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 Amdi Limestone Temporary Permit Quarry
(ii).Location / site (GPS Co-ordinate) BL1 23°14'29.29"N 83°23'51.22"E BL2 23°14'29.64"N 83°23'49.92"E BL3 23°14'27.47"N 83°23'49.25"E BL4 23°14'29.67"N 83°23'47.71"E BL5 23°14'31.95"N 83°23'49.50"E BL6 23°14'31.5
Annexure-GPS file      
(iii).
Type of LeaseCluster Area
Size of the Mining Lease (in ha.)2.55 ha.
(iv).Capacity of the Mining Lease (TPA) 56491.18
(v).Period of Mining Lease 2
(vi).Expected cost of the Project 18
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?No
Reason for not hiring the Consultant/RQP Due to B2 Category
(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.  2.90 km
2. (ii). Nearest Infrastructural along with distance in kms  0.560 km
(iii). Nearest Railway Line along with distance in kms  27.80 km
(iv). Nearest National Highway along with distance in kms  7.80 km
(v). Nearest State Highway along with distance in kms  10.30 km
(vi). Nearest Major District Road along with distance in kms 1.40 km
(vii). Nearest Any Other Road along with distance in kms  0.010 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.300 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  0.800 km
(x). Nearest In-take for drinking water pump house distance in kms  0.560 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  5.00 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
 No such sensitive areas are located
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests None around the mine area.
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration No study record found for such sensitive species or activites for study area.
6. Inland, coastal, marine or underground waters No such sensitive areas are located within study area except- - River -1.30 km (Gagar river at west) - Reservior - 16.40 km - Ground Water table is 30 meter deep and proposed depth of mining is 6 meter deep, hence no impact on water table is expected.
7. State, National boundaries There is no state or, national boundary close within 05 km aerial distance from project location.
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas No route or facilities are available in the study area, which are being used for public access to recreation or other tourist, pilgrim.
9. Defence installations The area is not located close to any of the defense installations moreover the such defense area is not situated with in study area.
10. Densely populated or built-up area, distance from nearest human habitation - Densely populated or have built-up area - Rajpur at 10.50 km. - Distance from nearest human habitation- at Changori village at 560 m
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) At Changori at 700 m/Rajpur at 10.40 km distance
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) No such important areas are located around the study area or mine area except- Ground Water resources: - Ground Water table is 30 meter deep and proposed depth of mining is 6 meter deep, hence no impact on water table is expected. Surface Water resources: No important surface water resources are located within mines or around the mine area except river, nalla or reservoir as stated in point number 2 and 6 above.
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) None around the study area.
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 area is safe with natural hazardous or flood prone area and No such sensitive areas are located within study area.
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/CG/MIN/12414/2018
File Number145/EC/SUR/2018
Date of Apply EC20 Jan 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)ChhattisgarhSurgujaLundra
(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.)EMP20 Jan 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameMS SHRI KISHAN AND COMPANY
DesignationAUTHORISEDSIGNATORY
Company MS SHRI KISHAN AND COMPANY
Address4/12 SHRI TOWER FIRST FLOOR SHANTI NAGAR RAIPUR
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