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 Doni Pothu Raju
(ii).Location / site (GPS Co-ordinate) Lat: 17°49'51.1"N Long: 82°27'38.9"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)4.27 ha.
(iv).Capacity of the Mining Lease (TPA) 50150.88
(v).Period of Mining Lease 20
(vi).Expected cost of the Project 25
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.140 
Name of Consultant/RQPSV ENVIRO LABS & CONSULTANTS
Address ENVIRO HOUSE, BLOCK-B, B-1, IDA, AUTONAGAR, VISAKHAPATNAM
Mobile No.9440338628
Landline No.2755528
Email Idsvenviro_labs@yahoo.co.in
(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.  50 km
2. (ii). Nearest Infrastructural along with distance in kms  50 km
(iii). Nearest Railway Line along with distance in kms  50 km
(iv). Nearest National Highway along with distance in kms  52 km
(v). Nearest State Highway along with distance in kms  0 km
(vi). Nearest Major District Road along with distance in kms 0 km
(vii). Nearest Any Other Road along with distance in kms  0 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.9 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  0.9 km
(x). Nearest In-take for drinking water pump house distance in kms  0.9 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  0.9 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 Tajangi Gedda – 2.0 Kms. Musali Madugu – 2.0 Kms. Tajangi Reservoir –5.5 Kms.
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration Dara Konda R.F, Bointi R.F, Vangasari RF, Sanivaram RFs are present within 10 km. radius from ML area.
6. Inland, coastal, marine or underground waters Tajangi Gedda – 2.0 Kms. Musali Madugu – 2.0 Kms. Tajangi Reservoir –5.5 Kms.
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 habitation Boyalagudem village is at a distance of 1.0 kms from mine site
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospitals, schools and community facilities like telegraph office, police station and public health centre etc. are available at Siripuram Village- 0.9 Kms away from the mine site.
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Tajangi Gedda – 2.0 Kms. Musali Madugu – 2.0 Kms. Tajangi Reservoir –5.5 Kms.
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) The study area falls under seismic zone - II
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/3528/2016
File Number05/DEIAA/AP/VSP/16-17
Date of Apply EC03 Feb 2017
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)Andhra PradeshVisakhapatnamChintapalle
(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.)Uploaded mines within 500m radius and DD of Rs. 18,000/-03 Feb 2017
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameSRI D POTHU RAJU
DesignationLesse
Company SRI D POTHU RAJU
AddressChinarajupakalu Village, Lambasingi Panchayat, Chintapalli Mandal, Visakhapatnam Dt
Print