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Application Form

The document is an application for consent to establish an industrial unit under the Water Act and Air Act, submitted by Pramod Bandukaka Purushottam Bachhav for Jyoti Agro Industry, which focuses on G96 CBG plants utilizing animal waste. The application includes detailed information about the industry, including its location, capital investment, waste management practices, and environmental compliance. The project is categorized as a green industry and does not require environmental clearance under the Environment (Protection) Act 1986.
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0% found this document useful (0 votes)
14 views20 pages

Application Form

The document is an application for consent to establish an industrial unit under the Water Act and Air Act, submitted by Pramod Bandukaka Purushottam Bachhav for Jyoti Agro Industry, which focuses on G96 CBG plants utilizing animal waste. The application includes detailed information about the industry, including its location, capital investment, waste management practices, and environmental compliance. The project is categorized as a green industry and does not require environmental clearance under the Environment (Protection) Act 1986.
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Application for Consent to establish (under Water Act & Air Act)

Consent Information

UAN No: Application submitted on:

-- 2025-07-10 18:29:07

Industry Information

Consent To: IIN No:

Establish --

Submit to: Establish Type:

SRO - Nashik New

Type of institution: Industry Type:

Other Planning Authority G96 CBG plants based on animal waste (dairy

farms, poultry farms, and other animal waste)

Category: Scale:

Green S.S.I

Location of industry/activity/etc: Name of MIDC:

Local Body

Name of Local Body: Name of Private Industry:

Vadner Gram Panchayat

Whether the project requires clearance under EC Obtained:

the Environment (Protection) Act 1986 --

(Environmental Clearance):

No

Parivesh Proposal Number: Date Of Application:

Status Of Application: Reason Thereof:

EC Ref. No.: Date of issue of EC:

MoEFCC/SEIAA File Number: Whether construction-builtup area is more than

20,000 sq.mtr.(Existing Expansion Unit):

No

General Information

1. Name, designation, office address with Telephone/Fax numbers, e-mail of the Applicant

Occupier/Industry/Institution / Local Body.


Applicant Name: Address:

Pramod Bandukaka Purushottam Bachhav Sno 33/1 Kedai Keshav Nagar Soygaon

Designation: Taluka:

Owner Malegaon

Area: District:

Soygaon Nashik

Telephone: Fax:

7311175111

Email: PAN number:

[email protected] AEHPB4540P

2. (a) Name and location of the industrial unit/premises for which the application is made (Give

revenue Survey Number/Plot number name of Taluka and District, also telephone and fax number)

Name of project: Location:

Jyoti Agro Industry Vadner

Survey number/Plot Number: Taluka:

Sno 187 Malegaon

District: Telephone:

Nashik 7311175111

Fax:

7311175111

(b) Details of the planning permission obtained from the local body/Town and Country Planning

authority/Metropolitan Development authority/ designated Authority.

Planning permission: Planning Authority:

Nashik Metropolitan Region Development Nashik Metropolitan Region Development

Authority Authority

Name of the local body under whose jurisdiction the unit is located and Name of the licence issuing

authority

Name of Local Body: Name of the licence issuing authority:

Vadner Gram Panchayat Village Development Officer

3. Names,addresses with Telephone and Fax Number of Managing Director / Managing Partner and

officer responsible for matters connected with pollution control and/or Hazardous waste disposal

Name of Managing Director:


Pramod Bandukaka Purushottam Bachhav Telephone number:

7311175111

Fax number: Officer responsible for day-to-day business:

Sandip Shivaji Sonawane

4.(a) Are you registered Industrial/HCE unit? :

No

Registration number: Date of registration:

5. Gross capital investment of the unit without depreciation till the date of application (Cost of

building, land, plant and machinery). (To be supported by an affidavit/undertaking on Rs.20/- stamp

paper, annual report or certificate from a Chartered Accountant for proposed unit(s), give

estimated figure)

Gross capital (in Lakh): Verified:

600 Undertaking

Term:

6. If the site is located near sea-shore/river bank/other water bodies/Highway, Indicate the crow

fly distance and the name of the water body, if any.

SH/NH Distance(KM): SH/NH Name:

21 Mumbai-Agra National Highway

River Distance(KM): River Name:

0 --NA--

Human Habitation Distance(KM): Human Habitation Name:

0 --NA--

Religious Place Distance(KM): Religious Place Name:

0 --NA--

Historical Place Distance(KM): Historical Place Name:

0 --NA--

Creek/Sea Distance(KM): Creek/Sea Name:

0 --NA--

6b. Enter Latitude and Longitude details of site


Latitude: Longitude:

204004.9 742221.4

7. Does the location satisfy the Requirements Under relevant Central/State Govt. Notification such

as Coastal Regulation Zone. Notification on Ecologically Fragile Area, Industrial Location policy,

etc. If so, give details.

Location: Approved Industry Area:

--

Sensitive Area: If Yes, Name Of Area:

--

Industry Location with Reference to CRZ:

--

8. If the site is situated in notified industrial estate

(a) Whether effluent collection, treatment and Details:

disposal system has been provided by the

authority.:

--

(b) Will the applicant utilize the system, if Details:

provided:

--

(c) If not provided, details of proposed

arrangement:

9.

(a) Total plot area (in square meter): (b) Built up area and (in square meter):

200000 20000

(c) Area available for the use of treated

sewage/ trade effluent for

gardening/irrigation. (in square meter):

25

10. Month and year of commissioning of the Unit.

2025-07-14
11. Number of workers and office staff

Workers: Staff:

Hrs. of shift: Weekly off:

12.

(a) Do you have a residential colony Within the Details:

premises in respect of Which the present

application is Made? :

--

(b) If yes, please state population staying

Number of person staying: Water consumption:

Sewage generation: Whether is STP provided? :

--

(c) Indicate its location and distance with reference to plant site.

Address of Residential colony: Distance from plant site (Km):

13. List of products and by-products Manufactured in tonnes/month, Kl/month or numbers/month with

their types i.e.Dyes, drugs etc. (Give figures corresponding to maximum installed production

capacity)

Products Name and Quantity

Product Name: UOM:

OTHERS --NA--

Product Name: Existing:

Eggs 30000

Consented: Proposed Revision:

30000 0

Total: Remarks:

30000

By Products Name and Quantity

BY Product Name: UOM:

Eggs Qnt/M

Quantity:
90000 Remarks:

14. List of raw materials and process chemicals with annual consumption corresponding to above

stated production figures, in tonnes/month or kl/month or numbers/month.

Name of Raw Material: UOM:

NA --NA--

Quantity: Hazardous Waste:

0 No

Hazardous Chemicals: Remarks:

No Na

15. Description of process of manufacture for each of the products showing input, output, quality

and quantity of solid, liquid and gaseous wastes, if any from each unit process.

Part B : Waste Water aspects

16. Water consumption for different uses (m3/day)

Purpose Consumptio Effluent Treatment Remarks Disposal Remarks

n Generation

Domestic 0 0 --NA-- --NA--

Purpose

Processing 0 0 --NA-- --NA--

whereby

water gets

Polluted &

Pollutants

are

Biodegrada

ble
Purpose Consumptio Effluent Treatment Remarks Disposal Remarks

n Generation

Processing 0 0 --NA-- --NA--

whereby

Water gets

Polluted,P

ollutants

are not

Biodegrada

ble &

Toxic

Industrial 0 0 --NA-- --NA--

Cooling,sp

raying in

mine pits

or boiler

feed

Others:

Na

17. Source of water supply, Name of authority granting permission if applicable and quantity

permitted.

Source of water supply: Name of MIDC:

Well/Bore well water

Name of Local Body: Wheater CGWA NOC Obtained:

NA

Others (Specify): Name of authority granting permission:

Na

Qauntity permitted (m3/day):

18. Quantity of waste water (effluent) generated (m3/day)

Domestic:
0 Boiler Blowdown:

Industrial: Cooling water blowdown:

0 0

Process: DM Plants/Softening:

0 0

Washing: Tail race discharge from:

0 0

19.Water budget calculations accounting for difference between water consumption and effluent

generated.

20. Present treatment of sewage/canteen effluent (Give sizes/capacities of treatment units).

Capacity of STP (m3/day):

Treatment unit: Size (mxm):

NA 0

Retention time (hr):

21. Present treatment of trade effluent (Give sizes/capacities of treatment units) (A schematic

diagram of the treatment scheme with inlet/outlet characteristics of each unit operation/process is

to be provided). Include details of residue Management system (ETP sludges)

Capacity of ETP (m3/day):

Treatment unit: Size (mxm):

0 0

Retention time (hr):

22.

(i) Are sewage and trade effluents mixed

together? :
No If yes, state at which stage-Whether before,

intermittently or after treatment:

23. Capacity of treated effluent sump, Guard Pond if any.

Capacity of treated effluent sump (m3):

Effluent sump: Details:

No

Guard pond: Details:

No

24. Mode of disposal of treated effluent With respective quantity, m3/day

(i) into stream/river (name of river): (ii) into creek/estuary (name of

0 Creek/estuary):

(iii) into sea: (iv) into drain/sewer (owner of sewer):

0 0

(v) On land for irrigation on owned land/lease (vi) Connected to CETP:

land. Specify cropped area: 0

(vii) Quantity of treated effluent reused/

recycled, m3/day Provide a location map of

disposal arrangement indicating the outler(s)

for sampling. Treated effluent reused /

recycled (m3/day):

25. (a) Quality of untreated/treated effluents (Specify pH and concentration of SS, BOD,COD and

specific pollutants relevant to the industry. TDS to be reported for disposal on land or into

stream/river).

Untreated Effluent

pH: SS (mg/l):

Na Na

BOD (mg/l): COD (mg/l):

Na Na
TDS (mg/l):

Na

Specific pollutant if any

Name: Value (mg/l):

Na Na

Treated Effluent

pH: SS (mg/l):

Na Na

BOD (mg/l): COD (mg/l):

Na Na

TDS (mg/l):

Na

Specific pollutant if any

Name: Value (mg/l):

Na Na

(b) Enclose a copy of the latest report of analysis from the laboratory approved by State Board/

Committee/Central Board/Central Government in the Ministry of Environment expected characteristics

of the untreated/treated effluent

Na

26. Fuel consumption

Fuel Type: Fuel UOM:

--NA-- --NA--

Fuel Consumption: Calorific value:

0 0

Ash content(%): Sulphur content:

0 0

Other (specify):

27. (a) Details of stack (process & fuel stacks: D. G. )

(a) Stack number(s):


0 (b) Attached to:

(c) Capacity(TPH): (d) Fuel Type:

0 0

(e) Fuel quantiy (Kg/hr.): (f) Material of construction:

0 NA

(g) Shape (round/rectangular): (h) Height, m (above ground level):

NA 0

(i) Diameter/Size, in meters: (j) Gas quantity, Nm3/hr:

0 0

(k) Gas temperature ℃ : (l) Exit gas velocity, m/sec:

0 0

(m) Control equipment preceding the stack: (n) Nature of pollutants likely to present in

0 stack gases such as CI2, Nox, Sox TPM etc:

(o) Emissions control system provided: (p) In case of D.G. Set power generation

0 capacity in KVA:

27.(B) Whether any release of odoriferous compounds such as Mercaptans, Phorate etc. Are coming out

from any storages or process house

28. Do you have adequate facility for collection of samples of emissions in the form of port holes,

platform, ladderetc. As per Central Board Publication “Emission regulations Part-III” ( December,

1985 )

Port hole: Details:

No

Platform: Details:

No

Ladder: Details:

No

29. Quality of treated flue gas emissions and process emissions. Quantity of treated flue gas

emissions and process emissions.

Stack attached to:


NA Parameter:

Concentration mg/Nm3: Flow (Nm3/hr):

0 0

(Specify concentration of criteria pollutants and industry/process-specific pollutants stack-wise.

Enclose a copy of the latest report of analysis from the laboratory approved by State Board/Central

Board/ Central Government in the Ministry of Environment & Forests. For proposed unit furnish

expected characteristics of the emissions..)

Part - D: Hazardous Waste aspect

30. Information about Hazardous Waste Management as defined in Hazardous Waste (Management &

Handling ) Rules, 1989 as amended in Jan.,2000. Type/Category of Waste as per

Waste (Annually) Schedule I

Cat No: Type:

NA NA

Qty: UOM:

0 --NA--

Method of collection: Method of reception:

NA NA

Method of storage: Method of transport:

NA NA

Method of treatment: Method of disposal:

NA NA

Waste (Annually) Schedule II

Class: Type:

NA NA

Qty: UOM:

0 --NA--

Method of collection: Method of reception:

NA NA

Method of storage: Method of transport:

NA NA

Method of treatment:
NA Method of disposal:

NA

31. Details about use of hazardous waste

Name of hazardous waste/Spent chemical: Quantity used/month:

NA 0

UOM: Party from whom purchased:

--NA-- NA

Party to whom sold:

NA

32.

a. Details about technical capability and equipments available with the applicant to handle the

Hazardous Waste:

NA

b. Characteristics of hazardous waste(s) Specify concentration of relevant pollutants. Enclose a

copy of the latest report of analysis from the laboratory approved by State Board/Central

Board/Central Govt. in the ministry of Environment & Forests. For proposed units furnish expected

characteristics:

NA

33. Copy of format of manifest/record Keeping practiced by the applicant

NA

34. Details of self-monitoring (source and environment system)

NA

35. Are you using any imported hazardous waste. If yes, give details

NA

36. Copy of actual user Registration/certificate obtained from State Pollution Control

Board/Ministry of Environment & Forests, Government of India, for use of hazardous waste

NA
37. Present treatment of hazardous waste, if any (give type and capacity of treatment units)

NA

38. Quantity of hazardous waste disposal

(i) Within factory: 0 (ii) Outside the factory (specify location and

enclose copies of agreement.):

(iii) Through sale (enclosed documentary proof (iv) Outside state/Union Territory, if yes

and copies of agreement.): particulars of (1 & 3 ) above:

0 0

(v) Other (Specify):

NA

Part-E: Additional information

39.

(a) Do you have any proposals to upgrade the (b) If yes, give the details with time-

present system for treatment and disposal of schedule for the implementation and approximate

effluent/emissions and/or hazardous waste expenditure to be incurred on it

NA NA

40.

Capital and recurring (O & M) expenditure on various aspect of environment protection such as

effluent, emission, hazardous waste, solid waste, tree- plantation, monitoring, data acquisition

etc. (give figures separately for items implemented/to be implemented)

NA

41.

To which of the pollution control equipment, separate meters for recording consumption of electric

energy are installed ?

NA

42.

Which of the pollution control items are connected to D.G. Set (captive power source) to ensure

their running in the event of normal power failure


NA

43. Nature, quantity and method of disposal of non- hazardous solid waste generated separately from

the process of manufacture and waste treatment. (Give details of area/capacity available in

applicant’s land)

Type Quantity

NA 0

UOM Treatment

--NA-- NA

Disposal Other Details

NA NA

44. Hazardous Chemicals – Give details of Chemicals and quantities handled and Stored

(i) Is the unit a Majot Accident Hazard unit as (ii) Is the unit an isolated storage as defined

per Mfg.Storage Import Hazardous Chemicals under the MSIHC Rules ?

Rules ? NA

NA

(iii) Indicate status of compliance of Rules (iv) Has approval of site been obtained from

5,7,10,11,12,13 and 18 of the MSIHC Rules the concerned authority?

NA NA

(v) Has the unit prepared an off-site Emergency (vi) Has information on imports of Chemicals

Plan? Is it updated ? been provided to the concerned authority?

NA NA

(vii) Does the unit possess a policy under the

PLI Act?

NA

45. Brief details of tree plantation/green belt development within applicant’s premises

Open Space Availability Plantation Done On

30 30 100.00 %

Number of Trees Planted

100

46
Information of schemes for waste Minimization, resource recovery and recycling - implemented and to

be implemented, separately

NA

47

(a) The applicant shall indicate whether (b) Any other additional information that the

Industry comes under Public Hearing, if so, the applicants desires to give

relevant documents such as EIA, EMP, Risk NA

Analysis etc. shall be submitted, if so, the

relevant documents enclosed shall be indicated

accordingly

NA

(c) Whether Environmental Statement submitted ?

If submitted, give date of submission

NA

48

I/We further declare that the information furnished above is correct to the best of my/our

knowledge.

49

I/We hereby submit that in case of any change from what is stated in this application in respect of

raw materials, products, process of manufacture and treatment and/or disposal of effluent,

emission, hazardous wastes etc. In quality and quantity; a fresh application for

Consent/Authorization shall be made and until the grant of fresh Consent/Authorization no change

shall be made.

50

I/We undertake to furnish any other information within one month of its being called by the Board

I/We enclosed here with a demand draft for Rs Drawn in favour of Maharashtra Pollution

Control Board as the fee for

Consent/authorisation for a period upto

Yours faithfully

Signature
Pramod Bandukaka Purushottam Bachhav Name

Pramod Bandukaka Purushottam Bachhav

Designation

Owner

Environment Clearance

Project Details Date

--

Capital Investment(Crs.) Total Plot area(sq. mtrs.)

Total Built area(sq. mtrs.) Amendment/Extension

Consent to Establish

Date Capital Investment(Crs.)

Total Plot area(sq. mtrs.) Total Built up area(sq. mtrs.)

Consent Type

--

Consent to Operate

Date Capital Investment(Crs.)

Total Plot area(sq. mtrs.) Total Built up area(sq. mtrs.)

CC/OC

Application Details (Applied for Consent To Establish Expansion)

Date Applied For

--

Capital Investment(Crs.) Total Plot area(sq. mtrs.)

Total Built up area(sq. mtrs.)

Remark/Present status and violation if any

Environment clearance/Consent Before 2008


Date Capital Investment(Crs.)

Product Details

Products Quantity(MT/A)

Amendment/Extension/Transfer :

Consent to Establish

Date Capital Investment(Crs.)

Product Details

Products Quantity(MT/A)

Consent Type

--

Consent To Operate

Date Validity

Capital Investment(Crs.)

Product Details

Products Quantity(MT/A)

Application Details (Applied for Consent To Establish Expansion)

Date Capital Investment(Crs.)

Product Details

Products Quantity(MT/A)"

Hazardous Waste Generation Categories C to E

Waste Name Quantity(MT/A)


Hazardous Waste Generation Categories C to O

Waste Name Quantity(MT/A)

Hazardous Waste Generation Categories C to E(Expansion)

Waste Name Quantity(MT/A)

Effluent Generation Categories C to E

Waste Name Quantity(MT/A)

Effluent Generation Categories C to O

Waste Name Quantity(MT/A)

Effluent Generation Categories C to E(Expansion)

Waste Name Quantity(MT/A)

Remark/Present status and violation if any

Additional Information

Air Pollution

Air Pollution Source Pollutants

Na Na

APCS Provided Remark

Na Na

Separate Electricity Meter Provided Other Emission Sources

Yes Na

Measures Proposed Foul Smell Coming Out

Na No

Air Sampling Facility Details

Na

D.G. Set Details


Description Capacity(KVA)

0 0

Remark

Hazardous Waste Generation

Hazardous Waste Quantity

NA 0

UOM Treatment

--NA-- Na

Disposal Other Details

Na Na

CHWTSDF Details

Member of CHWTSDF CHWTSDF Name

No --

Remarks

Na

Cess Details

Cess Applicable Cess Paid

No No

If Yes, UpTo

Legal Actions

legal Action Taken Legal Record Of Company

No

Legal Action Details Remarks

Bank Guarantee Applicable

Yes

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