Form-2
APPLICATION FOR PRIOR ENVIRONMENTAL CLEARANCE
S. No.Item Details
1.
Whether it is a violation case and application is being submitted under Notification No. S.O.804(E) dated 14.03.2017 ? No
Details of Project:
(a)Name of the project(s) Common Bio Medical Waste Treatment Facility
(b)Name of the Company / Organisation INSTROMEDIX INDIA PVT LTD
(c)Registered Address 10 JOSHI BAGH SAYYAD KA GATTA TONK ROAD JAIPUR,,Jaipur,Rajasthan-302015
(d)Legal Status of the Company Private
2.
Address for the correspondence:
(a)Name of the Applicant HIMANSU SURI
(b)Designation (Owner/ Partner/ CEO) AGM
(c)Address 10 JOSHI BAGH SAYYAD KA GATTA TONK ROAD JAIPUR 302015,,Jaipur,Jaipur,Rajasthan-302015
(d)Pin code 302015
(e)E-mail cbwtfjalore2017@gmail.com
(f)Telephone No. 141-4029115
(g)Fax No.
(h)Copy of documents in support of the competence/authority of the person making this application to make application on behalf of the User Agency . Annexure-Uploaded Copy of documents in support of the competence/authority
3.
Category of the Project/Activity as per Schedule of EIA Notification,2006:
(a)Major Project/Activity7(d) Common hazardous waste treatment, storage and disposal facilities (TSDFs)
(b)Minor Project/ActivityNIL
(c)Category B1
(d)Proposal Number SIA/RJ/MIS/40655/2018
(e)Master Proposal Number(Single Window) SW/113490/2019
(f)EAC concerned (for category A Projects only) INFRA-2
(g)Project Type Fresh EC
4.
Location of the Project:
(a)Plot/Survey/Khasra No. 4446
(b)Pincode 343001
(c)Bounded Latitudes (North)
From
Degree 552340.14
Minutes
Second
From
Degree 552344.82
Minutes
Second
(d)Bounded Longitudes (East)
From
Degree 723944.46
Minutes
Second
From
Degree 723944.82
Minutes
Second
(e)Survey of India Topo Sheet No. 45 C/10, 45 C/11, 45 C/15
(f)Uploaded Topo Sheet File Copy of Topo Sheet File
(g)Maximum Elevation Above Means Sea Level(AMSL) 165
(h)Uploaded (kml) File Copy of Kml File     
(i)Distance of Nearest HFL from the project boundary within the study area 2.5
(j)Seismic Zone 4
5.
(a)Number of States in which Project will be Executed 1
(b)Main State of the project Rajasthan
Details of State(s) of the project
S. No. State Name District Name Tehsil Name Village Name
(1.)RajasthanJaloreJalorMaheshpura
6.
Details of Terms of Reference (ToR):
(a)Whether TOR is mandatory for submitting application Yes
(b)MoEF&CC / SEIAA File Number 10-6-2018-IA-III
(c)Date of Apply of TOR 24 Jan 2018
(d)Date of Issue of TOR / Standard ToR 06 Apr 2018
(e)Previous TOR Letter Copy of Previous TOR letter
7.
Details of Public Consultation:
(a)Whether the Project Exempted from Public Hearing?No
(b)Whether details of Public Hearing available? Yes
(c)Whether Public hearing was presided over by an officer of the rank of Additional District Magistrate or above Yes
     7.1.       Details of Public Hearing
S. No.Details of Advertisement Details of Public Hearing Venue Location DetailsNo. of People AttendedIssues RaisedDesignation of Presiding OfficerOther Designation of Presiding Officer
(1.)
Date of Advertisement :25 Apr 2019
Copy of advertisement :Copy of Advertisement
Copy of Public Hearing :Copy of Public Hearing
Date :30 May 2019
Distance of Public Hearing Venue from the Proposed Project :3
Govt. Senior Sec. School
State :Rajasthan
District :Jalore
Tehsil :Jalor
Village :Maheshpura
67about water and air pollution, Toposheet distances, Water demand, Job generationOthers
8.
Details of Project Configuration/Product:
     8.1.       Project Configuration
S. No.Plant/Equipment/FacilityConfigurationRemarks
(1.)Incinerator150 kg/hr
(2.)Sharp pit1 no.
(3.)Ash pit1 no.
(4.)Autoclave100 kg/batch
(5.)Shredder100 kg/hr.
(6.)Effluent Treatment Plant1500 lit/hr
     8.2.       Product
S. No.Product/Activity (Capacity/Area)QuantityUnitOther UnitMode of Transport / Transmission of ProductOther Mode of Transport / Transmission of Product
(1.)Shredder2Others100 kg/hrOthersON SITE
(2.)Incinerator2Others150 kg/hrOthersON SITE
(3.)Autoclave2Others100 litre/ batchOthersON SITE
9.
In case of Expansion / Modernisation / One Time Capacity Expansion (only for Coal Mining) / Expansion under Clause 7(ii) / Modernisation under Clause 7(ii) / Change of Product Mix under Clause 7(ii):
Details Not Applicable
9.1.
Details of Consent to Operate
(i)Whether Consent to operate obtained ? NA
(ii)Copies of all Consent to operate obtained since inception NA
(iii)Date of Issue N/A
(iv)Valid Upto N/A
(v)File No. NA
(vi)Application No. NA
(vii)Copy of Consent to operate valid as on date NA
10.
Project Cost:
(a)Total Cost of the Project at current price level (in crores) 3.5
(b) Funds Allocated for Environment Management (Capital) (in crores) 0.315
(c) Funds Allocated Towards ESC (Entrepreneur Social Responsibility) (in crores) .07
(d) Funds Allocated for Environment Management Plan (EMP) (Recurring per Annum) (in crores) 0.0315
(e) Funds Allocated for Environment Management Capital(%) 9.00
11.
Whether project attracts the General Condition specified in the Schedule of EIA Notification ? No
12.
Whether project attract the Specific Condition specified in the Schedule of EIA Notification ? No
13.
Raw Material / Fuel Requirement:
(a)Proposed quantity of raw material/fuel 6
(b)Existing quantity of raw material/fuel N/A
(c)Total quantity of raw material/fuel 6
    13.1.        Raw Material / Fuel Profile
S. No.Raw Material / Fuel QuantityUnitOther UnitSource (incase of Import. please specify country and Name of the port from which Raw Material / Fuel is received )Mode of TransportOther Mode of TransportDistance of Source from Project Site (in Kilometres) (In case of import, distance from the port from which the raw material / fuel is received)Type of Linkage Other Type of Linkage Uploaded Copy of Linkage
(1.)Biomedical Waste6Tons per AnnumunitsRoad5 OthersProject is proposed.Copy of Linkage
(2.)deisel4800Otherslitre/daypetrolpumpRoad2 OthersProject is proposed.Copy of Linkage
14.
Baseline Data :
(a)Period of Base Line Data Collection FROM 01 Mar 2018 To 30 May 2018
(b)Season Pre-Monsoon
    14.1.     No. of ambient Air Quality (AAQ) Monitoring Locations : 8
S. No.Criteria Pollutants Other Criteria PollutantsUnitMaximum ValueMinimum Value98 Percentile ValuePrescribed Standard
(1.)SO2Micro Gram per Meter Cube11.007.1510.9680
(2.)PM10Micro Gram per Meter Cube77.0064.8075.71100
(3.)PM2.5Micro Gram per Meter Cube53.2335.1852.3260
(4.)NOxMicro Gram per Meter Cube31.5221.0731.1180
(5.)OthersCOMili Gram per Meter Cube1.010.591.014000
    14.2.     No. of Ground Water Monitoring Locations : 6
S. No.Criteria Pollutants Other Criteria PollutantsHeavy MetalUnitOther UnitMaximum ValueMinimum ValueDesirable LimitMaximum Permissible Limit
(1.)Total Hardnessmg/l596452200600
(2.)Fluoridemg/l1.80.811.5
(3.)OthersCalciummg/l128110.475200
(4.)pHNA8.157.926.58.5
(5.)TSSmg/l0000
(6.)Chloridesmg/l3742382501000
(7.)TDSmg/l15089385002000
    14.3.     No. of Surface Water Monitoring Locations : 0
S. No.Criteria Pollutants Other Criteria PollutantsUnitOther UnitMaximum ValueMinimum ValueClassification of inland water body
(1.)DONA00A
(2.)BODNA00A
(3.)CODNA00A
(4.)pHNA00A
    14.4.     No. of Ambient Noise Monitoring Locations : 8
S. No.Parameter UnitMaximum ValueMinimum ValuePrescribed Standard
(1.)Leq(Day)A-weighted decibels(dB(A))54.547.765
(2.)Leq(Night)A-weighted decibels(dB(A))39.235.345
    14.5.     No. of Soil Sample Monitored Locations : 6
S. No.Parameter UnitOther UnitMaximum ValueMinimum Value
(1.)N(Nitrogen)Percent0.05260.0365
(2.)P(Phosphorus)Milligram per Kilogram56.6323.93
(3.)K(Potassium)Milligram per Kilogram193.155148.2
(4.)pH8.688.1
(5.)Electric ConductivityMillisiemens per Centimetre463321
14.6.
Details of Ground Water Table:
(a)Range of Water Table Pre-Monsoon Season (Meters Below Ground Level (m bgl)) From 5 To 50
(b)Range of Water Table Post-Monsoon Season (Meters Below Ground Level (m bgl)) From 3 To 50
(c)Whether Ground Water Intersection will be there ? No
     15.      Details of Water Requirement (During Operation)
S. No.Source Source Other Required QuantityDistance from SourceCopy of Permission from Competent Authority Mode of TransportOther Mode of TransportMethod of Water WithdrawalOther Method of Water WithdrawalLetter No.Date of IssuePermitted Quantity
(1.)Otherstank50Copy of Permission LettermodeOthersTankOthersNA005 Aug 20190
15.1.
(a)Whether Desalination is proposed No
    16.       Waste Water Management(During Operation)
S. No.Type/Source Quantity of Waste Water Generated (Kilolitre per Day)Treatment Capacity (Kilolitre per Day) Treatment MethodMode of DisposalOther Mode of DisposalQuantity of Treated Water Used in Recycling/Reuse (Kilolitre per Day)Quantity of Discharged Water (Kilolitre per Day)
(1.)Groud water1.21.5ETPReuse within the Plant & Recycling,Green Belt Renewal Plant1.2
16.1.
(a)Total Waste Water Generation 1.2
(b)Total Discharged Water 0
(c)Total Reused Water 1.2
    17.       Solid Waste Generation/Management
S. No.Name of Waste Item Other ItemQuantity per AnnumUnitDistance from Site(KM)Mode of TransportOther Mode of TransportMode of DisposalOther Mode of Disposal
(1.)BiomedicalBio-Medical Waste6Tons0RoadTreatment, Storage and Disposal Facility(TSDF)
18.
    18.1.     Air Quality Impact Prediction
S. No.Criteria Pollutants Other Criteria PollutantsUnitBaseline ConcentrationDistance GLCIncremental ConcentrationTotal GLCPrescribed Standard
(1.)PM10Microgram per Meter Cube772.250.0593377.06100
(2.)SO2Microgram per Meter Cube11.0000.0329511.0380
(3.)NOxMicrogram per Meter Cube31.5201.1289632.6580
(4.)PM2.5Microgram per Meter Cube53.231.850.021153.2560
    18.2.     Stack Details
S. No.Source FuelStack Height(m)Stack Diameter(m)PollutantsOther PollutantsEmission (GLS)
(1.)DG Setdiesel2.50.1PM100.3
(2.)DG SetDiesel2.50.1NOx9.2
(3.)DG setDiesel2.50.1SO20.05%
19.
Power Requirement:
(a)Quantity (Kilo Volt Amps (kVA)) 100
(b)Source JVVNL
(c)Uploaded Copy of Agreement Copy of Agreement
(d)Standby Arrangement (Details of DG Sets) 1
(e)Stack Height (in m) 2.5
20.
Land Ownership Pattern:
(a)Forest Land 0
(b)Private Land 0
(c)Government Land 1.23
(d)Revenue Land 0
(e)Other Land 0
    Total Land 1.23
21.
Present Land Use Breakup of the Study Area in Ha:
(a)Agriculture Area 0
(b)Waste/Barren Land 0
(c)Grazing/ Community Land 0
(d)Surface Water Bodies 0
(e)Settlements 0
(f)Industrial 0
(g)Forest 0
(h)Mangroves 0
(i)Marine Area 0
(j)Others : Government land 1.23
    Total 1.23
    22.     Land Requirement for Various Activities
S. No.Description of Activity / Facility / Plant / Others OthersLand RequirementRemarks
(1.)Main Plant0.1870work shed, office
(2.)Green belt0.4182
(3.)Othersopen surface & undisturbed Area0.6248
Total 1.23
23.
Ecological and Environmental Sensitivity (Within 10 Km):- WLS-Wild Life Species; NPA-Notified Protected Area; ESAs-Eco Sensitive Areas; ESZs-Eco Sensitive Zones :
    23.1.     Details of Ecological Sensitivity :
S. No.Details of Ecological Sensitivity NameDistance from the Project (Km)Remarks
(1.)ESAsJawai Nadi2.85towards WSW
(2.)Wildlife CorridorsNone0None
(3.)Critically Polluted AreaNone0None
(4.)NPAJalore R.F.7.3towards SW
(5.)WLSNone0None
(6.)ESZsNone0None
(7.)CorridorsNone0None
    23.2.     Details of Environmental Sensitivity :
S. No.Details of Environmental Sensitivity Other Details of Environmental Sensitivity NameDistance from the Project (Km)Remarks
(1.)ForestJawai Nadi2.85Towards WSW
(2.)Archaeological SitesNone0None
(3.)Defence InstallationsNone0None
23.3.
(a)Whether Noc / Permission from the competent authority is required? No
(b)Whether NBWL recommendation is required? No
24.
Forest Land:
Whether any Forest Land involved? No
25.
Tree Cutting:
(a)No. of Trees Cut for the Project (if Forest Land not Involved) 0
(b)Details of Tree Cutting and Planting of Trees Copy of Details of Tree Cutting and Planting of Trees
26.
Land Acquisition Status:
(a)Acquired Land(Ha) 1.23
(b)Land yet to be acquired(Ha) 0
(c)Status of Land acquisition if not acquired None
27.
Rehabilitation and Resettlement (R&R):
(a)No. of Villages 0
(b)No. of Households 0
(c)No. of PDFs (Project Displaced Families) 0
(d)No. of PAFs (Project Affected Families) 0
(e)Funds Allocated for R&R(in Rs) 0
(f)Status of R&R Yet To Start
28.
Details of Presence of Schedule-I Species:
(a)Whether there is Presence of Schedule-I Species ? Yes
(i)Details of Schedule-I Species Indian peafowl
(b)Whether conservation plan for Schedule-I Species has been prepared ? No
(c)Whether conservation plan for Schedule-I Species has been approved by competent authority ? No
29.
Details of Presence of Water Bodies in Core Area:
(a)Whether there is Presence of Water Bodies in Core Area ? Yes
(i)Details of Water Bodies in Core Area Jawai Nadi, Sukari Nadi, Kher Nawala Nadi
(b)Whether there is Diversion Required ? No
(c)Whether permission has been obtained from competent authority ? No
30.
Details of Presence of Water Bodies in Buffer Area:
(a)Whether there is Presence of Water Bodies in Buffer Area ? Yes
(i)Details of Water Bodies in Buffer Area Jawai Nadi
(ii)Direction of Water Bodies in Buffer Area South West
(iii)Distance of Water Bodies in Buffer Area 2.85
31.
Manpower Requirement:
(a)Permanent Employment-During Construction 0
(b)Permanent Employment-During Operation 0
(c)Temporary Employment- During Construction 25
(d)Temporary Employment- During Operation 00
(e)No. of working days 730
(f)Total Manpower 25
32.
Green Belt in Ha:
(a)Total Area of Green Belt (in hectare) 0.4182
(b)Percentage of Total Project Area 34.00
(c)No. of Plants to be Planted 213
(d)Funds Allocated for Plantation 500000
(e)Uploaded Green Belt plan Copy of Green Belt Plan
    33.         Project Benefits
S. No.Type of Project Benefits Details of Project Benefits
(1.)EnvironmentalTreatment of Biomedical waste
(2.)SocialEmployment
   34.   CRZ Specific Details : Not Applicable
   35.   Sector Specific Details For INFRA-2
S. No.Item Details
1.
Details of Building Construction:
(a)Maximum Height of the Building (Meters) 3
(b)Total No. of Flats to be Build 0
(c)No. of Buildings 1
(d)Total plot area (sqm) 12300
(e)Total built up area (sqm) 1870
2.
Foreshore Facilities and/or Marine Disposal:
(a)Whether Project Involves Foreshore Activities and/or marine Disposal? No
3.
Rain Water Harvesting:
(a)No. of Storage 0
    Capacity 0
(b)No. of Recharge Pits 0
    Capacity 0
4.
Parking:
(a)Details of 4 Wheeler/ 2 Wheeler Parking NA
5.
Energy Saving Measures:
(a)Source/Mode NA
(b)Percentage 0
(c)Quantity 0
6.
Other details:
(a)Details of impact on Water Bodies and Drainage patters of catchment area None
(b)Details of Traffic Density Impact Assessment and Modelling Study Copy of Details of Traffic Density Impact Assessment and Modelling Study
(c)In case Underground Tunnel Project below the Forest Land - Subsidence Impact Study report Copy of Underground Tunnel Project below the Forest Land - Subsidence Impact Study report
     7.       Type of Industries to be established with Industrial Estate as per their category A/B
S. No.Type of IndustryNo. of UnitsCategory A/B
NIL
8.
Length of the alignment N/A
9.
Details Bridges/ROB/Interchanges,Flyovers,Vehicle Underpass and Pedestrian Underpass
Details Not Applicable
S. No.Item Details
36.
Details of Court Cases:
(a)Whether there is any Court Cases pending against the project and/or land in which the project is proposed to be set up ? No
37.
Details of Direction Issued under Environment (Protection) Act / Air (Prevention & Control of Pollution)) Act / Water (Prevention & Control of Pollution) Act:
(a)Whether any Direction issued under EPA Act/Air Act/Water Act ? No
38.
Details of EIA Consultant:
(a)Have you hired Consultant for preparing document? Yes
(i)Accreditation No. NABET/EIA/1720/IA0026
(ii)Name of the EIA Consultant Gaurang Environmental Solutions Pvt.Ltd.
(iii)Address Gaurang Environmental Solutions Pvt. Ltd. #102, SNG, Shri Ratna Apartment Near Tambi petrol pump, Peetal factory, Jhotwara road, Jaipur-302016
(iv)Mobile No. 9782074776
(v)Landline No. 0141402911
(vi)Email Id gaurangenviro@gmail.com
(vii)Category of Accreditation A
(viii)Sector of Accreditation INFRA-2
(ix)Validity of Accreditation 22 Jan 2020
(x)Uploaded Certificate of Accreditation certified by QCI/NABET Copy of Certificate of Accreditation
39.
Documents to be Attached:
(a.I)Upload Copy of EIA/EMP(Text) Copy of EIA/EMP(Text)
(a.II)Upload Copy of EIA/EMP(Annexures) Report Copy of EIA/EMP(Annexures)
(a.III)Upload Copy of EIA/EMP(Maps/Plans/Figures only) Copy of EIA/EMP(Maps/Plans/Figures only)
(b)Uploaded Copy of Risk Assessment Report Copy of Risk Assessment
(c)Uploaded Copy of Feasibility Report/ Detailed Project Report(DPR) /Detailed Engineering Report /Detailed Conceptual Plan /Approved Mining Plan Copy of Feasibility Report/ Detailed Project Report(DPR) /Detailed Engineering Report /Detailed Conceptual Plan /Approved Mining Plan
(d)Uploaded Copy of Final Layout Plan Copy of Final Layout Plan
(e)Uploaded Cover Letter Copy of Cover Letter
(f)Uploaded Copy of documents in support of the competence/authority of the person making this application to make application on behalf of the User Agency Copy of documents in support of the competence/authority of the person making this application to make application on behalf of the User Agency
(i)Uploaded Additional File Copy of Additional File
(j)Uploaded Proposal Presentation (To be given in EAC/SEIAA/SEAC meeting) NA
(k)Uploaded Updated Form1 NA
           Essential Details Sought
S. No.EDS Sought DateEDS SoughtLetter
(1.)26/09/2019The application/proposal submitted by PP has been examined and the proposals/ application is found deficient /incomplete in respect to following:- a) Form-1. b) Prefeasibility Report. c) Affidavit regarding violation of EIA notification and regarding correctness of submitted data & document by consultant as well as project proponent. a) Duly filled environment sensitivity portion of Form I clearly showing distance from national / state boundary / protected areas / sanctuaries/National park and if area falls within 10 kms from boundary of sanctuaries /National park a copy of application submitted to NBWL,New Delhi. b) Water demand and source of water with copy of application submitted to CCWA for withdrawal of ground water.EDS Letter
(2.)18/11/2019The correction have been made as per the instruction received
(3.)15/10/2022You have not yet submitted the requested yet. kindly submit. while uploading aforesaid documents you are required to check for any overwriting of existing files. you are advised not to overwrite existing documents.
           Addtional Details Sought
S. No.ADS Sought DateADS SoughtLetter
NO Record
Undertaking
I hereby give undertaking that the data and information given in the application and enclosures are true to be best of my knowledge and belief. And I am aware that if any part of the data and information found to be false or misleading at any stage, the project will be rejected and clearance given, if any to the project will be revoked at our risk and cost. In addition to above, I hereby give undertaking that no activity/ construction/ expansion has since been taken up.
Name of ApplicantHIMANSU SURI
DesignationAGM
Name of Company (Applicant Name should not be given here)INSTROMEDIX INDIA PVT LTD
Address10 JOSHI BAGH SAYYAD KA GATTA TONK ROAD JAIPUR
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