Common Application Form (TS-iPASS)

Step 1 of 9 Applicant

Unit, promoter and address for communication. Fields marked * are required.

UID No.

Name of industrial undertaking *

Name of promoter *

Relation

Father / husband name

Address for communication

Door No.

Street name

Village / Town

Mandal

District

State

Pin code

Cell No. *

+91

Telephone

Email ID *

Step 2 of 9 Proposal

Investment, employment and registration. All fields in this section are optional.

Proposal for

Land

Rs. lakhs

Building

Rs. lakhs

Plant and machinery

Rs. lakhs

Probable employment potential (number of persons)

Direct: male

Direct: female

Indirect: male

Indirect: female

Registration

Category of registration

Registration No.

Registration date

Total investmentRs. 0 lakhs

Direct employment0

Indirect employment0

Total employment0

Step 3 of 9 Manufacture

Products and raw materials. All fields in this section are optional.

Line of manufacture

#ItemQuantityUnits

1ItemQuantityUnits

2ItemQuantityUnits

3ItemQuantityUnits

Raw materials used in process

#Item nameQuantityUnits

1Item nameQuantityUnits

2Item nameQuantityUnits

3Item nameQuantityUnits

Step 4 of 9 Location

Proposed factory site and land. All fields in this section are optional.

Survey No.

Village / Town

Gram panchayat

Mandal

District

Pin code

Site email ID

Site telephone

Land and approach

Total extent of site as per document

sq m

Proposed area for development

sq m

Total built-up area

sq m

Existing width of approach road

feet

Type of approach road

Land comes under

Case type

Category of industry

Step 5 of 9 Power

Electricity load and working hours. All fields in this section are optional.

Contracted maximum demand

KVA

Connected load

KW / HP

Transformer capacity to be installed by the entrepreneur

KVA

Required voltage level

Any other services existing in the same premises

Proposed maximum working hours per day

hours

Proposed maximum working hours per month

hours

Expected month of trial production

Probable date power supply is required

Step 6 of 9 Water

Source and daily requirement. All fields in this section are optional.

Water supply from

Source of water

Drinking water

KL/day

Water for processing (industrial use)

KL/day

Total requirement of water

KL/day

Water for consumptive use

KL/day

Water for non-consumptive use

KL/day

Step 7 of 9 Pollution

Waste water, air emissions and waste (PCB). All fields in this section are optional.

Waste water generation (KLD)

Process

KLD

Washings

KLD

Boiler blow down

KLD

Cooling tower bleed off

KLD

Domestic

KLD

Total

KLD

Air pollution: DG set / boiler / thermic fluid heater

Equipment

Capacity

Fuel consumption per day

Fuel storage details

Stack height and diameter

Air pollution control equipment details

Process emissions

Emission characteristics and source

Quantity of emissions

Control equipment / system

Does the project require a generator?

YesNo

Solid and hazardous waste

#Waste nameCategoryQuantityStorageDisposal

1Waste nameCategoryQuantityStorageDisposal

2Waste nameCategoryQuantityStorageDisposal

3Waste nameCategoryQuantityStorageDisposal

Step 9 of 9 Review & submit

Check your details. Tap a section to change it.

Your answers will appear here.

Anything else we should know?

I confirm the details are correct to the best of my knowledge, and I agree that MKM Consultancy may contact me about this application.

Application received

Thank you. Our team will review your details and call you to plan the approvals.

Your reference number-

Fill another form

Common ApplicationForm

Address for communication

Probable employment potential (number of persons)

Registration

Land and approach

Waste water generation (KLD)

Air pollution: DG set / boiler / thermic fluid heater

Process emissions

Means of escape

Open spaces all around the building (m)

Fire detection and fighting systems

Transformer protection measures

Application received

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