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Bio-Medical Waste (Management and Handling) Rules, 1998 (3)
Date 19/10/11/05/59  Author Infrosoft Health Content Team  Hits 831  Language Global
New Delhi, 20th July, 1998.

FORM I

(see rule 8)

APPLICATION FOR AUTHORIZATION
(To be submitted in duplicate.)

To

The Prescribed Authority
(Name of the State Govt/UT Administration)
Address.

1. Particulars of Applicant

(i) Name of the Applicant
(In block letters & in full)
(ii) Name of the Institution:
Address:
Tele No., Fax No. Telex No.

2. Activity for which authorization is sought:

(i) Generation
(ii) Collection
(iii) Reception
(iv) Storage
(v) Transportation
(vi) Treatment
(vii) Disposal
(viii) Any other form of handling

3. Please state whether applying for resh authorization or for renewal:
(In case of renewal previous authorization-number and date)

4. (i) Address of the institution handling bio-medical wastes:

(ii) Address of the place of the treatment facility:

(iii) Address of the place of disposal of the waste:

5. (i) Mode of transportation (in any) of bio-medical waste:

(ii) Mode(s) of treatment:

6. Brief description of method of treatment and disposal (attach details):

7. (i) Category (see Schedule 1) of waste to be handled

(ii) Quantity of waste (category-wise) to be handled per month

8. Declaration

I do hereby declare that the statements made and information given above are true to the best of my knowledge and belief and that I have not concealed any information.

I do also hereby undertake to provide any further information sought by the prescribed authority in relation to these rules and to fulfill any conditions stipulated by the prescribed authority.

Date : Signature of the Applicant

Place : Designation of the Applicant

FORM II
(see rule 10)

ANNUAL REPORT

(To be submitted to the prescribed authority by 31 January every year).

1 . Particulars of the applicant:

(i) Name of the authorized person (occupier/operator):

(ii) Name of the institution:

Address

Tel. No

Telex No.

Fax No.

2. Categories of waste generated and quantity on a monthly average basis:

3. Brief details of the treatment facility:

In case of off-site facility:

(i) Name of the operator

(ii) Name and address of the facility:

Tel. No., Telex No., Fax No.

4. Category-wise quantity of waste treated:

5. Mode of treatment with details:

6. Any other information:

7. Certified that the above report is for the period from

Date ...............................

Signature ...........................................

Place.............................. Designation..........................................

 

 

FORM III
(see Rule 12)

ACCIDENT REPORTING

1. Date and time of accident:

2. Sequence of events leading to accident

3. The waste involved in accident :

4. Assessment of the effects of the accidents on human health and the environment,.

5. Emergency measures taken

6. Steps taken to alleviate the effects of accidents

7. Steps taken to prevent the recurrence of such an accident

Date ...............................

Signature ...........................................

Place..............................

Designation..........................................

[F.No.23-2/96-HSMD]
VIJAY SHARMA, Jt.Secy.

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