PK
<head>
<script language="JavaScript" type="text/javascript">
<!--
function checkform ( form )
{
// ** START **
if (form.certificateno.value == "") {
alert( "Please enter Certificate no." );
form.certificateno.focus();
return false ;
}
// ** END **
// ** START **
if (form.desgood.value == "") {
alert( "Please enter Desription of goods:" );
form.desgood.focus();
return false ;
}
// ** END **
// ** START **
if (form.quantitydeclared.value == "") {
alert( "Please enter Quantity declared:" );
form.quantitydeclared.focus();
return false ;
}
// ** END **
// ** START **
if (form.distmarks.value == "") {
alert( "Please enter Distinguishing marks:" );
form.distmarks.focus();
return false ;
}
// ** END **
// ** START **
if (form.desgood.value == "") {
alert( "Please enter Desription of goods:" );
form.desgood.focus();
return false ;
}
// ** END **
// ** START **
if (form.conslinkno.value == "") {
alert( "Please enter Consignment Link/Container No." );
form.conslinkno.focus();
return false ;
}
// ** END **
// ** START **
if (form.portcountry.value == "") {
alert( "Please enter Port & country of loading:" );
form.portcountry.focus();
return false ;
}
// ** END **
// ** START **
if (form.nameship.value == "") {
alert( "Please enter Name of the Vessel/Ship:" );
form.nameship.focus();
return false ;
}
// ** END **
// ** START **
if (form.countrydes.value == "") {
alert( "Please enter Country of Destination:" );
form.countrydes.focus();
return false ;
}
// ** END **
// ** START **
if (form.declentry.value == "") {
alert( "Please enter Quantity declared:" );
form.declentry.focus();
return false ;
}
// ** END **
// ** START **
if (form.datefumigantion.value == "") {
alert( "Please enter date:" );
form.datefumigantion.focus();
return false ;
}
// ** END **
// ** START **
if (form.placefumigantion.value == "") {
alert( "Please enter place here:" );
form.placefumigantion.focus();
return false ;
}
// ** END **
// ** START **
if (form.airtemp.value == "") {
alert( "Please enter air temp:" );
form.airtemp.focus();
return false ;
}
// ** END **
// ** START **
if (form.amount.value == "") {
alert( "Please enter amount:" );
form.amount.focus();
return false ;
}
// ** END **
return true ;
}
//-->
</script>
</head>
<table align="center" width="100%" border="3" cellpadding="0" cellspacing="0">
<form action="form/confirmform_ppq.php" method="get" onsubmit="return checkform(this);">
<input type="hidden" name="formno" value="<?php echo"$_GET[formno]";?>">
<input type="hidden" name="clntid" value="<?php echo"$_GET[clntid]";?>">
<input type="hidden" name="dtype" value="<?php echo"$_GET[dtype]";?>">
<input type="hidden" name="sub_c" value="<?php echo"$_GET[sub_c]";?>">
<?php
$dat=date('Y-m-d');
?>
<tr>
<td align="center" colspan="6">
<center>
<h2>UNIVERSAL FUMIGATION SERVICES</h2>
</center>
</td>
</tr>
<td align="left" colspan="6"><strong>AEI No.:</strong>: IN0104/MB</td>
</tr>
<tr>
<td colspan="2">Treatment Certificate Number:</td>
<td width="15%"><em>Auto assigned</em></td>
<td align="right" colspan="2">Date of Issue:</td>
<td width="24%"><input type="text" name="issuedate" value="<?php echo"$dat";?>"></td>
</tr>
<td colspan="6">This is to certify that the following
regulated articles have been fumigated according to the
appropriate procedures to confirm to the current Phytosanitary .Requirements of the importing country.
</td>
</tr>
<td align="left" colspan="6">
<HR>
<strong><font color="#339933">DETAILS OF GOODS:</font> </strong>
</td>
</tr>
<tr>
<td colspan="2">Desription of goods:</td>
<td width="24%"><input type="text" name="desgood"></td>
<td align="right" colspan="2">Quantity declared:</td>
<td width="25%"><input type="text" name="quantitydeclared"></td>
</tr>
<tr>
<td align="left" colspan="2">Distinguishing marks:</td>
<td><input type="text" name="distmarks"></td>
<td align="right" colspan="2">Consignment Link/Container No.</td>
<td><textarea name="conslinkno" rows="3" cols="25"></textarea></td>
</tr>
<tr>
<td align="left" colspan="2">Port & country of loading:</td>
<td><input type="text" name="portcountry"></td>
<td align="right" colspan="2">Name of the Vessel/Ship:</td>
<td><input type="text" name="nameship"></td>
</tr>
<tr>
<td align="left" colspan="2">Country of Destination:</td>
<td><input type="text" name="countrydes"></td>
<td align="right" colspan="2">Declared point of Entry:</td>
<td><input type="text" name="declentry"></td>
</tr>
<?php
echo"<input type=hidden name=clntid value=$_GET[clntid]>";
echo"<input type=hidden name=dtype value=$_GET[dtype]>";
$sql="SELECT * From head WHERE headid='$_GET[clntid]'";
$result=mysql_query($sql) or die('error in getting client details');
while($row=mysql_fetch_array($result))
{
if($_GET[dtype]=='import')
{
echo "<input type=hidden name=declarednameaddress value=$_GET[clntid]>";
echo "<tr>
<td align=left colspan=3>Name and address of consignor/exporter:</td>
<td align=center colspan=3>";
/*
echo "<select name=nameaddress>";
$sqlb="SELECT * From clients where subname<>'.' AND subname<>'' AND subname<>'..' ORDER BY subname ASC";
$resultb=mysql_query($sqlb) or die('error in getting Sub client details');
echo"<option value='1121'>.</option>";
while($rowb=mysql_fetch_array($resultb))
{
$subid="{$rowb['subid']}";
$subname="{$rowb['subname']}";
echo"<option value=$subid>".substr($subname,0,25)." -> ".substr($rowb['subaddress'],0,25)."</option>";
}
echo"</select>";
*/
?>
<input name='nameaddress' id="exporterslist" size="80" type="text" />
<?
echo "</td>
</tr>
<br>
<tr>
<td colspan=3>Name & address of consignee:</td>
<td align=center colspan=3>
<b>{$row['headname']}</b><br>{$row['headaddress']}<br>{$row['headphone']}
</td>
</tr>
";
}
else
{
echo "<input type=hidden name=nameaddress value=$_GET[clntid]>";
echo "<tr>
<td colspan=3>Name and address of consignor/exporter:</td>
<td align=center colspan=3>
<b>{$row['headname']}</b><br>{$row['headaddress']}<br>{$row['headphone']}
</td>
</tr>
<br>
<tr>
<td colspan=3>Name & address of consignee:</td>
<td align=center colspan=3>";
/*
echo "<select name=declarednameaddress>";
$sqlb="SELECT * From clients where subname<>'.' AND subname<>'' AND subname<>'..' ORDER BY subname ASC";
$resultb=mysql_query($sqlb) or die('error in getting Sub client details');
echo"<option value='1121'>.</option>";
while($rowb=mysql_fetch_array($resultb))
{
$subid="{$rowb['subid']}";
$subname="{$rowb['subname']}";
echo"<option value=$subid>".substr($subname,0,25)." -> ".substr($rowb['subaddress'],0,25)."</option>";
}
echo"</select>";
*/
?>
<input name='declarednameaddress' id="exporterslist" size="80" type="text" />
<?
echo" </td>
</tr>
";
}
}
?>
<tr>
<td colspan="6">
<hr>
<strong><font color="#339933">DETAILS OF TREATMENT:</font></strong>
</td>
</tr>
<tr>
<td width="33%" colspan="2">
Name of fumigation:<br>
<select name="namefumigant">
<option>METHYL BROMIDE</option>
<option>ALUMINIUM PHOSPHIDE</option>
</select>
</td>
<td width="33%" colspan="2">Date of fumigation:<br><input type="text" name="datefumigantion"></td>
<td width="33%" colspan="2">Place of fumigation:<br><input type="text" name="placefumigantion"></td>
</tr>
<tr>
<td width="33%" colspan="2">
Dosage rate of fumigation:<br>
<select name="dosagefumigant">
<option>3 LBS Per 1000 Cubic Ft.</option>
<option>3.5 LBS Per 1000 Cubic Ft.</option>
<option>4 LBS Per 1000 Cubic Ft.</option>
<option>9 Gms Per Ton</option>
<option>12 Gms Per Ton</option>
<option>6 Gms Per Cubic Meter</option>
<option>16 Gms Per Cubic Meter</option>
<option>24 Gms Per Cubic Meter</option>
<option>32 Gms Per Cubic Meter</option>
<option>40 Gms Per Cubic Meter</option>
<option>48 Gms Per Cubic Meter</option>
<option>56 Gms Per Cubic Meter</option>
<option>64 Gms Per Cubic Meter</option>
<option>80 Gms Per Cubic Meter</option>
<option>88 Gms Per Cubic Meter</option>
<option>96 Gms Per Cubic Meter</option>
<option>100Gms Per Cubic Meter</option>
<option>108Gms Per Cubic Meter</option>
<option>116Gms Per Cubic Meter</option>
</select>
</td>
<td width="33%" colspan="2">
Duration of fumigation:<br>
<select name="durationfumigantion">
<option>2 Hr 30 min</option>
<option>24 Hour</option>
<option>48 Hour</option>
<option>72 Hour</option>
<option>7 days</option>
</select>
</td>
<td width="33%" colspan="2">Minimum Air temperature:<br><input type="text" name="airtemp"></td>
</tr>
<tr>
<td colspan="4">Fumigation has been performed in a container/under gas tight enclosure/sheet:</td>
<td colspan="2"><input type="radio" name="contype" value="Yes">Yes /
<input type="radio" name="contype" value="No">No /
<input type="radio" name="contype" value="N/A" checked>N/A
</td>
</tr>
<tr>
<td colspan="4"> Containser pressure test conducted:</td>
<td align="center" colspan="2"> <input type="radio" name="presstest" value="Yes">
Yes /
<input type="radio" name="presstest" value="No">
No /
<input type="radio" name="presstest" value="N/A" checked>
N/A
</td>
</tr>
<tr>
<td colspan="4">Containser has 200mm free air space at top ofcontainer:</td>
<td align="center" colspan="2"> <input type="radio" name="airspace" value="Yes">
Yes /
<input type="radio" name="airspace" value="No">
No /
<input type="radio" name="airspace" value="N/A" checked>
N/A
</td>
</tr>
<tr>
<td colspan="4">In transit Fumigation-needs Ventillated at port of discharge:</td>
<td align="center" colspan="2"> <input type="radio" name="discharge" value="Yes">
Yes /
<input type="radio" name="discharge" value="No">
No /
<input type="radio" name="discharge" value="N/A" checked>
N/A
</td>
</tr>
<tr>
<td colspan="4">Container/Enclosure has been Ventilated to below 0.5ppm
v/v menthyl Bromide:
</td>
<td align="center" colspan="2"> <input type="radio" name="enclosure" value="Yes">
Yes /
<input type="radio" name="enclosure" value="No">
No /
<input type="radio" name="enclosure" value="N/A" checked>
N/A
</td>
</tr>
<tr>
<td colspan="6">
<hr>
<strong><font color="#339933">WRAPPING AND TIMER:</font></strong>
</td>
</tr>
<tr>
<td colspan="4">Has the commodity has fumigated prior to lacquering,varnishing,painting
or wrapping?
</td>
<td align="center" colspan="2"> <input type="radio" name="commodity" value="Yes">
Yes /
<input type="radio" name="commodity" value="No">
No /
<input type="radio" name="commodity" value="N/A" checked>
N/A
</td>
</tr>
<tr>
<td colspan="4">Has plastic wrapping been used in the consignment?:</td>
<td align="center" colspan="2"> <input type="radio" name="consignment" value="Yes">
Yes /
<input type="radio" name="consignment" value="No">
No /
<input type="radio" name="consignment" value="N/A" checked>
N/A
</td>
</tr>
<tr>
<td colspan="4">If yes,has the consignment been fumigated prior to wrapping?:</td>
<td align="center" colspan="2"> <input type="radio" name="wrapping" value="Yes">
Yes /
<input type="radio" name="wrapping" value="No">
No /
<input type="radio" name="wrapping" value="N/A" checked>
N/A
</td>
</tr>
<tr>
<td colspan="4">Or has the plasstic wrapping been slashed,open or perforated
<br>
in accordance with the wrapping and perfortion standard?
</td>
<td align="center" colspan="2"> <input type="radio" name="perforated" value="Yes">
Yes /
<input type="radio" name="perforated" value="No">
No /
<input type="radio" name="perforated" value="N/A" checked>
N/A
</td>
</tr>
<tr>
<td colspan="4">Is the timber in this consignment less than 200mm thick
in <br>
one dimension and correctly spaced every 200mm in height
</td>
<td align="center" colspan="2"> <input type="radio" name="height" value="Yes">
Yes /
<input type="radio" name="height" value="No">
No /
<input type="radio" name="height" value="N/A" checked>
N/A
</td>
</tr>
<tr>
<tr>
<td colspan="6">
<hr>
<input type="checkbox" name="addition"><strong><font color="#339933">ADDITION DECLERATION:</font></strong>
</td>
</tr>
<tr>
<td colspan="6"><textarea name="deck" cols="100"></textarea><br />I declare that these details are true and correct and the fumigation has been carried out in accordance with the NSPM -12 / ISPM-15
</td>
</tr>
<!--tr>
<td colspan="6"> Number of Container </td>
</tr>
<tr>
<td colspan="6"> 20’ <input type="text" name="container20feet" /> <br /><br />
40’ <input type="text" name="container40feet" /> <br /><br />
40HC <input type="text" name="container40HC" /> <br /><br />
LCL <input type="text" name="containerLCL" /> <br /><br />
</td>
</tr-->
<tr>
<td valign="top" colspan="3"><strong>Encloser Area of Fumigation</strong>:</td>
<td colspan="3"><input type="text" name="container20feet" /> Cubic meters</td>
</tr>
<tr>
<td colspan="3" align="right">
<center>
<strong>MAKE INVOICE:</strong>
</center>
</td>
<td colspan="3">
For agent:-
<input name='ajtname' id="agentslist" size="80" type="text" />
<!--select name="ajtname">
<option value="0">Select an agent</option>
<?php
$sql="SELECT ajcomp,ajid FROM ajent order by ajcomp";
$result=mysql_query($sql) or die('error in fetch');
if
(mysql_num_rows($result) == 0)
{ echo "<option value=0>no agents found</option>";
}
while($row=mysql_fetch_array($result))
{
echo"<option value='".$row['ajid']."'>{$row['ajcomp']}</option>";
}
?></select-->
</td>
</tr>
<tr>
<td colspan="3" align="right"><strong>Fumigation Amount</strong> :</td>
<td align="center" colspan="3"> Rs.<input type="text" name="famount">/-</td>
</tr>
<tr>
<tr>
<td colspan="3" align="right"><strong>Travel Expenses</strong> :</td>
<td align="center" colspan="3"> Rs.<input type="text" name="tamount">/-</td>
</tr>
<tr>
<tr>
<td colspan="3" align="right"><strong>Miscellaneous</strong> :</td>
<td align="center" colspan="3"> Rs.<input type="text" name="mamount">/-</td>
</tr>
<tr>
<td colspan="3" align="right"> Discount:<em>(in %age)</em></td>
<td colspan="3" align="center">
<input type="text" name="discount" size="4" value="0" onfocus="this.value=''">
%
</td>
</tr>
<tr>
<td colspan="3" align="right"><input type="checkbox" name="stax" value="yes" checked> GST :</td>
<td colspan="3" align="center"><input type="text" name="srtax" value="18" size="4">%</td>
</tr>
<tr class="highlight">
<td colspan="3" align="right">No. of Container:</td>
<td colspan="3"><input name="qty" size="4" type="text"></td>
</tr>
<tr>
<td colspan="3" align="right">GST Combine:</td>
<td colspan="3"><input name="gst_combine" value="1" type="checkbox"></td>
</tr>
<tr class="highlight">
<td colspan="3" align="right">Name of Product/Service:</td>
<td colspan="3"><input name="product" size="70" type="text"></td>
</tr>
<tr>
<td colspan="3" align="right">SAC:</td>
<td colspan="3"><input name="hsn" size="40" value="998531" type="text"></td>
</tr>
<tr class="highlight">
<td colspan="3" align="right">UOM :</td>
<td colspan="3"><input name="uom" size="40" type="text"></td>
</tr>
<tr>
<td colspan="2" align="center" valign="middle">Particulars</td>
<td colspan="4"><textarea name="particular" rows="2" cols="40"></textarea></td>
</tr>
<tr>
<td colspan="6" align="center">
<br>
<center><input type="submit" value="» Please Check & Confirm »" class="amo-submit"></center>
</td>
</tr>
</form>
</table>
PK 99