CONCEPTUAL PLAN For

EXPANSION OF

EMERGENCY MEDICINE UNIT AT S.G.P. G.I.

RAIBAREILLY ROAD – LUCKNOW –U.P.

Plot Area= 88403.00 m2 Built Up Area( Proposed ) = 61959.12 m2 Total Built Up Area = 2216447.65 m2

To be Developed By

UNIT INCHARGE U.P. R.N.N. S.G.P.G.I. ( PREMISES) Near Jheel. RaebareillyRoad - LUCKNOW – U.P.

Environmental Consultant Sawen Consultancy Services Pvt. Ltd. (QCI Accreditated) 409A, Sahara Shopping Centre, Faizabad Road Lucknow-260026, Telefax: 0522-2341312; Mobile: 7379444471-73 Email: [email protected] Website: www.sawenconsultancyservices.com

Doc No: SCSPL/EC-NOC/0/18 Date of Issue: 0/0/2018 Approved by: Satyendra Singh Company Seal:

Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh

LIST OF CONTENTS Chapter No. List of Chapters Page No. Executive Summary 3 1 Introduction 4-12 2 Project Description 13-17 3 Site Analysis 18-26 4 Project Planning 27-29 5. Proposed Infrastructure 30-31 6. Environment Management Plan 32-64 7. Emergency Preparedness Plan 65-68 8. Analysis Of Proposal (Final Recommendations) 69-70 9. Disclosure Of Consultant 71-73 LIST OF TABLES Table No. List of Tables Page No. 1 Capital expenditure 15 2 Recurring expenditure 15 3 Land uses at project site 27 4 Floor wise activities 27 5 Plotted Population Break Up 28 6. Water Use Calculation 34 7. Quantum of RainwaterHarvestFor Emergency Medicine Unit. 42 8. Municipal Solid Waste For Emergency Medicine Unit 45 9. Waste Generated from Floating Population . 46 10 Bio – Medical Waste Categorization Treatment & Disposal. 48 11 Bio – Medical Waste 52 12 Hazarduous Waste 60

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh EXECUTIVE SUMMARY

The present documents explain the findings of the Environmental pre-feasibility of the Expansion OfEmergency Medicine Unit At S.G.P.G.I. - Raebareilly road, District- Lucknow, Uttar Pradesh isproposed by Uttar Pradesh Rajkiya Nirman Nigam Ltd., P.G.I. unit-1, S.G.P.G.I. Parisar near Jheel, Raebareilly Road, Lucknow.SAWEN Consultancy Services Pvt. Ltd., Lucknow was contracted by UPRNN to secureEC from MoEF / SLEAC& No Objection Certificate (NOC) fromUttar Pradesh Pollution Control Board (UPPCB) The allocated land is having total plot areaof 88,403.0 m2 easily approachable through Raebareilly Road (NH-24B) 300 m, East from the project site, and well connected to various places, through national highways, rail links, bus ways, and telecommunication. The estimated cost of the project will be Rs.570.32 Crore. The U.P. State Electricity Board will provide essential load of 11 KVA to meet the electrical requirement of the proposed project. The power back up for essential load shall be provided through 02no. of DG Set of 500 KVAtotal capacity. Appropriate firefighting measures including entry and exit way marking signs, emergency lights, ventilation, essential emergency electrical services and stationary fire pump (jockey) shall be provided for the proposed project. In the layout, some area has been reserved for green belt development along with already existing green belt area for the vision to create a buffer to help in creation of calm, serene, and cool environment for the Emergency Medicine Unit at Sanjay Gandhi Post Graduate Institute, Lucknow, Uttar Pradesh. Green belt planning on 16706.07 m2will be provided with ecological perspectives for the proposed project taking into consideration of urban biodiversity and native species. The water with overall requirement of 161.15 KLD shall be managed by 01 no. of Tube well. The DG Set discharge shall be through stack of sufficient cumulative stack height of 4.47 m as per guidelines of CPCB. Noise level shall be maintained by providing acoustic enclosures in DG sets and traffic norms will be followed within building project.

STP of 30.0 KLDshall be provisioned within the proposed buildingfor treatment of domestic waste water generated&ETP OF 105.0 KLD shall be provisionedfor the treatment of effluents ( Lab generated waste and Hospital beds wastes ). Natural slope of the area will be retained and will be graded to fall towards the roads or drain paths and storm water will be made to percolateto01 no. of Rain Water Harvest pit proposed for ground water recharge. For traffic noise, plantation along the traffic route shall be provided to act as a noise barrier. It has been roughly estimated that of 271.5 kg/day of solid waste generated from the proposed building, for which 01 no. of transit center is provided. Awell facilitated parking area of 5047.73 m2is kept asstilt + open parking. But theTotal Requirement for parking = 7040.73 m2,thereforean Extra 1633 m2 ( Open Space)area shall be required to meet out the parking requirement..A Green Area of 16706.07 m2 has been kept for the development of green belt and landscape.

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh CHAPTER 1: INTRODUCTION ‘Of all forms of inequality, indiscrimination and injustice in healthcare is the most shocking and inhumane’. Martin Luther King Junior.Indian healthcare is the ultimate model of a schizophrenic health-care system. We take great pride, in our state-of-the-art hospitals and tertiary health-care centers which could compare with the best in the World. Health care provision in India is multi- pronged, including a tiered national health system, private hospitals, and a multitude of alternative medicine practitioners. Although emergency physicians and emergency medicine have remained a realized need in the country, the practice of emergent care has remained centralized, with traditionally few private hospitals admitting emergency cases as they prefer to avoid dealing with medico-legal formalities during emergencies (Supreme Court of India; ParmanandKatara vs. Union of India AIR1989SC 2039). This problem was mitigated to some extent when the judicial system mandated the delivery of care by any and every hospital regardless of a patient's paying and medico-legal status in times of emergency. Failure on the part of any hospital to provide timely medical treatment to a person in need of such treatment results in a violation of the patient's "Right to Life,‖ which is guaranteed under Article 21 of the Constitution of India. This is the closest India has come to enacting laws similar to The EMTALA (Emergency Medical Treatment and Labor Act) and the COBRA (Consolidated Omnibus Budget Reconciliation Act), which are well recognized in the USA. Most emergency departments in centrally run university and government hospitals do not match up to the ―Emergency Department Categorization Standards‖ proposed by the Society of Academic Emergency Medicine (SAEM). Emergency care is offered in areas designated as ‗casualties’ that are often manned by junior specialty residents with little overview and are mere ‗referral points‘ for specialized care. Triage, something that is instrumental to good emergency care, is rarely practiced. Problems are worse in rural areas, where even the most basic emergency obstetric care has been found to be lacking The EMS system in India is best described as ‘fragmented.‘ The basic fundamental principal behind EMS systems worldwide is to have a common emergency communication number connected to responsive agencies. Although India has the emergency number 102 for calling ambulances, the responsiveness of the system has always been doubted. In 2007, Ramanujam et al. reported that nearly 50% of trauma victims admitted to a premier hospital in an urban Indian city had received no pre-hospital care. The first of its kind, the CATS (Centralized Accident and Trauma Services) ambulance system was conceptualized in 1984. The service was expanded nationally, but lack of a driving force behind the initiative made it fall by the side. Today, NGOs (non-governmental organizations) and private hospitals in cities and states have constructed their own EMS setups. Principal among these are the National Network of Emergency Services (NNES), Ahmedabad, Delhi, Pune, Hyderabad, Chennai, Raipur, Ranchi, and Kolkata; Emergency Management and Research Institute (EMRI), Haryana, Chandigarh, Uttaranchal, Rajasthan, Gujarat, Madhya Pradesh, Andhra Pradesh, Goa, Karnataka, Tamil Nadu, Meghalaya, and Assam; Life Support Ambulance

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh Service (LSAS), Kerala, Mumbai; Operation Sanjeevani, Bengaluru; Ambulance Access for All (AAA), Mumbai; Indian Institute of Emergency Medical Services (IIEMS), Kerela, etc. India is currently in the midst of an economic and demographic transition. Increasing life expectancy and urbanization with accompanying lifestyle changes have led to an epidemiological transition, as evidenced by the increasing incidence of cardiovascular and cerebrovascular diseases, diabetes, COPD etc. Unintentional injuries due to road traffic accidents, fires, falls etc., and Intentional injuries such as self-inflicted injuries and those due to violence also constitute a significant burden of disease in the country. Many of these conditions require emergency care in their acute stages (diabetic hypoglycemia, septicemia, premature labour, asthma), or are acute in their natural presentation (such as myocardial infarction, acute hemorrhage and injuries. Most injuries, whether intentional or not, require emergency care. Injuries are the single highest cause of disability-adjusted life-years (DALYs) lost in India. A survey of Road Traffic Accidents in India shows that there is a vehicular accident every three minutes and death every ten minutes and in addition other trauma related deaths occur every second minute. Road Traffic Accidents which is currently the ninth leading cause of mortality is expected to be the third major cause of death in the country by 2020 (WHO, 2001). Much of the high maternal mortality rate of over 400 per 100,000 in the country is constituted by causes that could have been mitigated by quality emergency obstetric care.While it may be difficult to quantify the number of lives or DALYs saved through emergency medical care, it is evident that many of the conditions that contribute to the burden of disease in India can be mitigated through prompt treatment

Leading Causes of Deaths in India due to lack of emergency medical facilities S. No. Cause of death % of total deaths 1. Lower respiratory infections 12.8 2. Ischaemic heart disease 12.5 3. Diarrhoeal diseases 9.8 4. Tuberculosis 7.0 5. Perinatal conditions 6.9 6. Unintentional Injuries 15.2 7. Intentional Injuries 1.7 8. Cirrhosis of the liver 1.6 9. Chronic obstructive pulmonary disease 1.5

VISION:

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh Our vision is to preserve lives by establishing a gold-standard emergency medical protocol and equipping different stakeholders of emergency response system to diligently and effectively handle all medical emergencies. We aspire to provide the best of the emergency medical care to the developing world  Everybody has access to the best Emergency Medical Care.  There are adequate Emergency Physicians, Emergency Medical Technicians, First Responders, and Volunteers trained and ready to Save Lives.  Well-equipped and well-staffed Emergency Departments (EDs) and Emergency Response Vehicles (ERVs) are easily accessible to people in need of timely emergency medical care; irrespective of caste, creed, gender, wealth, or geographies. MISSION:  To provide standardized world-class training in the field of Emergency Medicine, Emergency Medical Services for the healthcare providers in the developing world.  To improve the quality and delivery of services in the field of Emergency Medicine, Emergency Medical Services, and Disaster Management Training and thereby set standards and benchmarks in this field.  To develop satellite training Centres across India and other Developing Countries in the world.  To support the National, State, and local governments/authorities in their efforts to improve Emergency Medicine, Emergency Medical Services, and Disaster Management.  To associate with Institutions, NGOs/civil societies and motivated individuals in building First Responder capacity by educating and conducting awareness in effectively handling medical emergencies and mass casualty incidents.  To provide consulting services for Governments and Institutions for establishing Centres of Excellence for Emergency Medicine, Emergency Medical Services (EMS), and Disaster Management Training.  To initiate and complete Capacity Building Measures for trained Emergency Physicians, Emergency Medical Technicians, and First Responders in India and Developing Countries. To develop Emergency Departments (ED), Emergency Medical Services, Disaster Mitigation and Management training and personnel for India and developing countries.

1.1 ENVIRONMENTAL CONCERNS OF BUILDING & CONSTRUCTION PROJECT

1.1.1 Building Construction Affects the Environment Using non-sustainable materials in the construction of the building has a temporary negative effect. Building construction is responsible for a huge percentage of the greenhouse gas emissions that have been affecting climate change. In fact, the buildings are responsible for nearly 38% of all CO2 emissions. Many of the materials used in the construction of buildings are produced in a non-sustainable way. The factories that make the materials produce damaging CO2 emissions. 1.1.2 Waste from Building Construction and Demolition

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh The destruction and renovation of buildings result in a large amount of waste. Building waste often includes concrete, metals, glass, plastics, wood, asphalt, bricks and more. This waste is often disposed of in either landfills or incinerators. Not only does this pollute the land and the air, but the transportation required to remove such waste has a major impact on the environment as well. According to the Environmental Protection Agency, there were already over 170 million tons of debris generated in the construction and demolition of buildings in the U.S. alone in 2003. 61 percent of which were produced by nonresidential buildings. The present proposal is about new development on vacant plot hence this category of waste generation is not applicable to this project. 1.1.3 Building Energy Consumption EIA‘s International Energy Outlook 2017 (IEO2017) projects that among all regions of the world, the fastest growth in buildings energy consumption through 2040 will occur in India. In the IEO2017 Reference case, delivered energy consumption for residential and commercial buildings in India is expected to increase by an average of 2.7% per year between 2015 and 2040, more than twice the global average increase. Most of this growth is the result of increased electricity and natural gas use (because of greater access to these energy sources) and the increased use of appliances and energy-using equipment. Despite the rapid growth in buildings energy consumption, the IEO2017 Reference case shows that, among the IEO2017 regions, India‘s per capita buildings energy use through 2040 is the second lowest after Africa. Rapid economic growth, rising income, growing population and urbanization are factors in the growth in India‘s buildings energy consumption. Patterns of energy use vary between rural and urban populations. India has the world‘s highest projected gross domestic product (GDP) growth rate among the IEO2017 regions, averaging 5.0% per year from 2015 to 2040. During the projection period, household disposable income in India is expected to increase by an average of 4.2% per year, which is the second highest among IEO2017 regions after China. India is projected to account for about 19% of the increase in world population over the projection period, surpassing China as the world‘s most populous country in 2023. India‘s population to continue to become more urbanized; about 45% of the Indian population will live in urban areas by 2040, an increase of nearly 12 percentage points from 2015. Buildings energy consumption represented about 14% of total delivered energy consumption in India in 2015. Although EIA expects the rate of India‘s commercial energy growth to be higher than its residential energy growth, the residential sector remains the greater consumer of buildings energy, representing more than 70% of the buildings total throughout the projection period. In the IEO2017 Reference case, residential delivered energy consumption is projected to grow by an average of 2.4% per year from 2015 to 2040, the fastest growth rate among IEO regions. EIA expects household per capita disposable income to grow by an average of 3.2% per year as more people have access to electricity and the ownership of electricity-using appliances and equipment (particularly air conditioners) grows. As a result, EIA expects residential electricity consumption to increase nearly twice as fast as total residential sector energy use from 2015 to 2040. Electricity‘s share rises from 46% of the energy delivered to India‘s residences in 2015 to 68% in 2040.

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh India‘s commercial sector accounted for nearly 69% of the country‘s gross domestic product in 2015, and this share is expected to continue growing, leading to more energy demand in the commercial sector. EIA projects that total delivered commercial sector energy use in India will increase by an average of 3.4% per year—again, the fastest growth rate among IEO regions. India‘s economic growth, rising income, and population growth are likely to increase the need for education, health care, leisure, recreation, and other services, which EIA expects will lead to an increase in demand for lighting, space cooling, and office equipment. In the IEO2017 Reference case, electricity and coal remain the most prominent fuels consumed in India‘s commercial sector. EIA projects the electricity share of India‘s total commercial energy consumption to continue increasing, from 59% in 2015 to 65% in 2040, displacing some coal consumption. Buildings energy consumption in India is also affected by various energy efficiency programs such as the Standards and Labeling program and the Energy Conservation Building Code. 1.1.4 Indoor Environment Is Detrimental To Human Health The quality of air inside buildings as represented by concentrations of pollutants and thermal (Temperature and Relative Humidity) conditions that affect the health, comfort, and performance of occupants. Indoor air quality (IAQ) is linked to health of the occupants: IAQ is an important concern – both rural and urban. US EPA pointed out that indoor air pollution poses a greater risk than outdoor air pollution - people spend 80-90% of their time indoors (Yu and Browers, 2013) Carbon based gaseous pollutants (VOCs) indoors could be 2 to 5 times higher than outdoors. Presence of air pollutants in indoor environment a global issue due to adverse effects on human health (Tsakas, Siskos, and Siskos, 2011).Indoor air pollution - ranked among the top five environmental health risks to the public by EPA. •Indoor air pollution – one of the top 10 deaths, disease risk factors - India Sick Building Syndrome: Building occupants experience acute health and comfort effects which are linked to time spent in the building, but no specific illness or cause identified. Not a clinically diagnosable disease. Casual Factors: 1. Inadequate ventilation/air tightness / poorly designed ventilation systems 2. High temperature and humidity levels 3. Other indoor sources including combustion 4. Infiltration of outdoor air contaminants into the indoor 5. Use of cleaning products, paints, printers, pesticides and other VOCs generating products.

Pollutants & Sources in the Indoor Air Environment: Location Sources Pollutant Offices, government buildings HVAC systems, carpets, painting Primary: PM, VOCs

& polishing , household cleaners, Additional : CO, NOx, SO2 aerosols, insecticides, pesticides

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh and personal care products

Parking areas Vehicular movement Primary : PM, CO, NOx, HC

Additional : SO2, VOCs, PAHs, Public places such as HVAC systems, carpets, painting Primary: PM, VOCs, restaurants, hotels, libraries, & polishing , insecticides, Nicotine shopping malls (misc. sources pesticides, smoking, constriction Additional : CO, NOx, SO2 activities Rural households using Biomass burning for cooking, Primary: PM, CO, BC biomass heating, waste burning. Additional : CH4, NMOC Kerosene burning for lighting, 1.2 LOCATION The proposed project of Expansion of Emergency Medicine UnitatS.G.P.G.I.is located adjacent to Raebareilly road, District- Lucknow, Uttar Pradesh

DEMOGRAPHICS According to the 2011 census Lucknow district has a population of 4,588,455, roughly equals to the nation of Georgia or the US state of Louisiana. This gives it a ranking of 31st in India (out of a total of 640). The district has a population density of 1815 inhabitants per square kilometer (4700 /sq. mi). Its population growth rate over the decade 2001-2011 was 25.79 %. Lucknow has a sex ratio of 906 females for every 1000 males, and a literacy rate of 79.33 %. Keeping in mind the increasing population census of Lucknow District, as it is capital of Uttar Pradesh, the requirements, & demand of more medical facilities has increased. So that students along with medical practioner, there is need of paramedical staff who is always supports the doctors to complete the medical cases. This developmental initiative will bring more wings to the young minds.

1.4 IDENTIFICATION OF PROJECT AND PROPONENT The PROPONENT ofthe Expansion Of Emergency Medicine Unitat S.G.P.G.I. - Raebareilly road, District- Lucknow, Uttar Pradesh is The Director, S.G.P.G.I(. LUCKNOW and Uttar Pradesh Rajkiya Nirman Nigam Ltd., P.G.I. unit-1, S.G.P.G.I. Parisar near Jheel, Raibareilly Road, Lucknow has been assigned the work to develop it.. As per the EIA Notification, 2006, the project having built up area more than 5000 m2 does require Environmental Clearance, but as per Water Act, 1974 & Air Act, 1981 every project required consent to establishment (NOC) from the respective State Pollution Control Board, before commencement of project.

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh The proposed project ofExpansion OfEmergency Medicine Unit at SGPGI, Lucknowdistrict, with Built up area of 61,959.12 m2, the project falls under purview of Environmental Clearance from SEIAA & NOC from the UPPCB as per EIA Notification 2006. 1.5 BRIEF DESCRIPTION OF AIM & OBJECTIVES OF THE PROJECT The project has been provisioned to serve the purpose of fulfilling the institute work effectively for the comprehensive study environment. The basic concepts of the projects are as; The basic concept of the project is: 1. Quality medical services 2. Good Environment 3. High quality infrastructure development. 4. Employment opportunities at one place.

The main purpose of the plan are; 1. Enhanced infrastructural development of the Emergency MedicineUnit at SGPGI, Lucknow. 2. The proposed project provides well developed medical facilities to the patients. 3. To achieve safe, healthy, aesthetic and socially pleasing environment in the Emergency medicineUnit, SGPGI, Lucknow. 4. To make open spaces available for the administrative and visitors. 5. To ensure efficient use of resources.

The main objective of the project is as follows 1. To promote a healthy relationship between urban development and environment particularly emphasizing on effective and planned space utilisation. 2. To construct well developed and well equipped Hospital Beds/Laundries, Emergency Medicine Unit . 3. Under this project well developed surface parking for the staff and visitors are established and green belt development is also being done with the maintenance of prevailing green belt. 4. Conservation of resources. 5. Development of a monitored landscape management program. 6. To reduce considerably the present workload of other Hospital blocks. The proposed development will cover rapid and time bound urban infrastructure development, improvement, & maintenance of ecological features. 7. To upgrade the professional efficiency of the doctors of the Emergency Departments so that each one of them is able to deal with all types of emergency cases for their immediate management. This will increase the level of patient satisfaction. 8. To create a cadre of professionals committed to delivery of emergency medical care as their satisfaction. 9. To create Emergency Medicine as a specialty and to start a Post-graduation course of awarding degree of Doctor of Medicine (M.D.) in Emergency Medicine at Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow by incorporating the necessary teaching, research program and patient care activities. 10. To train nurses and paramedics who will form the infrastructure of Emergency Medicine.

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh 11. To create a proto-type functional mode of Emergency Medical Colleges in the State and across the country at large.

1.6 SITE HISTORY & SELECTION FOR PROPOSED PROJECT AND ITS APPROVAL The site is located at Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareilly road, District- Lucknow, Uttar Pradesh. The location itself makes the project much more productive.

1.7 LAND USE- WITH REFERENCE TO PROPOSED LOCATION The site is vacant land with the green belt at the surroundings. The proposed project area has land use under Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareilly road, District- Lucknow. The location plan of the proposed project has been represented on Satellite images.

1.8 EMPLOYMENT GENERATION (DIRECT & INDIRECT) DUE TO THE PROJECT The proposed Expansioin ofEmergency Medicine Unit at S.G.P.G.I. - Raebareilly road, District- Lucknow, Uttar Pradeshwill provide better and more facilitate facilities. The benefit of developing a proposed building is related to the direct employment to the people associated with the development. It provides employment to about300 skilled and unskilled laborers during development of the project. Additional employment opportunities will lead to a rise in the income and improve employment opportunities for nearby population. The proposed facility will also generate jobs for the women labourers during development phase. This will considerably reduce their travel time in any employment and therefore enable them to attend the childrens and their nutritional demands with house hold chores.

1.9 ENVIRONMENTAL LEGISLATIONS APPLICABLE TO THE PROJECT: 1. The Water (Prevention and Control of Pollution) Act, 1974 a. The Water (Prevention and Control of Pollution) Rules, 1975 - Schedules b. Central Board for the Prevention and Control of Water Pollution (Procedure for Transaction of Business) Rules, 1975 c. The Water (Prevention and Control of Pollution) CESS Act, 1977 d. The Water (Prevention and Control of Pollution) Cess (Amendment) Act, 2003 2. The Air (Prevention and Control of Pollution) Act, 1981 a. The Air (Prevention and Control of Pollution) Rules, 1982 and Schedules b. The Air (Prevention and Control of Pollution) (Union Territories) Rules, 1983 3. The Environment (Protection) Act, 1986 a. The Environment (Protection) Rules, 1986and Schedules b. Environment (Protection) Third Amendment Rules, 2002 c. Rules for the Manufacture, Use, Import, Export and Storage of Hazardous Micro Organisms Genetically Engineered Organisms or Cells, 1989 d. The Environment (Protection) (Second Amendment Rules), 1999 - Emission Standards for New Generator Sets 4. Hazardous Wastes (Management and Handling) Rules, 1989 a. The Manufacture, Storage, and Import of Hazardous Chemicals Rules, 1989 b. Manufacture, Storage and Import of Hazardous Chemical (Amendment) Rules, 2000- Draft Notification c. Hazardous Wastes (Management, Handling &Transboundary Movement) Rules, 2010

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh 5. Bio-Medical Waste (Management and Handling) Rules, 1998 a. Hazardous wastes (Management and handling) amendment rules 2000 b. Hazardous Wastes (Management and Handling) Amendment Rules, 2002 6. S.O.979 (E), [27/8/2003] - Amendments to S.O.763 (E) dates 14/9/1999 Dumping and disposal of fly ash discharged from coal or lignite based thermal power plants on land 7. Municipal Solid Wastes (Management & Handling) Rules, 2000 8. Battery (Management and Handling), Rules, 2000. 9. The Noise Pollution (Regulation and Control) Rules, 2000 a. The Noise Pollution (Regulation and Control) Rules, May 2002 10. Re-cycled Plastics Manufacture and Usage Rules, 1999 a. Re-cycled Plastics Manufacture and Usage Amendment Rules, 2002 b. The Recycled Plastics Manufacture and Usage (Amendment) Rules, 2003 11.Ozone Depleting Substances (Regulation) Rules, 2000 12.The Indian Forest Act, 1927 a. The Forest (Conservation) Act, 1980 b. The Forest (Conservation) Rules, 1981 c. Guidelines for diversion of forest lands d. Forest (Conservation) Rules, 2003 13.The Wild Life (Protection) Act, 1972 and Schedules a. The Wild Life (Transactions and Taxidermy) Rules, 1973 b. The Wild Life (Stock Declaration) Central Rules, 1973 c. The Wild Life (Protection) Licensing (Additional Matters for Consideration) Rules, 1983 d. The Wild Life (Protection) Rules, 1995 e. The Wild Life (Specified Plants- Conditions for Possession by Licensee) Rules, 1995 f. Recognition of Zoo Rules 1992 g. The Circular Concerning Joint Forest Management h. The Wild Life (Protection) Amendment Act, 2002 14.The Public Liability Insurance Act, 1991 a. The Public Liability Insurance Rules, 1991 15.The National Environmental Tribunal Act, 1995 a. The National Environment Appellate Authority Act, 1997 16.Provisions of Indian Penal Code a. Provisions of Criminal Procedure Code b. Provisions of Factories Act, 1948 17.No.59 of 1960- The Prevention of Cruelty to Animal Act, 1960 18.The Biological Diversity Act, 2002 a. Draft Biological Diversity Rules, 2003 b. 2-T Oil (Regulation of Supply and Distribution) Order, 1998

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh

CHAPTER 2: PROJECT DESCRIPTION 2.1 PROJECT SUMMARY The Expansion Of Emergency Medicine Unit at SGPGI, Raebareilly road, District- Lucknow, Uttar Pradesh isto be developed by Uttar Pradesh Rajkiya Nirman Nigam Ltd., P.G.I. unit-1, S.G.P.G.I. Parisar Near Jheel, Raibareilly Road, LucknowSummary of the project is as follows: Existing Proposed Total Plot area 88403 0 m2 88403.0 m2 88403.0 m2 Ground Coverage 6333.0 m2 16720.21 m2 29374 .26 m2 Green area 30941.05 m2 16706.07 m2 16706.07 m2 Road area 20100.75 m2 12747.52 m2 12747.52 m2 Parking Area 200 ECS ( Stilt ) 5047.73 m2 5047.73m2 Built-up Area 13333.0 m2 61,959.12 m2 221647.65 m2 Total Expected Population 435 persons 910 persons 1345 persons Electric Load 500 KW 11 KV Network -- Standby DG Set: NIL 02 × 250 KVA 02 x 250 KVA Source of water supply 1 no. Bore Well 1 No. Bore Well 2No Bore Well Total Consumption of 79.181 KLD 161.15 KLD 240.331 KLD Water Total MSW generated 113.0 Kg/Day 271.5 Kg/Day 384.5 Kg/Day Total Bio – Medical Waste 5Kg/Day 58.8 Kg/Day 63.8 Kgt/Day Lumpsum Total Transit Centers 6 Nos 01 no. 07 Nos. Proposed rainwater 5.Nos 01 no. 06 Nos. harvesting pits STP capacity To Existing STP 30.00 KLD STP - System ETP capacity 40 KLD 105.00 KLD ETP -

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh Stack Height -- Cumulative height of 4.47 m above the 4.47 m above the tallest tallest building building Total Project Cost 5711.56 Lakhs 570.32 Crore 627.43 Crores ( 57.11 Crores ) 2.2 PROJECT CATEGORY Expansion Of Emergency Medicine Unit at S.G.P.G.I. – Raebareilly Road - Lucknow is having a built up area of 61,959.12m2,the project falls under the preview of Environmental Clearance from SEIAA & NOC from the State Pollution Control Board as per the EIA notification 2006 2.3 Project Cost: The total project cost is Rs. 570.32Crore. Table 1: Capital Expenditure S. No. Description Cost (Rs. in Lacs) 1. Landscaping 30.0 Emission Control, Air Pollution Control Measures 2. 06.0 etc. 3. STP 30 KLD & ETP 105 KLD Capacity 45.0 4. Rain Water Harvesting 30.0 5. Waste Management 20.0 6. Power Backup 25.0 7. Solar & Energy Conservation Measures 5.0 Total 161.0 Table 2: Recurring Expenditure

S. No. Description Cost (Rs. in Lacs) 1. Landscaping 6.0 2. STP & ETP 10.0 3. Rain Water Harvesting 03.0 4. Environmental Monitoring 04.0 5. Waste Management 05.0 6. Power Backup 03.0

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh 7. Solar & Energy Conservation Measures 01.0 Emission Control, Air Pollution Control 8. 03.0 Measures etc. Total 35.0 Development work of proposed Expansion OfEmergency Medicine Unit at SGPGI, Lucknow, Uttar Pradesh Process Flow Chart: Figure 1 The project shall be executed in 12 monthsand the process flow chart is as follows:

Earth Work

Civil Construction

Electrical & Sanitary work

Furnishing (Aluminum, wood, marble)

Painting

Horticulture/ Landscaping/ Rain Water Harvesting

Operation of proposed Emergency Medicine Unit at SGPGI, Lucknow, Uttar Pradesh

2.4Raw Material Required for Construction & Mode of Transportation of Raw Material/Finished Product. List of Raw & Building Materials: For Civil Construction: For Furnishing: 1. Cement 1. Wooden Planks/ Doors 2. Concrete 2. Gypsum based false ceiling 3. Reinforced steel 3. Glass 4. Sand 4. Sanitary Fittings & Fixtures 5. Bricks 5. Paints & Polishing 6. Marbles / Granite 6. Electrical Fittings & Fixtures 7. Plaster of Paris 7. Air Condition 8. Stone Aggregates 8. Aluminum Window 9. Fly ash 10. Water Proofing Compound 11. Tiles 12. Shuttering Plates 13. Scaffold

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh Electrical & Mechanical Equipment: 1. PVC wires/ Cables 2. Polycarbonate switches/ sockets 3. Ms Box/ Pannels 4. UPS/transformers 5. Fire fighting System 6. MCB, DBS List of Machinery used during construction: Loader loading of materials Dumper Mud and material handling Concrete mixer with hopper RCC work JCB Digging and earth work Concrete Batching Plant Concrete mixing Cranes Lifting and moving of materials Road roller Compacting the earth Tractor Trolley Carrying & transporting material

2.5 DRAINAGE PATTERN AT SITE

The drainage of the district is controlled by river Gomti, Sai its tributaries. Tributaries of Gomti river areAkhadi Nala, Jhilingi Nala, Behta Nadi, Loni Nadi & Kukrail Nala. Tributaries of Sai river are Nagwa Nala & Bankh Nala. The expansion site for the Emergency Medicine Unit at S.G.P.G.I. comprises of flat terrained land where natural drainage system is very poor with ground slopes trending towards south. The highest points of elevation is in the northeastern part whereas the lowest points of elevation are in the south western part of the S.G.P.G.I. premises. Sewerage system: A 30.0 KLD STPand 105.0 KLD ETPshall be developed for the treatment of waste water generated from domestic requirement and the hospital related effluents. The proposed project shall be developed with a dedicated and efficient sewage collection system having proper internal connectivity with the proposed STP to ensure the proper treatment of the sewerage.

2.6 SOLID WASTE MANAGEMENT A state of the art system for collection of solid waste from proposed Expansion OfEmergency Medicine Unit at SGPGI, Lucknow, Uttar Pradesh.has already been put into place through Nagar Palika. Efforts are on for scientific disposal of the waste through MoEF/CPCB/UPPCB approved vendors. The objective is to provide a neat and clean healthy environment in the building. The estimation of waste generation from the proposed project shall be done as per the standards. The collection system through garbage chutes has been proposed to develop within the

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh project. From those depots, tippers or carnage vans shall cart the waste up to designated disposal site for treatment.

2.7 ELECTRIFICATION/ POWER REQUIREMENT & ITS SOURCE Power supply of 11 KVA is provided by U.P. Power Corporation Limited. The electrical cables from electric substation shall be laid underground. At proposed project site the initial assessment of the development area and the mode of conceptual philosophy of electrical infrastructure development have been thought to include the following main components:  To cater the power requirements for construction work and for the development of the building.  Sourcing for immediate power requirement.  The broad layout of the electrical system for the entire building,  The sub-transmission and distribution network from substation & Transformers.  Meeting power demand through standby power supply from D.G set. The total expected power demand for the proposed project shall be fulfilled through 10000 KVA (Sub- station equipment which include H.T panel, transformer, H.T cable, LT Panel, automatic power factor connector etc.). The setting up of 02 nos. of 250 KVA (Capacity each) DG set is being proposed to combat emergency situations within proposed project site, like power back up, sewage pumping station, and water supply pumping system during power failure.

2.8 AVAILABILITY OF WATER & ITS SOURCE For the availability of water, water demand has been calculated based on the saturation density proposed in Lucknow Development Plan 2021. Initially the source of water supply will be from one ( 01 No.) deep bore well.Provision of water supply i.e. distribution networks, tube well, rising mains, overhead tank or the proposed underground tanks have been made accordingly. Mode of water supply will be continuous ( 7 days X 24 Hours ).Provision of one deep bore well has been taken into consideration.However Municipal water supply will also be available for fixed hours which can be stored in the proposed underground tanks and later on pumped to the overhead tank as required. 2.8 SCHEME FOR WASTES MANAGEMENT/ DISPOSAL For efficient waste collection management system, theLucknowcity is divided into Zone, the work relating to primary collection of waste has been decentralized at the zone level where it is supervised by health officers with the assistance of ward level inspectors, Sanitary supervisor. The primary collection involves waste disposal from Emergency Medicine Unit at SGPGI, Lucknow, Uttar Pradesh. Management has fleets of vehicles for collecting and transporting waste from collection points to the disposal site. Each of the vehicles is allotted specific area for collection and transportation to waste disposal site. Following steps have been proposed by for collection, treatment, and disposal of MSW: Step-1: Collection and Segregation of MSW at source of generation Step-2: Transportation of MSW to the disposal site Step-3: Shredding of the compostable waste to desired particle size Step-4: Treatment of biodegradable waste through composting Step-5: Disposal of non-bio-degradable solid waste into Secured Landfil

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh The year 2021 envisages a comprehensive and sustained solid waste management system with modern and scientific answers to collection, transportation, and disposal.

CHAPTER 3: SITE ANALYSIS

3.1 LOCATION WITH COORDINATES

Lucknow, the capital of Uttar Pradesh is situated on 26.30 & 27.10 North latitude and 80.30 & 81.13 East longitude. Lucknow covers an area of 2528 sq.km. It is surrounded on the eastern side by District Barabanki, on the western side by districtUnnao, on the southern side by Raebareli and on the northern side by Sitapur and Hardoi districts. River Gomti flows through the city. Some of the tributaries of this river are Kukrail, Loni, Beta etc. Sai river flows from the south of the city and in the east enters district Raebareli. Lucknow is accessible from every part of India through Air, Rail and Road. It is directly connected with New Delhi, Patna, Calcutta, Mumbai, Varanasi and other major cities by Chaudhry Charan Singh Airport at Amausi. Similarly city is linked to north, east, south and west through rail and road links. In fact rail link joins Lucknow to Pakistan via Amritsar in the west and to Bangladesh railways in the east.

District Lucknow has almost uniformed tropical climate. The temperature varies from 45°Celsius maximum in summer to 5° Celsius minimum in winter season. Rainfall is 100 cm. per annum. The forest area is negligible in the district. Shisham, Dhak, Mahua, Babul, Neem, Peepal, Ashok, Khajur, Mango and Gular trees are found here. In fact different varieties of mangoes specially Dashahri, Chausa, Safeda, Amrapali and Fajli and many morevarietes are grown in Malihabad block of the district and some of them exported to other countries too. The main crops are wheat, paddy, sugarcane, mustard, potatoes, and vegetables such as cauliflower, cabbage, tomato and brinjals are grown here. Similarly sunflowers, roses, and marigold are cultivated on quite a large area of the land. Apart from this many medicinal and herbal plants are also grown here.

G A 26°44'44.20"N F 80°56'50.24"E B 26°44'41.49"N 80°56'50.81"E C 26°44'40.93"N 80°56'51.33"E C A D 26°44'40.31"N B D E 80°56'51.19"E

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh E 26°44'30.93"N 80°56'53.46"E F 26°44'32.52"N 80°57'1.30"E G 26°44'45.71"N

80°56'58.64"E

3.2 CRITERIAS FOR SELECTION OF LAND Following criteria‘s were selected for selection of land. (Figure 2)

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh

1. a) Proximity to linkage: It was observed that development pattern generally follows the transportation corridors because of high accessibility development as opposed to haphazard growth, which is seen in most cities. The proposed site is well accessed in East at 0.3 Km by Raebareilly road NH- 24B. Lucknow is well connected by railways and roads from almost all the major cities of North India.

Roads:

 Raebareilly Road, NH-24B- 0.3 Km, E  Mahatma Gandhi Marg- 1.55 Km, SE

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh  Ekta Nagar Marg- 0.33 Km, S  Lucknow Road- 0.77 Km, N  Marshall St.- 1.26 Km, NE  Amar Shaheed Path- 2.68 Km, N  Uttrathiya Railway station road- 2.4 Km, NE  Jail Road- 5.2 Km, NE  Bijnor Road- 4.42 km, NE

1. b) Proximity to existing settlements: The areas of project site existing in a developing zone and population pressure is likely to witness growth pattern influenced by the surrounding existing institutes & institutional establishments. Nearby Areas  Ashiyana- 6.81 Km, NW  HarikanshGarhi- 3.35 Km, SE  KalliPoorab- 3.69 Km, S  Baraulli Khalilabad- 2.7 Km, E  Nilmatha- 5.24 Km, NE  RasoolpurIduria- 1.82 Km, W  Alinagar Khurd- 2.27 Km, SW  Sharda Nagar- 5 Km N 1. c) Ground water availability: Ground Water resources Ground water occurs in the pore spaces of the unconsolidated alluvium sediments in the zone of saturation under phreatic and semi confined conditions. In deeper aquifer it occurs under semi confined to confined conditions. To know the depth to water number of National Hydrograph stations and Piezometers are monitored four times in a year. On the basis of NHS & piezometers Pre-monsoon Depth to water maps 2008. Post-monsoon Depth to water map 2008 & fluctuation maps has been prepared. On the basis of Pre-monsoon map it is revealed that shallowest water level less than 2 metres & between 2-5 metres occurs in the eastern part of district in the Gosainganj block along the Sharda Sahyak Canal. Depth to water between 5 to 10 metres occurs in the northern & southern part of districts in part of Bakshi-Ka-Talab, Chinhat & Mohanlal ganj blocks. The western part of the district depth to water ranges between 10-20 meters in Mal, Malihabad, part of Bakshi-Ka-Talab. Kakori, Sarojini Nagar & part of Chinhat blocks. Minimum water level of 1.80 mbgl was observed at Gosainganj and maximum of 32.60 mbgl was observed at Gulistan Colony in the Lucknow town. In the urban areas depth to water generally remains more than 20 mbgl. Drainage: Lucknow is cut across by a number of streams and nalas. The area falls in the drainage basin of two rivers namely Gomati and Sai . Major part of the district, i.e. northern, western, eastern, and central parts is drained by river Gomati and its tributaries. Whereas the southern part to the South of Sharda canal, is drained by river Sai and its tributaries River Gomati enters the district in the North at a place near Jamkhonwan village and flows in a Southerly direction till Kankrabad village where it becomes a NW-SE trending stream and flows in this direction till Kukrail nala joins it, from where it changes its direction to become a West-

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh East stream and flows in this direction till it again adopts a NW-SE direction and forms the district boundary.The first sewerage network was established in different parts of the city over a century ago. The network has not been augmented from time to time to keep in pace with development of the city. About 70- 80% of population in old-Lucknow is covered by sewer lines, but a major portion of it is choked and virtually broken, leading over flow of sewage into storm water drains. There are 16 drains in Cis-Gomati and 12 drains in trans-Gomati area meeting river Gomati directly including the sewage pumping stations.The severe flooding in monsoon period in Lucknow city is believed to originate from insufficient drainage capacity and blockages of the drainage system due to huge volumes of garbage and polyethylene bags. Inadequate maintenance of existing natural and man-made drains due to lack of comprehensive and planned maintenance program, equipment, adequate budget, staffing, proper monitoring program and institutional set up to effectively operate and maintain the drainage network. Poor solid waste management is the main problem to maintain the rain water drainage. Drainage systems turn into most unpleasant condition when many other factors correlate with it.These factors are categorized as follows:  Improper Drainage System with low-lying topography  Blockage in Canal System  Blockage in existing drainage system  No drainage system  Open field and no drainage system, and disposal of wastage  Overflow in the nala  Railway bridge underpass area with no drainage

Aquifer groups in Lucknow: In Lucknow city, as per the extensive exploration carried-out by CGWB down to the depth of 750 m below ground level, 04 Aquifer Groups, each separated by 5 to 10 m thick clays, are distinguishable. Aquifer Group Depth Range (m below ground level) I 155 II 160-240 III 260-370 IV 380-485 The aquifer material in these aquifer groups comprises sands of various grades, clays, Kankar and silt.

1. d) Topography Awadh, known as the granary of India, was important strategically for the control of the fertile plain between the Ganges and the Yamuna rivers known as the Doab. Situated in the heart of the great Gangetic plain, Lucknow city is surrounded by its rural towns and villages like the orchard town of Malihabad, historic Kakori, Mohanlal ganj, Gosainganj, Chinhat, Itaunja. On its eastern side lies Barabanki District, on the western side is Unnao District, on the southern side Raebareli

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh District, and on the northern side the Sitapur and Hardoi districts. The Gomti River, the chief geographical feature, meanders through the city, dividing it into the Trans-Gomti and Cis-Gomti regions. Lucknow city is located in the seismic zone III. Lucknow has a warm humid subtropical climate with cool, dry winters from December to February and dry, hot summers from April to June. The rainy season is from mid-June to mid- September, when Lucknow gets an average rainfall of 896.2 millimeters (35.28 in) from thesouth-west monsoon winds, and occasionally frontal rainfall will occur in January. In winter the maximum temperature is around 25 °C (77 °F) and the minimum is in the 2 to 3 degrees Celsius range. Fog is quite common from late December to late January. Summers are extremely hot with temperatures rising to the 40 to 45 degree Celsius range.

GEOLOGY: Quaternary sediments have been divided upto older and newer alluvium. The older alluvium is comprised of grey to brown coloured silt clay and sand with or without Kankar of middle to late Pleistocene age. The newer alluvium overlies the older alluvium and has been sub divided into terrace alluvium and channel alluvium and belongs to Holocene age. The newer alluvium comprises of light khaki grey silt clay and is fine to medium and coarse grey sand which is micaceous in nature. The regional geology of the area is summarized below:- System Age Formation Lithology QuaternaryUpper Pleistocene Newer Fine sand and clays

Lower Pleistocene to Older Sand of different grade

Upper Pleistocene Clay mixed with Occasionally occurring Kankar

------B A S E M E N T ------Basic Dykes, Pegmatite

Pre – Cambrian Archean Bundelkhand Complex Granites & Gneisses

1. e) Seismicity of Lucknow As per Vulnerability Atlas of India by BMTPC (State disaster management plan for Earthquake of Uttar Pradesh), Lucknow falls under Seismic Zone III, moderate risk zone. Vulnerability of Uttar Pradesh to Seismic Hazard Uttar Pradesh is India's most populous state, quiet and a large part of this state lies in Earthquake High Damage Risk Zones IV and III. Objectives The objectives of State Disaster Management Plan are given below: i) To significantly reduce the risks of loss of life, injuries, economic losses and destruction if, in the future a damaging earthquake strikes Uttar Pradesh or nearby region with (adverse effects on Uttar Pradesh as well).

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh ii) To promote a culture of preparedness by ensuring that Disaster Management receives the highest priority at all levels. iii) To devise appropriate guidelines and strategies for applying existing scientific and technical knowledge and available resources for timely response and recovery. iv) To improve the capacity of the state to mitigate the effects of an earthquake. v) To foster scientific and engineering endeavors aimed at addressing critical gaps in knowledge. vi) To substantially increase public awareness to earthquake disaster risk and about do‘s and don‘ts before, during and after an earthquake. vii) To ensure that community is the most important stakeholder in the Disaster Management process. viii) To plan recovery in such a way that it brings back the community to a better and safer level than the pre-disaster stage. ix) To evolve a coordinated strategy for earthquake disaster risk reduction in U.P. with The involvement of all the stake holders in earthquake disaster management (administration, line departments, scientists, engineers, PRIs, NGO, CBOs, and above all the community) 1. f) Riverine Systems:The Gomti, Gumti, or Gomati River is a tributary of the Ganges. According to Hindu mythology, the river is the daughter of the Hindu sage Vashist; bathing in the Gomti on Ekadashi (the eleventh day of the two lunar phases of the Hindu calendar month) can wash away sins.According to Bhagavata Purana one of Hinduism's major religious works, the Gomti is one of India's transcendental rivers. The rare Gomti Chakra is found there.The Gomti, a monsoon- and groundwater-fed river, originates from Gomat Taal (formally known as Fulhaar jheel) near Madho Tanda, Pilibhit, India. It extends 960 kilometers (600 mi) through Uttar Pradesh and meets the Ganges near Saidpur, Kaithi, 27 kilometers (17 mi) from Varanasi district. It meets a small river, the Galilaeae, 20 kilometers (12 mi) from its origin. The Gomti is a narrow stream until it reaches Mohammadi Kheri, a tehsil of Lakhimpur Kheri district (about 100 km from its origin), where it is joined by tributaries such as the Sukheta, Choha and Andhra Choha. The river is then well-defined, with the Kathina tributary joining it at Mailani and Sarayan joining it at a village in Sitapur district. A major tributary is the Sai River, which joins the Gomti near Jaunpur. The Markandey Mahadeo temple is at the confluence of the Gomti and the Ganges. After 240 kilometers (150 mi) the Gomti enters Lucknow, meandering through the city for about 12 kilometers (7 mi) and supplying its water. In the Lucknow area, 25 city drains pour untreated sewage into the river. At the downstream end, the Gomti barrage converts the river into a lake. In addition to Lucknow, Lakhimpur Kheri, Sultanpur Kerakat, and Jaunpur are the most prominent of the 15 towns in the river's catchment basin. The river cuts the Sultanpur district and Jaunpur in half, becoming wider in the city.The Gomti has been stressed, particularly in and around Lucknow, for decades. There are three major issues: 1. Embankments - High embankments were built around the river to protect the population of Lucknow after a major flood during 1960s, altering the Gomati‘s natural floodplain. 2. Pollution - The Gomti has 40 natural drains, of which 23 are major. The drains, which carried surplus water into the river during the monsoon and recharged the underground water table, were reduced to carry residential and industrial sewage into the river.

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh 3. Development - The river's floodplains and fertile land were covered with residential areas, such as Gomti Nagar and Triveni Nagar. The Gomti began receding during the late 1970's, and was under major stress in 2016. Although government agencies planned major projects, such as the Bharwara sewage treatment plant and mechanical dredging, most were unsuccessful.The Gomti rises by 10–12 meters during the monsoon, and in 2008 a major flood was reported. Around 2012, the newly-elected government and the Lucknow Development Authority began a feasibility study with the Indian Institute of Technology, Roorkee to build a river-front similar to Sabarmati Riverfront in Ahmedabad. The LDA submitted the report, warning about the negative consequences of reducing the Gomti to less than 250 meters wide. At 250 meters wide (with walls on both sides), the river's velocity would increase by 20 percent and its bed-shear stress by 30 percent. Current embankments would have to be raised by 1.5 meters, and the high flood level (HFL) would increase by 1.25 meters. Two bridges would be threatened with collapse under flood conditions.The plan was given to the irrigation department, which signed a memorandum of understanding with IIT Roorkee in December 2015 to conduct a similar study on the project.The riverfront-development project is seen as a political showdownbetween the state government and the ruling party, whose similar construction in Ahmedabad over the Sabarmati River has been projected as a showcase of development in the state of Gujarat. Many noted environmentalists and river-system experts vehemently opposedthat project as well. Both projects are seen as a template for similar interference with river systems across India, including the Yamuna, the Hindon, and the Varuna.Monsoon flooding leads to several problems when the water recedes, including the danger posed by drying potholes and pits (which host diseases such as malaria and dengue. 1. g) Climate and Rainfall: The normal rainfall (1901-1970) of Lucknow district is 966.24 mm. The maximum rainfall occurs during the monsoon period i.e. June to September having normal value of 849.78 minimum which is 87.9% of the annual rainfall. July is the wettest month having the normal rainfall of 289.56 mm followed by August with normal rainfall of 287.66 mm. The climate of Lucknow district is subtropical type with three district seasons namely summer, monsoon, and winter. The winter commences usually in the month of November and extends till February followed by summer April to middle of June and then monsoon starts and lasts upto September / October. The maximum temperature remains 45°C during month of May and minimum temperature remains 5°C during January. The average relative humidity remains 25% in morning while in the evening it remains 68%. The annual normal potential evapotranspiration of the district is 1519 mm. The average wind speed varies between 4 and 7.5 km/hr. during winter and 9.9-11.7 km/hr. during summer seasons. The average number of rainy days is 44. 1. h) Soil: The district forms a part of Ganga basin with flat alluvial terrain. General elevation varies from 103 m to 130 metres above mean sea level. The general slope of the district is south-east. Geomorphologically the district is divided into two geomorphic units (i) Older flood plains & (ii) Active flood plain. Older flood plains are represented by two level of terraces viz erosional terrace (Te) occupying at higher level and Depositional terrace (Td) at lower depressions. Older flood plain exists between elevation of 103 and 110 mamsl. Both the terraces are developed on the either side of Gomti river. Erosional Terrace is also developed along Sai Nadi. Active flood

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh plains are restricted to present day bank line of the rivers. These are represented by land forms like point bars channel bars and lateral bars. Quaternary sediments have been divided upto older & newer alluvium. The older alluvium is comprised of grey to brown coloured silt clay and sand with or without Kankar of middle to late Pleistocene age. The Newer alluvium overlies the older alluvium and has been sub divided into terrace alluvium and channel alluvium & belongs to Holocene age. The newer alluvium comprises of light Khaki grey silt, clay and fine to medium and coarse grained grey sand which is micaceous in nature. Soils in the district exhibit a wide variation in composition texture and appearance. The major position of the district is occupied by soils locally known as "Bhur" or "Silty Sand" on the ridges. "Matiyar" or "Clay Soils" occurs along topographic lows and "Dumat or Loamy soils" in the level lands. Clay is dominant in the areas where "Reh" (Usar) prevails. Along the river valleys, a very fertile soil called "Dumat" is prevalent which is youngest. 1. i) Agriculture : Lucknow, the capital of Uttar Pradesh is a part of Central Ganga Plain of the state. The district has geographical area of 2528 sq. km. Lucknow district comprises of 4 tehsils and 8 blocks. The net sown area is 1.38 lakh ha and the cropping intensity is 154%. The district is mainly drained by river Gomti and its tributary Sai which are perennial. Lucknow has uniform tropical climate. The district receives a normal rainfall of 953 mm. is categorized under Agro Climatic Zone-5, and has basically agriculture oriented economy.Main crops of the district are wheat, paddy (rice), sugarcane, mustard, and potatoes. The district contains 18% area of cultivated land under mango which makes a special Agro Eco system of the district and plays vital role in socio economic conditions. Potential exist for increasing cereals, horticulture crops like mango, banana and increasing farm income to vegetable crops, dairy, fishery,mushroom cultivation and medicinal plants cultivation. The major constraints are non-availability of sufficient quantity of fertilizers and low use of hybrid variety (HYV) seeds. The situation warrant immediate steps for capital incentives and provision for granting higher quantum of loans to needy farmers. High vegetable productivity in the district needs quick and assured market and calls for improving market infrastructure. The lack of technology dissemination to newer farming technology, water saving technology is other constraints and needs immediate attention. Lucknow being the metro district, the availability of ready market is an additional benefit to the small and marginal farmers of this region where several high value crops, entrepreneurship development including mushroom, bee keeping, floriculture etc. should be promoted. With 21967 breedable cross-bred cows, 2.16 lakh breedable desi cows and 2.2 lakh breedable buffaloes in the district, high potential exists for development of dairy.

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh

CHAPTER 4: PROJECT PLANNING

4.1 PLANNING CONCEPT The proposed project isExpansion of Emergency MedicineUnit at S.G.P.G.I.-Raebareilly road, District-Lucknow. 4.2 Land Uses of proposed Emergency MedicineUnit: The proposed project, is Expansion of Emergency MedicineUnit at S.G.P.G.I. - Raebareilly road, District-Lucknow and various land uses of the land allotted for the purpose as propsed is summarized in the table below ; Table 3: Land Uses

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh S. No Particulars Area (m2) %age 1 Ground coverage 16720.21 18.91 2 Green Area 16706.07 18.90 3 Road area 12747.52 14.42 4 Parking Area 5047.73 5.71 5 Future Expansion/Open area 37181.47 42.06 Total Plot area 88403.00 100.00

Table 4: AREA STATEMENT CHART HOSPITAL BLOCK S. No. Area in m2 (PHASE- I) 1.0 Stilt floor covered area 13355.25 Stilt floor parking area 3364.96 2.0 First floor covered area 14975.59 3.0 Second floor covered area 10173.00 4.0 Third floor covered area 10045.16 5.0 Fourth floor covered area 10045.16 9.0 Open parking 1682.77 TOTAL AREA OF HOSPITAL SERVICE BLOCK & OTHER BUILDING BLOCK 02. Total built-up area of Hospital, Service block & other 61,959.12 m2 building block

4.3 Population details Table 5: Plotted Population Break Up at Project Site: S. No. STAFF DESIGNATION Population 1. Clinical Staff 150

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh 2. Non-clinical Staff 150 3. Emergency medicine beds 210 6. Visitors 400 Total Expected Population 910 Therefore, the total expected population of proposed Emergency Medicine Unit at SGPGI would be 910personnel.

4.1 SITE SETTINGS Nearby areas:  Ashiyana- 6.81 Km, NW  HarikanshGarhi- 3.35 Km, SE  KalliPoorab- 3.69 Km, S  Baraulli Khalilabad- 2.7 Km, E  Nilmatha- 5.24 Km, NE  RasoolpurIduria- 1.82 Km, W  Alinagar Khurd- 2.27 Km, SW  Sharda Nagar- 5 Km, N Roads:  Raebareilly Road, NH-24B- 0.3 Km, E  Mahatma Gandhi Marg- 1.55 Km, SE  Ekta Nagar Marg- 0.33 Km, S  Lucknow Road- 0.77 Km, N  Marshall St.- 1.26 Km, NE  Amar Shaheed Path- 2.68 Km, N  Uttrathiya Railway station road- 2.4 Km, NE  Jail Road- 5.2 Km, NE  Bijnor Road- 4.42 km, NE Railway Station:  Uttrathiya railway station- 3.35 Km, NE  Mohanlalganj Railway station- 7.3 Km, SE  Lucknow Railway station- 9.9 Km, N  Manak Nagar Railway station- 9.39 Km, NW Bus Station:  SGPGI bus station- 0.35 Km, NE  Deen Dayal Upadhyay bus station- 0.33 Km, E  Mawaiya bus station- 1.38 Km, NE

River/Canal/Pond:  Sharda canal- 0.4 Km, E  Lake- 1.89 Km, NW  Canal- 1.35 Km, W

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh  Gomti river- 10.94 Km, N Schools/Colleges:  Swami Vivekanand Mahila Mahavidyalaya- 2.37 Km, NW  MahrajBijliPasi degree college- 5.6 Km, NW  Sardar Patel PG Institute of Medical science- 5.2 Km, NE  Baba Saheb Ambedkar Central University- 3.71 Km, NW  JB Memorial Inter college- 4.5 Km, W  St. Terrassa College- 6.08 Km, N Hospital:  Nephrology OPD- 0.27 Km, W  Sun Rise Hospital- 0.29 Km, S  General Hospita- 0.61 Km, W  Javitri Hospital- 3.92 Km, N  Sanskar Hospital- 0.48 Km, N  SGPGI Apex Trauma centre- 1.18 Km, NE  Indira Gandhi Hospital and Research center- 4.34 Km, W Places of worship:  Bharat Mata Mandir- 0.38 Km, S  Durga Mandir- 0.68 Km, SW  Masjid faruqui- 0.84 Km, SW  Koat Mata Mandir- 1.78 Km, S  Mandir- 1.24 Km, SW  Shiv Mandir- 1.16 Km, SW Parks/ Playgrounds:  Iskon Vatika- 0.88 Km, W  Football ground- 1.06 Km, W  Deen Dayal Upadhyay Kisan Park- 0.5 Km, SE  SGPGI Forest- 1.96 Km, W  Playground- 2.17 Km, NW  Triangular Park- 2.20 Km, N

CHAPTER 5: PROPOSED INFRASTRUCTURE

5.1 CONNECTIVITY (TRAFFIC AND TRANSPORTATION ROAD/RAIL/METRO/ WATER WAYS ETC.)WITH IN THE DEVELOPMENT REGION. 5.1.1 Road Network

Environmental Consultant: M/S Sawen Consultancy Services Pvt. Ltd., Lucknow Page | 30

Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh The delineated project site is located at S.G.P.G.I, Lucknow - Uttar Pradesh. The proposed site is well connected to various places, Railway, Bus Terminus & other parts of the Lucknow city by road. The major road linkages are – Raebareilly Road, NH-24B- 0.3 Km, E  Mahatma Gandhi Marg- 1.55 Km, SE  Ekta Nagar Marg- 0.33 Km, S  Lucknow Road- 0.77 Km, N  Marshall St.- 1.26 Km, NE  Amar Shaheed Path- 2.68 Km, N  Uttrathiya Railway station road- 2.4 Km, NE  Jail Road- 5.2 Km, NE  Bijnor Road- 4.42 km, NE 5.1.2 Rail Linkages  Uttrathiya railway station- 3.35 Km, NE  Mohanlalganj Railway station- 7.3 Km, SE  Lucknow Railway station- 9.9 Km, N  Manak Nagar Railway station- 9.39 Km, NW

5.1.3 Water Courses &Riverine Systems:The Gomti, Gumti, or Gomati River is a tributary of the Ganges. The Gomti is one of India's transcendental rivers.The Gomti, a monsoon- and groundwater-fed river, originates from Gomat Taal (formally known as Fulhaar jheel) near Madho Tanda, Pilibhit, India. It extends 960 kilometers (600 mi) through Uttar Pradesh and meets the Ganges near Saidpur, Kaithi, 27 kilometers (17 mi) from Varanasi district. It meets a small river, the Galilaeae, 20 kilometers (12 mi) from its origin. The Gomti is a narrow stream until it reaches Mohammadi Kheri, a tehsil of Lakhimpur Kheri district (about 100 km from its origin), where it is joined by tributaries such as the Sukheta, Choha and Andhra Choha. The river is then well-defined, with the Kathina tributary joining it at Mailani and Sarayan joining it at a village in Sitapur district. A major tributary is the Sai River, which joins the Gomti near Jaunpur. The Markandey Mahadeo temple is at the confluence of the Gomti and the Ganges. After 240 kilometers (150 mi) the Gomti enters Lucknow, meandering through the city for about 12 kilometers (7 mi) and supplying its water.

5. 2 PARKING DETAIL: The Expansion Of Emergency Unit at S.G.P.G.I.has been planned on a total plot area of 88403 m2. According to the Building & Construction Manual for Hospitals and Nursing Homes, for every 100 m2 area of the plot 1.5 parking space is required. Therefore for the total plot area of 88403 m2. Thetotal numbers of parking = 88403 / 100 x 1.5 = 1326.045 ECS( Total ECS Required ).

Environmental Consultant: M/S Sawen Consultancy Services Pvt. Ltd., Lucknow Page | 31

Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh Now as the Expansion Of Emergency Medicine Unit at S.G.P.G.I. - Lucknow, will be carried out only in 16720.21 m2 area ( within the totalplot area of 88403 m2) i.e. Stilt + Four floors are to be constructed in Phase – I . Therefore for 16720.21 m2 area nos. of ECS required = 16720.21 / 100 x 1.5 = 250.80 ECS ( Say 251 ECS ) space will be required. Provided Parking;An area of 5047.73 m2 is provided as parking space.It includes 3364.96 m2 area as stilt parking space and 1682.77 m2 area as open parking space. (According to the Building & Construction Manual, for covered parking 1- ECS = 28 m2 , & for open Area Parking 1 ECS = 23 m2) So 3364.96 m2(The stilt parking area) will accomodate ; 3364.9 m2/ 28 m2 = 120.177 ECS. And the1682.77 m2( The open parking area ) will accommodate ; 1682.77 m2 / 23 m2 = 73.164 ECS. Therfore 5047.73 m2 area will collectively accommodate about 193 ECS. The Requirement is of 251 ECS space. The extra space requirement would be of 251 ECS – 193 ECS = 58 ECS. So, 58 ECS space in open parking would be = 58 ECS x 23 m2 = 13344 m2 Extra Open Parking Space Requirement would be =1334 m2 Total Requirement for for parking= 5047.73m2( Provided Parking Area )+ 1334 m2 (Extra Open Parking Space Required ) = 6381.73m2(Total Space Requirement) in the Emergency Medicine Unit At S.G.P.G.I . Rae Bareilly Road, Lucknow.

5.2 Green Areas ( For Landscape Parks. And Exclusive Plantation.): Natural landscaping is also referred to as sustainable landscaping. It stresses the use of native plants that are beautiful, hardy and that also benefit the local environment. Native plants are especially good at preventing soil erosion, reducing flooding, sustaining wildlife and filtering out harmful pollutants in the soil. Natural landscaping offers a way to reduce the use of chemical pesticides and fertilizers, while introducing natural techniques that are safer for the long-term health of the community. The Landscapingis Proposed on 16706.07 m2 area.

5.3 APPROACH ROAD & BUILDING HEIGHT Lucknow – Raebareilly – Allahabad Highway ( NH-24B ) - is the main road which passes from about 0.3 Km, in E of the proposed Expansion Of Emergency Medicine Unit at S.G.P.G.I.- Rae -Bareilly Road, Lucknow U.P. Phase – I of this expansion will have a building height of G + 4 .

CHAPTER 6 : ENVIRONMENTAL MANAGEMENT PLAN 6.1 WATER MANAGEMENT (SOURCE & SUPPLY OF WATER) Total water demand of the Proposed Emergency Medicine Unit at SGPGI, Lucknow, including green areas excluding fire-fighting water demand and losses is calculated to be 161.15 KLD. About 16.71 KLD water out of total water demand will be utilized for the irrigation of the green and landscape area proposed inside the project premises. The water demand estimation has been tabulated in Table 6.The one time water requirement for firefighting demand will be 1.6 KLD based on CPHEEO

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh guidelines, i.e. fire demand for < 50,000 population = 1% of total water demand. The water shall be withdrawn from tube well & Boring installed within premises.

WATER MANAGEMENT ( Construction Phase ): Labourers Population Calculation S.No. Detail Nos. Per Captia Water Waste water LPCD Requirement Generation KLD KLD 1 Workers- semi 250 25 lts 6.25 5.00 skilled, unskilled 2 Supervisor 30 25 lts 0.75 0.60 3 Visitor Labours 20 25 lts 0.50 0.40 Total Expected 300 7.50 6.00 Population

Waste water Generation @ 80% = 6.00 KLD. About 10 % of the waste water will be generated due to washing hands ,feet and face ie. 0.60 KLD. This type of waste water will be directed by suitable drains to the nearby plantation area. About 90 % of the waste i.e. 5.40 KLD will be black water generated due to flushing of toilets this water shall go to the proposed 2 nos of septic tanks . Two numbers of septic tanks at locations selected for the sewerage purpose are being suggested. The sizes as per CPHEEO manual will be 2 nos. Regular maintenance checks on to be conducted. (II) Mitigation Measures; - Although no significant impact is anticipated on the present water regime of the area during construction, yet, it is proposed to apply the following measures precautionary to reduce the loads on fresh water regimes.  Curing water will be sprayed on concrete structures and free flow of water will not be allowed.

Environmental Consultant: M/S Sawen Consultancy Services Pvt. Ltd., Lucknow Page | 33

Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh  After liberal curing on the first day, it is proposed that all concrete structures will be painted with curing chemical to save water curing. Hence a lot of water will be saved.  Concrete structures will be covered by thick cloth / gunny bags and there after water shall be sprayed on them to avoid renounce and ensure a long sustained curing.  Water pending will be done around all sunken slabs.  Water consumption during Construction phase: In order to meet the construction phase water requirement, will be provided to the construction site by tankers. 6.1.1 Water supply for green area The water demand estimated for maintenance of green covers of the building in the non- monsoon period works out to be 16.71 KLD. It has been calculated by assuming 1.0 liters of water required for 1 m2 of green area. The salient features for the water supply to the green area will be: • Garden hydrants will be provided along the supply line so as to access this water to irrigate the nearby green covers; • The spacing proposed for water hydrant will be in the range from 60 m to 100 m as per the requirement; • The pressure at outlet of hydrant will be maintained equivalent to 15 m head.

F O R T H E E X I S T I N G:

Table Of Water Use Calculation For The Existing S.No. Water Use Population Per Water Waste Water Captia in Requirement Generation (LCPD) (KLD) (KLD) 1. Administration Staff. 70 45 3.15 2.52 (Doctors,Surgeons,Nurses,Support Staff) 2. Resident Doctors/Research 65 86 5.59 4.47 Scholars 3. Patient 100 15 1.5 1.2 4. Visitors 200 15 3.0 2.4 TOTAL DOMESTIC REQUIREMENT 13.24 10.59 5. Laboratories ( Research Lab, Vet LUMPSUM 3.0 2.7 Lab, Lab 1 & Lab 2 )

Environmental Consultant: M/S Sawen Consultancy Services Pvt. Ltd., Lucknow Page | 34

Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh 6. HVAC System 1 x 400 T 10/T/8hrs 32.0 28.8 7. Gardening 30941.05m2 1 lt/ m2 30.941 NIL TOTAL WATER REQUIREMENT 79.181 42.09

PROPOSED EXPANSION: Of Emergency Medicine Unit At S.G.P.G.I. LUCKNOW.

One time Fire Fighting Demand = 1.6 KLD (As per CPHEEO Manual, GOI)

Table 6.WATER USE CALCULATION FOR EMERGENCY MEDICINE UNIT AT S.G.P.G.I. S. No. Water Use Population Per Capita in Water Requirement Waste Water (LPCD) (KLD) Generation (KLD) 1. Clinical Staff 150 45 6.75 5.4 2. Non – Clinical Staff 150 45 6.75 5.4 3. Visitors 400 15 6.0 4.8 REQUIREMENT TOTAL DOMESTIC WATER 19.5 15.6 4. Hospital Beds 210 450 94.5 75.6 4. Laundry - - 8 6.4 5. Lab/ Pathology - - 8 6.4 5. D.G. Set Cooling 04×1010KVA 0.9l/KVA/4 hr. 14.44 NIL 6. Gardening/Landscape 16706.07 m2 1 l/m2 16.71 NIL Area TOTAL WATER REQUIREMENT 161.15 104.0

6.1.2 WATER BALANCE DIAGRAM FOR THE EMERGENCY MEDFICINE UNIT Figure: 7

Total Water

Requirement 161.15 KLD

KLD Treated Water Requirement

Fresh Water Requirement 37.0 KLD Environmental124.15 KLD Consultant: M/S Sawen Consultancy Services Pvt. Ltd., Lucknow Page | 35

7.831 KLD Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh

Hospital beds Lab Laundry Gardening D.G. Set 94.5 KLD 8.0 KLD 8.0 KLD cooling 16.71 KLD 14.44 KLD 5.0 KLD 5.0 KLD 5.0 KLD Domestic Flushing Waste Water Waste Water Requirement 5.85 KLD 13.65KLD 75.6 KLD 6.4 KLD

Waste Water

Nil Waste water Waste water Waste water Total Waste Water 5.85 KLD NIL 6.4 KLD 9.75 KLD 82.0 KLD 9.60 KLD

Treated Total Waste Water Water 73.8 KLD 22.0 KLD

STP ETP 30.0 KLD 10 5.0 KLD

Treated Water for Reuse Balance 56.6 KLD Treated water Treated Water 19.8 KLD will be reused in SGPGI premises 19.8 KLD for landscaping of existing green 17.2 KLD from ETP are, drain& sewer washes will be reused in Gardening

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh

TOTAL WATER BALANCE Total Water Req.

240.331 KLD

Fresh Water Treated Water Req.94.5 KLD Req.99.94 KLD

Ho9spit HVAC Flushin Gardenin Lab. Laundry DWR DG Set al Beds 32.0 g 5.85 g 47.65 11.0 KLD 8.0 KLD 26.89 KLD 14.44 KLD 944.5 KLD KLD KILD KLD

W.W. W.W. Bleed W.W. W.W. W.W. 6.4 20.24 28.8 NIL 75.6KLD 9.1 KLD 5.85 KLD NIL KLD KLD KLD

Waste Effluents

113.5 KLD

Total Waste Water

Existing +105 32.48 KLD

KLD ETP Existing + 30KLD STP TreatedETP Water

102.15 KILD

Treated Water 70.71 KLD

29.24 KLD From ETP Environmental Consultant: M/S Sawen Consultancy Services Pvt. Ltd., Lucknow Page | 37

Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh

31.44 KLD Road Washing Etc.

SCHEME OF SEWAGE TREATMENT PLANT: During operation phase the generated waste water will be treated in proposed 30.0 KLD STP based FAB technologyand after post treatment, treated water is used for gardening, D.G. Set cooling, flushing purposes, Sewer washes within the premises.

TREATMENT PROCESS: The sewage treatment plant (Fluidizes Aerobic Bed Reactor- FAB) 30.0 KLD isproposed to be installed to treat the raw sewage.

The process for Sewage Treatment Plant is as follows (Figure 3)

RAW SEWAGE

BAR SCREEN CHAMBER

OIL & GREASE TRAP

RECEIVING SUMP FILTRATE

FLUIDIZED AEROBIC BED FILTER PRESS REACTORS (FAB)

PLATE SETTLER TANK SOLID SLUDGE

TERTIARY TREATMENT (Including U.V Treatment) After Tertiary Treatment pH 6.5-7.5 BOD mg/l <10 TREATED WATER TANK COD mg/l <50 TSS mg/l <10 Oil & Grease NIL Environmental Consultant: M/S Sawen Consultancy Services Pvt. Ltd.,mg/l Lucknow Page | 38

Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh

FOR REUSE SCHEMATIC DIAGRAM OF SEWAGE TREATMENT PLANT (Figure 4)

AEROBIC AEROBIC SCRENNING & REACTOR - I REACTOR - II TUBE SETTLER

OIL / GREASE

Waste Waste Waste Water Water REMOVAL

FLOATING MEDIA V V V V V V V V TERTIARY AIR BLOWERS TREATMENT SLUDGE M FILTER (including U.V AIR treatment) DIFFUSERS PRESS M

TREATED FOR REUSE WATER

TREATMENT PROCESS FOR FAB The sewage is first passed through a Bar Screen Chamber & an Oil & Grease Chamber where any extraneous / floating matter gets trapped. The sewage is then collected in a Receiving Sump where the variations in flow and characteristics are dampened, which otherwise can lead to operational problems and moreover it allows a constant flow rate downstream. Here the sewage is kept in mixed condition by means of coarse air bubble diffusion. The equalized sewage is then pumped to the Fluidized Aerobic Bed Reactors (FAB) where BOD/COD reduction is achieved by virtue of aerobic microbial activities. The FAB reactors run in series. The oxygen required is supplied through coarse air bubble diffusers. The excess bio-solids formed in the biological processes which are separated in the downstream Plate Settler Tank. The clear supernatant is sent to the tertiary treatment section comprising of a Dual Media Filter and an Activated Carbon Filter, and UV disinfections system. If needed Softener shall be provided. The biological sludge generated from the FAB will be passed through filter press where it will be dewatered and form a cake and then used as manure in green area of the block. BENEFITS OF USING FAB TECHNOLOGY Small space requirement The concept of compact sewage treatment plants is promoted so that expensive conventional treatment is dispensed herewith. The treatment scheme is also versatile, in the sense that units can be re-arranged in any which way the space and pile caps are available.

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh Lower operating power requirements The system utilizes aeration tanks of much smaller size, thereby reducing the overall power required in aerating the raw sewage. Since the bio-reactor depth is more, efficient transfer of oxygen takes place, thereby reducing the overall power consumed in treatment. Simplicity in operation and maintenance The system adopted has much less moving parts (only pumps and blowers). Further there is no moving part inside the bio-reactor. This gives the advantage of continuously running the bio- reactor system, under widely fluctuating conditions. All the maintenance on the mechanical systems can be done with normal skilled mechanics available. The system is unique in operation, such that, only inlet and outlet parameters (i.e. raw sewage BOD / COD / TSS /TP and treated sewage BOD / COD / TSS / TP etc.) need to be analyzed. Since the bio-reactor is self-sustaining, there is no requirement of recycling the biomass from the secondary clarifier. Hence, analysis such as MLSS / MLVSS / SVI (sludge volume index) / F / M ratio etc. is not required to be done. This greatly reduces the analytical load on the plant chemist / supervisor, and makes the system very simple to operate and control. The bio-reactor system adopted in the FAB based STP is provided with nutrients removal, and removal of disease causing E-coli bacteria. Nutrient removal The bio-reactor system operates at very food to micro-organisms ratio (F / M ratio). This helps in totally converting the Ammonical nitrogen to nitrate nitrogen. In the process of synthesis of organic substrate, about 40–50% of the total phosphates load is also reduced. The remaining phosphates can be precipitated by addition of aluminum ions dosed in form of Poly Aluminum Chloride (PAC). Phosphates react with aluminum ions and precipitate as aluminum phosphate, which is an insoluble salt. Thus the total phosphates load can be easily reduced by more than 90%. Coliform removal The outlet BOD of the bio-reactor system being very low (in other words, hardly any food is available to the E-coli); most of the coliform are killed in the reactor itself. Remaining coliform are killed by nominal chlorine dosing (of the order of 2–3 mg/l). The treated sewage outlet coliform count will conform to WHO standards, with such low chlorine doses. This will also ensure that there is not much residual chlorine. Sludge handling The sludge generated in the bio-reactors is totally digested. Since the F / M ratio in the bio- reactors is very low, the excess sludge generation is lower than compared to the conventional ASP system. Normally, this sludge is an-aerobically digested to stabilize the organic matter. The present system does not envisage any sludge digestion (since the sludge is aerobically stabilized in the bioreactors itself), making the system more suitable for operation with less manpower. The excess sludge is separated in the secondary clarifier, and then disposed off either on drying beds, or can be directly used as soil conditioner.

EFFLUENT TREATMENT At the project site 82.0 KLD generated wastewater from the Hospital beds and Laboratories will be treated at proposed 105.0 KLD ETP.

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh

PROCESS FLOW DIAGRAM FOR ETP The waste water from Hospital beds and Laboratories will be treated from105.0KLD ETP

OIL & GREASE TRAP

RECEIVING SUMP

FLASH MIXER & FLOCCULATOR CHEMICAL DOSING

TUBE SETTLER TANK

TREATED WATER OUT

SLUDGE DRYING BED FOR REUSE

SLUDGE FOR FURTHER DISPOPSAL

PROCESS DESCRIPTION FOR EFFLUENT TREATMENT PLANT The effluent will be first passed through a Bar Screen Chamber & an Oil & Grease Trap where any extraneous / floating matter would get trapped. The effluent would then be collected in a Receiving Sump where the variations in flow and characteristics are dampened, which otherwise can lead to operational problems and moreover it allows a constant flow rate downstream.

The equalized effluent will then be pumped to the MIXER & FLOCCULATOR where BOD/COD reduction is achieved by virtue of CHEMICAL DOSING. The treated suspended matter formed in the process will be separated in the downstream Tube Settler Tank and then the treated water will be reused for existing green belt within thehospital.

Li Alu me m

To STP Waste Water

From Sludge Drying Hospital Beds

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh

6.1.4 Water Conservation & Augmentation 1. For horticulture, a garden hydrant ring with pumping facilities has been proposed. 2. The sewer shall be treated within housing for bringing down the characteristics of sewer within the norms specified by Ministry of Environment & Forest, Govt. of India for safe disposal. 3. The building shall get piped water supply through an appropriately designed system and no area shall be having any individual system of water supply (i.e. jet pumps, hand pumps, or individual bore well). 4.It is necessary that lakes, ponds and small water storage bodies should be conserved and protected from misuse as well as efficient water harvesting system should be ensured in the development projects. 5. Taps and other water flushing devices including showers used shall be designed to waste less water. 6. Awareness plays a major role in water conservation. Public messages shall be prominently displayed for water conservation. 7. Water leaks shall be tracked and corrected regularly. 8. Dual flush WC (3 – 6 liters instead of 10 liters) shall be used to optimize the water demand.

6.2 RAINWATER HARVESTING

R.C.C.Slab 200 dia over flow to outside 560 dia Cover PLUG 560 dia Cover Drain (as per site)

300

Ground Level 300 SIZE Ground Level PIT DIAMETER = 3000 mm Step Variable (as per site) EFFECTIVE DEPTH = 3000 mm

300 200 dia 230 TK drain 3000 MM dia pipe from desilting Brick Wall / as per Str. Design chamber 3000

600 x 600 x 100 MM R.C.C. Deflector or 345 TK Stone Slab

560 dia M.H.Opening

500 560 dia M.H. Opening Coarse Sand 1.5 to 2 mm

Mesh Gravels 5 to 10 mm 500

500 200 dia over flow to outside 50 – 150 MM Size Boulders Drain (as per site)

Slotted Pipe or 1 MM V.Wire 200 dia LCG Johnson Screen Brick Wall drain 250 to 300 mm dia Bore Filled pipe from With Pea Gravels (3 – 6 MM) desilting chamber 16 mm dia PVC Pipe

Slotted Pipe or 1 mm V.Wire

PLAN OF RECHARGE PIT LDG Johnson Screen Depth Variable per as water table

1000 MM 1000 Bail Plug

RECHARGE PIT

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh

RAIN WATER HARVESTING :

F O R T H E E X I S T I N G : Total Volume Of Rain Water available for Rain Water Harvesting = 957.49 m3 Total quantum of rain water for 0.25 hr = 957.49 m 3/4 = 239.37 m3 The required dimension of pit = 44 m x 4 m x 3 m Total required Nos of Pits = 239.37 / 48 = 05 Nos. TOTAL EXISTING NUMBERS OF RAIN WATER HARVESTING PITS . = 05

PROPOSED EXPANSION : Of The Emergency Medicine Unit At S.G.P.G.I. Lucknow. Table 7.QUANTUM OF RAINWATER AVAILABLE FOR HARVEST FOR THE EMERGENCY MEDICINE UNIT AT S.G.P.G.I. :

Description Area Harvesting Average Annual Total Volume of of Area considered Factor or Rainfall intensity Water available for (m2) Collection (mm) Rain Water Efficiency harvesting (m3) 1. Roof-top 10552.00m2 0.8 25 mm 211.04m3/hr. Surfaces Grand Total 211.04 m3/hr. Total quantum of rainwater for 0.25 hr. = 211.04 m3/4 = 52.76 m3 The required dimensions of pit = 3m × 6 m × 3 m=54m3 Total required nos. of pits = 52.76/54= 0.977(Say 01 Recharge Pit) The total no. of rainwater harvesting pit shall be 01with dimensions of 3 m ×6 m × 3m at peak rainfall intensity of 25 mm. Proposed Rain Water Harvesting Pits For The Proposed Expansion Of Emergency Medicine Unit At S.G.P.G.I. = 01 Nos.

SO THE TOTAL NUMBER OF RAIN WATER HASVESTING PITS WOULD BE 05 Nos ( Existing ) + 01 No.(Proposed ) = 06 Nos. in Total.

Benefits of rain water harvesting:- In urban areas, the construction of houses, footpaths, and roads has left little exposed earth for water to soak in. In parts of the rural areas of India, floodwater quickly flows to the rivers, which then dry up soon after the rains stop. If this water can be held back, it can seep into the ground and recharge the ground water supply. This has become a very popular method of conserving water especially in the urban areas. Rainwater harvesting essentially means collecting rainwater

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh on the roofs of building and storing it underground for later use. Not only does this recharging arrest groundwater depletion, it also raises the declining water table and can help augment water supply. Rainwater harvesting and artificial recharging are becoming very important issues. It is essential to stop the decline in groundwater levels, arrest sea-water ingress, i.e. prevent sea-water from moving landward, and conserve surface water run-off during the rainy season. Town planners and civic authority in many cities in India are introducing bylaws making rainwater harvesting compulsory in all new structures. All you need for a water harvesting system is rain, and a place to collect it! Typically, rain is collected on rooftops and other surfaces, and the water is carried down to where it can be used immediately or stored. You can direct water run-off from this surface to plants, trees, or lawns or even to the aquifer. Some of the benefits of rainwater harvesting are as follows:  Increases water availability  Checks the declining water table  Is environmentally friendly  Improves the quality of groundwater through the dilution of fluoride, nitrate, and salinity  Prevents soil erosion and flooding especially in urban areas.

6.2. AIR POLLUTION CONTROL:

During construction,to reduce impacts of dust , enclosure walls with a height of 2 meters or above will be built around the construction site where on – site mixing will be done , cement , lime powder, and other construction materials shall be stored at storage yard or tightly covered spaces, discrete material such as sand and soil will be covered, the building materials to be loaded, unloaded and / or handled shall be covered, closed or sprinkled, and none of them shall be thrown or spread into the air; a water ditch with a width of 3.5 m and a length of 10 m and depth of 0.20 m shall be made at the exit to and from the construction site , in which crushed stones with a diameter of 50 mm will be laid, so as to reduce the amount of earth on tires of vehicles to and fro from the construction site; covers to be provided on materials which will require transportation or they will be transported in closed vehicles. The transporting trucks and vehicles shall be, enrouted avoiding residential areas and other environmentally sensitive areas, and vehicle speed shall also be limited.

During operation, the only source of air pollution is DG sets emissions. Hence a proper stack height has to be provided above roof top of buildings Exhaust height: In order to dispose emissions above building height, minimum exhaust stack height would be as follows: Minimum stack height for D.G. Set: H = h + 0.2 × √KVA Where, H = stack height of D.G. Set h = height of Building H = h + 0.2 × √ 500KVA ( 2 DG Set of 250 KVA each ) = h + 0.2 x 22.36 m = h + 4.47 m

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh = ACumulative stack height of 4,47 m 2nos. DG Sets of 250 KVAeach capacity shall be installed. For which cumulative stack height of 4.47m is being proposed above the tallest building. In the proposed project D.G set, will be supplied with acoustic enclosure as per CPCB norms.

Indoor Environmental Requirements And Compliances:

 Lighting load as per space function/building area of ECBC Norms  Ventilations for fresh air.  Hospital treatment area 2 air changes per hour / 15 CFM per person whichever is more.  Operation theatre air changes per hour as per NBC – 2005  ICU air changes per hour as per NBC – 2005  Clean corridor air changes per hour as per NBC – 2005.  Equipment load for Hospital treatment area , OTs and ICU as p[er BIS code / ISHRAE.  Glazing as per ECBC / GHIRA.

6.3 SOLID WASTE MANAGEMENT

6.3.1MUNICIPAL SOLID WASTE

F O R T H E E X I S T I N G :

TOTAL MUNICIPAL SOLID WASTE FOR THE EXISTING

Type of Waste Colour Category Disposal Total Waste of Method (Kg/ day) Bins Municipal Solid 45.65 Organics Green Bio Degradable Waste Site Paper Metals Glass Blue Recyclable Approved 10.79 Textiles Recycler Plastic Non-Bio Municipal Solid 26.56

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh Ash & Dust Grey degradable waste Site Total 83.0

MUNICIPAL SOLID WASTE FOR EXISTING FLOATING POPULATION Population Category Total Bio- Recyclable Non-Biodegradable Waste degradable Nos. Floating Kg/ day Kg/day Kg/ Day Kg/ Day 200 Visitors 30 15.0 5.4 9.6

Municipal Solid Wastefrom the existing is 83.00 Kg / Day + 30.00 Kg / Day (from Floating Population) = 113.00 Kg / Day.

PROPOSED EXPANSION: Of The Emergency Medicine Unitat S.G.P.G.I. Municipal Solid Waste for the Emergency Medicine Unit at SGPGI, Lucknowissummarized in tables given below. Table 8:MUNICIPAL SOLID WASTE ( EMERGENCY MEDICINE UNIT )

Type of Waste Colour Category Disposal Total Waste of Method (Kg/ day) Bins Municipal Solid 105.75 Organics Green Bio Degradable Waste Site Paper Metals Glass Blue Recyclable Approved 38.07 Textiles Recycler Plastic Non-Bio Municipal Solid 67.68 Ash & Dust Grey degradable waste Site

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh Total 211.5

Table 9: MSW Generated from Floating Population( @ 0.15 Kg/Day) Emergency Medicine Unit Population Category Total Bio- Recyclable Non-Biodegradable Waste degradable Nos. Floating Kg/ day Kg/day Kg/ Day Kg/ Day 400 Visitors 60 30.0 10.8 19.2

Total expected MSW at the Proposed Emergency Medicine Unit : 211.5 + 60.0 ( from Floating Population) = 271.5 Kg/day. The solid waste shall be segregated and collected as per the above scheme. These bins will be emptied into the main bin of the floor for which 1 no. of transit center is available. Service provider will collect the garbage and waste shall be discharged to main bin of Nagar Palika. The service provider carries this waste for recycling and rest to the municipal solid waste site. The management shall engage a vendor & they will dispose the waste at the proposed site identified by the concerned management.

SO THE TOTAL MUNICIPAL SOLID WASTE FOR THE EXISTING & THE PROPOSED COMES TO 113.00 Kg / Day ( From Existing ) + 271.50 Kg / Day ( From Proposed ) = 384.5 Kg / Day.

6.3.2 BIO – MEDICAL WASTE MANAGEMENT:

Hospital Waste Management

Non- Hazardous Waste Hazardous Biomedical Waste (Municipal Solid Waste)

Municipal Bin Segregation, Disinfection, Packaging, Labeling and storage at Source by Hospital Block Hospital

Transportation Transportation of BMW to treatment facility By service provider

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh

Disposal in Landfill Treatment of Hospital Waste by service provider

Safe disposal of Waste

6.3.3 BIO – MEDICAL WASTE:

FOR THE EXISTING : The Bio-Medical waste generation at the existing site is taken as 5 Kg /Day on Lumpsum basis.This waste would include mainly waste cotton and swags Syringes and empty eye drop bottles and other waste generated in the Ophthalmic Unit.

PROPOSED EXPANSION: Of Emergency Medicine Unit At S.G.P.G.I. LUCKNOW. The proposed Emergency Medicine Unit will be equipped with a total of 210 beds. The Bio-Medical waste generated is being given below in a tabulated form. Table – 10 Bio – Medical Waste Total No. of Hospital Beds = 210 Waste Generation Rate = 0.28 Kg/Bed Total Bio – Medical Waste Generated = 58.8 Kg/day

THE BIO – MEDICAL WASTE GENERATION FORM THE EXISTING AND THE PROPOSED EXPANSION OF EMERGENCY MEDICINE UNIT AT S.G.P.G.I. LUCKNOW = 5Kg/Day(Existing) 58.8 Kg/Day(Proposed) = 63.8 Kg/Day

CLASSIFICATION & CATEGORIZATION OF BIO – MEDICAL WASTE : Hospital waste generated during diagnosis, treatment, immunization of human beings may include waste like sharps, soiled waste, disposables, anatomical waste, cultures, discarded medicines, chemical waste etc. These are in the form of disposable syringes, swabs, bandages, body fluids, human excreta etc. This waste is highly infectious and can be a serious threat to human health if not managed in a scientific manner properly. About 0.28 Kg/Bed of rate of biomedical waste is expected to be generated from the Hospital Block which will be collected as per BMW Handling Rules and then given to UPPCB approved service provider. The World Health Organization (WHO) has classified medical waste into eight categories: 1. General Waste 2. Pathological

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh 3. Radioactive 4. Chemical 5. Infectious to potentially infectious waste 6. Sharps 7. Pharmaceuticals 8. Pressurized containers Table 10: Biomedical Waste Categorization Schedule 1: Categories of Bio-Medical Waste Waste Category Waste Category Type Treatment and Disposal Options Category No.1 Human Anatomical Waste (body parts, organs, Incineration @/ deep burial* human tissues etc.) Category No.2 Animal Waste (animal tissues, organs, body Incineration @/ deep burial* parts carcasses, bleeding parts, fluid, blood and experimental animals used in research, waste generated by veterinary hospitals, colleges, discharge from hospitals, animal houses) Category No.3 Microbiology & Biotechnology Waste (waste Local Autoclaving / micro waving/ from laboratory cultures, stocks or micro- incineration@ organism live or vaccines, human and animal cell culture used in research and infectious agents from research and industrial laboratories, waste from production of biological, toxins, dishes, and devices used for transfer of cultures). Category No.4 Waste Sharps (needles,syringes.Scalpels Disinfection (chemical treatment @ blade, glass, etc. that may cause puncture and @/autoclaving/ micro waving and cuts. This includes both used and unused mutilation/ shredding## sharps).

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh Category No.5 Discarded Medicines and Cytotoxic drugs Incineration @ / destruction and drugs (waste comprising of outdated, contaminated, disposal in secured landfills and discarded medicines). Category No.6 Soiled Waste (items contaminated with blood, Local autoclaving/microwaving/ and body fluids including cotton, dressing, incineration @ soiled plaster casts, lines, bedding, other material contaminated with blood). Category No.7 Solid Waste (waste generated from disposal Disinfection by chemical treatment @ items other than the sharps such as tubing, autoclaving / micro waving and catheters, intravenous, etc.) mutilation. Shredding # Category No.8 Liquid Waste (waste generated from Disinfection by chemical treatment laboratory and washing, cleaning, @and discharged into drains housekeeping and disinfecting activities). Category No.9 Incineration ash (Ash from incineration of any Disposal in municipal landfill bio-medical waste). Category No.10 Chemical Waste (chemical used in production Disinfection by chemical treatment @@ of biological, chemicals, used in disinfection as and discharged into drains for liquids insecticides, etc.) and secured landfill for solids. Note @ There will be no chemical pretreatment before incineration. Chlorinated plastics shall not be incinerated. *Deep burial shall be an option available only in towns with population less than five lakh and in rural areas. @ Chemicals treatment using at least 1% hypochlorite solution or any other equivalent chemical reagent. It must be ensured that chemical treatment ensures disinfection. # Mutilation / Shredding must be such so as to prevent unauthorized reuse. The biomedical waste generation for Emergency Medicine Unit willbe around 58.8 Kg/Day. This waste shall be given to CPCB approved recycler/ service provide.

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh

Schedule II : COLOR CODING SYSTEM Color Coding Type of Waste category Transportation Treatment option/ container disposal Yellow Plastic Bag Human Red Wheel Incineration/ Deep Anatomical Waste, Chair / local Burial Discarded body medicines, Cytotoxic drugs Red Disinfected Microbiology & Red Wheel Autoclaving / Micro- Container / Biotechnology, Chair / local waving / Chemical Plastic Bag toxins, soiled body Treatment waste (contaminated with blood & Body fluids, plaster, cotton, dress), Solid Wastes (Disposables) Blue/ White Puncture Proof Waste Sharps In Garbage Autoclaving / Micro- Cont Trolley waving / chemical treatment and destruction & shredding Black Plastic Bag Bio Incinerator ash In Garbage Disposal in secured degrade (sec landfill), Trolley landfill – Bio

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh Chemical Waste degradable – vermin- (neutralize), composting / Household / composting kitchen waste

Table. 11. – Bio- Medical Waste Categories ,Treatment And Disposal

CATEGORY TYPE OF WASTE TYPE OF TREATMENT AND DISPOSAL BAG OR OPTIONS CONTAINER TO BE USED YELLOW (A)Human Anatomical Wastes: Yellow Incineration or Plasma Human tissues, organs body parts coloured Pyrolysis or deep Burial and fetus below the viability non- period(as per medical termination chlorinated of Pregnancy Act 1971. Amended plastic bags from time to time). . (B)Soiled Waste :Items Incineration or Plasma contaminated with blood , body Pyrolysis or deep Burial. In fluids like dressings, plaster casts, absence of above facilities cotton swabs and bags containing Autoclaving or residual or discarded blood and microwaving/hydroclaving blood components. followed by shredding or mutilation or combustion of sterilization and shredding.

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh Treated waste to be sent for energy recovery. (C)Expired Or Discarded Medicines Yellow Expired cytotoxic drugs and :Pharmaceutical waste like Coloured items contaminated with antibiotics, cytotoxic drugs non- cytotoxic drugs to be including all items contaminated chlorinated returned back to the with cytotoxic drugs along with plastic bags manufacturer or supplier for plastic ampules, vials etc. or incineration at temperature . containers 1200 0C or to common bio – medical waste treatment facility of hazarduous waste treatment , storage and disposal facility for incineration at , 12000 C or Encapsulation or Plasma Pyrolysis at < 12000 C. All other discarded medicines shall be either sent back to manufacturer or disposed by incineration. (D)Chemical Waste :Chemicals Yellow Disposed off by incineration used in production of biological coloured or plasma Pyrolysis or and used or discarded containers Encapsulation in hazarduous disinfectants. or non- waste treatment, storage and chlorinated disposal facility. plastic bags (E) Chemical Liquid Waste :Liquid Separate After resource recovery, the

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh wastegenerated due to use o0f collection chemical liquid waste shall be chemicals in production of system pre- treated before mixing biological and used or discarded leading to with other waste water. The disinfectants, Silver X – ray film effluent combined discharge shall developing liquid discarded treatment conform to the discharge Formalin, infected system. norms given in Schedule – III. secretionsaspirated body fluids, liquid from laboratories and floor washings, cleaning, house-keeping and disinfecting activities etc., (F)Wastes (House Keeping Non- Non-chlorinated chemical Material) :Discarded Linen chlorinated disinfection followed by bedsheets pillow covers , Yellow incineration or Plasma matresses,beddings and blankets plastic bags Pyrolysis or for energy etc. contaminated with blood or or suitable recovery. In absence of above body fluids. packing facilities , shredding or material. mutilation or combination of sterilization and shredding . Treated waste to be sent for energy recovery or incineration or Plasma Pyrolysis.

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh (G) Micro-biologyBiotechnology Autoclave Pre – treat to sterilize with and other clinical laboratory waste: safe plastic non-chlorinated chemicals on Blood bags, Laboratory cultures , bags or site as per National AIDS stocks or specimenof micro containers Control Organisation or organisms live or attenuated World Health Organisation vaccines, human and animal cell guidelines thereafter for cultures used in research, industrial incineration. laboratories, production of biological, residual toxins, dishes and devices used for cultures. RED Contaminated Wastes ( Red Autoclaving or microwaving/ Recyclable ) : coloured hydroclaving followed by (a) Waste generated from non- shredding or mutilation or disposable items such as tubing, chlorinated combination of sterilization bottles, intravenous tubes and plastic bags and shredding . Treated sets, catheters, urine bags, syringes or waste to be sent to registered (without needles and fixed needle containers. or authorised recyclers or for syringes) and vaccutainers with e3nergy recovery or plastics their needles cut and gloves. to to diesel or fuel oil or for road making. Whichever is possible . Plastic waste should not be send to landfill sites. WHITE Waste Sharps Including Metals : Punchure Autoclaving or dry Dry Heat (Translucent) Needles, syringes with fixed proof, leak Sterilization followed by needles, needles from needle tip proof, shredding mutilation or cutter or burner . scalpels, blades tamper encapsulation in metal or any other contaminated sharp proof container or cement concrete

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh object that may cause puncture containers ; combination of shredding and cuts. This includes both used, cum autoclaving ; and sent discarded and contaminated metal for final disposal to iron sharps. foundaries(having consent to operate from the State Pollution Control Boards or Pollution Committees or sanitary land fill or designated concrete waste sharp pit. BLUE (a)Glassware : Cardboard Disinfection (by soaking the Broken or discarded and boxes with washed glass waste after contaminated glass including blue cleaning with detergent and medicine vials and ampules except coloured Sodium Hypochlorite those contaminated with cytotoxic marking treatment) or through wastes. autoclaving or microwaving or hydroclaving and then sent for recycling. (b) Metallic Body Implants Cardboard boxes with blue coloured marking

 Disposal by deep burial is permitted only in rural or remote areas where there is no access to common bio-medical waste treatment facility. This will be carried out with prior approval from the prescribed authority and as per the the standards specified in Schedule – III . The deep burial facility shall be located as per the provisions and guidelines issued by Central Pollution Control Board from time to time.

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh

THE BIO-MEDICAL WASTE GENERATION FOR THE EXISTING AND THE PROPSED EXPANSION Of THE EMERGENCY MEDICINE UNIT AT S.G.P.G.I. LUCKNOW , COMES TO AROUND 63.8 KG/DAY (Existing Opthalmic Unit = 5 Kg/Day (Lumpsum) & The Proposed Emergency Medicine Unit = 58.8 Kg/Day).

Deep burial may be proposed if no vender is finalized by the S.G.P.G.I. Governing Body or Management.

PART – 2: 1. All plastic bags shall be as per BIS Standards. 2. Chemical treatment using 10 % Sodium Hypochlorite with 30 % residual chlorine, for 20 minutes , or any other equivalent chemical or reagent which can demonstrate Log 104 reduction efficiency for micro organisms as given in Schedule – III. 3. Mutilation or shredding must to an extent to prevent unauthorized reuse. 4. No Chemical pre- treatment is proposed before incineration , except for the micro – biological , lab. And highly infectious wastes. 5. Incineration ash ( ash from incineration of any bio-medical waste ) shall be disposed through hazarduous waste treatment, storage and disposal facility, if toxic or hazarduous constituents are present beyond the prescribed limits as given in the Hazarduous Waste ( Management, Handling and Transboundary Movement) Rules, 2008 or as revised from time to time. 6. Dead foetus 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 anddispoisal facility in yellow bags with a copy of the Medical Termination Of Pregnancy Certificate from the Obstetrician or the Medical Superintendent of Hospital or Healthcare Establishment. 7. Cytotoxic drug vials shall not be handed to unauthorized persons or vendors at any circumustances. 8. These shall be sent back to the manufacturers for necessary disposal at a single point. As a second option , these way be sent for incineration at common bio-medical waste treatment and disposal facility or TSDFs or Plasma pyrolysis at temperature<12000 C . 9. Residual or discarded chemical wastes, used or discarded disinfectants and chemical sludge can be disposed at hazarduous waste treatment , storage and disposal facility. In such case, the waste should be sent to hazarduous waste treatment,, storage and disposal; facility through operator of common bio – medical waste treatment and disposal facility only. 10. On-site pre-treatment of laboratory waste , micro-biological waste, blood samples, blood bags should be disinfected or sterilized as per Guidelines Of The World Health Organisation or National AIDS Control Organisation and then Given to the common Bio- medical waste treatment and disposal facility.

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh 11. Installation of In-house incinerator is not allowed . However in case other is no common bio-medical facility nearby , the same may be installed by the occupier after taking authorisation from the State Pollution Control Board. 12. 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 occupier is not linked to a disposal facility it shall be the responsibility of the occupier to sterilize and dispose in the4 manner prescribed. 13. Bioi-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. 14. 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 the final disposal in the manner as prescribed in this Schedule.

Procedure of Bio-Medical Waste Disposal

Generation of Waste

Segregation at source

Collection of Waste

Transportation Autoclaving & shredding Treatment

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh Incineration

Wet Thermal Technology (Autoclave)

This technology utilizes saturated steam within a pressure vessel at temperature sufficient to kill infectious agents in the waste. Infectious waste with low density is more amenable for autoclaving. High density wastes such as large body part inhibits direct steam penetration and is not conducive for auto-calving. Low density plastics bags may be placed in a rigid container prior to autoclaving in order to prevent rupture of bags and consequent spillage of materials.

6.3.4 STANDARDS FOR WASTE AUTOCLAVING: 1. The autoclave should be dedicated for the purposes of disinfecting and treating bio-medical waste, A. When operating a gravity flow autoclave, medical waste shall be subjected to: (i) Temperature of not less than 1210 C and pressure of 15 pounds per square inch (PSI) for an autoclave residence time of not less than 60 minutes; or (ii) A temperature of not less than 1350 C and a pressure of 31 PSI for an autoclave residence time of not less than 45 minutes; or (iii) A temperature of not less than 1490C and a pressure of 52 PSI for an autoclave residence time of not less than 30 minutes.

(B) When operating a vacuum autoclave, medical waste shall be subjected to a minimum of one pre-vacuum pulse to purge the autoclave of all air. The waste shall be subjected to the following:

(i) a temperature of not less than 1210 C and pressure of 15 PSI per an autoclave residence time of not less than 45 minutes; or

(ii) A temperature of not less than 1350 C and a pressure of 31 PSI for an autoclave residence time of not less than 30 minutes;

(C) Medical waste shall not be considered 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.

(D) Recording of operational parameters Each autoclave shall have graphic or computer recording devices which will automatically and continuously monitor and record dates, time of day, load identification number and operating parameters throughout the entire length of the autoclave cycle.

(E) Validation test

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh 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 Bacillus stearothermophilus spores using vials or spore Strips; with at least 1X104 spores per milliliter. Under no circumstances will an autoclave have minimum operating parameters less than a residence time of 30 minutes, regardless of temperature and pressure, a temperature less than 1210 C or a pressure less than 15 psi.

(F) Routine Test

A chemical indicator strip/tape the changes color 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 location to ensure that the inner content of the package has been adequately autoclaved

6.3.5WASTE IN BLUE BAGS/ CONTAINERS: As per the BMW, 1998 (amended 2016) after Chemical Treatment & destruction this category of waste can be disposed off. In this category main constituent is needles, which should be destroyed before chemical treatment. There are two types of needle destroyer available in the market: Manual cutter Electric needle destroyer After needle destruction it should be dipped in container consisting of 1% hypo. After this sharp part shall be segregated from plastic part for disposal. Disinfected waste will be treated by steam sterilization or incineration before landfill disposal. Incineration Ash (Ash from incineration of any bio-medical waste) will be disposed in municipal landfill.

6.3.6 SEGREGATION OF WASTE It should be done at the site of generation of bio- medical waste, e.g. all patient care activity areas, diagnostic services areas, operation theatre labor rooms, treatment rooms, etc,. The responsibility of segregation would be with the generator of biomedical waste i.e. doctors, Nurses, Technicians, etc. the Bio medical waste would be segregated as per categories applicable. The collection bags and the containers would be labeled as per guideline of Schedule III, i.e. symbols for bio-hazard and cytotoxic. Those plastics bags which contain liquid like blood, urine, pus, etc, would be put into red color bag for microwaving and autoclaving and other items would be put into blue or white bag after chemical treatment and mutilation / shredding.

6.3.7 Hazardous & Electronic Waste Management Hazardous waste is a waste with properties that make it dangerous or potentially harmful to human health or the environment. Hazardous wastes can be liquids, solids, contained gases, or sludge‘s and even from compute at offices, simply discarded commercial products, likecleaning fluids or pesticides. All hazardous waste are required to be treated and disposed off in the prescribed manner. The main objective is to promote safe management and use of

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh hazardous substances including hazardous chemicals and hazardous wastes, in order to avoid damage to health and environment.As regards hazardous waste may generate at the hospitalbuilding, it shall be collected and stored as per the guidelines under Hazardous Waste Management & Handling Rules, 2016. The hazardous waste shall be disposed off to the approved recycler/ service provider of UPPCB.

Table 12: Hazardous Waste Type of Waste Color of Bins Disposal Method Total Waste Used Oil Black with Label Approved Service 2.0 kg/day Provider as per HWM 2016 Electronic Black with Label Approved Service 1.78 kg/day Battery Provider as per HWM 2016 Total 3.78 kg/day

The solid waste shall be segregated and collected as per the above scheme. These bins will be emptied into the main bin of the floor for which 1 no. of transit center is available. Service provider will collect the garbage and waste shall be discharged to main bin of District Administration. The red and green bins shall be picked up on the instructions of District Administration for disposal. The service provider carries this waste for recycling and rest to the municipal solid waste site. The management shall engage a vendor & they will dispose the waste at the proposed site identified by the concerned management.

6.4 NOISE ENVIRONMENT: The main sources of pollution would be four wheeler and two wheeler vehicle movement within the premises. However other known and anticipated sources of noise are :  Approach roads and other nearby highways.  Equipment, Monitors, AC and DG set etc.  Alarms and Horns.  Carts Noise  Electronic Hole Punch  Cardex machine  TV Noise.  Patient Moves.  Staff Noise.  Vocera Tube system.  Talking and Conversations (Staff, patient, visitors – loud voices

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh  General AQctivity  Overhead paging  Shared room noise.  Others – Slamming doors, cleaning, nurse calls, elevators etc.

Impacts Of High Noise Levels On Patients :  Annoyance  Sleep disturbance to insomnia.  Decreased oxygen saturation , elevated blood pressures, increased heart beats and respiration rate among neonatal intensive care patients.  Decreased rate of wound healing  Higher incidences of re – hospitalization.

Impacts Of Noise On Staff: Noise can be a source of stress for hospital and may interfere with their ability to work effectively.  Increased perceived work pressure, stress and annoyance.  Increased fatigue.  Emotional exhaustion and burnout and drained energy level.  Difficulty in communication , possibly leading to errors.

The Noise Control &Management ofIssues would Involve :

1. Architectural Approach:By installing sound – absorbing ceiling tiles and designing all single rooms. 2. New Materials : By re3piacing overhead paging with cell phones or wireless communication devices carried by staff, removing the sources of loud noises such as ice machines from the unit, turning off equipment when not in use, conducting group conversations in an enclosed space, and educating staff about the importance of talking quietly and maintaining a quiet environment. 3. Active and passive noise control.

Impacts Of Traffic Management: Traffic management is a systematic planning and implementation and control of transportation services for achieving the desired objectives and also to reduce the noise level in anyparticular project. The project proponent shall be responsible for managing all parking and its safety issues regarding the use of vehicles inside premises of proposed project area.To reduce the noise level , it will be ensured that the traffic movement must be smooth with strict restrictions on the use of horns.In order to avoid traffic congestion and facilitate proper parking the incoming and out going gates will be kept different.The traffic manager and all persons involved with the parking activities shall undergo traffic management training.A good traffic control system shall be set up and the following standards shall be maintained for the parking areas. All vehicles of the staff will have a permanently affixed parking sticker on the drivers side on the rear screen/back window and allotted a specific permanent spot in the parking lot.

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh All vehicles of the staff need to be parked in theirrespective designated parking spots Vehicles should be allowed to enter in the parking space from the Entry gate only and leave from the Exit gate. No vehicle will be allowed to park in the fire tender movement areas. All vehicles which donot belong to the staff will not be allowed to enter into the space designated for parking staff owned vehicles. All who disregard the parking policies or break the laid down norms shall be subjected to fine, or loss of parking previlages. in any case no vehicle shall be allowedto keep standing or in wait after dropping the patient. Such vehicles will have to go for the parking space or will have to leave the premises after dropping the patient.

Speed Limits : Aspeed limit of 20 Kmphis considered safe for movement of vehicles and persons on a road and 10 -15 Kmph speed in parking lots.

6.5 LANDSCAPING & HORTICULTURE Natural landscaping is also referred to as sustainable landscaping. It stresses the use of native plants that are beautiful, hardy and that also benefit the local environment. Native plants are especially good at preventing soil erosion, reducing flooding, sustaining wildlife and filtering out harmful pollutants in the soil. Natural landscaping offers a way to reduce the use of chemical pesticides and fertilizers, while introducing natural techniques that are safer for the long-term health of the community. The Landscaping Proposed on 16706.07m2 area. Details/ Distribution of Tree Plantation The greater part of the district is coverved with extensive forest. Trees:Madhuca indica Gmeli, Justicia adhatoda Nees, Ficus glomerata Roxb, Ficus benghalensi, Emblica officinalis Gaertn. Shrubs: Linn, Lantana camara Linn,Desmodium gangeticum,Carissa Carandus Linn. Herbs:Linum usitatissimum Linn, Leucas aspera (Willd.) Link, Launaea, asplenifolia, Evolvulus alsinoides Li, Euphorbia hirta Linn. Initially grassing would be done with doob grass including watering and maintenance of the lawn for 30 days or more till the grass forms a thick lawn. The project proponent hasproposed for landscaping in an area of 16706.07m2 with ornamental plants and trees to maintainaesthetic environment in area of the proposed project. The proposed project will have various trees/ornamental plants to be planted all over the landscape area. Plantation of avenue trees by the road side in 0.60 m dia. holes, 1 m deep dug in the ground shall be done and mixing the soil with decayed farm yard manure.

6.5.1Water-efficient landscaping Landscaping water usage can easily account for 20% or more of facility water consumption, and is a key area to target for water use savings. There are three major components to designing a water-efficient landscape for a new facility: 1) Reduce the amount of turf and other irrigated areas

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh 2) Ensure water-efficient design of irrigation systems, and 3) specify native or climate appropriate landscape materials. Reducing the amount of turf grass and overall irrigated areas will reduce water consumption and associated costs, and will result in time and money savings from mowing, fertilizing, waste removal, and maintenance. Remaining landscape areas that require irrigation should utilize water-efficient irrigation systems (low-flow sprinkler heads, efficient system design and layout, and optimized irrigation schedules and controls) to minimize water use and maximize plant health. Utilizing Xeriscape strategies whenever practicable will save on water, fertilizer, pruning, maintenance, labor, and overall costs.

CORPORATE SOCIAL RESPONSIBILITY CSR Budget Proposed: Rs 3.44 Lakh (> 2 %) Table With CSR Budget Details: S.No Activity Proposed Budget Beneficiary Allocation 1 Construction of Village Mahavir Nagar Latrines with soak Community : Rs.11.4 Lacs pit and Handpump Verification authority/ Facility Agency- Gram Panchayat 2 Development of Women population of Toilets for Rural Village Mahavir Nagar women-04 Rs. 11.4 Lacs Verification authority/ Agency- Gram Panchayat 3 Development of School students water tanks & Village Mahavir Nagar Distribution of Rs. 11.4 Lacs Verification authority/ books in primary Agency- Gram Panchayat school 4 Development of Village Mahavir Nagar Waste Bins in Rs. 11.4 Lacs Population Village Agency-Gram Panchayat

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh

CHAPTER7: EMERGENCY PREPAREDNESS PLAN

8.1 FIRE FIGHTING As most of the material and finished products are inflammable, no smoking and no fire will be allowed. In case of fire, fire extinguisher will be used. Fire extinguishers are put at the entrance of storage rooms. The Fire Extinguisher System has been provided as per fire safety plan in all floors of the building. The phone number of nearest fire service stations has been displayed at various points and also near the fire extinguishers. The proposed project is to provide with fire protection arrangements such as Wet Riser system (as per N.B.C standards), Hose Reel (as per I.S – 3844 standards), Yard Hydrant and Automatic Sprinkler System in every building. Manual call points, Automatic Detection System in every building, portable appliance, Exit signs, P. A. System, Mechanical Ventilation, Smoke extraction system, Pressurization shafts, staircase etc. for fire safely point view.  Fire Detection and Alarm system is proposed as per Fire Detection and Alarm system is proposed as per N.B.C. 2016, applicable Standards and Local Fire Regulations so that in case of fire in any area it can be immediately detected and required measures can be taken to fight it.

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh  Fire Detection and Alarm system is proposed so that in case of fire in any area it can be immediately detected and required measures can be taken to fight it. On the floors Detectors shall be provided in all the Common Areas.  Intelligent Addressable Fire Detection and Alarm system is proposed in which all detectors are addressable which means that in case of fire .the fire panel shall be able to pinpoint exact location of fire with the help of displaying exact address of each detector, whereas in case of Conventional system we come to know only about the zone. In this system response indicators are not required. This is an expensive system as compared to conventional system. Integrated Digital Evacuation system comprising speakers, amplifier, shall be provided. The speakers shall be installed in all the common areas. This system is required in order to make emergency announcements in case of fire or any other emergency. 1. Access: It must be ensured that the access roads all around the building must be kept clear all the time for free movement of fire engines and 4.5 m head clearance shall be provided. The access internal road shall be provided as per approved plan. 2. Exit Requirements: Exit requirements shall be in accordance with provision as per National Building Code of India Part – IV (Clause 8.1 to 8.15.1). (a) Means of escape/exit shall be continuous and unobstructed way of exit travel from any point in the building to a public way. All exit doorways shall open towards means of escape that is away from, but shall not obstruct the travel along any exit. No door when opened shall reduce the required width of staircase/corridor/passage way. (b) All exit and exit way marking signs, emergency lights shall be on separate circuit/laid in separate conduit, exit signs must be illuminated and wired to independent circuit supplied by alternate source of power supply. The wiring and all accessories in the electrical circuit shall be fire resistant and low smoke material duly ISI marked. 3. Material for construction: The material used for construction of the building shall be of non- combustible. The interior finish materials shall be of very low flame spread ability, i.e. Class-I. All the fabric used for seats, curtain, covering on sidewall, matting carpeting etc. shall also have Class-I rating as prescribed in NBC part-IV. 4. Compartmentalization: The building shall be suitably compartmentalized so that the fire/smoke remain confined to the area where fire incidents has occurred and mechanically exhausted as approved in the meeting, so smoke does not spread to the remaining part of the building. The services, standby generator, store etc. must be segregated from other by erecting fire- resisting wall of not less than 2 hours rating. Each of the compartments must be individually ventilated and the opening for entry into each of these compartments must be fitted with self- closing fire/smoke check doors of not less than one hour fire rating fitted with magnetic latches. All electric cables shall be laid in separate shafts shall be sealed at every floor with fire resisting material of similar rating. The partition wall in between and all around the shafts shall also be of minimum two hours fire rating. Under no circumstances, two services shall pass through the same shaft, i.e. separate shaft be used for different purpose. The entry to the staircase from all levels shall be segregated with a self-closing fire/smoke check door of not less than 1 hour fire rating. All vertical and horizontal opening at each floor level in entire building shall be sealed properly with the non-combustible material. Wherever false

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh ceiling/suspended ceiling is provided, the same shall be of non-combustible in nature and that the compartmentalization shall be extended up to ceiling level. 5. Ventilation: The building shall be provided with the ventilation strictly in accordance with Part-VIII Section-I and Clause D-1.6 of Part IV of National Building Code of India Mechanical ventilation system having interlocking arrangements as well as upper floor also. Extractor system shall be designed to permit 30 air changes per hour in case of fire in basement. The smoke extraction system shall be designed as per NBC Part-IV and approved by the department. 6. Air Conditioning System: Air conditioning system shall conform to Section-3 Part-VIII and Clause D-1.17 of Part-IV National Building code of India 1983. Following points shall be ensured.  All ducting shall be constructed of substantial gauge metal conforming to IS: 655. Air duct serving main floor areas, corridors etc. shall not pass through the staircases enclosures.  Automatic fire dampers shall be provided in the ducts at the inlets of the fresh air and return air of each compartment/floor.  Automatic fire dampers shall be closed automatically upon operation of a detector sprinkler.  The air ducts for every floor/compartment shall be separated. In no way inter-connected with the ducting of any other compartment  Under no circumstances, plenum shall be used as ―Return Air Passage‖ for air conditioning purposes. 7. Essential Emergency Electrical Services: Separate electrical circuits to feed emergency services such as firefighting pumps, lifts, staircase and corridor lighting blowers, panel and such a smoke venting and signage circuit shall be laid in separate conduit so that fire in one circuit will not affect the others. Master switches controlling essential services circuits shall be clearly labeled. The electrical wiring shall be provided in metal conduits. MCBs and ELCB shall be installed. The electrical services shall be strictly in accordance to Clause D.1.12 of Appendix-‗D‘ of NBC Part-IV fire resisting cables shall be used. Power supply cables and the ducting shall not be taken through the staircase or any passage way used as an escape route. All the cables shall be only of Fire Resistant Low Smoke type. 8. Emergency Power Supply: The standby electric generator shall be installed of adequate capacity to supply power to staircase and corridor lighting circuit, lifts, exit signs and fire pump in case of failure of normal electric supply. The generator shall be capable of taking starting current of all the machines and circuits stated above simultaneously and must be automatic in action. 9. Static Water Tank: The underground water storage tank of the adequate quantity shall be provided. The replenishment through bore well or from the town main shall be ensured. This shall conform to the requirements given in National Building Code of India Part-IV. An additional overhead tank as proposed on the terrace shall be provided for fire-fighting as an alternative source of water supply. The underground water storage tank shall be approachable by the fire engine. 10.Stationary Fire Pump: Two electrically driven pumps – one each for Wet Riser and sprinkler system with 70 meters head shall be provided for wet riser and sprinkler system so as to give adequate pressure of 3.5 kg/cm2 at the farthest point. The standby diesel engine driven pump of similar capacity and the two-jockey pumps – one each for wet riser and sprinkler system

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh shall be installed. Al the pumps shall be automatic in operation shall be provided. The pumps shall have positive suction. 11. Automatic Sprinkler System: The system shall be installed in entire building in accordance with BIS 15105/2002. Flow alarm switch/gang shall be incorporated in the installation for giving proper indication/sound. The pressure gauge shall also be provided near the testing facility. The entire system including pump capacity & head, size of pipe network, housing control panel etc. shall be provided in accordance to relevant code. Fire service inlet shall also be provided at ground floor level. Testing/flashing facilities shall be provided at each floor. The wielding shall not be done for the pipe less than 50 mm diameter. 12. Wet Riser: The wet riser system shall be provided in the building as per NBC -05 standards. 13. Hose Boxes, Fire Hose, and Branch Pipe: Hose boxes of suitable dimension shall be provided near each internal hydrant. Its design shall be such that it can be readily opened in an emergency. Each box shall contain two lengths of 63 mm diameter, 15 m length, rubber lined delivery hoses conforming to IS:636 complete with 63 mm instantaneous coupling conforming to IS:903 and short branch pipe conforming to IS:903 with a nozzle of 16 mm diameter. 14. Hose Reel: A hose reel near each internal hydrant containing 30 m of length of 20mm bore terminating into a shut-off nozzle of 6.5 mm outlet connected directly to riser shall be provided. This will conform to IS: 3844. 15.Automatic Detection System: Automatic fire detection (smoke/heat) shall be provided in all the areas of the building and shall conform to IS: 2189/1999. 16.Portable Fire Extinguishers: The portable fire extinguishers of water CO2 type and CO2 type ISI mark shall be provided as marked on the plans. The number of the fire extinguishers may have to be increased later when the layout of the partition etc. is known. All the fire extinguishers will be installed and maintained in accordance with IS: 2190-1992. 17. Public Address System: The public address system shall be provided having loud speakers on each floor level at strategic location. The microphone, amplifier, and control switches of public address system shall be installed in the fire control room. 18. Lighting Protection: The lighting protection shall be provided in the building as per IS: 2309. 19. Intercommunication System: An emergency inter-communication system shall be provided in the entire complex. The instrument shall be provided in the common areas on each floor. 20. Yard Hydrants: Yard hydrants shall be provided in the building as per BIS specifications.

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh

CHAPTER-8: ANALYSIS OF PROPOSAL (FINAL RECOMMENDATIONS)

On the basis of information provided by the Project proponent and the other data procured from the Government Agencies, Census Report, IMD etc., and the data generated by the Consultants and analysis of generated information, the following generalized conclusions can be drawn. 1. In the proposed project, construction will be developed at plot area 88,403m2. 2. UPPCL will provide necessary power demand of 11 KV tomeet the requirement of the proposed project. The essential power back up shall be provide through 02 nos. of D.G sets of250 KVA capacity each. 3. The water demand shall be 161.15 KLD managed by using water through Tube well & boring in the premises. 4. The daily fresh water requirement would be 124.15 KLD and 37.0KLD treated water shall be utilized for flushing, gardening and D.G. cooling after treatment of 22.0KLD total waste water from domestic requirements in30.00 KLD STPand 17.20 KLDtreated water from 105.0 KLD ETP. 82.0 KLD waste water from the Hospital Beds and Laundries shall be treated in 105.00 KLD ETP. Out of 73.80 KLD treated water from ETP, 17.20 KLD treated water will be used for gardening in the proposed block and balance 56.6 KLD treated water shall be reused for landscaping in the existing SGPGI green area,sewer and drain washing.

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh 5. The rain water harvesting will improve ground water quality. One (01) number of rain water harvesting pits shall be provided at proposed site to recharge the ground water. 6. Ambient air quality shall remain within the prescribed standards. The recognized sources of air pollution in the area are transport system. Efficient Traffic Management shall be regularized within the project to control air and noise pollution. 7. Noise level shall be maintained. For traffic noise, plantation along the traffic route shall be provided to act as a noise barrier. 8.The 271.5 Kg/Day generated solid waste shall be segregated at source and managed through Nagar Palika or District Administration at designated site, for which about 1 no. of Transit Centers is available. 9. Appropriate firefighting measures including entry and exit way marking signs, emergency lights, ventilation, essential emergency electrical services and stationary fire pump and automatic sprinkler system shall be provided for the buildings at proposed project. 10. At proposed project, landscape shall be developed at 16706.07 m2of provided green area with various shrubs & trees planted. There is already existing green belt at the project site which will be retained. There is 37181.47 m2 area left in this project as open area for future expansions.. 11. The impacts, which have been identified in the planning, construction and development phase, will be transitory and enough provisions have been made to mitigate them. The development& operation phase will have both positive & negative impacts. But negative impacts will be made positive through environmental control measures. The health services development, greenery, and rainwater harvesting are positive impacts. The benefits relate to the direct employment associated with the development and during operation of the building. The proposed facility would also generate jobs for the women labours during development phase. Women are likely to get job during development phase. The facilities provided during development to women labours, will considerably reduce their travel time in any employment, and therefore enable them to attend to their children, their nutritional demands, and also household chores. The environment friendly technological alternatives will be considered for the given project with regard to construction material, layout, orientation, cooling, heating, vertical fenestration etc. The individual building/ towers developers will comply with the norms of MoEF & ECBC which will be a part of their development agreement. The site is advantageous for development of this project due to the following reasons: 1. The site has good provision for drainage facilities. 2. The climatic conditions are suitable. 3. The connectivity of the site by rail, road, and air is very much ensured keeping in view the existing and proposed development. 4. The easy availability of nearby institutional and community facilities 5. The landscape area along with 30.0 KLDSTP and 105.0 KLD ETP will ensure purification of waste water. 6. Surface parking provision will reduce generation of dust and air pollution within project premises 7. Proposed site is a prominent place where an uninterrupted power supply would be ensured.

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh The site is strategic for developing proposed project of Emergency Medicine Unit at SGPGI, Lucknow as part of the Development Plan 2021.

CHAPTER 9 - DISCLOSURE OF CONSULTANT The consultants engaged for the preparation of EIA/EMP of the proposed project are: M/s Sawen Consultancy Services Pvt. Ltd., Lucknow. The information about the company is as follows: 10.1 INTRODUCTION SAWEN has provided a vast range of consultancy services; Environment Impact Assessment Studies (EIA), Environment Management Plans (EMP), Environmental Training & Education, R&R Survey. Environmental Audit, Bio diversity studies, Socio Economic Studies, Mine Plans, Risk Assessment and Disaster Management, Solid Waste Management, Ground Water Studies, Rain Water Harvesting Study, water shed management studies, water & effluent management studies, water balance studies, land use mapping green belt designing, zonal mapping etc. to all sectors of economy notably Government Sector, Semi –Government Sector, Corporate Sector and reputed Private Sector. SAWEN is a multidisciplinary professionally managed consultancy group providing consultancy on all aspects related to Environment & Pollution control and undertake study of environmental parameters, through two complementary companies SAWEN Consultancy Services & SAWEN Projects & Laboratories Pvt. Ltd Legal Status of Organization Pvt. Ltd. Company Date of Registration/ Incorporation

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh SAWEN Consultancy Serviceswas established in the year 1993. UTTAR PRADESH POLLUTION CONTROL BOARD REGISTRATION NO.: G35962/21/Paryavaran/S/1/99 dated 07 .09.1999 An ISO 9001:2008 Certified Quality Standard Company Certificate No.: RQ91/JA/254. Certificate Issue Date: 16.08.2011 EIA CONSULTANTS ACCREDITATION SCHEME (QCI-NABET) REGISTRATION NO.:118 NABL ACCREDITATION CERTIFICATION NO.: T-2091; TC-5005 10.2 SERVICES & EXPERTISE We are monitoring environmental impact & providing services of pollution control systems to Institution, Thermal Power Plant, New Construction projects, Highways, Township & Area Development, Mineral Beneficiation Plant, Chemical Fertilizers, Municipalities, UPSLRP, UPDASP, NHAI, UPSHA, Cluster mining, Mine- surface and underground for all minerals & metals, Polymer, distilleries, sugar industry, Leather, Petrochemical, Electroplating & other polluting industries. So far the following EIA/ EMP projects have been executed Sector Numbers Building & Large Construction 150 Township & Area Development 15 Thermal Power Plants 03 Highways 15 Sugar industry 13 Mineral Beneficiation 01 Chemical Fertilizers 04 Pulp & Paper Industry 03 Leather Industry 03 Textile Industries 03 Airport 04 Electroplating & Metal Coating 04 Food Processing 04 Minor Mineral Mining 200 Major Mineral Mining 60 10.3 PERSONNEL SAWEN is a group backed by the vision of experienced and dedicated scientists, engineers, and management professionals having expertise in the field of Environment, Civil, Architecture, Structural Engineering, Chemical Engineering, Agricultural, Horticultural, & Rural Development & Road Rehabilitation Projects. EIA COORDINATORS S. No. Name 1 Dr. Rajesh Kumar Singh

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh M.Sc.(Chem.) Ph.D. (Chem.) 2 Satyendra Singh M.A 3 Dr. Arpita Sinha M.Sc. (Env. Science), Ph. D. (Env. Science), PGD Env Protection Law NET –Lectureship PGD Env. Protection Law NET-Lectureship 4. Dr. Rajendra Kumar Sharma Ph.D. (Geology) RQP Approved FUNCTIONAL AREA EXPERTS Functional Area/s Applied for (as per S. No. Name abbv. given below) In-house expert/s Air Pollution Control Water Pollution Control 1 Dr. Rajesh Kumar Singh Air Quality Modeling Risk & Hazard management

2 Dr. Dharam Raj Singh Soil Science

Solid & Hazardous Waste Management Dr. Arpita Sinha Noise 3 Soil Science Ecology & Biodiversity 4 Er. Naveen Kumar Singh Hydrology, ground water & Conservation 5 Dr. R.K. Sharma Geology 6 Mr. Satyendra Singh Socio-Economic Empanelled expert 7. Rama Shanker Shukla Land Use 8. Hydrology, ground water & Conservation Ritendra Kumar Agarwal Geology Testing Laboratory Academic and Professional Experience Name Designation Qualifications* related to

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh present work (in years) Ph. D. Chemistry (Organic) Dr. R. K. Singh Managing Director M. Sc. Chemistry (Organic) 17 years

Ph. D Environmental Sciences Management M. Sc. Environmental Dr. Arpita Sinha Representative/ Sciences 08 years Quality Manager P.G. Diploma (Environmental Protection Law) LL.B. B.SC. (Zoology & Botany) P.G. Diploma Deputy Quality Mr. S. K. Singh (Environmental Protection Manager 14 years Law) Diploma in Rural Development Lab Incharge / M. Sc. Chemistry (Organic) Mrs. Kalpana Singh 20 years Technical Manager B. Sc. (Chemistry & Botany)

Mr. Pramod Kumar M. Sc.– Chemistry (Organic) Lab Incharge 05 years Tiwari B. Sc. (Chemistry & Botany)

M. Tech. Environmental Environmental Officer Er. Mausami Sonker Engineering 02 years (Admin)

Mr. Sumit Singh Lab Chemist B. Sc. (Chemistry & Botany) 01 year

M. Tech. Environmental Er. Indresh Singh Lab Chemist Engineering 03 years

B. Sc. (Chemistry & Botany) Ms. Sandhya Singh Lab Chemist 01 year

Mrs. Sarita Singh Chemist B. Sc. (Chemistry & Botany) 06 months

Field Leader Mr. Anurag Singh B. Sc. (Chemistry & Botany) 02 Years Monitoring

End of Project Report

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Conceptual Plan For Expansion Of Emergency Medicineat SGPGI - RaibareillyRoad, District- Lucknow, Uttar Pradesh

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