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 Sri Sanjeevi Rao, S/o Kannam Naidu, ROAD METAL & BUILDING STONE QUARRY Lease area Government Land Survey No 241 in Village Kondakarakavalasa, Mandal Salur District Vizianagaram, State Andhr
(ii).Location / site (GPS Co-ordinate) Latitude 18 33’53.99” to 18 34’00.59” Longitude 83 10’41.80” to 83 10’ 49.99”
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)1.00 ha.
(iv).Capacity of the Mining Lease (TPA) 46237.50
(v).Period of Mining Lease 10
(vi).Expected cost of the Project 3.00
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.RQP/DMG/AP/36/2017 
Name of Consultant/RQPB Seshagiri Rao
Address Flat No 301 SRI VENKATESWARA RESIDENCY Velturivari Street VIZIANAGARAM ANDHRA PRADESH
Mobile No.9440771649
Landline No.279114
Email Idbseshagirirao@gmail.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.  5.02 km
2. (ii). Nearest Infrastructural along with distance in kms  1.50 km
(iii). Nearest Railway Line along with distance in kms  5.02 km
(iv). Nearest National Highway along with distance in kms  6.06 km
(v). Nearest State Highway along with distance in kms  5.78 km
(vi). Nearest Major District Road along with distance in kms 63.05 km
(vii). Nearest Any Other Road along with distance in kms  1.0 km
(viii). Nearest Electric transmission line pole or tower distance in kms  1.60 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  5.84 km
(x). Nearest In-take for drinking water pump house distance in kms  1.65 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  5.84 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
 None Such
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests None Such
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration None Such
6. Inland, coastal, marine or underground waters None Such
7. State, National boundaries Odisha State boundary within distance of 10.50 Km. in towards SW direction Roddavalasa
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas Quarry Lease nearer to Village Kondakararvalasa is in SE direction about 1.0 Km. and which connects Salur road is from Mamidipalli
9. Defence installations None Such
10. Densely populated or built-up area, distance from nearest human habitation Village Distance in Km. Direction Janavarrvalasa 1.5 NE Kondakarakavalasa 1.0 SE Kottavalasa 1.0 SW Gundapavalasa 4.0 W
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospital At Salur about 6.5 Km. School At Salur about 6.1 Km. Temple At Salur about 6.75 Km Gram Panchayat At Kondakarakavalasa about 1.0 km SE
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Groundwater Resources: The minimum depth of water table is about more than 50 meters based on the observation from nearby tube wells and water bodies. The groundwater resources will not be affected due to small scale mining. Surface resources: Vangala Rao Sagar Reservoir is 5.84 Km. towards NE Forestry, Agriculture, Fisheries, Tourism, minerals: All details are available in State Forest Census Reports
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) Presently no such area is air marked but after EIA notification dated 14th September 2006 has been amended by Ministry of Environment, Forests and Climate Change, New Delhi by S.O. 141(E) dated 15th January 2016 the norms of environmental standards will be monitored accordingly.
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 Such
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/19592/2018
File NumberTo be assigned
Date of Apply EC12 Dec 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)Andhra PradeshVizianagaramSalur
(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)
NameGSANJEEVARAO
DesignationOwner
Company GSANJEEVARAO
AddressD No 28-388 Main Road Near Church Salur Vizianagaram Andhra Pradesh
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