APPENDIX I
(See Paragraph-6)
FORM 1M
Note : If space provided against any parameter is inadequate,Kindly upload supporting document under 'Additional Attachments if any'  at the last part of the Form 1M. Please note that all such Annexures must be part of single pdf document.
(I)Basic Informations
S.No.Item Details
(i).Name of the Mining Lease site M/s Srinivasa Stone Crusher
(ii).Location / site (GPS Co-ordinate) 17°57'8.42"N, 83°13'33.58"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)1.129 ha.
(iv).Capacity of the Mining Lease (TPA) 95776
(v).Period of Mining Lease 10
(vi).Expected cost of the Project 15.00
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.143 
Name of Consultant/RQPSV ENVIRO LABS & CONSULTANTS
Address Block-B, B1, IDA, Auto Nagar, Visakhapatnam
Mobile No.9491215528
Landline No.2755528
Email Idtechnical@svenvirolabs.com
(II) Environmental Sensitivity
S.No Areas Distance in kilometer / Details
1. (i).  Nearest rail or road bridge over the concerned river,rivulet,nallah etc. in kms.  15 km
2. (ii). Nearest Infrastructural along with distance in kms  25.34 km
(iii). Nearest Railway Line along with distance in kms  4.0 km
(iv). Nearest National Highway along with distance in kms  36.7 km
(v). Nearest State Highway along with distance in kms  15.4 km
(vi). Nearest Major District Road along with distance in kms 0.94 km
(vii). Nearest Any Other Road along with distance in kms  0 km
(viii). Nearest Electric transmission line pole or tower distance in kms  1.70 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  11.85 km
(x). Nearest In-take for drinking water pump house distance in kms  0 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  0 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
None within 15 km radius
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Reserve Forests: Advanapalem Reserve Forest at 1.52 kms Water Bodies: Boni Lake at a distance of 11.85 kms. Gottipalli Pond at a distance of 13.55 kms. Nookamma Cheruvu at a distance of 13.18 kms. Balarampuram pond 13.20 kms.
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration None within 15 km radius
6. Inland, coastal, marine or underground waters None within 15 km aerial distance from proposed mine
7. State, National boundaries None within 15 km radius
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas None within 15 km radius
9. Defence installations None within 15 km radius
10. Densely populated or built-up area, distance from nearest human habitation Nearest village is Katakapalli Village at 0.48 kms and densely populated area Kothavalasa Mandal at a distance of 7.45 kms
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Ramalayam at a distance of 0.57 kms. Marlamamba Temple at a distance of 0.86 kms Satyanarayana Swamy Temple at 0.71 kms from mine area. MPUP School Kantakapalli Main at a distance of 0.66 kms from mine area. State Bank of India at a distance of 1.04 kms.
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) None within 15 km radius.
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) None within 15 km radius
14. Areas susceptible to natural hazard which could cause the project to present environmental problems (earthquakes, subsidence, landslides, erosion, flooding or extreme or adverse climatic conditions) None within 15km radius.
15.
Is proposed mining site located over or near fissure/fracture for ground water recharge?No
16.
Whether the proposal involves approval or clearance under the following Regulations or Acts namely?
(a).
The Forest (Conservation) Act,1980?No
(b).
The Wildlife (Protection) Act,1972?No
(c).
The Coastal Regulation Zone (C.R.Z) notification,2011?No
17.
Is forest land involved (ha)?No
18.
Whether there is any litigation pending against the project and/or land in which the project is proposed to be set up?No
19.
New/Expansion/ModernizationNew
Proposal NumberDIA/AP/MIN/15969/2018
File NumberTo be assigned
Date of Apply EC22 Jun 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)Andhra PradeshVizianagaramKothavalasa
(III) EC Attachments
1 Uploaded PFR (Pre Feasibility Report) File Annexure-PFR file
2 Uploaded Approved Mining Plan File Annexure-Approved Mining Plan file
3 Uploaded District survey report Annexure-District Survey Report
4 Uploaded Cover Letter Annexure-Cover Letter
Uploaded Additional attachments, if any
S.No. Attached File Date of Submission
(1.)Additional Documents22 Jun 2018
(2.)Form-I22 Jun 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameM/s Srinivasa Stone Crusher
DesignationProprietor
Company M/s Srinivasa Stone Crusher
AddressSy.No.180, Kantakapalli Village, Kothavalasa Mandal
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