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FORM - 4
[See rule 9(2)]
Format for the submission of returns, regarding disposal of Hazardous Waste
(To be submitted to the State Pollution Control Board)
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Date of issuance of authorization for the disposal of hazardous waste and its reference number (1) |
Description of Hazardous Waste (2) | ||
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Mode of transport- -ation to the site of
disposal (3) |
Site of disposal (attach a sketch showing the locat -ions
of disposal) (4) |
Brief description of the method of
disposal (5) |
Date of dispo
-sal (6) |
(if any) (7) |
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3. Details of environmental survelliance :
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Date of Measurement |
Analysis of ground water (1) |
Analysis of Soil samples (2) | ||
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Location of sampling |
Depth of Sampling |
Data |
sampling |
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Name and signature of the Head of the Facility
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