9/30/2019 Index

FORM RE-12
(See rules 47 and 50 of the Explosives Rules, 2008)
Pass issued by the Consignor for Transport of a Consignment of Explosives.
1. Pass No: RE-12/2019/611653 Date: 30/09/2019
Supplier Ref. No : SE193
2. This pass covers 40 packages containing following explosives :
Explosive Name Size No of Bar
Sr.No Size Code Description ClassDivision Quantity Unit
(Brand ID) Code Packages Code
Barcode
CDA - 83 MM - 2780 GM
1 Toeblast(367) CDA 2 0 1000.000 Kg. 40 as Per
x 9 Nos. = 25 KG
Annexure
Sub Total(367) 1000.000 40
while transit from Village Town Name : Sapol, District : RAJASMAND, State : Rajasthan to Village
Town Name : PHALWA, District : CHITTORGARH, State : Rajasthan
The explosives are being transported by rail or road van number RJ-27/GB-3443 having licence
3. number E/NC/RJ/25/483(E71674) till 31/03/2021 or lorry number NA otheron mechanically
propelled vehicle.
M/S WONDER CEMENT LTD
4. Name and address of Consignees licence Village Town Name : PHALWA,
District : CHITTORGARH, State : Rajasthan
E/NC/RJ/22/813(E61476) -LE-3 (Old Form
5. Number and Form of Consignees licence
22)
Consignees order number and date and quantity of RE-11/2019/1049530 dated: 09/09/2019
6.
each explosives ordered Toeblast(Cl 2(0)) - 1000.000 Kg.,
Consignees letter number and date intimating
7. RE-11/2019/1049530 dated: 09/09/2019
readiness to receive explosives
8. Date of dispatch of consignment 30/09/2019
Approximate date on which consignment should
9. 04/10/2019
reach destination
Signature of the Authorised Person
Signature of the Authorised Person

SHRI KANHIYA LAL JAIN

M/S WONDER CEMENT (Occupier)
LTD(Consignee) For M/s. Shree Ji
Licence Number Enterprises(Consignor)
Police Station :E/NC/RJ/22/813(E61476) Licence Number
Licence Form : LE-3 (Old Form :E/HQ/RJ/21/469(E46603)
22) Licence Form : LE-3 (Old Form
21)
Copy Forwarded to :
Approximate
date of Arrival
Sr.
Name of Authority District Name State Name of the
No.
Explosives
Van
1. The Jt. Chief Controller of Explosives, North Circle, Faridabad
2. The Dy. Chief Controller of Explosives, Jaipur
3. DM RAJASMAND Rajasthan
4. Superintendent of Police RAJASMAND Rajasthan 30/09/2019
5. DM UDAIPUR Rajasthan
6. Superintendent of Police UDAIPUR Rajasthan 02/10/2019
7. DM CHITTORGARH Rajasthan
8. Superintendent of Police CHITTORGARH Rajasthan 04/10/2019

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