FORM II
(See Rule 10)
APPLICATION FOR AUTHORIZATION OR RENEWEL OF AUTHORISATION
(To be submitted by occupier of Health Care Facility or Common Bio-Medical Waste Treatment
Facility)
To
District Environmental Engineer
Telangana Pollution Control Board
Bhadradri
1 Particulars of the applicant:
i) Name of the applicant : DR J SRINU NAIK
Designation : MEDICAL OFFICER
ii) Name of the Institution : PHC SULAHNAGAR
Address for correspondence : PHC SULAHNAGAR
Landline phone No : -
Mobile No. : 8106207761
E-mail Id :
[email protected] 2 Activity for which authorisation is sought:
Generation, segregation,Collection,Storage,Packaging,Disposal or destruction use
3 i) Authorization now Applied For : : Renewal
ii) Category of the HCE : :
iii) No. of. beds : : 6
iv) Previous Authorization Details :
Date of Application BMWA Type Authorisation No Issued date Valid date
for BMWA
v) Status of CTE/CTO-latest consent type, :
issued date and validity date
vi;) GPS Coordinates- Lat/Lon of the location of Latitude: (N Decimal degrees)
applicant facility(In decimal degress with 6 Longitude: (E Decimal degrees)
decimals)
4 i) BMW Facility Type : HCF
ii) BMW Facility Status : HCF-Common Facility Member
iii) Address of the location of Health Care Facility : PHC SULAHNAGAR
or CBMWTF
iv) CBMWTF-Office and location address of : M/s. AWM Consulting Ltd.,
treatment and disposal Gopalapeta (V), Tallada (M),
Khammam District
5) Details of HCF
i) Medical Treatment Facility provided to : 120
Outpatients
1
ii) Medical Treatment Facility provided to : 12
Inpatients
iii) No of Beds :
iv) For Non bedded Hospital (Specify) :
v) Total number of inpatients & outpatients treated : 3000
per month in the HCF
vii) Quantity of BMW handled, treated or disposed:
Catego Type of Waste Quantity Method of Treatment and
ry Generated or Disposal as per Schedule-I
collected in
Kg/day
Yellow a) Human Anatomical 1 Incineration
Waste
b) Animal Anatomical 0 Incineration
Waste
c) Soiled Waste 2 Incineration
d)Expired or Discarded .25 Incineration
Medicines
e)Chemical Solid Waste 0 Incineration
f) Chemical Liquid Waste .05 Onsite ETP to treat and conform to
the discharge standards
g)Discarded linen, 1 Disinfection followed by
mattresses, beddings Incineration
contaminated with blood
or body fluid
h) Microbiology, 0 Sterilisation followed by
Biotechnology and other Incineration
clinical laboratory waste
Red Contaminated waste 1 Autoclaving followed by shredding.
(Recyclable) Treated waste to be sent to
Authorised recyclers or for energy
recovery or plastic to Diesel or fuel
oil or for road making
White( Waste sharps including .25 Autoclaving followed by shredding.
Translu Metals Treated waste to be sent to Iron
cent) foundries or sanitary landfill or
designated concrete waste sharp pit.
Blue Glassware 1 Disinfection or Autoclaving or
microwaving or hydroclaving and
then sent for recycling
Metallic Body Implants 0
Total 6.55 Kg/Day
6i) Mode of Transportation of BMW : Common Facility Vehicle
ii) Details of Treatment equipments available for treatment of BMW:
2
Sl Treatment equipment No of units Type and capacity of each unit
No
1 Incinerators
2 Plasma Pyrolysis
3 Autoclaves
4 Microwave
5 Hydroclave
5 Hydroclave
6 Shredders
7 Needle tip cutter or
destroyer
8 Sharp encapsulation or
Concrete pit
9 Deep burial pits
10 Chemical disinfection
11 Any other treatment
equipment
7 Details of directions or notices or legal :
actions if any during the period of earlier
authorisation
8 Declaration
I do hereby declare that the statements made and information given above is true to the best of
my knowledge and belief and that I have not concealed any information.
I do also hereby undertake to provide any further information sought by the prescribed Authority
in relation to these rules and to fulfil any conditions stipulated by the prescribed Authority.
Date: 28/12/2020
Signature of the applicant
Name and Designation
Enclosures:
1. PHC Sulhanagar
