Air (Prevention and Control of Pollution) Rules, 1983 - Form I

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[FORM I
(See rule 9)

Application for Consent for emission/continuation of emission under Section 21 of the Air (Prevention and Control of Pollution) Act, 1981.

From


To

The Member Secretary,
Central Pollution Control Board,


Sir,


I/We hereby apply for CONSENT/RENEWAL OF CONSENT under Section 21 of the Air (Prevention and Control of Pollution) Act, 1981 (14 of 1981) to bring into use a new/altered *stack for the discharge of emission/to begin to make new discharge of emission/to continue to discharge emission* from stack in industry owned by .................................


1
2

3 (a)

Name of Owner/Occupier



(b)


4 (a)

Whether the unit is generating hazardous waste as defined in the Hazardous Wastes (Management and Handling) Rules, 1989



(b) If so the category No.
5 (a) Total capital invested on the project

(b) Year of commencement of production

(c) Whether the industry works general/2 shifts/round the clock
6 (a) List and quantum of products and bye-products

(b) List and quantum of raw materials used
7

Furnish a flow diagram of manufacturing process showing input and output in terms of products and waste generated including for captive power generation and demineralised water


PART B-Pertaining to sewage and trade effluent
8 Quantity and source of water for:

(a) Cooling m3/d

(b) Process m3/d

(c) Domestic use m3/d

(d) Others m3/d
9 Sewage and trade effluent discharge

(a) quantum of discharge m3/d

(b) Is there any effluent treatment plant

(c) If yes, a brief description of unit operations with capacity

(d) Characteristics of final effluent pH


Suspended solids


Dissolved solids


Chemical Oxygen Demand (COD)


Biochemical Oxygen Demand (BOD)


Oil and grease20 C


(Additional parameters as specified by the concerned Pollution Control Board)

(e) Mode of disposal and final discharge point (enclose .map showing discharge point)

(f) Parameters and Frequency of self-monitoring
PART C-Pertaining to stack and vent emissions
10 (a) Number of stacks and vents with height and dia (m)

(b) Quality and quantity of stack emission from each of the above stacks-particulate matter t and Sulphur Dioxide (S02) (Additional parameters as specified by the concerned Pollution Control Board)

(c) A brief account of the air pollution control unit to deal with the emission

(d) Parameters and Frequency of self monitoring
PART D-Pertaining to hazardous waste and hazardous chemicals.
11 Solid wastes

(a) Total quantum of generation

(b)

Quantum of hazardous waste generated and its nature, as defined under the Environment (Protection) Act, 1986. (See the Hazardous Wastes Management and Handling Rules, 1989).



(c)

Mode of storage within the plant, method of disposal and any other information sought by the concerned Pollution Control Board


12 (a)

Hazardous Chemicals as defined under Environment (Protection) Act, 1986 (See the Manufacture, Storage and Import of Hazardous Chemicals Rules, 1989)



(b)

Whether any isolated storage is involved if yes, attach details

Yes/No

(c)

Whether emergency plans are prepared for taking




-on-site measures

Yes/No


I/We enclose herewith Receipt No. ...... Bank Draft No Dated .......... for Rs (Rupees ............) in favour of the Central Pollution Control Board, New Delhi towards the fees payable under Section 25 of the Act.


Name and Signature of applicant

[F.No. Q.-15011/1/91 -CPW]
T. GEORGE JOSEPH, Jt. Secy.


Note: 1. Any applicant knowingly giving incorrect information or suppressing any information pertaining thereto shall be liable to be punished under the Act.
2. * Strike out which is not relevant.]


Foot Note: The principal rules were published in the Gazette of India vide Notification No. G.S.R. 6(E) dated the 21st December, 1983 and subsequently amended vide Notification (1) G.S.R. 350(E) dated the 9lh March 1989.


Source: Gazette of India Extraordinary Part-II Section 3(i), G.S.R. 379(E) dated 31.03.92.

 



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