FORM - 4 [See rule 9(2)] Form For Filing Returns Regarding Handling Of Hazardous Wastes [to be submitted to the Meghalaya State Pollution Control Board by 31st January of every year] 1. Name and address of Occupier/Operator of Facility: 2. Categories of Wastes generated and quantity (in metric tonnes): 3. Details of waste treatment operations: 4. Details of waste disposal operations; S.No Description of Hazardous Waste Date of issuance of authorisation for the disposal of hazardous waste and its reference number Physical form and contents Chemical form Total Volume of the hazardous waste disposed with no. of packages Mode of transportation on to the site of disposal Site of disposal (attach a sketch showing the location(s) of disposal Brief description of the method of disposal Date of disposal Remarks (if any) 1 2 3 4 5 6 7 8 9 10 5. Details of environmental surveillance: Date of Measurement Analysis of ground water samples Analysis of soil samples Analysis of air sampling Analysis of any other Samples (give details) Location of Sampling Depth of sampling Data Location of Sampling Depth of sampling Data Location of sampling Data Place: Signature: Date: Designation:
