FORM NO.1 Prescribed under Rule 3(2) and 3(6) Application for permission to construct, extend or take into use any building as factory 1. Full name of the factory 2. Full Address and location of the site / factory with pin code 3. Address to which Communications are to be sent 4. Number of workers proposed to be employed Men Women 5. List of Plant and machinery (Give full details with Horse power of prime mover or Motors). 6. Raw materials used in the manufacturing process 7. Brief description of manufacturing process 8. Final products and their output 9. Type and nature of wastes and effluents, their quantities and the methods of their disposal 10. In case of extensions or additional Installations, reference numbers of plans approved earlier Date Signature of Occupier (Name and Designation) INSTRUCTIONS The Form together with following annexures shall be submitted in triplicate: 1. A flow chart of the manufacturing process supplemented by brief description of the process in its various stages. 2. Plans drawn to metric scale , prepared by a person holding a Diploma or Degree in Engineering or a Draughtsman Course approved by the Board of Technical Education or Equivalent thereto, showing: (i) The site of the factory and Immediate surrounding including adjacent building ,other structures, roads, canals, rivers, ponds, tanks, etc., drawn to a scale of 1 : 400 or 1 : 1200. (ii) The plan, elevation and necessary cross-sections of various building indicating all relevant details relating to natural lighting, ventilation and means of escape in case of fire, drawn to scale of 1:100, ad (iii) The position of the plant and machinery, aisles and passage ways, and (iv) The materials to be used for the constructions of buildings and roofing. 3. Original challan for scrutiny fee of Rs. 100- shall be enclosed for small scale industry; Rs. 1000- for large scale industry.
