EIS/FOR/01-4

Engineering Inspection Group

Product Certification & Inspection Department
SIRIM QAS International Sdn. Bhd.
Block 25, 1st Floor, SIRIM Complex
No. 1, Persiaran Dato Menteri
P.O. Box 7035, 40700 Shah Alam
Selangor Darul Ehsan, Malaysia
Tel: 603-5544 5639

Fax: 603-5544 6757

APPLICATION FOR ENGINEERING INSPECTION

1. APPLICANT INFORMATION
1. Name and address of applicant:
BENNOVA MECHANICAL ENGINEERING SDN. BHD.
No. 5, Jalan P6/2, Seksyen 6,
Bandar Teknologi Kajang,
43500 Semenyih,
Selangor Darul Ehsan.
Company/ Business Reg. No.: 391508-T
Contact Person: Muhammad Afendi Bin Abdollah Zawawi
Tel.: 012 - 666 5627

Fax. : 03 - 8723 2037

2. Name and address of inspection site (if different from A1):

MCB INDUSTRIES SDN. BHD.
76 km, Butterworth-Ipoh Main Trunk Road,
P.O. Box 9, 34007 Taiping,
Perak.
Company/ Business Reg. No.: 133638-K

Tel.: 05 891 5622 / 891 5873

SIRIM QAS International Sdn. Bhd.

Issue:1 Rev: 2

Fax. : 05 891 2295

Engineering Inspection

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EIS/FOR/01-4

2. PROJECT INFORMATION
1. Project Name: Registration For Pressure Vessel With DOSH

2. Project Description:
a. To do inspection and final report for six (6) unit of pressure vessel. :
I.
Condenser
II.
Generator
III.
Low Pressure dryer
IV.
Purifier
V.
Scrubber
VI.
High Pressure Dryer

3. Applicable reference drawings and technical specifications:

4. Standard(s) applicable to project:

SIRIM QAS International Sdn. Bhd.

Issue:1 Rev: 2

Engineering Inspection

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3. DECLARATION AND UNDERTAKING

In connection with this application, I/we:
(a) undertake to supply all information required by SIRIM QAS International Sdn. Bhd.
for the purpose of evaluation of the product(s) to be inspected;
(b) undertake to make samples of product(s) and materials available to SIRIM QAS
International Sdn. Bhd. for evaluation and testing purposes;
(c) undertake to pay SIRIM QAS International Sdn. Bhd. all costs of processing this
application;
(d) agree that SIRIM QAS International Sdn. Bhd. may release information obtained in
the course of processing the application to the regulatory authorities so far as is
prudent to warn in the opinion of SIRIM QAS International Sdn. Bhd.;
I/We enclose herewith a cheque / Purchase Order / letter of Award payable to
SIRIM QAS International Sdn. Bhd. for a sum of RM ________________ as detailed in
the quotation number _____________ .

Signature of authorized representative:

Date:

Name:

Designation:

Please return form duly completed to:

Engineering Inspection Group
Industrial & Consumer Certification and
Inspection Section
Product Certification & Inspection Department
SIRIM QAS International Sdn. Bhd.
Building 25, 1st Floor, SIRIM Complex
1, Persiaran Dato' Menteri
P.O. Box 7035
40700 Shah Alam
Selangor Darul Ehsan

SIRIM QAS International Sdn. Bhd.

Issue:1 Rev: 2

Engineering Inspection

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