APPLICATION NO: 2294374

Assam State Pollution Control Board

From :
Moazzem Hussain Khan
Vill-Tangaon Pt-II P.O-Dhanua, P.S- Mankachar, Tangaon Pt-II,South Salmara Mankachar, 783135

Sir,
I / We hereby apply for *
(i) Consent to Establish under section 25 and 26 of the Water (Prevention and Control of Pollution) Act,
1974, as amended.
(ii) Consent to Establish under Section 21 of the Air (Prevention and Control of Pollution) Act, 1981, as
amended.
(iii) Authorization under rule 5 of the Hazardous Wastes (Management and Handling) Rules, 2016, as
amended in connection with my / our existing / proposed / altered / additional manufacturing / processing
activity from the premises as per the details given below.

Part A : General
1. Name, designation, office address with telephone Name :Moazzem Hussain Khan
number, e-mail of the Applicant Street Name 1:Vill-Tangaon Pt-II
Street Name 2:P.O-Dhanua, P.S-
Mankachar
Village/Town:Tangaon Pt-II
District:South Salmara Mankachar
Pincode:783135
Mobile:9365237050
Phone Number:
Email-id:[email protected]
2(a) Name and location of the industrial unit / premises for Name:M/s Khan Stone Crusher
which the application is made. (Give revenue Survey Applicant Designation:Proprietor
Number /plot number, name of Taluka and District also Street Name 1:Vill-Tangaon Pt-II
telephone number) Street Name 2:P.O-Dhanua, P.S-
Mankachar
Village/Town:P.O-Dhanua, P.S- Mankachar
District:South Salmara Mankachar
Pincode:783135
Mobile Number:9365237050
Phone Number:
2(b) Details of the planning permission obtained from the Permission Reference No. :
local body / Town and Country Planning authority / DICH/SSM/PUPC/2022-23/
metropolitan development authority / designate Date :10/07/2023
authority Issuing Authority :General Manager
2(c) Name of the local body under whose jurisdiction the Local Body Name :DICC, South Salmara
unit is located and name of the license issuing authority Mankachar
License Issuing Authority :General
Manager

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 3. Names, addresses with telephone number of Managing Name :Moazzem Hussain Khan
Director/Managing Partner and officer responsible for Designation :Proprietor
matters connected with pollution control and / or Street Name 1 :Vill-Tangaon Pt-II
hazardous waste disposal. Street Name 2 :P.O-Dhanua, P.S-
Mankachar
Village/Town :Tangaon Pt-II
District :
Pincode :
Mobile Number :9365237050
Phone Number :
Email ID :
[email protected]
4. (a) Are you registered as a small-scale industrial unit? NO
4(b) If yes, give the number and date of registration. Reg. No. :
. Date of Registration : 21/09/2023
5. Gross capital investment of the unit without 25.0
depreciation till the date of application (Cost of
building, land,plant and machinery)
(To be supported by an affidavit, Annual Report or Document is attached
certificate from a Chartered Accountant. For proposed
unit(s), give estimated figure)
6. If the site is located near sea-shore / river bank / other Distance meters 0
water bodies; indicate the distance and the name of the Name of the water body NIL
water body, if any
7. Does the location satisfy the requirements under N/a
relevant Central / State Govt. notifications such as
Coastal Regulation Zone, Notification on Ecologically
Fragile Area, Industrial location policy, etc. If so, give
details.
8. If the site is situated in notified industrial estate No
whether effluent collection, treatment and disposal
(a). system has been provided by the authority
will the applicant utilize the system, if provided
(b).
if not provided, details of proposed arrangement.
(c).
9. Total plot area, built-up area and area available for the Plot Area (sq. meters) 2676
use of treated sewage / trade effluent Build-up Area (sq. meters)
Area for Treated Sewage(sq. meters)
10. Month and year of proposed commissioning of the unit Month :November
Year :2023
11. Number of workers and office staff. 7
12 . Do you have a residential colony within the premises in No
respect of which the present application is made ?
If yes, please state population staying
(a).
(b). Indicate its location and distance with reference to plant Location:
site. Distance:
13. List of products and by-products manufactured in tonnes / month,kl / month or numbers / month
(Give figure corresponding to maximum installed production capacity)

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 Sr. No. Name Type Quantity Units
1 Stone Chips product 3000 Cubic
Meters/Year
14. List of raw materials and process chemicals with annual consumption corresponding to above stated
production figures, in tonnes / month or kl / month or numbers / month.
Sr. No. Name Type Quantity Units
1 Stone bolders Raw Material 3090 Cubic
from Santi Meters/Year
Sangma
Stone Quarry,
Meghalaya
15. Description of process of manufacture for each of the
products showing input, output, quality and quantity of
solid, liquid and gaseous wastes, if any from each unit
process. (To be supported by flow sheet and / or
material balance and water balance sheet).
Part B : Waste water aspects
16. Water consumption for different uses (in m3 / day)
16(i Industrial cooling, spraying - in mine pits or boiler
). feeds.
16(i Domestic purpose 1
i).
16(i Processing whereby water gets polluted and the
ii). pollutants are easily biodegradable
16(i Processing whereby water gets polluted and the
v). pollutants are not easily bio-degradable and are toxic
16( Others such as agriculture, gardening etc. (specify) .5
v).
Total 1.5
17. Source of water supply. Name of authority granting permission if applicable and quantity permitted
Source of water supply Name of authority granting Quantity permitted (in
permission if applicable m3/day)
ground water n/a
18. Quantity of waste water (effluent) generated (in m3 / day)
Domestic Industrial Process Washings Boiler Cooling DM
Blowdown water Plant/Soften
blowdown ing Plant
washings
No Effluent
will be
generated
19. Water budget calculations accounting for difference N/a
between water consumption and effluent generated. :
20. Present treatment of sewage / canteen effluent (Give N/a
sizes / capacities of treatment units).

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21. Present treatment of trade effluent (Give sizes / N/a
capacities of treatment units). (A schematic diagram of
the treatment scheme with inlet / outlet characteristics
of each unit operation / process is to be provided.
Include details of residue management system (ETP
sludges))
22(a Are sewage and trade effluents mixed together ? no
).
22( If yes, state at which stage whether before,
b). intermittently or after treatment.
23. Capacity of treated effluent sump. Guard Pond if any. N/a
24. Mode of disposal of treated effluents, with respective quantity, in m3 / day
Name of Name of Name of sea Owner of Owned land Quantity of Provide a
river creek/estuar sewer treated location
y effluent map of
reused / disposal
recycled, arrangemen
m3 / day t indicating
Provide a the outlet
location (s) for
map of sampling
disposal
arrangemen
t indicating
the outlet
(s) for
sampling
N/a
25. (a) Quality of untreated / treated effluents (Specify pH and concentration of SS, BOD, COD and
specific pollutants relevant to the industry. TDS to be reported
pH Biochemical Specific Concentration Chemical Total
Oxygen Pollutants of Suspended Oxygen Dissolved
Demand Solid Demand Solids
(b) Enclose a copy of the latest report of analysis from the DOCUMENT IS ATTACHED
laboratory approved by State Board / Committee / Central
Board / Central Government in the Ministry of Environment
& Forests. For proposed unit furnish expected characteristics
of the untreated / treated effluent.
Part - C : Air emission asp ects
26. Fuel Consumption
Fuel Fuel Calorific Ash content Sulphur Other
consumption value % content % (specify)
(TPD / KLD)
Others 30 KW Electricity
27.( Stack Details
a)

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 St Attac Capac Fuel Fuel Mater Shape Heigh Diam Gas Gas Exit Contr
ac hed to ity type quant ial of (roun t, m eter / quant tempe gas ol
k ity constr d/ (abov size, ity, rature veloci equip
nu (TPD uction rectan e in Nm3 / , 0C ty, ment
m / gular) groun meter hr m/sec prece
be KLD) d s ding
r level) the
stack
1 NIL
27( Whether any release of odoriferous compounds such as N/a
b) Mercaptans, Phorate etc. are coming out
28 Do you have adequate facility for collection of samples N/a
of emissions in the form of port holes, platform, ladder
etc. as per Central Board Publication 'Emission
Regulations Part-III' December 1985)
29 Quality of treated flue gas emissions and process
emissions.(Specify concentration of criteria pollutants
and industry / process-specific pollutants stack-wise.
Enclose a copy of the latest report of analysis from the
approved laboratory by State Board / Central Board /
Central Government in the Ministry of Environment
and Forests. For proposed units furnish the expected
characteristics of the emission
Part - D : Hazardous waste aspects
30 Whether the unit is generating hazardous waste as No
defined in the Hazardous Waste (Management and
handling) Rules, 2016, as amended.
(a) If so, the category No.:
31. Authorization required for * N/a
32. Quantity of hazardous waste generated (in kg / day) or N/a
(in mt / month)
33. Characteristics of the hazardous waste(s).Specify N/a
concentration of relevant pollutants. Enclose a copy of
the latest report of analysis from the laboratory
approved by State Board/Central Board/ Central
Government in the Ministry of Environment and
Forests ). For proposed units furnish expected
characteristics.
34. Mode of storage (intermediate or final) (describe area,
location and methodology).
35. Present treatment of hazardous waste, if any (give type
and capacity of treatment units)
36. Quantity of hazardous waste disposed
pH Biochemical Oxygen Demand
Part - E : Additional information
37(a Do you have any proposals to upgrade the present yes
) system for treatment and disposal of effluent/ emission
and / or hazardous waste

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37( If yes, give the details with time-schedule for the
b) implementation and approximate expenditure to be
incurred on it.
38 Capital and recurring (O & M) expenditure on various Document is attached
aspects of environment protection such as effluent,
emission ,hazardous waste, solid waste, tree plantation,
monitoring, date acquisition etc. (give figures
separately for items implemented / to be implemented).
39. To which of the pollution control equipment, separate meters for recording consumption of electric
energy are installed ?
Pollution Control Equipment Emission/Effluent Type Seperate Meters are installed
?
Water Spraying System Emission NO
40. Which of the pollution control items are connected to NO DG
D.G. set (captive power source) to ensure their running
in the event of normal power failure ?
41. Nature, quantity and method of disposal of non- n/a
hazardous solid waste generated separately from the
process of manufacture and waste treatment. (Give
details of area / capacity available in applicants land)
42. Hazardous Chemicals - Give details of chemicals and N/a
quantities handled and stored.
(i) Is the unit a Major Accident Hazard unit as per MSIHC No
Rules ?
(ii)Is the unit an isolated storage as defined under the MSIHC No
Rules ?
(iii) Indicate status of compliance of Rules 5, 7, 10, 11, 12, No
13 and 18 of the MSIHC Rules.
(iv) Has approval of site been obtained from the concerned Yes
authority ?
(v) Has the unit prepared an Off-site Emergency Plan ? No
(vi) Has information on imports of chemicals been provided No
to the concerned authority ?
(vii) Does the unit possess a policy under the PLI Act? No
43 Brief details of tree plantation / green belt development Plantation will be done
within applicants premises (in hectares).
44 Information of schemes for waste minimization,
resource recovery and recycling - implemented and to
be implemented, separately.
45(a The applicant shall indicate whether industry comes
) under Public Hearing, if so, the relevant documents
such as EIA, EMP, Risk Analysis etc. shall be
submitted, if so, the relevant documents enclosed shall
be indicated accordingly
(b) Any other additional information that the applicant Jaw Crusher of 25 TPH will be installed.
desires to give.
46. Do You Have DG Set?

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 SI. Name Product Maker's Capacit Investm Final Stack Control Acoustic
No. ID Name y ent Quantit Height Equipm Enclosu
y per ent re
Annum
1 NIL yes
47. I / We further declare that the information furnished above is correct to the best of my / our
knowledge.
48. I / We hereby submit that in case of any change from what is stated in this application in respect of
raw materials, products, process of manufacture and treatment and / or disposal of effluent,
emissions, hazardous wastes etc. in quality and quantity; a fresh application for Consent /
Authorization shall be made and until the grant of fresh Consent / Authorization no change shall be
made.
49. I / We undertake to furnish any other information within one month of its being called by the Board /
Committee.
50. I / We agree to submit to the Board an application for renewal of consent / authorization in two
months in advance before the date of expiry of the consent / authorization validity period:
Payment Details :
Payment Mode : OFFLINE
Payment Transaction Details : Transaction Status: Successfully Completed
Bank Name Branch Name Draft No./Money Date Amount (In
Receipt No. Rupees)
Payment Details : Payment Mode :
ONLINE Payment Transaction Details :
Application Id Transiction Id Date Amount Status
Place :South Salmara Mankachar Yours faithfully,
Date : Name :Moazzem Hussain Khan
Designation :Proprietor

Acknowledgement

Your APPLICATION FOR CONSENT TO ESTABLISH (UNDER WATER ACT, 1974 AND AIR
ACT 1981)has been submitted successfully to POLLUTION CONTROL BOARD ASSAM , Assam.
Your Application Number is 2294374
You may track your application by entering https://asocmms.nic.in/OCMMS/ URL and after login
Track Your Application inside complete tab in the dashboard.

Disclaimer : This is a computed generated acknowledgement, which is subject to granting of the final
approval from the concerned authority. This acknowledgement should not be treated as the approval
or its substitute for the purpose of any other application and/or approval. The concerned authority
holds no responsibility if any other approvals are granted based on this acknowledgement.