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. REYYA GOPALA RAO
(ii).Location / site (GPS Co-ordinate) The quarry lease applied area falls in the Survey of India, Toposheet No. 65 K / 13 (Scale 1 : 50,000) and is bounded MAP DATUM : WGS – 84 B.P No. LATITUDE LONGITUDE 1 19° 6'27.30"N 84°40'22.00"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.5 ha.
(iv).Capacity of the Mining Lease (TPA) 19348
(v).Period of Mining Lease 10
(vi).Expected cost of the Project 10
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.RQP/DMG/AP/43/2017 
Name of Consultant/RQPK.SANTHOSH KUMAR
Address VIZIANAGARAM
Mobile No.9703955183
Landline No.2234567
Email Idksantoshkumar87@yahoo.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.  0.9 km
2. (ii). Nearest Infrastructural along with distance in kms  1 km
(iii). Nearest Railway Line along with distance in kms  0.9 km
(iv). Nearest National Highway along with distance in kms  1.7 km
(v). Nearest State Highway along with distance in kms  5.3 km
(vi). Nearest Major District Road along with distance in kms 1 km
(vii). Nearest Any Other Road along with distance in kms  1 km
(viii). Nearest Electric transmission line pole or tower distance in kms  1 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  0.45 km
(x). Nearest In-take for drinking water pump house distance in kms  1 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
 Nil
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Bahudha Nadhi at 0.85 kms Bahuda Muhana Sagar at 0.45 kms Bay of Bengal at a distance of 10.2 kms
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration Nil
6. Inland, coastal, marine or underground waters Nil
7. State, National boundaries Orissa villages are at a distance of 7.7 kms from mine lease area.
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas None within 10 km radius.
9. Defence installations None
10. Densely populated or built-up area, distance from nearest human habitation Ratakanna at a distance of 0.4 kms in NW side
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospitals, Schools, Temples are available at Ratakanna village.
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) The ground water level is about 35-45 M BGL at the foot hill.
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) All environmental standards will be monitored and maintained according to the standards.
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) Nil
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/19551/2018
File NumberTo be assigned
Date of Apply EC11 Dec 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)Andhra PradeshSrikakulamIchchapuram
(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
NIL
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameSRI REYYA GOPALA RAO
DesignationProponent
Company SRI REYYA GOPALA RAO
AddressSy.No.197, Ratakanna Village, Itchapuram Mandal, Srikakulam District
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