[If yes, how many cases registered & settled during last three years (give year wise details)]
Dated:
Signature of Municipal Commissioner
Form - IV
[See Rule (8)(3)]
Format of Annual Report to be submitted by the State Pollution Control Board/ Committees to the Central Pollution Control Board
To,
The Chairman,
Central Pollution Control Board,
Parivesh Bhawan, East Arjun Nagar,
Delhi-110032
1.
Name of the State/ Union territory
:
2.
Name & address of the State
Pollution Control Board/ Pollution
Control Committee
:
3.
Number of municipal authorities
responsible for management of
municipal
solid wastes in the State/ Union
territory
under these rules
:
4.
A Summary Statement on progress made
by municipal authorities in respect
of
implementation ofSchedule III]
:
Please attach as Annexure-I
5.
A Summary Statement on progress made
by
municipal authorities in respect of
implementation ofSchedule IV
:
Please attach as Annexure-II
Date:
Chairman or the
Member Secretary
State Pollution Control Board/
Pollution
Control Committee
Place:
Form-V
[See Rule 14]
Accident Reporting
1.
Date and time of accident
:
2.
Sequence of events leading to accident
:
3.
The type of construction and demolition waste involved in
accident
:
4.
Assessment of the effects of the accidents
a.
on traffic, drainage system and the environment
:
5.
Emergency measures taken
:
6.
Steps taken to alleviate the effects
a.
of accidents
:
7.
Steps taken to prevent the recurrence
a.
of such an accident
:
8.
Regular monthly health checkup of workers at
a.
Processing/ recycling site shall be made
9.
Any accident during the collection,
a.
transportation and treatment including
b.
processing and recycling should be informed
c.
to the Competent Authority (Local Authority) or
d.
Prescribed Authority
Date :
Authorized Signatory
Place:
Designation