FORM -3

[See Rule 9(1)]

(Format for maintaining records of Hazardous wastes at the facility)
1. Name & address of the occupier or operator of a facility:
M/S Omkamal Technosystems
PLOT NO.520 Ecotech 3 Udyog Kendra 2
Greater Noida (U.P)

2. Date of issuance of authorization and its reference number:

Date: 21.09.2016
DATE-
Ref No: AWH-36516Valid up to: 31/03/2019. (Applied For)
3. Description of hazardous waste:

Physical form with description Chemical form Total volume and weight (in kg.)

4. Description of storage and treatment of Hazardous waste.

Date Method of storage of hazardous wastes Date Method of treatment of hazardous wastes

5. Details of transportation of hazardous waste:

Name & address of the consignee of Mode of packing/ of the Mode of Date of
the Package waste for transportation transportation to site transportation
of disposal

6. Details of disposal of hazardous wastes:

Date of disposal Concentration of Site of disposal Method of Persons

hazardous material (identify the location disposal involved in
on the relevant layout disposal
drawing for reference)

7. Date of environmental surveillance:

Date of Analysis of ground water Analysis Analysis Analysisof any

measurement of soil samples of air Othersamples
samples (giveDetails)

Location Depth of Data Location Depth of Data Data LOCATION OF

of sampling of sampling SAMPLING
sampling sampling

8. Details of hazardous wastes reused & recycled:

Date Total qty of hazardous Details of hazardous waste Material Final qty of Net reduction in waste
waste generated minimization activity received waste generated generation quantity &
percentage

Signature Department:
(Name &Designation) Date: SIGNATURE: EHS Officer