Bottled Water Registration

Name of the Representative *

Please enter representative name.

Email Address *

Please enter a valid email address.

Password *

Please choose a password.

Min 8 chars 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 *

Required.

Authorized Person *

Required.

Land Extent (Perches) *

Must be at least 160 perches.

Ownership Tenure *

Please select the ownership tenure.

Street Address *

Please enter the street address.

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.

Provide information about your primary water source.

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 *

Required.

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 (GIS Location also accepts JPG/PNG). Max size: 10MB 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