Form 1

Consent Seeking Form

Application for Consent for Discharge / Continuation of Discharge u/s 25/26 of the Act
Name of Applicant
Address of Applicant

PRADEEP DANWANI
MS. SHAHI EXPORTS PVT. LTD.
E-10,SECTOR-11,NOIDA

1. Land Premises owned by

2. For period up to
3. Stream Name

SHAHI EPORTS PVT. LTD.

31ST. DEC. 2016
WATER

4. River Name

NA

5. On land for irrigation survey no.

NA

6. Adjoining / at a Distance

NA

7. Directly on land for open percolation into

sub Terrance on strata of survey no.

NA

8. Adjoining / at a distance of

NA

9. Solid Waste into

NA

Annexure to Form
1.
i) Full Name of applicant with address

PRADEEP DANWANI MS. SHAHI EXPORTS PVT. LTD.

ii) Telephone No.

9910441993

ii) Telegraphic Address

MS. SHAHI EXPORTS PVT. LTD.

i).Full name of land/ premises/ institute/

factory/ industry/ local body: with
address
ii) Telephone No.

MS. SHAHI EXPORTS PVT. LTD.E-10,SECTOR-11,NOIDAGAU

2.

9910441993

ii) Telegraphic Address

MS. SHAHI EXPORTS PVT. LTD.
3. Give revenue/ city surrey number of land / premises
for which the applicant is made stating District, Tehsil,
Pargana and Village
i) District
ii) Tehsil
iii) Pargana
iv) Village
v) City Survey No. Mauza / House No.
vi) Area in Hectare
vii) Revenue Survey No.
viii)Area in Hectare

GAUTAM BUDH NAGAR U.P.

GAUTAM BUDH NAGAR U.P.
N.A.
N.A.
.
.
.
.

4. State Month and year in which the land/ premises /

institute / factory / industry was actually put into
commission or the month and year from which the local
body in functioning

1995

5. State the Civil / Military / Defense/ Industrial

Estate etc.,under whose administrative
jurisdiction the applicants land / premises is
situated
i) Collectorate
ii) Municipality / Improvement Trust
iii) Village Panchayat
iv) Cantonment
v) Department
vi) Defense
vii) Prohibited Area

N.A.
NOIDA
N.A.
N.A.
NA.
N.A.
NO

6. a) State whether the land/ premises / Institute/

factory / Industry has been declared as
prohibited area

NO

b) If yes, state the name of the authority and

furnish a certified copy of the order under
which the areas has been declared as prohibited

N.A

7. Is the Industry / Factory for which application is

made closed on Sunday / Holiday

YES

8. State working seasons per year for the Industry / factory

Full Year

01/01/2014

To

12/31/2014

From

.//.///./.

To

.//.///./.

From

.//.///./.

To

.//.///./.

From

.//.///./.

To

.//.///./.

From

.//.///./.

To

.//.///./.

Every Year
9.

a) Number of workers attending the factory Shiftwise

b) Number of workers residing in the premises

1200
N.A.

10. For Local Bodies only

a) Present Population
b) Population covered under regular sewer facilities
c) Population having septic tank / pit privg facilities
d) Population covered by conservancy latrines

N.A.
N.A.
N.A.
N.A.

11. For Industries Only

a) Give the list of raw materials such as metals, alloys,
chemicals, oils, fuels, etc., used per month in Notice
Metric Tons

1.FABRIC
2.THREAD
3.BUTTON
Name

Weight

i) Metal Alloys

N.A.

N.A.

ii) Chemical Inorganic Dyes

N.A.

N.A.

iii) Organic Pesticides

N.A.

N.A.

iv) Oils and Greases

N.A.

N.A.

a) Wood

N.A.

N.A.

b) Coal

N.A.

N.A.

c) Oil

HSD

12000 LTR.

d) Gases

N.A.

e) Other

N.A.

N.A.
N.A.

v) Fuels

b) Give the list of names of products and bye products manufactured per month (MT)
No.

Name of Products

Qty. in MT per month

225000

GARMENTS

28

N.A.

N.A.

N.A.

N.A.

N.A.

N.A.

N.A.

N.A.

N.A.

N.A.

N.A.

N.A.

N.A.

N.A.

N.A.

N.A.

N.A.

N.A.

c) Give the list of possible intermediate products

50 KL

12. State daily quantity of water in liters used

i) Domestic

25 KL

ii) Industrial

N.A.

iii) Agricultural

25 KL

iv) Other

50 KL

13. a) State the hourly maximum and daily quantity of effluents arising from land / premises of which the
application is made
Uses

Hourly Max.

Daily Max

Domestic

.625 KL

5 KL

Industrial

3.125 KL

25 KL

Agricultural

N.A.

N.A.

Other

2.5 KL

20 KJL

Total Qty. of Effluent

6.25

50 KL

b) State how measurement of rate and quantity are carried out

N.A.

14. State whether storm water drains are kept separate from
Industrial / Domestic Effluents?

YES

15. a) Is domestic effluent allowed to get mixed in industrial effluents?

NO

b) If yes, state ratio

16. a) Describe if any treatment industrial or domestic effluent or one for
combined effluent is made. If yes, state the process of treatment
in brief (separately)
b) Is the quantity of effluent emanating either without or after
treatment approved by the authority?
c) If approved, furnish the authority (Two certified copies to be
sent)
d) If any effluent from any shop/ shops toxic? If so volume of this
effluent

N.A.
ETP INSTALLED

NO

NO
NO

17. Is there any provision for disposal of?

a) Domestic effluent in public underground sewer.

YES

b) Industrial Effluent in Public Underground

NO

c) Give the name public authority owning the sewer.

NOIDA AUTHORITY

18. Is there any provision for disposal of

a)
b)
c)
d)

Domestic effluent overload for irrigation

Industrial effluent overload ground strata
Domest effluent in the under for irrigation
State the area of land used for
i) Above in Hectares
e) State the area of land used for
i) Above in Hectares

NO
NO
NO
N.A.
N.A.

19. Give the quantitative disposal of effluent in liters provided for the
places mentioned below
a)
b)
c)
d)

Stream / River
On lands for irrigation
On land for precolation
Lake/Pond

45 KL
N.A.
N.A.
N.A.

20. Is there any provision for equalizing or made holding lagoons of

tanks
N.A.

i) Domestic Effluent
ii) Industrial Effluent
iii) Combined Effluent

N.A.
N.A.

21. Is sufficient land available / can be made available? In case pumping

effluent: on lands have to considered.

NO

22. a) Give details of composition of Domestic / Industrial / Combined effluent in respect of the Following
Effluent before treatment

Effluent after treatment

i)

pH

6.73

7.19

ii)

Colour Unit oC

iii)

Temperature oC

N.A.

iv)

Suspended Solids

140

62.0 mg/L

a) Total mg/1

b) Fix mg/1

c) Volatile mg/1

Dissolved Solids

1602.0

1350.0 mg/L

a) Total mg/1

b) Fix mg/1

c) Volatile mg/1

vi)

Total Volatile Solids mg

vii)

Ammonical Nitrogen (m

viii)

Nitrate (mg/1)n

ix)

Dissolved Oxygen mg/1

x)

B.O.D. 5 days 20* mg/1

215.0

21.0

xi)

C.O.D. mg/1

630.0

90.6

xii)

Oil and Greases mg/1

10.0

4.0

xiii)

Chloride mg/1 as [Cl]

xiv)

Phosphates [P] mg/1

xv)

Phenolic compounds
mg/1 [as] Phenol

xvi)

Cyandes (as CN mg/1)

xvii)

Sulphate [as SO4]

mg/1

xviii)

Sulphides only [as S]

mg/1

xix)

Insecticides mg/1

Total residual chlorine

[as C2mg/1]

xxi)

Fluoride [as F] mg/1

xxii)

Bon [as B] mg/1

xxiii)

Arsenic [as As] mg/1

xxiv)

Barium [as Ba] mg/1

xxv)

Percent Sodium

xxvi)

Cadmium [as Cd] mg/1

v)

xx)

xxvii)

Copper [as Cu] mg/1

xxviii

Lead [as Pb] mg/1

xxix)

Chromium [as Cr.] mg/1

xxx)

Mercury [as Hg] mg/1

xxxi)

Nickel [as Ni] mg/1

xxxii)

Selenium [as Se] mg/1

xxxiii)

Silver [as Ag] mg/1

.
.

xxxiv)

Zinc [as Zn] mg/1

xxxv)

Any other metals mg/1

xxxvi)

Carbon Chloroform Extrac

xxxvii)

Pesticides mg/1

xxxviii

Coliform Organisms

xxxix)

MPN per 100 mg (monthl

xxxx)

Bioassay for Toxic constitu

1. Furnish a copy of the analysis report of representative samples carried out by a competent laboratory
2. Methods of determination as approved by the Board will be followed for determination of above
mentioned parameters.
b) Is the effluent toxic

NO

c) State if the Industrial effluent is having

i)
ii)
iii)
iv)

Unpleasant Smell
Irritating and / or harmful
Corrosive
With odour

NO
NO
NO
PLEASANT

d) Is there any hidden change of temperature

exceeding 10*c at any time

NO

23. a) Are facilities available with the applicant for carrying out the following test of the waste waters
Existing

Proposed

i) Physical

YES

NO

ii) Chemical

YES

NO

iii) Bacteriological

NO

YES

iv) Toxicological

NO

YES

b) If yes, give details of equipments

1.PH PAPER

24. Has the land/premises, etc., for which the application is made open?

25.

a) Cooling Tank

N.A.

b) Mixing Tank

N.A.

c) Mixing Pond

N.A.

d) Re-circulating wells

N.A.

NO

State details for solid waste

Des.

Qty.

Method of Selection

Method of Disposal

Season Waste

N.A.

N.A.

N.A.

N.A.

Spillage

N.A.

N.A.

N.A.

N.A.

Rejected Materials

N.A.

N.A.

N.A.

N.A.

26.

Total Investment of plant

4,47,53,910.00

Date:
Place:
Note: Any applicant knowingly giving incorrect information or suppressing any information pertaining there to shall be liable to
be punishable under the ACT.