M/S CARE HOSPITALS CONCEPTUAL PLAN

M/s CARE HOSPITALS SURVEY NO. 58 PART, HEALTH CITY, CHINAGADILI VILLAGE, VISAKHAPATNAM

CONCEPTUAL PLAN Hospital Building Construction Project

Submitted By Studies & Documentation by M/s CARE Hospitals, M/s Team Labs and Consultants Plot No. 3, Health City, (An ISO Certified Organization) Survey No. 58(PT), Chinanagadila B-115 - 117 & 509, Annapurna Block, Vishakhapatnam – 530 041 Aditya Enclave, Ameerpet, Phone: 0891- 3041444 Hyderabad- 500 038 Phone: 91-040-23748555/616 Fax : 91-040-23748666 e-mail: [email protected]

SUBMITTED TO STATE LEVEL ENVIRONMENT IMPACT ASSESSMENT AUTHORITY, ANDHRA PRADESH GOVERNMENT OF INDIA CARE Hospitals Environmental Impact Statement

2. CONCEPTUAL PLAN /PROJECT DESCRIPTION

This chapter details the need for the project, description of the proposed project and alternatives, and identifies the valued ecosystem components. The project would cater to various market demands and needs to the people.

2.1 THE PROJECT LOCATION The project is envisaged to develop 1.6756 hectares of land for Hospital Building in Survey No. 58 Part, Health City, Chinagadili Village, Visakhapatnam. The project site is surrounded by roads in west and South directions, open lands in east and north directions. An existing 36 m wide road Simhachalam - Hanumanthavaka road in south direction. Bay of Bengal is at a distance of 3.92 km. The nearest railway station is Visakhapatnam railway station at a distance of 5.4 km.

2.2 PROJECT DESCRIPTION 2.2.1 DESIGN STAGE The land area available for the project is 1.6756 hectares and will be allocated for Hospital Building construction project based on the development rules of GVMC. It is proposed to provide Basement floor and surface for parking. The land allocation and the number of units proposed are presented in table 2.1.

Table 2.1 Land Allocation for various purposes Total Built Up area Land Use No. of floors Total Site Area (m2) (m2) Hospital B+G+7 2235.6 17989.0 Green area 1661.0 Road area 3016.1 Future Development 6128.3 Parking Basement 4043.8 Surface parking 3568.6 Net Site area 16609.5 Buffer Zone 146.7 Total Site area 16756.3 22032.8

It is proposed to develop an Hospital Building has Basement floor and surface for parking and G+7 floors for Hospital space. The land allocation will be optimized to ensure compliance with the regulations of GVMC. The water requirement of the project during operation will be drawn from GVMC. Sewage treatment plant will be provided to treat the sewage/wastewater. Water conservation measures will be incorporated in the plumbing designs. Water recycling/reuse will be adopted by way of using treated sewage for green belt development. The rainwater will be let-out into the storm water drain and discharged into external drains. The required power will be drawn from the APTRANSCO and providing open space to allow sunlight will optimize the energy requirement. Solar Energy will be used for fencing, and for external lighting. The designs of the flats will also incorporate Indian Architectural principles of “Vastu”, as

2 - 1 Team Labs and Consultants CARE Hospitals Environmental Impact Statement the market demands the same. Construction material will be drawn from local sources. The parking provision follows the guidelines prescribed by GVMC and Building policy of Andhra Pradesh. The layout of the project site is presented in fig. 2.1 and typical floor plans are presented in fig. 2.2. The parking provision follows the guidelines prescribed by GVMC and Building policy of Andhra Pradesh.

PARKING PROVISION It is proposed to provide single Basement floor and Surface for parking. The parking provision follows the guidelines prescribed by GVMC and Building policy of Andhra Pradesh. The parking floor plan of the project is presented in fig. 2.3. The number of parking spaces provided is presented in table 2.2.

Table 2.2 Parking Space Provision of the Project Floor 4 - Wheeler 2 - Wheeler Ambulance Basement 68 40 Surface parking 108 54 2 Total 176 94 2

Circulation Plan: Ground Floor Driveway : 7.0 m No. of Basement : 1 No. of Ramps : 2 - one way Width of Ramp : 4.5 m Slope of Ramp : 1 : 9 basement Driveway : 4.5 m No. of Lifts : 6 Capacity of each Lift: 15 pax. Connecting Road : 36 m ROW

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Fig 2.1 Site Plan

Fig 2.2 Typical floor plan

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SEVENTH FLOOR PLAN

C OR E 1

C OR E 2

FIFTH FLOOR PLAN

Fig 2.3 Parking Floors

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BASEMENT FFL-99.80M

BASEMENT PLAN 8 0 0 0 2 9 9 0 0

SECTION-AA'

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2.2.1.1 Storm water drains Conservation of water resource is most important aspect of the project during construction and occupation phases. Storm water drainage planning, domestic water planning and sewerage transfer and sewage treatment planning are critical aspects of construction and occupation stages of Hospital projects.

Storm water drains will be provided all over the site to meet the expected increase in the runoff during rainy seasons due to the impervious nature of the roads and other paved areas. It is proposed to maintain the levels as much as possible storm water is letting into side drains of main road. The expected runoff is calculated for the entire site is mentioned below.

Calculation for Storm Water Drain Quantity of storm water

(a) With out project Area of Catchment, ‘A’ : 1.6756 Ha Run off Coefficient, ‘C’ : 0.6 Maximum intensity of rainfall, ‘I’ : 76 mm/hr Therefore Q : 0.212 m3/sec

(b) With project : Area for catchment for roof and road : 0.525 Ha Area of Catchment, ‘A’ : 0.525 Ha Run off Coefficient, ‘C’ : 0.9 Maximum intensity of rainfall, ‘I’ : 76 mm/hr Therefore Q = : 0.100 m3/sec

Area for catchment for open areas : 1.150 Ha Run off Coefficient, ‘C’ : 0.6 Maximum intensity of rainfall, ‘I’ : 76 mm/hr Therefore Q = : 0.146 m3/sec Total Discharge : 0.246 m3/sec But, Discharge, Q = A/V Where, A= Area of the Drain, V= Max. Permissible Velocity : 6 m/sec for concrete drain

Area of drain, ‘A’ = Q/V : 0.041 m2 Taking depth of drain as 0.6 m at the starting point : 0.6 Width of drain = Area/depth = : 0.068 m 68 mm

Width of the drain is to taken 70 mm and depth varies according to the slope of ground.

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Table 2.3. Strom Water Runoff Vol./hr Vol./hr Area in after before Difference in Land Use Remarks Hectares developme Developme Discharges nt C=0.8 nt C=0.6 Roof 0.22 135.9 101.9 34.0 Area Stored in 50 KL Road capacity sump and 0.30 183.4 137.5 45.8 Area used for domestic Open purpose 1.15 262.3 524.6 -262.3 Area Total 1.68 -182.5 * C=0.3 after development of greenery

2.2.1.2 Water Availability: Water is required for the construction as well as during occupation stage as the same is an important resource. The water requirement during construction will be on an average of 30 cum/day with a peak demand of 60 cum/day, and during occupation stage in the order of 186.6 KLD. The water resource available with the Municipal authorities was studied to identify the source and feasibility. The water resource both domestic water and sewage is dealt by the Greater Visakhapatnam Municipal Corporation (GVMC) in the GVMC area.

Domestic Water: It is proposed to draw domestic water from the Municipal Supply (GVMC), which have been encouraging the bulk consumers. The water shortage if any during summer season will be drawn from ground water sources. The water requirement of the project during occupation stage is in the order of 186.6 KLD. The water requirement during construction will be from ground water sources and the requirement is in the order of 30 cum/day. The water requirement for the project during the occupation stage is presented in table 2.4. The water saving for the Hospital project is presented in table 2.5.

Table 2.4 Water Requirement of the Project Water Total water Total No. of requirement in Requirement in Land Use persons lpcd* KLD Beds (247 beds) 247 450 111.2 Attendant (1 person/bed) 247 45 11.1 Staff (3 shifts/day) 800 45 36.0 Visitors (1 person/bed) 247 15 3.7 Out Patients 500 15 7.5 Visitors (1 persons/patient) 500 15 7.5 Cafeteria (84 seats) 84 70 5.9 OPT Lab @ 5lper patient 5 3.7 Total 186.6 * Water requirement is as per NBC (National Building Code, 2005)

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Table 2.5 Water Saving Measures No. of Water Treated Effective Water Land Use Persons Requirement water reuse Requirement in / unit KLD klpd KLD Beds (247 beds) 247 111.2 11.1 100.0 Attendant (1 person/bed) 247 11.1 1.9 9.3 Staff (3 shifts/day) 800 36.0 6.0 30.0 Visitors (1 person/bed) 247 3.7 1.9 1.9 Out Patients 500 7.5 3.8 3.8 Visitors (1 persons/patient) 500 7.5 3.8 3.8 Cafeteria (84 seats) 84 5.9 3.8 2.1 OPT Lab @ 5lper patient 3.7 3.7 Total 186.6 32.1 154.5

The effective water consumption is reduced by 32.1 kl/day and the requirement will be in the order of 154.5 kl/day. The water balance of the project during occupation stage is tabulated in table 2.6.

Table 2.6 Water Balance Input KL/Day Output KL/Day Domestic water from GVMC 154.5 HVAC Chillers 112.1 Recycled water 32.1 Recycled water 32.1 Water requirement for green 5.1 belt during non monsoon Losses approx 20% 37.3 Total 186.6 Total 186.6

The water used in the order of 186.6 KL/day would generate 149.27 KL/day of wastewater, which has to be treated for reuse and or disposal. The OPT Lab waste water is Disinfection by Ultraviolet radiation and then send to STP for treatment.

Treatment plant for treating sewage in the project has been proposed for a capacity of 200 m3/day. The Sewage Treatment flow chart is shown in fig 2.4. The effluent characteristics of wastewater are presented in table 2.9.

Disinfection by Ultraviolet radiation: The disinfection of treated wastewater via ultraviolet (UV) radiation is a physical process that principally involves passing a film of wastewater within close proximity of a UV source (lamp). The efficiency of UV disinfection depends on the physical and chemical water quality characteristics of the wastewater prior to disinfection. With a better quality of wastewater comes a more efficient UV disinfection process. The advantage of the UV disinfection process is that it is rapid and does not add to the toxicity of the wastewater. There have been no reports of byproducts produced from UV disinfection that adversely impact on the receiving environment. UV disinfection does not result in a lasting residual in the wastewater. This is a disadvantage when

2 - 8 Team Labs and Consultants CARE Hospitals Environmental Impact Statement wastewater must be piped or stored over significant distances and time (particularly relevant to reuse schemes) as re-growth of the microbial population is considered a risk.

Sewage Treatment based on Sequential Batch Reactor (SBR) technology (200 KLD):

PROCESS DESCRIPTION: The proposed sewage treatment plant is of “Advanced Sequential Batch Reactor System”. In this method, the processes of BOD removal, nitrification/denitrification, phosphorus removal and sludge separation are achieved continuously in a single SBR tank. The process operates on the continuous inflow and batch outflow principle. The phases of aeration, settling, decantation occur sequentially and are controlled by a PLC.

The tank is divided into pre-aeration and main aeration tanks by a baffle wall with openings at the bottom. The sewage flows continuously into the pre-aeration tank, which acts as a biological selector enhancing the growth of the most desirable organisms while limiting the growth of filamentous bacteria. Sewage from pre-aeration tank flows through openings at the bottom of the baffle wall and into the main aeration tank where BOD removal and nitrification occur. After aeration phase, sludge separation occurs in the settling phase. After settling, the clear water from top is removed through a PLC operated decanter. Denitrification occurs during anoxic periods of settling and decant phases. The excess sludge is wasted during decant phase. The SBR treated water is disinfected using Sodium Hypochlorite and filtered through a Pressure Sand Filter. The final treated water will be stored for recycling for toilet flushing purpose. The waste sludge is used as manure after dewatering.

The Treatment methodology includes. 1) Bar screen. 2) Oil & Grease Trap (O&G) 3) Equalization tank 4) Sequential Batch Reactor. 5) Sludge Holding tank 6) Multi Grade Filter 7) Activated Carbon Filter: 8) Treated water Tank 9) UV 10) Filter press

Biological stabilization of the wastewater is accomplished in the sequential batch reactor tank in the presence of micro organisms, for the respiration of which, Oxygen is supplied by means of diffused aeration comprising membrane diffusers and air blowers. Phosphorous removal and sludge separation are also achieved in this tank. After the aeration phase, sludge settling takes place. Sludge is then pumped to the sludge dewatering system through sludge transfer pumps.

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Table 2.7 Characteristics of Waste water Parameter Quantity in mg/l PH 6 – 7 Total Suspended Solids 400 – 600 BOD 200 – 300 COD 450 – 500

Data Capacity : 200 m3/day or KLD Flow : 149 m3/day Influent BOD : 350 mg/lit Influent Suspended Solids : 300 mg/lit Influent COD : 600 mg/lit Effluent BOD : 30 mg/lit Effluent COD : 200 mg/lit Effluent Suspended Solids : 100 mg/lit

1. Bar Screen Chamber Flow rate : 25 m3/hr Peak factor : 3.00 Peak flow : 75 m3/hr Velocity through screen : 0.80 m/hr Clear area through rack opening : 103.13 Gross area : 1.20 times net area m (considering half 123.75 Gross area : pipe full flow) Assuming the inclination of screen of 60° to horizontal. Gross area of screen needed would be 1.0X0.80 Mt. for ease of maintenance.

2. Oil & Grease Trap (O&G) Flow Rate : 200.0 m3/day or KLD Average flow/Hourly flow : 9.2 m3/hr Peak factor : 2.50 Peak flow : 22.92 m3/hr Retention Period : 6.00 min

Volume of the tank : 2.29 m3 (Say 2.5 m3) Side water depth : 1.00 m Surface Area required : 2.29 m2 length of the tank : 3.00 m (Say 3.0 m) Width of the tank : 0.76 m (Say 1.0 m)

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3. Equalization tank Peak flow : 22.92 Hydraulic retention time : 3 hrs. at peak flow Volume of the tank : 68.8 m3 Assuming depth : 3.5 m Area : 19.6 m2 length of the tank : 10.0 m width of the tank : 2.0 m (Say 2.5 m) Area required 19.64 m2 Diffuser required 13.1 Nos. Diffuser adopted 40.0 Nos. Diffuser size 5" dia. disk diffuser air required 200.0 m3/h

4.Sequential Batch Reactor (SBR) Tank Flow Rate : 200 m3/day or KLD Volume of SBR tank : 149 KLD (80% of STP Capacity) No. of tanks in series : 2 m Capacity of each Tank : 110 KLD Number of Batch Per day : 5 /day/tank Batch Volume : 22.00 m³ Fill Fraction : 0.28 Reactor Volume Required : 78.6 m³ Water Depth : 3.70 meter Surface Area Required : 21.2 m² width required : 8.0 meter Length required : 2.7 meter Area Proposed : 21.24 Diffuser reqd. : 7.96 Diffuser proposed : 26.00 Total diffuser required : 52.00 Diffusers size : 2 m long tubular diffuser Air Required : Inlet BOD : 350 mg/lit Batch volume : 22.0 m³ BOD load Per batch : 7.7 Kg Oxygen required : 11.94 Kg Aeration Time : 2.4 Hrs. Oxygen Required Rate : 4.97 Kg/Hrs Field correction Factor : 0.51 SOTR : 9.75 Kg/Hrs

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SOTE : 0.06 Water Depth : 3.50 m Air Required per tank : 168.23 m³/hr (Say 180) Air Required Total Air required (Eq. Tank + SBR tank) : 750.00 m3/hr Add for others (10%) : 75.00 m3/hr Grand Total : 825.00 m3/hr Proposed Blower Capacity : 850 m3/hr

5. Sludge Holding tank No. of Tanks : 1.00 Nos. Sludge weight : 126.00 kg/d Hydraulic retention time : 48.00 hrs. Sludge volume : 12.60 m3/d SHT Volume : 25.20 m3 Water Depth : 2.50 m surface Area : 10.08 m2 Length : 5.00 m Width reqd. : 2.02 m surface area adopted : 10.08 m2 diffuser required : 5.04 Nos. diffuser adopted : 5.00 Nos. diffuser size : 5"disk diffuser Air Required : 25.00 m3/hr

6. Multi Grade Filter surface loading rate : 15 m³/m²/Hr Filtration rate proposed : 39 m³/Hr Nos. of filter : 1 filtration rate of each filter : 39 m³/Hr Area Required : 2.6 m² Dia Required : 1819.9 mm Dia Adopted : 1850 mm HOS : 1800 mm

7. Activated Carbon Filter: Surface loading rate : 15 m³/m²/Hr Filtration rate proposed : 39.0 m³/Hr Nos. of filter : 1.0 filtration rate of each filter : 39.0 m³/Hr Area Required : 2.60 m²

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Dia Required : 1819.9 mm Dia Adopted : 1850 mm HOS : 1800 mm

8. Treated water tank Number of tanks : 1 nos. Volume proposed for Tank-1 : 37 m³

9. Filter Press Sludge generation per day : 12.60 m3/d Size 14" X 14" X 9

Characteristics of Treated Waste water Parameter Quantity in mg/l PH 7 – 8 Total Suspended Solids 20 BOD 10 COD 50

Disposal of Treated Wastewater: The treated water shall be treated and reused for flushing the toilets, followed by on land irrigation and HVAC make up water requirement, and on land irrigation. Hence all the recycled water is utilized completely and is considered as a zero discharge.

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Fig 2.5 Sewage Treatment Flow Diagram 1 Pump (1W+1S) Filter Feed Filter MGF To Reuse To capacity Decanter Tank Decanter ACF UV TREATED WATER TANK KLD SBR 3.7 (Package unit) (Package SLUDGE HOLDING TANK HOLDING Filter Press Filter EQT TANK OPT Lab @ 5lper patient 5lper Lab @ OPT SEWAGE TREATMENT PLANT TREATMENT SEWAGE KLD 200 O & G O STP Capacity = Capacity STP Disinfection . Bar Screen Bar Raw Sewage Raw SEQUENTIAL BATCH REACTOR TECHNOLOGYSEQUENTIAL BATCH (SBR)

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2.2.1.3 Solid Waste Municipal Solid Waste Composition In India the biodegradable portion dominates the bulk of Municipal Solid Waste. Generally the biodegradable portion is mainly due to food and yard waste. The table 2.9 presents Composition of Municipal Solid Waste.

Table 2.8 Composition of Municipal Solid Waste Type Composition (%) Solid waste in kg Paper 8 48 Plastics 9 54 Metals 1 6 Glass 1 6 others 4 24 Biodegradable 48 290 Inerts 25 151 Rags 4 24 Total 100 604.3 (Source: NSWAI- National Solid Waste Association of India estimate)

Design Stage Solid Waste The domestic solid waste (604.3 Kg / Day) of the project will be segregated into two categories i.e. Bio-degradable and Non-biodegradable waste. The waste from all the rooms will be collected by the workers and all the waste is sent through service lift to the segregation point which will be collected by the management. Solid waste/garbage waste to be collected in green and blue dustbins. The green bins to be filled with Biodegradable kitchen waste, while the blue bins to be filled with Non Biodegradable waste (recyclable waste) like glass, plastic, paper, etc. The Biodegradable and Non Biodegradable waste is collected by the maintenance department and sent to M.S.W management facility. Table 2.9 presents the anticipated garbage quantity after occupation. The waste management for the hospital is shown in fig 2.6. The responsibility of garbage collection and disposal lies with the municipality, however the project authorities propose to educate the employees/workers to segregate the waste at source before disposal.

Bio-medical waste The hospital is 247 Beds hospital with an average occupancy of about 50%. The Number of patients (OPD) visited the hospital is about 500 persons. The wastes will be segregated at the source in color coded bags as per the Bio-medical waste (management and Handling) rules, 2000. The Bio-Medical wastes such as human waste, infectious waste are stored in yellow bins. The Bio-Medical waste is collected separately and stored. The bio-medical waste from the hospital is outsourced through an approved agency for appropriate disposal. It is expected that about 173.5Kg / day of Bio-medical waste will be generated after the development of the proposed hospital and the same will be handled and disposed as per the Bio-medical Waste (Management & Handling) Rules 1998. The bio-medical waste from the hospital is

2 - 15 Team Labs and Consultants CARE Hospitals Environmental Impact Statement outsourced to M/s. Maridi Eco Industries (Andhra) Pvt. Ltd., Sy.No.314, Kapulupadu, Bheemunipatnam (M), Visakhaptnam District. The hospital management shall train all the medical and Para medical staff about segregation and disposal.

Fig 2.6 Source of Hospital Waste

Hospital Waste

Bio-Medical Waste General Waste (about 15%) (about 85%)

Human anatomical waste, animal Kitchen waste, waste, micro-biological & bio- packaging materials, technology waste, waste sharps, paper, etc discarded medicines & cytotoxic drugs, soiled waste, incineration ash, chemical waste

* Source: CPCB Bio-Medical Waste Management Table: 2.9. Solid Waste Generation Total No. of Total Solid Total Bio-Medical Land Use persons waste in kgs. waste in kgs. Beds (247 beds) 247 74.1 123.5 Attendant (1 person/bed) 247 74.1 Staff (3 shifts/day) 800 240.0 Visitors (1 person/bed) 247 74.1 Out Patients 500 50.0 50 Visitors (1 persons/patient) 500 50.0 Cafeteria (84 seats) 84 42.0 Total 604.3 173.5

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Classification of Biomedical Waste Type of Bag/ Category Type of Waste Container to be used Yellow (a) Human Anatomical Waste Human tissues, organs, 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 Yellow colored non- animal carcasses, body parts, organs, tissues, chlorinated plastic including the waste generated from animals used bags in experiments or testing in veterinary hospitals or colleges or animal houses. (c) Soiled Waste Items contaminated with blood, body fluids like dressings, plaster casts, cotton swabs and bags containing residual or discarded blood and blood components. (d) Expired or Discarded Medicines Pharmaceutical waste like antibiotics, cytotoxic Yellow colored non- drugs including all items contaminated with chlorinated plastic cytotoxic drugs along with glass or plastic bags or containers ampoules, vials etc. Yellow colored (e) Chemical Waste Chemicals used in production containers or non- of biologicals and used or discarded disinfectants. chlorinated plastic bags (f) Chemical Liquid Waste: Liquid waste generated due to use of chemicals in production of Separate collection biological and used or discarded disinfectants, Silver system leading to X-ray film developing liquid, discarded Formalin, effluent treatment infected secretions, aspirated body fluids, liquid system from laboratories and floor washings, cleaning, house- keeping and disinfecting activities etc. Non-chlorinated (g) Discarded linen, Mattresses beddings yellow plastic bags contaminated with blood or body fluid. or suitable packing material (h) Microbiology, Biotechnology and other clinical laboratory waste Blood bags, Laboratory cultures, stocks or Autoclave safe specimens of micro- organisms, live or plastic bags or attenuated vaccines, human and animal cell containers cultures used in research, industrial laboratories, production of biological, residual toxins, dishes and devices used for cultures. Red Contaminated Waste (Recyclable) (a) Red coloured non-

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Type of Bag/ Category Type of Waste Container to be used Wastes generated from disposable items such as chlorinated plastic tubing, bottles, intravenous tubes and sets, bags or containers catheters, urine bags, syringes (without needles and fixed needle syringes) and vaccutainers with their needles cut) and gloves. White Waste sharps including Metals Needles, syringes with fixed needles, needles from needle (Translucent) Puncture proof, Leak tip cutter or burner, scalpels, blades, or any proof, tamper proof other contaminated sharp object that may cause containers puncture and cuts. This includes both used, discarded and contaminated metal sharps Blue (a) Glass Broken or discarded and contaminated glass including medicine vials and ampoules Cardboard boxes except those contaminated with cytotoxic with blue colored wastes. marking (b) Metallic Body Implants Source: G.S.R. 343(E) Bio-Medical Waste (Management & Handling) Rules, dated 28th March, 2016

FIGSOLID 2.7 WASTE WASTE MANAGEMENT MANAGEMENT PLAN FOR HOSPITALSPLAN Segregation at Source

Biodegradable Non-Biodegradable Domestic Bio-Medical waste Waste Hazardous Wastes Waste

Maintenance Maintenance Maintenance Maintenance Department Department Department Department Main Collection Main Collection Main Collection point/Segregation point/Segregation point/Segregation Storage Area Point Point Point Local Body Local Body Local Body Local Body M/s. Maridi Eco Authorized Agency Authorized Agency Authorized Agency Industries (Andhra) of Local Body of Local Body of Local Body Pvt. Ltd.,

Segregation at source into bio-degradable, non biodegradable and domestic hazardous Segregationwastes. Facilitation at sourceby owners intoco - biooperative-degradable,to dispose nonrecyclable bio- wastedegradableto Authorized and Waste domestic hazardousPickers / Authorized wastes. RecyclersFacilitation. Balanceby ownerssegregated co-operativewaste given toto disposeAuthorized recyclableAgency of wasteLocal to Body for disposal. Authorized Waste Pickers / Authorized Recyclers. Balance segregated waste given to2 Authorized Agency of Local Body for disposal

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2.2.2 CONSTRUCTION STAGE The sequence of construction operations and the approximate time requirement is presented in the following table 2.10. The construction sequence is for more number of floors.

Table: 2.10 Construction Sequence S.No Description of work 1 Clearing and Grubbing 2 Leveling by way of cut and fill 3 Foundation Excavation. 4 Foundation PCC & Concrete & Plinth Beam. 5 Column lifting up to GF Roof. 6 1st floor slab reinforcement & shuttering & Concreting. 7 Stair case slab 8 1st floor column lifting up to 1st floor roof. 9 1st floor roof shuttering, reinforcement & concreting. 10 Deshuttering of GF Roof & cleaning. 11 Deshuttering of 1st Roof & cleaning. 12 Brick work in GF floor. 13 Brick work in 1st floor. 14 Staircase up to terrace. 15 Staircase headroom slab. Plumbing works (concealed works). 16 Electrical conduit junction boxes & board fixing. a. Internal (GF & FF). Plastering works. b. External (GF & FF). 17 Fixing of door & window frames. 18 Plinth filling & floor PCC. 19 Floor Tiling Works, bathroom, kitchen & platform works. 20 Staircase stone works. 21 Terrace waterproofing works. 22 Parapet wall in terrace & miscellaneous works. 23 Fixing of door & window shutters. 24 Fixing of sanitary fittings. 25 Electrical wiring & fixtures. 26 Painting works. 27 External development & compound wall.

The clearing and grubbing activity involves clearing of shrubs mainly as the site has no major trees. The cut and fill operation for the entire area is presented in table 2.11.

Table 2.11 Earth Work Quantities S.No Area Qty. of fill. Qty of cut Surplus fill Surplus cut (m3) (m3) (m3) (m3) 1 Site 6720 8000 --- 1280

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The construction of this magnitude would require huge quantities of construction materials. The material requirement for the project is presented in table 2.12. Thus aggregate requirement will be met from within the plant site. The lead distance for various construction materials is presented in table 2.13.

Table: 2.12 Material Consumption for Hospital Building Total Total Total Total Total Total Total Reinfo BUA per Ready Mix Aggre Bricks Units Cement Sand Water rcement unit in (m2) Concrete gate (Nos) (bags) (m3) (m3) steel (m3) (m3) x 1000 (MT) Total BUA 22033 9033 20491 8593 947 5332 2556 507 Total 22033 9033 20491 8593 947 5332 2556 507

Table: 2.13 Lead distances for Construction Materials S.No. Material Source Lead Distance (Km) ROBOSAND and Gov. 1 Sand 150 – 240 registered suppliers. 2 Aggregate With in the site 0 – 2 3 Cement Manufacturing units 140 – 200 4 Reinforcement Steel SAIL/TATA godowns 10 5 Bricks Local Manufacturers 0-15 6 Plumbing Material Local suppliers 2 – 7 7 Electrical Material Local Suppliers 2 – 7 8 Sanitary Material Local suppliers 2 – 7 9 Flooring and Tiles Manufacturers 100-150 10 Paints Local Manufacturers 10 – 25

2.2.2.1 Water Requirement The water required for this project is in the order of 5500 cum for the entire project implementation period. The peak demand for water may be 60 cum/day, however typical daily consumption will be in the order of 30 cum/day. The required water will be drawn from ground water sources. The water supply and plumbing will be optimized and low water consuming faucets and flush tanks will be used to conserve water.

2.2.2.2 Construction Debris The construction debris consists of various types of materials. The construction debris will be in both hazardous and non-hazardous categories. The hazardous debris consists empty containers of adhesives, thinners, paints, and petroleum products. These empty containers will be sold to authorize recycling agencies. The non hazardous wastes contain recyclable debris like iron and other metal, glass, plastics, cartons of paper, wood etc. These wastes will be sent for reuse/recycle. The waste percentage will be in the order of 2%. Construction debris containing bricks, demolished RCC will be used for land filling in the place of subgrade.

2.2.2.3 Paints All the paints used in the premises will be ensured to have an albedo of at least 0.4 to increase the reflectivity and reduce the heat dissipation and heat island effects.

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2.2.2.4 Work Force: The labor/work force requirement is approximately 5000 man-days of various skilled and unskilled employees. Sufficient labor force and skilled employees are available as Visakhapatnam is a favorite destination of skilled employees and migrating people from the rural areas. The peak labor force requirement will be in the order of 1000 people. The water requirement for the labor force will be approximately 5000 lt/day.

2.2.2.5 Material preparation and transport Most of the construction material will be drawn from outside. The material will be transported by trucks and the approximate number of truck trips is 900. The material transport within the site will be facilitated by 8 trippers.

2.2.3 OCCUPATION PHASE A number of facilities will be provided by M/s CARE Hospitals for the occupants and the facilities are shown in table 2.14.

Table 2.14. Amenities Proposed Amenity Nos. or description Tot Lots and Green Area 1661.0 m2 Sewage Treatment Plant 1 DG Sets 750 kVA X 4 nos. Community Center 1 The owners/purchasers will form cooperatives to run the amenities like sewage treatment plant, DG sets. The major requirement of resource is for electricity and water. The electricity will be drawn from APTRANSCO. Transformers will be provided to reduce voltage fluctuation and to provide quality energy. The power requirement during operation phase is presented in table 2.15.

Table 2.15 Energy Consumption Statement Total Total Power Power allocated S.No Description area in required in in watts per m2 m2 (KW) Hospital & 1 17989 120.00 2158.68 Common area Total 2158.68

Maximum demand in kw at 0.6 diversity factor 1295.2 Consumption of power for 12 hours per day 15542.5 Maximum demand in kw at 0.1 diversity factor 215.9 Consumption of power for 12 hours per day 2590.4 Total consumption of power per day 18132.9 KW Total consumption of power per year 66.2 Lakh Units

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Table 2.16 Energy Saving by using copper wound transformers for Comm. Power loss using CU. wound transformer 1.20%

Savings in power loss using CU wound transformer 0.8 Lakh Units

Table 2.17 Energy Saving by using HF Ballast Power loss using conventional ballast 25% Power loss using HF ballast 14% Savings in power loss using HF ballast 11%

Total Power Total Power S.No Description area in allocated in required in m2 watts per m2 (KW) 1 Parking 4044 3.00 12.13 2 Common Area 5397 5.00 26.98 Total 39.11

Maximum demand in kw at 0.8 diversity factor 31.3 Consumption of power for 12 hours per day 375.5 Maximum demand in kw at 0.2 diversity factor 7.8 Consumption of power for 12 hours per day 93.9 Total consumption of power per day 469.4 KW Total consumption of power per year 1.7 Lakh Units Savings in power loss using HF ballast 0.2 Lakh Units

Table 2.18 Electrical Power savings using CFL/T5 for lighting Savings in power Using CFL/T5 as against Fluorescent Lamps 30%

Power Total Power Total area S.No Description allocated in required in in m2 watts per m2 (KW) 1 Parking 4044 3.00 12.13 2 Common Area 5397 5.00 26.98 Total 39.11

2 - 22 Team Labs and Consultants CARE Hospitals Environmental Impact Statement

Table 2.19 Electrical Power savings using Solar Power for External lighting Power Total Power Total area S.No Description allocated in required in in m2 watts per m2 (KW) 1 External Lighting 7.00 Total 7.00

Maximum demand in kw at 1.0 diversity factor 7.0 Consumption of power for 6 hours per day 42.0 Maximum demand in kw at 0.5 diversity factor 3.5 Consumption of power for 6 hours per day 21.0 Total consumption of power per day 63.0 KW Total consumption of power per year 0.23 Lakh Units Savings in power using Solar Power 0.23 Lakh Units

Table 2.20 Electrical Power savings using water Cooled Chillers Savings in power by using Water Cooled Chillers as against Air cooled Chiller 40%

Total Power Total Power S.No Description area in allocated in required in m2 watts per m2 (KW) 1 Hospital 17989 40.00 719.56 Total 719.56

Maximum demand in kw at 0.6 diversity factor 431.7 Consumption of power for 12 hours per day 5180.8 Maximum demand in kw at 0.1 diversity factor 72.0 Consumption of power for 12 hours per day 863.5 Total consumption of power per day 6044.3 KW Total consumption of power per year 22.1 Lakh Units Savings in power using water Cooled Chillers and heat 8.82 recovery wheel Lakh Units

Table 2.21 Total Saving Savings in lakh Savings in S.No Description kwh units percentage 1 With Cu wound Transformer 0.8 1.2 2 with HF Ballast 0.2 0.00 3 With CFL 0.5 0.8 4 With Water Cooled Chillers 8.8 13.3 5 With Solar Power for External lighting 0.2 0.3 Total Saving 10.6 15.9 Total Consumption 66.2

2 - 23 Team Labs and Consultants CARE Hospitals Environmental Impact Statement

2.2.3.1 Domestic Water The domestic water will be drawn from Ground water to augment the supplies. The wastewater will be treated and reused for gardening. The line providing treated water will be colored blue and ensured that the tank is at least 1 foot below the level of other tanks and a distance of minimum 2 feet from the other water pipelines.

2.2.3.2 Solid Waste The solid wastes anticipated during occupation stage include garbage, sludge from STP, hazardous waste of used oils, and batteries from generators. The quantity of wastes is presented in table 2.23.

Table: 2.22. Solid Waste Generated during Occupation Phase Type of S.No. Quantity Collection/storage Disposal Waste 1 Segregation at source into Municipal solid bio-degradable, non bio- waste disposal degradable and Domestic Hazardous wastes. Disposal 604.3 of recyclable waste to Garbage kg/day Authorized Waste Pickers / Authorized Recyclers. Balance segregated waste given to Authorized Agency of Local Body. 2 Sewage Collection sump Used as manure and 20 Treatment or given to farmers. kg/day Plant Sludge 3 Sold to Authorized Used 10 nos. recyclers or returned Batteries year to seller 4 Used 200 Stored in HDPE Carboy Sold to authorized lubricant l/year recyclers 5 Stored in black/yellow/ Sent to Authorized red/white bins at each Bio Medical waste level and collected by management facility Bio-Medical 173.5 service lift and transported (M/s. Maridi Eco Waste kg/day to the segregation point by Industries (Andhra) management Pvt. Ltd.) for treatment and disposal 6 e-waste Stored in designated area e-parisara

2 - 24 Team Labs and Consultants M/s CARE HOSPITALS SURVEY NO. 58 PART, HEALTH CITY, CHINAGADILI VILLAGE, VISAKHAPATNAM

Studies and Documentation by: Team Labs and Consultants (An ISO Certified Organization) B-115 – 117 & 509, Annapurna Block, Aditya Enclave, Ameerpet, Hyderabad- 500 038 Phone: 91-040-23748555/23748616 Fax : 91-040-23748666 e-mail: [email protected]