Guidelines for according NoC/SOP/Application for disposal of discharge by industries

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Please Fill Up The Form
1.a) Organization Name*	:
b) Office Address*	:
c) Landline No*	:
d) Mobile No *	:
e) Email *	:
2.a) Location Mouza *	:
b) Block *	:
c) Police Station *	:
d) District *	:
e) Scanned copy of mouza map/Google Earth map *		Scanned copy of mouza map Google earth map
		(Scanned copy of Map ( PNG, JPG ) )
f) Ltitude,Longitude *	:
3.a) Name of the river / channel / canal *	:
b) Approximate length (in metre) * (From boundary of proposed unit to the river/channel/canal)	:
c) A4 size Index Map showing lay out of the proposed drain from the boundary of the proposed unit up to the river / channel/ canal to be uploaded in the upload documents section	:
4.a)Ultimate total quantum of discharge to be disposed considering future expansion of the unit (in cumec), including any one or all of the following	:	Treated effluent and domestic sewage discharge Run-off discharge within the premises of the unit
b) Total quantum of discharge to be disposed considering future expansion of the unit (in cumec)	:
5) Whether NoC / clearance from WBPCB certifying the quantum of discharge has been obtained	:	Yes No Attach scanned copies of consent to establish( PNG, JPG )
6)Existence of intake structures / outlet of field channels / offtake of branch canals for drawal of water within 500 metre in the upstream and 1000 metre in the down-stream of the proposed outfall point on rivers / channels / canals *	:	Yes No number of such structures and distance thereof from the proposed outfall point, in the upstream as well as downstream
		3F9L
*Enter Text as displayed in Image	:
I / We undertake to bear the cost of outfall structure and appurtenant bank protection and/or embankment improvement works to be designed and constructed by the Irrigation & Waterways Department and sign Agreement with the concerned field level Officers of the Department on payment of such cost.
I / We also undertake the responsibility of construction of drain / conduit from the premises of the unit up to the outfall structure, as per suggestion / guidance of the Irrigation & Waterways Department, so as to make it befitting with the outfall structure.
Note : 1 . DRAINAGE NOTIFICATION
		I undertake

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