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State of Haryana - Act

Haryana (Prevention and Control of Water Pollution) Rules, 1978

HARYANA
India

Haryana (Prevention and Control of Water Pollution) Rules, 1978

Rule HARYANA-PREVENTION-AND-CONTROL-OF-WATER-POLLUTION-RULES-1978 of 1978

  • Published on 22 December 1978
  • Commenced on 22 December 1978
  • [This is the version of this document from 22 December 1978.]
  • [Note: The original publication document is not available and this content could not be verified.]
Haryana (Prevention and Control of Water Pollution) Rules, 1978Published vide Notification No. GSR-125/C.A.6/74/S.64/78, dated 22.12.1978Last Updated 8th January, 2020No. GSR-125/C.A.6/74/S.64/78. - In exercise of the powers conferred by section 64 of the Water (Prevention and Control of Pollution) Act, 1974, (Parliament Act No. 6 of 1974), the State Government, after consulting the Haryana State Board for the Prevention and Control of Water Pollution, hereby makes the following rules, namely :-

1. Short title and commencement .

- These rules may be called the Haryana (Prevention and Control of Water Pollution) Rules, 1978.They shall come into force at once.

2. Definitions.

- In these rules, unless the context otherwise requires,--
(a)"Act" means the Water (Prevention and Control of Pollution) Act, 1974 (Parliament Act No. 6 of 1974);
(b)[ "State Board" means the Haryana State Pollution Control Board constituted under section 4;] [Substituted by Notification No. S.O. 80/C.A. 6/1974/S. 64/2019, dated 20.11.2019 (w.e.f. 22.12.1978).]
(bb)[ "capital investment" means the original cost invested and includes investment on land, factory building, office building and machinery and factory whether ownership, on rent, mortgage, or lease basis.] [Inserted vide Notification No. G.S.R. 30/C.A.6/74/S.64/68, the 25th March 1988.]
(c)"Chairman" means the Chairman of the Board;
(d)"Executive Committee" means a committee, constituted under section 9;
(e)"Government" means the Haryana Government in the Administrative Department;
(f)"Member" means a Member of the Board including the Chairman and the Member- Secretary;
(g)"Member-Secretary" means the Member Secretary of the Board;
(h)"section" means a section of the Act;
(i)"State Board Laboratory" means a Laboratory established or recognized as such under sub-section (2) of section 17;
(j)"State Water Laboratory" means a laboratory established or specified as such under sub-section(1) of section 52;
(k)"year" means the financial year commencing on the 1st day of April; and ending on the 31st March of the succeeding calendar year;
(l)The words and expressions used herein but not defined in these rules shall have the same meaning as are assigned to them in the Act.

3. Terms and conditions of the service of the Member of the Board other than Member.

- Secretary and Government officials. Section 5(8).-(1) Non-official Members of the Board resident in Chandigarh shall be paid an allowance of Rupees thirty per day for each day of [attending] [Inserted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.] the actual meeting of the Board or actual meeting of any Committee constituted under sub-section (1) of section 9.
(2)Non-official members of the Board, not resident in Chandigarh shall be paid an allowance of rupees fifty per day (including daily allowance) for each day of [attending] [Inserted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.] the actual meetings of the Board or for each day of [attending] [Inserted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.] actual meeting of any committee constituted under sub-section (1) of section 9 and also travelling allowance at such rates as is admissible to a grade I officer of the Government.
(3)When the Legislative Assembly is not in session, a Member of the Legislative Assembly who is also a member of the Board shall be entitled to such allowance as are admissible to him for attending an Assembly Session on production of a certificate by the Member that he has not drawn any such allowance for the same journey and halts from any other Government source.

4. [ Qualifications and other terms and conditions of service of Chairman, section 5(9). [Substituted by Notification No. S.O. 80/C.A. 6/1974/S. 64/2019, dated 20.11.2019 (w.e.f. 22.12.1978).]

(1)A person, shall not be eligible to be nominated as Chairman, under clause (a) of sub-section (2) of section 4 of the Act, unless, -
(a)he possesses Post Graduation degree in Science relating to environment or Degree in Engineering, in a discipline relating to environment from recognized university or institute and has special knowledge and fifteen years of experience relating to environment protection, including industrial pollution mitigation or waste water treatment or air pollution control devices and has rendered twenty-five years of Government/Semi-Government service; or
(b)is or has been a member of All India Services in the service of Central or any State Government of the rank and equivalence of Principal Secretary and has experience in administering institutions dealing with matters related to the environment; or
(c)is or has been in the service of State Public Sector Undertaking and possess the qualifications and experience for nomination as Chairman under clause (a) above.
(2)
(a)The Chairman who is serving officer and continues to remain in the service of the State Government shall receive the pay and other allowances in his own pay scale as admissible, under Haryana Government;
(b)A person, who is not a serving/retired Government servant, nominated as Chairman, shall receive pay and other allowances in the pay scale of Principal Secretary in Haryana Government;
(c)Any retired person from Government service nominated as Chairman shall receive a pay equivalent to last drawn minus pension along with other allowances as admissible to the Principal Secretary to Government, Haryana.
(3)In addition to disqualification as specified in section 6 of the Act, no person, -
(i)who has entered into or contracted a marriage with a person having a spouse living; or
(ii)who having a spouse living, has entered into or contracted a marriage with any person, shall be eligible for nomination to the said post;
Provided that the Government may if satisfied that such marriage is permissible under the personal law applicable to such person and the other party to the marriage and there are other grounds for so doing, exempt any person from the operation of this rule.
(4)The Chairman, Haryana State Pollution Control Board shall hold office for a term of three years from the date on which he assumes charge or till he attains the age of sixty-five years, whichever is earlier.]

4A. [ [Omitted 'Section 4A' by Notification No. S.O. 80/C.A. 6/1974/S. 64/2019, dated 20.11.2019 (w.e.f. 22.12.1978).]

***]
4A. [ Tenure and age Limit section 5 (9). [Inserted vide Notification No. S.O. 12/C.A.6/1974/S.64/2012, the 9th February 2012.]- The Chairman, Haryana State Pollution Control Board shall hold office for a term of three years from the date on which he assumes charge or until he attains the age of 70 years, whichever is earlier. He shall be eligible for renomination for a second term subject to the age limit of 70 years.]

5. Powers and duties of the Chairman Section 64 (2) (g).

(1)The Chairman shall have overall control over the day-to-day activities [and functions] [Inserted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.] of the Board.
(2)
(i)The Chairman may undertake tours within Haryana State and any Union Territory/State within India for carrying out the functions of the Board and for consolation with the Central Board:
Provided that he shall keep the Government informed of his tours and as far as possible send an advance copy of his tour so that it reaches [Secretary to Government Haryana, Environment Department,] [Substituted vide Notification No. G.S.R. 1/C.A.6/74/S.64/88, the 1st January, 1988.] at least two days before the commencement of his tour. Prior permission of the Government shall also be necessary for visiting any place outside Haryana, Union Territory, Chandigarh and Delhi :Provided further that the Chairman may undertake tours within India to attend any meetings convened either by Government of India or by Chairman, Central Board for the Prevention and control of Water Pollution, after giving intimation to the State Government. No prior approval from the Government will be necessary in such cases.
(ii)The Chairman may, with the prior approval of the Government visit any country outside India.
(3)Subject to rules, if any, made under sub-section (3)of section 12,the Chairman shall have full powers in the matters of appointment, promotion, confirmation, transfer and termination of services of the officers and employees of the Board, except in the case of the officers and employees the maximum stage of whose pay-scale exceeds [Rs.2,600/-] [Substituted vide Notification No. G.S.R. 30/C.A.6/74/S.64/68, the 25th March, 1988.]. For officers whose maximum stage of pay-scale exceeds [Rs.2,600/-] [Substituted vide Notification No. G.S.R. 30/C.A.6/74/S.64/68, the 25th March, 1988] all such powers shall vest in the Board.
(4)
(i)In the matter of acceptance of the tenders for works, the Chairman shall have the same powers as are vested with the Engineer-in-Chief, P.W.D.(Public Health Branch)Haryana, from time to time subject to the concurrence of the Board.
(ii)For making purchases of all kinds of goods or obtaining supply of any materials or articles, the powers of the Chairman will be as follows: -
(a)up to Rs. 500 for each item at a time, without calling tenders subject to the condition that the total amount of such purchases does not exceed Rs. 5,000 per item in a year;
(b)upto Rs. 20,000 at a time after calling tenders;
(c)above Rs. 20,000 at a time after calling tenders subject to the approval of the Board.
(5)Subject to over all sanctioned budget provision, the Chairman shall have the same powers to administratively approve and sanction all estimates as are delegated by the Government to the Engineer-in-Chief, Haryana P.W.D. (Public Health Branch) from time to time. The Board shall have full powers to administratively approve and sanction all estimates subject to budget provision.

6. Meeting of the Board section 8.

(1)Meeting of the Board shall ordinarily be held at Chandigarh on such dates as may be fixed by the Chairman.
(2)The Chairman shall, upon the written request of not less than 5 members of the Board or upon a direction of the State Government of if he so chooses himself, call a special meeting.
(3)["Ten clear days"] [Substituted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.] notice of an ordinary meeting and two clear days' notice of a special meeting specifying the time and place at which this meeting is to be held and the business to be transacted thereat, shall be given to the members by the Members-Secretary. A copy of the notice shall also be pasted on the Notice Board of the office of the Board. Such notice shall, in the case of special meeting, include a motion or proposition, if any, mentioned in the written request made for such meeting or in the Government direction or in the proposal made by the Chairman. [The Member - Secretary may telephonically give notice to the Members of the special meeting] [Inserted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.].
(4)The notice may be given to the Members personally or by sending it by registered post [acknowledgement due] [Inserted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.] to his last known place of residence or business or in such other manner as the Chairman in the circumstances of each case thinks fit.
(5)No Member shall be entitled to bring forward for consideration at the meeting any matter of which he has not given ["fourteen days"] [Substituted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.] clear notice to the Member-Secretary, unless the Chairman in his discretion, permits him to do so.[***] [Omitted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.]

7. Presiding Officer Section 8.

- Every meeting shall be presided over by the chairman and in his absence, by any other member elected by the member present at the meeting for that purpose.

8. All questions to be decided by majority Section .

- (i) All questions at a meeting shall be decided by a majority of votes of members present and voting shall be by raising of hands in favour of the proposal.
(ii)In case of an equality of votes, the Presiding Officer shall have and exercise a second or casting vote.

9. Quorum section .

- (i) Five Members (including the Chairman and Member-Secretary) shall form the quorum for any meeting.
(ii)[If a meeting of the Board could not held for want of quorum then the meeting shall automatically stand adjourned to the same day in the next week, at the same time and same place and if that day is a public holiday, to the next succeeding day which is not a public holiday.] [Substituted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986]
(iii)No quorum shall be necessary for the adjourned meeting.
(iv)No matter which had not been on the agenda of the original meeting shall be discussed at such adjourned meeting.
(v)No fresh notice shall be required for the adjourned meeting.

10. Minutes Section .

- (i) Record shall be kept of the names [and signatures] [Inserted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.] of members who attend the meeting of the Board and of the proceedings at the meeting in a minute book to be maintained by the Member-Secretary.
(ii)The minutes of the previous meeting shall be read at the beginning of every succeeding meeting, and shall be confirmed and signed by the Presiding Officer at such meeting.
(iii)The proceedings shall be open to inspection by any member in the office of the Board during office hours.
(iv)[ The proceedings of each meeting of the Board shall be sent to the Members for their comments, if any.] [Inserted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.]

11. Business to be transferred at the Meeting. Section 8.

- Except with the permission of the presiding Officer no business which is not entered in the agenda or of which due notice has not been given by a member, shall be transacted at any meeting.

12. Order of business.

- Except with the permission of the presiding Officer, no business shall be transacted at any meeting otherwise than in the order on which it is entered in the order of the business [of the day] [Substituted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.].

13. Procedure for transaction of Business of the Committee. Section 9.

(1)[The date, time] [Inserted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.] and the place of the meeting of the Committee constituted by the Board under sub-section (1) of section 9 shall be as specified by the Chairman [and in the absence of the Chairman, the Member-Secretary] [Substituted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.].
(2)The quorum for the meeting of a committee constituted under sub-section (1) of section 9 shall be one- half of the total number of members of the committee.
(3)Subject to sub-rule (1) and sub-rule (2), the meetings of any of the committees constituted under sub-section (1) of section 9 shall as far as possible be governed by the rules applicable to the meetings of the Board.

14. Fees and allowances to be paid to such members of a committee of the Board as are not members of the Board. Sub-section (3) of section 9.

- If a member of the committee of the Board is a non-official, he shall be paid traveling and daily allowance at the rates prescribed in rule 3 of these rules. The official members and members from corporations and local bodies shall draw T.A.at the rates admissible under the relevant rules of the Government/Corporation or local body concerned.

15. Manner and purpose of association of persons with the Board section 10.

(1)The Board may invite any person, whose assistance or advice is considered useful in the performance or any of its functions, to participate in the deliberations of any of its meetings.
(2)If the person associated with the Board under sub rule (1) happens to be a non-official and a resident of Chandigarh; he shall be entitled to get an allowance at the rate of rupees thirty only per day for each day of actual meeting of the Board, in which he is so associated.
(3)If such a person is non-official and is not a resident of Chandigarh ; he shall be entitled to get an allowance of Rs. 45 (including daily allowance) for each day of the actual meeting of the Board in which he is so associated and also to traveling allowance at such rates as is admissible to a Grade I Officer of the State Government.
(4)If such person is a serving officer or an employee in a Government undertaking, etc., he shall be entitled to traveling and daily allowance at the rates admissible under the relevant rules applicable to him.

16. [ Educational and other qualifications for appointment, pay, allowances and tenure as Member Secretary. [Substituted by Notification No. S.O. 80/C.A. 6/1974/S. 64/2019, dated 20.11.2019 (w.e.f. 22.12.1978).]

(1)The Government may appoint any serving officer from All India Services or in any services of the Central or State Government or Public Sector Undertaking or university or Government Research Institute or Autonomous or Statutory Body, on deputation, who is -
(i)holding a post on regular basis in the parent cadre or department in the pay scale of Level 13A in pay matrix of the Central Government or its equivalent in the State Government; or with two years of regular service in the grade rendered after appointment thereto on regular basis in the pay level of 13 in parent cadre or department, or six years of service in the grade rendered after appointment thereto, on regular basis in the pay level of 12 in the pay matrix of the Central Government or equivalent in the cadre or department; and
(ii)possessing Post Graduation degree in Science or degree in Engineering from a recognized institute or university or its equivalent with knowledge and experience relating to environment.
(2)The Member Secretary shall be entitled to draw pay in his own pay-scale and other allowances admissible under the Haryana Government rules.
(3)The Member Secretary shall be on deputation as per State Government instructions.]

17. Powers & duties of the Member-Secretary Section 12(2).

- The Member-Secretary shall be subordinate to the chairman and shall subject to the control of the Chairman, have the following functions, powers and obligations, namely :-
(1)The Member-Secretary shall be incharge of all the confidential papers of the Board and shall be responsible for preserving them.
(2)The Member-Secretary shall produce the aforesaid papers only when so directed by the Chairman or by the Board.
(3)The Member-Secretary shall make all arrangements for holdings meetings of the Board and meetings of the committees constituted by the Board.
(4)All orders or instructions to be issued by the Board shall be under the signature of the Member-Secretary or of any other officer authorized in this behalf by the Chairman.
(5)The Member-Secretary shall write the confidential reports of all officers or employees of the Board (except the personal staff of the Chairman) the maximum of whose pay, pay- scale exceeds Rs.1,100 and shall submit the same to the Chairman for further recording of remarks by him. The reports of all other officers or employees (except the personal staff of the Chairman) shall be initiated by such officers as are authorized for the purpose by the Chairman and submitted to the Member-Secretary for record of the Chairman shall be written by him. [Appeal against adverse remarks given by the Member Secretary to and officer or employee shall lie to the Chairman and where such remarks have been recorded by the Chairman the appeal there against shall lie to the Board] [Inserted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.].
(6)The Member-Secretary shall authorize sanction or pass all payments against allotments made or estimates sanctioned.
(7)The Member-Secretary shall allow the annual increments of all officers or employees the maximum of whose pay-scales exceeds Rs 1,100. The annual increments of other employees of the Board shall be allowed by an officer and officers authorized in this behalf by the Member-Secretary :Provided that the increment of an officer or an employee shall be with held only with the approval of the Chairman.
(8)The member-Secretary shall be entitled to call for the service of any officer or employee of the Board and files, papers and documents for study from any department of the Board and files, papers and documents for study from any department at any time, including checking of accounts, vouchers, bills and other records and stores pertaining to the Board or regional offices there under.
(9)The Member-Secretary may withhold any payment :Provided that, as soon as may be, after such withholding of payment, the matter shall be placed before the Chairman for his approval.
(10)The Member-Secretary may undertake tours within India for carrying out the functions of the Board and for consultation with the Central Board with the prior approval of the Chairman, subject to such directions as the Government may issue from time to time.
(11)The Member-Secretary may visit any country outside India with the prior approval of the Government.

18. Creation and abolition of posts Section 12(3).

- (i) The Board may create such posts as it considers necessary for the efficient performance of its functions and may abolish any post, so created :Provided that for the creation of any post the maximum of whose pay scale exceeds [Rs.3200/-] [Substituted vide Notification No. G.S.R. 30/C.A.6/74/S.64/68, the 25th March 1988.]. per month the Board shall obtain prior sanction of the Government.
(ii)Provision contained in rule 49(iv) with regard to Chairman shall be applicable to all such other officers and employee of the Board also if they are taken on deputation form the State Government.

19. Appointment and conditions of service of consulting Engineer Section 12 (4).

(1)The consulting Engineer may be appointed by the Board for a specified period not exceeding four months :
(i)Provided that Board may with the prior approval of the State Government, extend the period of appointment from time to time.
(ii)Provided further that if at the time of the initial appointment the Board has reason to believe that the services of the Consulting Engineer would be required for a period of longer than four months, the Board shall not make the appointment without the prior approval of the Government.
(2)Notwithstanding the appointment of a Consulting Engineer for a specified period under sub-rule (1) of rule 19, the Board shall have the right to terminate the services of the Consulting Engineer before the expiry of the specified period if, in the opinion of the Board the Consulting Engineer is not discharging his duties properly or to the satisfaction of the Board or if such a course of action is necessary in the Public interest.
(3)The Board may pay the Consulting Engineer suitable emoluments or fees depending on the nature of work and the qualification and experience of the incumbent :Provided that the Board shall not appoint any person as consulting Engineer without the prior approval of the Government if the emoluments or fees payable to him exceed rupees two thousand per month.
(4)The Consulting Engineer may with the prior approval of the Chairman undertake tours within the State for the performance of the duties entrusted to him by the Board or by the Chairman in connection with such tours, he shall be entitled to get such traveling and daily allowance as is admissible to a Grade-I Officer of the Government.
(5)Consulting Engineer shall not without the written permission of the Chairman disclose any information either obtained from Board's office or obtained otherwise during the performance of his duties except when it is necessary for the due discharge of such duties.
(6)The Consulting Engineer shall discharge such duties and perform such function as are assigned to him by the Chairman or the or the Board and it will be his duty to [advise the Chairman or Board] [Substituted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.] on all technical and other matters referred to him by the Chairman.
(7)The Industries, Municipal Committees, Corporations and other such bodies shall get the schemes for waste water management, collections, treatment and disposal, etc., etc. prepared from some Consulting Engineer/Engineers in the open market or the State Public Health Engineering Department. If, however, the Chairman, Member- Secretary, any other technical officer or any other member of the staff of the Board performs the functions jointly or separately of a Consulting Engineer for any industry, Municipal Committee, Corporation or any other body for drawing up some scheme for them jointly or separately suitable fee/honorarium as may be decided by the Board/Chairman will be charged from those for whom the scheme is drawn up 75 per cent of such fee/honorarium will go to the funds of the Board and the disbursement of balance 25 per cent for the fee/honorarium will be made as an incentive to such officers/personnel of the Board as have drawn up the scheme, in a proportion to be decided officer or employee of the Board shall be limited, to his one month's emoluments in a year.For obtaining this remuneration, the officers and employees on deputation to the Board from other Department will neither be acquired by the Board/Government to obtain any sanction form their parent department or Government nor will they be required to deposit any part of this remuneration into Government Treasury.

20. Power to take samples Section 21(1).

- The Board or any officer empowered by it in this behalf shall have power to take, for the purpose of analysis, samples of water from any river, stream or well or any other water body or of sewage or trade effluent which is passing from any plant or vessel or from or over any place into any such rivers, streams, drains or wells or any other water bodies in the State of Haryana.

21. Form of Notice Section 21(3).

- A notice under clause (a) of subsection (3) of section 21 of the Act shall be in Form 'A'.

22. Application for consent and procedure therein Section 25(2) and (3) and Section 26.

-
(1)[ An application under sub-section (2) of section 25 or section 26 shall be made to the Haryana State Board in From 'B' which shall be accompanied with the receipt of having deposited the amount of consent fee with the said Board as specified hereunder :-] [Substituted vide Notification No. G.S.R. 30/C.A.6/74/S.64/68, the 25th March 1988.]
[A-I [Sr. No. A(I & II) substituted vide Notification No. G.S.R. 90/CA6/74/S.64/97 the 5th December 1997.] Consent to Establish (N.O.C.) Industries other than Covered under Headings A-II to A-V
(a) Industries having capital investment exceedingRs. 100 crores 35,000
(b) Industries having a capital investmentexceeding Rs. 50 crores but not exceeding Rs. 100 crores 20,000
(c) Industries having a capital investmentexceeding Rs. 10 crores but not exceeding Rs. 50 crores 12,000
(d) [ [Sr. No. (d & d-i) in A-I(i) &(ii) substituted vide Notification No. S.O.16/C.A. 6/74/S.64/99 dated 25th January, 1999.] Industries having a capital investmentexceeding Rs. 3 crores but not exceeding Rs. 10 crores 8,000]
[(d-i) [Sr. No. (d & d-i) in A-I(i) &(ii) substituted vide Notification No. S.O.16/C.A. 6/74/S.64/99 dated 25th January, 1999.] Industries having a capital investmentexceeding Rs. 1 crore but not exceeding Rs. 3 crores 5,700]
(e) Industries having a capital investmentexceeding Rs. 0.50 crores but not exceeding Rs. 1.0 crore 4,500
(f) Industries having a capital investmentexceeding Rs. 0.25 crores but not exceeding Rs. 0.5 crore 2,500
(g) Industries having a capital investmentexceeding Rs. 0.10 crores but not exceeding Rs. 0.25 crore 1,500
(h) Industries having a capital investmentexceeding Rs. 0.02 crores but not exceeding Rs. 0.10 crore 750
(i) Industries having a capital investment upto Rs.0.02 crore 200]
[A-II [Sr. No. A(I & II) substituted vide Notification No. G.S.R. 90/CA6/74/S.64/97 the 5th December 1997.] Consent Fee to Establish (N.O.C.) Highly Polluting Industries such as Fertilizer (Nitrogen/phosphate) sugar, Cement, Fermentation and Distillery, Petro-Chemical, thermal, power plant, Oil Refinery Sulfuric acid, iron and Steel, Pulp and Paper, Dye and Dye Intermediates, Pesticides Manufacturing, Basic Drugs and Pharmaceuticals Etc.
(a) Industries having capital investment exceedingRs. 100 crores 1,05,000
(b) Industries having a capital investmentexceeding Rs. 50 crores but not exceeding Rs. 100 crores 60,000
(c) Industries having a capital investmentexceeding Rs. 10 crores but not exceeding Rs. 50 crores 36,000
(d) [ [Sr. No. (d & d-i) in A-I(i) &(ii) substituted vide Notification No. S.O.16/C.A. 6/74/S.64/99 dated 25th January, 1999.] Industries having a capital investmentexceeding Rs. 3 crore but exceeding Rs. 10 crores 24,000]
[(d-i) [Sr. No. (d & d-i) in A-I(i) &(ii) substituted vide Notification No. S.O.16/C.A. 6/74/S.64/99 dated 25th January, 1999.] Industries having a capital investmentexceeding Rs. 1 crore but not exceeding Rs. 3 crores 17,700]
(e) Industries having a capital investmentexceeding Rs. 0.50 crore but not exceeding Rs. 1.0 crore 14,500
(f) Industries having a capital investmentexceeding Rs. 0.25 crore but not exceeding Rs. 0.50 crore 7,500
(g) Industries having a capital investmentexceeding Rs. 0.10 crores but not exceeding Rs. 0.25 crore 4,500
(h) Industries having a capital investmentexceeding Rs. 0.02 crores but not exceeding Rs. 0.10 crore 2,250
(i) Industries having a capital investment upto Rs.0.02 crore 600]
[A-III [Sr. No. A(III, IV, & V) & B-I(i) substituted vide Notification No. G.S.R. 90/CA6/74/S.64/97 the 5th December, 1997.] Consent Fee to Establish (N.O.C.) Legally Constituted Bodies other than Industrial Units
(a) Munciptal corporation Faridabad 25,000
(b) Class 'A' Municipalities 5,000
(c) Class 'B' Municipalities 2,500
(d) Class 'C' Municipalities 500
(e) Public Health Rs. 5,000 per each town
(f) Haryana Urban Development Authority Rs. 50,000 per each Estate
(g) Private Colonizers Rs. 50,000 per each town ship]
[A-IV [Sr. No. A(III, IV, & V) & B-I(i) substituted vide Notification No. G.S.R. 90/CA6/74/S.64/97 the 5th December, 1997.] Consent Fee to Establish (N.O.C.) Rice Shellers
(a) Unit having a capital investment not exceedingRs. 30 lacs 20,000
(b) Unit having a capital investment exceedingRs. 30 lacs but not exceeding Rs. 50 lacs 30,000
(c) Unit having a capital investment exceedingRs. 50 lacs 50,000]
[A-V [Sr. No. A(III, IV, & V) & B-I(i) substituted vide Notification No. G.S.R. 90/CA6/74/S.64/97 the 5th December, 1997.] Consent fee to Establish (N.O.C.) Mining Activities
(a) Units paying licence fee for Mining not exceeding Rs. 25 lacs annually. 1,00,000]
(b) Units paying licence fee for Mining exceedingRs. 25 lacs but not exceeding Rs. 50 lacs. 1,50,000
(c) Units paying licence fee for Mining exceedingRs. 50 lacs 2,00,000]
[A-VI [Added by Notification No. S.O.56/C.A.6/1974/S.64/2018, dated 27.8.2018.] Consent fee to establish projects/units covered under Haryana Bio-Energy policy 2018 Nil;]
[B-I(i) [In Rule 22 (1) B-I (I-V) Substituted vide Notification No. G.S.R. 90/CA/6/74/S.64/97 the 5th December 1997.] Consent Fee to be Charged Annually for Sub-Sequent Years to Operate Industries not Covered under Headings B-II to B-V
(a) Industries having capital investment exceedingRs. 100 crores Rs. 50,000
(b) Industries having a capital investment exceedingRs. 50 crores but not exceeding Rs. 100 crores Rs. 40,000
(c) Industries having a capital investment exceedingRs. 10 crores but not exceeding Rs. 50 crores Rs. 30,000
(d) [ [Sr. No. d & d-i in B-I (i) Substituted vide Notification No. S.O. 16/CA6/74/S.64/99 dated 25th January, 1999.] Industries having a capital investment exceedingRs. 3 crores but not exceeding Rs. 10 crores Rs. 20,000]
[(d-i) [Sr. No. d & d-i in B-I (i) Substituted vide Notification No. S.O. 16/CA6/74/S.64/99 dated 25th January, 1999.] Industries having a capital investment exceedingRs. 1 crore but not exceeding Rs. 3 crores Rs. 10,000]
(e) Industries having a capital investment exceedingRs. 0.50 crore but not exceeding Rs. 1.0 crore Rs. 5,000
(f) Industries having a capital investment exceedingRs. 0.25 crore but not exceeding Rs. 0.50 crore Rs. 2,000
(g) Industries having a capital investment exceedingRs. 0.10 crores but not exceeding Rs. 0.25 crore Rs. 500
(h) Industries having a capital investment exceedingRs. 0.02 crores but not exceeding Rs. 0.10 crore Rs. 200
(i) Industries having a capital investment uptoRs. 0.02 crore Rs. 100]
[B-I(ii) [Sr. No. A(III, IV, & V) & B-I(i) substituted vide Notification No. G.S.R. 90/CA6/74/S.64/97 the 5th December, 1997.] Consent fee to be Charged Annually for Sub-Sequent Years to Operate Industries not Covered under Headings B-II to B-V
(a) Industries having capital investment exceedingRs. 100 crores Rs.25,000
(b) Industries having a capital investment exceedingRs. 50 crores but not exceeding Rs. 100 crores Rs. 20,000
(c) Industries having a capital investment exceedingRs. 10 crores but not exceeding Rs. 50 crores Rs. 15,000
(d) Industries having a capital investment exceedingRs. 3 crores but not exceeding Rs. 10 crores Rs. 8,000
(d-i) Industries having a capital investment exceedingRs. 1 crore but not exceeding Rs. 3 crores Rs. 3,700
(e) Industries having a capital investment exceedingRs. 0.50 crore but not exceeding Rs. 1.0 crore Rs. 1,500
(f) Industries having a capital investment exceedingRs. 0.25 crore but not exceeding Rs. 0.50 crore Rs. 1,500
(g) Industries having a capital investment exceedingRs. 0.10 crores but not exceeding Rs. 0.25 crore Rs. 500
(h) Industries having a capital investment exceedingRs. 0.02 crores but not exceeding Rs. 0.10 crore Rs. 200]
[B-II(i) [Sr. No. A(III, IV, & V) & B-I(i) substituted vide Notification No. G.S.R. 90/CA6/74/S.64/97 the 5th December, 1997.] Consent fee for Ist Year to Operative Highly Poluting Industries such as Fertilizer (Nitrogen/phosphate), Sugar, Cement, Tanneries, Fermentation And Distillery, Petro-Chemical, Thermal Power Plant, Oil Refinery Sulfuric acid, iron and steel, Pulp and Paper, Dye and Dye Intermediates, Pesticides Manufacturing, Basic Drugs and Pharmaceuticals etc.
(a) Industries having capital investment exceedingRs. 100 crores Rs. 1,50,000
(b) Industries having a capital investment exceedingRs. 50 crores but not exceeding Rs. 100 crores Rs. 1,20,000
(c) Industries having a capital investment exceedingRs. 10 crores but not exceeding Rs. 50 crores Rs. 90,000
(d) [ [Sr. No. d & d-i in B-I (i) Substituted vide Notification No. S.O. 16/CA6/74/S.64/99 dated 25th January, 1999.] Industries having a capital investment exceedingRs. 3 crores but not exceeding Rs. 10 crores Rs. 60,000]
[(d-i) [Sr. No. d & d-i in B-I (i) Substituted vide Notification No. S.O. 16/CA6/74/S.64/99 dated 25th January, 1999.] Industries having a capital investment exceedingRs. 1 crore but not exceeding Rs. 3 crores Rs. 30,000]
(e) Industries having a capital investment exceedingRs. 0.50 crore but not exceeding Rs. 1.0 crore Rs. 15,000
(f) Industries having a capital investment exceedingRs. 0.25 crore but not exceeding Rs. 0.50 crore Rs. 6,000
(g) Industries having a capital investment exceedingRs. 0.10 crores Rs. 1,500
(h) Industries having a capital investment exceedingRs. 0.02 crores but not exceeding Rs. 0.10 crore Rs. 600
(i) Industries having a capital investment uptoRs. 0.02 crore Rs. 300]
[B-II(ii) [In Rule 22 (1) B-I (I-V) Substituted vide Notification No. G.S.R. 90/CA/6/74/S.64/97 the 5th December 1997.] Consent fee to be Charged Annually for Subsequent Years to Operate Highly Polluting Industries such as Fertilizer (Nitrogen/phosphate), Sugar, Cement, Fermentation and Distillery, Petro-Chemical, Thermal Power Plant, Oil Refinery Sulfuric acid, iron and Steel, Pulp and Paper, Dye and Dye Intermediates, Pesticides Manufacturing, Basic Drugs and Pharmaceuticals, Tanneries Etc.
(a) Industries having capital investment exceedingRs. 100 crores Rs. 75,000
(b) Industries having a capital investment exceedingRs. 50 crores but not exceeding Rs. 100 crores Rs. 60,000
(c) Industries having a capital investment exceedingRs. 10 crores but not exceeding Rs. 50 crores Rs. 45,000
(d) [ [Sr. No. ((d) & di) in B-II & B-III substituted vide Notification No. G.S.R. 90/CA6/74/S.64/97 the 5th December, 1997.] Industries having a capital investment exceedingRs. 3 crores but not exceeding Rs. 10 crores Rs. 24,000]
[(d-i) [Sr. No. ((d) & di) in B-II & B-III substituted vide Notification No. G.S.R. 90/CA6/74/S.64/97 the 5th December, 1997.] Industries having a capital investment exceedingRs. 1 crore but not exceeding Rs. 3 crores Rs. 11,000]
(e) Industries having a capital investment exceedingRs. 0.50 crore but not exceeding Rs. 1.0 crore Rs. 4,500
(f) Industries having a capital investment exceedingRs. 0.25 crore but not exceeding Rs. 0.50 crore Rs. 3,000
(g) Industries having a capital investment exceedingRs. 0.10 crores but not exceeding Rs. 0.25 crore Rs. 1,500
(h) Industries having a capital investment exceedingRs. 0.02 crores but not exceeding Rs. 0.10 crore Rs. 600
(i) Industries having a capital investment uptoRs. 0.02 crore Rs. 300]
[B-(iii) [Sr. No. ((d) & di) in B-II & B-III substituted vide Notification No. G.S.R. 90/CA6/74/S.64/97 the 5th December, 1997.] Consent fee to be Charged Annually Legally Constituted Bodies Other than industrial units
(a) Municipal Corporation Faridabad Rs. 25,000
(b) Class `A' Municipalities Rs. 5,000
(c) Class `B' Municipalities Rs. 2,500
(d) Class `C' Municipalities Rs. 500
(e) Public Health Rs. 5,000 per each town
(f) Haryana Urban Development Authority Rs. 50,000 per each Estate
(g) Private Colonizers Rs. 50,000 per each town ship]
[B-IV(i) [Sr. No. B-IV (i) Substituted vide Notification No. 16/23/2000-Env.-II dated 03.05.2002.] Consent fee for Ist Year to Operate Rice Shillers
(a) Units having a capital investment not exceedingRs. 25 lacs Rs. 10, 000
(b) Units having a capital investment exceedingRs. 25 lacs but not exceeding Rs. 50 lacs Rs. 12,500
(c) Units having a capital investment exceedingRs. 50 lacs Rs. 15,000]
[B-IV(ii) [Sr. No. B-IV (ii) Substituted vide Notification No. 16/23/2000-Env.-II dated 03.05.2002.] Consent fee to be Charged Annually for Subsequent Years to operate Rice Shellers
(a) Units having a capital investment not exceedingRs. 25 lacs Rs. 10, 000
(b) Units having a capital investment exceedingRs. 25 lacs but not exceeding Rs. 50 lacs Rs. 12,500
(c) Units having a capital investment exceedingRs. 50 lacs Rs. 15,000]
[B-V(i) [In Rule 22 (1) B-I (I-V) Substituted vide Notification No. G.S.R. 90/CA/6/74/S.64/97 the 5th December 1997.] Consent fee for Ist Year to Operate Mining Activities
(a) Units paying license fee for Mining not exceeding Rs. 25 lacs annually. Rs. 1,50, 000
(b) Units paying license fee for Mining exceedingRs. 25 lacs but not exceeding Rs. 50 lacs. Rs. 2,25,000
(c) Units paying license fee for Mining exceeding Rs. 50 lacs Rs. 3,00,000
(ii) Consent fee to be Charged Annually for Subsequent Years to Operate Mining Activities
(a) Units paying license fee for Mining not exceeding Rs. 25 lacs annually. Rs. 1,25, 000
(b) Units paying license fee for Mining exceedingRs. 25 lacs but not exceeding Rs. 50 lacs. Rs. 1,75,000
(c) Units paying license fee for Mining exceeding Rs. 50 lacs Rs. 2,25,000]
[B-VI (i) [In Rule 22 (1) B-VI (i, ii) Add vide Notification No. 16/42/2005-Env.-III the 4th October 2007.] Consent fee to establish screening plant
(a) Screening unit with the capacity not exceeding 100 tons/day Rs. 5,000
(b) Screening unit with the capacity exceeding 100 tons/day Rs. 7,500
(ii) Consent fee to be charged annually to operate screening plant
(a) Screening unit with the capacity not exceeding 100 tons/day Rs. 5,000
(b) Screening unit with the capacity exceeding 100 tons/day Rs. 7,500]
[B-VII [Added by Notification No. S.O.56/C.A.6/1974/S.64/2018, dated 27.8.2018.] Consent fee to be charged for 1st and for subsequent year to operate projects/units covered under Haryana Bio-Energy policy 2018. Nil.]
(2)On receipt of any application for consent under section 25 or section 26, the Board may depute any of its officer's accompanied by as many assistants as may be necessary for the purposes of verifying the correctness or otherwise of the particulars furnished in the application or for obtaining such further particulars or information as it may consider necessary, to visit the premises of the applicant to which such application relates. Such officers may for that purpose, inspect any place where water, sewage or 1[trades effluent] is discharged by the applicant as also any treatment plants, purification works, disposal systems and plants of the applicant and may require the applicant to furnish to him any plans, specifications and other data relating to such water treatment plants, purification works or disposal systems and plants or any part thereof, that may be considered necessary.
(3)[Such officer may] [Substituted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.], before visiting any premises of the applicant for the purpose of inspection under sub-rule (2) give, [***] [Omitted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.], a notice to the applicant to his intention to do so in form 'C' and the applicant shall furnish to such officer all facilities that he may legitimately require for the purpose.
(4)The officer of the Board may, before or after carrying out the inspection under sub-rule (2) summon the applicant or his authorized agent, to the office of the Board or to any of its regional or sub-regional offices or to his camp office and require the applicant to furnish to him orally or in writing such additional information or clarification or to produce before him such documents as he may consider necessary for the purpose of investigation of the application.

23. Appellate Authority Section 28.

- [(1) The Appellate Authority shall consist of either a single person or three persons appointed by the State Government, -(A)(i)in case of single person authority, the Appellate Authority shall consist of, either retired District and Session Judge or Administrative Secretary of Environment and Climate Change Department or a member of All India Services who is or has been in the service of Central or any State Government of the rank and equivalence of Principal Secretary and has experience in administering instructions dealing with matters related to the environment; or(ii)in case of three persons, the Appellate Authority shall consist of one of the persons, indicated at (i) above, who shall be designated as President of the Appellate Authority; and any two persons from the following category shall be appointed by the Government as Members, -(a)Scientist having experience of fifteen years in the field of Environment Management equivalent to the status of group A services;(b)Professional/Expert at least in the rank of Professor from the Department of Environment of a reputed university;(c)Secretary/Director level of All India Services officer;(d)Serving/Retired Engineer of not below the level of Superintending Engineer;(e)Serving/retired Additional Director from Prosecution Department, Haryana;(f)Retired District/Additional District and Session Judge;(g)Administrative Secretary/Secretary of Forest or Irrigation Department.In case, the President is a non-judicial person, in that case one of the two members shall be from judicial/prosecution side.(B)The President of the authority shall be paid with an honorarium of one lakh rupees per month and members shall be paid fifty thousand rupees per month by the Government and the Government shall pay the travelling allowances of the Appellate Authority, at such rates as are admissible to Grade I officer of the Government.(C)The term for President and Members of the Appellate Authority shall be for a period of two years.(D)The President and/or members of the Appellate Authority may hold office till sixty-seven years of age.]
(2)A memorandum of appeal shall be in form 'D' and the same shall be presented to the President of the appellate authority either personally or through registered post duly signed by the appellate or by his duly authorized agent.
(3)
(i)The Appellate Authority shall as soon as may be after the memorandum of appeal is filed, fix a date for hearing of the appeal and give intimation of the same to the appellant and the Member Secretary in such manner as it deems fit. A copy of the memorandum of appeal along with its enclosures shall be sent to the Member-Secretary.
(ii)The appellate authority shall call for the record of the case from the Member-Secretary, if necessary.
(iii)Where the material on record is insufficient to enable the appellate authority to arrive at a definite conclusion it may take additional evidence and/or call for such further material from the appellate or the Member-Secretary as it thinks fit. Such material shall form part of the record.
(iv)If, on the date fixed for hearing or on any date to which hearing of the appeal may be adjourned, the appellant or his duly authorized agent does not appear when the appeal is called for hearing, the appeal may be either dismissed or decided ex parte [and in such a case the ex parte order so passed shall be conveyed to the party immediately thereafter, by registered post] [Inserted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.].
(v)Where, an appeal is dismissed under sub-rule (iv) above the appellant may within 30 days from the date of dismissal of the appeal, apply to the appellate authority for the restoration of the appeal and if it is shown to the satisfaction of the appellate authority that the appellant had not received intimation of the date of hearing of the appeal or was prevented by any sufficient cause from appearing when the appeal was called for hearing, the appellate authority may restore the appeal on such terms and conditions as it thinks fit.
(4)
(i)The order of the appellate authority shall be writing and shall state the points for the determination, of the decision thereon as also the reasons on which the decision is based.
(ii)Copy of the order passed on appeal shall be supplied free of cost to the appellant. Copy of the order shall also be sent to the Member-Secretary.
(5)[ The fee payable for filing an appeal under section 28 of the Act shall be as decided by the Government from time to time. This fee shall be deposited with the Environment and Climate Change Department of the Government of Haryana before filing the appeal.
(6)The Head Quarter of the Appellate Authority shall be either Panchkula or Chandigarh, as decided by the Government. The Government shall also make the arrangements of the sitting, conducting and functioning of the Appellate Authority and other secretarial services.] [Substituted by Notification No. S.O. 80/C.A. 6/1974/S. 64/2019, dated 20.11.2019 (w.e.f. 22.12.1978).]

24. Form of Budget Estimates Section, 38.

(1)The Budget in respect of a financial year next ensuing showing the estimated receipts and expenditure of the Board shall be prepared in form 'E' and submitted to the Government. (2) The estimated receipts and expenditure shall be accompanied by the revised budget estimated for the current year. (3) The Budget shall, as far as may, be based on the account heads specified in form 'F'.

25. Submission of Establishment expenditure and fixed recurring charges Section 38.

(1)The estimates of expenditure on fixed establishment as well as fixed monthly recurring charges on account of rent, allowances etc., shall provide for the gross sanctioned pay without deductions of any kind.
(2)To the estimates referred to in sub-rule (1) shall be added a suitable provision for leave salary based on past experience with due regard to the intension of the members of the staff in regard to leave as far as the same can be ascertained.
(3)If experience indicate that the total estimate for fixed charges referred to in sub-rules (1) and (2) is not likely to be fully utilized a suitable lump sum deduction shall be made from the total estimated amount.

26. Submission of budget estimates to the Board Section 38.

(1)The budget estimates as complied in accordance with the rule 24 shall be placed by the Member-Secretary before the Board by the 5th October each year for approval.
(2)After approval of the budget estimates by the Board four copies of the final budget proposals incorporating therein such modifications, if any as have been decided upon by the Board, shall be submitted to the Government by the 15th October, each year.

27. Reappropriation and emergent expenditure Section 38.

- No expenditure which is not covered by a provision in the budget approved by the Board or which is likely to be in excess over the amount provided being made by re-appropriation from some other head under which savings are firmly established and available;[Provided that such reappropriation shall be submitted to the State Government.] [Inserted vide Notification No. G.S.R. 44/C.A.6/74/S.64/86, the 30th May 1986.]

28. Power to incur expenditure Section 38.

(1)The Board shall incur expenditure out of the funds received by it in accordance with the instructions laid down under the Punjab Financial Rules as are applicable to the State of Haryana, and such other instructions issued by the Government on this behalf, from time to time either generally to all concerned or specifically to the Board.
(2)The Board may delegate any financial power to the Chairman, Member Secretary or any other officer of the Board to incur expenditure to a specified extent.

29. Operation of fund of the Board Section 38.

- Subject to the control of the Chairman, the fund of the Board shall be operated by the Member-Secretary of the Board or in his absence by any officer of the Board who may be so empowered by the Chairman. The Chairman may also delegate powers to any officer of officers of the Board either singly or jointly to issue on account of the expenditure which has been sanctioned for payment.

30. Savings Section 38.

- Nothing in these rules shall apply to a budget already finalized before the commencement of these rules.

31. Form of Annual Report Section 39.

- The annual report giving a true and full account of the activities of the Board during the previous financial year and containing the particulars specified in the form 'G' shall be submitted to the Government by the 15th of May, each year.

32. Form of Annual Statements of Accounts Section 40.

- The annual statements of account of the Board shall be in form H-I, HII, H-III, H-IV and H-H-V.

33. Function of the State Water Laboratory Section 22(1).

- The State Water Laboratory shall get analysed any samples of water, sewage or trade effluent received by it from any officer authorised by the Government for the purpose and the findings shall be recorded in triplicate in form 'I'.

34. Fee for Report Section 52.

- The fees for each report as referred in rule 33 shall be such as may be notified by Government from time to time.

35. Qualification of Government Analyst Section 53.

- A Government Analyst shall be a person who-
(a)is a graduate of University recognized by the Government for the Purposes of this rule in any branch of science including Chemistry, Bio- Chemistry, Industrial Chemistry Engg or Medicine ; and
(b)has practical experience of not less than five years in a recognized Public Health Laboratory which in the opinion of the Government is a reputed laboratory.

35A. [ Qualification of Board Analyst-section 53(3). [Inserted vide Notification No. G.S.R. 61/C.A.6/74/S.64/88 dated 26th August, 1988.]

- A Board analyst shall be a person who-
(a)is a M.Sc. in Chemistry or has Bachelor Degree in Chemical Engineering or in Chemical Bio-Engineer-ing;and
(b)has practical experience of not less than five years in the analysis of water sewage or industrial wastes in the analysis of water sewage or industrial wastes in teaching or research or in Government Laboratory.]

36. Form of report of State Board Analyst Section 22(3).

- When sample of any water, sewage or trade effluent has been sent for analysis to a laboratory established or recognized by the Board Analyst to a laboratory established or recognized by the Board, the Board Analyst appointed under sub-section (3) of section 53 shall analyse the sample and submit to the Board a report of the result of such analysis in triplicate in form 'J'.Form 'A'(See Rule 21)Haryana State Board for the Prevention and Control of Water PollutionNotice of intention to have sample analysedTo___________________________________________________________________________Take notice that it is intended to have analysed the sample of water/sewage effluent /trade effluent which is being taken today the _____________________ day of ___________ 19_____________ from (I) ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Name and designation of the person who takes the sample.
(I)Here specify the stream, well, plant, vessel or place from where the sample is taken.
To___________________________________________________________________________[Form B] [Substituted vide Notification No. 16/3/2001-Env.-iii. the 17th April, 2002.][See Rule 22(I)]Common Application Form For ConsentFrom______________________________________________________ToMember Secretary,Haryana State Pollution Control Board,Chandigarh.Sir,I/We hereby apply for consent/authorization for the year ___________ to ___________.

1. consent to /operate/renewal of consent under Section 25 and 26 of the Water Prevention and Control of Pollution) Act, 1974 as amended.

2. consent to /operate/renewal of consent under Section 21 of Air (Prevention and Control of Pollution) Act, 1981 as amended.

3. Authorization/renewal of authorization under Rule 5 of the Hazardous Waste (Management and Handling rules) 1989 as amended in connection with my/our existing/proposed/altered/additional manufacturing/processing activities from the premises as per detail given below:-

PartA : General

1. Name, Designation, Office Address, Telephone Fax and E-mail address of the Applicant.

2. (a) Name and location of the Industrial Unit/Premises for which the application is made (Give Revenue Survey Number/Plot No. Name of the Taluka and District, also Telephone No. and Fax No.

(b)Details of planning permission obtained from Municipal Corporation / Directorates of Urban Development or Town & Country Planning/Haryana Urban Development Authority, which ever applicable.
(c)Name of the Municipal Corporation/Panchayat Samiti/Panchayat under whose jurisdiction the unit is located & name of the license issuing authority.

3. Name Address with Telephone, Fax and E-mail address of the Managing Director/Managing Partner and officer responsible for the matter connected with Pollution Control and Hazardous Waste Disposal.

4. If registered as a Small- Scale Industries Unit give number and date of registration.

5. Gross Capital Investment of the unit without depreciation till the date of application (cost of building, land, pant and machinery) (to be supported by an affidavit, annual report and certificate from Chartered Accountant, for proposed units, give estimated figure).

6. If the site is located near seashore/river bank/other water bodies; indicate the name & distance of the water body.

7. Does the location satisfy the requirements under relevant Central/State Government notification on ecologically fragile area etc. if so give details?

8. If the site is situated in notified industrial estate:

(a)Whether effluent collection, treatment & disposal system has been provided by the authority;
(b)Will the applicant utilize the system, if provided.
(c)if not provided, details of proposed arrangement for the treatment of effluent.

9. Total Plot area, Built up area and area available for the use of treated sewage/trade effluent.

10. Month and Year of the proposed commissioning of the unit.

11. Number of workers and office staff :

12. (a) Do you have a residential colony within the premises in respect of which the present Application is made?

(b)If yes, please state population staying.
(c)Indicate its location & distance with reference to plant site.

13. List of products and by-products manufactured in tones/month, kilolitre/month or Numbers/month (give figures corresponding to maximum installed production capacity).

14. List of Raw materials and process chemicals with annual consumption corresponding to above stated production figures, in tones/month, kilo litre/month or numbers/month.

15. Description of process of manufacture for each of products showing input/output, quality and quality of solid, liquid and gaseous wastes, if any, forms each unit process. (to be supported by flow sheet and /or material balance.

Part B – Waste Water aspects (for Water Consent) if not applicable write not applicable)

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

(1)Industrial cooling, Spraying in mine pits or boiler feeds.
(2)Domestic purpose.
(3)Processing whereby water gets polluted & the pollutants are easily biodegradable & are toxic.
(4)Processing whereby water gets polluted and the pollutants are not easily biodegradable and are toxic.
(5)Other such as agriculture, gardening etc. (Specify).Total ________________

17. Source of Water supply, Name of the authority granting permission if applicable & quality permitted.

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

(1)Domestic
(2)Industrial

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

20. Present treatment of sewage/canteen effluent (give sizes capacity).

21. Present treatment of trade effluent (give sizes/capacity of treatment units)

(A schematic diagram of treatment scheme with inlet/outlet characteristics of each unit operation/process is to be provided. Included details of residue management system (sludge's).

22. (a) Are sewage and trade effluent mixed together?

(b)If yes, state at which stage whether before or after treatment.

23. Capacity of treated effluents, sump, guard pond, if any.

24. Mode of Disposal of treated effluent, with respective quantity, m3 per day.

(1)Into stream/river (name of the river).
(2)Into drain/sewer (owner of the sewer).
(3)On land for irrigation on owned land/lease land specifies the cropped area (to be supported by relevant documents).
(4)Quantity of treated effluent reused /recycled. Provide a location map of the disposal arrangement indicating the outlets of for sampling.

25. Quality of untreated / treated effluents (specify pH and concentration of Suspended Solids, Bio Chemical Oxygen Demand, Chemical Oxygen Demand & specific pollutants relevant to the industry. Total Dissolved Solids to be reported for disposal on land or into stream/river).

Enclose a copy of latest report of analysis from the laboratory approved/recognized by Haryana State Pollution Control Board/Central Board/Central Government in the Ministry of Environment and Forests. For proposed unit furnish expected characteristics of the untreated/treated effluents.

Part C – Air Emission aspect (for Air Consent) if not applicable write not applicable

26. Fuel Consumption
Coal   Low Sulpher High Speed Furnace Natural
  Others        
        Oil Gas
(specify)          
(a) Fuel Consumption (Tones per Day)
(b) Calorific value
(c) Ash content%
(d) Sulpher content%
(e) Others (Specify).
27. Details of stack
(a) Stack numbers 1 2 3  
(b) Attached to
(c) Fuel type
(d) Fuel quantity
(e) Material of Construction
(f) Shape (Round/Rectangular)
(g) Height in meters (above ground level)
(h) Diameter /size in meters
(i) Gas quantity, Nm3/hour
(j) Gas temperature C
(k) Exit Gas Velocity, Tones/sec
(l) Control equipment preceding the stack
(Attach Specification including residue management Systems ofeach of the Control equipment indicating the inlet/outletconcentration of relevant pollutants.

28. Do you adequate facility for collection of samples of emission in the form of portholes, platform, ladder etc. as per Central Board Publication "EMISSIONS regulations Part III'' (December, 1985).

29. Quality of treated flue gas emission and process emissions Specify concentration of criteria pollutants and industry/process specific pollutants stack wise. Enclose a copy of latest report of analysis from the approved/recognized laboratory by Haryana State Pollution Control Board/Central Government in the Ministry of Environment and Forest. For proposed units furnish the expected characteristics of the emissioin.

Part D – Hazardous Waste Aspects (for authorization under Hazardous Waste Rules) if not applicable write not applicable.

30. (a) Whether the unit is generating Hazardous Waste as defined in the Hazardous Waste (Management and Handling) Rules, 1989 as amended.

(b)If so, the Category No.

31. Authorization required for

(i)Collection
(ii)Reception
(iii)Treatment
(iv)Transport
(v)Storage
(vi)Disposal of the Hazardous Waste

32. Quantity of the Hazardous Waste generated (kilogram/day) or (tones/month).

33. Characteristics of the Hazardous Waste specify the concentration of the relevant pollutants Enclose the copy of latest report of analysis from the laboratory approved/recognized by Haryana State Pollution Control Board/Central Government in the Ministry of Environment and Forest. For proposed unit furnish expected characteristics.

34. Mode of Storage (intermediate/final) (describe area, location and methodology)

35. Present treatment of Hazardous Waste, if any, (give type and capacity of treatment units)

36. Quantity of Hazardous Waste disposed

(i)Within the factory
(ii)Outside the factory (specify location and enclose copies of agreement)
(iii)Through sale (Enclose documentary proof and copies of agreement)
(iv)Outside State/Union Territory. If yes particulars of (i) and (ii) above.
(v)Others (specify).

Part E – Additional Information

37. (a) Do you any proposals to upgrade the present system for treatment and disposal of effluent /emission and or Hazardous Waste.

(b)If yes give the detail with time-schedule for the implementation and approximate expenditure to be incurred on it.

38. Capital and Recurring (Operations and Maintenance) expenditure on various aspects of environment protection such as effluent emission HW solid waste tree plantation monitoring data acquisition etc.

39. To which the pollution control equipment separate meters for recording consumption of electric energy are installed?

40. Which of the pollution control items are connected to Diesel Generator set (captive power source) to ensure the running in the event of normal power failure?

41. Nature, quantity and method of disposal non- hazardous solid waste generated separately from the process of manufacture & waste treatment (give detail of area/capacity available in applicants land).

42. Hazardous chemicals are defined under the Manufacture, Storage and Import of Hazardous Chemicals Rules, 1989.

(a)List of Hazardous chemicals stores (imported and indigenous)
(b)Details of isolated storage.
(c)Details of emergency preparedness plans (On-site/Off-site prepared).

43. Brief details of tree plantation/green belt development within applicant's premises.

44. Information of schemes for waste minimization, source recovery and recycling implemented and to be implemented, separately.

45. Any other additional information that the applicant desires to give.

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

47. 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 manufacturing & treatment and /or disposal of effluent, emission, Hazardous waste etc. in quality & quantity; a fresh application for consent /authorization shall be made & until the grant of fresh consent/authorization no change shall be made.

48. I/We undertake to furnish any other information within 1 month of its being called by the Board/committee.

49. I/We agreed to submit to the board an application for renewal of consent/authorization in 2 months in advance before the date of expiry of the consent/authorization validity period.

50. I/We enclose herewith a demand draft for Rs. _________(______________rupees) drawn in favour of _________ Haryana State Pollution Control Board as the fee for consent/authorization.

Yours faithfully,Signature _____________________Name ________________________Designation ___________________Documents enclosed :

1. Demand draft or receipt of deposit in an authorized bank towards consent fee/authorization.

2. Undertaking or affidavit or statement from the annual report or certificate from the Chartered Accountant in support of gross fixed capital investments.

3. Site pan/location map (in cases No. Objection Certificate was not obtained earlier).

4. Declaration regarding the distance of unit from the bank of Main River and in respect of stone crusher, hot mix plant for distance from highways and habitations.

5. Layout plan showing the location of stacks (chimney), effluent treatment plant, effluent disposal areas, air pollution control devices, Hazardous Waste treatments and disposal areas.

6. Manufacturing process flow sheet, with descriptive note on the manufacturing process for each product.

7. Copies of latest consent/authorization/environment impact assessment clearance.

8. Copy of small -scale industries registration certificate, if applicable.

9. Copies of letter of indent/industrial licenses, clearances from the department or any other relevant document (Please state).

10. Copies of the planning permission certificate issued by the Municipal Corporation/ Directorates of Urban Development or Town and Country Planning/Haryana Urban Development Authority.

Note : - The documents at Serial No. 2-10 are necessary for first application. For applications for renewal only document at Serial No. 7 is necessary.]Form 'C'[See Rule 22(3)]Haryana State Board for the Prevention and Control of Water Pollution Notice for inspection
Chairman Member Secretary
Shri __________________________________________________No. _________________________Dated_________________________To____________________________________________________________________Take notice that for the purpose of enquiry under section 25/26 the following officers of the Board, namely :-
(i)Shri ___________________________
(ii)Shri ___________________________
(iii)Shri ___________________________
and the following persons authorized by the Board to assist them shall inspect the, (i) Shri ____________________ (ii) Shri ______________________ (iii) Shri _______________________
(a)Water works.
(b)Sewage works.
(c)Waste treatment plant.
(d)Factory.
(e)Disposal system.
(f)Any other parts thereof or pertaining thereto under management/control on date(s) _______________________ between _______________ hours when all facilities requested by them for such inspection should be made available to them on the site. Take notice that refusal or denial to above-stated demand made under the functions of the Board shall amount to obstruction punishable under Section 42 of the Act.
By order of the BoardMember SecretaryCopy to :-

1. __________________________

2. __________________________

3. __________________________

Form 'D'[See Rule 23(2)](to be submitted in duplicate)Appeal Against the order of the BoardUnder Section 28(3)__________

1. Name of the applicant.

2. Date of the order appealed against.

3. Date of the communication of the order.

4. Grounds of appeal.

5. Relief claimed in appeal.

6. The following documents are attached:-

(i)Certified copy of the order appealed against.
(ii)A receipt showing that the fees have been paid.
I certify that the facts stated above are true to the best of my knowledge and belief.Signature of applicantDated________________Form--E (Part-I)[See rule 24 (1)]Haryana State Board for the Prevention and Control of Water PollutionDetailed Budget Estimates for the year 19______Administration
  Actuals of last six months i.e. year   Actuals of last six months i.e. year            
Heads of Accounts 19 19 Sanctioned estimate for the current year 19 19 Actuals of six months of the current year 19 Received estimate for the current year 19 Budget estimate for the next year 19 Variations between columns 5 and 8 Variations between columns 8 and 9 Explanation for the columns 10 and 11
1 2 3 4 5 6 7 8 9 10 11 12
Form--E (Part-II)Haryana State Board for the Prevention and Control of Water PollutionEstablishmentStatement of details of provisions proposed for pay of officers / establishment for the year 19____
    Sanctioned pay of the post   Increment falling due within the year    
Name and designation Reference to page of estimates form Mini-Maxi-Actual pay of the person concerneddue on 1st April next year Amount provided for the year at the rate incolumn Date of increment Rate of increment Amount of increment for the year Total provisions for the year i.e. total ofcolumns 4 &5 (c) Remarks
    (a) (b) (c)   (a) (b) (c)    
Form--EPart-IIIHaryana State Board for the Prevention and Control of Water PollutionNominal Rolls
Name and designation Pay Dearness allowance City Com-pensatory allowance House Rent allowance Children Educational Allowance Leave or Travel concession Other allowance Total
1 2 3 4 5 6 7 8 9
                 
                 
                 
                 
                 
                 
                 
Total                
Form--EPart-IVHaryana State Board for the Prevention and Control of Water PollutionAbstract of Nominal Rolls
    Sanctioned Grant 19 Budget 19 Revised 19 Estimate 19 Budget 19 Estimate 19  
Actual sanctioned strength Particulars of Post No. of posts included Pay and Allowances No of Posts included Pay and allowances No. of posts included Pay and Allowances Explanation for the differences betweensanctioned Budget Grant, Revised Estimates and Budget Estimates
1 2 3 4 5 6 7 8 9
I. Officers-              
(a) Posts filled :              
(b) Posts vacant : ____________________________________________________________________    
Total -I Officers ___________________________________________________________________    
II. Establishment--              
(a) Posts filled :              
(b) Posts vacant : ___________________________________________________________________    
Total -II Establishment ___________________________________________________________________    
III. Class IV-              
(a) Posts filled :              
(b) Posts vacant : ___________________________________________________________________    
Total -III Class IV |  
Grand Total I,II,III ____________________________________________________________________    
Form 'F'[See rule 24 (3)]Budget and Account HeadsAdministrationHeads and Accounts (Expenditure)

1. Salaries

2. Wages

3. Travelling expenses

4. Office expenses-

(a)Furniture
(b)Postage
(c)Office Machines/Equipments
(d)Liveries
(e)Hot and Cold Weather charges
(f)Telephones
(g)Electricity and Water charges
(h)Stationery
(i)Printing
(j)Staff cars and other vehicles
(k)Other items

5. Fee and Honoraria

6. Payment for professional and special services

7. Rents, Rates and Taxes/Royality

8. Publications

9. Advertising, Sales and publicity expenses

10. Grants-in-aid/Contributions/ Subsidies

11. Hospitality Expenses /Sumptuary Allowances etc.

12. Pensions/Gratuities

13. Write off/Losses

14. Suspenses

15. Expenses in connection with the setting up and maintenance of the Board laboratory.

16. Other charges (A residuary head, this will also include rewards and prizes)

Head of Account (Receipts)

1. Payments by Haryana Government

2. Fees

3. Fines and other receipts.

Form 'G'[See rule 31]Haryana State Board for the Prevention and Control of Water PollutionAnnual Reports for the year __________

1. Introductory.

2. Constitution of the Board including changes therein.

3. Constitution of the Committee by the Board and meeting of the committee constituted by it.

4. Meetings of the Board.

5. Activities of the Board including the various functions performed under section 17 of the Act.

6. Prosecutions launched and convictions secured.

7. Finances and Accounts of the Board.

8. Visits to the Board by experts/important persons etc.

9. Any other important matter dealt with by the Board.

Form -H-I(See rule 32)Haryana State Board for the Prevention and Control of Water Pollution
Previsionsyear Receipts Previous year Payments
1 2 3 4
Opining Balance Rs. ________________   1. Capital Expenditure
1. Grants received____________________   (i) Works________________________
2. (a) From Govt. ____________________   (ii) Fixed Assest____________________
  (b) From other agencies_____________   (iii) other Assets ____________________
II. Fees   (a) Laboratory Equipment
      (b) Vehicle
      (c) Furniture and Fixtures
      (d) Scientific Instruments and office application
      (e) Tools and Plant
    2 Revenue Expenditure
III. Fines and Forfeitures (A) Administrative ___________________
      (i) Pay of officers _________________
IV. Interest on investment   (ii) Pay of Establishment ___________
      (iii) Allowances and Honoraria ______
V. Miscellaneous Receipts   (iv) Leave Salary and Pension Contribution
      ________________________________
VI. Miscellaneous Advances   (v) Contingent Expenditure
      ________________________________
      Deduct Recoveries _______________
      ________________________________
VII. Deposits __________________________ (B) (i) Board Laboratory
  Total_____________________________   (ii) Charges to be paid to the Central Water Laboratory.
    (C) Running and Maintenance of Vehicles
      ________________________________
    (D) Maintenance and Repairs
      (i) Building and Land Drainage including rents, if any________________________________
      (ii) Works _______________________
      (iii) Furniture and Fixtures _________________
      (iv) Scientific Instruments and office appliances
      ________________________________
      (v) Tools and Plants _______________
      (vi) Temporary works (including maintenance and repairs________________________________
    (E) Fees to consultants and specialists____
      ________________________________
    (F) Law charges _____________________
    (G) Miscellaneous ____________________
    (H) Fees for Audit ____________________
    3. Purchases _______________________
    4. Miscellaneous ____________________
    5. Advances _______________________
    6. Deposits _______________________
      Closing Balance ________________
      Total
Accounts Officer     Member Secretary
H-II(See Rule 32)Haryana State Board for the Prevention and Control of Water PollutionAnnual Statement of AccountsIncome and Expenditure Account for the year ended 31st March, 19________
Expenditure Income
Previous year Details Total of sub-head Total of Major Head Previous year Details Total of sub-head Total of Major Head
1 2 3 4 5 6 7 8
To _______________________________________ Rs. Rs.   Rs.   Rs.
Revenue Expenditure     By____________________________    
(A) Administrative :   (I) Grants Received      
  (i) Pay of officers :   (a) From Government      
  (ii) Pay of establishment :   (b) From Government      
  (iii) Allowance and Honoraria :   (c) From other agenciesLess :      
  (iv) Leave Salary and Pension Contribution :   Amount utilized for Capital expenditure      
  (v) Board's Contribution to the staff Provident Fund :   Net grant available for Revenue expenditure      
  (vi) Contingent expenditure :          
  Deduct-Recoveries -            
(B) Running expen. of Laboratory --     (II) Fees      
  (i) Main Laboratory     (III) Services Rental charges      
  (ii) Payment to be made to Central Water Laboratory            
(C) Running and Maintenance of vehicles :   (IV) Fines and forfeitures      
(D) Maintenance and Repairs :   (V) Interest on Investments      
  (i) Building and Land Drainag :          
  (ii) Works :          
  (iii) Furniture and Fixtures :          
  (iv) Scientific instruments and office appliances :          
  (v) Tools and Plant :   (VI) Miscellaneous Receipts      
(E) Temporary Works (including Maintenance and Repairs) :   (VII) Excess of expenditure over income      
(F) Fees to Consultants and Specialists :   Total      
(G) Law Charges :          
(H) Depreciation :          
  (i) Buildings :          
  (ii) Laboratory Equipment :          
  (iii) Vehicles :          
  (iv) Furniture and Fixtures :          
  (v) Scientific Instruments and Office Appliances :          
  (vi) Tools and Plant :          
 
(I) Miscellaneous :          
  (i) Write off of losses (as per details in the statementattached) :          
  (ii) Other miscellaneous expenditure :          
(J) Fees for Audit :          
(K) Excess of Income over expenditure :          
  Total :          
Accounts Officer   Member Secretary Chairman
Form -H-III(See Rule 32)Haryana State Board for the Prevention and Control of Water PollutionAnnual Statement of AccountsBalance Sheet as on 31st March, 19________
Capital and Liabilities Property and Assets
Previous year Details Total of sub-head Total of Major Head Previous year Details Total of sub-head Total of Major Head
1 2 3 4 5 6 7 8
A Capital Fund : 1. Works(As per Schedule A)    
  (i) Grants received from Government for Capital Expenditure     2. Fixed Assets(As per Schedule B)    
  (a) Amount utilized up to 31st March, 19 ________     (a) Value of land provided by Government (at cost)    
  (b) Utilised balance on 31st March, 19 ________     (b) Building __________    
  (ii) Grant from other agencies for Capital Expenditure     Balance as per last Balance SheetAdditions during the year ____________________    
  (a) Amount utilized up to 31st March, 19 ________        
  (b) Utilised balance on 31st March, 19 ________     Total __________________________________________    
  (iii) Value of land provided by Government (per contra)     Depreciation during the year_____________________Less-Total __________________________________________    
B Capital Receipts   3 Other Assets(As per Schedule (C)    
C (i) Deposits received for works from outside bodies -Deposits(ii) Other deposits     (a) Laboratory equipment as perlast Balance sheetAdditional during the year________________Total _______________Less Depreciation during the year____________Total ________________    
D Amounts due ----(i) Purchases(ii) Others     (b) Vehicles as per last BalanceSheetAdditional during the year_______________Total ________________Last Depreciation during theyear_____________Total ________________    
E Excess of income over expenditure -(i) Up to 31st March, 19 ____(ii) Add for the year or(iii) Deduct - Excess ofexpenditure over income        
        (c) Furniture and Fixturesas per last Balance SheetAdditional during theyear________________Total _______________Last Depreciation during the year____________Total ________________    
        (d) Scientific Instruments andoffice Appliance -as per last Balance SheetAdditional during theyear________________ Total_______________Last Depreciation during the year____________Total _______________    
        (e) Tools and Plantsas per last Balance SheetAdditional during the year _________________ Total_______________    
      4 Sundry Debtors--(i) Amounts due from outsidebodies for expenditure incurredExpenditure ---Less Amount received(ii) Other Sunday Debtors    
      5 Advances -(a) Miscellaneous Advances(b) Other amounts recoverable    
      6 Cash-(a) Notice/Short Term Deposits(b) Cash in Bank(c) Cash in Hand(d) Cash in transit    
Total : Total   ___________________
Accounts Officer Member Secretary Chairman
Form H-IV(See Rule 32)Haryana State Board for the Prevention and Control of Water PollutionAnnual Statement of Accounts(Schedule A showing the Expenditure on Works as on 31st March, 19 ___________________)(Item I _________________ Assets of the Balance Sheet)
    Upto 31st March, 19 _______ During the year 19 _______ Upto 31st March, 19 _______
Sr.No. Name of Works Direct Expenditure Overhead charges Total expenditure Direct Expenditure Overhead charges Total expenditure Direct Expenditure Overhead charges Total expenditure
Total                  
Accounts Officer     Member Secretary Chairman
Form H-V(See Rule 32)Haryana State Board for the Prevention and Control of Water PollutionAnnual Statement of Accounts
  Fixed Assets as at 31st March, 19 ______ (Item 2 Assets of the Balance Sheet)
  Other Assets as at 31st March, 19 ______ (Item 2 Assets of the Balance Sheet)
Sr.No. Particulars of Assets Balance as on 31st March, 19____ Additions during the year Total Depreciation during the year Sales or write off during the year Balance as on 31st March, 19 _____ Cumulative depreciation as at 31st March,19____
                 
  Accounts Officer   Member Secretary     Chairman
Form -I(See Rule 33)Report by the Government AnalystReport No. ____________________________Dated the ____________________________I, hereby certify that I, (I) ____________________________________________________Government Analyst duly appointed under sub-section (I) of section 53 of the Water (Prevention and Control of Pollution) Act, 1974 (6 of 1974) received on the (II) _____________________ day of __________________19________________from(III) ________________________________ a sample of _________________________________________________ for analysis. The sample was in a condition fit for analysis reported below:-I further certify that I have analysed the aforementioned sample on (IV) _____________________________and declare the result of the analysis to be as below:-
(V)_________________________________________________________________________________________ ___________________________________________________________________________________________ The condition of the seals, fastening and container on receipt was as follows:-
Signed this ______________________________________day of ______________________________19______
(Signature)Government Analyst
Address__________________________________________________________________________________________To_____________________________________________________________________________________________________________________________________________________________________________________
(I)Here write the full name of the Government Analyst.
(II)Here write the date of receipt of the sample.
(III)Here write the name of the Board or person or body of persons or officer from whom the sample was received.
(IV)Here write the date of analysis.
(V)Here write the details of the analysis and refer to the method of analysis. If the space is not adequate the details may be given on a separate sheet of paper.
Form 'J'(See Rule 36)Report by the Board AnalystReport No. ____________________________Dated the ____________________________I, hereby certify that I, (I) _________________________________________________________Board analyst duly appointed under sub-section (3) of section 53 of the Water (Prevention and Control of Pollution) Act, 1974 (6 of 1974) received on the (II) ___________________ day of _____________19________________from(III) ___________________________________ a sample of _______________________________________________ for analysis.I further certify that I have analysed the aforementioned sample on (IV) __________________________and declare the result of the analysis to be as follows:-
(V)________________________________________________________________________________________ ___________________________________________________________________________________________ The condition of the seals, fastening and container on receipt was as follows :-
__________________________________________________________________________________________________________________________________________________________________________________Signed this _______________________________day of ______________________________________19_____
(Signature)Board Analyst
Address__________________________________________________________________________________________To_____________________________________________________________________________________________________________________________________________________________________________________
(I)Here write the full name of the Board employee.
(II)Here write the date of receipt of the sample.
(III)Here write the name of the Board or person or body of persons or officer from whom the sample was received.
(IV)Here write the date of analysis.
(V)Here write the details of the analysis and refer to the method of analysis. If the space is not adequate the details may be given on a separate sheet of paper.
[Substituted by Notification No. S.O. 80/C.A. 6/1974/S. 64/2019, dated 20.11.2019 (w.e.f. 22.12.1978).]