FORM III

Bombay Prohibition Act, 1949 [1949 : Bom. XXV FORM III [See rule 7 (1) and 9 (2)] Survey Register —————————————————————————————————————————— Declaration of Notice to remove wash Date and hour of wash make or spirits Nos. of survey or of receiver washbacks of declaration or——————————— ————————————— tested for gravity notice Date andNos. of washDate andFrom To hour when backs hour of prepared removal 1 2 3 4 5 6 7 —————————————————————————————————————————— —————————————————————————————————————————— —————————————————————————————————————————— Conditions of spirits receivers Conditions of Stills No. 1 No. 2 Nos. 1 to Charged orEmpty or Dip.Tempera-IndicationDip. TemperatureIndication at work silent ture 8 9 10 11 12 13 14 15 —————————————————————————————————————————— —————————————————————————————————————————— —————————————————————————————————————————— Conditions of spirit receivers—contd. —————————————————————————————————————————— No. 3 No. 4 Dip. Temperature Indication Dip. TemperatureIndication 16 17 18 19 20 21 —————————————————————————————————————————— —————————————————————————————————————————— 6051949 : Bom. XXV] Bombay Prohibition Act, 1949 FORM III—contd. —————————————————————————————————————————— Conditions of spirit receivers—contd. —————————————————————————————————————————— No. 5 No. 6 ———————————————————— ———————————————————— Dip. TemperatureIndication Dip. Temperature Indication 22 23 24 25 26 27 —————————————————————————————————————————— —————————————————————————————————————————— —————————————————————————————————————————— Nos. of labels used Observation Officer’s ———————————————————— initials From To 28 29 30 31 —————————————————————————————————————————— ——————————————————————————————————————————