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 Smt Priya Parakh Limestone Quarry Madhota
(ii).Location / site (GPS Co-ordinate) Latitude 19° 12' 2.92" N to 19° 12' 9.25"N & Longitude 81° 49' 21.68" E to 81° 49' 30.80"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)2.1 ha.
(iv).Capacity of the Mining Lease (TPA) 15665
(v).Period of Mining Lease 30
(vi).Expected cost of the Project 20
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.RQP/DGMCG/81/2016 
Name of Consultant/RQPLikesh Kumar Nayak
Address Village Kumhali, PO Amaguda, Tehsil Jagdalpur, District Bastar, CG
Mobile No.8085273922
Landline No.223922
Email Idlikesh.nayak@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.  0.05 km
2. (ii). Nearest Infrastructural along with distance in kms  0.1 km
(iii). Nearest Railway Line along with distance in kms  32 km
(iv). Nearest National Highway along with distance in kms  10 km
(v). Nearest State Highway along with distance in kms  6 km
(vi). Nearest Major District Road along with distance in kms 1.4 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  1 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  0.05 km
(x). Nearest In-take for drinking water pump house distance in kms  0.100 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  0.05 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
 There are any no 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 Indravati river is present at a distance of 2.1km in south of the lease area Seasonal nala is located at a distance of about 4km in north west of the lease area Small pond is present at a distance of about 0.03km in east direction from lease area Madhota Protected Forest is situated at a distance of 0.07 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 No such area is nearby which is used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting over, wintering, migration
6. Inland, coastal, marine or underground waters No such sensitive area are located around the mine area except Indravati River at 2.1 km
7. State, National boundaries There is no state or national boundary close within 10 km from the lease area. State Boundary of Odisha is about 30 km aerial distance.
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas No routs or facilities available on the lease area which is used for recreation or other tourist, pilgrim area.
9. Defence installations The area is not located close to any of the Defence installations. Aerial distance of Mardum is about 29 km and Girola is about 33 km.
10. Densely populated or built-up area, distance from nearest human habitation Densely populated area Madhota at 4 km, Distance from nearest human habitation -Lamker 0.5 km.
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Bastar - 12 km
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) No such important area are located within the lease area except ground water resources and Indravati River which is quite far about 2.1 km.
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) None within 20 km.
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, there is no any natural hazards which could cause environmental problems.
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/ModernizationExpansion
New Proposal NumberDIA/CG/MIN/13669/2018
New File NumberDIA/JDP/MIN/128/2018
Date of Apply EC09 Mar 2018
Proposal NumberDIA/CG/MIN/3845/2017
File Number(Previous EC)DIA/JDP/MIN/75/2017
Date of Previous EC22 Mar 2017
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)ChhattisgarhBastarJagdalpur
(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.)LOCATION MAP09 Mar 2018
(2.)GOOGLE MAP09 Mar 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameSMT PRIYA PARAKH LIMESTONE QUARRY MADHOTA
DesignationOwner
Company SMT PRIYA PARAKH LIMESTONE QUARRY MADHOTA
AddressVillage Madhota, Tehsil Bastar
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