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 Brick earth & Brick Kiln Village Dwarika nagar
(ii).Location / site (GPS Co-ordinate) A23°13'54.07"N 83°07'01.76"E B23°13'55.85"N 83°07'02.00"E C23°13'55.77"N 83°07'03.11"E D23°13'56.84"N 83°07'03.80"E E23°13'56.40"N 83°07'04.73"E F23°13'53.75"N, 83°07'03.98"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.51 ha.
(iv).Capacity of the Mining Lease (TPA) 1116.8
(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?No
Reason for not hiring the Consultant/RQP not required
(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.  1.5 km
2. (ii). Nearest Infrastructural along with distance in kms  00.00 km
(iii). Nearest Railway Line along with distance in kms  12.0 km
(iv). Nearest National Highway along with distance in kms  15.0 km
(v). Nearest State Highway along with distance in kms  15.0 km
(vi). Nearest Major District Road along with distance in kms 35.0 km
(vii). Nearest Any Other Road along with distance in kms  0.2 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.2 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  1.5 km
(x). Nearest In-take for drinking water pump house distance in kms  00.00 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  00.00 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
No area is protected under international conventions, national or local legislation for their ecological, landscape, cultural or other related value.
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Galfuli river is present at a distance of about 1.5 km east of the lease area The canal is present at a distance of 2 km south east of the area The small reservoir is situated at a distance of 1km south of the lease area Sanvai Protected Forest at about 2.0 km south east of the area. Phulwar Protected Forest is situated at a distance of 3 km east of the lease area
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration There is no any sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration.
6. Inland, coastal, marine or underground waters No underground water will be affected as the ground water level is quite below the proposed quarry bottom.
7. State, National boundaries State and National boundary is not present within 50 km from the lease area
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 area, which are being used for public access to recreation or other tourist, pilgrim.
9. Defence installations Not present nearby the lease area
10. Densely populated or built-up area, distance from nearest human habitation Latori is a small thinly populated village, Which is about 2.0 km west of the area.
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Primary school, temple and hospital in village Latori.
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) No area exists nearby containing important, high quality or scarce resources.
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) The area is not either polluted or environmentally damaged.
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 not either polluted or nor environmentally damaged.
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/1304/2016
File Number13
Date of Apply EC20 Sep 2016
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)ChhattisgarhSurajpurSurajpur
(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.)Form 1M20 Sep 2016
(2.)EMP20 Sep 2016
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameHIRAN SINGH
DesignationOwner
Company HIRAN SINGH
AddressVillage Dwarika Nagar Tehsil Surajpur District Surajpur
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