FORM - 1 FOR
WATER CONSENT
(To be submitted in triplicate)
Application for Consent for
establishing or taking any steps for establishment of Industry/ Operation/
Process/ or any treatment/ disposal system for discharge, continuation of
discharge under section 25 or section 26 of the Water (Prevention & Control
of Pollution), Act 1974.
(See Rule 3)
Date:
From:
-------------------------------------
-------------------------------------
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To,
The
Member Secretary,
M.P.
Pollution Control Board
Sir,
I / We here by apply for
Consent/ Renewal of consent under section 25 or section 26 of the Water
(Prevention and Control of Pollution) Act. 1974 (No. 6 of 1974) for
establishing or taking any step for establishment of Industry/ operation/
Process/ or any
treatment/ disposal system to bring in to use any new/ altered outlet for
discharge of sewage/trade effluent/ to continue to discharge Sewage/ trade
effluent from land/ Premises owned by
.
The other relevant details are as below:-
1. Full name of
applicant
...
2. Nationality
of the applicant
3. Status of
the applicant
a)
Individual
b) Proprietory
concern
c) Partnership firm
(Whether registered or unregistered)
d)
Joint family concern
e)
Private Limited Company
f)
Public Limited Company
g) Government Company
(1) State Government
(2) Central Government
(3)
h) Foreign Company
(If a Foreign Company, the details of
registration, incorporation etc.)
i) Any other Association or Body
4. Name,
Address and Telephone No. of the
applicant [the full
list of individuals, partners
persons, Chairman (Full
time or part time)
Managing Directors,
Managing Partners/
Directors (Full time or
part time) other kinds .
.
of office bears are to be furnished.
With
their period of tenures
in the respective office,
with telephone No. and
address]
5. Address of
the Industry
(Survey No,
Khasra No, Location as per
the Revenue Record, Village, Firka. Tehsil,
District, Police Station or SHO,
Jurisdiction
of the First-Class Magistrate)
..
6. Details of
Commissioning etc:
a)
Approximate date of the Proposed
.
..
commissioning of work.
b) Expected date of Production/date
of
production (if Existing)
..
..
7. Total Number
of employees expected to be
.
..
.
employed
8. a) Details of license, if any obtained under
.
.
.
the provisions of Industrial Development
Regulation Act.1951.
b) Total
capital investment and category
(SSI/Medium/Large).
(Gross capital
investment)
9. Name of the
person authorized to sign this .
.
form (the original authorized except in
the
case of individual /proprietory
concern to be
..
enclosed.)
10. a) Attach the list of all raw materials and
Chemicals used per month.
b) Licensed
annual capacity of the Factory /
Industry and name of Product.
c)
Manufacturing Process in details.
.
11. State daily
quantity of water in kilolitres and
.
its source (Domestic/Industrial/Process/Boiler /
Cooling/Other)
Domestic
.
Industrial
.
Process
.
Boiler
.
Cooling
.
Others
12. a) State the
daily maximum quantity of
.
effluents & mode of effluents and mode
of disposal (sewer or drains or river)
also attach analysis repot of the
effluents.
Type of effluent quantity in kilolitres mode
of disposal.
i)
Domestic.
....
ii) Industrial
iii) Others
b) Quantity of effluent currently
being discharged
or expected to be discharged.
c) What monitoring arrangement is
currently
there are proposed.
13. 1) State
weather you have any treatment
plat for industrials, domestic of combined
effluents. (Yes/No./Proposal)
2) If yes, Proposal attach a
description of
the process of treatment in details along with
drawing & design and give the investment
on (E.T.P.).
3) Attach
information on the quality of treated
...
effluent vis-ΰ-vis the standards.
14. State details
of solid wastes. Generated
From process and during waste
treatment.
Description Quantity/Quality Method of collection
Method of disposal
15. I
/ We further declare that the information furnished above is correct to be best
of my /our knowledge.
16. I
/ We hereby submit that in case of change either of the point of the discharge
or quantity of discharge or its quality, a fresh application for consent shall
be made and until such consent is granted no change shall be made.
17.
I / We hereby agree to submit to the State Board an application for
renewal of consent four Months in advance of the date of expiry of the
consented period for out let/ discharge to be continued thereafter.
18. I / We undertake to furnish any other information within
one month or its being called by the State Board.
19. I
/ We enclose herewith cash receipt No./bank Draft No
.Dated
...for (Rs.in Figures)
(Rs.in
words)
...)in favour of Member Secretary,
Madhya Pradesh Pollution Control Board, as fees payable under section 25 of
this Act.
Accompaniments :
1. Site
plan & topo sheet.
2. Lay
out and statement of (total area of the plant/ constructed area/ open area/
area reserved for plantation.
3. a) Name of Local Body / Panchayat.
b)
NOC from GOI/State Govt./Local Body/ Panchayat / etc.
4. List
of Industries, villages, rivers & lakes other important feature and
distances from site, within a radius of 5/10 km. in case of medium / large
industry.
5. A
copy of Project Report.
6. Flow
sheet of process and chemical involved (if any)
Your Faithfully,
Signature of the Applicant.
GOVERNMENT
OF MADHYA PRADESH
HOUSING & ENVIRONMENT DEPARTMENT
NOTIFICATION
No F (121) 32/90 In exercise of
the powers conferred by Section 64 of the Water (Prevention & Control of
Pollution) Act, 1974 (No. 6 of 1974). the State government, after consultation with
the Madhya Pradesh Pollution Control Board, hereby makes the following further amendments in the
Water (Prevention & Control of Pollution) (Consent) Madhya Pradesh Rules,
1975 namely :-
AMENDMENTS
In the said
Rules :-
1) In clause (i) of rule 2 for works "License Fee" the words
"Consent Renewal Fee" shall be substituted.
2) for sub rule (V) of rule 4, the following sub rule shall be
substituted, namely :-
"(V) The application form should be duly accompanied
with the consent fee as a specified in the following schedule:-
SCHEDULE
Industries
having an investment of :-
1)
More than 200 crores 1,50,000.00
2) More than 100 crores but less than 200 crores. 1,50,000.00
3) More than 50 crores but less than 100 crores. 75,000.00
4)
More
than 10 crores but less than 50 crores 60,000.00
5)
More
than 3 crores but less than 10 crores 40,000.00
6)
More
than 50 Lakhs but less than 3 crores 10,000.00
7)
More
than 50 Lakhs 1,000.00
The above consent
fee includes the consent renewal fee for the first year.
"(5) The applicant shall pay an
annual" Consent renewal fees" (except the fee for the first year) to
the Board as specified in the following schedule namely:-
(A) Industries having an investment of :- Rs.
3. More than 50 crores but less than 100 crores. 30,000.00
4. More than 10 crores but less than 50 crores 20,000.00
5. More than 3 crores but less than 10 crores 15,000.00
(B) Annual
consent renewal fee and consent fee
chargeable from local bodies
extracting water from natural
resources and discharging effluent into streams shall be as under :-
Rs.
a) Municipal
corporation 3000.00
b) Class A-A
municipalities 2000.00
c) Class A
municipalities 1000.00
d) Class B
municipalities 500.00
e) Class C
municipalities 250.00
f) Minimum fee 250.00
Provided that the
consent application and consent renewal application received to the publication
of this notification shall not be liable for the excess payment of difference
of fees owing to pendncey of application.
By order and in the name of the
Governor of Madhya Pradesh
S/d.
(G.V. Upadhyaya)
Deputy Secretary
Government od Madhya Pradesh
Housing and Environment Department