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Volume 3 - Atomic Energy Regulatory Board

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ANNEXURE-1<br />

(Refer section 3.2.1.2)<br />

Government of India<br />

<strong>Atomic</strong> <strong>Energy</strong> <strong>Regulatory</strong> <strong>Board</strong><br />

Form ID : AERB/RSD/GRAPF/SA<br />

Niyamak Bhavan,<br />

Anushaktinagar,<br />

Mumbai - 400 094<br />

APPLICATION FOR CONSENT FOR SITE APPROVAL OF<br />

LAND-BASED STATIONARY GAMMA RADIATION<br />

PROCESSING FACILITY (GRAPF)<br />

(a)<br />

(b)<br />

(c)<br />

(d)<br />

(e)<br />

This application would be considered by the competent authority for issuance of<br />

relevant consents, under the <strong>Atomic</strong> <strong>Energy</strong> (Radiation Protection) Rules, 2004<br />

[AE(RP)R].<br />

The duly filled-in form should be sent to Director/Head, Radiological Safety<br />

Division (RSD), AERB, Niyamak Bhavan, Anushaktinagar, Mumbai-400094 with<br />

the necessary documents<br />

Incomplete applications and those without all relevant documents are liable to<br />

be rejected<br />

All the forms pertaining to this facility can be downloaded from the website<br />

(www.aerb.gov.in)<br />

Attach extra sheets wherever required<br />

PART A<br />

GENERAL PARTICULARS<br />

A.1 Name and address of the institution:<br />

Telephone No.<br />

Fax No.<br />

E-mail<br />

(O):<br />

A.2 Name and address of the Head of the institution $<br />

Telephone No. (O): (R)<br />

Fax No.<br />

Mobile No.<br />

E-mail<br />

261

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