, “Opinions of the Applying Entity” and “Affiliated Enterprise” ； Production units that conduct independent cost accounting for production activities and are affiliated with branches or subsidiaries shall apply for a work safety license by filling in all fields. IV. In the “Date of Establishment” field of this application form, enter the date of approval for establishment ； “In the “Name” field for “Affiliated Enterprise”, “Applicant Unit”, and “Certification Issuing Unit”, enter the name as registered in the business registry ； “In the “Enterprise Type” column, fill in the enterprise registration type as specified in the “Regulations on Classifying Enterprise Registration Types” (Guo Tong Zi No. 200). V. The final products, intermediate products, and raw materials referred to in this application are hazardous chemicals listed in the Catalogue of Hazardous Chemicals; the names of these chemicals shall be filled in according to the Chinese names specified in the Principles of Chemical Nomenclature (1980) ； “The “hazardous goods number” shall be filled in according to the “List of Hazardous Chemicals”. VI. The “production capacity” indicated in this application should be the annual designed production volume of the product ； “Enter the date on which the production system for this product was officially put into operation as the \"Date of Commissioning\" ； “Enter the approval document number as the identifier of the safety facility approval document issued by the safety supervision department prior to the product’s commissioning. VII. In the “Brief Description of the Production Process System for Hazardous Chemicals” section of this application, the “brief description of the process system” refers to the production processes used for manufacturing the product as well as the main production equipment; it can be represented by a process flow diagram, and it is necessary to indicate the main hazard factors in each process step as well as the key production equipment. This column provides one table per product; additional tables are required for multiple products. VIII. In the “Production Raw Materials” column of the “Registration Form for Raw Materials Used in the Production of Hazardous Chemicals” in this application, the main raw materials should be indicated. IX. In the “Basic Information Table of Hazardous Chemical Storage Tanks and Warehouses” section of this application, fill in the specific location of the storage tank area and warehouses within the plant site under “Location within the plant site” ； “Select and enter from the options of \"Industrial zone, Agricultural zone, Commercial zone, Administrative office zone, Transportation hub zone, Science, technology and culture zone, Water source protection zone, Cultural relics protection zone\" for the \"Function area\". X. In the “Self-Assessment Form for Applying for a Safety Production License for Hazardous Chemicals Manufacturing Enterprises” included in this application, all information must be filled in truthfully. For the yes/no and yes/no questions in the form, only “yes” or “no” and “yes” or “no” should be entered” ； Enter the number of people and distance in the table. Any content that needs to be explained can be provided in separate written notes. 11. The fields “Review Comments,” “Contents of the Original Document,” and “Contents of the Copy” in this application form shall be filled in by the issuing authority. Name of the main person in charge of the affiliated enterprise; Name of the applying entity: Changzhou Gas Co., Ltd. – Main person in charge; Registered address: Xinbei District, Changzhou, Jiangsu; Postal code: 213026; Date of establishment: 28/3/2001; Contact phone number; Fax number; Enterprise type: Limited liability company; Business license number; Number of employees: 7; Person in charge of safety management; Number of full-time safety management personnel: 2; Address of the production site: Property owned □ Rented □ Contracted; Land area (m2): 1084.9; Building area (m2): 300; Net value of fixed assets last year (10,000 yuan): 230; Sales revenue last year (10,000 yuan): 120; Name of the entity that issued the certification: Changzhou Gas Co., Ltd.; Main person in charge; Registered address: Changzhou, Jiangsu; Postal code: 213026; Date of establishment: 28/3/2001; Contact phone number; Fax number: 3206177; Enterprise type: Limited liability company; Business license number; Number of employees: 7; Person in charge of safety management; Number of full-time safety management personnel: 2; Address of the production site: Property owned □ Rented □ Contracted; Land area (m2): 1084.9; Building area (m2): 300; Net value of fixed assets last year (10,000 yuan): 230; Sales revenue last year (10,000 yuan): 120; Comments from the applying entity: Legal representative’s signature: (Company seal) Date: Year/Month/Day; Comments from the entity that issued the certification: Main person in charge’s signature: (Company seal) Date: Year/Month/Day; Form for reporting the production of hazardous chemicals: Serial number; Product name; Hazardous goods code; Production capacity (tons/year); Date of commissioning; Approval document number; Remarks: 1. Oxygen (compressed): 22001; 1200; 2. Argon (compressed): 22011; 600; 3. Argon-carbon dioxide mixture: 600; Form for reporting intermediate products of hazardous chemicals: Serial number; Product name; Hazardous goods code; Final products produced from these intermediate products (product names); Remarks; Brief description of the production process for hazardous chemicals: Product name: Final product – Oxygen (compressed); Intermediate products; Design agency: Changzhou Chemical Engineering Design Institute; Source of technology: Changzhou Chemical Engineering Design Institute; Brief description of the process system (process flow diagram and main equipment): I. Brief description of the process system: Liquid oxygen is stored in low-temperature storage tanks. It is then pressurized by a low-temperature pump and vaporized in a vaporizer before being fed into the filling and discharge cylinders. II. Process Flow Diagram III. Information on Key Equipment Sequence Equipment Name Model Specification Quantity Remarks 1 Cryogenic Storage Tank ZCF20000-8 1 2 Cryogenic Pump BPO300-160 1 3 Vaporizer QQ300-160 1 4 Filling and Discharging Unit GC20*2 1 Brief Overview of the Production Process for Hazardous Chemicals Product Name: Final Product – Argon (compressed); Intermediate Products Design Institution: Changzhou Chemical Engineering Design Institute; Technical Source: Changzhou Chemical Engineering Design Institute Brief Overview of the Process System (process flow diagram and information on key equipment): I. Brief Overview of the Process System: Liquid argon is stored in a cryogenic storage tank. The liquid argon is pressurized by a cryogenic pump and then vaporized in a vaporizer, before being fed into the filling and discharging unit for filling into bottles. II. Process Flow Diagram III. Information on Main Equipment Sequence Equipment Name Model Specification Quantity Remarks 1 Cryogenic Storage Tank ZCF15000-8 1 2 Cryogenic Pump BPO300-160 1 3 Vaporizer QQ300-160 1 4 Filling and Discharging Unit GC20*2 1 Brief Overview of the Production Process for Hazardous Chemicals Product Name: Final Product – Argon-Carbon Dioxide (compressed); Intermediate Products Design Agency: Changzhou Chemical Engineering Design Institute; Technical Source: Changzhou Chemical Engineering Design Institute Brief Overview of the Process System (Process Flow Diagram and Information on Main Equipment): I. Brief Overview of the Process System: Liquid oxygen is stored in a cryogenic storage tank. It is then pressurized by a cryogenic pump and vaporized in a vaporizer, before being fed into the filling and discharging unit for filling into bottles. II. Process Flow Diagram III. Information on Main Equipment Sequence Equipment Name Model Specification Quantity Remarks 1 Cryogenic Storage Tank ZCF20000-8 1 2 Cryogenic Pump BPO300-160 1 3 Vaporizer QQ300-160 1 4 Filling and Discharging Unit GC20*2 1 Brief Description of the Production Process for Hazardous Chemicals Product Name: Final Product – Argon-Carbon Dioxide (compressed); Intermediate Products. Design Institution: Changzhou Chemical Engineering Design Institute; Technical Source: Changzhou Chemical Engineering Design Institute. Brief Description of the Process System (process flow diagram and information on main equipment): IV. Brief Description of the Process System: First, the mixed gas-filled containers are filled with a specified amount of carbon dioxide; the subsequent processes are the same as those used for filling with argon. V. Process Flow Diagram
VI. Overview of Main Equipment

| No. | Equipment Name | Model/Specifications | Quantity | Remarks |
|-----|----------------------|----------------------|----------|---------|
| 1 | Cryogenic storage tank | ZCF15000-8 | 1 | |
| 2 | Cryogenic pump | BPO300-160 | 1 | |
| 3 | Vaporizer | QQ300-160 | 1 | |
| 4 | Filling/discharge pipe | GC20*2 | 1 | |

Registration Form for Raw Materials Used in the Production of Hazardous Chemicals

| No. | Product Name | UN Number | Annual Consumption (tons) | Maximum Daily Storage Capacity (tons) | Remarks |
|-----|----------------------------|-----------|----------------------------|----------------------------------------|---------|
| 1 | Oxygen (liquid) | 22002 | 120 | 20 | |
| 2 | Argon (liquid) | 22012 | 600 | 15 | |
| 3 | Carbon dioxide (liquid) | 22020 | 600 | 20 | |

Registration Form for Basic Information on Hazardous Chemicals Storage Tank Areas

**Name of Storage Tank Area:** Cryogenic Storage Tank Area
**Location within the Plant:** Southwest corner
**Functional Zone:** —
**Area of Storage Tank Area (m²):** 30
**Presence of protective dikes:** None
**Area enclosed by protective dikes (m²):** —
**Presence of fire lanes:** Yes
**Number of storage tanks:** 3
**Minimum distance between two tanks (m):** 3
**Maximum distance between two tanks (m):** 5

| Tank No. | Volume (m³) | Shape | Type | Installation Method | Substance Stored | Maximum Storage Capacity (t) | Physical State | Material Handling Method | Commissioning Year |
|----------|-------------|------------|-------------|---------------------|------------------|-------------------------------|----------------|--------------------------|--------------------|
| 1 | 20 | Cylindrical| Vertical | — | Liquid oxygen | 20 | Liquid | — | 2006 |
| 2 | 15 | Cylindrical| Vertical | — | Liquid argon | 15 | Liquid | — | 2006 |
| 3 | 15 | Cylindrical| Vertical | — | Liquid CO₂ | 20 | Liquid | — | 2006 |

Fire Protection Status
- Fire water pipelines
- Fire foam pipelines
- Firefighters

Main fire protection equipment and facilities: Carbon dioxide, dry chemical extinguishing agents, fire hydrants

Diameter (cm) | Pressure (MPa) | Diameter (cm) | Pressure (MPa) | Full-time Personnel | Part-time Personnel
--------------|----------------|----------------|----------------|---------------------|---------------------
10 | 0.3 | 2 | 5 | — | —

**Presence of explosion-proof and flameproof facilities:** Yes
**Main explosion-proof and flameproof facilities:** Reinforced concrete explosion-proof walls

Monitoring and Inspection Status
- Presence of lightning protection inspection: Yes; Conducted by: Changzhou Lightning Protection Testing Center; Inspection cycle: 1 year
- Presence of anti-static inspection: Yes; Conducted by: Changzhou Lightning Protection Testing Center; Inspection cycle: 1 year
- Presence of safety accessory inspection: Yes; Conducted by: Changzhou Boiler Inspection Institute; Inspection cycle: 1 year
- Presence of monitoring system: Yes; Number of monitoring cameras: —; Whether all key areas are equipped with monitoring facilities: —
- Presence of alarm system: Yes; Number of alarm sensors: —; Whether all key areas are equipped with alarm facilities: —

Main gas detection instruments: —

Status of Major Hazard Sources
- Whether any major hazard sources exist: No
- Number of major hazard sources: —; Which storage tanks they are located in: —
- Whether major hazard sources have been evaluated: —
- Whether emergency response plans for major hazard sources exist: —
- Whether major hazard sources have been registered: —; Registered with: —; Registration date: Year/Month/Day