Organisation : Central Ground Water Board
Facility : Application for Permission to Groundwater
Home Page : https://cgwb.gov.in/
Download here :https://www.statusin.in/uploads/5438-Application%20for%20%20Industries.pdf
Permission to Abstract Ground Water :
General Information
** Name of the Industry
Related : CGWB Application for permission to Abstract Ground Water for Industrial Use : www.statusin.in/5443.html
** Location details of the Industrial unit : (attach site plan and certified revenue sketch) Village/town: Block/Mandal Tehsil/Taluka District State:
** Communication address i. Complete Postal Address ii. Phone / Mobile No.
** E-mail address
** Fax No.
** Salient features of the Industrial activity
** Land use details of the existing/proposed Industrial unit premises
** Ownership of the land Enclose documents of ownership/lease
** Total land area sq m
Detail of water requirement /recycled water usage :
(Please enclose flow chart of activities and requirement of water at each stage)
** Total water requirement m3 Ground Water requirement : m/day Surface Water requirement: m/day Proposed/existing water supply from any agency: m/day
Industrial Use New :
Application for permission to abstract ground water for industrial use – w.e.f. 15th Nov , 2012 Page 2/3
** Breakup of water requirement and usage Activity Existing requirement (m3 Proposed requirement (m/day)
** Total requirement (m/day)
** No. of operational days in a year /day) Annual requirement (m3 Industrial activity /year) Residential/ domestic
** Greenbelt development/ Environment maintenance
** Other use
Whether permission/ registered with CGWA, if so details thereof :
** Groundwater availability report (Please enclose a comprehensive report/note on groundwater condition/groundwater quality in and around 5 km of the areas) (This is applicable to all industries consuming more than 500m3
/day and / or having a land area of more than 2 ha.)
** Details of rainwater harvesting and artificial recharge measures for groundwater recharge in the area. If the firm has proposed to take up rainwater harvesting and recharge outside the industrial unit premises, then provide NOC from the concern authority/agency where the
Application for permission to abstract ground water for industrial use – w.e.f. 15th Nov , 2012 Page 3/3
harvesting measures are proposed, if already implemented, details may be furnished. (attach report on comprehensive & feasible Rainwater harvesting/recharge proposal).
** Copy of referral letter seeking NOC from CGWA from Central Pollution Control Board /State Pollution Control Board/Bureau of Indian Standards/Ministry of Environment and Forests/other central/state agencies shall be annexed.
** Have you applied earlier for groundwater clearance from CGWA/Stage Government Agency, if so, give details thereof with status :
Undertaking
** It is to certify that the details and information furnished above are true to the best of my knowledge and belief and I am aware that if any part of the data/information submitted is found to be false or misleading at any stage the application will be rejected out rightly.
Note :
** Application Proforma is subject to modification from time to time.
** Application in duplicate should be submitted either to the Member Secretary, Central Ground Water Authority, West Block 2, Wing 3, R K Puram, Sector 1, New Delhi 110066 or to the Regional Director, Central Ground Water Board of concerned State.
** Incomplete application will be summarily rejected.