UP Pollution Control Board, Lucknow

Introduction

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Industrial PollutionControl

No Objection Certificate

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Ambient Air Quality

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Hazardous Waste

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Application Forms

Public Notices

Hazardous WasteRecycling units in U.P.E-waste Recycling units inthe U.P.Permission/Authorizationissued from SPCB

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Application Forms

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UP Pollution Control Board, Lucknow http://www.uppcb.com/form3.htm

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/ / / / / 1986 /

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(Annexure to NOC Application)

1. , Name and Address,Category & Type ofIndustry

// ( ) // / /// // / ( )Large/Medium/Small (Strike which ever is not applicable)Chemical/ Metallurgical/ Mechanical/ Electronics/Electrical/Sugar/Cement/Pulp & Paper/Textile/Food Processing/ Others. (Tick whichever is applicable inCase of any other type mention it)

2. / General -2.1

/ Name & Addressof Applicant

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2.2 : ( ) 2.3 Proposed Location(Attach location mapof site Showing of point2.3)

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(5 )Details of direction anddistance of nearestsanctuary, highwayrailway line, humansettlements, river,drain, reserved forestsreligious places etcform the site (In a 5km. distance)

2.4 :(- )///Present use of land(enclousure certificate)Agricultural/Residential/Commercial/ Industrial

2.5 / Details of letter ofintent/SSI Registration

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2.6 Brief processdescription with flowchart

./Enclosure No.

2.7 List of main productswith daily designedcapacity

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2.8 List of bye productswith daily designedcapacity

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2.9 List of Basic rawmaterial with dailyconsumption

2.10 List of other industrialunits operated byapplicantorits partners.

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2.11 Capital cost of project

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2.12 Expected date ofcommissioning of plant

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3. / WaterPollution

3.1 Source of Supply ofwater

/ /// ( )Tube well/MunicipalsSupply/River/ Lake/Other specification)

3.2 Daily Consumption ofwater

/IndustrialProcess ........................................ /IndustrialCooling ....................................... /Boiler BlowDown .......................................... /Floor &Equipment washing ( )/ Others (Specify) / Total / Domesticeffluent .................................................

3.2 Total quantity of liquideffluents dischargedper pay.

/ IndustrialProcess .................................... / IndustrialCoolling .......................................... / Boiler Blow Down .............................. / Floor &Equipment washing ( ) / Others (Specify) / Total / Domesticeffluent ...............................................

3.3 Are there any expectedPollutants.

@ Yes/No

3.4 Type of Pollutants

//Liguid/Solid/gaseous

3.5 Indicate available information on effluent characteristic as below :

/Physical / Chemical / Temperature / Hardness

.......................................... . . / P.H. / B.O.D. /Colour . . . / C.O.D. / Turbidity / Oil & Grease / Obour / Total Nitrogen / Total Solid / {Phosphate) /

Totalsuspended solid

/ Chloride

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TotalVolatile solid

/ Sodium / Potassium / Calcium/ Magnesium / Other

// /Other toxic Constituents such as Cyanide/Phenol/Heavy Metals etc.

3.6 /Is the effluent to begenerated withinspecifications

@ , Yes/NoIf no furnish details of treatment method proposedEnclosure .........................

3.7 Proposed Time bound programme for Water Pollution Control System.

3.8 Mode of final discharge

/ /Open drain/Closed drain/Lagoons.

3.9 Point of final discharge

/ / / ( ) Municipal corporation/sewagesystem/water bodies/field (specify)/Any other.

3.10 , Is industrial effluent allowed to mix with domestic effluent, if no specifydisposal of domestic effluent.

4. / AirPollution

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4.1 Type and quantity of fuel consumed per day in manufacturing or subsidiaryprocess.

4.2 Details of emissionsform fuel combustion

/ Expected / Analysis..................................... / Quantity//M3/hour//Maximum/Minimum

4.3 , , Expected process emissions sources quantity

44. , {Proposed AirPollution ControlSystem for flue gas andprocess emission

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Details enclosed :.....................................................

4.5 .., Capacity of Proposed Diesel Generating Set in K.V.A.

4.6 Height of all sources of emission

5. //Solid/Waste


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5.1 Total Quantity per day

5.2 Nature of waste

/ //// Solid/SemiSolid/Powder/Oily/Combustible/obourcus

5.3 ApproximateComposition

/Physical/Chemical

5.4 Hazardous

@ Yes/No

5.5 Mode of disposal

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6. Details of use andstorage of Hazardousmaterials

/S.N.S.N.

Chemical

Daily Use

Storage at a time

6.1 Plan for Safety anddisastermanagement

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UP Pollution Control Board, Lucknow

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