HSW45                                               THE NOTIFICATION OF COOLING TOWERS
AND EVAPORATIVE CONDENSERS REGULATIONS 1992

Please return the completed form to:
Environmental Health Services
Public Realm Division, Place Department, 6th Floor Zone A
Bernard Weatherill House
8 Mint Walk Croydon, CR0 1EA

1.   Address where cooling tower/evaporative condenser is to be situated:  Please continue overleaf if necessary

Name of premises: Address:

2.   Person(s) in control of Premises:  Please continue overleaf if necessary

Name of person: Company name: Address:
Tel. No:

NB: This information is required to enable access to be gained at all times to the notifiable device.

3.   How many cooling towers or evaporative condensers are at the address shown in box 1?

4.   Please give brief location of each piece of equipment being registered at this time. (e.g. North works, Main
Building, south-east corner of 3rd  floor roof). Please continue overleaf if necessary.

Declaration

Signed by:

Position:                                                                                Date:

Acknowledgement tear-off: for Local Authority use

THE NOTIFICATION OF COOLING TOWERS AND EVAPORATIVE CONDENSERS REGULATIONS 1992

To:

Name of person(s) in control:

Address:

Date of registration:

Number of cooling towers registered:                            Local Authority Stamp

Reference number in case of query:

File/New/H&S/HSW45 Cooling Tower Registration
Additional details if any

DO NOT WRITE IN THIS SPACE:  FOR LOCAL AUTHORITY USE ONLY

File/New/H&S/HSW45 Cooling Tower Registration