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GOVT.BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

PROJECT FEASIBILITY REPORT FOR COMMON BIOMEDICAL TREATMENT FACILITY

Proposed By Govt. Bundelkhand Medical College Sagar

At Village- Habsili , Tehsil- Sagar Dist-Sagar (MP )

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

1. Identification of project and project proponent Govt. Bundelkhand Medical College Sagar proposes Common Bio Medical Facility in the Dist. of Sagar. The Proposed project of addition of CBWTF as a part of the Common Treatment, Storage and Disposal facilities (TSDFs) of falls under Category B, schedule 7(da) as per the EIA notification 14th Sep, 2006 and subsequent amendments dated 1st December, 2009 & 17th April, 2015. The setting up of CBWTF attracts the recent directions of National Green Tribunal dated 28th November, 2013 making Environmental Clearance from MoEF&CC mandatory.

2. Brief Description of Nature of The Project A Common Bio-medical Waste Treatment Facility (CBWTF) is a set up where bio- medical waste, generated from a number of healthcare units, is suitably treated to reduce adverse effects that this waste may pose. The treated waste may finally be sent for disposal in a secured or for purposes. Expansion of Existing BMW Facility from land fill method to Rotary Kiln ,Auto clave, Shredder Etc. Proposed project of setting up of the Common Bio-medical Waste Treatment Facility for treatment of 100 kg per hour rotary kiln based bio medical project, includes Incinerator, , Shredder, Storage and Effluent Treatment Facility. Following will be the capacity of the facility:

Sl. Number Equipment Installed Capacity No. 1 Rotary Kiln 01 100 kg per hr 2 Autoclave 01 0.25 m3 3 Shredder 01 50 kg per hour 4 Effluent Treatment Plant 01 6 KLD

3. Need for the project and its importance to the country and or region Ministry of Environment, Forests & (MoEF & CC), Govt. of India has notified the Bio-Medical Rules 2016. In accordance to the rule, every occupier of a Health Care Establishment (HCE shall either set up requisite bio- medical waste treatment facilities on site or ensure requisite treatment of the bio- medical waste at an approved Common Biomedical Waste Treatment Facility. No untreated bio-medical waste shall be kept stored beyond a period of 48 hours.

Keeping in view the difficulties faced by private , Nursing Homes and that cannot make their own arrangements due to high cost involved in Treatment facilities, there was need for centralized system for treatment. Most of the tribal villages have very poor transportation and communication infrastructure. Most of the hospitals do not have adequate arrangement for disposal of the waste.

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

A Common Biomedical Waste Treatment Facility (CBWTF) is now proposed to be set up by where bio-medical waste, generated from a number of healthcare units, will be suitably treated to reduce adverse effects that this waste may pose. The Bio-medical Waste (Management & Handling) Rules, provides an option to the Bio-medical waste generators to get the biomedical waste treated and disposed at the secured . The objective for the proposed project is to Establish an Integrated Common Bio- medical Waste Treatment facility including the Incinerator, autoclave, shredder and effluent treatment unit.  Collection of Segregated Biomedical waste and its transportation, storage, treatment and disposal in accordance to the Bio medical Waste Management Rules 2016.  Compliances with statutory and environmental norms.  Develop concise waste management principles.  Introduce a continuing waste management education program for all staff to increase awareness of Occupational Health & Safety issues and waste minimization principles.  Adopt policies and procedures to minimize the environmental impacts of Waste treatment and disposal.  Reporting to regulatory authorities as needed.

4. Demand –Supply Gap As per the guideline, one CBWTF facility will cover 150 km area and 10000 beds. However as per the record available, Considering the number of nursing home and hospitals with beds, the existing facility is not able to meet the requirement of the city. There area around 2853 HCF’s in MP state. The estimated quantity of BMW generated in MP is around 9409 kg/day. Following are the data available for the State of MP

Total no. of healthcare facilities (HCFs) 2853 Total no. of beds ( approx) 71417 No of common biomedical waste treatment facilities (CBWTFs)/private agencies Operational 15 Under construction Nil No. of HCFs utilizing CBWTFs/private 2793 agencies No. of HCFs having own treatment and 60 disposal facilities No. of HCFs applied for authorization 2853 No. of HCFs granted authorization INP Total no of onsite treatment equipment ( Excluding CBWTFs) installed by HCFs Incinerator with APCD 02 Incinerator without APCD 0 Autocalve 163 Microwave 0 Hydroclave 0 Shredder 572

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

Total no of equipment installed at 15 CBWTFs

Following are the data available for the district Sagar.

Location Detail of Health Care Facility Total number Estimated waste (HCF) of Beds quantity in kg Around 53 Registered Members by B.M.C. 2150 592 per Day 150 KM Sagar. Sagar,Damoh, Tikamgarh, Chhatarpur

Incineration in C.B.W.T.F. Jabalpur as per permission of M.P.P.C.B. Bhoapl.

5 Imports vs. Indigenous production No imports for production have been proposed for the project.

6 Export possibility The project is a common treatment facility for safe disposal of biomedical waste. No export possibility is envisaged.

7 Domestic/export markets Not envisaged.

8 Employment generation (direct and indirect) due to the project During Construction phase the labors and workers will be hired from nearby villages. Total 30 numbers of persons are proposed to hire for Plant operations and transportation including staff, skilled and unskilled workers.

9 Project Description Types of project: A Common Bio-medical Waste Treatment Facility (CBWTF) is required for the treatment of the biomedical waste generated from a number of healthcare units to reduce adverse effects that this waste may pose. Proposed project of setting up for treatment of 100 kg per hour rotary kiln based bio medical incineration project, which also includes Incinerator, Autoclave, Shredder, Destroyer, Storage and Effluent Treatment Plant.

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

1. Location of the Project District/State Taluka Village Khasara No Area in acres

Sagar(MP) Sagar Habsili 166 1.5 (0.607 ha)

Railway line:

Ratona Railway station is the closest railway station which is approx. 1.09 km in South direction from site.

Roadways:

Road ways: The site is proposed in the dist of Sagar and well connected through road network. The nearest SH-14 road is 1.14 km from the site.

Airways:

The closest air strip is the Dhana which is 21km at SE direction from the Site.

2. Details of alternate site: The proposed projects have no alternative site. As the site is identified to cover good range of medical facilities in the major cities of the state Parameters Criteria Observation Lake of Pond ( Distance Should not be within 200 No lake of pond is located within from NEbody) mt 200 mt from the site The nearest water body is Karawan Nadi at 1.53 km on W direction & Local Village Dam at 1.75 km in NE direction. River Should not be within 100 The nearest water body is Local mt village Dam at 1.75 km in NE direction. Flood Plain Should not be within 100 Not in a flood plain mt of flood plain Highway State or national Should not be within 500 No national highway with in 500 mt mt. The state highway - 14 Khurai- Sagar is 1.14 km from the site Habitation – Notified Should not be within 500 Nearest notified habitation is Habituated area mt Habsili at 0.65 km in NW direction Public Park Should not be within 500 No public park within 500 mt mt` Critical Habitat area in Not suitable There is no endangered spice in the which one or more site. endangered species alive

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

3. Size or magnitude of operation:

The proposed facility is extended up to 1.5 acre (0.607 ha) land. The total cost of the project is around Rs.2.05Cr (2,05,25,000). The following are the proposed equipment’s to be installed in the plant. Bio Medical waste quantity is required 1MT to 6 MT per day for operation of the project.

Sl. Number Equipment Installed Capacity No. 1 Rotary Kiln 01 100 kg per hr 2 Autoclave 02 0.25 m3 3 Shredder 01 50 kg per hour 4 Effluent Treatment Plant 01 6 KLD

5 Project Description with Process Details:

List of Major Plant & Machineries

 Rotary Kiln –Incinerator –Multiple Chamber  Air Control Device  Chimney  Steam Based Bio Medical Autoclave  Bio Medical Shredder  Hypochloride Washer  Centrifugal Liquid Filter  Effluent Treatment Plant  NG Vehicle  Wheel Barrows  containers

Components of Integrated Bio-Medical Waste Management An integrated waste management system for bio-medical waste must look into various stages of the process. These key components can be broadly classified into the following: Waste Segregation: Waste segregation will reduce the load of bio-medical waste and this also minimizes the environmental impacts associated with further processing. Waste will have to be segregated into domestic refuse, hazardous waste and infectious waste separately. Further the infectious waste will have to be segregated into , metals, and other infectious waste generated. Segregation is done effectively if performed at source. CPCB has issued clear guidelines for color coded segregation.

Waste Collection and Transport: Facility / unit have to ensure that there are no environmental or human health impacts while collecting & transporting Bio-Medical waste.

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

Treatment/ Storage/ Disposal: Treatment/ Storage and disposal of the waste have various options available. Waste treatment can be effectively performed by two operations running parallel to each other:

A Disinfecting Unit A Disinfecting unit is one that will effectively kill all the microorganisms. Autoclaving, Microwaving, Hydroclaving and Chemical disinfection processes are the most prevalent technologies used for disinfection of pathogens from the bio-medical waste. Autoclave used for the purpose of bio-medical waste management is expected to be dedicated for the purpose and is expected to operate under standards specified by CPCB. Medical Waste shall not be considered treated unless the time, temperature and pressure indicated in the standards are reached (for eg. 1210 C, 15 psi for 1 hour for normal autoclave). Microwave and Hydroclave disinfection units are similar in application to that of an autoclave. Microwave technology cannot be applied for cytotoxins, hazardous or , contaminated animal carcasses, body parts and large metal items. Microwave should completely and consistently kill the bacteria and other microorganisms. Chemical disinfection is a process of disinfection wherein chemical disinfectants like chlorine and its derivatives or their disinfectants are used in a closed process to attain complete killing of the pathogens.

A Destruction Unit A Destruction unit is one that will completely destroy the waste into safe end products. High temperature incinerators are used to achieve this. Incineration is a process by which combustible materials are burnt, producing combustion gases and non-combustible residue and ash. The combustible gases are vented into the air after treatment through control devices. Ash and other non combustible residue remain after the destruction/ incineration process is disposed off securely into a landfill site.

Waste Storage Waste Storage is an applicable option for effective storage of certain hazardous waste like and cytotoxins that do not have a cost-effective treatment technology as yet. Waste Disposal is primary performed by deep burial of waste into secure landfills.

Waste disposal Waste disposal is an option which remains to exist irrespective of the treatment options, in case of disinfection waste material post-disinfection needs to be land filled and in case of incineration the non combustible residue and ash needs to be disposed off into a landfill and thus landfill remains to be an integral part of an integrated bio- medical waste management facility.

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

Process Description Govt. Bundelkhand Medical College proposes to establish an Integrated Common Bio- medical Waste Treatment Facility includes Incinerator, Autoclave, Shredder and Effluent Treatment Plant. Treatment Technology Incineration through rotary kiln This is a high temperature thermal process employing combustion of the waste under controlled condition for converting it into inert material and gases. Incinerators can be oil fired or electrically powered or a combination of both. Broadly, three types of incinerators are used for biomedical waste: multiple hearth type, rotary kiln and controlled air types. All the types have primary and secondary combustion chambers to ensure optimal combustion. These are refractory lined. Rotary kiln: burning of bio medical waste at 800 c° to 950 °c de grading of organic

Secondary chamber: re burning of flue gas up to 1050 °c -1200°c de gradeing of in organic Gas dilution chamber: reduce the concentration and temperature of thermal treated flue gas

Fly ash control device: high temperature filter to prevent fly ash from thermal treated gas

Ventury : high pressure ejector venturi unit for liqid quenching treatment of thermal treated

Flue gas treatment media tank : 6kl 5-7% NAOH water tank lined with isothalic FRP with high pressure pumping unit

Mist eliminator: post quenching and filtering of exhaust gas and seprat mist from gas (de misting)

Id fan : high capacity ID fan for sucking the high quantity of negative pressure generating the whole unit

Gas ducting ; containing passage of gases

Chimney: discharge the treated gas from the machine to 30 mtr above from ground level

Specification Of Rotary Kiln 1) Capacity 100 KH Per Hour 2) Type ` Cylindrical Horizontal ( Solid Waste Feeding) 3) Inclination 2.5° 4) Revolution (Rpm) 2 To 1rpm(Vfd) 5) Volume 12.4m³ 6) Moc (Shell) Sa 516 Gr70-30 20mm Thk 7) Chamber Pressure 10-20mm Wc 8) Travel Speed 6.02mtr/ Hr

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

9) Refractory Thick 12 Inch 10) Grith Gear Moc En 19 Forged 8 Module Spur Gear Type 11) Drive Gear Box Elecon / Reputed Company Make 12) Gear Box Ratio 1:60 Ratio Foot Mounted 22nm 13) Drive Motor 20 Hp Simense Make 3 Ph Class S4 Duety Induction Motor 14) Inner Diameter Of Kiln 1600mm 15) Inner Length Of Kiln 6200mm 16) Tyre Wheel 250wide 2 Set 17) Flue Gas Velocity 1.3mtr / Sec 18) Ash And Resudes Sepration Ash Seprator With Hot Ash Removel Screw Convayor 19) Gas Leakage Privention Unit High Pressure Airsealing For Privent Flue Gas Leakage 20) Back Pressure Privention From Charging Door Compressed Door Mechanisum 21) Explosion Safety Explotion Davit Arrangement (Internal) 22) Waster Loading Mechanisum Bucket Elevator With Hoper 23) Waste Reciving From Kiln Side Hoper Unit With Saftey Door 24) Waste Feeding Mechanisum Hydralic Ram And Pusher 25) Hydralic Unit 10hp With Power Pack 26) Rotary Air Lock Valve 6 Inch Nb 27) Nature / Category Of Waste Incinerable Bio- Medical Waste With Maximum 85% Moisture Content. 28) Source Of Energy Diesel 29) Fuel Burner’s Fully Automatic Burners (Oil Or Gas burner) 30) Heat Loss Fraction 0.05 31) Combustion Efficiency At Least 99 %. 32) Design Temperature 1400 0c 33) Preheating Time Maximum One Hour. 34) Temperature In Primary Chamber 800 + 50 0 C. 35) O2 Content In Primary Chamber 6 %. Post Gas Combustion Chamber 1) Type `Cylindrical Statical 2) Inclination Vertical 90° 3) Volume 7.6m³ 4) Moc (Shell) Sa 516 Gr70-30 12mm Thk 5) Chamber Pressure 10-20mm Wc 6) Refractory Thick 12 Inch 7) Inner Sizeof Chamber 1250mm 8) Inner Length Of Chamber 6200mm 9) Tyre Wheel 250wide 2 Set 10) Flue Gas Velocity 1.9 Mtr / Sec 11) Ash And Residues Separation Ash Separator With Hot Ash Removal Screw Conveyor

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

12) Gas Leakage Prevention Unit High Pressure Airsealing For Privent Flue Gas Leakage 13) Explosion Safety Explosion Davit Arrangement (Internal) Top With Counter Weight Linked With Plc Control 14) Retention Time of Flue 2To2.2Second. Gases In Chamber Post Gas Combustion Chamber

1) Type ` Cylindrical L Type 2) Vessel Orientation 180° Horizontal-90° Vertical 3) Volume 8.3m³ 4) MoC (Shell) SA 516 Gr70-30 8mm THK 5) Chamber Pressure 10-20mm WC 6) Refractory Thick 12 Inch 7) Inner Diameter 1200mm 8) Inner Length 6200mm 9) Fresh Air Source Forced Air Fan 10) Flue Gas Velocity 1.9 Mtr / Sec 11) Ash Separation 10microne High Temperature Bag Filter Unit 12) Bag Filter Cleaning Pulse Jet Compressed Air 13) Explosion Safety Explosion Davit Arrangement At Post Gas Burning Chamber (Internal)

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

Air Pollution Control System (APC) The gases after being burnt at 1050oC shall be run into a ventury followed by a flooded scrubber with water quenching arrangement. The scrubber shall be an alkaline scrubber to neutralize the gases and ensure trapping of any escaping into the environment. The purpose of water quenching is to reduce the temperature of the gases which are at high temperature. The clean gases are let out into the environment. The scrubbed water shall be collected into a sump, where the water is neutralized, and then sent into a cooling tower from where the water is recirculated into the scrubber after cleaning them of their by way of pressure sand filter and activated carbon filter. The system is thus a zero discharge system in terms of water discharges and is pollution free.

. The high pressure Venturi scrubbing system shall be retrofitted to the incinerator. This Air Pollution Control device takes care of the flue gases exiting from the dilution chamber which shall pass through the scrubbing system where water and 5% caustic soda solution is sprayed on the flue gases by S.S. nozzles at a very high pressure. The Venturi Scrubber shall be High Pressure Type manufactured from S.S. 316L sheet. The system shall have Venturi nozzles made from S.S. 316L. The pressure drop in system shall be 350 mm WC and scrubbing media circulation rate 3000 LPH. Outlet temperature of the flue gases shall be around 85 to 95 0C. The complete accessories like valves, fittings shall also be provided. Centrifugal type re-circulation pump of suitable size. Casing and Impellor of the pump shall be manufactured from stainless steel / HDPE. In addition to it a dosing pump unit shall be retrofitted to maintain the PH value of the scrubbing media.

. Droplet Separator : A sprat Tower Scrubber shall also be provided which is fitted (Mist eliminator) with the Venturi Scrubber to separate the water droplets from the flue gases. It shall be manufactured from mild steel internally FRP lined material and shall have the de-mister pad which separates the water droplets. The flue gases existing from the Venturi scrubbing system shall travel through the droplet separator where they shall be again mix up with the water for more cooling. It shall be Cyclonic Static type with tangential entry to remove carry over water / drops. Water droplets usually are carried off by the gas stream exiting the scrubber known as a white plume. A mist eliminator is a stationary piece of equipment that removes most of the entrained water droplets from the gas and will reduce the moisture collected at the induced draft fan and other downstream equipment. The temperature shall be maintained between 85- 90 0C at the exit.

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

Feeding of Waste The feeding of the waste to the rotary kiln chamber is done automatically by electrically motorized operated waste Charging elevator. The packed waste is loaded in the hopper type waste ram pusher and pressing of the switch moves the waste into the rotary kiln burning chamber this eases in charging the waste and thus safety of operator. The bucket type elevator waste charging unit is so designed to load waste from the room

Stack Height: Minimum stack height shall be 30 meters above the ground and shall be attached with the necessary monitoring facilities as per requirement of monitoring of „general parameters‟ as notified under the Environment (Protection) Act, 1986 and in accordance with the Central Pollution Control Board Guidelines of Emission Regulation Part-III. 1. Base Diameter 1300mm 2. Top Diameter 550mm 3. Type Conical Self Supported (Msrl),Mild Steel Internal Rubber Lined Chimney. 4. The internal hard rubber lined chimney is manufactured from Mild Steel pipes of 350 mm dia. and minimum thickness of 5 mm. With a conical bottom of 1300 mm dia. and the height of chimney shall be 30 Meters. Caged ladder, Gas sampling Platform , Gas sampling nozzle, top platform, Aviation lamp assembly with cable , Lightning arrester with jumpers ,Rain cowl , Bottom manhole , Chimney Drain , Base plate with compression Ring and stiffness ,Chimney Base template for foundation casting (R C C ) , Foundation bolts , Hardware’s, The RCC foundation for the chimney shall be in your scope of work.

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

Autoclave An autoclave is a specialized piece of equipment designed to deliver 1210 0C temperature under 15 psi pressures to a chamber, with the goal of decontaminating or sterilizing the contents of the chamber. Decontamination is the reduction of contamination to a level where it is no longer a hazard to people or the environment. The project proponent intends to establish an autoclave with above principle. To ensure safety and quality control, all bio-hazardous materials and items contaminated with potentially infectious agents should be decontaminated before use or disposal. Such items include, but are not limited to: culture media, surgical instruments, equipment, glassware, and biomedical waste including sharps.

Shredder Shredding is a process by which waste are de-shaped or cut into smaller pieces so as to make the waste unrecognizable. Shredder has non- corrosive sharp blades capable for shredding of plastic waste, sharps, bottles, needles, tubings, and other general waste. The low speed two shaft systems is effective for shredding hard and solid waste. The dis-infected waste shall then be segregated into HDPE, PP, rubber, latex, glass and metal. The segregated materials shall then be shredded completing the process of

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.) dis- and ensuring non-recycling of the waste materials for medical/ food grade purposes.

Waste Treatment and Disposal Scheme

Depending on the category/nature of the waste the following treatment and disposal method are employed according to Bio-Medical Waste Management Rules 2016.

Category Type of Waste Type of Bag or Treatment and Disposal Container to be options used Yellow a) Human Anatomical Yellow coloured Incineration or Plasma Waste: non chlorinated Pyrolysis or deep burial* Human tissues, organs, plastic body parts and fetus below the viability period (as per the Medical Termination of Pregnancy Act 1971, amended from time to time). (b)Animal Anatomical Waste : Experimental animal carcasses, body parts, organs, tissues, including the waste generated from animals used in experiments or testing in veterinary hospitals or colleges or animal houses. (c) Soiled Waste: Incineration/ deep Items contaminated with burial*or Plasma Pyrolysis , body fluids like Or In absence of above dressings, plaster casts, facilities, Autoclaving or cotton swabs and bags micro-waving/ containing residual or hydroclaving followed by discarded blood and shredding or mutilation or blood components combination of sterilization and shredding. (d) Expired or Yellow coloured Expired `cytotoxic drugs Discarded Medicines: non-chlorinated and items contaminated Pharmaceutical waste plastic bags or with cytotoxic drugs to be like antibiotics, cytotoxic containers returned back to the drugs including all items manufacturer or supplier contaminated with for incineration at cytotoxic drugs along temperature >1200 0C or with glass or plastic to common bio-medical , vials waste treatment facility or hazardous waste

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

treatment, storage and disposal facility for incineration at >12000C Or Encapsulation or Plasma Pyrolysis at >12000C. All other discarded medicines shall be either sent back to manufacturer or disposed by incineration.. (e) : Yellow coloured Disposed of by Chemicals used in containers or incineration or Plasma production of biological non-chlorinated Pyrolysis or Encapsulation and used or discarded plastic bags in hazardous waste disinfectants. treatment, storage and disposal facility. (f) Chemical Liquid Separate After , Waste : collection the chemical liquid waste Liquid waste generated system leading shall be pre-treated before due to use of chemicals to effluent mixing with other in production of treatment wastewater. The combined biological and used or system discharge shall conform to discarded disinfectants, the discharge norms given Silver X-ray film in Schedule- III. developing liquid, discarded Formalin, infected secretions, aspirated body fluids, liquid from and floor washings, cleaning, house-keeping and disinfecting activities etc g) Discarded linen, Non-chlorinated Non- chlorinated chemical mattresses, beddings yellow plastic disinfection followed by contaminated with blood bags or suitable incineration or Plasma or body fluid. packing material Pyrolysis or for energy recovery. In absence of above facilities, shredding or mutilation or combination of sterilization and shredding. Treated waste to be sent for energy recovery or incineration or Plazma Pyrolysis. (h) Microbiology, Autoclave safe Pre-treat to sterilize with Biotechnology and plastic bags or non-chlorinated chemicals other clinical containers on-site as per National laboratory waste: AIDS Control Organisation

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

Blood bags, Laboratory or World Health cultures, stocks or Organisation guidelines specimens of thereafter for Incineration. microorganisms, live or attenuated vaccines, human and animal cell cultures used in research, industrial laboratories, production of biological, residual toxins, dishes and devices used for cultures. Red Contaminated Waste Red coloured Autoclaving or micro- (Recyclable) non-chlorinated waving/ hydroclaving (a) generated plastic bags or followed by shredding or from disposable items containers mutilation or combination such as tubing, bottles, of sterilization and intravenous tubes and shredding. Treated waste sets, catheters, urine to be sent to registered or bags, syringes (without authorized recyclers or for needles and fixed needle energy recovery or plastics syringes) and to diesel or fuel oil or for vaccutainers with their road making, whichever is needles cut) and gloves. possible. Plastic waste should not be sent to landfill sites. White Waste sharps Puncture proof, Autoclaving or Dry Heat (Translucent) including Metals: Leak proof, Sterilization followed by Needles, syringes with tamper proof shredding or mutilation or fixed needles, needles containers encapsulation in metal from needle tip cutter or container or cement burner, scalpels, blades, concrete; combination of or any other shredding cum contaminated sharp autoclaving; and sent for object that may cause final disposal to iron puncture and cuts. This foundries (having consent includes both used, to operate from the State discarded and Pollution Control Boards contaminated metal or Pollution Control sharps Committees) or sanitary landfill or designated concrete waste sharp pit. Blue (a) Glassware: Cardboard boxes Disinfection (by soaking Broken or discarded and with blue the washed glass waste contaminated glass colored marking after cleaning with including medicine vials detergent and Sodium and ampoules except Hypochlorite treatment) or those contaminated with through autoclaving or cytotoxic wastes. microwaving or hydroclaving and then sent for recycling.

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

(b) Metallic Body Cardboard boxes Implants with blue colored marking

Part -2

 All non-chlorinated plastic bags shall be as per BIS standards prevailing Plastic Waste Management Rules.  Chemical treatment using at least 10% Sodium Hypochlorite having 30% residual chlorine for twenty minutes or any other equivalent chemical reagent that should demonstrate Log104 reduction efficiency for microorganisms as given in Schedule- III.  Mutilation or shredding will be to an extent to prevent unauthorized .  There will be no chemical pretreatment before incineration, except for microbiological, lab and highly infectious waste.  Incineration ash (ash from incineration of any bio-medical waste) shall be disposed through hazardous waste treatment, storage and disposal facility, if toxic or hazardous constituents are present beyond the prescribed limits as given in the Hazardous Waste (Management, Handlin and Transboundary Movement) Rules, 2008 or as revised from time to time.  Dead Fetus below the viability period (as per the Medical Termination of Pregnancy Act 1971, amended from time to time) can be considered as human anatomical waste. Such waste should be handed over to the operator of common bio-medical waste treatment and disposal facility in yellow bag with a copy of the official Medical Termination of Pregnancy certificate from the Obstetrician or the Medical Superintendent of hospital or healthcare establishment.  Cytotoxic drug vials shall not be handed over to unauthorised person under any circumstances. These shall be sent back to the manufactures for necessary disposal at a single point. As a second option, these may be sent for incineration at common bio- medical waste treatment and disposal facility or TSDFs or plasma pyrolysis at temperature >12000C.  Residual or discarded chemical wastes, used or discarded disinfectants and chemical sludge can be disposed at hazardous waste treatment, storage and disposal facility. In such case, the waste should be sent to hazardous waste treatment, storage and disposal facility through operator of common bio-medical waste treatment and disposal facility only.  On-site pre-treatment of laboratory waste, microbiological waste, blood samples, and blood bags should be disinfected or sterilized as per the Guidelines of World Health Organisation or National AIDS Control Organisation and then given to the common bio-medical waste treatment and disposal facility.  Installation of in-house incinerator is not allowed. However in case there is no common biomedical facility nearby, the same may be installed by the occupier after taking authorization from the State Pollution Control Board.  Syringes should be either mutilated or needles should be cut and or stored in tamper proof, leak proof and puncture proof containers for sharps storage. Wherever the

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

occupier is not linked to a disposal facility it shall be the responsibility of the occupier to sterilize and dispose in the manner prescribed.  Bio-medical waste generated in households during healthcare activities shall be segregated as per these rules and handed over in separate bags or containers to municipal waste collectors. Urban Local Bodies shall have tie up with the common bio-medical waste treatment and disposal facility to pickup this waste from the Material Recovery Facility (MRF) or from the house hold directly, for final disposal in the manner as prescribed in this Schedule.

1. Standards for Incineration.- Proposed incinerators shall meet the following operating and emission standards- A. Operating Standards 1) Combustion efficiency (CE) shall be at least 99.00%. 2) The Combustion efficiency is computed as follows:

%C02 C.E. = ------X 100 %C02 + % CO

3) The temperature of the primary chamber shall be a minimum of 8000C and the secondary chamber shall be minimum of 10500C + or - 500C. 4) The secondary chamber gas residence time shall be at least two seconds.

B. Emission Standards

Standards Limiting S.No. Parameter Sampling Duration in concentration in minutes, unless stated mg Nm3 unless 1 Particulate matter 50 30 or 1NM3 of sample volume, whichever is more 2 Nitrogen Oxides NO 400 30 for online sampling or NO2 expressed asNO2 grab sample 3 HCL 50 30 or 1NM3 of sample volume, whichever is more 4 Total Dioxins and 0.1ngTEQ/Nm3 8 hours or 5NM3 of sample Furans (at 11%O2) volume, whichever is more 5 Hg and its 0.05 2 hours or 1NM3 of sample compounds volume, whichever is more 6 CO2 correction 12%

Note: All standards for incineration mentioned above shall be compiled from the date of commissioning of plant 1. Wastes to be incinerated shall not be chemically treated with any chlorinated disinfectants.

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

2. Ash from incineration of biomedical waste shall be disposed of at common hazardous waste treatment and disposal facility. However, it may be disposed of in municipal landfill, if the toxic metals in incineration ash are within the regulatory quantities as defined under the Hazardous Waste (Management and Handling and Transboundary Movement) Rules, 2008 as amended from time to time. 3. Only low Sulphur fuel like Light Diesel Oil or Low Sulphur Heavy Stock or Diesel, Compressed Natural Gas, Liquefied Natural Gas or Liquefied Petroleum Gas shall be used as fuel in the incinerator. 4. Monitoring of the stack gaseous emissions (under optimum capacity of the incinerator) will be done once in three months through a laboratory approved under the Environment (Protection) Act, 1986 and record of such analysis results shall be maintained and submitted to the prescribed authority. In case of dioxins and furans, monitoring will be done once in a year. 5. Continuous emission monitoring system for the parameters as stipulated by State Pollution Control Board or Pollution Control Committees in authorization and transmit the data real time to the servers at State Pollution Control Board or Pollution Control Committees and Central Pollution Control Board will be installed 6. All monitored values shall be corrected to 11% Oxygen on dry basis. 7. Incinerators (combustion chambers) shall be operated with such temperature, retention time and turbulence, as to achieve Total Organic Carbon content in the slag and bottom ashes less than 3% or their loss on ignition shall be less than 5% of the dry weight. 8. Combustion gas analyzer to measure CO2, CO and O2 will be installed.

Standards for Autoclaving of Bio-Medical Waste The autoclave should be dedicated for the purposes of disinfecting and treating bio- medical waste. 1. When operating a vacuum autoclave, medical waste shall be subjected to a minimum of three pre-vacuum pulses to purge the autoclave of all air. The air removed during the pre-vacuum, cycle should be decontaminated by means of HEPA and activated carbon filtration, steam treatment, or any other method to prevent release of pathogen. The waste shall be subjected to the following: 2. Temperature of not less than 121°C and pressure of 15 psi per an autoclave residence time of not less than 45 minutes; or 3. Temperature of not less than 135°C and a pressure of 31 psi for an autoclave residence time of not less than 30 minutes; 4. Medical waste shall not be considered as properly treated unless the time, temperature and pressure indicators indicate that the required time, temperature and pressure were reached during the autoclave process. If for any reasons, time temperature or pressure indicator indicates that the required temperature, pressure or residence time was not reached, the entire load of medical waste must be autoclaved again until the proper temperature, pressure and residence time were achieved. 5. Recording of operational parameters: Each autoclave shall have graphic or computer recording devices which will automatically and continuously monitor and record dates,

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

time of day, load identification number and operating parameters throughout the entire length of the autoclave cycle. 6. Validation test for autoclave: The validation test shall use four biological indicator strips, one shall be used as a control and left at room temperature, and three shall be placed in the approximate center of three containers with the waste. Personal protective equipment (gloves, face mask and coveralls) shall be used when opening containers for the purpose of placing the biological indicators. At least one of the containers with a biological indicator should be placed in the most difficult location for steam to penetrate, generally the bottom center of the waste pile. The occupier or operator shall conduct this test three consecutive times to define the minimum operating conditions. The temperature, pressure and residence time at which all biological indicator vials or strips for three consecutive tests show complete inactivation of the spores shall define the minimum operating conditions for the autoclave. After determining the minimum temperature, pressure and residence time, the occupier or operator of a common biomedical waste treatment facility shall conduct this test once in three months and records in this regard shall be maintained. 7. Routine Test: A chemical indicator strip or tape that changes colour when a certain temperature is reached can be used to verify that a specific temperature has been achieved. It may be necessary to use more than one strip over the waste package at different locations to ensure that the inner content of the package has been adequately autoclaved. Common bio medical waste treatment facility shall conduct this test during autoclaving of each batch and records in this regard shall be maintained. 8. Spore testing: The autoclave should completely and consistently kill the approved biological indicator at the maximum design capacity of each autoclave unit. Biological indicator for autoclave shall be Geobacillus stearothermophilus spores using vials or spore Strips; with at least 1X106 spores. Under no circumstances will an autoclave have minimum operating parameters less than a residence time of 30 minutes, a temperature less than 121o C or a pressure less than 15 psi. The occupier or operator of a common bio medical waste treatment and disposal facility shall conduct this test at least once in every week and records in this regard shall be maintained.

Standards for Efficacy of Chemical Disinfection Microbial inactivation efficacy is equated to “Log10 kill” which is defined as the difference between the logarithms of number of test microorganisms before and after chemical treatment. Chemical disinfection methods shall demonstrate a 4 Log10 reduction or greater for Bacillus Subtilis (ATCC 19659) in chemical treatment systems.

Standards for Dry Heat Sterilization Waste sharp can be treated by dry heat sterilization at a temperature not less than 1850 C, at least for a residence period of 150 minutes in each cycle, which sterilization period of 90 minutes. There should be automatic recording system to monitor operating parameters.

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.) i) Validation test for Sharp sterilization unit Waste sharp sterilization unit should completely and consistently kill the biological indicator Geobacillus Stearothermophillus or Bacillus Atropheausspoers using vials with at least log10 6 spores per ml. The test shall be carried out once in three months. ii. Routine test A chemical indicator strip or tape that changes colour when a certain temperature is reached can be used to verify that a specific temperature has been achieved. It may be necessary to use more than one strip over the waste to ensure that the inner content of the sharps has been adequately disinfected. This test shall be performed once in week and records in this regard shall be maintained.

Standards for Liquid Waste The effluent generated or treated from the premises of occupier or operator of a common bio medical waste treatment and disposal facility, before discharge into the sewer should conform to the following limits- Parameters permissible limits pH 6.5-9.0 Suspended solids 100 mg/l Oil and grease 10 mg/l BOD 30 mg/l COD 250 mg/l Bio-assay test 90% survival of fish after 96 hours in 100% effluent. Sludge from Effluent Treatment Plant shall be given to common bio-medical waste treatment facility for incineration or to hazardous waste treatment, storage and disposal facility for disposal

Label for Bio-Medical Waste Containers or Bags

Biohazard symbol Cytotoxic hazard symbol

Management proposes that, ash, residue from high temperature incineration and other material residues from the process shall be collected into containers and shall be disposed into a secure landfill. The Process Flow Chart, plan and ETP flow diagram for the proposed CBWTF is given below in Figure 5.1 , 5.2 1nd 5.3.

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

Figure 5.1(A): Flow diagram for Common Bio-medical Waste Management Facility.

Figure 5.1 (B) : Flow Chart showing Biomedical Waste Management Process

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

Figure 5.1 (C) : Flow Chart showing Biomedical Waste Management Process

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

Figure 5.1(D): Block diagram for Operation

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

Collection and Transportation of Bio medical Waste Biomedical Waste segregated in color coded containers as per Biomedical Waste Management and Handling Rules shall be collected from various Health Care Facilities located in the 150 Km radius (Covering 10000 beds) The collected waste shall be transported in specially designed closed vehicle to the proposed CBWTF for treatment and disposal. 6-7 closed vehicles for the Collection & transportation of bio-medical waste to proposed facility.

10 Resource optimization/Recycling and reuse The entire wastewater around 4 KLD shall be treatment in ETP will be used for floor washing and gardening/green belt. The treated effluent recycled for the use in scrubber will not be treated with hypochlorite solution. The plastic waste after disinfection & shredding shall be given to registered recyclers.

11. Availability of water its source, Energy/Power requirement and source Water requirement which is around 5 KL for the project will be met through bore wells. Power requirement will be sourced from Madhya Pradesh Vidyut Vitaran Company Ltd. D.G. set of 25 KVA will be installed as back up supply

12. Quantity of waste to be generated (liquid and solid) and scheme for their Management / disposal The Treated effluent shall meet the discharge standards laid down by MoEFCC/PCB for disposal/reuse. The water recovered during treatment in ETP will be used for floor washing and gardening/Green belt. The solid waste generation during wastewater treatment & treatment of common Bio-medical waste will be disposed to Secured landfill.

Details of Water Balance

Heads Water Consumption (KLD) Waste Water Generation (KLD) Unit Proposed Proposed Incineration 1200 ltr 400 ltr Floor washing 800 ltr 680 ltr Vehicle washing 1000 ltr 900 ltr Steam Generation 100 ltr Nil Green Belt 500 ltr Nil Others 1400 ltr 1300 ltr Total 5000 ltr 3280 ltr

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

Treatment Scheme

The waste water generated from bio waste contains suspended particles, blood stains, bacteria and other pathogenic organism etc.

Principle of operation for E.T.P.

While scrubbing emission/flumes generated from high capacity E.T.P plant (100kg & above) lot of water is used for removing various gases & particulate matter from the bio medical waste E.T.P. This waste water is required to be treated before discharge however by installing ETP plant waste water can be recovered after treatment from various stages of ETP Plant. The waste water contains chemical used in the usage of medicines etc. The initial characteristic of waste water normally contains the following parameter. PH - 4.5-6 T.S.S. - 400-600mg/Lts. BOD - 300-400mg /lts. O & G. - 20-30mg/Lts. COD - 800-1000 mg/ Lts.

The treatment of effluent generated from hospital will be done in three steps. Mainly know as Primary, Secondary and Tertiary treatment. The effluent generated from the bio medical plant should conform to the following limits:

PH - 6.5-9.0 T.S.S. - 100 mg/Lts. BOD - 30 mg /lts. O & G. - 10 mg/Lts. COD - 250 mg/ Lts.

Bio-assay test - 90% survival of fish after 96 hours in 100% effluent These limits are applicable to those hospital which are either connected with sewers without terminal treatment plant or not connected to public sewers, for discharge into public sewers with terminal facilities, the general standards as notified under the Environment (Protection) Act, 1986 shall be applicable. Primary Treatment: This is the first steps of inlet waste water mainly consist of removal of coarse particles, oil and Greece and mixing co-agents in the water for removal of suspended solids through sedimentations After this treatment scheme the BOD, TSS, COD & O& G levels come down to 25% of initial levels.

Secondary Treatment: This is the second step of wastewater treatment. it mainly consist of extensive aeration of the Primary treated water , bacterial growth , addition of oxygen and chemical which help in bacterial growth and lastly settlement of the biological waste

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.) as sludge. Normally it is found that the reduction levels in TSS, BOD, O & G and COD after an efficient secondary treatment will be as under Tertiary Treatment: This is the final stage of treatment where the effluent after secondary treatment first is mixed with Sodium Hypo Chloride and then effluent will be pass passed through (DMF) dual media filter and (ACF) activated carbon filter where sand, anthracite and activated carbon will be used as filtration media. Once the above limits achieved thereafter the final outlet water will also confirms the Bio Assay test of 90% of fish survival.

Description PH T.S.S. Lts.BOD Lts. O & G Lts.COD Lts. mg. mg. mg. mg. Inlet water 4.5-6 400-600 300-400 20-30 5000-7000

Outlet 8-10 300-450 225-300 15-22.5 4500-5000 water

Description PH T.S.S. Lts. BOD mg. Lts. O & Lts. COD mg. Lts. mg. G mg. Inlet water 6.5-9 128-150 96-128 <10 <250 Outlet 6.5-9 <100 <30 <10 <250 water

Description PHT.S.S. Lts.BOD mg. Lts.O & Lts.COD mg. Lts. mg. G mg. Inlet water 8-10 300-450 225-300 15-22.5 3000 Outlet 6.5-9 128-150 96-128 <10 <250 water

Treatment of Effluent:

Effluent initially will be passed through Screen & grit chamber for the removal of coarse particles before it enters into oil and grease trap. After this the effluent is being stored in an underground tank where partial aeration is being done to keep the solids into suspension for pumping ease.

The effluent then will be pumped from underground tank to flash mixer where Lime, Alum and Polymer solution is being mixed. The capacity for the Reaction chamber/ Flash mixture cum flocculate is as per requirement.

After chemical mixing the effluent will be transferred to Primary lamella clarifiers by gravity where settling of solids take place. The capacity of the lamella clarifiers will be as per requirement having minimum retention time for 1hr. Clarified water will be taken to aeration

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

Details of Units of ETP

List of equipment’s

 Holding, collection & equalization tanks (capacity of 4m³ fabricated from M.S sheets & structural materials, internally FRP (fiber reinforced plastic to avoid corrosion and metal reactions)).  CFG (Centrifugal sediment arrester/Filter)capacity 2.5m³/hr  Fins heater (tubular fins heater arrangement for water boiling )  Aeration tank (6m³ capacity with compressed air sooting arrangement )  Air compressor (12.5kg/cm²)  Secondary Filtration unit  High pressure MGE FRP vessel.  High pressure ACF FRP vessel.  Sodium hypo chloride dosing unit.  Piping (High quality APVC piping and fittings).  Pumps (CNP SS304 Centrifugal Pump)  Resin column .8m3

13. Electric System Total power required is 50 KVA for the proposed project.

6. Site analysis

i. Connectivity Common Biomedical Waste Treatment Facility is located on State Highway No. 14 at Habsili which is 6.30 km from Sagar district. The nearest railway station is Ratona which is 1.09 km from the site. The airport situated at Bhopal and it is 146 km from the site.

ii. Land form, land use & land ownership: The land is developed by Govt. Bundelkhand Medical College Sagar. It is Govt. waste land and being diverted for industrial purposes.

Topography :-

The topography is almost plain with elevation of 516 mRL and Topo Sheet no.- 55 I/9. S. No. Particulars Details 1 Co-ordinate 23°50'38.07"N- 78°40'23.59"E 23°50'39.43"N- 78°40'76.42"E 23°50'41.04"N- 78°40'75.69"E 23°50'36.56"N- 78°40'23.63"E 2 Height above mean sea 516 mRL level 3 Nearest Town Sagar- 6.30 km

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

4 Nearest Railway Station Ratona- 1.09 Km 5 Nearest Airport Bhopal - 146 km 6 Nearest Highway/Road Khurai- Sagar SH- 14 km – 1.14 km - N 7 Hills/Valley None 8 Ecological Sensitive None Zone 9 Reserve Forest Barkhera R.F.- 3.50 km-N Pagara R.F.- 3.80 km - NE Lalakpatan R.F.- 5.60 km -NW 10 Nearest Village Habsili – 0.65 km - NW 11 Nearest River/ Nalla Karawan Nadi-1.53 km - W Molali Nala-2.70 km -N Local Village pond- 1.75 km -NE 12 Surrounding Features East- Open Mixed Jungle West- Open Mixed Jungle North-Open Land South- Open Mixed Jungle

iii. Existing land use pattern: The land use of the area is Govt. Waste land and being diverted for industrial use.

Topo sheet No.-55 I/9.

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

Google Image of the site

V. Existing infrastructure: The site is located 6.30 km away from the Sagar and

The facility will enjoy strong infrastructure present in the surrounding.

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

iv. Climate data from secondary sources: Meteorological data month of 15th March, 16 to 14th April, 2016 Evening Relative Morning Cloudiness Temperature OC km/hr Humidity % km/hr 8.00hr % 17.00hr Date Wind Wind Wind Wind Max Avg Min Max Avg Min Mor Eve Dirt Speed Dirt Speed 15 35 27 18 64 48 32 SE 7.4 WNW 14.8 10 - 16 34 27 19 66 45 30 E 5.6 NE 9.3 - - 17 37 28 19 51 40 29 SE 14.8 WNW 24.1 - - 18 35 28 22 51 38 30 C 0 WSW 18.5 10 - 19 33 24 16 61 40 27 ENE 14.8 WNW 14.8 - - 20 34 26 17 55 36 23 SE 11.1 WNW 22.2 - 10 21 35 26 16 71 37 21 S 9.3 W 27.8 - - 22 34 25 16 64 43 28 WSW 7.4 NW 14.8 - - 23 36 26 17 61 41 30 NNW 3.7 WSW 3.7 10 - 24 36 28 19 55 39 20 SE 9.3 WSW 18.5 20 - 25 36 29 22 60 32 12 C 0 C 0 - 30 26 36 28 19 37 24 9 WNW 14.8 W 18.5 - - 27 38 29 21 41 27 11 SSE 7.4 WNW 22.2 - - 28 38 29 19 41 24 11 N 5.6 W 18.5 10 - 29 38 30 22 32 19 10 NW 14.8 WSW 20.4 - - 30 38 29 20 30 20 9 NW 14.8 W 18.5 - 10 31 37 29 21 48 23 11 ENE 18.1 W 18.5 - - 1 36 28 19 39 19 9 WNW 9.3 W 22.8 - - 2 36 28 19 27 18 10 W 18.5 WSW 11.1 - - 3 37 29 21 39 22 12 WNW 18.5 NNW 14.8 - - 4 37 29 22 35 22 12 C 0 NW 5.6 - - 5 39 30 21 38 20 7 S 14.8 WSW 11.1 10 6 39 30 21 33 18 11 NNW 14.8 WSW 22.8 - 7 38 30 23 30 21 12 C 0 C 0 - 8 37 29 22 33 25 13 C 0 C 0 - 9 37 29 21 47 22 8 E 5.6 WNW 18.5 - 10 37 28 19 33 18 10 NE 9.3 WSW 9.3 - 11 37 28 19 35 19 10 NNE 7.4 SW 11.1 - 12 37 28 18 31 18 7 C 0 SSE 9.3 - 13 38 30 21 35 22 10 SE 7.4 SSW 5.6 - - 14 39 30 21 39 27 13 S 18.5 SW 9.3 - -

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

Meteorological data month of 15th April, 16 to 14th May, 2016 Relative Morning km/hr Evening km/hr Cloudiness Temperature OC Humidity % 8.30hr 17.30hr % Date Wind Wind Wind Wind Max Avg Min Max Avg Min Mor Eve. Dirt Speed Dirt Speed 15 39 30 22 42 25 13 SW 7.4 W 9.3 - - 16 40 32 25 31 21 12 WSW 5.6 NNW 18.5 - - 17 39 31 24 48 29 15 C 0 C 0 - - 18 39 31 23 44 32 14 C 0 C 0 40 40 19 35 29 23 56 36 25 WSW 9.3 ENE 11.1 - - 20 36 29 22 56 35 19 NE 5.6 SSE 13.0 - - 21 37 29 22 49 30 17 SSE 9.3 W 7.4 - - 22 38 30 23 62 33 13 C 0 C 0 40 - 23 38 29 20 72 40 14 C 0 C 0 - 40 24 38 30 21 48 23 11 NNE 9.3 N 5.6 - - 25 41 31 22 40 21 9 E 7.4 WSW 9.3 - 10 26 42 33 24 25 16 7 NW 14.8 W 16.7 - - 27 42 33 24 24 16 6 NW 5.6 NNW 14.8 40 - 28 41 33 26 32 19 9 NE 11.1 NNW 18.5 - - 29 41 33 26 28 18 8 SE 11.1 SSE 9.3 - - 30 42 34 27 30 20 8 W 11.1 NNW 22.2 30 40 1 42 34 27 28 14 8 WNW 22.2 W 22.2 - - 2 42 33 25 20 13 6 WNW 22.2 W 22.2 - - 3 39 33 27 25 17 9 WNW 22.2 W 24.1 - - 4 38 31 24 29 21 10 W 14.8 SW 14.8 - - 5 39 31 23 38 25 13 WSW 22.2 WSW 22.2 10 - 6 38 30 23 45 26 13 S 7.4 SW 44.4 - 10 7 40 32 24 47 25 10 S 5.6 NW 14.8 - 20 8 41 33 26 45 30 14 SSW 9.3 NW 14.8 - - 9 38 32 27 47 27 11 C 0 C 0 40 - 10 40 32 24 30 16 7 WSW 18.5 W 29.6 - - 11 39 31 24 31 17 9 NW 27.8 W 22.2 - - 12 38 32 25 41 23 13 WNW 14.8 WNW 29.6 - - 13 38 32 26 31 21 10 WNW 35.2 WSW 9.3 40 - 14 37 31 24 57 32 16 C 0 C 0 40 -

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

Meteorological data month of 15th May, 2016 to 14th June, 2016 Relative Morning km/hr Evening km/hr Cloudiness Temperature OC Humidity % 8.30hr 17.30hr % Date Wind Wind Wind Wind Max Avg Min Max Avg Min Mor Eve. Dirt Speed Dirt Speed 15 39 30 22 58 30 11 C 0 C 0 - - 16 38 32 26 30 23 12 WNW 16.7 W 9.3 10 - 17 39 32 25 47 28 15 NW 24.1 NNW 22.2 - 20 18 39 32 26 39 24 15 WNW 22.2 NNW 9.3 - - 19 42 33 26 37 20 10 E 14.8 N 5.6 - 40 20 41 34 23 47 23 10 NNW 11.1 W 11.1 - - 21 41 34 28 26 15 7 NW 14.8 WNW 25.9 40 40 22 42 33 24 26 15 7 W 14.8 NNW 18.5 - - 23 42 34 28 19 14 9 WNW 22.2 S 9.3 20 40 24 42 36 28 21 16 12 C 0 C 0 10 - 25 39 33 27 36 27 18 C 0 C 0 20 - 26 39 33 28 64 36 21 C 0 C 0 - - 27 40 33 26 50 28 10 C 0 C 0 - - 28 42 34 26 46 23 10 S 11.1 NNW 18.5 - - 29 44 37 29 32 20 9 WNW 27.8 WNW 22.2 40 - 30 44 38 31 32 19 9 WNW 25.9 W 22.2 - - 31 44 36 28 37 21 13 W 29.6 W 11.1 - - 1 43 35 27 53 25 13 WSW 11.1 NNE 14.8 30 - 2 43 36 28 37 21 13 C 0 NNW 18.5 60 - 3 43 35 27 43 20 9 WBW 7.4 NNW 22.2 - - 4 44 36 28 33 18 9 W 11.1 NNE 14.8 - - 5 44 37 29 27 20 10 NW 25.9 NNE 22.2 10 - NWN 6 45 38 30 34 24 13 NNW 22.2 18.5 - - W 7 44 39 33 26 21 13 WNW 29.6 WNW 11.1 - 40 8 44 37 31 38 23 13 W 25.9 N 14.8 - 40 9 44 37 31 37 25 18 WNW 40.7 W 5.6 - 10 10 43 37 30 41 29 19 NNW 11.1 WNW 5.6 - - 11 43 37 28 47 31 14 WNW 11.1 WNW 5.6 - - 12 37 30 22 94 56 27 WNW 11.1 WNW 25.9 - - 13 38 32 26 56 36 21 W 18.5 W 25.9 - - 14 38 32 27 54 36 22 NNE 3.7 W - -

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

7 Planning brief: a. Planning concept: Detail Planning Concept has been given in the project report

b. Population projection: The project is small in magnitude. No influx of population is expected as staff/labor shall be deployed from the surrounding.

c. Land use planning (breakup along with green belt etc.)

Particulars Unit Area in sq mt Plant and Machineries Sqm 348 Office and administration Sqm 100 Waste storage area Sqm 67 Fuel storage area Sqm 66 Road Sqm 100 Green belt area Sqm 2000 Open Land Sqm 3389 Total 6070 Sq.mt

d. Amenities/facilities Rest shelters, Toilets, drinking water facilities, first aid facilities, and regular medical checkup facilities shall be provided to labors, staff and their families.

8. Proposed infrastructure a. Industrial area (processing area) The components of the CBWTF are:  Administration Building  Training & Seminars room  Staff Locker and wash room  Vehicle Washing bay  Effluent Treatment Plant  Incinerator and Incineration shed  Sterilization room  Store room  Workshop  Security office  Transformer  DG set  Sharp pit  Ash storage pit

Residential area (non processing area) The employees will make their own arrangements for their housing & allied amenities in nearby area. There is no need for any additional facilities.

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

b. Green belt Total 33% area i.e. 2000 sq mt shall be dedicated for the green belt. Green belt will be developed according to CPCB/PCB guidelines. Plants of the various species will be developed in the plant and peripheral areas. c. Social infrastructure Schools, Colleges, Hospitals & Healthcare Centers, Shops & Bazaars, Community Centers, etc. are all available in nearby villages and towns.

d. Drinking water management (source & supply of water): The Drinking water will be supplied through bore well with proper RO system.

e. system: Solid waste generated during the biomedical waste treatment process and wastewater treatment process is mainly ash and sludge which will be generated depending upon the hydraulic load. Sludge will be disposed off in secured landfill. The disinfected plastic waste shall send for recycling to registered recycler.

f. management: As above

g. Solid waste management: As above

h. Power requirement & supply/source: Power shall be evacuated through state electricity board. Back up supply through DG set shall be ensured.

9 Rehabilitation and Resettlement (R & R) Plan: No R&R plan is required as no displacement of people is proposed for the project.

10 Project Schedule and Cost estimates The Total Cost for proposed project is Rs 205 lacs

a Likely date of start of construction and likely date of completion (time schedule for the project to be given) After obtaining environmental clearance and Water / Air consent the company shall start the project. Proposed date shall be April 2017 (subject to clearances).

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

b. Estimated project cost along with analysis in terms of economic viability of the project

Projected (Figures Balance Sheet in lacs) Moratorium

Projected PARTICULARS Projected Projected Projected Projected Projected Projected Projected Year Year Year Year Year Year Year Year 1 2 3 4 5 6 7 8

A LIABILITIES Capital 1. Opening Capital 55.00 55.00 55.00 55.00 55.00 55.00 55.00 55.00 Unsecure d Loans / Quasi Capital 2. Reserves & Surplus (Op.Bal.b/f.) 0.00 0.00 11.07 30.25 57.53 93.24 137.92 192.33 Add- Profit for the yr. 0.00 15.07 25.19 35.28 45.70 56.69 68.40 81.02 Less:- Drawings 0.00 -4.00 -6.00 -8.00 -10.00 -12.00 -14.00 -16.00 Capital 55.00 66.07 85.25 112.53 148.24 192.92 247.33 312.35 3. Term Liabilities Term Loan 165.00 159.25 140.50 119.16 94.88 67.24 35.79 0.00 Add-Capitalised Interest 10.73 4.Bank OD 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5.Unsecured Loan 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 6. Bank Borrowings: For Working Capital 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 7. Current Liabilities 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 8.Creditors for Expenses 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 9. Provision 0.00 9.04 9.95 10.94 12.04 13.24 14.57 16.02

Sub Total: 230.73 234.36 235.70 242.64 255.15 273.40 297.68 328.37

B ASSETS

1. Fixed Assets Gross Block 230.73 230.73 230.73 230.73 230.73 230.73 230.73 230.73 Less: Depreciation 0.00 -30.90 -56.88 -79.05 -98.10 -114.54 -128.76 -141.06 Net Block 230.73 199.83 173.85 151.68 132.62 116.18 101.97 89.66 2. Cash & Bank Balances 0.00 -0.69 24.21 50.66 79.29 110.76 145.71 184.81 3. Other Investment 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)

4. Current Assets: Inventories 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Trade Debtors 0.00 24.22 26.64 29.30 32.23 35.46 39.00 42.90 Deposits 0.00 11.00 11.00 11.00 11.00 11.00 11.00 11.00 Other Current Assets 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

5. Miscellaneous Expenditure 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 6. Non Current Assets 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Sub Total: 230.73 234.36 235.70 242.64 255.15 273.40 297.68 328.37

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.0

11 Analysis of proposal i. Financial and social benefits with special emphasis on the benefit to the local people including tribal population, if any, in the area. The proposed CBWTF project of for treatment of bio-medical waste, generated from a number of healthcare units is to reduce adverse effects that this waste may pose. The concept of CBWTF within a radius of 150 Km catering to 10000 beds has been introduced by the MoEFCC as a part of Biomedical Waste Management and Handling Rules 2016 as amended thereafter to prevent proliferation of treatment equipment area. It also reduces pressure on regulatory agencies for compliance monitoring. By operating the treatment equipment at CBWTF to its full capacity, the cost of treatment per kilogram gets significantly reduced.

GOVT. BUNDELKHAND MEDICAL COLLEGE SAGAR (M.P.)