Subdivision: ............................................... ................................................
facility name base: ................................. ........ ..................................
tax code: ................................. .. ................................. ....... ....
Address: ... ........................... .............. [Name District ....] [Name Province ... ..]
person responsible the contents of the report: ............................................ .............................
Phone: .................. ........ Fax: ... ............................, Email:. ...... ..... .. ............ .......
Subordinated (parent company name): ............................ .................................................. .
Address: ... ..................................... ... [name District ....] [name Province ... ..]
Phone: ............. ............. Fax: ... ............................, Email:. ...... ....... ............ ........
owners: (State / other economic sectors /
I. Information on infrastructure and products
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