Chikiti NAC ¥ OR ~ i Trade License Certificate This License is Issued U/S 617 of OMC & U/S 337 of OM Act License No.:- TL/CKT/2022-12-06/019699 Application No.:- TL-CKT-2022-08-19-028044 | Valid from: - 19/08/2022 Valid up to: Particulars of License Trade Name JS EYE HOSPITAL Trader Owner MINOTI NAYAK Trade Premises (Address): HANUMAN NAGAR, CHIKITIPENTHO, HANUMAN NAGAR, Trade Type ‘TRADELICENSE_TRADETYPE_MEDICALESTABLISHMENTS_TS 3 Trade Purpose HOSPITAL License Fee Rs 500 received on 19/08/2022, Receipt No - 08/2022-23/511923 License Issue Date 06/12/2022 DISCLAIMER 1. This license is granted solemnly on basis of documents submitted and self-certification. If any of the statements of undertaking/self-declaration are subsequently found otherwise, the License is liable to be cancelled/ revoked for all intents and purposes forthwith while forfeiting the fee, 2. Applicant shall be liable for legal and penal action for obtaining license fraudulently by making false averments and further in this regard will not amount to permission for change of land use of premises in question. By Order of Sambit Sangramjeet Sahoo Authorized Officer Signature vali CChikiti NAC Rie Sonat ‘st gay sg leony rete cele nd fren ms ive, Th ind pe sc. of Waren ey 08 ant 19/08/2023OFFICE OF THE ASST. FIRE OFFICER, BERHAMPUR FIRE STATION VETO SAVE émoit-asstfire wi perhompur@gmailcom Tel. Ph, No, 0660 (2223833 & 2220842) L. No.813/BPR FS Dtd. 20.02.2022 TO JS. EYE CLINIC Prop Minoti Nayak W/o Prashant Kumar Nayak, Hanuman Nagar, Chikiti Pentho, Chikiti, Ganjam . Ref:- Application No-FCS1408260072022000001 sub:- Fire Safety Certificate of J .S. EYE CLINIC, Prop. Minoti Nayak Inspected the premises Clinical Establishment J .S. EYE CLINIC, Prop. Minot Nayak situated at Plot No 236/4887 ,Khata No 179/2761, Mouza ~Sanibarpentho, Chikiti, Ganjam regarding fire safety measures. | _ Name of the premises | Usage TS. EYE CLINIC | Clinical Establishment ,Ground floor only Height Below 12 meter Icu /CCU Nil | | Bed -15 NOS The Building beyond the ambit of the Odisha Fire Prevention and Fire Safety Rule 2017 read with the Odisha Fire Prevention & Fire Safety (Amendment) Rules 2019. Installation of Fire Prevention and Fire Safety measures in the Building Eye care Hospital as per Table -7, Part-IV of National Building Code of India -2016 to combat any initial outbreak of Fire & to conduct mock drill in regular interval involving local Fire Station. dire Asst. Fire Officer Berhampur Fire Station Certificate valid up to Dtd. 19.02.2024.| GOVERNMENT OF ODISHA ENERGY DEPARTMENT AEE cum AE! GED-S Digapahandi (Regulation 30 & 43) | INSPECTION OF ELECTRICAL INSTALLATION OTHER THAN DG SETS || __MINOTI NAYAK has been granted Electrical Safety Clearance for the entrgisation of the Electrical Installation as per Regulation 30 and 43 of the Central Electricity Authority (Measures relating to Safety & Electric Supply) Regulation, 2010 subject to the fullillnent of the recommendation. Report No./ Date - — 19/16/07/2022 Date Of Inspection - 14/07/2022 i Name Of The Applicant - — MINOTI NAYAK \ Address Of The _ At-Jaya Mangal Nagar, Gate Bazar, Berhampur, | Applicant Dist:-Ganjam || Location Of The _ 4S Eye Clinic/Hospital, At-Hanuman Nagar, Chikiti Installation Pentho, Dist:-Ganjam Particulars of the H Installation (The details of the installation which has besn granted Safety Clearance ie at Annexure of the Electrical Safety Recommendations.) Clearance Valid till - 19/07/2023 “Signature of Issuing AuthorSTATE POLLUTION CONTROL BOARD, ODISHA A/118, Nilakanthanagar, Unit-Vill, Bhubaneswar 751012 Tel: 2562822/2560955, EPABX : 2561909/2562647 E-Mail- paribesh @ospeboard.ora FORM-HI (See Rule 10) AUTHORISATION ORDER No._ SO Y9 | SpcBiAuthorization (Biomedical Waste) Date /0- 05-2023 INDV-BW. 9993 BY SPEED SPOST ‘Sub: Authorization under Biomedical Waste Management Rules, 2016 and Amendment thereof for operating a facility for generation, collection, reception, treatment, storage and disposal. ‘APPLICATION NO: 4053280 ‘Smt. Minati Nayak, Proprietor of M/s J S Eye Clinic, Ganjam an occupier of the facility located at Hanuman Nagar, Chikiti Pentho, Dist: Ganjam sharing the treatment and disposal facility at M/s Mediaid Marketing Services, Seragada, Dist: Ganjam is hereby granted an authorization for; Activity Generation and Segregation \, Collection, Storage V, Packaging \, Receptiony, Transportation, Treatment \ and Recycling The authorization is valid up to 31.03.2026 for handling wastes generated from 15 no. of beds. For any increase in number of beds, the applicant shall obtain prior permission of the prescribed authority. An application shall be made by the Occupier for renewal of authorization in Form-ll before four months from the date of expiry of this authorization. This authorization is subject to the general conditions, standards & special conditions Stated below; (A) GENERAL CONDITIONS: 1. The authorization shall comply with the provisions of the Environment (Protection) Act, 1986 and the rules made there under. 2. The authorization or its renewal shall be produced for inspection at the request of an officer authorized by the prescribed authority, i. e, State Pollution Control Board, Odisha 3. The person authorized shall not rent, lend, sell, transfer or otherwise transport the biomedical wastes without obtaining prior permission of the State Pollution Control Board, Odisha. 4. Any unauthorized change in personnel, equipment or working conditions as mentioned in the application by the person authorized shall constitute a breach of his authorization. 5. _ tis the duty of the occupier to report major accidents including accidents caused by fire hazards, blasts during handling of bio-medical waste and the remedial action taken and the records relevant thereto, (including nil report) in Form-l to the prescribed authority and also along with the annual report. 6. The biomedical waste container shall be labeled as specified schedule-IV of the rules.size faari RA UHR INCOME TAX DEPARTMENT GOVT. OF INDIA Para AST AEA STE Permanent Account Number Card BJHPN9971N ‘3TH / Name MINOTI NAYAK ‘faa ST ATH / Father's Name BIRENDRA DAS ‘Wer ST ATH / Date of Birth . 13/06/1981 Mtnod Nayak ‘FeATT/ Signature Minot