Download Performa for No Objection Certificate

Form-1 m v k j k ap y i ; ka ZZ aa aa i znz ww = . k c k aa M ss ZZ n ss u o j . k l j { k . k , o " k . k f u ; g j k n ww u k i f v k @ l g e zz k d k j i zz k . k i = g sq k o ss v f r @ i k f / e s v n u d k i f j f ' r k " V 1. m|ksjkukeoir]J.kh,oa o`;e@y? tkykxgks@eSZdy@xdk iwsgn@e/kqs w ´Vkykftkko SyDkfudlhi,oiij LoHedsfudy@bsV es.V@iYa s Name/and Address, Category VslVkbwzklflxa; tks w Dy @«M iss@vUykxgk ( & Type of Industry) mls grdja;= dksZ gks s ksA fpfUsbka A;fn vUrfy[´ 2. lkekU;@General : 2.1 vkosa irk nu dk uke,o tek dja]fcU2.3 ij oka ´r snqfN toi ihcever tu k Sitr (me Ce mal eowhsn /Sugar/liltecrca E/litecroncsE /hilcanca/ leTitex/aper Plu/tn p&P is )t.itno p ty emeni ihcever ic Th(toers./irocessng kwh hterfanasle dPiblcap ;inceoyo Fooap: ) 23.Pitonlfo itea Mem/ Siu d/Large) leibcalpapfitse itocao ac itocao nProposehso dLn(At hlnowigd lwsn'Zr,´% puk;a kks gq 2.3 LFs rZojf{krou]jss ykbu]unhkkfed Lky]kcknhvk;kj.; vkfn kydfudVegkbsyo]ukyk]/ZFv]H ]lq dhn'kk,onwa shnwa% a fj;ksdk fooj.k 5 fdykeVj dhjhes ´ Details of direction and distance of nearest sanctuary, highway, railway line, human settlements, river, drain, reserved forests, religious places etc. from the site (in a 5 km distance) : Sanctuary vHk;kj.;´& Railway Line jss Zu@L'& yoykbVsku´ / ilurgca t miMeal Me /lca heC :itcanlpp -maMoe: l: ilm|kLFF2.2 sz xdk irkforLky Lky ekufp= i b E meadAsofA x: dresd n NaFa e: honP Highway eqZo´ [; gkbs& River unh´& Drain ukyk´& Reserve Forest lq& jf{krou´ Human Settlement vkcknh´& Religious Places /kkfeZd LFky´& 2.4 LFZews ky dk orku Hk&mi;kx% izek.k i= layXu djas´ Present use of land : (enclose certificate) (a) As per master plan/ zonal development plan/by laws. v´ekLVj Iyku@tksuy fodkl@mifu;ekasds uq vlkj (b) Name of the municipality/Development authority/ Industrial estate where the unit is to be located c´ml LFky dhuxjikfydk@fodkl izkf/|kssysa tgka kdj.k@vkSfxd{k=dk mY[k djsm|ksFsa xLkkfirdjuk pkgrgS 2.5 vk'kqm|ksthdj.k dk fooj.k% k; i=@y?xia Details of Letters of intent/SSI Registration : Licence NO., Boiler License No. etc. 2.6 (a) mRiknu izf¬;k dk ykpkVsZ ,oa fooj.k% Brief process description with Flow Chart : (b) Source of Energy =tkZ dk lzksr´ 1. D. G. Set Mh0ths´ 0lV 2. Boiler ckW ;yj´ 3. Type of fuel to be used bZaku ftldk iz;ks /xfd;k tkuk gS ´ 4. Power Load f"k@vkoklhf'|kfxd d`;@dkekZ;y@vkSs Agricultural/Residential/Commercial/Industrial laudl0 yXa-------------------------- Enclosure No.................................... Related Capacity in KVA laakr{kek d-ohs´ cf/rs-,-ea Rating/Steam generation capacity tonnes/hr. jsa@Hiknu{kekVuizafVxkki mRrfr?kVk´ Coal/Furnace Oil/Diesel/Natural Gas/ Wood /Briquettes dkssl vkWty@izfrd ;y@QuZ;y@Mhkd`xShsfJrfczs l@ydM+@dky@feDoVl´ 2.7 eqiknkswa fud{kek% [; mRa dhlph,onSr List of main products with daily capacity 2.8 lgmRiknksdhlwa fud{kek% a ph,onSr List of By-products with daily designed capacity : 2.9 eqp&ky dhnSkirdhlw [; dPsefud[ph List of Basic raw material with daily consumption (in Kgs/Mt) vUpefud[wk=k ; dPs ky dhnSkirdhlpho e List of other Raw Material to be used and their quantity. 2.10 v´m|ehvFkok Hkkxhnkjkasdhdk;ZjrvU; lg bdkb;ksdhlw% Za ph List of other industrial unit operated by applicant or its partners : c´dk;Zjrdkesdhla xkjka [;k% No. of workers employed : 2.11 ifj;ksy ykxr% tuk dhdq Capital cost of Project : 2.12 bdkbZ easmRiknu dhfrfFk % Expected date of commissioning of plant : 3. ty izn"k.k@wWater Pollution 3.1 ty iznk; dk lzksr% Source of supply of water 3.2 ty dhnSkir% fud [ Daily consumption of water : V~wsznk;@unh; fooj.k na ;coy@ikfydk i@>hy@vUs´ Tubewell/Municipal Supply/River/Lakeother (specify) vkSszf¬;k/Industrial Process (In Kilolitres) |kfxd i vkSswa@Industrial Cooling........................... |kfxd dfyxCok;yj easiz;kxs@Boiler Blow down...................... 3.3 izfrfnu fuLrkfjrmRizokg % Total Quantity of liquid effluents discharged per day 3.4 D;k izn"k.k rwRo tfurgksxas \ Are there any expected Pollutants ? "kd rR 3.5 iznwokasdk oxZ Type of Pollutants : 3.6 mRizokg fof'kf"V;kasds vkSszf¬;k@Industrial Process (In Kilolitres) |kfxd i yksa ;aykb@ j ,o= dh/kqZ Floor & Equipment washing............................................ vU; Li"Vdjsa@Other (Specify) ´dqs@Total y ;kx?kjysw iz;kstu@Domestic effluent............................ vkSszf¬;k@Industrial Process (In Kilolitres) |kfxd ivkSswa@Industrial Cooling...................... |kfxd dfyxCok;yj easiz;kxs@Boiler Blow down...................... vkSszf¬;k@Industrial Process (In Kilolitres) |kfxd i yksa ;aykb@ j ,o= dh/kqZ Floor & Equipment washing.................................... vU; Li"Vdjsa@Other (Specify) ´dqs@Total y ;kx?kjysw iz;kstu@Domestic effluent.................... gkaa @ugh Yes/No nzo@Bkl@xsSlh; Liquid/Solid/Gaseous c/smiyCk fooj.k fuE~ laak ea /uorfd;k tk;s% Indicate available information on effluent characterized as below : HkkSfrd@Physical jklk;fud@ Chemical rkieku@Temperature dBksjrk@Hardness ih-,p-@P.H. ch-vks-Mh-@B.O.D dyj@Colour lh-vks-Mh-@C.O.D. VfcZfMfV@Turbidity vk;y ,.M xzhl@Oil & Grease xa/k@Odour dqy ukbV kstu@Total Nitrogen dqy lkWfyM@Total Solid QklQsV@Phosphate dqy fuyfEcrlkWfyM@Total Suspended Solid DyksjkbM@Chloride dqsfyM@Total Volatile Solid QV@Sulphate y okykVkby lkWlYs lks fM;e@Sodium ikssk;e@Potassium Vf'dSk;e@Calcium yf'eSuhk;e@Magnesium xf'vU;@Others vUrro tSs ukbuky@HkkrqR ; fo"kkDRllkbM@Qhskkjh/b;kfnA Other toxic constituents such as cyanide/phenol/heavy metals etc. 3.7 D;kmRzokgea s uqsk\ ikudksdv:i tfurgkxIs the effluent to be generated with in Standard specifications 3.8 izLkforty izwa;oLkk rn"k.k fu;=.k OFdk lec) dk;Z¬e% Proposed time bound programme for Water Pollution Control System 3.9 vfUrefuLrkj.k dk ek/;e% Mode of final discharge : 3.10 varnq frefuLkj.k fcU% Point of final discharge : gkaa @ugh;fn ugha rizLkfor'f)dj.k OFsA ks rkq;oLkk dk fooj.k nalaud yX Yes/No If no, furnish details of treatment method proposed. Enclosure.......................... [kqaxu yk ukyk@cn ukyk@ySw Open drain/Closed drain/Lagoons ikfydk@lhoj flLVe@ty lzksr@ Hkw.kZ fooj.k na@vU fe iws´; Municipal corporation/Sewage system Water bodies/Field (Specify) any other 3.11 D;k vkSsizkjsw izs lkFydj fuLkfjrgkss kjsw mRzokg dk |kfxdmRokg]?ymRokgdkferxk];fnughrk?yifuLrkj.k fcUn Li"VdjasA Is industrial effluent allowed to mix domestic effluent, if no specify of domestic effluent 4. ok;qinzw"k.k@Air Pollution 4.1 mRizokg gsi;qrbaku ,omldhnS rqzDZ/a fud ek=k % Type and Quantity of fuel consumed per day in manufacturing or subsidiary process : 4.2 bZaku i;kxlltu dk fooj.k% uqkfur@Expected /zsstfurmRZveDetails of emissions from fuel fo's y"k.k@Analysis............................................. Combustion ek=k@Quantity.................................................. ?kueVj@?a hkVk (M3/hr) vf/e;w@Max./Minimum kdr@Uure 4.3 lEHkkforizf¬;k]mRltZu]lzksr,oa ek=k % Expected process, emissions, sources and quantity : aku xSlt=.k grirkfor 4.4 bZ/loizf¬;kmRufu;ZasqzLok;qiznw"k.k fu;a;oLF =.k Okk% Proposed Air Pollution Control System for fooj.k laud yX--------------------------­ flue gas and process emission Details enclosed .................................... 4.5 izLty tujVj lsk d-ohs% rkforMhssVdh{kers-,-ea Capacity of proposed Diesel Generating Set in K.V.A. .............................................................................. 4.6 leLrmRltZu lzksrkasdh=apkbZ % Height of all sources of emission : 4.7 bZaku dtyus ls ltu % mRiknu izf¬;k ls mRltuZ /s mRZ Emission from fuel burning; Emission from production activity Flue gas -nm3/hr Expected Emission Qty. ..................................nm3/hr Particulate matter -Particulate gases SO2 -SO2 ­ NOX -NOX -Hydrocarbons -CO2 -CO2 -Ammonia -Mist -Acid Mist -Others -Flourine - Chlorine - Halogens -Height of Stack Height of Stacks for process From GL.......................... (m) From GL ......................... (m) From Top of Building........................(m) From Top of Building...................... (m) 5. Bksk"V l@vif' Solid/Waste 5.1 dqfude y nSk=k Total Quantity per day 5.2 vof'zdBkl@lsfyM@ikmMj@ k"Vdhi`shlkW fr% evkW@TkhxUk;qr ;yhoyu'y@nqZ/D Nature of waste Solid/Semi solid/Powdery/Oily/ Combustible/odourous 5.3 [krjukd aaa ks mldhidfr gk@ugh];fn gkrz` Hazardous Yes/No, if yest its nature 5.4 fuLrkj.k ek/;e% Mode of disposal : 6. [krjukdjlk;ukasdsiz;ksx,oaHk.Mkj.kdk fooj.k% Details of use and storage of hazardous materials : ¬eajlk;u fud kir ,d le; dk Hk.Mkj.k kd nS[ Sl. No. Chemical Daily use Storage at a time 6.1 lqj{kk mik;ks,oa kZkfrea cpko gsqs a nqFsr;ktuk %?Vuk dhfL Plan for safety and disaster management in"k.k fu;=.k grdkbOFxrs A 7.1 D;k ty@ok;qzwasqsZ ;oLkk dh;hgSkmldk fooj.k nsaWhether Water/Air Pollution Control System required to be installed ? If yes give details. 7.2 bl gsizkforykxdS izkkj@izfr rqLrr fiVy frHekg Expenditure proposed for Capital Recurring/per month (a) ty iznw"k.k fu;a=.k ................................... ................................... Water Pollution Control (b) ok;qizn"k.k fu;a ................................... ................................... w=.k Air Pollution Control (c) Disposal arrangements ................................... ................................... (d) Solid Waste Handling ................................... ................................... (e) Expenditure Proposed for ................................... ................................... Pollution monitoring 7.3 Total Capital Investment Proposed on Pollution ............................................................................. Control as a percentage on total investment of the industry / establishment 7.4 Any other additional information about beneficial/ ............................................................................. . Adverse environment impact of your industry. Date : Signature : fnukagLk{kj % -------------------­ d---------------------r Place : ......................................... Name@uke LFkku % ------------------------------------Designation@in v u k i f v k @ l g e f r @ i zk f /z k d k j i zez k . k i = g ss q m | k sk ass r xs a } k j k i z sz s ss o k y h l p u k , ww aa f " k r d h t k u 1 . fu/kkZfjriza kos&1i= esvnu i= la 2 . ykssku ei vkosnq2, 2 ,o2.3´ d'Snui=dkfcUa 3 . (1) Hkmi;kszesnqw xik.k&i= vkonu i= dk fcU2.4) (2) Hkw LokfeRo izek.k&i= 4 . ia;uiesnqthzk.k&i= vkonu i= dk fcU2.5´ 5 . mRiknu izf¬;k vkosnu i= dk fcUnq2.6´ 6 . dk;ZjrbZ dhuqsnq dkbvikyu vk[;k vkonu i= dk fcU2.10´ 7 . ysvkufp= vkosyXa &kmVenu i= dk laud l[;k-3´ 8 . ty izn"k.k fu;;oLkk dk izko vkos3.5, 3.11´ wa=.k OFLrnu i= dk fcUnq 9 . mRiokg dk vfUefuLkj.k fcU vkos3.10´ zrrnqnui=dkfcUnq iw=.kOFLsnq 1 0 . ok;qzn"k.k fu;a;oLkk dk izrko vkonu i= dk fcU4.1, 4.6´ ku lkbuteyku vkonu i= dk fcU6.0, 6.1´ 1 1 . lsVh,oa vVfMtkLVj eSsasVIsnq 12. * bdkbls -dhf=Ts {kssvsspq]jk"V ; ikdvkfn dk Z 15 fd-eh;k d= ea kjf{krou {k=]lajhhZ fooj.kA 1 3. * i;kZoj.k izkko eYasZA Hw;kdu fjikVxLky dq=Qy ,osrkforfofHu dk;tSxyxkuF 1 4. * m|ksFy{ksamleaizLkUZ lsm|kssdkLkku mipkj laki][kkyhHwj gfjrifVVdk gsfu/Zfjr{k ;=]Vkmuf'kfevkS~qkks r=Qy dk fooj.kA xdhLkkiuk eFu[;k dk fooj.k rFiq 1 5. * m|ksFasfoLkkfirgkss okyhtulakk mlds uokZl dh ;ks tuk dk fooj.kA ukssrfcaka s cUk ea rrfooj.k fu/Zfjrizs asfn;k x;k V% (1) mijkDvdlE/sfoL`kki=dvrea nqsgSaws]y?J.khdm|ksksdfy,nsa A Arkjkfdrlpuk;akqss xa s uk vko';dughgS (2) RofjrfuLkj.k gsmijkDwsdlkFkkZfjrizi= ea kos rrqsrlpukvka s kfu/svnui=dh ,d izfr{k=hZy; ,oa nkiz[;ky; izf"krdjA s;dk;ks freqssa (3) vi.kZvswalaudkss HsLdkjughfd;ktk;s wkonui=lpuk,oyXadvkkoea oha xkA