3.TSPCB Form-3 E - Waste Returns - 2022

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FORM-3

[See rules 4(5), 5(5), 8(6), 9(4), 10(8), 11(9), 13 (1) (xi), 13(2)(v), 13(3)(vii) and 13(4)(v) under E-
Waste (Management) Rules, 2016 & Amendment Rules, 2018]

FORM FOR FILING ANNUAL RETURNS

[To be submitted by producer or manufacturer or refurbisher or dismantler or recycler by 30 th day of


June following the financial year to which that return relates].

Quantity in Metric Tonnes (MT)

1. Name and address of the producer or MRF Ltd


manufacturer or refurbisher or dismantler or SADASIVPET
recycler MEDAK – TELANGANA
2. Name of the authorised person and complete
address with telephone and fax numbers and Mr.Y Suryanarayana
e-mail address [email protected]
9247490069

3. Total quantity of e-waste collected or


channelised to recyclers or dismantlers for
processing during the year for each category 637 Kg
of electrical and electronic equipment listed in
the Schedule I (Attach list) by PRODUCERS
Details of the above TYPE QUANTITY No.
(kg/tons)
3(A)* BULK CONSUMERS: Quantity of ewaste NA NA NA
3(B)* REFURBISHERS: Quantity of e-
waste:
3(C)* DISMANTLERS: Desktops 9 kg 44
i. Quantity of e-waste processed (Code wise); Printers 11 kg 20
ii.Details of materials or components Laptops 3 kg 2
recovered and sold; Server 15 kg 1
iii. Quantity of e-waste sent to recycler;
iv. Residual quantity of e-waste sent to
Treatment, Storage and Disposal Facility.
3(D)* RECYCLERS: NA NA NA
i. Quantity of e-waste processed (Code wise);
ii. Details of materials recovered and sold in
the market;
iii. Details of residue sent to Treatment,
Storage and Disposal Facility.
4 Name and full address of the destination E-Waste Recyclers India
with respect to 3(A)-3(D) above
Address: A-46, OKHLA INDUSTRIAL AREA, OKHLA,
South Delhi, 110020
5 Type and quantity of materials segregated or Type Quantity
recovered from e-waste of different codes as
applicable to 3(A)-3(D) NA NA

✔ Enclose the list of recyclers to whom e-waste have been sent for recycling.

Place: SADASHIVAPET
Date : 08.04.2021 Signature of the authorised person
Note:-

(1) * Strike off whichever is not applicable.


(2) Provide any other information as stipulated in the conditions to the authoriser.
(3) In case filing on behalf of multiple regional offices, Bulk Consumers and Producers need to add
extra rows to 1 & 3(A) with respect to each office.

(TSPCB Contact details: Kumar Pathak, EE – 6309007808, B. Ravinder, AEE – 8008404626,


E-mail: [email protected])

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