- Ca quan Clru n~n
Mfi u1 Mfiu
Mfiu 2
Don denghi cApGiAychUng nh~n hufu11uy~nky thu~t an tom v~n chuy~n hang cong nghi~p nguy hi&rn Gifty chUng nh~ huftn luy~nky thu~t an toim v~n chuy~n
hang cong nghi~p nguy hi~rn
M~u 1. Don d~ ugh! cAp GiAy chUng nh~n huAnluy~n kY thu~t an torm v~n chuy~n himg cong nghi~p nguy hi~m
- .
CONG HoA xA HQI CHU NGHiA VItT NAM Dqc l~p - TV do - H,nh phiic
DON DE NGlIJ
cAp giAy chung nh~n huAn luy~n kY thu~t an torm v~n chuy~n hang cong nghi~p nguy hi~m
K'nh1 gut:,. .
Toi la (ghi roh9 ten bling chil' hoa) : Nam / Ntr Sinh ngay: ./ ./ Dan tQc: Qu6c tich: .
S6 CMND (ho~c HQ chi~u) Ngay cAp: .
Noi cAp: .
. Noi dang kY hQ khfru thuemg tm: .
Ch'X00, hi" t'e:tn ~11:.••...•.••••••..•..••••••..•••••••••••••••.•••••.•••••••.• . : .•••••••..••• Th\lC hi~n Thong tu s6 ./2012/TT-BCT ngay thang 12 nam 2012 cua BQ tfuOng BQ Cong Thuong quy dinh danh m\lc hang cong nghi~p nguy hi~m phili dong goi trong qua trinh v~n chuy~n va v~n chuyen hang cong nghi~p nguy hiSm bfutg phuong ii~n giao thong co gi6i duemg bQ, duemg s~t va duemg
thuy nQi dia. '
.. De nghi cAp GiAy chUng nh~
hudDluy~n ky thu~t an toan v~ chuySn hang cong nghi~p nguy hiem cho toL
, th' Y
... , ngay ang nam .
NgtrOi dS ngh! .
(KY,ghi roh(Jten)
H6 sagirl kem thea:
. Mlu '2. Giiy chung nh~n huin luy~n ky thu~t an toilD v~n chuy~n hang cong nghi~p nguy hi~m
Mat ngoai: Kich thuac: 190mm x 130mm
(1) .
(2) .
GIAv CHlrNG NH~N HuAN LUVeN KY
THUAT AN ToAN VAN CHUYEN HANG .CQNG NGHII~P NGUV Hn~M
-(1) Ten ca quim quAn'ly don vi t6 ch(rc huAnluy~n-(Vi dv: Uy bar(-rihan dan tinh ..) (2) Ten don vi t6 ch(rc huAn luy~~ (Vi dv: SO'Cong Thuong tinh ... )
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Mat trong: Kich thuac: 190mm x 130mm
CONG HoA. xA HOI CHO NGHjA VIET NAM. _. .
£)Qc I,p- T" do -H~nh phuc
---000---
GIAv CHl1NG NH~N HuAN LUVeN KY THU~ T AN ToAN V~N CHUVEN HANG
CONG NGHlep NGUV HIEM
8a qua lap huan luy$n ky thu~t an toan v~n chuy~n hang cOng nghi$p nguy hi~m
do SaCOng ThU'O'ng to chuc
tCrngay: d~n ngay: .
8U'Q'c cOng nh~n du di~u ki~n d~ v~n chuy~n hang cOng nghi$p nguy hi~m .
Anh3x4 HQ va ten: .
Ngay sinh: .
Tru quan: .
Trinh dQ van hoa: .
. ngay thang nam .
Giam d6c SaCong ThU'O'ng
(Ky fen c16ng dAu)
s6: .
Giay chung nh~n nay co gia trj 02 nam tCr
ngay thang nam d~n ngay .thang
... nam .
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