Form - IV (See rule 13)

ANNUAL REPORT

To be submitted to the prescribed authority on or before 30th every year for the period from January to December of the preceding yea, by the occupier of health care facility (HCF) or common bio-medical waste treatment facility (CBWTF)

S.No Particulars
1
Particulars of the Occupier:HOSPITAL ADMINISTRATOR
(i) Name of the authorized person (occupier or operator od facility):SR. ADMINISTRATOR
(ii) Name of HCF or CBMWTF:FATHIMA HOSPITAL (JKM)
(iii) Address for Correspondence:FATHIMA CONVENT (JKM)
(iv) Address of facility:FATHIMA HOSPITAL (JKM)
(v) Tel.No, Fax.No:04331 - 296033 / 296034
(vi) E-mail ID:fathimahospital25@gmail.com
(vii) URL of Website:www.fathimahospital.in
(viii) GPS coordinates of HCF or CBMWTF:REGISTERED SOCIETY NO: 9/1972
(ix) Ownership of HCF or CBMWTF:(State Government or Private or Semi Govt. or any other)
(x) Status of Authorization under the Bio-Medical waste (Management and Handling) Rules:Authorization No: 18BADI5777729 valid upto 31-03-2030
(xi) Status of Consents under water act and air act:valid upto
2
Type of Health Care Facility:
(i) Bedded Hospital:No. of Beds: 15
(ii) Non-bedded hospital (Clinic or blood bank or Clinical laboratory or Research institute or Veterinary hospital or any other):
(iii) License number and its date of expiry:
3
Details of CBMWTF:three1
(i) Number health care facilities covered by CBMWTF:
(ii) No of beds covered by CBMWTF:
(iii) Installed treatment and disposal capacity of CBMWTF: Kg per day
(iv) Quantity of bio-medical waste treated or disposed by CBMWTF: Kg/day
4
Quantity of waste generated or disposed in Kg per annum (on monthly average basis):
Yellow Category : 25 KGS/YEAR
Red Category : 100 KGS/YEAR
White : 60 KGS/YEAR
Blue Category : 60 KGS/YEAR
General Solid waste : 200 KGS/YEAR
5
Details of the Storage, treatment, transportation, processing and Disposal Facility
(i) Details of the on-site Storage facility:
Size :
Capacity :
Provision of on-site Storage : (cold storage or any other provision)
(ii) Disposal facilities:
Type of treatment equipment No of units Capacity Kg/day Quantity treated or disposed in Kg per annum
Incinerators, Plasma pyrolysis, Autoclaves, Microwave, Hydro clave, Shredder, Needle tip cutter or destroyer, Sharps, Encapsulation or concrete pit, Deep burial pits, Chemical disinfection, Any other treatment equipment 2
(iii) Quantity of recyclable wastes sold to authorized recyclers after treatment in Kg per annum: Red Category (like plastic, glass etc.)
(iv) No of vehicles used for collection and transportation of bio-medical waste:
(v) Details of incineration ash and ETP sludge generated and disposed during the treatment of wastes in Kg per annum:
Quantity generated Where disposed
Incineration ash ETP sludge
(vi) Name of the Common bio-medical waste treatment facility operator through which wastes are disposed of: MEDICARE ENIVRO SYSTEM
(vii) List of member HCF not handed over bio-medical waste: NIL
6
Do you have bio-medical waste Management committee? If yes, attach minutes of the meetings held during the reporting period:NO
7
Details trainings conducted on BMW:
(i) Number of trainings conducted on BMW Management:1 PER MONTH
(ii) Number of personnel trained:10
(iii) Number of personnel trained at the time of induction:15
(iv) Number of personnel not undergone any training so far:NOBODY
(v) Whether standard manual for training is available?:NIL
(vi) any other information:
8
Details of the accident occurred during the year:NIL
(i) Number of accidents occurred:NIL
(ii) Number of the persons affected:NIL
(iii) Remedial action taken (Please attach details if any):NIL
(iv) Any fatality occurred details:NIL
9
Are you meetings the standard of air pollution from the incinerator? How many times in last year could mot met the standards?:N/A
Details of continuous online emission monitoring systems installed:NIL
10
Liquid waste generated and treatment methods in place. How many times you have not met the standards in a year?:
11
Is the disinfection method or sterilization meeting the log 4 standards? How many times you have not met the standards in a year?:DISINFECTION METHODBY SODIUM HYPOCHLORIDE
12
Any other relevant information:(Air pollution control devices attached with the incinerator)

Certified that the above report is for the period from

Name and Signature of the Head of the Institution
SR.SEBASTINA FRANCIS

Date : 22-08-2020

Place : JAYAKONDAM