1.

Introduction

As per Clause No. 10 of the EIA Notification 2006, all the projects accorded with Environmental Clearance need to submit Six-monthly Compliance Reports. The six-monthly reports should be submitted by 7th January and 7th June, every year. Such reports should be submitted to the Regional Office of the Ministry of Environment & Forests, Zonal Office of Central Pollution Control Board and State Pollution Control Boards (reference: Clause No.3, Circular No. J11013/41/2006-IA.II(I) dated 30.06.2009, issued by the Ministry of Environment & Forests).

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2. Background of Project

Artemis Health Institute is a 206-bed super-specialty flagship hospital established by Artemis Health Sciences (AHS) - a healthcare venture launched by the promoters of the Apollo Tyres Group. Artemis aims at creating an integrated world-class healthcare system by leveraging the best medical practices backed by cutting-edge technology. The super-specialities chosen by Artemis as its area of focus include cardiovascular, oncology, orthopaedics, neurosciences and bariatric & minimal invasive surgery. The facility at Gurgaon is designed and constructed in strict accordance with International guidelines.

3. Project Location

The hospital project is located in sector-51, Gurgaon in Haryana state. Geographical location of the unit could be stated as approximately 28 37 latitude and 77 04 longitude. The location is about 225 meters above the mean sea level.

4. Legal Status

The hospital project has obtained Environmental Clearance from the Union Ministry of Environment & Forest, Govt. of India vide their letter No. 21-292/2007-IA.III dated July 19, 2007. Prior to this, Haryana State Pollution Control Board accorded No Objection Certificate vide letter No. HSPCB/2007/TAC-I/199A/56 dated 09.02.2007 to establish the hospital project.

Six-monthly Compliance Report, M/s Artemis Hospitals, Sector-51, Gurgaon

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The project started its operations during the financial year 2008-2009 for which Consent-toOperate under section 25, 26 of the Water (Prevention & control of Pollution) Act, 1974 as amended, under section 21 of Air (Prevention & control of Pollution) Act, 1981 as amended was sought from the Haryana State Pollution Control Board was sought along with Authorization under rule V of the Hazardous waste (Management & handling rules) 1989 as amended and BioMedical Wastes Rules. Page | 2

The Haryana State Pollution Control Board has accorded Consent-to-Operate under section 25, 26 of the Water (Prevention & control of Pollution) Act, 1974 as amended, under section 21 of Air (Prevention & control of Pollution) Act, 1981 as amended vide their letter No. HSPCB/Water Consent/2009/754 dated 22/7/09 and HSPCB/Air Consent/2009/756 dated 22/7/09. The stated consents are valid up to March 2010. The application for extension of validity of Authorization under Bio Medical Wastes Rules is under active consideration by the Board.

5. Six-monthly Data and Information, July December, 2010

(i)

Month-wise Occupancy of Beds: Average monthly occupancy of beds in the hospital during July December, 2010 could be given as below:

S. No. 1. 2. 3. 4. 5. 6.

Month, Year July, 2010 August, 2010 September, 2010 October, 2010 November, 2010 December, 2010

No. of Patients 126 149 164 168 140 130

The above data shows that the hospital project operates within the maximum capacity that is 206 beds, approved by the Ministry of Environment & Forests in its Environmental Clearance. Hence, no expansion has been made during the period under consideration.

(ii)

Environment Surveillance Monitoring Data: Environmental surveillance monitoring for the period was performed by different agencies such as Hitech Research Centre, New Delhi; ITL labs Pvt. Ltd., Delhi and M/s Ultratec Research & Analytik Labs, Gurgaon, besides sample collected by the Haryana State Pollution Control Board.

Six-monthly Compliance Report, M/s Artemis Hospitals, Sector-51, Gurgaon

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A> Objectives of Environmental Monitoring:

The main objectives of environmental monitoring conducted in the project would be described as follows: a) Environmental monitoring was conducted to assess prevailing status of environment during operational phase b) The monitoring and analysis data could be useful to determine, performance of pollution control strategies as advised by implementing authorities and work to bring down the pollution level, or installation of any new and additional control measures, if required. c) Present status of air quality assessment would help to judge effectiveness of pollution control measures and strategies. d) The purpose of present study is confined to this project and its surrounding environment by evaluating the quality of its components such as quality of water resources, ambient air, land and noise etc. The following parameters and components were monitored: Table 1: Environment Monitoring Details
S. No. 1 Sample Details Ambient Air Quality Monitoring No. of samples 3 Parameters Monitored PM10, PM2.5, SO2, NO2, CO Monitoring Agency Ultratec Research & Analytik Labs, Daulatabad Road Industrial Area, Gurgaon Ultratec Research & Analytik Labs, Daulatabad Road Industrial Area, Gurgaon Ultratec Research & Analytik Labs, Daulatabad Road Industrial Area, Gurgaon Hitech Research Centre, New Delhi; ITL labs Pvt. Ltd., Delhi

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Ambient & Source Noise level Monitoring

Ambient Noise: Leq Source Noise: SPL

Soil Quality

Wastewater Quality

Color by appearance, pH, Conductivity, Water Holding Capacity, Texture, NitrateNitrogen, Available Phosphorous, Available Potassium, Organic Carbon, Arsenic & Mercury pH, TSS, TDS, BOD, COD, Oil & Grease

B> Monitoring Methodology

B.1> Ambient Air Quality Monitoring: Ambient air quality was monitored at three locations inside the project premises for parameters such as Particulate Matters of size less than 2.5 m (PM2.5),Particulate Matters of size less than 10 m (PM10), Sulphur Dioxide (as SO2), Nitrogen Dioxide
Six-monthly Compliance Report, M/s Artemis Hospitals, Sector-51, Gurgaon January 2011 3

(as NO2), Carbon Monoxide (as CO), Ozone (as O3) and Nickel (as Ni). The monitoring was conducted by Respirbale Dust Sampler of Envirotech Make, Model APM 460 fitted with PM2.5 sampling attachment supplied by Ecotech Instruments, Greater Noida. The stated monitoring for all parameters except CO was conducted on 24 hourly-basis. Grab sample of ambient air was taken to monitor CO concentration, while O3 was monitored on 1-hourly basis. Further, air quality was monitored inside the work zone for parameters such as particulate matters of size less than 10 m (PM10), sulphur dioxide (as SO2), nitrogen dioxide (as NO2), carbon monoxide (as CO). The test protocols would be noted in Table 2. Table 2: Methods of Ambient Air Monitoring & Analysis Description Guidelines for planning the sampling Respirable Suspended Particulate Matters of size less than 2.5 m (PM2.5) Respirable Suspended Particulate Matters of size less than 10 m (PM10) Sulphur Dioxide as SO2 Nitrogen Dioxide as NO2 Carbon Monoxide as CO Ozone as O3 Methods of Measurement -Gravimetric Standard Method No. IS- 5182(part 14) USEPA QAGD1 2.12 Page | 4

-doImproved West and Geake Method Jacob Hochheister Method Gas Chromatographic Colorimetric Measurement

IS- 5182 (part 23) IS- 5182 (part 2) IS- 5182 (part 6) IS- 5182 (part 10) CPCB2 Method

B.2> Noise Level Monitoring: Ambient and source noise level monitoring was conducted by the help of a Sound Level Meter of Envirotech make, Model No. SLM 100. The instrument has a range of 32 130 dB. The monitoring instrument was having valid calibration certificate at the time of monitoring. Noise level was monitored inside the project location for day and night time, continuously to generate hourly data. Day time3 was reckoned in between 6 AM to 10 PM while between 10 PM to 6 AM, it was considered as night time. Noise equivalent level (Leq) was recorded and reported in the unit of dB (A). Sound Pressure Level readings from acoustic enclosed DG sets were taken at a distance of 1 meter from the source and values were reported in dB (A).

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United States Environment Protection Agency Quality Assurance Guiding Document Central Pollution Control Board Guidelines for Ambient Air Quality Monitoring 3 Reference: Schedule III of the Noise Pollution (Regulation and Control) Rules, 2000) Six-monthly Compliance Report, M/s Artemis Hospitals, Sector-51, Gurgaon January 2011 4

B.3> Soil Quality Monitoring: Two soil samples of surface soil were collected from the project site. Surface soil at a depth of about 6 was collected manually. The samples were analyzed with reference to the standard methods prescribed in IS: 2720, IS: 14767, IS: 14765 and widely acknowledged reference and text books. A list of methods of measurement of various parameters in soil sample is given in Table 4. Table 4: Methods of Analysis of Soil Sample S. No. 1 2 3 4 5 6 7 8 9 10 11 12 Parameter Colour pH value Conductivity Moisture Contents Water Holding Capacity Texture Organic Matters Available Calcium as Ca Nitrate Nitrogen Available Phosphorous as P2O5 Available Potassium K2O Sodium as Na Instruments / Apparatus Used Visual / Colour Chart pH Meter Conductivity Meter Heating Oven & Analytical Balance Porus Cup Container and Balance Gravimetric Titrimetric Extraction & Titrimetric Extraction & Colorimteric Extraction & Colorimetric Extraction & Flame Photometric Extraction & Flame Photometric Page | 5

C> Hazardous Waste Data:

The hospital generates two types of hazardous wastes. One falls under Hazardous Waste (Management, Handling & Transboundary Movement) Rules, 2008 and other under BioMedical Wastes (Management & Handling) Rules, 1998 and subsequent amendments.

i)

Waste under Hazardous Waste (Management, Handling & Transboundary Movement) Rules, 2008: Category No. 5.1. Quantity generated: 840 liters. The used oil from DG sets is being stored in separate leak proof HDPE drums, labeled as Hazardous Waste. Such wastes shall be disposed off with the help of oil recyclers with due approvals from the Ministry of Environment & Forests. Quantity disposed off 840 liters (also contains quantity generated previously) on 18.12.2010 (Copy of Form-13 attached). ii) Bio-medical wastes are being disposed off by the help of an approved company namely, M/s Vulcan Waste Management Company. Month-wise data on BioMedical Wastes (BMW) has been given in annexure II.

Six-monthly Compliance Report, M/s Artemis Hospitals, Sector-51, Gurgaon

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6. Point wise compliance to conditions as stipulated in Environmental clearance

(vide letter No. 21-292/2007-IA.III dated July 19, 2007):

S. No. 1

Condition Diesel power generating sets as source of backup power for lifts and common area illumination should be of enclosed type and conform to rules made under Environment (Protection) Act 1986, prescribed for air and noise emission standards as per CPCB guidelines. Exhausts should be discharged by stack, raised to 4 meters above the rooftop. During night time the noise levels measured at the boundary of the building shall be restricted to the permissible levels to comply with the prevalent regulations

The sewage treatment plant of adequate capacity should be provided and it should be certified by an independent expert for adequacy as well as efficiency and submit a report in this regard to the Ministry before the project is commissioned for operation. The wastewater should be treated up to tertiary level and after treatment reused for cooling, flushing, landscaping and gardening etc. However, discharge of treated sewage, if any, shall conform to the norms & standards prescribed by Haryana Pollution Control Board

Note on Compliance Status Silent DG sets are installed in the project as back up for lifts and all emergency areas in the hospital. The DG sets conform to the prevailing rules made under Environment (Protection) Act 1986, prescribed for air and noise emission standards (Photographs enclosed as Figure-I) as per CPCB guidelines. Exhausts are discharged by stack, raised above 4 meters (at about 7.5 meters) from the rooftop (Photographs enclosed as Figure-II). During night time the noise levels measured at the boundary of the building were found to be less than 40 dB (A). This little higher side value would be attributed to vehicular movements on the adjoining main sector road. However, in all other places of the hospital boundary the values comply with the prevalent standards for silence zone, as per The Noise Pollution (Regulation & Control) Rules, 2000 (copy of test certificate vide No. 001454 issued on 15.02.2011 enclosed as Annexure-I). One sewage treatment plant of 325 KLD capacities has been installed with provision to treat the wastewater. The treated wastewater is being reused for cooling, flushing, landscaping and gardening. The treated sewage does conform to the standards prescribed by Central Pollution Control Board. The latest test certificates issued by ITL Labs Pvt. Ltd., Delhi on 14.12.2010 could be summarized as under:
Parameter, Unit pH BOD (at 27C for 3 days), mg/L COD, mg/L Oil & Grease, mg/L Total Suspended Solids, mg/L STP Inlet 8.01 33.3 156.3 1.5 64 STP Outlet 7.63 22.2 143.9 Nil 28

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Rain water harvesting and ground water recharging shall be practiced. The ground water levels and its quality should be monitored regularly in consultation with the Central Ground Water Authority. Oil & Grease trap shall be provided to remove oil and grease from the surface run off and

Copies of test reports are enclosed as Annexure I) Rain water harvesting to recharge the ground water is being practiced inside the project. The ground water quality is being monitored regularly Oil & Grease trap has been provided to remove oil and grease from the surface run off and suspended matter is being removed in a settling tank before its utilization for rainwater harvesting
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Six-monthly Compliance Report, M/s Artemis Hospitals, Sector-51, Gurgaon

suspended matter shall be removed in a settling tank before its utilization for rainwater harvesting The solid waste including hazardous waste generated should be properly collected & segregated. Biodegradable waste should be composted and non bio-degradable solid waste should be disposed of to municipal landfill sites after recovering recyclable waste. STP sludge shall be used as manure for gardening Bio-medical Waste including hazardous waste should be disposed of as per applicable Rules & norms with necessary approvals of the Haryana State Pollution Control Board

The green belt design along the periphery of the plot shall achieve attenuation factor conforming to the day and night noise standards prescribed for residential land use. The open spaces inside the plot should be suitably landscaped and covered with vegetation of indigenous variety

Incremental pollution loads on the ambient air quality, noise and water quality should be periodically monitored after commissioning of the project

All the solid wastes including hazardous waste generated are properly collected & segregated from the source of generation. All the wastes including STP sludge are being managed by an approved company namely, M/s Vulcan Waste Management Company. However, the used oil (that falls under hazardous category was disposed off through sale to M/s Lubir Sales, 32, IDC, Mehrauli Road, Gurgaon (Haryana) (i) Bio-medical wastes are being disposed off by the help of an approved company namely, M/s Vulcan Waste Management Company, as per Bio-Medical Wastes (Management & Handling) Rules, 1998 and subsequent amendments. (ii) The used oil from DG sets is being stored in separate leak proof HDPE drums, labeled as Hazardous Waste. Such wastes shall be disposed off as per Hazardous Waste (Management, Handling & Transboundary Movement) Rules, 2008 and subsequent amendments. The green belt along the periphery of the hospital has been designed in such a way that it helps to achieve the day and night noise standards prescribed for residential land use (copy of test certificate vide No. 001454 issued on 15.02.2011 enclosed as Annexure-I). The open spaces inside the plot are suitably landscaped and covered with vegetation of indigenous varieties. Selective photographs of greenbelt have been given as Figure-III & IV. Monitoring of the ambient air quality, noise level and soil quality are being conducted on sixmonthly basis. Water quality is being monitored on monthly basis during the operation phase. The ambient air quality monitoring was performed on 24 hourly basis for the parameters such as Respirable Suspended Particulate Matters (RSPM), Sulfur Dioxide (as SO2), Oxides of Nitrogen (as NO2) and Carbon Monoxide (as CO). All the parameters were observed to be within the permissible limits prescribed in Central Pollution Control Boards National Ambient Air Quality Standards for Residential Areas. (Please refer copy of test certificate vide No. (copy of test certificate vide No. 001451-53 issued on 15.02.2011 enclosed as Annexure-I)
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Six-monthly Compliance Report, M/s Artemis Hospitals, Sector-51, Gurgaon

Ambient noise level monitoring was conducted for 24 hours. The day and night time Leq values were recorded by means of a noise level meter. Instant Sound Pressure Level from DG sets was also recorded. (copy of test certificate vide No. 001454 issued on 15.02.2011 enclosed as Annexure-I) Ground Water Quality Monitoring has been conducted for various parameters as required in IS 10500: 1991 (2003). Prior permission for use of ground water was obtained from Central Ground Water Authority vide their letter No. 40-4/GURArtemis/CGWA/2007-1492 dated December 11, 2007 Tapping of solar energy shall be implemented during the second phase of the project. Details shall be submitted in due course.

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Prior permission of the Central Ground Water Authority should be obtained for the utilization of ground water

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The Solar energy shall be used for water heating as well as lighting common areas and verifiable measures shall be adopted for energy conservation and water conservation Report on the energy conservation measures should be prepared incorporating details about building materials & technology, R & U Factors etc and submitted to the Ministry in three months time The values of R & U for the building envelope should meet the requirements of the hot & humid climatic location. Details of the building envelope should be worked out and furnished in three months time

Already complied

The building envelope for external walls made of bricks, concrete and steel. The R-value for bricks is approximately 0.87 K.m2.W-1 while that for steel and concrete ranges from 1.07 1.25 K.m2.W-1 and 0.78 1.25 K.m2.W-1, respectively. For fenestration, aluminium panels with glass panes with R-value ranging between 0.004 0.005 K.m2.W-1 and 1.075 1.25 K.m2.W-1, respectively, shall be used. Sun film with solar energy rejection up to 79% and glare reduction up to 91% have been fixed in all patient rooms (South and East facing) and consultant rooms with single glazed glass. All other area is having double glazed windows. This would reduce the load due to solar radiation and also the heat load of the building envelope. Typical thermal conductivity (U-values) ranges between 1.2-1.4 W-m2-K as compared to 1.5-1.7 W-m2-K range for normal glass.

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Compliance with Haryana State Pollution Control Board Guidelines and Orders

a) Compliance with various orders of the Board as to upgrade the STP and install ETP. b) Point-wise compliance note against
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Six-monthly Compliance Report, M/s Artemis Hospitals, Sector-51, Gurgaon

Water & Air Consent enclosed as Annexure - III c) Submission of Annual Returns as Form-4: Copy of proof-of-submission enclosed Point-wise compliance note against Water & Air Consent enclosed (please see Annexure III) d) Submission of Environment Statement: Copy of proof-of-submission enclosed (please see Annexure III)

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7.

Expenses on Environment Management: Details of expenses incurred in environment management would be as under-

Expenses Head APCM Sewage Treatment Noise control Monitoring Rainwater Harvesting Greenbelt Development & maintenance Fire Management Miscellaneous TOTAL 8.

Capital Cost in INR 2.50 15.00 2.00 -5.00 3.00 10.00 23.50 61.00

Recurring Cost in INR (July-December, 2010) 0.50 6.30 0.50 1.60 0.40 7.50 3.00 5.00 24.30

Schedule for Next Six-Monthly Compliance Report: The next six-monthly progress report shall be submitted latest by 7th June 2011 at Northern Regional Office of the Ministry of Environment & Forests, Government of India.

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