Rajasthan State Pollution Control Board

Environmental Guidance Manual Sector: Brick Kilns

Prepared by

Zero Draft

Administrative Staff College of India

Hyderabad

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ENVIRONMENTAL GUIDANCE MANUAL SECTOR: BRICK KILNS

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Contents
Chapter No. Title
Foreword Acknowledgements Project Team List of Tables List of Annexures About the Manual Chapter 1 Introduction 1.0 About Rajasthan State Pollution Control Board 1.1 About the Industrial Activity 1.2 Typical Sizes of Brick Kilns 1.3 Material Balance in Brick Kilns 1.4 Energy Balance in Brick Kilns 1.5 Sources of pollution in Brick Kiln activity Important Definitions of the Environmental Acts 2.0 Important Definitions Environmental Acts and Legal Requirements 3.0 Requirements Under the Provisions of the Water (P & CP) Act 1974 as Amended 3.1 Requirements Under the Provisions of the Air (P & CP) Act 1981 as Amended 3.2 Requirements of Ground Water Extraction 3.3 Requirements Under the Provisions of the Hazardous Waste (MH &TM) Rules 2008 3.4 Restriction of Certain Activities in Specified Area of Aravalli Range 3.5 Mount Abu Eco-Sensitive Zone Statutory Clearance Process 4.0 Consent To Establish (CTE) 4.1 Consent To Operate (CTO) 4.2 Hazardous Waste Authorization 4.3 Water Cess Assessment Environmental Aspects and Guidance 5.0 Environmental Aspects 5.1 Pollution Prevention and Control Options 5.2 Environmental Norms 5.3 Guidelines in respect of establishment of Brick Clamp units issued by Govt. Of AP Checklist 6.0 Environmental Checklist Annexures

Page No.
(To be given later) (To be given later) v vi vi vii 1 2 8 8 10 11 13 15 15 16 16 16 18 21 26 27 27 28 29 30 30

Chapter 2 Chapter 3

Chapter 4

Chapter 5

Chapter 6

31 36-66

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ii

Foreword (To be given by RSPCB)

iii

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Acknowledgements (To be given by ASCI)

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Project Team
Project Coordination Dr. Deep Narayan Pandey Rajasthan State Pollution Control Member Secretary Board Mr. Anand Lal Mathur Chief Environmental Engineer Core Group - RSPCB Mr. A.K.Puri, Sr.E.E Mr. V.K. Singhal, Sr.E.E Mr. R.K.Gaur, Supdt.S.O Mr. Pradeep Agarwal, In charge Mines, Mr. Manoj Agarwal, L.O Mr. Mahesh Rastogi, E.E

Project Team Prof. V.S. Chary ASCI Director, Centre for Energy, Environment Urban Governance, and Infrastructure Development, Mr. V.R.M.Rao Consultant Ms. N. Pavani Research Associate Mr. G. Bala Subramanyam Advisor, Environment Area Project Leader

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Tables
Tables No. Table No. 1.4 Table No. 1.5 Title Avg. Energy Balance Sheet of Brick Kilns Typical Stack emissions from Brick Kilns Page No. 10 11

Annexures
Annexure No. Annexure No. 1 Annexure No. 2 Annexure No.3 Annexure No.4 Annexure No.5 Annexure No.6 Annexure No.7 Annexure No.8 Annexure No.9 Annexure No.10 Annexure No.11 Annexure No.12 Title Common Application for CTE under Air Act & Water Act Proforma of Affidavit for CTE/CTO Affidavit Consent Fee Under the Provisions of Air Act Consent Fee Under the Provisions of Water Act Areas as Identified by CGWA as- Safe Areas, Semi-Critical Areas, Critical Areas & Over Exploited Areas National Ambient Air Quality Standards Common Application for CTO under Air Act & Water Act And Authorization under HW Rules Emission Standards for Brick Kilns Noise Ambient Air Quality Standards Noise Limits for Generator Sets run with Diesel Format for Environmental Statement Format for Filing Annual Returns by the Occupier or Operator Facility Page No. 36 42 44 45 46 49 51 58 60 61 63 66

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About the Manual

The purpose of developing sector specific guidance manual for Brick Kilns is to provide clear and concise information to all the stakeholders i.e. project proponent, environmental consultant, Rajasthan State Pollution Control Board officials and the public to have a better understanding on the relevant environmental aspects in the initial stage itself. This manual covers the legal requirements, clearance process, environmental standards and maintenance of statutory records. The manual will also covers the environmental concerns related Brick Kilns. The project proponent may use this manual to ensure that all the aspects of the environment due to the project are addressed and adequate mitigation measures are planned in the environmental management plan and he will be fully aware of the environmental process and requirements. The consultants will have similar understanding of the sector and the procedures involved, so that the quality EMP reports will be improved. The reviewers across the Board may have same understanding about the sector and helps them in the process of review and appraisal. Public who are concerned about Brick Kilns, will have information about the environmental aspects, standards, regulatory requirements etc., and have a better understanding about the Brick Kilns industry. The preparation of sector specific guidance manual by Rajasthan State Pollution Control Board is in line with National Environmental Policy 2006, which emphasizes on: Formulate and periodically update, codes of good practices for environment for different category of industries Ensure faster decision making with greater transparency and access to information, together with necessary capacity building

The manual is meant to serve as a guidance purpose. In case of interpretation of any question related to law, the provisions of the original law and the rules made thereunder with various government directions/resolutions will have to be read and followed. In case of amendment to the original Act/Rules/Notifications made thereunder, the provisions as amended from time to time shall be applicable.

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CHAPTER 1 Introduction
1.0 About Rajasthan State Pollution Control Board
The Rajasthan State Pollution Control Board (RSPCB) is a statutory authority entrusted to implement environmental laws & rules within the jurisdiction of the State of Rajasthan. The Board ensures proper implementation of the statues, judicial and legislative pronouncements related to environmental protection within the state. The Board was established in the year 1975 under the provisions of Water (Prevention & Control of Pollution) Act 1974. Over the years, RSPCB was entrusted with various responsibilities under different enactments made. Currently RSPCB is responsible completely or partially for the implementation of following Acts and rules: The Water (Prevention & Control of Pollution) Act, 1974 and Rules made there off The Air (Prevention & Control of Pollution) Act, 1981 and Rules made there off The Water (Prevention & Control of Pollution) Cess Act 1976 and Rules made there off The Public Liability Insurance Act, 1991 and Rules made there off The Environmental Protection Act, 1986 and Rules made there off Hazardous Wastes (Management, Handling & Transboundary Movement) Rules 2008 Manufacture, Storage and Import of Hazardous Chemical Rules, 1989 as amended Municipal Solid Waste (Management and Handling) Rules, 2000 Bio Medical Waste (Management and Handling) Rules, 1998 as amended Ozone Depleting Substances (Regulation) Rules, 2000 The Batteries (Management and Handling) Rules, 2001 Fly Ash Notification as amended S.0. 2804(E) dated 3rd November 2009 Environmental Impact Assessment Notification, 2006 as amended 1st December 2009 The Chemical Accidents (Emergency Planning, Preparedness and Response) Rules, 1996 The Recycled plastic (Manufacture and Usage) Rules, 1999 as amended The Manufacture, Use, Import, Export and Storage of Hazardous Micro Organisms, Genetically Engineered Organism or Cells Rules, 1989 Notification No. S.O. 319 (E) dated 7th May 1992 (Restricting certain activities in special specified area of Aravalli Range) Notification No. S.O. 1545 (E) dated 25th June 2009 declaring Mount Abu Eco Sensitive Zone The Noise Pollution (Regulation and Control) Rules, 2000

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1.1 About the Industrial Activity Fire clay bricks are produced in India in small or cottage scale brick kilns and Clamps, operates seasonally. The raw materials in the brick kilns include topsoil, coal, paddy husk, fly ash, wood & locally available agro wastes to some extent. There are large variations in quality of soils available in different parts of the country and also in brick manufacturing process. The Physicochemical properties of typical clay and fired bricks are as follows Physico-chemical properties of clays Particulars Value Clay (%) (< 2 ) 16 - 25 Silt (%) (2 20 ) 18 25 Sand (%) (> 20 ) 51 65 Organic matter (%) 0.08 0.15 H 7.3 7.6 P Properties of Fired Clay Bricks Particulars Value 2) Comprehensive strength (Kg/cm 120 175 Water absorption (%) 12 - 16 Source: COINDS/16/1995-96, CPCB Based on the manufacturing process and operational process, brick kilns are categorized basically as follows: 1. Intermittent Kilns 2. Continuous Kilns Intermittent Kilns Intermittent kilns are those kilns in which green bricks are set, fired, cooled and then taken out of the kiln and either stocked or delivered. The process is then repeated with another change of green bricks. Intermittent kilns are very adaptable to changing market demands but not fuelefficient. These include clamps and down draught Kilns. Clamp Brick Kilns Clamp brick kilns are most primitive type of brick kilns since no permanent kiln structure is built. It consists of essentially a pile of green bricks inter spread with combustibles material. Normally, the clay from which the bricks are moulded also includes fuel material. The capacity of the clamp varies from 25,000 to 500,000 bricks. A flat dry area of land is first chosen and checkwork pattern of spread out, already burnt bricks were laid down in a desired length. Fuel in the form of cinder, coke or small pieces of coal is then spread between the check work bricks, covering the latter with a layer at least 20 cm thick. Dry green bricks are next closed - laid on edge upon this fuel bed. The height of the clamp is generally made up of approximately 20 to 30 layers of bricks. A thin layer of fuel is inter spread after every second layer of bricks, if the bricks dont contain fuel in the body. Its sides are sloped for stability. Three or four holes at the base of one of the clamp walls are provided in order to allow the initial ignition of the fuel bed.

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Two courses of already fired bricks are next laid on top of the green bricks for insulation purposes. Once a desired length of the clamp has been built up, the fuel bed may be ignited with wood stuffed into the fire holes of the clamp. The latter are bricked up with loosely placed burnt bricks once the flue bed is alight. As the fire advances, more green bricks are built into clamp. During burning, the heat rises through the bricks above and smoke leaves from the top of the clamp. The rate of burning is not controlled and depends on wind strength and direction. Once the fire has passed through a particular point, the bricks start to cool. They may be unloaded and sold. Fuel consumption in clamps is very high and at the same time the firing of bricks is not uniform. Down Draught Kiln These are used not only for firing facing bricks but also roofing tiles, glazed tiles and refractory goods. These kilns may be either circular or rectangular with fire holes in the circular walls or in the two sidewalls. In these kilns the combustion gases from fire hole rise from behind the bag walls into the crown of the kiln and then descend through setting of bricks/ tiles to the openings in the kiln floor through which they pass into flues and then to the chimney. The size of the kilns varies considerably, capacities ranging from 10,000 to 100,000 bricks. Fuel consumption depends upon largely upon the conditions of the kiln, the manner of setting the bricks and the control of firing process. The loss of heat varies from one type of kiln to another. These kilns are comparatively much more efficient than the clamps. Continuous Kilns Continuous kilns are those in which firing is done continuously, green bricks being put into one part of the kiln and fired bricks withdrawn from the another end. Fuel is fed regularly at a more or less constant rate. Continuous kilns utilize heat from cooling bricks to preheat green bricks and combustion air. Consequently continuous kilns are economical from fuel point of view. The continuous group of kiln includes Bulls Trench, Fixed Chimney, High Draught, Hoffman and Tunnel Kilns. Bulls Trench Kiln (BTK) The kiln consists of two parallel trenches connected at the end in semi-circles to form an elliptical shape. The kiln can be round also. Each trench is generally about 8 m wide 2.25 m deep and is sunk below the ground level to half of its depth. The effective burning length is about 15 m. and such a kiln has an output of 500,000 to 600,000 bricks per circuit, which takes about 25 to 30 days to complete burning. Various operations in BTK are depicted as follows: Bituminous slack coal is the usual fuel used in this type of kiln. In this kiln, bricks are arranged in columns leaving 10 cm space between the columns to provide passage for circulation of hot gases and cooling air. A row of 25 columns constitutes a blade and a space of one brick length is left between successive blades to provide space of for the combustion of fuel. This space is spanned by bricks at certain heights to provide stepwise platforms which help in preventing the whole of the fuel charged through a feedhole from dropping on the kiln floor and forming a large heap.

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The feedholes are covered by mild steel sheet caps. Draught is provided by a pair of lightweight sheet iron chimneys each about 10 to 12 m high. The chimneys are positioned over open feedholes on the top of the brick setting and are shifted periodically as the fire travels forward. At a certain distance behind the chimneys, cross dampers are fixed across the setting to seal the air passage and to separate the firing and the loading sections. While starting the fire, a temporary cross wall, with furnace at the foot, is constructed at a distance of 25 cm from the row of bricks. Initial firing is started by burning wood in the furnaces. Firing at the furnaces is continued till the first row of bricks is brought up to red heat and there is good bottom heat in the furnaces beyond the first row. Top feeding of fuel is then started. 0.5 to 1.0 kg of coal being charged per feedhole every 15-20 minutes, and the charge is gradually raised when sufficient temperature at the bottom is attained. There are no adjustable dampers to regulate the draught. The distance maintained between the firing zone and the chimney is of importance. In the initial sages a distance of 7 m is maintained. When the kiln is brought up to full firing order and an adequate draught is established, the chimneys are shifted further along the kiln to maintain a distance of 15 to 20 m between the chimneys and the fire. Firing is started in the straight portion of the trench and when the fire has traveled round the semi-circular end, drawing of bricks from the cool end is commenced. Setting, firing and unloading of bricks are then carried out simultaneously. A variation of the bulls kilns is, whether the chimneys move on the inner and the outer walls of the kiln. A fuel opening is made at the bottom of the wall and the flue hole runs through the wall up to top. The chimneys are placed at the flue openings at the top of the walls and are moved from one hole to the other on rails. All the operations of the kiln are exactly like bulls kiln. Fixed Chimney Kiln Fixed chimney kiln is combination of Bulls and Hoffman kilns. The operative practices of the kiln are similar to Bulls kiln, but the chimney and draught control is on the pattern of Hoffman kiln. The moving steel chimneys have been replaced by a fixed tall masonry chimney generally located at the center of the kiln. The chimney in turn is connected to the trench through a system of flues, which open in the inner wall. A cavity is left over the flue passing wide enough to allow a man to reach the flue opening leading to the trench and open or close it as required. The height of the masonry chimney is between 20 and 35 m depending upon the capacity of the kiln. Generally they are known as high capacity kilns holding 8 to 10 lacs bricks per circuit. All the operations of the kiln including loading, firing and unloading remain unchanged from the Bulls kiln.

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Hoffman Kiln Hoffman kiln is generally used for firing roofing tiles. The kiln was developed in Germany in 1858. The early kilns of these type too the form of great circular ring-chamber with massive walls with a chimney at the center to which 12 underground radial flues converged from the inside wall of the chamber. The chamber was barrel arched like a railway tunnel and in the chamber. The chamber was arched like a railway tunnel and in the arch were small feedholes through which the coal could be fed into the setting. Twelve wickets were arranged for setting and drawing the bricks, in the outer wall of the chamber alternating with the flues. The annular chamber was thus divided in effect into 12 compartments defined by the wickets and flues leading from them. Once the kiln was lit, it was not allowed to cool out and the sequence of operations is continuous and when the kiln was in full operation two wickets would be probably be open and the other ten brick up. Latter to give increased length, the kiln was changed to an elliptical form with main flue in the center wall connected direct to the chimney at its center. Also, an extra flue was added so that hot air could be transferred from the cooling zone of the kiln to chambers containing freshly set bricks to dry them CBRI High Draught Kiln High draught kiln is basically an archless, top feed, coal fired continuous kiln in which the fire follows a zigzag path. The main flue is located running parallel to the two sidewalls and the two flues join together at the head of the kiln. The main flue is connected to the galleries through 16 chamber flues opening into the outer walls of the kiln. A cast iron cap damper is placed on each flue opening, which can be lowered or raised from the top of the wall through a nut and collar arrangement. The main flue is connected to a short masonry chimney to exhaust the flue gases at a convenient height. Two additional plate dampers are provided in the main flue just before the fan to secure further control on the draught. For loading and unloading bricks 12 wickets of 1.5 m wide are provided in the outer walls of the kiln. The kiln is covered by a shed. The setting is space is divided into 32 chambers by constructing temporary partition walls with unfired bricks. Each partition walls runs along the whole cross section of the gallery except at one end where space is left for communication between adjacent chambers. Bricks in these walls are thoroughly burnt and are removed at the time of loading the bricks. The pattern of brick setting adopted in the kiln is more or less similar to Hoffman kiln but the firing platforms for burning of coal at different levels of the kiln are taken from the Bulls kiln. Spaces are left between the settings to permit coal being fed from top. The top of the setting is sealed with compact layer of ash, leaving out feed holds for charging coal. The feedholes are fitted with portable cast iron feed pots, which are closed with cast iron lids. Method of initiation of fire in the kiln is similar to the Bulls kiln. Damper nearest to the fire is opened and a small draught is maintained by partially lowering the damper plate in the main flue. When the bricks in the first blade are red hot, the top feeding of coal is started. Both the top and bottom firing is continued till fire reaches the end of the second chamber. As the fire advances, next chamber is opened and the previous one closed. To achieve optimum efficiency of the kiln, a firing rate of two chambers a day is maintained.

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Manufacturing Process of Brick Kilns by Manual Operation

Water Manual Digging

Clay

Weathering + Kneeding

Hand Moulding

Open Drying

Coal
Transporting to kilns Coal crushing

Setting of bricks in kiln & firing

Coal

Stockyard

Unloading & sorting

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Manufacturing of Bricks by Semi-Mechanized Process

Water

Water

Manual Digging Clay Pit

Weathering Heap

Box Feeder

Brick M/C

Solid waste Fugitive emissions ash laying on top of the kiln

Ash Blown By Wind

Crushed Coal

H.D. Kiln

Drying Shed

Cutting Table

Transport Wheel Barrows

Coal Crusher

Unloading Sorting

Stock Yard

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1.2 Typical Sizes of Brick Kilns S. No 1. 2. 3. Size Small Medium Large Kiln capacity Less than 15,000 bricks per day (less than 4.5 m trench width) 15,000 30,000 bricks per day (4.5 7 m trench width) More than 30,000 bricks per day (more than 7.0 m width)

Source: COINDS/16/1995-96, CPCB

The energy consumption in various types of kilns and range of firing temperatures maintained in them are tabulated below: Energy Firing consumption Temperature (MJ/T of bricks) (0C) 1. Clamp 5000 6000 750 800 2. Bulls kiln 1200 1700 950 1000 3. Fixed chimney kiln 1000 1300 950 1000 4. High draught kiln 850 900 950 1000 5. Down draught kiln 3000 4000 850 950 + 6. Hoffman kiln 1000 2000 850 1050 Note: Calorific value of the coal has been assumed to be 5000 k. cal/kg for the purpose of calculations +Waste heat from the cooling zone is also used for drying of bricks Source: COINDS/16/1995-96, CPCB 1.3 Material Balance in Brick Kilns Requirement of water for the formation of bricks depends upon the nature of clay. The more plastic the clay, the more water is required to make it workable. Normally the water requirement varies between 28 to 35%. Typical material balance for manufacture of 1,000 bricks is shown below: S. No Type of kiln

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1000 kg water

3000 Kg Soil
Moulding & drying of bricks

2940 Kg dry bricks (980 No.s)

1000 kg water Evaporated during drying

60 kg of broken bricks Reused for brick manufacturing

Stocking of kutcha bricks

Coal

1000 kg water

6000 Kg air

150 Kg unburnt brick rejects

2640 Kg burn bricks (930 No.s)

50 Kg coal ash

6260 Kg flue gas

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1.4 Energy balance in brick kilns Bulls kiln operating on movable chimneys, due to its inherent design parameters and operating practices show poor thermal performance and require more energy input. On an average requirement of thermal energy input in fixed chimney and high draught kiln is less by 15% and 25% respectively as compared to bulls kiln. The energy balance sheet indicates that heavy sources of heat losses in kilns are (i) sensible heat in waste flue gas/ excess air, (ii) heat losses the kiln structure through radiation and convection, (iii) potential heat loss due to improper combustion of coal leading to the formation of carbon monoxide. Sensible heat losses through waste flue gases/ excess air depend upon its quantity and temperature. There losses are maximum in bulls kiln with moving chimneys are waste flue gas temperature in this type of kiln is higher i.e. up to 2500C as compared to fixed chimneys high draught kiln. Working draught in movable chimney kiln is comparatively low (3 to 4 mm WG) whereas in fixed chimney kiln it is 6-8 mm WG. Low draught affects the combustion of fuel and reduces rate of fire travel. These parameters ultimately increase potential heat loss due to formation of CO. Heat losses through radiation/ convection from the kiln structure are enhanced because of low rate of fire travel. Table: 1.4 Average energy balance sheet of brick kilns K. Cal Parameter Bulls kiln Fixed High draught chimney kiln kiln Heat input 1. Coal/ fuel consumed 275,000 225,000 200,000 2. Organic carbon present in 5,000 5,000 5,000 clay 3. Total 280,000 230,000 205,000 Heat output 4. Total heat of water vapor 5. Mechanically combined water 25,000 25,000 25,000 in clay 6. Chemically combined water 20,000 20,000 20,000 in clay 7. Moisture in coal and 10,000 8,500 7,200 combustion of H2 in coal 8. Decomposition of carbonates 6,000 6,000 6,000 present in clay 9. Through flue gas 60,000 48,000 38,000 Potential heat loss 10. In ash 2,500 2,200 2,000 11. Due to CO 16,000 10,000 7,500 12. Other heat losses* 140,500 110,300 99,300 13. Total 280,000 230,000 205,000 *Heat losses from kiln walls, top etc through radiation, convection. Source: COINDS/16/1995-96, CPCB S. No

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The bricks at the top of the kiln are closely set and layer of ash 10-15 cm thick is spread to seal it to the atmosphere and also for the thermal insulation. The ash does not provide adequate thermal insulation hence maximum thermal energy (about 50% of the input) is thus wasted through radiation and convection from the kiln top and walls. 1.5 Sources of Pollution in Brick Kiln Activity Air pollution Stack emissions though are not excessive but significant. Use of thermally low efficient kilns and poor grade coal result in particulate and gaseous emissions. Brick kiln emissions consists of mainly coal fines and dust particles. The fugitive dust emissions are mostly siliceous except for coal crushers where there are coal fines. Crushing of coal, if any through jaw crushers also releases fine coal powder. Table 1.5 The typical stack emissions from brick kilns are tabulated below for reference use: Parameter Bulls trench Kiln Fixed chimney

High draught* 75 100 12 15 10000 12000

Flue gas Temperature (0C) 100 200 80 120 Velocity (m/s) 5-7 8 10 Exhaust (m3/hr) 5500 7000 7000 9000 Emissions Dust (mg/Nm3) Coal feeding period 1721 558 Non feeding point 602 219 SO2 (mg/Nm3) 0.26 0.29 NOX (mg/Nm3) 0.08 0.11 Hydrocarbons (mg/Nm3) 275 216 Co (%) 0.33 0.3 CO2 (%) 3.3 2.7 *Kiln operations as per traditional bulls trench kiln Source: COINDS/16/1995-96, CPCB Solid waste generation

853 354 1.12 0.2 227 0.3 3.0

Coal ash is the main solid waste generated in brick kilns. Its quantity depends upon the amount of coal/ other fuel used and their ash content. The amount of ash generated is about 1 1.5 tonnes per day which goes on accumulating on or around the brick kilns. In addition, over burnt and broken bricks also constitute a substantial amount of waste and are piled up near the stockyard.

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Water pollution Not much water is used in the manufacture of bricks except for preparation of soil for moulding into bricks. No excess water is used which could be released after moulding of bricks. Water in green bricks evaporated mostly during drying and remaining water is lost during brick burning. No wastewater is released during moulding or any other operations during brick manufacture. Noise pollution Manual production of bricks as well as firing is not accompanied by any appreciable noise generation. It is only in the semi-mechanized production of bricks that substantial noise is generated.

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CHAPTER 2
CHAPTER 2 Important Definitions of the Environmental Acts
2.0 Important Definitions The Water (Prevention & Control of Pollution) Act, 1974 Key word Definition Occupier In relation to any factory or premises, means the person who has control over the affairs of the factory or the premises, and includes, in relation to any substance, the person in possession of the substance Outlet Any conduit pipe or channel, open or closed, carrying sewage or trade effluent or any other holding arrangement which causes or is likely to cause pollution Pollution Contamination of water or such alteration of the physical, chemical or biological properties of water or such discharge of any sewage or trade effluent or of any other liquid, gaseous or solid substance into water (whether directly or indirectly) as may, or is likely to, create a nuisance or render such water harmful or injurious to public health or safety, or to domestic, commercial, industrial, agricultural or other legitimate uses, or to the life and health of animals or plants or of aquatic organisms Sewage Effluent from any sewerage system or sewage disposal works and effluent includes sullage from open drains Sewer Any conduit pipe or channel, open or closed, carrying sewage or trade effluent Stream Includes river, water course (whether flowing or for the time being dry), inland water (whether natural or artificial), sub-terranean waters, sea or tidal waters to such extent or, as the case may be, to such point as the state government may, by notification in the official gazette specify in this behalf Trade Includes any liquid, gaseous or solid substance, which is effluent discharged from any premises used for carrying on any industry, operation or process, or treatment and disposal system, other than domestic sewage Company Any body corporate, and includes a firm or other association of individuals Director In relation to a firm means a partner in the firm The Air (Prevention & Control of Pollution) Act, 1981 Air Any solid, liquid or gaseous substance (including noise) present in pollutant the atmosphere in such concentration as may be or tend to be injurious to human beings or other living creatures or plants or property or environment Air The presence in the atmosphere of any air pollutant pollution Approved Any equipment or gadget used for the bringing of any

Section Section 2 (d)

Section 2 (dd)

Section 2 (e)

Section 2 (g) Section 2 (gg) Section 2 (j)

Section 2 (k)

Section 47 (2) (a) Section 47 (2) (b) Section 2 (a)

Section 2 (b) Section 2 (c)

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appliances Section 2 (d) Section 2 (h) Approved fuel Chimney

combustible material or for generating or consuming any fume, gas of any particulate matter and approved by the State Board Any fuel approved by the State Board for the purpose of the Act

Includes any structure with an opening or outlet from or through which any air pollutant may be emitted Section 2 (i) Control Any apparatus, device, equipment or system to control the quality equipment and manner of emission of any air pollutant and includes any device used for securing the efficient operation of any industrial plant Section 2 (k) Industrial Any plant used for any industrial or trade purposes and emitting plant any air pollutant into the atmosphere Section 2 (j) Emission Any solid or liquid or gaseous substance coming out of any chimney, duct or flue or any other outlet Section 2 (m) Occupier The person who has control over the affairs of the factory or the premises, and includes, in relation to any substance, the person in possession of the substance Section 40 (2) (a) Company Any body corporate, and includes a firm or other association of individuals Section 40 (2) (b) Director In relation to a firm means a partner in the firm The Water (Prevention & Control of Pollution) Cess Act, 1977 Section 2 (a) Local Municipal corporation or a municipal council (by whatever name Authority called) or a cantonment board or any other body, entrusted with the duty of supplying the water under the law by or under which it is constituted Section 2 (c) Industry Any operation or process, or treatment and disposal system, which consumes water or gives rise to sewage effluent or trade effluent, but does not include any hydel power unit Section 15 (2) (a) Company Any body corporate, and includes a firm or other association of individuals Section 15 (2) (b) Director In relation to a firm means a partner in the firm The Hazardous Waste (Management, Handling & Transboundary Movement) Rules, 2008 Rule 3 (l) Hazardous Any waste which by reason of any of its physical, chemical, waste reactive, toxic, flammable, explosive or corrosive characteristics causes danger or is likely to cause danger to health or environment, whether alone or when in contact with other wastes or substances, and shall include: Waste specified under column (3) of Schedule-I Wastes having constituents specified in Schedule-II if their concentration is equal to or more than the limit indicated in the said Schedule, and Wastes specified in Part A or Part B of the Schedule-III in respect of import or export of such wastes in accordance with rules 12,13 and 14 or the wastes other than those specified in Part A or Part B if they possess any of the hazardous characteristics specified in Part C of that Schedule

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CHAPTER 3 Environmental Acts and Legal Requirements

3.0 Requirements Under the Provisions of the Water (Prevention & Control of Pollution) Act 1974 as Amended Section 25 (1) Subject to the provisions of this section, no person shall, without the previous consent of the State Board:

Restrictions on new outlets and a. Establish or take any steps to establish any industry, operation or discharges process, or any treatment and disposal system or an extension or addition thereto, which is likely to discharge sewage or trade effluent into a stream or well or sewer or on land (such discharge being hereafter in this section referred to as discharge of sewage); or b. Bring into use any new or altered outlets for the discharge of sewage; or c. Begin to make any new discharge of sewage Whoever contravenes the provision of section 25 shall be punishable with imprisonment for a term which shall not be less than two years Penalty of but which may extend to six years and with fine contravention of section 25 Section 44 3.1 Requirements Under the Provisions of the Air (Prevention & Control of Pollution) Act 1981 as Amended Section 21 (1) Subject to the provisions of this section, no person shall, without the previous consent of the State Board, establish or operate any Restrictions on industrial plant in an air pollution control area use of certain industrial plants Section 37 (1) Whoever fails to comply with the provisions of section 21, be punishable with imprisonment for a term which shall not be less than Penalty of one year and six months but which may extend to six years and with contravention of fine Section 21

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3.2 Requirements for Ground Water Extraction

Keeping in view of the requirements stated in the Policy guidelines for clearance of ground water abstraction for various uses issued by the Central Ground Water Authority, Ministry of Water Resources, GoI vide their letter dated 14.10.2009, the following guidelines regarding the requirement of NOC from CGWA for abstraction of ground water by any industry/ infrastructure project/ mine (proposed/existing) are being followed: S. No 1. Guidelines NOC from CGWA shall not be required for abstraction of ground water in the following cases: In case of over-exploited areas abstraction<25m3/day In case of critical areas abstraction <50 m3/day In case of semi critical areas abstraction <100 m3/day 2. Industry/infrastructure project/mine (proposed/existing) located in safe category areas, are required to obtain NOC from CGWA if ground water abstraction exceeds 1000 m3/day for hard rock areas and 2000 m3/day for alluvial areas 3. For the industry/infrastructure project/mine which proposed to abstract ground water more than the exempted quantity referred above, the Consent to Establish application will be considered only after submission of NOC from CGWA Please refer RPCB Circular dated 08.01.2010 for further information 3.3 Requirements Under the Provisions of the Hazardous Waste (Management, Handling & Transboundary Movement) Rules, 2008 Processes Schedule I: generating hazardous waste (S.No 5) Industrial operations using mineral/synthetic oil as lubricant in hydraulic systems or other applications Rule 5 (1) Grant of authorization for handling hazardous waste 5.1 Used/spent oil 5.2 Wastes/residues containing oil

Every person who is engaged in generation, processing, treatment, package, storage, transportation, use, collection, destruction, conversion, offering for sale, transfer or the like of the hazardous waste shall require to obtain an authorization from the SPCB

3.4 Restriction of Certain Activities in Specified Area of Aravalli Range The MoEF, GoI had stipulated restrictions on certain activities in specified area of Aravalli Range vide Notification No. S.O. 319 (E) dated 7th May 1992 and as amended. As per the Notification the Central Government prohibits the carrying on the following processes and operations, except with its prior permission, in the specified area.

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Processes and activities which require prior permission

Location of new industry including expansion/modernization A. All new mining operations including renewals of mining lease B. Existing mining leases in sanctuaries/national park and areas covered under Project Tiger and/or C. Mining is being done without permission of the competent authority Cutting of trees Construction of any clusters of dwelling units, farms houses, sheds, community centres, information centres and any other activity connected with such construction (including roads a part of any infrastructure relating thereto) Electrification (laying of new transmission lines) Areas covered All reserved forests, protected forests or any other area shown as under the forest in the land records maintained by the State Government as on Notification the date of this notification in relation to Gurgaon District of the State of Haryana and the Alwar District of the State of Rajasthan All areas shown as a. Gair Mumkin Pahar, or b. Gair Mumkin Rada, or c. Gair Mumkin Behed, or d. Banjad Beed, or e. Rundh In the land records maintained by the State Government as on the date of this notification in relation to Gurgaon district of the State of Haryana and the Alwar district of the State of Rajasthan All areas covered by notifications issued under Section 4 and 5 of the Punjab Land Preservation Act, 1900, as applicable to the State of Haryana in the district of Gurgaon up to the date of this notification All areas of Sariska National Park and Sariska Sanctuary notified under the Wildlife (Protection) Act, 1972 (53 of 1972) Clearance Any person desirous of undertaking any of the activities mentioned in process the Notification No. 319 (E) dated 7th May 1992 shall submit an application to the Secretary, Department of Environment of the Government of Haryana/Rajasthan, as the case may be. The applicant shall also furnish environment impact statement and an environment management plan and such other information as may be prescribed by such State Governments. The application after due scrutiny shall be placed before the Expert Committee for its recommendations. Based on the recommendations of the Expert Committee, the Department of Environment in the State Government concerned shall take a final decision and convey the same to the applicant within the three months from the date of receipt of application or when further information has been asked for from the applicant within three moths from the date of receipt of such information Note: Refer the Notification for details

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3.5 Mount Abu Eco Sensitive Zone Mount Abu area has significant ecological importance comprising of tropical dry deciduous forests at lower altitude and evergreen forests at higher altitude and the flora and fauna of the region comprise of several endemic and rare species; besides Mount Abu has natural heritage such as Nakki Lake and man-made heritage like Dilwara temples and other heritage buildings and structures. To conserve and protect the area from ecological and environmental point of view, the MoEF had issued Notification No. S.O. 1545 dated 25th June 2009 regulating certain activities in the eco-sensitive zone Boundaries of the ecosensitive zone a. The said eco-sensitive zone is situated in the southern area of Rajasthan in Sirohi District between 240 3342 and 240 39 00 North latitude and between 720 41 36 and 720 48 06 East longitude and the configuration of land is hilly and rugged with high altitudinal variation ranging from 300 meter to 1727 meter. Gurushikar, the highest peak of the Aravalli, is the highest peak between the Himalayas and the Nilgiris. The boundaries of the said ecosensitive zone comprise North South East West - Southern boundary of Abu Forest Block No.3 - Northern Boundary of Abu Forest Block No. 1 - Western and Southern Boundary of Abu Forest Block No.2 - Eastern boundary of Abu Forest Block No. 3

b. The Eco-sensitive zone covers the entire area of Notified Urban Area Limit, including Mount Abu Municipal Limits adjoining Forest Block Areas c. The list of the villages in the eco-sensitive zone Sanigaon, Machgaon, Goagaon, Delwara, Oriya, Jawal, Achalgarh, Salgaon, Torna, Dudhai, Hetamji, Ama d. All activities in the Forest Block Areas (both within and outside Municipal Areas) shall be governed by the provisions of the Rajasthan Forest Act, 1953 and the Forests (Conservation) Act, 1980 (69 of 1980) and all the activities in the Protected Areas (Sanctuary) shall be governed by the provisions of the Wildlife (Protection) Act, 1972 (53 of 1972) Zonal Master Plan Pending the preparation of the Zonal Master Plan for Eco-sensitive zone and approval thereof by the Central Government in the MoEF, there shall be no increase in the existing parameters of permissible floor area ratio, permissible ground coverage, maximum number of floors and maximum height and all new constructions shall be allowed only after the proposals are scrutinized and approved by Monitoring Committee and all other development activities including additions, alterations, demolitions, repairs, renovations and restorations of buildings shall require prior approval of the Monitoring

Regulated Activities

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Industrial units

Committee provided that these do not involve structural changes and are on the existing authorized plinth areas in the Mount Abu Municipal Limits and there shall be no consequential reduction in Tribal area, Forest area, Green area and Agricultural area Only non-polluting, non-hazardous cottage industries like ice cream, hosiery, embroidery or ready made garments, sewing works, ayurvedic drugs, etc. situated in the villages in the Notified area and service industries, agriculture, floriculture, horticulture or agro-based industries producing products from Mount Abu shall be permitted as per the guidelines drawn by the Government of Rajasthan Structure connected with small agro-based industries activities related to the needs of the local village economy and processing or storage of local agrobased products may be allowed subject to the usual non Agricultural permission requirements and a maximum of 1/8th of the plot areas being built up The quarrying and mining activities shall be restricted in the Eco-sensitive zone The monitoring committee shall have the authority to grant special permission for limited quarrying of materials required for the construction of local residential housing and traditional road making and maintenance work in Mount Abu, based on site evaluation

Quarrying and mining

No quarrying shall be permitted on steep hill slopes with a gradient of 20 degrees or more or areas with a high degree of erosion, or on forestland Trees There shall be no felling of trees whether on Forest, Government, Revenue or Private lands within the Eco-sensitive zone without the prior permission of the State Government in case of forest land and the respective District Collector in case of Government, Revenue and Private land as per the procedure which shall be laid down by the State Government Water The extraction of ground water shall be permitted only for the bona-fide agricultural and domestic consumption of the occupier of the ply and the extraction of ground water for industrial or commercial or residential estates or complexes shall require prior written permission, including of the amount that can be extracted, from the State Ground Water Department. However, the areas rich in ground water may not be delivered for construction activities Development The zonal Master Plan shall indicate areas of hill slopes where development on and shall not be permitted protection of hill slopes No development shall be undertaken in areas having a steep slope or areas which fall in fault or hazard zones or areas falling on the spring lines and first order streams or slopes with a high degree of erosion as identified by the State Government on the basis of available scientific evidence

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No development on existing steep hill slopes or slopes with a high degree of erosion shall be permitted Discharge of No untreated sewage or effluent shall be permitted to be discharged into any sewage and water body or forests within the eco-sensitive zone and the local authority effluents shall provide proper drainage and treatment system for collection, treatment and disposal of untreated/and treated effluent in accordance with the provisions of the Water (Prevention and Control of Pollution) Act, 1974. Moreover, the treated sewage and treated effluent shall be disposed only at or into a point(s) identified and approved by the local authorities and the Monitoring Committee Note: Refer the Notification for complete details

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CHAPTER 4 Statutory Clearance Process

4.0 Consent To Establish (CTE)
It is mandatory on the part of the project proponent to obtain Consent To Establish from the RSPCB, before start of the project. The CTE process adopted by RSPCB is explained below in the form of different questions and answers to facilitate better understanding for the project proponent as well as other stakeholders. 01. What is categorization of Kilns by RSPCB? the Brick S.No Project Description Category of Industry S.No. 6 Brick Kilns Orange Reference: RSPCB office order dated 03.04.2008

02. Whether the CTE is The project proponent shall obtain CTE under section 21(1) of the required under the Air (P&CP) Act, 1981 as amended before establishing the unit. provisions of Water Act & Air Act? In case the project involves the discharge of sewage or trade effluent in to stream or well or sewer or on land, CTE shall be obtained under section 25(1) of the Water (P&CP) Act, 1974 as amended. 03. What are the The project proponent shall apply in the prescribed CTE documents required for application form (Annexure 1) along with the following submission? documents. The CTE application form can be downloaded from RSPCB web also (www.rpcb.nic.in). Requisite consent fee Requisite declaration on Rs. 10/- non-judicial stamp paper duly attested by notary public (Annexure 2) Ownership document for land/lease deed Details of various sources of air pollution and proposal for pollution control measures to meet the norms Copy of partnership deed/MoU & Article of Association as the case may be Site layout plan of plant & machinery (civil & mechanical) Location plan of proposed site Details of registration with Industries Department

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04. What is the fee to be CTE fee is to be paid along with CTE application as notified by the submitted? DoE, Government of Rajasthan under section 54 of the Air (P&CP) Act, 1981 as amended (Annexure 3) (www.rpcb.nic.in) In case if the proposed activity attracts the provisions of section 25 0f the Water (P&CP) Act, 1974 as amended, then CTE fee as notified under section 64 of the Water (P&CP) Act, 1974 is also to be paid (Annexure 4) (www.rpcb.nic.in) The CTE fee is to be paid on the following basis as per the Notification dated 25th May 2009: Capital investment Categorization of the project Whether the project attracts the provision of the Hazardous Waste (Management & Handling) Rules, 1989? If yes, then fee equal to one and half times fee prescribed in the schedule of the Notification shall be paid For calculating the investment in plant and machinery, the cost of pollution control, research & development, industrial safety devices and such other items as may be specified by the notification, shall be excluded (RSPCB office order amendment dated 18.12.2008). Instrument: Demand Draft In favor of: Member Secretary, Rajasthan State Pollution Control Board, payable at respective Regional Office The application with requisite documents shall be submitted at the concerned Regional Office of the Board The Board is in the process of upgrading the systems to accept the applications on line. For details visit RSPCB web site. Inputs requested from RPCB Yes. For details visit RSPCB web site

05. What is meant by capital investment of the industry?

06. What is the mode of payment of CTE fee? 07. Whom to submit the CTE application? 08. Is there any provision to apply CTE application on-line? 09. What is the procedure to apply on line? 10. Whether system will generate selfacknowledgement? 11. Whether NOC from CGWA is a pre-requisite for processing CTE application?

Yes, in the following cases: If the abstraction of ground water is 25 m3/day, in case of over exploited areas If the abstraction of ground water is 50 m3/day, in case of critical areas If the abstraction of ground water is 100 m3/day, in case of semi critical areas The exemption shall not be applicable to industries, which are using water as raw material such as packaged drinking water

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industries, distilleries and breweries Industry/infrastructure project/mine (proposed/existing) located in safe category areas, are also required to obtain NOC from CGWA if ground water abstractions exceeds 1000m3/day for hard rock areas and 2000m3/day for alluvial areas CTE application will be considered by RPCB only after submission of NOC from CGWA in above cases (Please refer RPCB Circular Guidelines dated 08.01.2010) 12. What are the areas as The details are given in Annexure 5 identified by CGWA as safe areas, semi critical areas, critical areas & over exploited areas? 13. Whether NOC from Inputs requested from RPCB Local authority is a pre requisite to submit CTE application? 14. Whether conversion of Inputs requested from RPCB land, wherever required, is a pre requisite to submit CTE application? 16. Who is the authority to Red Category Chairperson accord the CTE projects application? Orange category Regional officer Units covered by Dealt at Head Office the Aravalli level and not at R.O Notification level 17. What is the maximum Statutory time limit: time period to process the CTE application? Section 25(7) of Water (P&CP) Act, 1974 as amended: Four months on submission of application, complete in all aspects Section 21(4) of Air (P&CP) Act, 1981 as amended: Four months after receipt of the application Administrative time limits of RPCB: Orange category projects 4 weeks 19. What is the mode of RPCB to confirm the following: communication of the approval / rejection order Hard copy: By RPAD of CTE? Soft copy: By mail Down loads: From RPCB web 20. Is there any appeal Section 28 (1) of Water (P&CP) Act, 1974 as amended: mechanism? Any person aggrieved by the order made by the State Board under section 25, 26 and 27 may within 30 days from the date on which is

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communicated to him, prefer an appeal before Appellate Authority constituted by the State Government. Section 31 (1) of Air (P&CP) Act, 1981 as amended: Any person aggrieved by an order made by the State Board under this Act may, within thirty day from the date on which the order is communicated to him, prefer an appeal to Appellate Authority constituted by the State Government The appellate authority may entertain the appeal after the expiry of the said period of thirty days if such authority is satisfied that the appellant was prevented by sufficient cause from filing the appeal in time 21. Whether the CTE Where a person to whom consent has been granted by the State obtained from the board Board, transfers his interest in the industry to other person, such can be transferred to any consent shall be deemed to have been granted to such other person other person? and he shall be bound to comply with all the conditions subject to which it was granted as if the consent was granted to him originally. Such changes shall be notified to the Board. 22. What is the validity period for CTE? 23. What is the procedure for extension of CTE? CTE will be valid for a period of three years or till the commissioning of the unit, which ever is earlier Shall submit a request letter to the concerned Regional Office duly furnishing the stage of the project and action taken to comply the CTE conditions so far. 24. Are there any Yes. G.S.R 543 (E) dated 22nd July 2009 standards notified specific to Brick Kilns under the provisions of the E (P) Rules, 1986? 26. What is minimum fly S.O. 2804 (E) Dated. 03.11.2009. ash content for clay based To qualify for fly ash based products, the minimum percentage of building materials such as fly ash used in production of clay based building materials such as bricks, blocks, tiles etc? bricks, blocks, tiles etc shall be 25% of total raw material on weight basis. 27.Are there any S.O. 2804 (E) Dated. 03.11.2009. mandatory restrictions on Every construction agency engaged in the construction of usage of clay bricks etc in buildings within a radius of hundred kilometers from a coal or certain areas? lignite based thermal power plant shall use only fly ash based products for construction, such as cement or concrete, fly ash bricks or blocks or tiles or clay fly ash bricks, blocks or tiles or cement fly ash bricks or bricks or blocks or similar products or a combination or aggregate of them, in every construction project It shall be applicable to all construction agencies of Central or State or Local Government and private or public sector and it shall be

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the responsibility of the agencies either undertaking construction or approving the design or both to ensure compliance of the above rule and to submit annual returns to the concerned State Pollution Control Board In case of non-availability of fly ash from thermal power plants in sufficient quantities as certified by the said power plants, within 100km of the site, the above stipulation shall be suitably modified (waived or relaxed) by the concerned State Government Level Monitoring Committee. 26. Are there are any Notification No. 371(E) dated 27.05.2002 E (P) Act, 1986 and specific noise standards amended thereof. applicable to D.G. Sets? Noise limit for Diesel Generator Sets (up to 1000 KVA) manufacture on or after the 1st July, 2003 Requirement of certification Every manufacturer or importer of DG set to which these regulations apply must have valid certificates of type approval and also valid certificates of conformity of production for each year, for all the product models being manufactured or imported from 1st July 2003 with the noise limit specified in the Notification. The conformance label must contain the following information a. Name and address of the supplier (if the address is described in the owners manual, it may not be included in the label) b. Statement This product confirms to the Environment (Protection) Rules, 1986 c. Noise limit viz. 75 dB (A) at 1m d. Type approval certificate number e. Date of manufacture of the product 27. Is there any guideline The CPCB had evolved the minimum height of the stack to be to calculate the minimum provided to the DG set and published in Emission Regulations Part requirement of the stack IV: COINDS/26/1986-87. of D.G set? H= h+0.2 x KVA Total height of stack in meter Height of the building in meters where the generator set is installed KVA Total generator capacity of the set in KVA 29. Are standards notified CPCB notified National Ambient Air Quality Standards dated 18th for ambient noise level? November 2009 (Annexure 6) H H

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4.1 Consent To Operate (CTO) 01. Whether Brick kiln activity is required to apply for Consent To Operate? 02. What is the procedure to apply for Consent To Operate (first time)? Yes. Prior to commercial production, it is obligatory on the part of the occupier of the unit to apply for CTO in the prescribed format.

The application (Annexure 7) in the prescribed form along with the following documents shall be submitted Requisite consent fee Requisite declaration on Rs. 10/- non-judicial stamp paper (Annexure 2) Report of compliance of conditions of consent to establish in tabular form

Copies of the following documents, if not submitted earlier: Ownership document for land/lease deed Details of various sources of air pollution and pollution control measures adopted Copy of partnership deed/MoU & Article of Association as the case may be Site layout plan of plant & machinery (civil & mechanical) Location plan of the project site 03. What is the procedure The application in the prescribed form along with the following to apply for Consent To documents shall be submitted Operate (renewal)? Requisite consent fee Requisite declaration on Rs. 10/- non-judicial stamp paper (Annexure 2) Report of compliance of conditions of CTO in tabular form 05. Who should submit The application for consent and reply to notices etc., shall be the application for consent furnished by owner (including lawfully empowered attorney for and reply to the notices such purpose) of the crusher industry. Where the owner of the etc? Brick Kilns industry is a juristic person (company, firm, association etc.,) the applications must be filed/information must be furnished under the seal and signature of a person authorized for such purpose and the document confirming the authorization shall be attached

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4.2 Hazardous Waste Authorization 01. Whether Brick kiln activity is required to apply for Hazardous Waste Authorization? If the industry is using D.G. set on standby use or on regular for operation of the Brick Kilns, the spent oil generating from the D.G. sets is categorized as Hazardous waste, which need to be disposed off to the authorized recyclers/ reclamation units duly obtaining authorization from the RSPCB. The prescribed application form to apply for HWA (Common Application for CTO & Authorization for HW) is given as Annexure 7

4.3 Water Cess Assessment 34. Whether Brick kiln S.O. 49 (E) dated 6th May 2003 activity is required to file water cess returns? If the industry consumes water for different applications including domestic more than 10 KLD shall file the water cess returns in the prescribed format. 35. Self Assessment RSPCB had simplified the cess assessment procedure for certain Scheme for the industries category units. The scheme shall be applicable to small assessees whose cess liability under the existing rates does not exceed Es. 6,000/- PA. Under this scheme the eligible assessees shall submit a selfassessment before 31st May of every year, for the ensuing year as a whole, based on earlier years data and as per the latest rates. The amount payable shall be submitted in the form of Demand Draft taken in favor of Member Secretary, Rajasthan State Pollution Control Board and the same shall be submitted to the Member Secretary, Rajasthan State Pollution Control Board, Jaipur with a copy to the concerned Regional Officer of the Board. Please refer RSPCB web site for further details.

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CHAPTER 5 Environmental Aspects and Guidance

5.0 Environmental Aspects
The typical environmental aspects of the brick kilns activity are given in the following table Activity Mining/ quarrying of clay Transportation Brick kilns Process sources Manual excavation Fugitive emission sources Top soil removal from fixed soil bed Loading and hauling Transportation of quarried Haul roads clay/ soil Crushing of coal Size reduction of coal to make it compatible to the design feed & draught of the kiln Screening of coal Filtration of crushed coal to attain the slack coal for kiln feed and rejects to re-crushing Slack coal feeding Handling & feeding of slack coal to fuel the burning of green bricks. Burning of green bricks Fugitive emissions getting air borne by wind currents across the brick kilns during burning of green bricks Flue gases Resultant flue gases generation from partial/ complete combustion of coal and decomposition of organic matter in the process of brick formation Manual separation Segregation of over/ under burnt bricks De-dusting Removal of ash from brick and top layer of ash from kiln Handling Loading of bricks Transportation Transporting of fly ash from Thermal Power Plant. Hauling Wind blow over the loosely packed and un covered trucks carrying fly ash from power plants to brick kiln site. Stocking Fugitive emissions from stockpiles of fly ash. Handling Light particles of fly ash getting air borne during handling and mix preparation of green bricks.

Fly ash

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5.1 Pollution Prevention and Control Options Discharge Through Stack The height of steel movable chimneys varies from 12 to 15 m which discharges the flue gases at a lower level as compared to fixed chimney. The height of the steel chimney is limited and cannot be increased because of their movement during the operation of the kiln. CPCB recommended that the use of moving chimney Bulls kiln may be stopped and they are to be phased out gradually (COINDS/16/1995-96, CPCB). The MoEF has notified minimum stack height for different category of units vide G.S.R 543(E) dated 22nd July 2009 (Annexure 8) and the same shall be provided. Monitoring requirements in the stack shall be proved to monitor the particulate matter norm. Gravitational Settling Chamber Amount of dust to be handled, nature of collected material such as its particle size and handiness and efficiency of air cleaning equipment required determine the choice of air cleaning apparatus. The amount of energy required increases with decreasing particle size of dust. Gravitational method of collecting dust is recommended for collecting bigger dust particles more than 10 . About 70% of this dust contains particles of size bigger than 10 . Hence gravitational settling chamber may be efficiently used in brick kilns particularly in fixed chimney and high draught kilns for collecting dust particles. In settling chambers, dust is caught by settlement, if the time of passage of dusty air through the chamber is long enough to allow the dust to settle from the top to bottom of chamber. The air velocity inside the chamber should be kept as low as possible since the settling rate of dust particles decreases with increasing turbulence of air/ flue gases. It has been reported that a velocity of about 0.30 to 0.50 m/s are generally used. The design of entrance and discharge openings must be such as to ensure even airflow throughout the chamber. Settling chambers though have low efficiency but they have a distinct advantage in terms of low cost, low-pressure loss, simple fabrication and operation and dry/dust collection of particular matter.

Charging of coal
Considering the fact that draught available in these kilns is feeble, large sized coal takes longer time to burn due to slow rate of diffusion of oxygen into the coal masses. Ideally, coal fed to the kiln should be of such a grain size that most of it should burn out completely during its passage from top to the floor of the kiln. It is recommended that the lump coal may be reduced in size to 10 mm in a jaw crusher prior to feeding into kiln. The interval between the feeds has been observed to be 20 to 30 minutes, which stretches to even 45 minutes during severe weather conditions. To overcome the temperature in the kiln being going down during these long intervals, the kiln is very heavily feeded. This results into black emissions from the stack for a long period. The feed interval of the coal into the kiln should be between 15-20 minutes.

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5.2 Environmental Norms S. No 01. Description of the norms Notification/Circular Sector specific standards G.S.R 543 (E) dated 22nd July 2009,MoEF,GoI notified under the provisions of Standards for particulate matter in the stack E (P) Act emissions Categorization Minimum stack height requirement Requirement of APC system (Annexure 8) Minimum fly ash content for S.O 2804 dated 3rd November 2009, MoEF, GoI building materials or products (www.moef.nic.in) to qualify as fly ash based products category National Ambient Air Quality CPCB Notification No. B-29016/20/90/PCI-I Standards dated 18th November 2009 (Annexure 6) National Noise Ambient Air The Noise Pollution (Regulation & Control) Quality Standards Rules, 2000 S.O. 123 (E) dated 14th February 2000 and as amended in S.O. 1046 (E) dated 22.11.2000 and S.O 50 (E) dated 11th January 2010 (Annexure 9) Noise Limit for Generator Sets Notification No. G.S.R 371 (E) dated 17th May, Run With Diesel 2002 as amended (www.moef.nic.in) (Annexure 10) Hazardous waste categorization Hazardous Material (Management, Handling and Transboundary Movement) Rules, 2008 (www.moef.nic.in)

02.

03.

04.

05.

06.

5.3 Guidelines in respect of establishment Brick Clamp Units issued by Government of Andhra Pradesh The edge of the Brick Clamp (batti) shall be at a radial distance of: 1km from any human habitation, hospitals, educational or any other institutions 100m as far as practicable, but in no case les than 50mtrs from the neighbors agricultural/horticulture lands. The Brick Clamp shall have the accessibility without disturbing the surrounding crops 100mtrs from flood banks of river 200mtrs from the National Highways/State Highways/Expressways/Ring Roads; and 25m from the village roads Source: G.O.Ms.No.80 dated 22.04.10, E.F.S & T Department, Government of Andhra Pradesh (www.ap.gov.in/goir)

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CHAPTER 6 Checklist
6.0 Environmental Checklist
The project proponent and the reviewer may use the following checklist to have a better understanding on the environmental aspects and requirements concerned with Brick kilns: Consent To Establish A. Documentation Check List S.No. Document Yes 01. Completely filled application form duly signed by authorized signatory 02. Document authorizing the applicant for signing application and other documents 03. Copy of memorandum of article of Association/Partnership deed 04. Demand draft for consent fee 05. Copy of the DIC registration or enlistment/copy of SIA acknowledgement 06. Copy of the duly signed project report 07. Certificate from Chartered Accountant for capital investment (In case capital investment is Rs. 25 lakhs or more) 08. Copy of letter of land allotment/conversion letter from the competent authority 09. Copy of the site plan 10. Feasibility report on the proposed pollution control measures (For all large/medium scale units in Orange category) 11. Legal undertaking in the prescribed format on non-judicial stamp paper of RS. 10/- only duly attested by notary public B. Environmental Check List General 12. Category of industry (Orange) 13. Requirement of Consent To Establish (Water Act only/ Air Act only/ Both Acts) 14. Whether the technology adopted for brick kiln is defined Land Environment 15. Whether location falls under restrictions on development projects in Aravali region and Mount Abu zone?

No

Remarks

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16. 17.

18. 19. 20.

21. 22.

23. 24.

25.

26. 27.

28.

29.

30. 31.

Whether the proposed site falls with in highly polluted areas as identified by CPCB? Whether the proposed project is in conformity with the approved master plan/development plan of the area, if any? Water Environment Whether estimation of water demand for peak requirement is assessed? Whether reliable source of water for peak demand is identified? Whether it is proposed to use ground water? If yes, whether NOC from CGWA is required as per the norms? If yes, whether NOC from CGWA obtained? Whether any rainwater harvesting structures proposed to re-charge ground water? Whether adequate storm water drainage is planned and measures taken to avoid contamination of storm water? Air Environment Whether all sources of air pollution identified and included in CTE application? Whether sampling ports proposed for chimneys as per guidelines given in emission standards of CPCB? Whether the height of the stack is as per the stack height regulations/ norms prescribed by MoEF, GoI. Whether fugitive emission sources identified and if so, measures proposed? Whether the details of air pollution preventive and control measures are furnished completely to meet the norms? Hazardous Wastes Whether the activity attracts the provisions of HW (MH&TM) Rules 2008, as amended? Noise Environment Whether noise due to unit operations and DG set is addressed? Green belt Whether EMP outlined the green belt development? Whether soil suitability for the development of green belt is addressed?

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Consent To Operate & Hazardous Waste Authorization A. Documentation Check List Completely filled application form duly signed by authorized signatory Document authorizing the applicant for signing application and other documents Demand Draft for consent fee Legal undertaking in the prescribed format on non-judicial stamp paper of RS. 10/- only duly attested by notary public Certificate from Chartered Accountant for capital investment (In case capital investment is 25 lacs or more) Is there any change in capital investment with reference to previous CTE/CTO application? Whether Document proof for capital investment is furnished? B. Environmental Check List

01. 02. 03. 04.

05.

06. 07.

General
08. 09. 10. Category of industry (Orange) Requirement of Consent To Establish (Water Act only/ Air Act only/ Both Acts) Whether the unit applied for the same line of products and capacity as per CTE (in case of first CTO) or CTO (in case of renewal of CTO)? Whether any change in the categorization of the unit due to expansion/modernization or due to change in the Board guidelines? Whether any HW is generated? If yes, whether correct CTO fee paid? Whether copy of the environmental statement (in case of renewal of CTO) is furnished? Whether copy of Annual return of HW is furnished? Consent To Operate Whether report of compliance of the CTE conditions (for first CTO) / CTO conditions (for the renewal of consent) are submitted? Whether any amendment to CTE/CTO conditions is sought? Whether environmental monitoring reports (in case of renewal CTO) are furnished?

11.

12. 13. 14.

15.

16. 17.

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18.

19.

20.

21. 22.

23. 24.

25. 26.

27.

Whether any court judgment issued against the unit? If yes, whether compliance report/ status report furnished? Whether the unit falls under the purview of Self assessment Scheme Cess? If yes, whether cess paid as per the RSPCB scheme (in case of CTO renewal) Whether the unit filed the cess returns as per the requirements? Cess returns filed up to. and cess paid up to and copies are furnished? Whether the unit is claiming the cess rebate? Whether all sources of air pollution are identified and included in CTO application? Whether any changes in sources and APC system from that CTE/CTO given earlier? Whether measures adopted for abatement of noise pollution identified? Whether green belt provided as submitted in the CTE/CTO application? Hazardous Waste Authorization Whether the activity attracts the provisions of HW (MH&TM) Rules 2008, as amended? If yes, Whether HW quantities are furnished for different categories as per the norms? Fly Ash Utilization Whether the unit is manufacturing any fly ash based products such as bricks, blocks, tiles etc. If yes, the compliance with reference to MoEF notification S.O.2804 (E) dated 3rd November 2009.

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34

======================================================================

Annexures
======================================================================

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Annexure 1 Common Application For Consent To Establish under Air Act & Water Act FORM No.

Common Application Form for Consent To Establish under section 21 of the Air (P & CP) Act, 1981 and under section 25/26 of the Water (P & CP) Act 1974, as amended

(Application for Brick Kilns) From

Date

To The Member Secretary, Rajasthan State Pollution Control Board, 4, Industrial Area, Jhalana Doongri, Jaipur 302 004 (Through the concerned Regional Officer)

To be submitted in triplicate

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36

Explanatory Note for Filing the Application Form Occupier in relation to factory or premises, means the person who has control over the affairs of the factory or the premises, and includes, in relation to any substance, the person in possession of the substance Out let- Any conduit pipe or channel, open or closed, carrying sewage or trade effluent or nay other holding arrangement which causes or is likely to cause pollution

Trade Effluent Includes any liquid, gaseous or solid substance, which is discharged from any premises used for carrying on nay industry, operation or process, or treatment and disposal system, other than domestic sewage
Chimney Includes nay structure with an opening or outlet from or through which any air pollutant may be emitted Industrial Plant Nay plant used for any industrial or trade purposes and emitting any air pollutant into the atmosphere Emission Any solid or liquid or gaseous substance coming out of any chimney, duct or flue or any other outlet Sir, I/We hereby apply for: 1. Consent To Establish under Section 25/26 of the Water (P & CP) Act Yes No 1974 as amended, to discharge or continue to discharge sewage/trade effluent owned by. Consent To Establish under Section 21 of the Air (P & CP) Act 1981 as Yes No amended, to discharge emissions from industrial plant owned by

2.

Part A: General Information

01. Name & Address of the occupier: Phone No: Fax No: Mobile No: E-mail: 02. Name & Location of the unit: Survey No/Plot No/Shed No: Village: Tehsil:

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BRICK KILNS

District: Pin Code: 03. Whether located in industrial area developed by RIICO?

04. Category and Scale of the industry: a. Large/Medium/Small: 05. Surrounding details (with in 2 Kms) Human settlement

Yes/No If yes: RIICO allotment No. Orange

Please mention habitation with and population

nearest distance

06.

07. 08. 09. 10. 11.

12.

13. 14.

Forest/Sanctuary/National Park/Hill Resort/National Monument/Inter state boundaries Water Bodies Nallah/Stream/River/Pond/Dam and any other water bodies Site details: Total Area in Ha Built up area in Ha Green belt area in Ha Latitude Longitude Boundaries of the unit North/East/West/South Number of employees working in the industry: Capital investment of the industry (in lakhs): Capital investment proposed for pollution control (in lakhs): Applicability of HW (MH&TM) Rules 2008 as amended Applicable/Not applicable If not applicable, Part D of the form is not to be filled Whether the industry is required to obtain NOC from Yes/No CGWA for extraction of ground water? If yes: NOC NoDate Whether the industry attracts the provisions of the Water (P Applicable/Not applicable & CP) Cess Act, 1977 as amended? Raw materials including fuel requirement at installed Name Quantity capacity in TPD/Kl: Name Quantity

15. Products and by- products at installed capacity in TPD/Kl:

16. Furnish a flow diagram of manufacturing process showing Pl attach as Annexure... input and output in terms of products, waste generated including for captive power generation and de-mineralized water:

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Part B: Information Required in Connection with Prevention and Control of Water Pollution
17. Source of water: Municipal Supply/Well/Tube Well/Canal/River/Others 18. Water consumption per day for the following streams: Trade purpose: Domestic purpose: Total Water requirement: 19. Wastewater generation per day: Trade effluent: Domestic effluent: Total wastewater generation per day: 20. Treatment and disposal of effluent: 21. Mode of disposal of waste water:

KLD

KLD

Part C: Information Required in Connection with Prevention and Control of Air Pollution
22. Sources of Air Emissions: A From manufacturing process (Name the unit ---------------operations causing emission of pollutants attach ---------------additional sheet if required) ---------------Annexure attached Yes/No C From Kiln etc. Description Capacity Fuel Fuel quantity Chimney Type of APC height from GL From Diesel Generator Sets a. No. of DG Sets: b. Capacity of each DG set: c. Height of the stack above DG room: d. Height of the DG room: Noise pollution control measures: e. i. Acoustic enclosure/acoustic treatment of DG room: ii. Exhaust muffler: E Fugitive emissions Sources and Mitigation Measures If not applicable Say No If applicable Attach as Annexure. 23. Characteristics of critical parameters of air emissions before If not applicable Say No and after APC, as per the designs: If applicable Attach as Annexure. D

39

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24. Whether APC and minimum stack height proposed to meet the norms notified in G.S.R.543 (E) dated 22nd July, 2009 of MoEF, GoI 25. Details of solid waste generation other than HW, quantity, storage and disposal 26. Is your industry likely to cause noise pollution?

27. Is your industry likely to cause any other pollution?

Yes/No If yes, pl attach details as Annexure If not applicable Say No If applicable furnish details If not applicable Say No If applicable furnish details If not applicable Say No If applicable furnish details

Part D: Information Related to Hazardous Waste

28. Code No: 29. Whether the unit falls in a critically polluted area as Yes/No identified by MoEF? 30. Hazardous waste generation A Type of hazardous waste generated as defined under the rules: B Quantum of hazardous waste generated (TPD/KLD) Category wise: C Sources and waste characteristics (also indicate wastes amenable to recycling, re-processing and reuse): D Mode of storage within the plant, method of disposal and capacity (provide details): 31. Disposal of hazardous waste:

Part E: Other Information, in case of expansion/modernization

32. Notices / Directions issued under section 33(A) of the Water Act, 1974 as amended and section 31(A) of the Air Act, 1981 as amended during the last one year along with compliance report 33. Compliance to the conditions stipulated in the Consent and HW Authorization to the existing activity

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40

Declaration I/We further declare that the information furnished in the application form, Annexure / Appendices and plans is correct to the best of my / our knowledge I/We hereby submit that in case of change either of the point, or the quantity of discharge/emissions or its quality, a fresh application for Consent shall be made and until such consent is granted, no change shall be made I/We undertake to furnish any other information within one month of its being called by the State Board. Enclosures 1. I/We enclose herewith Bank Draft NoDatedfor Rs.(Rs. In words) in favor of the Member Secretary, Rajasthan Pollution Control Board, payable under Section 25/26 of the Water Act. The Consent Fee paid is for the period fromto.. 2. I/We enclose herewith Bank Draft NoDatedfor Rs.(Rs. In words) in favor of the Member Secretary, Rajasthan Pollution Control Board, payable under Section 21 of the Air Act. The Consent Fee paid is for the period fromto.. 3. In support of amount paid as fee, document on capital investment on the industry must be enclosed. An application not accompanied with the prescribed fee and support document shall not be entertained by the Board 4. Affidavit in the prescribed proforma 5. Land allotment/ land conversion order 6. Site map 7. Document in support of authorizing the person to sign the application 8. Different Annexures duly giving numbers as mentioned in the application Yours faithfully, Signature of the Applicant. Name. Designation.. Office Seal

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Annexure 2 Performa Affidavit for CTE/CTO AFFIDAVIT I, _______________ (with name and designation) S/o Shri __________________ Resident of __________________ do solemnly affirm and declare as under:1. 2. 3. 4. 5. 6. 7. That I am responsible for establishing / operating the unit named M/s. _________________________ (Name & address of the unit). That, I, ____________________ (with name and designation) am authorized to sign the consent application form and other enclosures with the application. That the plot area of the unit is ____________________ Sq. Meters. That the number of workers to carry out various activities in the unit is _________________________. That the total number of employees proposed in the unit is _______________. That the total capital investment on the project is Rs. _________________. That this Consent to Establish/Operate is being obtained for manufacturing of/providing service for ________________ up to _________________ per year. In case of any increase/change in capacity or addition/modification/alteration or change in process or raw material or project or discharge points, we will obtain fresh Consent to Establish. That the quantity of trade/domestic effluent shall not exceed __________ KLD. The mode of disposal shall be ________________. In case of any increase in quantity of effluent or alteration in outlet or mode of disposal, we shall obtain prior consent from the Board.

8.

OR That there will no effluent discharges from the premises (applicable only in the case of dry units). 9. 10. That the industry is a small/medium/large scale unit with SSI Registration No. / DGTD Registration No. /Letter to Intent No. ___________________. That all adequate measures for control and treatment of water/air pollution from the various processes/activities shall be taken to meet the prescribed standards as per the Environment (Protection) Rules, 1986 as amended to date. That the adequate pollution control measures (if required) shall be prescribed to meet the prescribed standards.

11.

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42

12. 13. 14.

That the adequate Emission Control System (ECS) (if required) shall be provided to meet the prescribed standards. That the adequate pollution control measures shall be taken to meet the prescribed ambient noise standards. That if Diesel Generator Sets (of capacity 5 KVA or more) shall be installed it will be EcoFriendly or with inbuilt acoustic enclosures to meet the prescribed norms w.r.t. noise as per the Gazette Notification on Ministry of Environment & Forests, Government of India dated 2.1.1999. Adequate stack height with D.G. Set(s) shall also be provided and maintained and shall submit noise monitoring report. That all orders and directions issued by the Board from time to time shall be complied with. That the name and addresses of Managing Director or other working Directors or Partner shall be given ____________ under. Any change there of shall be intimation immediately to the State Board.

15. 16.

DEPONENT VERIFICATION Verified at _____________ on this __________ (day, month and year) that the above contents of this affidavit are true and correct to the best of my knowledge and belief and nothing has been concealed there from.

DEPONENT Note: The aforementioned Affidavit must be duly signed by the Deponent and duly attested by the Notary Public thereof. Note: Please omit whatever is not applicable.

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Annexure 3 Consent Fee Under the Provisions of Air Act SCHEDULE (See rule 5) Part I Fee for Industries other than Mining Units
S. No Capital Investment of the Industry (in Rs.) 1 Upto 5 Lacs 2 More than 5 Lacs upto 10 Lacs 3 More than 10 Lacs upto 25 Lacs 4 More than 25 Lacs upto 50 Lacs 5 More than 50 Lacs upto 1 Crore 6 More than 1 Crore upto 5 Crore 7 8 9 10 11 12 13 14 15 More than 5 Crore upto 10 Crore More than 10 Crore upto 25 Crore More than 25 Crore upto 50 Crore More than 50 Crore upto 100 Crore More than 100 Crore upto 250 Crore More than 250 Crore upto 500 Crore More than 500 Crore upto 750 Crore More than 750 Crore upto 100 Crore Above 1000 Crore One Time Consent Fee to Annual Consent Fee to Operate (in Establish Rs.) (in Rs) Red Orange Other Red Orange Other 3,000 2,000 1,000 1,400 1,200 1,000 4,500 6,000 9,000 15,000 18,000 24,000 30,000 37,500 45,000 1,05,000 1,27,500 1,50,000 1,87,500 2,25,000 3,000 4,000 6,000 10,000 12,000 16,000 20,000 25,000 30,000 70,000 85,000 1,00,000 1,25,000 1,50,000 1,500 2,000 3,000 5,000 6,000 8,000 10,000 12,500 15,000 35,000 42,500 50,000 62,500 1,50,000 2,100 2,800 4,000 4,800 6,400 8,000 9,600 12,000 22,000 31,000 44,000 53,000 57,000 75,000 4,800 2,400 3,500 4,200 5,600 7,000 8,400 10,500 19,000 26,000 38,000 45,000 49,000 53,000 1,500 2,000 3,000 3,600 4,800 6,000 7,200 9,000 15,000 21,000 30,000 36,000 39,000 42,000

Note: 1. The categorization of the industries / mining units into Red, Orange and Other categories shall be as specified by the State Board. 2. All industries and mining units requiring environmental clearance under the Environmental (Protection) Act, 1986 shall pay an extra amount of Rs. 15,000/- as one time consent fee to establish in addition to that mentioned in Schedule IV. 3. Provided that where a person who is establishing or carrying on any industry, operation or process and is generating hazardous waste as defined under the Hazardous Wastes (Management & Handling) Rules, 1989; and requiring authorization thereunder; the application for consent shall be accompanied with a fee equal to one and half times of the amount of fee prescribed under Schedule IV. (Please refer Notification dated 25th May 2007 of Dept. of Environment, Govt. of Rajasthan)

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Annexure 4 Consent Fee Under the Provisions of Water Act SCHEDULE IV (See rule 29) Part I Fee for Industries other than Mining Units
S. Capital Investment of the Industry No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 (in Rs.) Upto 5 Lacs More than 5 Lacs upto 10 Lacs More than 10 Lacs upto 25 Lacs More than 25 Lacs upto 50 Lacs More than 50 Lacs upto 1 Crore More than 1 Crore upto 5 Crore More than 5 Crore upto 10 Crore More than 10 Crore upto 25 Crore More than 25 Crore upto 50 Crore More than 50 Crore upto 100 Crore More than 100 Crore upto 250 Crore More than 250 Crore upto 500 Crore More than 500 Crore upto 750 Crore More than 750 Crore upto 100 Crore Above 1000 Crore One Time Consent Fee to Annual Consent Fee to Operate (in Establish Rs.) (in Rs) Red Orange Other Red Orange Other 3,000 2,000 1,000 1,400 1,200 1,000 4,500 6,000 9,000 15,000 18,000 24,000 30,000 37,500 45,000 1,05,000 1,27,500 1,50,000 1,87,500 2,25,000 3,000 4,000 6,000 10,000 12,000 16,000 20,000 25,000 30,000 70,000 85,000 1,00,000 1,25,000 1,50,000 1,500 2,000 3,000 5,000 6,000 8,000 10,000 12,500 15,000 35,000 42,500 50,000 62,500 1,50,000 2,100 2,800 4,000 4,800 6,400 8,000 9,600 12,000 22,000 31,000 44,000 53,000 57,000 75,000 4,800 2,400 3,500 4,200 5,600 7,000 8,400 10,500 19,000 26,000 38,000 45,000 49,000 53,000 1,500 2,000 3,000 3,600 4,800 6,000 7,200 9,000 15,000 21,000 30,000 36,000 39,000 42,000

Note: 1. The categorization of the industries / mining units into Red, Orange and Other categories shall be as specified by the State Board. 2. All industries and mining units requiring environmental clearance under the Environmental (Protection) Act, 1986 shall pay an extra amount of Rs. 15,000/- as one time consent fee to establish in addition to that mentioned in Schedule IV. 3. Provided that where a person who is establishing or carrying on any industry, operation or process and is generating hazardous waste as defined under the Hazardous Wastes (Management & Handling) Rules, 1989; and requiring authorization thereunder; the application for consent shall be accompanied with a fee equal to one and half times of the amount of fee prescribed under Schedule IV. (Please refer Notification dated 25th May 2007 of Dept. of Environment, Govt. of Rajasthan)

45

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Annexure 5 Areas as Identified by CGWA as Safe Areas, Semi Critical Areas, Critical Areas & Over Exploited Areas
S.No 1 8 9 10 District 2 Bikaner Bundi Chittorgarh No of Blocks 3 5 4 14 Safe 4 1. Lunkaransar 2. Kolayat Semi-Critical 5 Critical 6 1. Dungargarh Over-Exploited 7 1. Bikaner 2. Nokha 1. Hindoli 2. Nainwa 1. Amod 2. Bari Sadri 3. Begun 4. Bhadesar 5. Bhopalsagar 6. Chhotisadri 7. Chittorgarh 8. Dungla 9. Gangrar 10. Kapasan 11. Nimbahera 12. Pratapgarh 13. Rashmi 1. Rajgarh

1. Kesorai Patan 2. Talera 1. Bhainsrorgarh -

11

Churu

1. Churu 2. Atangarh 3. Sardarshahar

1. Sujangarh -

12

Dausa

13 14 15

Dholpur Dungarpur Ganganagar

4 5 7

1. Bari 1. Aspur 1. Anupgarh 2. Ganganagar 3. Karanpur 4. Padampur 5. Raisingh nagar 6. Sadulshahar 7. Suratgarh 1. Bichhiwara 2. Dungarpur

1. Baseri 1. Sagwara 2. Simalwara

1. Bandikui 2. Dausa 3. Lalsot 4. Mahua 5. Sirai 1. Dholpur 2. Rajakhera

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46

16 Hanumangarh

1. Bhadra 2. Hanumangarh 3. Nohar 1. Dudu 2. Phagi 1. Amer 2. Bairath 3. Bassi 4. Chaksu 5. Govindgarh 6. Jamwa Ramgarh 7. Jhotwara 8. Kotputli 9. Sambher 10. Sanganer 11. Shahpura 1. Jaisalmer 2. Sankra 1. Ahore 2. Bhinmal 3. Jalore 4. Jaswantpura 5. Raniwara 6. Sanchore 7. Sayla 1. Bakani 2. Dag 3. Jhalra Patan 4. Khanpur 1. Alsisar 1. Manoha Thana 2. Pirawa

17 Jaipur

13

18 Jaisalmer 19 Jalore

3 7

1. Sam

20 Jhalawar

21 Jhunjhunu

1. Bhuhana 2. Chirawa 3. Jhunjhunu 4. Khetri 5. Nawalgarh 6. Surajgarh 7. Udaipurwati 1. Phalodi 1. Luni 2. Shergarh 1. Balesar 2. Bhopalgarh 3. Bilara 4. Mandore 5. Osaian 1. Sapotra 1. Hindaun 2. Karauli 3. Todabhim 1. Sultanpur 1. Itawa 2. Khairabad 3. Ladpura 4. Sangod

22 Jodhpur

1. Bap

23 Karauli

1. Nadauti

24 Kota

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25 Nagaur

11

1. Nagaur

1. Ladnu

1. Jayal 2. Makrana

26 Pali

10

27 Rajsamand

1. Degana 2. Didwana 3. Kuchaman 4. Merla 5. Mundwa 6. Parbaisar 7. Riyan 1. Bali 1. Jaitaran 2. Desuri 2. Kharchi 3. Pali 3. Rani 4. Raipur 4. Sojat 5. Rohit 5. Sumerpur 1. Railmagra 1. Amet 2. Rajsamand 2. Bhim 3. Deogarh 4. Khamnor 5. Kumbhalgarh 1. Bamanwas 1. Gangapur 2. Bonli 2. Sawai Madhopur 3. Khandar

28 Sawaimadhopur

29 Sikar

1. Fatehpur

30 Sirohi

1. Danta Ramgarh 2. Dhod 3. Khandella 4. Lachhmangarh 5. Neem Ka Thana 6. Piprali 7. Sri Madhopur 1. Abu Road 1. Reodar 2. Pindwara 2. Sheoganj 3. Sirohi 1. Deoli 2. Malpura 3. Newai 4. Toda Rai Singh 5. Tonk 1. Kherwara 2. Kotra 3. Sarada 1. Untara

31

Tonk

32 Udaipur

11

1. Badgaon 2. Bhinder 3. Dhariawad 4. Girwa 5. Gogunda 6. Jhadot 7. Mavli 8. Salumber 140

Total 237 32 14 50 (Source: CGWA No: 21-4/Guidelines/CGWA/2009-832 dated 14.10. 2009 , www.rpcb.nic.in)

RSPCB inputs requested for other districts, as the same is not available on the web

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48

Annexure 6 National Ambient Air Quality Standards (NAAQS)

S. No Pollutant Time Weighted Average Industrial, Residential, Rural and other areas (4) 50 80 40 80 60 100 40 60 100 180 0.50 1.0 Concentration in Ambient Air Ecologically Methods of sensitive area measurement (notified by central government) (5) (6) 20 -Improved West & Gaeke -Ultraviolet fluorescence 80 30 -Modified Jacob & Hochheiser (Na80 arsenite) -Chemiluminescence 60 - Gravimetric - TOEM 100 - Beta attenuation 40 60 100 180 0.50 1.0 - Gravimetric - TOEM - Beta attenuation - UV photometric - Chemiluminescence - Chemical method -AAS/ICP method after sampling on EPM 2000 or equivalent filter paper -ED-XRF using Teflon filter -Non Dispersive Infra Red (NDIR) spectroscopy - Chemiluminescence - Indophenol blue method -Gas chromatography based continuous analyzer -Adsorption and Desorption followed by GC analysis

(1) 1

(2) Sulphur dioxide (SO2), g/m3 Nitrogen Dioxide (NO2), g/m3

(3) Annual* 24 hours** Annual* 24 hours** Annual* 24 hours** Annual* 24 hours** 8 hours** 1 hour** Annual* 24 hours**

Particulate Matter (Size less than 10m) or PM10g/m3 Particulate Matter (Size less than 2.5m) or PM2.5g/m3 Ozone (O3) g/m3 Lead (Pb) g/m3

Carbon Monoxide (CO) mg/ m3 Ammonia (NH3) g/m3 Benzene (C6H6) g/m3

8 hours** 1 hour** Annual* 24 hours** Annual*

02 04 100 400 05

02 04 100 400 05

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10

11

Benzo(a)Pyrene (BaP) particulate phase only, ng/m3 Arsenic (As) ng/m3 Nickel (Ni) ng/m3

Annual*

01

01

-Solvent extraction followed by HPLC/GC analysis -AAS/ICP method after sampling on EPM 2000 or equivalent filter paper -AAS/ICP method after sampling on EPM 2000 or equivalent filter paper

Annual*

06

06

12

Annual*

20

20

* Annual arithmetic mean of minimum 104 measurements in a year at a particular site taken

twice a week 24 hourly at uniform intervals

** 24 hourly or 08 hourly or 01 hourly monitored values, as applicable, shall be complied with 98% of the time in a year. 2% of the time, they may exceed the limits but not on two consecutive days of monitoring. Note: Whenever and wherever monitoring results on two consecutive days of monitoring exceed the limits specified above for the respective category, it shall be considered adequate reason to institute regular or continuous monitoring and further investigation (Source: National Ambient Air Quality Standards, CPCB Notification dated 18th November 2009)

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Annexure 7 Common Application for Consent To Operate under Air Act, Water Act and Authorization under Hazardous Waste Rules FORM No.

Common Application Form for Consent To Operate under 25/26 of the Water (P & CP) Act, 1974, under Section 21 of the Air (P & CP) Act 1981 & Authorization under HW (MH & TM) Rules 2008 as amended (This application is only for Brick Kilns) From

Date

To The Member Secretary, Rajasthan State Pollution Control Board, 4, Industrial Area, Jhalana Doongri, Jaipur 302 004 (Through the concerned Regional Officer)

To be submitted in triplicate

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BRICK KILNS

Explanatory Note for Filing the Application Form Occupier in relation to factory or premises, means the person who has control over the affairs of the factory or the premises, and includes, in relation to any substance, the person in possession of the substance Out let- Any conduit pipe or channel, open or closed, carrying sewage or trade effluent or nay other holding arrangement which causes or is likely to cause pollution

Trade Effluent Includes any liquid, gaseous or solid substance, which is discharged from any premises used for carrying on nay industry, operation or process, or treatment and disposal system, other than domestic sewage
Chimney Includes nay structure with an opening or outlet from or through which any air pollutant may be emitted Industrial Plant Nay plant used for any industrial or trade purposes and emitting any air pollutant into the atmosphere Emission Any solid or liquid or gaseous substance coming out of any chimney, duct or flue or any other outlet Sir, I/We hereby apply for: 1. Consent To Operate under Section 25/26 of the Water (P & CP) Act Yes No 1974 as amended, to discharge or continue to discharge sewage/trade effluent Consent To Operate under Section 21 of the Air (P & CP) Act 1981 as Yes No amended, to discharge emissions from industrial plant owned by Authorization/renewal of authorization under sub-rule (3) of Rule 5 of Yes No HW (MH & TM) Rules 2008 as amended

2.

3.

Part A: General Information

01. Name & Address of the occupier: Phone No: Fax No: Mobile No: E-mail: 02. Name & Location of the unit: Survey No/Plot No/Shed No:

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52

Village: Tehsil: District: Pin Code: 03. Whether located in industrial area developed by RIICO?

04. 05. 06. 07. 08. 09. 10. 11. 12.

13.

14.

15.

16.

17.

Yes/No If yes: RIICO allotment No. Whether the unit is situated in a critically polluted area as Yes/No identified by MoEF? Category and Scale of the industry: Orange Large/Medium/Small: Number of employees working in the industry: Year of commencement of production: Whether the industry works general/2 shifts/round the clock: Power supply agency at the industry premises along with Service No: Capital investment of the industry: Applicability of HW (MH&TM) Rules 2008 as amended Yes/No Whether obtained Consent To Establish from the Board? Yes/No If yes: CTE No.Date.. In case of renewal, please furnish earlier CTO/HWA details CTO order No as per applicability: Date. Valid up to. HWA No Date. Valid up to. Whether the industry is required to obtain NOC from Yes/No CGWA for extraction of ground water? If yes: NOC NoDate Whether the industry attracts the provisions of the Water (P Yes/No & CP) Cess Act, 1977 as amended? If yes: Cess paid up to.. Whether the industry is meeting the criteria of RSPCB of Yes/No Self Assessment Scheme (Cess) If yes: Latest submission date. Raw materials including fuel requirement at installed Name Quantity capacity in TPD/Kl: Name Quantity

18. Products & By products at installed capacity in TPD/Kl:

19. Furnish a flow diagram of manufacturing process showing Pl attach as Annexure... input and output in terms of products, waste generated

53

BRICK KILNS

including for captive power generation and de-mineralized water: 20. Details of solid waste generation/ quantity/mode of Yes/No disposal including re-use etc. other than HW as per the If yes, furnish details Rules

Part B: Information required in connection with Prevention and Control of Water Pollution
21. Source of water: Municipal Supply/Well/Tube Well/Canal/Others 22. Water consumption per day for the following streams: Trade purpose: Domestic purpose: Total Water requirement: 23. Wastewater generation per day: Trade purpose: Domestic purpose: Total wastewater generation per day: 24. Whether water meters provided? Yes/No 25. Details of Effluent Treatment Plant: 26. Mode of disposal of waste water:

KLD

KLD

Yes/No If yes, attach as Annexure

Part C: Information required in connection with Prevention and Control of Air Pollution
27. Sources of Air Emissions: A From manufacturing process (Name the unit ---------------operations causing emission of pollutants attach ---------------additional sheet if required) ---------------Annexure attached Yes/No C From Kiln etc. Description Capacity Fuel Fuel quantity Chimney Type of APC height from GL D From Diesel Generator Sets a. No. of DG Sets: b. Capacity of each DG set: c. Height of the stack above DG room: d. Height of the DG room: e. Noise pollution control measures:

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54

Acoustic enclosure/acoustic treatment of DG room: ii. Exhaust muffler: E Fugitive emissions Sources and Mitigation Measures If not applicable Say No If applicable Attach as Annexure. 28. Latest monitoring report of the Board or Boards If not applicable Say No recognized laboratory: If applicable Attach as Annexure.

i.

Part D: Information required in connection with Hazardous Waste (Management Handling & Transboundary Movement) Rules, 2008 for obtaining Authorization for Collection/Reception/Treatment/Transport/Storage/Disposal of HW*
* Delete which ever is not applicable 29. Code No: 30. Authorization required for Collection/ Reception/ Please specify Treatment/ Transport/ Storage/ Disposal 31. In case of renewal of authorization previous authorization HWA No. Date of issue... number, date of issue and validity period: Validity period... 32. Hazardous waste A Type of hazardous waste generated as defined under these rules: B Quantum of hazardous waste generated (TPD/KLD) Category wise: C Sources and waste characteristics (also indicate wastes amenable to recycling, re-processing and reuse): D Mode of storage within the plant, method of disposal and capacity (provide details): 33. Disposal of hazardous waste: Treatment, Storage and Disposal Facility 34. Detailed proposal of the facility (to be attached) to include: A Location of site (provide map): B Name of waste processing technology: C Details of processing technology: D Type and quantity of waste to be processed per day: E Site clearance (from local authority, if any): F Utilization programme for waste processed (product utilization): G Method of disposal (details in brief be given): H Quality of waste to be displayed per day: I Nature and composition of waste:

55

BRICK KILNS

J K

L M

Methodology and operational details of land filling/incineration: Measures to be taken for prevention and control of environmental pollution including treatment of leachate: Investment on project and expected returns: Measures to be taken for safety of workers working in the plant:

Note: If the industry is not having DG set for power generation, information of Part: D is not required to furnish.

Part E: Other Information

35. In case of CTO first time, please attach the compliance statement to the conditions stipulated in CTE in a tabular form: 36. In case of CTO renewal, please attach the compliance statement to the conditions stipulated in the earlier CTO in a tabular form: 37. In case of HWA renewal, please attach the compliance statement to the conditions stipulated in the earlier Authorization in a tabular form: 38. Submission of Environmental Statement in Form V If not applicable Say No If applicable Attach as Annexure. If not applicable Say No If applicable Attach as Annexure. If not applicable Say No If applicable Attach as Annexure. Yes/No If yes, date .

Declaration I/We further declare that the information furnished in the application form, Annexure / Appendices and plans is correct to the best of my / our knowledge I/We hereby submit that in case of change either of the point, or the quantity of discharge/emissions or its quality, a fresh application for Consent shall be made and until such consent is granted, no change shall be made I/We hereby agree to submit to the State Board an application for renewal of consent/HWA 90 days (RSPCB may kindly review the stipulated requirement) in advance of the date of expiry of the consented period for outlet/discharge, if to be continued thereafter I/We undertake to furnish any other information within one month of its being called by the State Board.

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Enclosures 1. I/We enclose herewith Bank Draft NoDatedfor Rs.(Rs. In words) in favor of the Member Secretary, Rajasthan Pollution Control Board, payable under Section 25/26 of the Water Act. The Consent Fee paid is for the period fromto.. 2. I/We enclose herewith Bank Draft NoDatedfor Rs.(Rs. In words) in favor of the Member Secretary, Rajasthan Pollution Control Board, payable under Section 21 of the Air Act. The Consent Fee paid is for the period fromto.. 3. In support of amount paid as fee, document on capital investment on the industry must be enclosed. An application not accompanied with the prescribed fee and support document shall not be entertained by the Board 4. Affidavit in the prescribed Proforma 5. Document in support of authorizing the person to sign the application 6. Different Annexures duly giving numbers as mentioned in the application Yours faithfully, Signature of the Applicant. Name. Designation.. Office Seal

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Annexure 8

Emission standards for Brick Kilns [G.S.R. 543 (E) dated 22nd July 2009]
G.S.R 543 (E) In exercise of the powers conferred by Sections 6 and 25 of the Environment (Protection) Act, 1986 (29 of 1986), the Central Government makes the following rules further to amend the Environment (Protection) Rules, 1986, namely: 1. (1) These rules may be called the Environment (Protection) Fourth Amendment Rules, 2009 (2) They shall come into force on the date of their publication in the Official Gazette 2. In the Environment (Protection) Rules, 1986, in Schedule I, for serial number 74, relating to Emission Standards for Brick Kilns and entries relating thereto, the following serial number and entries shall be substituted namely: S. No (1) 74 Industry (2) Brick Kilns Parameter (3) Emission Standards i. Bulls Trench Kiln (BTK) Category* Particulate matter Small Medium Large Stack height Small Standard (4)

Limiting conc. in mg/Nm3 1000 750 750 Minimum (meter) 22 or induced draft fan operating with minimum draft of 50mm WG with 12 meter stack height 27 or induced draft fan operating with minimum draft of 50mm WG with 15 meter stack height 30 or induced draft fan operating with minimum draft 50mm WG with 17 meter stack height Production (bricks/day) Less than 15,000 15,000-30,000 Above 30,000 Limiting conc. In mg/Nm3 1200 12 15 18

Medium

Large

*Category Trench width (m) Small BTK <4.50 Medium BTK 4.50-6.75 Large BTK Above 6.75 ii. Down-Draft Kiln (DDK) Category++ Particulate matter Small/Large/Medium Stack Height Small Medium Large ++Category Production (bricks/day) Small DDK Less than 15,000 Medium DDK 15,000-30,000

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Large DDK Above 30,000 iii. Vertical Shaft Kiln (VSK) Category** Particulate matter Small/large/medium Small Medium Stack height **Category Small VSK Medium VSK Large VSK Notes: Large No. of shafts 1-3 4-6 7 or more

Limiting conc. In mg/Nm3 250 Minimum (meter) 11 (at least 5.5m from loading platform) 14 (at least 7.5m from loading platform) 16 (at least 8.5m from loading platform) Production (bricks/day) Less than 15,000 15,000-30,000 Above 30,000

1. Gravitational Settling Chamber along with fixed chimney of appropriate height shall be provided for all Bulls Trench Kilns 2. One chimney per shaft in Vertical Shaft Kiln shall be provided. The two chimneys emanating from a shaft shall either be joined (at the loading platform in case of brick chimney or at appropriate level in case of metal chimney) to form a single chimney 3. The above Standards shall be applicable for different kilns if coal, firewood and/or agricultural residues are used as fuel (www.moef.nic.in)

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Noise Ambient Air Quality Standards Area code A B C D Category of area Industrial area Commercial area Residential area Silence zone Limits in db (A) Leq Day time Night time 75 70 65 55 55 45 50 40

Annexure 9

Note:
1. 2. 3. Daytime shall mean from 6.00 a.m. to 10.00 p.m. Nighttime shall mean from 10.00 p.m. to 6.00 a.m. Silence zone is an area comprising not less than 100 meters around hospitals, educational institutions, courts, religious places or any other area, which is declared as such by the competent authority. Mixed categories of areas may be declared as one of the four above-mentioned categories by the competent authority.

4.

* dB(A) Leq denotes the time weighted average of the level of sound in decibels on scale A which is relatable to human hearing. A decibel is a unit in which noise is measured. A, in dB(A) Leq, denotes the frequency weighting in the measurement of noise and corresponds to frequency response characteristics of the human ear. Leq: It is an energy mean of the noise level over a specified period. (Source: Noise pollution (Regulation and control) Rules, 2000)

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Annexure 10 Noise Limits for Generator Sets run with Diesel 1. Noise limit for diesel generator sets (up to 1000 KVA) manufacture on or after the 1st July 2003 The maximum permissible sound pressure level for new diesel generator (DG) sets with rated capacity up to 1000 KVA, manufactured on or after the 1st July, 2003 shall be 75 dB (A) at 1 meter from the enclosure surface The diesel generator sets should be provided with integral acoustic enclosure at the manufacturing stage itself The implementation of noise limit for these diesel generator sets shall be regulated as given in paragraph 3 below 2. Noise limit for DG sets not covered by paragraph 1 Noise limits for diesel generator sets not covered by paragraph 1, shall be as follows: 2.1 Noise from DG set shall be controlled by providing an acoustic enclosure or by treating the room acoustically, at the users end 2.2 The acoustic enclosure or acoustic treatment of the room shall be designed for minimum 25 dB (A) insertion loss or for meeting the ambient noise standards, whichever is on the higher side (if the actual ambient noise is on the higher side, it may not be possible to check the performance of the acoustic enclosure/acoustic treatment. Under such circumstances the performance may be checked for noise reduction up to actual ambient noise level, preferably, in the nighttime). The measurement for insertion loss may be done at different points at 0.5m from the acoustic enclosure/room, and then averaged 2.3 The DG set shall be provided with proper exhaust muffler with insertion loss of minimum 25 dB (A) 2.4 these limits shall be regulated by the State Pollution Control Boards and the State Pollution Control Committees 2.5 Guidelines for the manufacturers/users of Diesel Generator sets shall be as under: 01. The manufacturer shall offer to the user a standard acoustic enclosure of 25 dB (A) insertion loss and also a suitable exhaust muffler with insertion loss of 25 dB(A) 02. The user shall make efforts to bring down the noise levels due to the DG set; outside hid premises, within the ambient noise requirements by proper siting and control measures

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03. Installation of a DG set must be strictly in compliance with the recommendations of the DG set manufacturer 04. A proper routine and preventive maintenance procedure for the DG set should be set and followed in consultation with the DG set manufacturer which would help prevent noise levels of the DG set from deteriorating with use 3. Limits of noise for DG Sets (Up to 1000 KVA) Manufactured on or after the 1st July 2003 3.1 Applicability 01. These Rules apply to DG sets up to 1000 KVA rated output, manufactures of imported in India, on or after 1st July 2003 02. These rules shall not apply to a. DG sets manufactures or imported for the purpose of exports outside India; and b. DG sets intended for the purpose of sample and not for sale in India (Please refer Notification No. G.S.R. 371 (E) dated 17th May, 2002 for details)

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Form-V

Annexure 11

(See rule 14) Environmental statement for the financial year ending the 31st March Part A Name and address of the owner/occupier of the industry operation or process Industry category primary- (STC Code) Secondary- (SIC Code) Production capacity Year of the establishment Date of last environmental statement submitted Part B Water and raw material consumption (1) Water consumption m3/d Process Cooling Domestic Name of Products Process Water consumption per unit of product output During the Previous During the current Financial year financial year (1) (2)

(1) (2) (3)

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Raw material consumption

* Name of raw Materials

Name of products

Consumption of raw material per unit of output -------------------------------------------------------------------During the previous during the current Financial year financial year

----------------------------------------------------------------------------------------------------------------*Industry may use codes if disclosing details of raw material would violate contractual obligations; otherwise all industries have to name the taw materials used. Part C Pollution discharged to environment/unit of output (Parameter as specified in the consent issued) (1) Pollutants Quality of pollutants discharged (mass/day) Concentrations of pollutants discharges (Mass/volume) Percentage of variation from prescribed standards with reasons

(a) Water (b) Air Part D HAZARDOUS WASTES (As specified under hazardous wastes (Management and Handling) Rules, 1989) Hazardous Wastes Total Quantity (Kg) During the Previous Financial year

During the current financial year

a. From process b. From pollution control facilities

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Part E Solid Wastes Total Quantity -----------------------------------------------------During the Previous During the current Financial year financial year a. From process b. From pollution control facilities c. (1) Quantity recycled or reutilized within the unit. (2) Sold (3) Disposed PART F Please specify the characterizations (in terms of composition of quantum) of hazardous as well as solid wastes and indicate disposal practice adopted for both these categories of wastes. PART G Impact of the pollution abatement measures taken on conservation of natural resources and on the cost of production. PART H Additional measures/investment proposal for environmental protection including abatement of pollution, prevention of pollution PART I Any other particulars for improving the quality of the environment

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Annexure 12 Hazardous Waste (Management, Handling and Transboundary Movement) Rules, 2008 FORM 4 [See rules 5 (6) and 22 (2)] FORM FOR FILING ANNUAL RETURNS BY THE OCCUPIER OR OPERATOR OF FACILITY To be submitted by occupier/operator of disposal facility of Sate Pollution Control Board/Pollution Control Committee by 30th June of every year for the preceding period April to March]
1. 2 Name and address of the generator/operator of facility Name of the authorized person and full address with telephone and fax number Description of hazardous waste : :

3.

Physical form with description

Chemical form

4.

Quantity of hazardous wastes (in MTA)

Type of hazardous waste (a) (b) (c) ..

Quantity (in Tonnes KL)

5. 6. 7.

Description of Treatment Description of transportation Details of transportation

: : :

Name & Address

Mode of packing

Mode of transportation

Date of transportation

8.

Details of disposal of hazardous waste

Name & address of consignee

Mode of packing

Mode of transportation

Date of transportation

9.

Quantity of useful materials sent back to the manufacturers and others

Name and type of material sent back to Manufacturers* Others#

Quantity in Tonnes/KL

*Delete whichever is not applicable # Enclose list of other agencies Date: .. Place: .. Signature: Designation:

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