Application Form

  1. Objectives of the project:

  2. Climate and Air Quality:

  3. Water balance:

  4. Solid Wastes:

  5. Power requirement indicating source of supply:Complete environmental details to be furnished separately,if captive power unit is proposed:

  6. Peak labour force to be deployed giving details of:

  7. Risk Assessment Report and Disaster Management Plan:

       I hereby give an undertaking that the data and information given above
are true to the best of my knowledge and belief and I am aware that if any
part of the data/information submitted is found to be misleading at any stage, 
the project be rejected and the clearance given,if any,to the project is likely 
to be revoked at our risk and cost.

                                                    Signature of the applicant
                                                    with name and full address.

                                                    Given under the seal of 
                                                    Organisation on behalf of
                                                 whom the applicant is signing. Date:

     In respect to item for which data are not required or is not available as
per the declaration of project proponent,the project would be considered on 
that basis.
Previous Page