FORM XIII
APPLICATION FOR CONSENT FOR DISCHARGE/CONTINUATION OF
DISCHARGE UNDER SECTION 25 OF THE ACT.
(See rule 32)
APPLICATION FOR CONSENT FOR DISCHARGE/CONTINUATIONOF DISCHARGE
From M/S.VIRUPAKSHA ORGANICS LTD UNIT-1., Date: 27/09/2019
To
THE MEMBER SECRETARY
Telangana State Pollution Control Board
Paryavaran Bhavan,A-3,Industrial Estate,
Sanathnagar, Hyderabad-500018.
Sir,
I/We apply foer CONSENT under section 25 of Water(Prevention and Control of Pollution Act, 1974(No. 6 of
1974)or bring into any new or altered outlet for the dischrage of Sewage/trade effluent to begin to make new dischrge
of sewage/trade effluent or continue to make discharge of Sewage/trade effluent from land/premises owned by(1)
MAMILLA BALASUBBA REDDY for a period upto(2)............
(a) Sewage/sullage Via drains/outfall sewers/treatment works.
(b)Trade effluent Via drains/outfall sewers/treatment works.
(c)Solid wastes into (3):
(i) Stream .........
(ii) Onland for irrigation, bearing Survey No.... Adjoining at a distance of....
(iii) Lake, pond adjoining/at a distance of stream/River.
(iv) Directly on land for open percolation into sub-terranean strata of survey No... Adjoining /at a distance of.....
(v) Tidal waters/estuarine waters known as.......
(vi) Sea along/off the seashore shown as.......
2. The Annexure, Appendices other particulars and plan in triplicate are attached herewith.
3. I/We further declare that the information furnished in the Annexure, Appendices and plans is correct to the best of
my/out knowledge.
4. I/We hereby submit that in case of change either of the point or the quality of discharge or its quality, a fresh
application for CONSENT shall be made and until such CONSENT is granted, no change shall be made.
5. I/We hereby agree to submit to the State Board an application for renewal of Consent one month in advance of date
of expiry of the consented period for outlet/discharge, if to be continued thereafter.
6. I/We undertake to furnish any other information within one month of its being called by the State Board.
7. Here I/We now enclose fee details.
D.D NO. Bank Name Amount(Rs)
Yours Faithfully
Signature
Name of applicant :MAMILLA BALASUBBA REDDY
Address of applicant :SANGAREDDY II,Jinnaram,Gaddapotharam,Sy.No.10,Gadapotharam,502319
ANNEXURE TO FORM XIII
EXISTING / NEW/ ALTERED
OUTLET/ DISCHARGE
Note: Any applicant knowingly giving incorrect information or suppressing any information pertaining
thereto shall be liable to punished under the Act. While filling this Annexure, the applicant not concerned
with any of the items shall state “Not Concerned” against the relevant one:
1. Full name of the applicant : MAMILLA BALASUBBA REDDY
2. Full Name of land premises/ institute/factory/ M/S.VIRUPAKSHA ORGANICS LTD UNIT-1.,
industry/ local body with address : S A N G A R E D D Y
II,Jinnaram,Gaddapotharam,Sy.No.10,Gadapotharam,502
319
3. Give revenue / city survey number of land/ premises
for which the application is made stating District/ Mandal
and Village. :
(a) Mandal : Jinnaram
(b) Village : Gaddapotharam
4. State : month and year in which the land/ premises/ /
institute/ factory/ industry was actually put into
commission or is proposed to be put into commission or
the month and year from which the local body is
functioning. :
5. State the Civil/ Military/Defence/ Industrial Estate Collectorate
etc., under whose administrative jurisdiction the
applicant's land/ premises is situated. :
6. (a) State whether the land/premises/ industry/ factory no
has been declared as prohibited area :
(b) If yes, state the name of the Authority and furnish
a certified copy to the order under which the area has
been declared as prohibited area. :
7. Is the industry/ factory for which application is made no
closed on Sunday/ Holiday?. :
8.State working season per year of the Industrial plant.
From Date To Date
9. (a) No. of workers attending the factory. :
Shift Hours No. of Workers
(b)No. of workers residing in the premises
10. For local bodies only
(a)Present Population
(b)Population Covered under regular sewerage
facilities.
(c)Population covered by conservancy latrines.
(d)Population having septic tank/pit privy facilities.
14.Raw material used
Sl. No. Description Quantity Units
1. 1-Benzhydryl 106.00 Kg/day
piperazine
2. Para Bromo fluoro 13.50 Kg/day
benzene
3. 2-(Cyclohex-1-en-1-yl) 383.33 Kg/day
ethanamine
4. 4-[4-Dimethyl amino- 26.17 Kg/day
1-(4-Fluoro phenyl)-1-
hydroxy butyl]-3-
hydroxy methyl
benzonitrile
5. Benzyl cyanide 141.67 Kg/day
6. Methallyl chloride 211.67 Kg/day
7. 1,3 Di fluoro benzene 114.47 Kg/day
8. Dimethylamine 582.08 Kg/day
Hydrochloride
9. Dimethylamine 175.00 Kg/day
Hydrochloride
(b)Give the list of Names of products manufactures per month in (M.T)
Sl. No. Name of The Product Capacity Units
1. Cinnarizine 100.00 Kg/day
2. Cyano diol base 100.00 Kg/day
3. Dextromethorphan 166.67 Kg/day
Hydrobromide
4. Escitalopram Oxalate 33.33 Kg/day
5. Fexofenadine 166.67 Kg/day
hydrochloride (BCN)
6. Fexofenadine 166.67 Kg/day
hydrochloride (MAC)
7. Fluconazole 166.67 Kg/day
8. Tramadol 833.33 Kg/day
Hydrochloride (MBA)
9. Tramadol 833.33 Kg/day
Hydrochloride (MCA)
(c)Give the list of Names of by-products manufactures per month in (M.T)
Sl. No. Name of The By-Product Capacity Units
1. Aluminium chloride 342.42 Kg/day
2. Aluminium chloride 170.87 Kg/day
3. Trimethyl silyl iodide 3.17 Kg/day
4. Hydrobromic acid 461.42 Kg/day
solution
(d)Give the list of possible intermediate products:
Intermediate Product Name Source Quantity
12. State Daily Quantity of Water in liters utilised.
Uses Quantity (KLD)
13. (A)State the hourly minimum and daily maximum quantity of effluents arising from land premises for which the
application is made.
Name Hourly Maximum Quantity(in Daily Maximum Quantity(in KLD)
KLD)
(B) State how measurement of Rate and QUANTITY are no
carried out..
14. State whether storm water drains are kept separate no
from industrial/ domestic effluents.
15. Is domestic effluent allowed to get mixed in no
industrial effluent?
If yes, state ratio
16. (a)Describe if any treatment of industrial or domestic no
effluent or one for the combined effluent is made.
(b)Is the quality of effluent emanating either without no
or after treatment approved by any authority?
16(A). Is any effluent from any shop/ shops toxic? no
17. Provision of disposal
Provision for disposal State the area of land used Already made Proposed to be made
for(in Hectares)
18. Given quantitative disposal of effluent in litres provided for the places mentioned below:
Place of Disposal Domestic Industrial Mixed Quantity(KLD)
19. Is there any provision for equalizing or holding lagoons for tanks to store the effluents during unfavourable
stream of tidal conditions?
Type of Effluent Status
20. Is sufficient Land available/can be made available in caste pumping of the effluent on land has to be considered?
21(a). Details of composition of Domestic/ Industrial/ Combined effluents
Details Of Before Treatment Discription of After Treatment Discription of
Composition Effluent Before Effluent After
Treatment Treatment
21. (b)Is the effluent toxic? yes
(c)State if the industrial effluent is having
Unpleasant smell Irritating and/ or harmful Corrosive Colour
effect
(d)Is there any sudden change of temperature yes
exceeding 10°C at any time?
22. (a)Are facilities available with the applicant for carrying out the following tests of the waste water ?
Tests of waste water Existing Proposed Details of Equipment
23. Does the Land/ Premises etc., (for which application is made) have open
Land/Premises Toxic Organic Inorganic Microbiological
24. State details of solid wastes
Solid wastes Dis. Quantity Method of collection Method of Disposal
Place :
Signature
Date :
Name & Address of the applicant
