安全生产许可证延期申请书[1]

申请编号： 受理编号: 申请日期： 受理日期: 非煤矿矿山企业 安 全 生 产 许 可 证 延 期 申 请 书 申请单位 取证单位 联 系 人 联系电话 填写日期

国家安全生产监督管理总局制样

allied mechanical maintenance group, lawn maintenance, plant protection group。 Establishment of conservation of garden plants in long sections, professional engineers, professional technicians and other related jobs。 1, the maintenance lead responsibilities （1) familiar with the Group's foundations of political thought，

technology， culture, work attitudes, feelings and emotions， habits and other personal problems， easy to work。 (2) before work， quality of work， requirements engineering, safety， mechanical equipment and some of the technical issues seriously disclosure to workers， and keep the information in writing。 (3) when assigning production tasks to the workers， to implement safety measures, complete the task to do self—examination record. (4) section chiefs be vanguard of work， must step

forward are familiar with the relevant business， work in the field, hard, dirty work， heavy work need to be at the head of work to do \"before charge in and retreat.” （5) pay attention to every team, every process of close cooperation and coordination， based on the situation as any, check ”play clean\" construction diaries and day information. (6) the community \"active conservation， waste crimes”， section chiefs be sure to lead the staff do thrift and combat waste. (7) for violation of construction laws, adverse quality， safety and engineering progress of unusual to have the courage to succeed， stop. （8） Unity is strength， section chief is the core of the conservation work， so modest。 2, professional engineer job description of garden plants (1） implement the national construction engineering quality and safety standards, norms and regulations, combined with engineering, development,

implementing specific measures. (2） to process the project has overall responsibility for all technical work， their sacred responsibilities given to technical work， according to the technical requirements， serious research 。.。 Groups and plant groups。 Section with garden plant

填 写 说 明

一、本申请书适用于非煤矿矿山企业申请安全生产许可证延期,由申请单位用钢笔、签字笔填

写或用计算机打印，要求字迹清楚、工整。

二、申请书封面的“申请编号”、“申请日期”、“受理编号”、“受理日期”由发证机关填写,其

余各项由申请单位填写。其中,“联系人\"是指申请单位指定办理申请事宜人员. 三、申请书表格中申请单位栏“名称”，应当填写工商登记名称;“地址”应当填写工商登记地

址；“经济类型”，应当按照《关于划分企业登记注册类型的规定》填写。 四、申请书表格中取证单位栏加粗框内内容所有取证单位均需填写，取证单位栏“名称”,应

当填写全称;“地址”应当填写所在地详细地址;“单位类型”应当按照取证单位业务分别

填写金属非金属矿山企业、尾矿库、地质勘探单位、采掘施工企业、石油天然气企业.取

证单位栏加粗框外内容按照取证单位类型分别填写。

五、申请书表格中“申请许可范围\"栏,应当按照取证单位类型分别填写: 1（ 金属非金属矿山企业填写:××（开采矿种,名称应与《采矿许可证》一致）露天开采、

××（开采矿种，名称应与《采矿许可证》一致)地下开采； 2( 尾矿库填写：尾矿库运行；

3（ 地质勘探单位填写：金属非金属矿产资源地质勘探； 4（ 采掘施工企业填写:金属非金属矿山采掘施工作业;

5（ 石油天然气企业填写:陆上采油(气)、海上采油(气）、钻井、物探、测井、录井、井

下作业、油建、管道储运、海油工程。

六、申请书表格中“取证单位意见”和“申请单位意见\"栏内,必须由主要负责人和法定代表

人用钢笔或签字笔签字。

nity is strength, section chief is the core of the conservation work, so modest。 2， professional engineer job description of of construction laws， adverse quality， safety and engineering progress of unusual to have the courage to succeed， stop. (8） Uation munity \"active conservation, waste crimes”, section chiefs be sure to lead the staff do thrift and combat waste. (7) for violion and coordination， based on the situation as any， check ”play clean\" construction diaries and day information. (6） the comoperated to be at the head of work to do \"before charge in and retreat。” (5) pay attention to every team, every process of close conguard of work， must step forward are familiar with the relevant business, work in the field， hard, dirty work, heavy work neexamination record。 (4) section chiefs be va-ction tasks to the workers， to implement safety measures， complete the task to do selfd some of the technical issues seriously disclosure to workers, and keep the information in writing。 (3） when assigning produnt another personal problems, easy to work. (2） before work, quality of work, requirements engineering， safety, mechanical equipme iar with the Group's foundations of political thought, technology， culture, work attitudes， feelings and emotions, habits andfamil ctions， professional engineers， professional technicians and other related jobs. 1, the maintenance lead responsibilities （1）anical maintenance group, lawn maintenance, plant protection group. Establishment of conservation of garden plants in long seallied mech-oups and plant groups. Section with garden plantwork， their sacred responsibilities given to technical

work， according to the technical requirements, serious research 。。. Gr icalengineering， development, implementing specific measures. (2） to process the project has overall responsibility for all techn plants (1) implement the national construction engineering quality and safety standards， norms and regulations, combined with garden 1 —

名 称 地 址 申

邮政编码 从业人数 专职安全管理人员 请 工商注册号 登记日期 数量 单 登记机关 经济类型 位 法定代表人 办公室电 移动电话 安全负责人 办公室电 移动电话 话 话 名 称 地 址

邮政编码 单位类型 川区分局

主要负责人 办公室电 移动电话 安全负责人 办公室电 移动电话 话 从业人数 专职安全管理人员数量 话 以下由金属非金属矿山企业填写 局 发证机关 证号 采矿许可证

有 效 期 年 月 日— 年 月 日 开采矿种 开采方式 取 设计服务年限 设计生产能 实际生产能力 证 评价/评定单位 力 独立生产系统

单 安全现状评价评价/评定时间 /安全标准化 位 评价结论/评定等 发证机关 级 原安全生产

证 号 许可证

有 效 期 年 月 日— 年 月 日 以下由地质勘探单位填写 发证机关

地质勘查 证 号 资质等级 资质证书 资质范围 有 效 期 年 月 日— 年 月 日 发证机关 原安全生产 证 号

lean” construction diaries and day information. （6） the community ”active conservation, waste crimes\"， section chiefs be sureay attention to every team， every process of close cooperation and coordination, based on the situation as any， check \"play cn the field, hard， dirty work， heavy work need to be at the head of work to do \"before charge in and retreat。\" (5） pexamination record。 (4) section chiefs be vanguard of work, must step forward are familiar with the relevant business, work i—ask to do selfthe t d keep the information in writing. (3） when assigning production tasks to the workers, to implement safety measures， complete， requirements engineering, safety， mechanical equipment and some of the technical issues seriously disclosure to workers， anwork culture, work attitudes, feelings and emotions, habits and other personal problems， easy to work. （2） before work， quality of ed jobs。 1， the maintenance lead

responsibilities (1) familiar with the Group’s foundations of political thought, technology，in long sections， professional engineers,

professional technicians and other relat allied mechanical maintenance group, lawn maintenance， plant protection group。 Establishment of conservation of garden plants—rding to the technical requirements， serious research 。。. Groups and plant groups。 Section with garden plantss the project has overall responsibility for all technical work， their sacred responsibilities given to technical work, accoroceand safety standards, norms and regulations， combined with engineering, development， implementing specific measures。 (2) to p modest. 2， professional engineer job description of garden plants (1) implement the national construction engineering quality rk, soress of unusual to have the courage to succeed， stop. (8) Unity is strength， section chief is the core of the conservation woad the staff do thrift and combat waste. (7） for violation of construction laws, adverse quality， safety and engineering progto le 2 —

许可证 有 效 期 年 月 日- 年 月 日 以下由采掘施工企业填写 发证机关

矿山工程施 证 号 资质等级 工资质证书 资质范围 有 效 期 年 月 日— 年 月 日 发证机关 原安全生产 证 号 许可证

有 效 期 年 月 日— 年 月 日 以下由尾矿库单位填写

库 类 型 ？山谷型 ？傍山形 ?平地型 ?截河型

筑坝方式 ?上游式 ？下游式 ？中线式

33设计库容 万m 已堆积尾 万m 实际干滩长度 米 设计总坝高 米 初期坝高 米 堆积坝高 米 矿量

初期坝长 米 初期坝外1： 排洪方式 堆积坝长 米 堆积坝外坡1： 安 全 度 坡比

设计服务年限 库等别 比

评价/评定单位 安全现状评价评价/评定时间 /安全标准化 评价结论/评定等 发证机关 级 原安全生产 证 号 许可证

有 效 期 年 月 日- 年 月 日

以下由石油天然气勘探、开发生产和储运单位填写 发证机关 采矿许可证 证 号 (采油、采气单

位填写） 有 效 期 年 月 日— 年 月 日 评价单位 安全现状评价 评价时间 评价结论

发证机关 原安全生 产许可证 证 号

ation munity \"active conservation, waste crimes\sure to lead the staff do thrift and combat waste. (7) for violion and coordination, based on the situation as any， check \"play clean\" construction diaries and day information。 (6) the comoperated to be at the head of work to do \"before charge in and retreat.\" (5) pay attention

to every team， every process of close conguard of work， must step forward are familiar with the relevant business， work in the field， hard, dirty work， heavy work neexamination record。 (4） section chiefs be va—ction tasks to the workers, to implement safety measures， complete the task to do selfd some of the technical issues seriously disclosure to workers, and keep the information in writing. (3） when assigning produnt another personal problems， easy to work. (2） before work， quality of work, requirements engineering, safety， mechanical equipme iar with the Group's foundations of political thought， technology, culture， work attitudes， feelings and emotions, habits andfamil ctions, professional engineers， professional technicians and other related jobs。 1, the maintenance lead responsibilities (1）anical maintenance group， lawn maintenance, plant protection group。 Establishment of conservation of garden plants in long seallied mech—oups and plant groups。 Section with garden plantwork, their sacred responsibilities given to technical work, according to the technical requirements, serious research 。。. Gr icalengineering， development, implementing specific measures. （2） to process the project has overall responsibility for all techn plants （1) implement the national construction engineering quality and safety standards， norms and regulations， combined with gardennity is strength， section chief is the core of the conservation work, so modest。 2, professional engineer job description of of construction laws, adverse quality， safety and

engineering progress of unusual to have the courage to succeed， stop. （8) U 3 —

有 效 期 年 月 日— 年 月 日 申请

许可 伊利石粘土、露天开采 范 围 取证 单位

意 主要负责人（签字盖章) 见 年 月 日 申请 单位

意 法定代表人(签字盖章） 见 年 月 日

and safety standards， norms and regulations， combined with engineering, development, implementing specific measures. (2) to p modest。 2， professional engineer job description of garden plants （1） implement the national construction engineering quality rk， soress of unusual to have the courage to succeed, stop。 （8) Unity is strength, section chief is the core of the conservation woad the staff do thrift and combat waste。 (7) for violation of construction laws， adverse quality, safety and engineering progto le lean” construction diaries and day information。 （6) the community ”active conservation， waste crimes\"， section chiefs be sureay attention to every team， every process of close cooperation and coordination, based on the situation as any， check ”play cn the field, hard, dirty work, heavy work need to be at the head of work to do \"before charge in and retreat。” （5)

pexamination record。 (4） section chiefs be vanguard of work, must step forward are familiar with the relevant business, work i-ask to do selfthe t d keep the information in writing。 （3） when assigning production tasks to the workers， to implement safety measures， complete, requirements engineering， safety, mechanical equipment and some of the technical issues seriously disclosure to workers, anwork culture， work attitudes， feelings and emotions, habits and other personal problems， easy to work. （2) before work， quality of ed jobs。 1, the maintenance lead responsibilities (1) familiar with the Group’s foundations of political thought, technology，in long sections, professional engineers, professional technicians and other relat allied mechanical maintenance group, lawn maintenance， plant protection group。 Establishment of conservation of garden plants-rding to the technical requirements， serious research .。。 Groups and plant groups. Section with garden plantss the project has overall responsibility for all technical work， their sacred responsibilities given to technical work， accoroce 4 -