*(Here mention the name & designation of the authority)
Before* ……………………………………………………………………………………….
Appellate Authority constituted under section 31 of the Air (Prevention & Control of
Pollution) Act, 1981 (14 of 1981).
Memorandum of appeal of Shri…………………………………………………………….
………………………………………………(Appellant)…………………………………
…………………………………………………..Vs….…………………………………..
The Central Pollution Control Board…………….. (Respondent) The appeal of Shri…………Resident of…………………………… District………………. against the order……………Dated………………. passed by the Central Pollution Control Board under section 21/22 of the Air (Prevention and Control of Pollution) Act, 1981 as showeth follows:
(1) Under Section 21/22 of the Air (Prevention & Control of Pollution) Act 1981 (14 of 1981) the appellant has been granted consent subject to the conditions mentioned in the consent order in respect of……….………………company/ corporation/ municipality/ notified area committee etc., noted below:
(a) Name of the plant/ company/ corporation / municipality/ notified area committee :
(b) Place:
(c) Card No.
(d) Name of the street; and
(e) District
A copy of the consent order in question is attached here to.
(2) The facts of the case are as under:
(Here briefly mention the facts of the case)
(3) The ground-, on which the appellant relies the purpose of this appeals are as below (here mention the grounds on which appeal in made)
1.
2.
3.
(4) In the light of what is stated above, the appellant respectfully prayed that
(a) The unreasonable conditions(s)……………………….imposed should be treated as annuled or it/they should be constituted for such other conditions is it appears to be reasonable
Or
(b) The unreasonable conditions(s)……………………………….should be varied in the following manner (Here mention the manner in which the condition(s) objected) an amount of Rs………………………..as fee for this appeal has been paid vide receipt No…………….. Dated ………………an authorised copy of which attached in proof of payment.
Signature of the Applicant Name……………………… (in Block letters) Occupation………………. Address…………………..
………………………….
Dated:
________________________________________________________________________
*Strike out what is not applicable.
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