Taloja Common Effluent Treatment Plant Co-op. Society Ltd.

TCETP
(Reg. No. RGD/PNL/GNL/(O)/509)

Application for Membership of the Society by a firm / a company or any other body corporate

Sir, We, M/s. ................................ having address at . Hereby make an application for membership of the CETP Co-op. Society Ltd. The application is accompanied by a resolution authorizing it to apply for membership. Shri / Smt. . Has been authorized by us to sign the application for the purpose consideration of our application for admission to the membership. We also undertake to pay the liabilities which may become due till the from application is approved. We are situated in the area of operation of the Society, where we are carrying on our business. The aim and objects of our firm / company are not contrary to those of the Society. We have gone through the registered Bye Laws of the Society and notification issued by Government from / time to time under section 22 of the Maharashtra Co-operative Societies Act 1960 regulating membership of corporate bodies and for undertake the abide by the same with any modification that the Registering Authority / Government respectively may make in them.

For and behalf of the

SIGNATURE: . NAME: .. DESIGNATION: .. (With seal of Company}

Taloja Common Effluent Treatment Plant Co-op. Society Ltd.

TCETP
(Reg. No. RGD/PNL/GNL/(O)/509)

MEMBERSHIP APPLICATION FORM FOR CETP

To, Hon. Chairman, Taloja CETP Co-op. Society Ltd., P-24 & G-8, MIDC Taloja. Navi Mumbai - 410 208. Dear Sir, We wish to enroll ourselves as Member of Taloja CETP Co-op. Society Limited for participating in the COMMON EFFLUENT TREATMENT PLANT, for Taloja Industrial area, Our particulars are given below: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. Name of the Company Plot No. Contact Person Telephone No. Mailing Address E-mail Address S.S.I. Certificate No. Products Manufactured Effluent generated Qty. of effluent discharged Primary treatment given Daily Water Consumption: List of Raw Materials Proposed Manufacturing item Feasibility Report of effluent Process Chart of Production : : : : : : : : : : : : : : :

We undertake to abide by the rules and regulations made by the Society for its members. As per checklist, documents are attached herewith. SIGNATURE : .... DESIGNATION : ........... STAMP OF COMPANY :

Taloja Common Effluent Treatment Plant Co-op. Society Ltd.

TCETP
(Reg. No. RGD/PNL/GNL/(O)/509)

AUTHORITY LETTER

Date: The Chairman Taloja C.E.T.P. Co-p. Society Limited, P-24 & G-8, M.I.D.C. Industrial Area, Taloja 410 208.

Dear Sir, We hereby authorize Mr. ................. to represent our organization on Taloja C.E.T.P. Co-op. Society Limited and we have no objection to his signing any papers, documents in connection with the COMMON EFFLUENT TREATMENT PLANT, on our behalf.

SIGNATURE : .. DESIGNATION : . SEAL OF THE ORGANIZATION : .

Taloja Common Effluent Treatment Plant Co-op. Society Ltd.

TCETP
(Reg. No. RGD/PNL/GNL/(O)/509)

CHECK LIST OF THE DOCUMENTS WHICH ARE REQUIRED TO BE ATTACHED TO THE APPLICATION FORM
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. Application form duly signed and stamped, as required Authority letter favouring your representative List of raw materials Production Process Chart List of Products Manufactured Copy of latest water bill of M.I.D.C. S.S.I. Current Certificate Copy of M.P.C.B. consent to establish / operate Undertaking on a stamp paper of Rs. 100 /- for Non-Polluting units Lease Agreement with MIDC Article of Association / Memorandum of Association Plot Allotment Letter Transfer Letter from MIDC Partnership Deed Subletting from MIDC Signing Authority 1. Proprietorship : Self 2. Partnership : Partner {Authorized this partner by all partners} 3. Ltd. / Pvt. Ltd. : Director (Resolution to be passed for Authorization in Board of Directors Meeting} UNDERTAKING To, Hon. Chairman, Taloja CETP Co-op. Society Ltd., P-24 & G-8, MIDC Industrial Area, Taloja, Navi Mumbai - 410 208. Dear Sir, We hereby give below the undertaking on a stamp paper of Rs. 100 /- as our industrial effluent is Nil. The industrial effluent quantity shown in the application for consent of M.P.C.B. was mentioned to be NIL and accordingly. M.P.C.B. has granted the consent for industrial effluent quantity to be NIL. If any discharge of industrial effluent is found from our Premises, then we assure to become the member of POLLUTING UNIT CATEGORY with retrospective effect, from the date of joining and ay the fees with interest and M.P.C.B. office will also be informed suitably, at the same time.

Name and Seal of the Company.