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: 0364-2521533
2522802
2521514
2522726
Tele-Fax. : 0364-2521217
2521764
Meghalaya State Pollution Control Board, Shillong
FORM - 1

APPLICATION FOR CONSENT FOR EMISSION/CONTINUATION OF EMISSION UNDER SECTION

21 OF THE AIR (PREVENTION AND CONTROL OF POLLUTION) ACT, 1981

(SEE RULE 4)

From Dated:
MS PREMSON PROMOTORS PRIVATE LTD, 02/05/2024
SONGSAK
City:
Block:Songsak C and RD Block
District:East Garo Hills District

To

The Member Secretary,

Meghalaya State Pollution Control Board
'ARDEN', Lumpyngngad, Shillong-793014

Sir,

1. I ,MS PREMSON PROMOTORS PRIVATE LTD occupier of the industrial plant MS PREMSON
PROMOTORS PRIVATE LTD hereby apply for consent under section 21 of the Air (Prevention and
Control of Pollution) Act, 1981 for a period upto of (not exceeding three years) to operate the above
mentioned industrial plant, detail pertaining to it being given in the Annexure.

2. I declare that the information furnished in this application, annexure, accompaniments and appendixes, if
any, are correct and true to the best of my knowledge and belief

3. I hereby agree to inform the Board within 15 days of my change in the particulars in respect of the
occupier and/or authorised agent.

4. I hereby submit that in case of a change either of the point or the quality of emission or its quantity, a
fresh application for consent shall be made and until such consent is granted no change shall be made.

5. I hereby agree to submit to the Board application for renewal of consent six months in advance of the date
of expiry of the date of expiry of the consented period if the operation of the industrial plant is to be
continued thereafter.
6. Bank Details:-

Bank Draft No. Date Amount

7. I undertake to furnish any other information called for by the Board within such times as specified by the
Board.

Yours faithfully,
Occupier's signature________________
Name : MS PREMSON PROMOTORS PRIVATE
LTD
Address : WILLIAMNAGAR
NOTE: * Here enter the names and address of the occupier who, in relation to any factory or the premises,
is the person who has control over the affairs of the factory or the premises and where the said affairs are
entrusted to a managing agent, such agent shall be deemed to the occupier of the factory or the premises.
Here enter the names and address of the industrial plant
Accompaniments:- 1. SITE PLAN (Attached)
2. Site Plan/Plan Layout (Attached)
3. Project Report/Estimated Cost of the Project
(Attached)
4. NOC District Council (Attached)
5. NOC Headman (Attached)
6. Land Agreement/Lease Deed (Attached)
 ANNEXURE TO FORM - I

Chimney : Existing/New/Altered
Note: (i) While filling this Annexure, the applicant (occupier) shall 'not applicable' against which are not
pertaining to this Industrial plant and no space shall be left blank.
(ii) Any applicant knowingly giving incorrect information or suppressing any information pertaining there to
shall be liable to be punished under the Act.

1) a) Full name of the occupier : MS PREMSON PROMOTORS

PRIVATE LTD
b) Designation : PARTNERSHIP FIRM
c) Postal address : WILLIAMNAGAR
d) Telegraphic address :
e) Telex/Fax No. : -
f) Telephone No. : -
2) Full name and address of the industry & its registered : MS PREMSON PROMOTORS
office PRIVATE LTD,,SONGSAK
3) Name /s, designation/s and postal address of authorized :
agent/agents
4) a. Type of industry( with reference to the schedule of the : 3131259
Act )
b. Category of Industry, small scale/medium scale/large : ORANGE,small
scale
c. Total Capital investment (with year of investment) : 35.0
5) Month and year in which the plant was actually put into : April,2024
commission or is proposed to be put into commision
6) Location of the Industrial plant
a. Revenue Survey No. :
b. Area in Hectares :
c. Village : village
d. Taluk :
e. District : East Garo Hills District
f. Panchayat/Muncipality/Corporation :
7) a. State whether plant site has been declared as : NO
prohibited area:
b. If yes, state the name of the Authority and furnish a : -
certified copy of the order under which the area has
been declared as prohibited area
8) a. State whether the Industry is working round the year : Jan to Jan
or seasonal
9) a. No. of persons attending in the premises/factory per : 10
day:
b. No. of persons residing in the permises : 2
10) List of individual plants in the industry :
11) a. List of materials used in process (other than fuels)
S.No. Name of Material Process where used Consumption in tonnes/day
A process flow diagram must be attached showing the entry and exit points of all raw materials,
intermediate products, by-products and products Label process and control equipments and give process
description.

b) Details of fuel consumption

Fuel Name Daily Where Uses Calorific Ash Sulphur Others(speci

Comsumpti value contents contents fy)
on(T/day)
List of products and by-products

S.No. Name of Products Quantity.in(Metric

Tonnes/month)
12) a. Indicate the present use of the land within 5 km :
radius,
Name of Surrounding Distance(in meters) Description
b. Climatological and metrological details (if available)
i) Climate condition & the site :
ii) Rainfall, yearly average, range :
iii) Temperature, seasonal changes :
iv) Speed and direction of wind :
v) Humidity, solar radiation :
13.a)Details of furnaces

Ref. No. of Chimney in Types of furnace Fuel used, quantity of Operation & Loading
layout plant through fuel, tonne/day
which plant through
which emission take
place
b)Details of boliers

Ref. No. of Type of Fuel Bolier Quantity Steam Capacity

chimney in Fuel Pressure
Operation tonne/day
layout plant
through
which
emission
takes place
Loading
14a)Details of Chimney

Ref. No of Nature of Height in m Inside Inside Qnty. Exit Gas

Chimney constructi shape dimensio m3/hour Temeratu Velocity
Above Above
in lay-out on circle, n in m
ground roof level re m/sec
plan square diameter
level 0C
etc. size C°
etc.(specif
y)
b)Chimney Emission
 Ref. of chimney in Source of emission Analysis of gas * mg/m3 Others
layout Plan
c)Any other emissions

Source/Outlet Quantity m3/hr Temperature Analysis of gas * Others

0c mg/m3
d)Particulate analysis (if available)

Level Size distribution Chemical Composition

15. Laboratory faclities for air emission analysis :

16. State the total quantity of air handled by ventilation equipments,specify size and no.of
equipments, installed or to be installed
Equipment Name Equipment Size No. of equipments Status
17. Details of emmission sampling facilities available
Identification of emission Sampling, points ladder Remarks
Platforms etc., available
18. Details of Air pollution control system with specifications and drawings :-
Stack Name Equipment Name State
19. (a) Total investment in the factory and the year of : 1925
investment.
20. Number and date of consent, if any, under the Water (Prevention and Control of Pollution) Act,
1974 (Central Act of 1984_______________________________________)
21. Other relevent information, if any :
Signature
(Name and address of the applicant on
behalf of name and address of the Firm.):
MS PREMSON PROMOTORS PRIVATE
LTD,WILLIAMNAGAR

NB : This is computer generated Application Form, hence no signature is required from the applicant.