FORM V (See Rule 14) st th Environmental Statement for the financial year ending on 31March on or before 30of September every year. PART A (i) Name and address of the owner/ occupier of the industry operation or process. (ii) Industry category Primary-(STC Code) Secondary-(STC Code). (iii) Production capacity-Units__ (iv) Year of establishment (v) Date of the last environmental statement submitted. PART B Water and Raw Material Consumption 1. Water consumption m3/ d Process Cooling Domestic Name of products Process water consumption per unit of product output During the previous During the current financial year financial year (1) (2) (1) (2) (3) (2) Raw material consumption *Name of raw Name of Consumption of raw material per unit materials products ________________________________ During the previous During the current financial year financial year *Industry may use codes if disclosing details of raw materials would violate contractual obligations, otherwise all industries have to name the raw material used. PART C Pollution discharged to environment/ unit of output. (Parameter as specified in the consent issued) Pollution Quantity of pollutants Concentration of Percentage of Discharged pollutants in variation from _ (mass/ day) discharges prescribed standards (mass/ volume) with reasons (a) Water (b) Air PART D Hazardous Wastes (as specified under Hazardous Wastes (Management and Handling) Rules, 1989) Hazardous Wastes Total Quantity (Kg) _____________________________________ During the previous During the current financial year financial year (a) From process (b) From pollution control facilities. PART E Solid Wastes Total Quantity During the previous During the current financial year financial year (a) From process (b) From pollution control facility (c) (1) Quantity recycled or re-utilised within the unit (2) Sold (3) Disposed PART F Please specify the characterization (in terms of composition and quantum) of hazardous as well as solid wastes and indicate disposal practice adopted for both these categories of wastes. PART G Impact of the pollution abatement measures taken on conservation of natural resources and on the cost of production. PART H Additional measures/ investment proposal for environmental protection abatement of pollution, prevention of pollution. PART I Any other particulars for improving the quality of the environment.
