GOVERNMENT OF TELANGANA ABSTRACT

TS-iPASS - Rules - Telangana State Industrial Project Approval and Self Certification System (TS-iPASS) Rules, 2015 — Revised Combined Application Form-Orders — Issued

======================================================================= INDUSTRIES & COMMERCE (IP & INF) DEPARMENT

G.O.Ms.No. 57 Dated: 09-08-2017 Read the following:

1. Telangana State Industrial Project Approval and Self Certification System (TS-iPASS) Act, 2014 (Act No. 3 of 2014)

2. G.O. Ms No.35, Industries and Commerce (IP&INF) Dept., Dated:17-06-2015 3. G.O. Ms No.36. Industries and Commerce (IP&INF) Dept., Dated:17-06-2015 4. G.O.MS.No. 92 Industries and Commerce (IP&INF) Dept., Dated: 23-12-2015. 5. G.O.MS.No. 50 Industries and Commerce (IP&INF) Dept., Dated: 28-07-2017 6. From COI, Hyderabad Lr.No.12/2014/1782/TS-iPASS ,Date:28/07/2017

ORDER:

In exercise of powers conferred under sub-section (1) of Section 26 of the Telangana State Industrial Project Approval and Self Certification System (TS-iPASS) Act, 2014 (Act No.3 of 2014), Government has issued Telangana State Industrial Project Approval and Self Certification System (TS¬iPASS) Rules , 2015 vide reference 3rd read above for implementation of the provisions of the said Act.

2. In the reference 3rd & 4th read above, Government has issued orders framing and amending respectively roles under TS-iPASS Act bringing clearances from various departments under the purview of TS-iPASS. Specfic timelines have been refined for each clearance and clearances are to be issued within the time limit failing which penalties will be imposed on the Officer’s for causing delay. 3. In the reference 5th read above, the Government have issued orders for amending the TS-iPASS Rules for inclusion of services pertaining to various Departments and authorized the Government to make necessary changes in the Combined Application Form as and when required. 4. In the reference 6th read above, Commissioner of Industries has stated that the existing Combined Application Form has been modified to cater the requirements of Departments whose services are included in the TS-iPASS Rules and requested the Government to issue necessary orders for replacement of the existing Combined Application Form with the modified Combined Application Form. 5 Government after careful examination in the matter hereby decides to revise the Combined Application Form annexed at Annexure-II to the Rule 5 of the G.O. in the 3rd read above shall be substituted attached herewith to Annexure-II.

6 The Commissioner of Industries, Hyderabad shall take further necessary action accordingly.

(BY ORDER IN THE NAME OF THE GOVERNOR OF TELANGANA)

JAYESH RANJAN

PRINCIPAL SECRETARY TO GOVERNMENT & COMMISSIONER FOR INDUSTRIAL PROMOTION(FAC)

To The Commissioner, Printing, Stationery and Stores Purchase (Printing Wing), Hyderabad.(for publication in the Extra-ordinary issue of Telangana Gazette and to furnish 1000 copies of the notification to the Government.) Copy to: The Commissioner of Industries, Telangana, Hyderabad. All Departments of Telangana Secretariat. All Heads of Departments,. All District Collectors. The Vice Chairman & Managing Director, Telangana State Industrial Infrastructure Corporation, Hyderabad. The Secretary, Law (A) Department, Telangana Secretariat, Hyderabad P.S. to Prl. Secretary to Hon’ble Chief Minister. P.S. to Hon’ble Minister for Industries. P.S. to Chief Secretary to Government. P.S. to Secretary to Govt & CIP. Industries & Commerce Department All Officers and Sections in Industries and Commerce Department. SF/SC.

//FORWARDED::BY::ORDER//

SECTION OFFICER

TS-iPASS UID No: NAME OF INDUSTRIAL UNDERTAKING NAME OF PROMOTER S/o. D/o. W/o

PROPO Location of Factory Survey No/Plot Number(s) Village/Town District Email-ID Total extent of site area as per document(in Sq.mts) Total built-up area(in Sq.mts) Type of Approach Road Case type Caste Building Approval

A

Door No. Village/Town District Cell No

S COMMON APPLICATION FORM(CFE)

G

OSED LOCATION OF UNIT ADDRESS

Name of Grampanchay at Mandal

PinCode

Telephone

Proposed area for development(in Sq mts)

Existing width of approach road(in feet)

Land comes under

Category of Industry

Height of Building

ADDRESS OF THE ENTREPRENUER Street Name State PinCode Mandal

S

Email-ID Telephone

PROJECT COST

Proposal For New

A) Existing B) Expansion Total Investment Investment Investment

Land Value(in Lakhs)

Building Value(in Lakhs)

Plant and Machinery Value (in Lakhs)

Total Value (in Lakhs)

PROPOSED EMPLOYMENT (In No. of persons to be employed)

Male Female

DIRECT

INDIRECT

TOTAL

Category of Registration :

Registration No

Date

LINE OF ACTIVITY

Line of Activity

LINE OF MANUFACTURE

S Item Quantity Units Quantity Per

No

RAW MATERIALS USED IN PROCESS

S Item Quantity Units Quantity Per

No

1

Land use as per master plan

Existing built up area

Effected by road widening

Architect Name

Architect Cell No

Structural Engineer License Number

Price of the land

Process Fee

Functional Responsibilities

Liabilities

Expected Date of commencement of construction

Expected date of commencement of commercial operations

Plant and Factory Buildings

Storage and warehousing

Open Areas, Green Belt etc.

Equity

List of Plant and Machinery

Sl.No

Contracted maximum demand in KVA

Aggregate installed capacity of the tra Entreprenuer:

Power Required for construction purp

Existing SC No

DTCP/HMDA/KUDA/IALA Is land part of Type of Building Effected area by road widening( Architect License Number Structural Engineer Name Structural Engineer Cell No

TSIIC (Land Allotment)

EMD

Service Tax

Assets

Other Assets

Expected date of trial operations

Project sector

Administration Buildings

Roads, Water storage, s station etc.

Total

Debt

Description Capacity

Power

A:

ansformer to be installed by the

ose in HP:

Conn

Requ KV: Exist

sq.mts)

s

sub-

Indigenous/Imported

nected load in HP:

ired Voltage Level in

ing Load in HP:

Any other services existing in the sam

Prop

Per day

Per month

Expected month and year of trial production:

Water supply from :

Drinking water ( in KL/Day ):

Source of water:

Quantity of water water required for consumptive use (in KL/Day)

Waste water generation in KLD

a Process:

c Boiler blow down:

e Domestic:

I DG SET/Boiler/Thermic Fluid He

a Capacity :

c Fuel storage details:

Air Pollution Control Equipement Details

a Emission Characteristics and Source

Is the Project requires Generator

me premises:

posed maximum working hours:

Probable date of requirement o supply:

Water Water requirement Water for processing(In KL/Day ): Requirement of water (i Quantity of required for consumptive use (in KL/

PCB

b Washings: d Cooling tower bleed off: f Total:

Air Pollution

eater

s::

b.Fuel consumptio d Stack height &D

Process

e details: b.Quantity of emissions: c C

of power

dustrial use) ( in

n KL/Day):

non-/Day):

n per day :

Dia(mts):

Control equipment/system:

Solid and Hazardous waste

FIRE

Height of the building (in mtrs.)

Height of each floor (in mtrs.)

Means of Escape

Intrnal Stair Case

Width of Stair Case((min 1)

Width of each exit (in mts.)

External Stair Case No Of Exits Width of Stair Case((min 1.5 mtrs)

Open spaces all around the building: (in mts)

East West

North South

Level of the ground

Fire Detection System (Automatic) Smoke

Fire Alarm System Automatic

Automatic Fire Fighting System:

Sprinkler

Fire Extingishers

Down Corner

Manually Operated electrical fire alaram system

Under ground water sump

Terrace Pumps

Diesel Pumps

Hose Reel Wet Riser Yard Hydrant Automatic Detection System Terrace Tank Electrical pumps Jockey Pumps

Other protection measures:

Transformer Safety Provided*

Fire Lifts Provided

Air Conditioning Safety Provided

Lightening protection

Control Room

Whether the Hydraulic Platform can be moved all around the bldg

Address of the Manager or person respo Category of Establishment Full name Father's Name Designation Address of the Manager Nature of work / is to be carried on in th establishment Estimated date of commencement of bui other construction work Maximum number of building workers to employed on any day Estimated date of completion of building other construction work Full name and address of the Principal E Name Father's Name Designation Age Email Mobile No Address Name and address of the Director / Part Full Name Door No. District Mandal Village/Town Particulars of Contractors and migrant w

Name of the Contractor Addr

Labour Department

nsible for the Supervision and control of the Establ

he

ilding or

o be

or

mployer:

ners (in case of companies/firm)

workmen

Nature of Maximum No. of

ess Mobile No. Migrant/ContractWork Workmen

lishment:

Details ofManufacturing

Depts

A. Forest

Species Timber

TLength(mts)

B. Boundary Description North East West South

Forest Details

Timber Volume(cum) Timber Girth(mts) Estimateed Firewood Pole

TS-iPAS

UID No:

NAME OF INDUSTRIAL UNDERTAKING

NAME OF PROMOTER

S/o. D/o. W/o

Age

Occupation

Proposed Location of Factory

Survey No

Village/Town

Extent

Date of Commencement of Production

Telephone(incl STD Code)

Door No.

Village/Town

District

Cell No

Email-ID

Nature of Organisation

Landmark

Women entrepreneur

SS COMMON APPLICATION FORM(CFO

G

UNIT LOCATION DETAILS

Distric

Manda

PinCo

n Telep

Street

ADDRESS FOR COMMUNICATION Street Name State Mandal

PinCode Telephone Fax Differently a Minority

O)

ct

al

de

hone

t Name

e

abled

Category Of Registration

Registration No

Registration Date

Proposal For

A) Ex

Land Value(in Lakhs)

Building Value(in Lakhs)

Plant and Machinery Value (in Lakhs)

Total Value (in Lakhs)

Adults (above 18 Yrs)

Adolescents (15-18 Yrs)

Children (14-15 Yrs)

S Item No

1

S Item No

1

Contracted Maximum Demand in KVA

Already installed

Registration Particulars Type of Project Registration Expiry Date

PROJECT COST

xisting B) ExInvestment Investment

EMPLOYMENT DETAILS

Male

LINE OF MANUFACTURE

Quantity Units Quan

RAW MATERIALS USED IN PROCESS

Quantity Units Quan

POWER DETAILS(CEIG)

pansion Total Investment

Female

ntity Per

ntity Per

Proposed

Total

Already installed

Total

Voltage Level

P

G

Height of the building(in Meters)

Built up Area (Including Parking Cella

Nature of manufacturing process or processes

Factory plan approval number

Approval date

Full Name and Residential address of the Owner

Location of th District

Village/Town

Quantity (In Ltrs.)

In b

Petroleum Class A/Naptha

Petroleum Class B/Naptha

Petroleum Class C/Naptha

Total

Connected Load in KW

Proposed

Aggregate installed capacity of the transformer

Generating plans

Other Details

rs)

Factory Details Full Name & residential address of th Date of occupation of the factory by

Full Name and residential address o

the purpose of Act

he premises where Petroleum is to be

Police Station

Nearest Railway Station

of Petroleum proposed to be imported

bulk (above 1000 Lts) Not in bulk (less t

he Occupier

y the occupier

of Manager for

stored:

d and stored.

than 1000 Lts) Total

Quantity (in Ltr

In b

Petroleum Class A/Naptha

Petroleum Class B/Naptha

Petroleum Class C/Naptha

Total

Sales Tax Registration Details

Regular

Type Of Boiler

Maker's Name

Registration Number of the Boiler

Name of the Owner/Agent

Date of Inspection desirable

Place of Manufacture

Maximum Continous Evaporation

Maximum Pressure of Economiser

Class of Erector

State

Classification of Establishment Category of Establishment Address of the Manager or person respo Full name Father's Name Designation

s) of Petroleum already stored in the

bulk (above 1000 Lts) Not in bulk (less th

Explosive Licnece Details Stand by

Boiler Details

Maker's Number

Description of Boiler and Ag

Where situated

Boiler Used for

Year of Manufacture

Boiler Rating/Heating Surfa

Total Length of Steam PipeL

Details of Boiler Erector :

Name of Erector

Labour Department

nsible for the Supervision and control of the Establ

premises.

han 1000 Lts) Total

e

ace

Line

lishment:

Age Mobile

Email

Address of the Manager

Nature of work / is to be carried on in th

Estimated date of commencement of bui

Maximum number of building workers to

Estimated date of completion of building

Location of Office, Godown, Warehouse opremisis of it

Work Place Door N

Residential address of the employer

Door No.

Locality

District

Mandal

Village

Name and address of the Director / Part

Full Name

Door No.

District

Mandal

Village/Town

Name of family members of employees f Name of the Family member Relat

Adults (18 You (Fro years and to B

above) yea

he establishment

ilding or other construction work

o be employed on any day

or other construction work

or workplace attached to the shop/establishment b

No. Locality

ners (in case of companies/firm)

family engaged in Shop / Establishment

tionship Gender Adult/You

ung Persons

om 14 years

Below 18

ars)

but situated outside the

ng Person

MALE FEMALE

Name of Employees

Occupation Name

Particulars of Contractors and migrant w

Name of the Contractor Addr

MANUFACTURE

Application for Registration as a :

Date of Commencement of Pre-packing/

Partner/Director Name Hous

Trade License of municipality or Gram Pa

Label Details

TIN Number (Issued by Sales Tax Depar

Manufacturing Models

Number of Employees :

Skilled Workers

Semi-Skilled Workers

Un-Skilled Workers

Specialist trained in the line

S No Name of Worker Skill in

e Gender

workmen

Nature of Maximum No. ofess Mobile No. Migrant/Contract

Work Workmen

ER/PACKER/IMPORTER REGISTRATION FORM

Importing

se No/Door No. District Mandal

anchayat

rtment)

n the field of Skill certificate Number

Details of

Manufacturing

Depts

Village Pincode

Next date for renewal

Brand Details

Brand Name

Commodity Details : Commodity Name

Constitution Details of the firm

Name of the proprietor/partners / Desig directors

DETAILS OF THE TECHNICAL STAFF

Name of the Staff member Quali

LIST OF APPLIED DRUG PRODUCTS

Name of the product (along with the strength and Comp pharmacopoeial produ specifications)

Net Quant

Drug control Authority Details

Permanent ID Proof Ref. No. (gnation Address No.)

ification Designation Experience in relevantsection (in years)

position of the Export/ Brand name (ifuct domestic only drugs)

Print Home

tity

Aadhaar Card/ Passport

Section for which

approval is sought

f applicable in case of export

TS-iPASS C UID No: NAME OF INDUSTRIAL UNDERTAKING NAME OF PROMOTER S/o. D/o. W/o Age

Survey No

Village/Town

Extent

Address of enterpreneur

Cell No

Registration Number License Numbe

Circle Installed hors

Calendar Year No:of years for w

Type Of Boiler Registration Number of the Boiler Name of the Owner/Agent Maximum Continous Evaporation

Allowed maximum working pressure (W.

Expiry date

COMMON APPLICATION FORM(Renew

District

Mandal

PinCode

Designation

Email Id

Factory Details

er

se power

which renewal is required and agreeable for pay

Boiler Details

P)

Boiler Used for Where situated Boiler Rating/Heating Surface

Whether certificate of boiler Uis required Inspection required

wal)

ment of fee

e

U/R 376(ff)/396/ff

Registration number of steam pipeline

Exemption of boiler under section 34-2 is required

Remarks

Total length of steam pipeline

choose the inspecting authority

Labour Details

Labour registration number

Previous renewal date

Category of Establishment

Manager Details:

Name

S/D/W/o

Age

TSPCB (CFO Renewals)

1. B1(Form XIII under Water Act)(Attachment)

2. B2(Form-I under Air Act)(Attachment)

3. Form-1 under HW(M,H &TM) Rules for HWA(Attachment)

Print

Home