Xc nhn ng k bn cam kt bo v mi trng. 1. Trnh t thc hin. - Bc 1. C nhn np h s ti B phn tip nhn v tr kt qu ca UBND cp huyn.

Cng chc tip nhn kim tra tnh y , hp l ca h s. Nu y , hp l th vit phiu hn; nu cha y , hp l hng dn hon thin, b sung. - Bc 2. Phng Ti nguyn Mi trng kim tra, thm nh h s tham mu trnh Ch tch UBND cp huyn quyt nh. - Bc 3. n ngy hn, c nhn nhn kt qu ti B phn tip nhn v tr kt qu ca UBND cp huyn. Khi n nhn phi xut trnh phiu hn v k vo s theo di h s. Trng hp n nhn thay thi phi c giy u quyn (c xc nhn ca UBND cp x) v giy chng minh nhn dn ca ngi c u quyn. 2. Cch thc thc hin: Trc tip ti tr s c quan hnh chnh nh nc. 3. Thnh phn, s lng h s: a) Thnh phn h s, bao gm: - 01 vn bn ngh xc nhn ng k cam kt bo v mi trng (CKBVMT) (theo mu, bn chnh). - 05 bn cam kt bo v mi trng (CKBVMT) (theo mu); trng hp u quyn cho UBND cp x xc nhn, gi thm 01 bn CKBVMT (i vi d n nm trn 01 huyn); trng hp d n nm trn 02 huyn tr ln, gi thm s lng bn CKBVMT bng s lng cc huyn tng thm.(bn chnh) - 01 bn d tho bo co nghin cu kh thi hoc bo co gii trnh v u t ca d n.(bn chnh hoc bn sao) b) S lng h s: 01 (b); 4. Thi hn gii quyt: 20 ngy lm vic k t ngy nhn h s hp l. 5. i tng thc hin th tc hnh chnh: C nhn, T chc. 6. C quan thc hin th tc hnh chnh: Phng Ti nguyn v mi trng ca UBND cp huyn. 7. Kt qu thc hin th tc hnh chnh: Giy xc nhn. 8. L ph (nu c): Khng. 9. Tn mu n, mu t khai (nu c v ngh nh km): - Bn cam kt bo v mi trng Ph lc 24, 26. - Vn bn ngh xc nhn bn cam kt bo v mi trng Ph lc 25. 10.Yu cu, iu kin thc hin th tc hnh chnh (nu c): - Ph hp vi quy hoch s dng t c c quan c thm quyn quyt nh. 11. Cn c php l ca th tc hnh chnh: - Lut Bo v Mi trng nm 2005 - Ngh nh 80/2006/N-CP ngy 09/8/2006 ca Chnh ph v vic quy nh chi tit v hng dn thi hnh mt s iu ca Lut Bo v mi trng; - Ngh nh s 21/2008/N-CP ngy 28/02/2008 ca Chnh ph v sa i, b sung mt s iu ca Ngh nh 80/2006/N-CP ca Chnh ph; - Thng t 05/2008/TT-BTNMT ngy 08/12/2008 ca B Ti nguyn v Mi trng hng dn v nh gi tc ng mi trng chin lc, nh gi tc ng mi trng v cam kt bo v mi trng

PH LC 24 CU TRC V YU CU V NI DUNG CA BN CAM KT BO V MI TRNG (Ban hnh km theo Thng t s 05/2008/TT-BTNMT ngy 08 thng 12 nm 2008 ca B Ti nguyn v Mi trng hng dn v nh gi mi trng chin lc, nh gi tc ng mi trng v cam kt bo v mi trng) I. THNG TIN CHUNG 1.1. Tn D n: (ng nh tn trong bo co u t/bo co kinh t - k thut/phng n sn xut kinh doanh hoc ti liu tng ng ca D n) 1.2. Tn c quan, doanh nghip Ch d n: 1.3. a ch lin h ca c quan, doanh nghip Ch d n: 1.4. Ngi ng u c quan, doanh nghip Ch d n: 1.5. Phng tin lin lc vi c quan, doanh nghip Ch d n: (s in thoi, s Fax, E-mail ). II. A IM THC HIN D N M t v tr a l (ta theo quy chun hin hnh, ranh gii) ca a im thc hin d n km theo s minh ha ch r cc i tng t nhin (sng ngi, ao h, ng giao thng ), cc i tng v kinh t - x hi (khu dn c, khu th; c s sn xut, kinh doanh, dch v; cng trnh vn ha, tn gio, di tch lch s ) v cc i tng khc xung quanh khu vc d n. Ch r u l ngun tip nhn nc thi, kh thi ca d n km theo cc tiu chun, quy chun k thut v mi trng hin hnh p dng i vi cc ngun ny. III. QUY M SN XUT, KINH DOANH Nu tm lc v quy m/cng sut sn xut; cng ngh sn xut; lit k danh mc cc thit b, my mc km theo tnh trng ca chng. IV. NHU CU NGUYN, NHIN LIU S DNG - Nhu cu v nguyn liu, nhin liu phc v cho sn xut c tnh theo ngy, thng hoc nm v phng thc cung cp. - Nhu cu v ngun cung cp in, nc cho sn xut. V. CC TC NG MI TRNG 5.1. Cc loi cht thi pht sinh 5.1.1. Kh thi: 5.1.2. Nc thi: 5.1.3. Cht thi rn: 5.1.4. Cht thi khc: (i vi mi loi cht thi phi nu cc thng tin v: ngun pht sinh, tng lng pht sinh trn mt n v thi gian, thnh phn cht thi v hm lng/nng ca tng thnh phn) 5.2. Cc tc ng khc:

Nu tm tt cc tc ng (nu c) do: s xi mn, trt, st, l, ln t; s xi l b sng, b sui, b h, b bin; s bi lng lng sng, lng sui, lng h; s thay i mc nc mt, nc di t; xm nhp mn; xm nhp phn; s bin di vi kh hu; s suy thoi cc thnh phn mi trng; s bin i a dng sinh hc v cc yu t khc. V. BIN PHP GIM THIU TC NG TIU CC 6.1. X l cht thi: - Mi loi cht thi pht sinh u phi c km theo bin php x l tng ng, thuyt minh v mc kh thi, hiu sut/hiu qu x l. Trong trng hp khng th c bin php hoc c nhng kh kh thi trong khun kh ca d n phi nu r l do v c kin ngh c th cc c quan lin quan c hng gii quyt, quyt nh. - Phi c chng minh rng, sau khi p dng bin php th cc cht thi s c x l n mc no, c so snh, i chiu vi cc tiu chun, quy chun, quy nh hin hnh. Trng hp khng p ng c yu cu quy nh th phi nu r l do v c nhng kin ngh c th cc c quan lin quan c hng gii quyt, quyt nh. 6.2. Gim thiu cc tc ng khc: Mi loi tc ng pht sinh u phi c km theo bin php gim thiu tng ng, thuyt minh v mc kh thi, hiu sut/hiu qu x l. Trong trng hp khng th c bin php hoc c nhng kh kh thi trong khun kh ca d n th phi nu r l do v c kin ngh c th cc c quan lin quan c hng gii quyt, quyt nh. VII. CC CNG TRNH X L MI TRNG, CHNG TRNH GIM ST MI TRNG 7.1. Cc cng trnh x l mi trng: - Lit k y cc cng trnh x l mi trng i vi cc cht thi rn, lng, kh v cht thi khc trong khun kh ca d n; km theo tin thi cng c th cho tng cng trnh; - Cc cng trnh x l mi trng phi c lm r v chng loi, c tnh k thut, s lng cn thit. 7.2. Chng trnh gim st mi trng: i hi phi gim st lu lng/tng lng thi v gim st nhng thng s nhim c trng cho cht thi ca d n theo tiu chun, quy chun hin hnh ca Vit Nam, vi tn sut ti thiu 06 (su) thng mt ln. Cc im gim st phi c th hin c th trn s vi ch gii r rng v ta theo quy chun hin hnh. VIII. CAM KT THC HIN Cam kt v vic thc hin cc bin php x l cht thi, gim thiu tc ng khc nu trong bn cam kt; cam kt x l t cc tiu chun, quy chun k thut hin hnh v mi trng; cam kt thc hin cc bin php bo v mi trng khc theo quy nh hin hnh ca php lut Vit Nam. Ch d n (K, ghi h tn, chc danh, ng du)

PH LC 25 MU VN BN NGH XC NHN NG K BN CAM KT BO V MI TRNG (Ban hnh km theo Thng t s 05/2008/TT-BTNMT ngy 08 thng 12 nm 2008 ca B Ti nguyn v Mi trng hng dn v nh gi mi trng chin lc, nh gi tc ng mi trng v cam kt bo v mi trng) (1) ------S: ...
V/v ngh xc nhn ng k bn cam kt bo v mi trng ca D n (2)

CNG HA X HI CH NGHA VIT NAM c lp T do Hnh phc -------------(a danh), ngy thng nm

Knh gi: (3) Chng ti l: (1) , Ch D n: (2) . - a im thc hin D n: ; - a ch lin h: ; - in thoi: ; Fax: ; E-mail: Xin gi n (3) nhng h s sau: - 01 (mt) bo co u t/bo co kinh t - k thut/d n u t/phng n sn xut kinh doanh hoc ti liu tng ng ca D n; - 05 (nm) bn cam kt bo v mi trng ca D n bng ting Vit. Chng ti xin bo m v trung thc ca cc s liu, ti liu trong cc vn bn nu trn v cam kt rng: D n ca chng ti khng s dng cc loi ha cht, chng vi sinh b cm theo quy nh ca Vit Nam v quy nh ca cc cng c quc t m Vit Nam l thnh vin; cc tiu chun, quy chun, quy nh c trch lc v s dng trong cc h s nu trn ca chng ti l ng s thc v ang c hiu lc p dng. Nu c g sai tri chng ti xin hon ton chu trch nhim trc php lut ca Nc Cng ha X hi Ch ngha Vit Nam. ngh (3) xem xt, ng k v cp giy xc nhn ng k bn cam kt bo v mi trng ca D n. (4) Ni nhn: (K, ghi h tn, chc danh, ng du) - Nh trn; - Lu Ghi ch: (1) Tn c quan, doanh nghip ch d n; (2) Tn y ca d n;

(3) y ban nhn dn cp huyn c thm quyn xc nhn ng k; (4) Th trng c quan, doanh nghip ch d n. PH LC 26 MU BA V TRANG PH BA CA BN CAM KT BO V MI TRNG (Ban hnh km theo Thng t s 05/2008/TT-BTNMT ngy 08 thng 12 nm 2008 ca B Ti nguyn v Mi trng hng dn v nh gi mi trng chin lc, nh gi tc ng mi trng v cam kt bo v mi trng) (tn c quan ch qun/ph duyt d n) (nu c) (tn c quan, doanh nghip ch d n)

BN CAM KT BO V MI TRNG ca D N

C QUAN CH D N (*) (Th trng c quan k, ghi h tn, ng du)

C QUAN T VN LP BN CAM KT (*) (nu c) (Th trng c quan k, ghi h tn, ng du)

(a danh), thng nm 200

Ghi ch: (*) ch th hin trang ph ba