PK
<head>
<script language="JavaScript" type="text/javascript">
<!--
function checkform ( form ){
// ** START **
if (form.certificateno.value == "") {
alert( "Please enter Certificate no. here." );
form.certificateno.focus();
return false ;
}
// ** END **
// ** START **
if (form.datefumigantion.value == "") {
alert( "Please enter date and place of fumigation." );
form.datefumigantion.focus();
return false ;
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// ** END **
// ** START **
if (form.temp.value == "") {
alert( "Please enter Temp here." );
form.temp.focus();
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alert( "Please enter Volume." );
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alert( "Please enter Value:" );
form.value.focus();
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alert( "Please enter gsheet:" );
form.gsheet.focus();
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if (form.seelno.value == "") {
alert( "Please enter seel no:" );
form.seelno.focus();
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// ** START **
if (form.port.value == "") {
alert( "Please enter Destination Port:" );
form.port.focus();
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if (form.vessal.value == "") {
alert( "Please enter vessal:" );
form.vessal.focus();
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if (form.desc.value == "") {
alert( "Please enter Desc:" );
form.desc.focus();
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alert( "Please enter quantity:" );
form.quantity.focus();
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</head>
<table cellspacing="3" align="center" width="100%" border="4" cellpadding="3">
<form action="certificate-nspm-confirm.php" method="get" onsubmit="return checkform(this);">
<input type="hidden" name="formno" value="<?php echo"$_POST[formno]";?>">
<input type="hidden" name="clntid" value="<?php echo"$_POST[clntid]";?>">
<input type="hidden" name="dtype" value="<?php echo"$_POST[dtype]";?>">
<tr>
<td valign="top" colspan="8">
<center>
<h3> FUMIGATION CERTIFICATE - NSPM</h3>
</center>
</td>
</tr>
<tr>
<td colspan="8" align="center">
<p>This is to certify that the goods
deseibed below were treated in accordance with the fumigation treatment
requirements of importing country USA and declared that the consignment
has been verified free of impervious surfaces/layers such as plastic
wrapping or laminated plastic films,lacqured or painted surface,aluminium
foil,tarred or waxed paper etc.that may adversely effect the penetration
of the fumigant,prior to fumigation.
</p>
</td>
</tr>
<tr>
<td valign="top" colspan="4">Dte PPQS Regd.No.:456/MB</td>
<td valign="top" colspan="4">Date:28-11-2005</td>
</tr>
<tr>
<td valign="top" colspan="4">Treatment Certificate No.:
<em>Auto assigned</em>
</td>
<td colspan="4">Date:<input type="text" name="dat" value="<?php echo date('d-m-Y'); ?>"> </td>
</tr>
<tr>
<td colspan="8" align="center">
<hr>
<font color="#339933"><strong>DETAILS OF TREATMENT:</strong></font>
</td>
</tr>
<tr>
<td colspan="2">Name of fumigation:<br></td>
<td colspan="2">
<select name="namefumigant">
<option>METHYL BROMIDE</option>
<option>ALUMINIUM PHOSPHIDE</option>
</select>
</td>
<td colspan="2">Dosage rate of fumigation:<br></td>
<td colspan="2">
<select name="dosagefumigant">
<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>9 Gms Per Ton</option>
</select>
</td>
</tr>
<tr>
<td colspan="2">Date and Place of Fumigation:<br></td>
<td colspan="2"><input type="text" name="datefumigantion"></td>
<td colspan="2">Duration of Exposure:<br></td>
<td colspan="2">
<select name="durationfumigantion">
<option>24 Hour</option>
<option>48 Hour</option>
<option>72 Hour</option>
<option>7 days</option>
</select>
</td>
</tr>
<tr>
<td valign="top" colspan="2">Temparure During Fumigation:</td>
<td colspan="2"><input type="text" name="temp"></td>
<td valign="top" colspan="2">Volume:</td>
<td colspan="2"><input type="text" name="volume"></td>
</tr>
<tr>
<td valign="top" colspan="2">Fumigation Performed under Gastight Sheets:</td>
<td colspan="2"><input type="text" name="gsheet"></td>
<td valign="top" colspan="2">If Containers are not fumigated Under
Gas-Tight sheers,Pressure decay Value
(From 200-100 Pascal's Insecond:
</td>
<td colspan="2"><input type="text" name="value"></td>
</tr>
<tr>
<td colspan="8" align="center"><strong>Descripition of Goods</strong></td>
</tr>
<tr>
<td valign="top" colspan="4">Container Number(or Numerical Link)./
Seal Number:
</td>
<td colspan="4"><input type="text" name="seelno"></td>
</tr>
<tr>
<td valign="top" colspan="4">Port of Discharge:</td>
<td colspan="4"><input type="text" name="port"></td>
</tr>
<tr>
<td valign="top" colspan="4">Vessal Name:</td>
<td colspan="4"><input type="text" name="vessal"></td>
</tr>
<tr>
<td valign="top" colspan="4">Name & Address Of Exporter:</td>
<td colspan="4"><?php echo"$_GET[clntid]";?></td>
</tr>
<tr>
<td valign="top" colspan="4">Type and Description of Cargo:</td>
<td colspan="4"><input type="text" name="desc"></td>
</tr>
<tr>
<td valign="top" colspan="4">Quantity(MTS)/No Of Packages/No Of Pieces:</td>
<td colspan="4"><input type="text" name="quantity"></td>
</tr>
<tr>
<td valign="top" colspan="4">Description Of Packing Material:</td>
<td colspan="4"><input type="text" name="packing"></td>
</tr>
<tr>
<td valign="top" colspan="4">Skaning marks or Brand:</td>
<td colspan="4"><input type="text" name="brand"></td>
</tr>
<tr>
<td valign="top" colspan="4">Invoce No.& Date:</td>
<td colspan="4"><input type="text" name="invoice"></td>
</tr>
<tr>
<td valign="top" colspan="8" align="center">P.S.No Liability to the Certifying or Its proprietors or repersentative with Respect to this Certificate.</td>
</tr>
<tr>
<td colspan="8" align="center">
<br>
<center><input type="submit" value="» Confirm details »" class="amo-submit"></center>
</td>
</tr>
</form>
</table>
PK 99