Professional Documents
Culture Documents
[See rules 5(6) and 22 (2)]
FORM FOR FILLING ANNUAL RETURNS BY THE
OCCUPIER OR OPERATOR OF FACILITY
[To be submitted by the occupier/operator of disposal facility to State Pollution Control Board/
th
Pollution Control Committee by 30 June of every year for the preceding period April to March]
1 : Mahima Pure Spun
. Name and address of the (A Unit of Mahima Fibre Pvt Ltd.)
generator/operator of facility Plat no.7374 Pithampur Sector2 Dist.Dhar,
(M.P)
2 Name of the authorized person : B.S.Yadav Factory Manager
. and full address with Plat no.7374 Pithampur Sector2 Dist
telephone and fax number. Dhar,(M.P.)
3 Description of hazardous : Chemical form
Physical form with description
. waste
Inliquid foam Spent oil
Category 5.1
4 :
Quantity of hazardous wastes Type of hazardous waste Quantity (in Tonnes/KL)
.
(in MTA) (a)
(b)
(c)
……………………… ……………………………..
5 Description of Storage :
.
6 Description of Treatment :
.
7 Details of transportation : Name & Mode of packing Mode of Date of
. address of transportatio transportation
consignee n
* delete whichever is not applicable # enclose list of other agencies
: :
Date:……………………… Signature Designation
Place…………………………