Download Application for Site Appraisal Committee

1. Name and Address of the applicant: 2. Site Ownership Data: 2.1 Revenue details of the site such as Survey No. Plot No: 2.2 Whether the proposed site attracts the provisions of section 3 of Environment Protection Act, 1986, if so the nature of the restriction: and 2.3 Local authority under whose jurisdiction the site is located. 3. Site Plan: 3.1 Site Plan with clear identification of boundaries and total area proposed to be occupied and showing details near by the proposed site­ (a) Name of adjoining manufacturing Units and human habitats, educational and training institutions, petrol installation, storage liquefied Petroleum Gas and other hazardous substances, if any, with in one kilometer from the proposed site. (b) Water sources (rivers, streams, canals, dams, and water filtration plants) in the vicinity. (c) Nearest hospitals, Fire stations, Civil Defence Stations and Police Station and their distances. (d) Details of high tension electrical transmission lines, pipe lines for oil, gas or sewerage, if any passing through the site, and (e) Location of railway stations, railway lines, scheduled road bypass, if any, near the site. 3.2 Plot Plan of the factory, showing the entry and exit points, roads. 4. Project Report 4.1 A summary of the salient features of Project 4.2 Maximum number of persons likely to be working in the factory. 4.3 Maximum amount of power and water requirements and source of their supply. 4.4 Block diagrams of the building and installations, in the proposed site and 4.5 Details of housing colony, hospital, school and other infrastructural facilities proposed. 5 Organisation structure of the proposed manufacturing unit/factory: 5.1 Person responsible for protection of safety, health and environment. 5.2 Proposed health and safety policy of the proposed enterprise. 6 Meteorological data relating to the site 6.1 Average, minimum and maximum of Temperature Humidity Wind velocities during the previous 10 years 6.2 Seasonal variations of wind direction 6.3 Highest water level reached during the floods in the area recorded so far 6.4 Lightening and seismic data of the area 7 Communication Links 7.1 Availability of telephone/telex/wireless and other communication facilities for outside communication 7.2 Internal communication facilities proposed 8 Manufacturing Process Information: 8.1 Process flow diagrams. 8.2 Briefs write up on process and technology. 8.3 Critical Process parameters such as pressure build-up, temperature rise and run-away reaction. 8.4 Other external effects critical to the process having safety implications such as ingress of moisture or Water, contact with incompatible substances, sudden power failure: and 8.5 High lights of the built-in-safety/pollution control devices or measures in-corporated in the manufacturing technology. 9 Information of Hazardous Materials: 9.1 Raw materials, intermediates, products and bye-products and their quantities, (enclosed Material Safety Data Sheet in respect of each hazardous substance). 9.2 Main and intermediate storages proposed for raw material/intermediates/products/Bye products (maximum quantities to be stored at any time). 9.3 Transportation methods to be used for materials in flow and out flow, their quantities to be stored at any time; and 9.4 Safety measures proposed for: 9.5 Handling of materials 9.6 Internal and external transportation and disposal (packing and forwarding of finished products). 10 Information on Dispersal/Disposal of wastes and pollutants: 10.1 Major Pollutants (gas, liquids, solid) their characteristics and quantities (average and at peak loads). 10.2 Quality and quantity of solid wastes generated, methods of their treatment and disposal. 10.3 Air, Water and Soil Pollution problems anticipated and the proposed measures to control the same, including treatment and disposal of effluents. 11 Process Hazards Information: 11.1 Enclose a copy of the report on environmental impact assessment. 11.2 Enclose a copy of the report on Risk Assessment Study; and 11.3 Published (open or classified) reports if any, on accident situation/occupational health hazards of similar plants (within or outside the country). 12 Information of proposed Safety and Occupational Health Measure; 12.1 Details of fire fighting facilities and minimum quantity of waste carbon dioxide and other fire fighting measures needed to meet the emergencies; and 12.2 Details of in-house medical facilities proposed 13 Information on emergency preparedness: 13.1 On Site Emergency Plan: and 13.2 Proposed arrangements, if any for mutual aid scheme with the group of neighbouring factories. 14 Any other relevant information I certify that the information furnished above is correct to the best of my knowledge and nothing has been concealed while furnishing it. Date: Signature Designation