Himachal Pradesh State Pollution Control Board,

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1 Cost of Form Rs.15/ (To be paid along with Consent Fee) Himachal Pradesh State Pollution Control Board Him Parivesh, Phase III, New Shimla , HP. Form I [See Rule 27] Application for Consent to Establish/Operate/Renewal the industrial plant/plants under Section 21 of the Air (Prevention & Control of Pollution) Act, 1981 From: Date: To, The Member Secretary, Himachal Pradesh State Pollution Control Board, Him Parivesh, Phase III, New Shimla, Shimla , HP. I/We hereby apply for Consent/Renewal of Consent under Section 21 of the Air (Prevention & Control of Pollution) Act, 1981 to Establish/Operate the industrial plant/plants owned by to be located/located at The relevant details are as under: 1. Full name of the applicant with designation and address and telephone/fax number. 2. Full address with PIN Code of the factory/industrial plant/s with telephone numbers (Give Revenue/City Survey No. for which application is made, 1

2 stating District, Taluka/Village). 3. Names of full time directors/partners/ owners with addresses and telephone numbers. (Use separate sheet if space provided is not sufficient) 4. Total capital cost of the project (Rs. In Lakhs). 5. Specify whether small, medium or large scale. State whether the proposed industrial plant/facility etc. is proposed to be located in the prohibited area. If yes, state the name of the authority and furnish the certified copy of the order under which the area has been declared prohibited. Yes/No 6. Date of commission of industrial plant/s or proposed date of commissioning. 7. Total number of employee. 8. List of raw materials with monthly consumption rate (MT/month) (Use separate sheet if space provided is not sufficient) Raw Materials Quantity in MT/month 9. List of products with monthly production rate (MT/month) (Use separate sheet if space provided is not sufficient) Products Quantity in MT/month 2

3 10. Brief description of the manufacturing process together with a flow diagram and layout plan showing location o all vents, stacks and any other emission points. (Use separate sheet if space provided is not sufficient) 11. Details of boilers/heaters/ furnaces/ DG sets installed in the plant (a) Boilers Boiler No. Type of boiler Type of fuel (coal, HSD, furnace oil, gas etc.) Fuel consumption rate in MT/hour or KL/hour or M 3 /hour. (b) Heaters/Evaporators Heater No. Type of Heater Fuel Fuel consumption rate in MT/hour or KL/hour M 3 hour. (c ) Furnaces Furnace No. Type of Furnace Fuel Fuel consumption rate in MT/hour or KL/hour or M 3 hour. (d) DG Sets DG Set No. Type of DG Set Fuel Fuel consumption rate in MT/hour or KL/hour or M 3 hour. (e) Others No. Type Fuel Fuel consumption rate in MT/hour or KL/hour or M 3 hour. 3

4 12. Emission details: Emission from boilers/heaters/furnaces and other processes involving fuel combustion (a) (1) (2) (3) (4) (5) Boiler/Heater/Furnace No. Stack Identification (attached to boiler/heater/furnace) Concentration of pollutants like participate Matter (in mg NM 3 )SOx, NOx, (in ppm) B/T A/T Rate of emission in Kg/hr. Height of stack from ground level (b) Process emissions (1) (2) (3) (4) Name and location of the process vessel to which the stack/vent is attached Rate of emission in Kg./hr. Concentration of pollution like SO 2, NOx, H 2 S, Cl, HCl etc. in mg/nm 3 B/T A/T Height of Vent/outlet/stack from ground level in meters 13. Details of air Pollution control for the control of pollution resulting from emission of pollutants from process plant and combustion. (a) Boilers (b) Heaters/Evaporators 4

5 (c) Furnaces (d) DG Sets (e) Others 14. Any other relevant information: 15. Copy of the Environment Statement for the previous year as prescribed in Form V under Rule 14 of Environment (Protection), Rules, 1986 attached. (Applicable only in case of operational units) Yes/No 5

6 16. Declaration: (i) I/We hereby submit that in case of any change relating to manufacturing process/product, fuel, emission rate, pollution control, capacity of the plant etc., fresh application for consent shall be made until such Consent is granted, no change will be implemented. (ii) I/We hereby agree to submit to the Board, application for renewal of Consent at least one month prior to the date expiry of the present consent period. (iii) I/We further declare that information furnished through this application is correct to the best of my/our knowledge. (iv) I/We undertake to furnish any other information within one month of such intimation received from the Board. (v) I/We enclose herewith Bank Draft No. dated for Rs. (Rupees drawn in favour of the Environmental Engineer/Assistant Environmental Engineer/Regional Officer, Himachal Pradesh State Pollution Control Board payable at as the Consent fees under Section 21 of the Act. (Please refer to Fee Schedule for the rate of consent fees.) Note: Strike out which is not relevant. Yours faithfully, Signature: the application: Designation: Address: 6

7 Fee Schedule Consent Fees under Air (Prevention and Control of Pollution) Act, 1981 and HP Air (Prevention and Control of Pollution) Rule 19(2a): ( i ) (a) Fee for all Development Projects: S. No. Classification (Capital Investment) Consent Fee (Amt. in Rs.) 1. All Projects above Rs Crores. 10,00, More than Rs.5000 Crores and up to Rs Crores. 7,50, More than Rs.1000 Crores and up to Rs.5000 Crores. 5,00, More than Rs.600 Crores and up to Rs.1000 Crores. 4,00, More than Rs.300 Crores and up to Rs.600 Crores. 2,50, More than Rs.100 Crores and up to Rs.300 Crores. 1,50, More than Rs.50 Crores and up to Rs.100 Crores. 1,00, More than Rs.5 Crore and up to Rs.50 Crores. 75, More than Rs. 1 Crores and up to Rs.5 Crores. 25, More than Rs.50 lakhs and up to Rs. 1 Crores. 7, More than Rs.10 lakhs and up to Rs. 50 lakhs 3, Minimum Fee. 1, (a) Fee for Mining Projects: S. No. Area of the mining lease for non captive mines Fee for Consent to Establish and / or Operate. 1. All mining lease upto 10 bighas Mining leases above 10 bighas and upto 50 bighas Mining leases above 50 bighas and upto 100 bighas Mining leases above 100 bighas and upto 200 bighas Mining leases above 200 bighas Notes: 1. Consent to Establish / Rs. 1, 00,000/ for all categories of the captive mines of major industries / development project shall be charged. 2. In case of the picking of the stone, bajari and sand from the riverbeds, the Consent to Establish / Operate fee shall be Rs. 500 and Rs. 200 per annum. 3. The annual Consent Renewal fee shall 40% of the Consent to Establish / Operate fee. 7

8 (c) Fee for Captive mining for micro / mini hydroelectric projects: S. No. Type of Project 1. Hydel Projects upto 3 MW installed capacity with ceiling of capital investment upto Rs Crores. 2. Hydel Projects more than 3 MW but with a ceiling of capital investment upto Rs Crores. 3. Hydel Projects with capital investment between more than Rs Crores and less than Rs Crores. Consent to Establish (Amt. in Rupees Consent to Operate (Amt. in Rupees) Renewal of Consent (Amt. in Rupees) 15, , , , , , , , , (ii) For Hospitals generating Infectious & Hazardous wastes: 1. All hospitals having above 400 beds. 5, Hospitals having 200 to 399 beds. 3, Hospitals having 100 to 199 beds. 1, Hospitals having 100 or less beds (iii) For Local Bodies covered under Air Act, 1974: S. No. Classification Consent Fee (Amt. in Rupees) 1. For Discharge of Sewage I&PH Department for Discharge of Sewage Municipal Corporation Municipal Council Nagar Panchayat Cantonment Board For Discharge of effluent from Water Treatment Plant I&PH Department For Discharge of Waste Water from Slaughter House Municipal Corporation / Municipal Council / Nagar Panchayat / Cantonment Board The fee for Consent to Establish/Operate shall be charged only once and consent shall be valid for one year. (iv) The Renewal fees in case of (i) and (ii) above shall be 40% of the Consent to Establish/Operate, whereas, in case of (iii) above the Renewal shall be equivalent to Consent to Establish/Operate. HOME 8

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