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"附表一" "全国工业产品生产许可证申请书",,

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, "产品类别:危险化学品",,

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, "产品名称: "企业名称:(公章) "联系

电话: "联系人: "申请类别:发证迁址增项其他",,

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, "申请日期:年月日",,

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, "国家质量监督检验检疫总局印制",,

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一、申请企业基本情况",,

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"企业名称",,

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"住所",,

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"生产地址","省市(地)区(县)乡(镇)路(街道)号",,

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, "邮政编码",,

,"电话",,

, "传真",,

,"电子邮箱",,

, "组织机构代码",,

,"经济类型",,

, "工商登记机构",,

,"营业执照注册号",,

, "成立日期",,

,"经营期限",,

, "固定资产(万元)",,

,"注册资金(万元)",,

, "年总产值",,

,"年销售额",,

, "年缴税金额",,

,"年利润",,

, "法定代表人",,

,"企业负责人",,

, "质量保证负责人",,

,"联系人",,

, "从业人员总数",,

,"专业技术人员数",,

, "其他需要说明的情况",,

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二、申报产品基本情况",,

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, "项目总投资",,

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"年设计生产能力",,

, "涉及国家产业政策的情况",,

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, "产品单元",,

"产品品种、规格型号",,

"产品标准",,

"申请类别", ,,

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, "3","

三、企业主要负责人和技术人员情况" ,"序","姓名","性别","身份证号码","职务","职称","学历","所学专业","工作","工作岗位" ,"号"年限", "4","

四、主要生产设备、工艺装备明细" ,"序","产品单元","名称","规格型号","数量","完好","使用场所","生产厂及国别","生产","购置" ,"号",,

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,"状态",,

,"日期","日期" "5","

五、主要原材料、外购件和外协件明细",,

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,"序","产品","名称","规格型号","年需量","标准名称","生产单位" ,"号","单元",,

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"和编号", ,,

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, "6","

六、主要检测仪器、设备明细" ,"序","产品单元","名称","规格型号","精度","数量","完好","使用","生产厂国别","生产","购置" ,"号",,

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"等级",,

"状态","场所",,

"日期","日期" "7","

七、危险化学品销售渠道和产品流向明细表",,

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,"序号","产品名称","销售方式","销售对象","销售依据" ,,

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八、集团公司所属单位明细",,

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, "序号","所属单位名称","与集团公司关系", ,,

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, "

九、提交的文件资料目录",,

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, "序号","文件资料名称","页数", ,,

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, "省、自治区、直辖市质量技术监督局受理意见","经手人(签字)年月日(盖章)" "企业实地核查结论","年月日(盖章)" "产品质量检验结论","年月日(盖章)" "全国工业产品生产许可证办公室审批意见","年月日(盖章)" "全国工业产品生产许可证申请书" "填写说明" "1适用范围" "《全国工业产品生产许可证申请书》(以下简称《申请书》)适用于企业发证、换证、迁址、增项等的生产许可证申请.