IWK/C/ PP _/__ / sccnarcapew2017 Agensi Perakuan Pembetungan (Pulau Pinang) IndahWater No 41, Tingkat 1, Jalan Todak 4, Pusat Bandar Seberang Jaya. 13700 Perai © 04.3978 101 B 04-3978 102 SUBMISSION FOR SCC PARTA Type.of Submission Part B. Payment Bank Guarantee (8G)[__] OFFSET Application submitted YES| Bankers Cheque| No] Pert C. Offset *BG is required for ofst application at POCB stage Part DB. *Pengecualian* Part E Refund PART B: Payment litem Description Remarks Z | Submitter Z |i 2, SPAN SCC Checklist 1Odigit b. SCC FORM KI/SCCK1 1Odigit 10digit . Bankers Cheque » Bank > No édigit * Date 7 7 Jddvenrny » Payto SPAN-KWSMP » Amount RM d. Consultant cover letter e. Copy of PDCt jean £ Copy of POC2 g. Copy of Engineering Report h. Valuation report (Valid for only 3 months from valuation date) Applicants Information Submiver Collector Signature & Date Signature & Date Name Name Company Company © ®IWK/ C/ PP_/__ /. SCCRI/CA.PEN/2017, PART C: Offset * Refer Latter SPAN/AKP/STO/S/4 (12) dated Julai 2016 a. Upgrading work Yes| NO b. Coverletter ©. SCC payment (BG) Document required as Part B d. **Senarai Semak Permohonan Offset Bayaran KWSMP* e. Document as required in “senarai semak" f. Copy of PDC 9g. Copy of PDC2 h. Copy of Engineering Report "Pengecualian” a. Cover letter b. Borang Rayuan SPAN . Copy of PDC1 d. Copy of PDC2 @. Copy of Engineering Report f. STP Catchment Layout (can be obtained from PSS-IWK) PART E: Refund * Refer Letter SPAN/JKP/STDYS/4 Jd. 2 dated 31 Mac 2017- Part D a. *Cover letter b. *Original Receipt/ Copy with Certified True Copy . "SCC K1 and/or SCC K2 forms d. *Copy of PDC1 (Letter and drawing) e. Copy of PDC 2 e. Copy of Engineering Report f. *Copy of Master plan 9g. *Copy of Sales & Purchase (if necessary) h. *Valuation Report *Copy of A&P Permit if necessary) *Senarai Semak dan Borang Permohonan ‘Terms and consltion “Sewerage Contribution Capital is only can be paid process after approval of PDC2 and before/with PCB Docurmont shall be provided in 2 sets Document listed in this form is only 2 guidelines. Others document may required based on necessity This document is only use in CA-Penang.