Bottled Water Registration

Name of the Representative *

Please enter a valid representative name (alphabets and spaces only).

Email Address *

Please enter a valid email address.

Password *

Please choose a password.

Min 8 chars Uppercase & lowercase letters Numbers Special char

Confirm Password *

Please confirm your password.

Unit Name (Facility Name) *

Please enter the facility name.

Firm Type *

Please select the firm type.

Managing Director *

Please enter a valid name (alphabets and spaces only).

Authorized Person *

Please enter a valid name (alphabets and spaces only).

Land Extent (Perches) *

Must be at least 160 perches.

Ownership Tenure *

Please select the ownership tenure.

Street Address *

Please enter the street address.

District *

Please select a district.

GPS Coordinates *

Please enter valid latitude.

Please enter valid longitude.

Type coordinates or click/drag the pin on the map below.

Facility Location Map

Click on the map or drag the pin to set your facility location.

Please provide information about all water sources that belong to your first brand being registered now. These will be automatically linked to your initial brand.

Primary Source

Source Type *

Required.

Distance to Plant (km) *

Required.

WRB Approval Ref (Optional)

WRB Document (Optional)

Provide information about your brands.

Brand 1

Brand Name *

Please enter a valid brand name (alphabets and spaces only).

Water Category *

Required.

Label Specimens * Accepted formats: JPG, PNG, PDF. Max size: 10MB.

Please upload at least one label specimen.

Upload the mandatory facility documents.

Accepted formats: PDF, JPG, PNG. Max size: 5MB per file.

GIS Location Proof *

Survey Plan *

Factory Layout *

Process Flow Chart *

Organization Hierarchy *

Medical Report *

Legal Deed *

Lease Agreement *

Bottled Water Facility Registration

Primary Source

Brand 1