Form -I [See Rules 4(2) & 6(2)] Application for obtaining authorization To, The Member Secretary --------------------------- --------------------------- 1. Name of the municipal authority/Name of the agency appointed by the municipal authority : 2. Correspondence address Telephone No. Fax No. : 3. Nodal Officer & designation(Officer authorized by the municipal authority or agency responsible for operation of processing or disposal facility) : 4. Authorization applied for (Please tick mark) : (a) Setting up & operation of waste processing facility (b)Setting up & operation of disposal facility 5. Detailed proposal of waste processing/disposal facility (to be attached ) to include : 5.1 Processing of Waste i. Location of site ii. Name of waste processing technology iii. Details of processing technology iv. Quantity of waste to be processed per day v. Site clearance (from local authority) vi. Details of agreement between municipal authority and operating agency vii. Utilization program for waste processed (Product utilization) viii. Methodology for disposal of waste processing rejects (quantity and quality) : ix. Measures to be taken for prevention and control of environmental pollution x. Investment on Project and expected returns xi. Measures to be taken for safety of workers working in the plant 5.2 Disposal of Waste i. Number of sites identified ii. Layout maps of site iii. Quantity of waste to be disposed per day iv. Nature and composition of waste v. Details of methodology or criteria followed for site selection vi. Details of existing site under operation vii. Methodology and operational details of land filling viii. Measures taken to check environmental pollution : Date Signature of Nodal Officer
