8. PREFERENCE RATINGS (assigned to chlorine requested) AND Uses.—See definitions on back of Instruction Sheet for PD-190. -.
List below preference ratings assigned to uses by Amendment No. i to General Preference Order M-29 er otherwisey.and
item numbers for each use. Show the amount of chlorine required for each use. The total of all such chlorine should
be the same as the quantity requested. (Pulp and paper producers requiring chlorine must file PD-190A in addition to

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PD-190).
DEFENSE ORDERS—ALL “A” RATINGS
LEAVE BLANK
Use— PREFER- QUANTITY Esti ATED : ESTIMATED
— ipa ya ei ee eS OPM Tina DURATION
No. RATING CHLORINE SUPPLY Suncenen ADJUSTMENT SCHEDULE OF eg
(1), (2) (Tons) (Days) (Tons) (Tons) (Tons) (Days)
TOTAL FOR
DEFENSE ORDERS Xk Se ese x
CIVILIAN ORDERS—ALL “B” RATINGS
TOTAL FOR
CIVILIAN ORDERS ks oe. 6 oe Stk XX
GRAND TOTAL
FOR ALL ORDERS XEN H Se Se Ne

 

 

 

 

 

 

 

 

 

9. Additional revelant information applicant may wish to present:

 

 

 

 

The undersigned certifies to the supplier and to the Office of Production Management that:

1. He executed this certificate on behalf of and by authority of
the purchaser of the above chlorine. (This item is to be filled in only if purchaser is other than individua!.)

 

2. He has read and is familiar with the provisions of General Preference Order M-19 and Amendment No. 1 to it.
3. The facts set forth herein are true and correct.
4. The chlorine to be delivered on this order will not be used for other than the purposes specificd above.

5. The chlorine to be delivered on this order is not greater in quantity than the minimum required commensurate with eco-
nomic delivery and permissible inventory, at the expected rate of use, taking into consideration supplies on hand and
on order.

Section 35 (A) of the United States Criminal Code
18, U.S. C. A. 80, makes it a criminal offense to make a
false statement or representation to any department or (Siznature of official)
agency of the United States as to any matter within the
jurisdiction of any department or agency in the United
States, : (Bate) (Title)

 

 

3. COVERN WES RINTING CEFITE Risse oa