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 Target of fumigation:" );
form.desgood.focus();
return false ;
}
// ** END **
// ** START **
if (form.quantitydeclared.value == "") {
alert( "Please enter Commodity:" );
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 Target of fumigation:" );
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 Consignment link:" );
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 Commodity:" );
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="confirmformfive_sub.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"$_GET[dtype]";?>">
<input type="hidden" name="certificate_id" value="<?php echo"$_GET[clnt]";?>">
<?php
$dat=date('d-m-Y');
?>
<tr>
<td align="center" colspan="6"><center>
<h2>UNIVERSAL FUMIGATION SERVICES</h2> </center>
</td>
</tr>
<td align="left" colspan="6"><strong>DPPQS Registration No</strong>: 104 MB</td></tr>
<tr>
<td colspan="2">Treatment Certificate Number:</td>
<td width="15%"><em>Auto assigned</em></td>
<td align="right" colspan="2">Date of Issue:</td>
<td width="24%"><input type="text" name="issuedate" value="<?php echo"$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">Target of fumigation:</td>
<td width="24%">
<select name="desgood" id="desgood" >
<option value="Commodity">Commodity</option>
<option value="Packing">Packing</option>
<option value="Both Commodity and Packing">Both Commodity and Packing</option>
</select>
</td>
<td align="right" colspan="2">Commodity:</td>
<td width="25%"><input type="text" name="quantitydeclared"></td>
</tr>
<tr>
<td align="left" colspan="2" valign="top"> Consignment link:<br /><br />Container No:</td>
<td><input type="text" name="consignment_link" value="N/A"> <br /><br /><textarea name="nameship" rows="3" cols="25"></textarea></td>
<td align="right" colspan="2">Country of origin:</td>
<td><input type="text" name="portcountry"></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 of loading:</td>
<td><input type="text" name="declentry"></td>
<td align="right" colspan="2">Country of destination :</td>
<td><input type="text" name="countrydes"></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">AQIS prescribed dose rate (g/m3):<br><select name="namefumigant">
<option>METHYL BROMIDE</option>
<option>ALUMINIUM PHOSPHIDE</option>
</select>
</td>
<td width="33%" colspan="2">Date frrpigation completed:<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">Exposure period (hrs):<br><select name="durationfumigantion">
<option>24 Hour</option>
<option>48 Hour</option>
<option>72 Hour</option>
<option>7 days</option>
</select></td>
<td width="33%" colspan="2">Forecast minimum temp (C):<br><input type="text" name="airtemp"></td>
</tr>
<tr><td colspan="4">Stack under sheet</td>
<td colspan="2"><input type="radio" name="contype" value="Yes">Yes /
<input type="radio" name="contype" value="No">No
</td></tr>
<tr>
<td colspan="4"> Container/s under sheet</td>
<td align="center" colspan="2"> <input type="radio" name="presstest" value="Yes">
Yes /
<input type="radio" name="presstest" value="No">
No </td>
</tr>
<tr>
<td colspan="4">Permanent Chamber</td>
<td align="center" colspan="2"> <input type="radio" name="airspace" value="Yes">
Yes /
<input type="radio" name="airspace" value="No">
No </td>
</tr>
<tr>
<td colspan="4">Pressure tested container/s :</td>
<td align="center" colspan="2"> <input type="radio" name="discharge" value="Yes">
Yes /
<input type="radio" name="discharge" value="No">
No </td>
</tr>
<!--<tr>
<td colspan="4">Container/Enclosure has been Ventilated to below 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"> Dose the target of fumigation conform to the AQIS plastic wrapping, impervious surface and timber thickness requirements at the time of fumigation?</td>
<td align="center" colspan="2">
<input type="radio" name="consignment" value="Yes">
Yes /
<input type="radio" name="consignment" value="No">
No
</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">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>
<td colspan="4"> Ventilation Final TLV reading(ppm):</td>
<td align="center" colspan="2"> <input type="text" name="perforated" value=""> </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 Australian Methyl Bromide Standards
</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 colspan="6" align="center"><br><center><input type="submit" value="» Confirm details »" class="amo-submit"></center></td></tr>
</form>
</table>
PK 99