1. Is your organisation under EMS system ISO 14001?

1. a. Does your Organisation have valid consent State Pollution Control Board:
   YES / NO / Not applicable under Air, Water & Hazardous waste act
2. b. Type and quantity of Hazardous Waste generated by you per annum

   Type	Quantity
   type 1	20

3. c. Are you aware of handling the Hazardous Waste, as per Hazardous Wastes (Management & Handling) Rule 1989
   Yes / No
4. d. Are you filing below mentioned information annually, to State Pollution Control Board in the prescribed format as per Hazardous Wastes (Management & Handling) Rule 1989?
   Annual Environmental statement
   Yes / No
5. e. If YES, Please submit us a copy of these forms.
   Yes / No
6. f. List of important Clients with short Address (Please also mention the clients who are having ISO 14001 certification):

   SLNo	Client Name	Address
   1	name 1	abcd

7. g. Are you registered with any of the Common Hazardous Waste Disposal & transport agency (e.g. Like Kerala Enviro Infrastructure Limited, Ambalamugal, Ernakulam )
   Yes / No

   SLNo	Agency Name	Address	Membership No.
   1	name 1	abcd	34

8. h. Do you have industrial Waste Treatment Plant (ETP/STP)
   Yes / No
   If YES, Please submit us a copy of Waste Water quality monitoring report.
9. j. Do you have any Air Pollution Mitigation Equipments
   Yes / No
   If YES, Please mention the process where the equipments are fitted with the type of equipment.(Please attach separate sheet if required)
   If NO, Please identify the requirement and submit us a plan for implementation. (Please attach separate sheet if required)