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FORM-10: Intimation To Person From Whom Sample of Pesticidef Is Taken

An inspector took a sample of pesticide from premises for testing or analysis. The document provides details of the sample taken including the name and batch number of the pesticide, quantity, dates of manufacture and expiry, registration number, and name of the company. The inspector and two witnesses signed the document noting the date, time and license number of the inspector.

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Anees Ahmed
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114 views1 page

FORM-10: Intimation To Person From Whom Sample of Pesticidef Is Taken

An inspector took a sample of pesticide from premises for testing or analysis. The document provides details of the sample taken including the name and batch number of the pesticide, quantity, dates of manufacture and expiry, registration number, and name of the company. The inspector and two witnesses signed the document noting the date, time and license number of the inspector.

Uploaded by

Anees Ahmed
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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FORM-10

[See Rule 33]

INTIMATION TO PERSON FROM WHOM SAMPLE OF PESTICIDEF IS TAKEN


I have this day taken from the premises of ______________________________situated at sample of pesticide specified below for the purpose
of test or analysis.

DETAIL OF SAMPLE TAKEN

S.NO Name of Pesticide Batch No. QTY Date of MFG Date of Expiry Regd No. Name of Company

SIGNATURE OF WITNESS

1. ________________________
2. ________________________________________

License No: ___________________

Dated: ________________________
Time: _________________________ SIGNATURE OF INSPECTOR

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