FORM XIII C (For small scale industry in Green Category) (Application for Industries other than highly polluting Industries) (Please see Annexure - D & E) (To be submitted in Quarduplicate) To The Environmental Engineer, Punjab Pollution Control Board, _________________________ Subject: Application for grant of consent to establish (NOC) consent to operate an Industrial Plant under Section 25/26 of the Water (Prevention & Control of Pollution) Act, 1974 or under Section 21 of Air (Prevention & Control of Pollution) Act, 1981. 1. a. Name and Address of the ............ Industry .................. Location ................. b. Name of the Partner/Prop ........ Capital Investment ..... 2. Permission/License from local authorities to establish industry taken (in case of location inside municipal units) Yes/ No No......Date... 3. Name of products ........... Daily Production..... ............ 4. Name of raw material and chemicals used. .......... Daily Consumption ... ............. 5. Brief description manufacturing process ............ .............. 6. Water is used inside the Industry Yes/ No Quantity of water used per day ....... KI 7. Effluent from the industry produced Yes/ No Quantity of effluent in KI/ day ........... Treatment Provided Yes/ No Prescribed parameters achieved Yes/ No Mode of discharge................ ACKNOWLEDGEMENT Form XIII C Received from M/S. .........................address ..................................... an application for consent to establish (NOC) along with the consent fee of Rs. ................. Vide local cheque/ Demand Draft No. .............. Dated .......... drawn on Bank ........................ payable at .......... For Regional Environmental Engineer. Punjab Pollution Control Board .................. 1. D.G set installed Yes/ No a. D.G. Sets capacity ........ b. Stack height above roof level ... 2. Boiler installed Yes/No Steam Generation Capacity in ton/hr .................. 3. Furnace installed Yes/ No Type of furnace ........... Air Pollution Control Device installed Yes/ No Prescribed parameters achieved Yes/No Stack height provided with each Furnace above G.L 4. Fuel used Yes/ No Type of Fuel ............. Quantity of fuel ....... tons/day 5. Noise pollution Yes/ No Measures to contain Noise pollution taken Yes/ No Prescribed parameters achieved in noise pollution 6. Hazardous Substance used Yes/ No Name of substance .......... Qty. In tons/day ............. 7. Hazardous waste is being produced Yes/ No Name of hazardous waste ....... Qty. In tons/day 8. UNDERTAKING: a. The information given above is true to the best of my knowledge b. Consent application fee Rs. (TO BE COMPLETED BY AUTHORITY OF THE PUNJAB POLLUTION CONTROL BOARD) Subject: Consent to establish an industrial plant under Section 25/26 of the Water (Prevention & Control of Pollution) Act, 1974 or under Section 21 of Air (Prevention and Control of Pollution) Act, 1981. Application dated .................. is received from M/s................................. located at ........... Tehsil ............ District ......... the industry do not fall in the list of highly polluting industry as notified by the Board vide No. ............ dated ............ This acknowledgement may be constructed as a consent to establish an industrial plant under Section 25/26 of Water (Prevention & Control of Pollution) Act, 1974 or under Section 21 of Air (Prevention & Council of Pollution) Act. 1981. This is valid as long as the information and data given in the application remain unchanged. SPECIAL CONDITIONS:- The Board reserve the right of inspection of the industry as per the provision of the Water (Prevention & Control of Pollution) Act, 1974 or the Air (Prevention & Control of Pollution) Act, 1981. The industry shall comply with all general conditions as mentioned in Annexure I The Board reserves the right to revoke the consent in case any pollution/nuisance is created by the industry and to impose necessary conditions for pollution control as per the provisions of the Water (Prevention & Control of Pollution) Act, 1974 or Air (Prevention & Control of Pollution) Act, 1981. Environmental Engineer. Punjab Pollution Control Board. ................ Dated: ..........
