Himachal Pradesh State Pollution Control Board

'Him Parivesh', Phase –III, New Shimla-171009, HP.

Form-XIII
(See Rule 22)

Application for Consent to Industry /Operate/Renewal the industrial plant/plants under

Section 25/26 of the Water (Prevention & Control of Pollution) Act, 1974 .

Application for Consent to Establish or take any step to establish any Industry , operation processes or any
treatment and disposal system for discharge,under Section-25 or continuation or discharge under Section -26
of the Water (Prevention and Control of Pollution) Act, 1974.
RCTO for the period(01/04/2023-31/03/2030)

From Date:06/10/2023
Hotel Sansar, Near HP High Court, Shimla, District Shimla, HP Industry ID: 22190
City:Shimla Application No.: 10838084
Block:Shimla Urban
District:Shimla

To
The Member Secretary,
Himachal Pradesh Pollution Control Board,
Him Parivesh, Phase-III, New Shimla,
Shimla- 171009, HP.

Sir,

I / we hereby apply for Consent/ Renewal of Consent under Section-25 of Water (Prevention and
Control of Pollution) Act, 1974 (6 of 1974) to establish or take any step to establish any Health Care
Facility/CBWTF/Research Lab or operation or process or a treatment and disposal system or any extension
or addition to bring into use any new altered outlet for discharge of sewage / trade effluent*
to continue to discharge sewage /trade effluent * from land/ premises owned byHotel Sansar

The other relevant details are below:

1. Full name of the Industry Hotel Sansar

2. Nationality of the applicant Indian

“This is computer generated document from OCMMS by HPSPCB”

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3. Type of Industry Individual
4. Full Address of the Industry with PIN Code: Name of applicant: Vikas Sood
Address:Near HP High Court, Shimla, District
Shimla, HP
District:Shimla
Block:Shimla Urban
5. Details of Establishment etc.:
(a)Approximate date of proposed Establishment. : Month :August
Year :2012
(b)Expected date of commencement of date of Month :August
Operation : Year :2012
6. Total number of employee expected to be : 3
Employed
7. Details of license/registrations, if any obtained Registration No. : 8-143/90-DTDO-SML
under the provisions of Industrial Development Registration Add. : 23-09-2022
Regulation Act, 1951. Registration Date : 2012
8. Name of the person authorised to sign this form Vikas Sood
(the original authorization except in the case of
individual proprietor concern is to be enclosed)
9 List of raw materials with monthly consumption rate (MT/month)
Raw Materials Quantity Unit
Food Stuff Items As per requirement K.G./Month
10 List of products with monthly production rate (MT/month)
Name of Quantity Unit Intermediate Principal Use
Products Product
DBRs 9 Number/Year -- For Lodging
Family Suit 1 Number/Year -- For Lodging
(Four Bedded)
Kitchen/Dining 1 Number/Year -- For Food
Serving
11 List of By Product Details
Name of By Products Installed Capacity Unit Average Production
(c)License/Registration of Annual Capacity of the 9.0
Industry, Operation or process etc. :
Expansion Cost
12. Source of Water and Consumption Detail :
Usage Average Production
Domestic 4.36
13. Whether permission for water abstraction has Yes
been taken from the Competent Authority
(enclose copy).

“This is computer generated document from OCMMS by HPSPCB”

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14 (a)Effluent Currently Discharged or Expected
Type of Effluent Capacity(KLD) Quantity(KLD)
Domestic 3.49
(c)What monitoring arrangement is currently Self
existing or proposed to be created?
15. Process of treatment (if industry has any treatment plant for industrial, domestic or combined
effluent).
Description Quantity(in KLD) Method of Treatment Method of Disposal
Domestic 3.49 MC Sewerage Line Common STP
16. Water Emission Discharge
Installed Capacity Common STP Unit

STP Common STP 3.49 KLD

17 Please indicate whether storm water drains are Yes
kept separate from industrial/domestic effluent
drains.
18 Please indicate expected composition of the MC Sewerage Line
effluent. In case of operational Industry actual
composition of the effluent is to be indicated and
latest analysis report to be attached.
19 (a)Are facilities available with the applicant for carrying out the test of waste water
Test of Waste Water Existing Proposed
20. I/we further declare that the information furnished above is correct to the best of my/ our knowledge.
I/we hereby submit that in case of change either of the point of discharge or the quantity of discharge
or its quantity, a fresh application for CONSENT shall be made and until such CONSENT is granted
no change shall be brought into use.
I/we hereby agree to submit to the Himachal Pradesh State Pollution Control Board an application for
Renewal of Consent one month in advance of the date of expiry of the consented period for outlet/
discharge if, to be continued thereafter.
I / we undertake to furnish any other information within one month of its being called for by the
Himachal Pradesh State Pollution Control Board.
I/we, enclose herewith Bank Draft No. null Date null for Rs 0.0 ( Rupees ) in favour of the
Environmental Engineer/ Assistant Environmental Engineer / Regional Officer , Himachal Pradesh
State Pollution Control Board,…………………………….. payable at under section-25 of the Act as
per the Fee Schedule attached.

Yours faithfully,
Signature :

Name of the application :

Designation :

“This is computer generated document from OCMMS by HPSPCB”

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 Address :

“This is computer generated document from OCMMS by HPSPCB”

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