K E R A L A

ffi\ilrSTATE POLLUTI

g oUo ccD oeilcnlaoPattom P.O.. Thiruvanantha

.'JSo oil.Gl., oflolrucnool

N CONTROL BOARDm'l col lcnD 6'm c 6nlc 6rui

ram - 695 004Oo - 695 004

PCB/HO/EE1 MWG N/03/07

FromThe C

To

Date: l4l0ll20l5

The Ch ef Envir nmental EngineerI Office, /EKMRegi

The Se ior Env nmental EngineerRegio I OfficeKozhik

The SDistri

ior Envi nmental Engineer

PalOfficed

The E ironm l EngineerDistri Office, / K L M / P T A / K /ALPY/IDK/EKM 1, 2&3(Esc)TSR I /MLPM/WYND/ / KSGD

Sub: - Conse of the for dental clinrcs - oD

sentati n of Indian Dental Assocation dated 0I .07 .2014utes of t meeting held in the pre nce of Honourable Minister for

T4er & Pol ution Control, on 1 1.1 1.

f the re rence (2) is enclosed. e representatives of Indian Dental

as vide ference (1) expressed ir grievance with respect to the

in getti g clearances from the

es (1) & (2) it was

. Considering their grievances

cided to introduce the following

Ref: - 1. Re2. Mi

Po

SirA4ad?ffi,

A copy

Association

time involv

and based o

procedure in

referen

processing the applicatiture, fi received from dental clinics.

The den

in-princip

submissio

in-princip

stamp p

per mon

generated

immedia

3rrcsDArii) If the s

the unit i

issued fr

formal co

years app

obtained

The

(ii) for a

necessary

Copy to:-

1. The EHead

2. The SIndiPayyaPayyaKann

3. The

e c l

ly and

icable fl

ithin

actron.

fficecretaryDental

sistant

4. All T chnical fficers in Head Office

of appli ation for consent in the

e shall be accompani

r) from e occupier, stating the a

I clinics

clearan

in the cl

in the c

or four

may be required to s

e for consent to the con

ic, details of affiliation

nic, etc. The in-princip

validity of the in-prin

onths from the date of

lce glve by the dental clinics is

affiliat to IMAGE, Palakka

m t h e D strict Office to the occ

nt to perate in the prescribed

red category, at the earli

brmats (

validity period of the in-

) for submission of app

idavit an (iii) for furnishing itt-p

vironme tal Engineer - 2

sociationoor Denoor

I Clinics

r - 6 7 0 6 aJ

vironmental Enqineer -

tbmit a formal application

erned DO of the Board, pnor

prescribed form. The request

by an affidavit (in 100 rupees

erage number of patients treated

ith IMAGE for disposing BMW

e clearance shall be applied for,

ple clearance shall be limited to

plication, whichever is earlier.

ess than 1000 patient/month and

in principle clearance may be

ier with directions to apply for

brm with necessary fee for three

and consent to operate shall be

rinciple clearanoe.

ication for in-principle clearance

inciple clearance are enclosed for

Yours faithfully,

n i : , , ' "

' i a - - ' . \ - : - .

\' . \

CHAIRMAN

(for uploading the formats inBoard's website)

tor

to

for

3

Palticui. Nr

In

1 .

2.

3 .

4.

To

Mode of

Whether

7. Whetherattached

prescribed format)

Yes / No

Yes / No(if yes, AuthorisatioNo...dated of, issue . ....Validity . ..... )

Yes/ No

The ember SState Po ution Control Board,

Plam Patto- 69s 004

of applcant (Occupier)of app cant

& in tullof Inst

ATel NF

Faciliti in the

Average

Activityi.ii. Coliii.iv. Sv . Tvi. Tvll.

5.

no. of treated per month

which principle clearanceerationection

isposal o liquid waste

unit is ving authorisationunder theBMW es

Method f disposalof bio medical wasteThrough GEAny oth mode of isposal(please

6.

davit (i

9.

Capital vestmentestabli ent (in

Fee for incipl(as draft)

I d o hffue to the of myinformation

I do alsoby the State Pany conditi stipul

br the)

clearance

Declaration

declare that all statemenwledge and belief and

ereby undertake to provilution control Board in re

by the Kerala State Poll

h

: Rs. 500/-

made and information givejr arert I have not concealed any

any further information soufht:ion to these Rules and to fu1filon control Board.

Signature of Applicant

the in

1 .

that

I

submi

5

subm

I submit the following itional inforrnation foriple application.

My clinic has been to IIvIAGE, Palalilsad treailnentand di of bio medical generated in the clinic. liation isvalid

The no. of patients in my dental clinic is than 1000patients month.

I lare that the furnished above is h.re. Iissue of inciple clearance is on the infonnation prov by me.

that if any variation is

l e c given is liable toformal lication to the Board

) and to consent to operate

bserved subsequently byrevoked. Funher, I alsofor integrated clearance

the Board within the validi

SignatureName of ApplicarrtDesignation

Board the

to

to

period of

of thefaihne of which would result in

allotted.

File no. PC

d. The

the

1 .2.3 .

This n-princip

revl and

fit asper the

The i prmclp

no (a

The

above s

entire

b.

the of

cl shall

shall n

eml from

f. This

for

copy

CEE/ Se Me

avoor,4. I GE, I

inrvanan5 . S file

uram - 695 029

ard

IN-PRINCIPLE CLE

Date of issue :

Valid upto :

clearance is granted ect to the power of the

e variation in all or any of conditions 16 the Board

ant Acts/ Rules.

clearance unless withdra n earlier and subject to c

specified above.ll be valid for the period

generated shall segregated, collected,

and disposed in with the BMW Rules,

the unit shall apply for to operate of the

brmat at the earliest and consent shall be obtained

iry of in-principle cl , failing which the in

e automatically lled.

b€ any unauthorised ischarge of effluents or itive

dental clinic.

is subject to all statutory

e dental clinic.

mandatory clearance uired

Office seal Signatr,ue & seal of

Head of District Offi

E, Regional Office, KeraSecretary, Head Office, K, Indian Dental Associati

ur - 670 633State Head Quarters,

d i n

fore

;iple

State Pollution Control noa{dala State Pollution Control po, Payyavoor Dental Clinics,

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