[Rules 3(c) and 5(5)]

1 . Number of authorization and date of issue ………………………

2 ………….. of ……… is hereby granted an authorization to operate a facility for collection, reception, treatment, storage, transport and disposal of hazardous waste on the premises situated at ………………

3. The authorization is granted to operate a facility for collection, reception, treatment, storage, transport and disposal of hazardous wastes.

4. The authorization shall be in force for a period of ………. years from the date of issue.

5. The authorization is subject to the conditions stated below and to such conditions as may be specified in the rules for the time being in force under the Environment (Protection) Act, 1986.

Date …………………

Signature ………………

Designation ……………..

Terms and conditions of authorization

1 . The authorization shall comply with the provisions of the Environment (Protection) Act, 1986, and the rules made thereunder.

2. The authorization or its renewal shall be produced for inspection at the request of an officer authorized by the 2[State Pollution Control Board or Committee].

3. The person authorized shall not rent, lend, sell, transfer or otherwise transport the hazardous wastes without obtaining prior permission of the 2[State Pollution Control Board or Committee].

4. Any unauthorized change in personnel, equipment or working conditions as mentioned in the application by the person authorized shall constitute a breach of the authorization.

5. It is the duty of the authorized person to take prior permission of the 2[State Pollution Control Board or Committee] to close down the facility.

6, An application for the renewal of an authorization shall be made as laid down in rule 5(6)(ii).