The Rajasthan Occupational Safety, Health and Working Conditions Rules, 2026
Form 33A
Official text
Open in the official PDF (pp. 209–210)
Tables and forms lose their layout when extracted; the PDF is the authoritative version.
(see rule 101)
PART-I
APPLICATION FOR APPRAISAL OF SITES
Application number-
1. Previous online application id (if any):
2. Name, address, Contact details of the applicant:
3. Address and details of site proposed to be used as factory involving a hazardous process or for the
expansion of such factory:
4. Has the site been used/approved previously by any other or same factory. If yes then details:
5. Details of surrounding area such as Site Plan with clear identification of boundaries and total area proposed
to be occupied and showing details nearby the proposed site.
6. Site plan of the factory showing the entry and exit points, roads within, water drains, etc.
7. Project Report: A summary of the salient features of the project.
(a) Status of the organization (Government, Semi Government, Public or Private etc.)
(b) Maximum number of person likely to be working in the factory.
(c) Maximum amount of electric power HP/KW/MVA.
(d) Block diagram of the buildings and installations, in the proposed factory.
8. Area allocated for treatment of waste and effluent.
9. Manufacturing process information with Process flow diagram.
10. Information of hazardous materials: Raw materials, intermediates, products and by-products and their
quantities (enclose Material Safety Data Sheet in respect of hazardous substance).
11. Information on dispersal/disposal of wastes and pollutants.
12. Process hazards information, information on safety and health measures and proposed Health and Safety
Policy.
13. Any other relevant information:
I certify that the information furnished above is correct to the best of my knowledge
and nothing of importance has been concealed while furnishing it.
Name, Signature and Seal of the Occupier.
PART II
Recommendation of Site Appraisal Committee
1. Application Number: ------------------------------------------------------------------
2. Name, address, Contact details of the applicant: ----------------------------------
3. Recommendations:--------------------------------------------------------------------
4. Whether Site is suitable for grant of permission or not : Yes/No
5. If no, then reasons thereof; ---------------------------------------------------------
Signature, Name, Designation of site appraisal committee members