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 Stone Quarry, Village - Indarpur
(ii).Location / site (GPS Co-ordinate) A 23°28'8.39"N 82°46'9.72"E B 23°28'8.62"N 82°46'13.35"E C 23°28'4.98"N 82°46'13.33"E D 23°28'4.96"N 82°46'8.54"E E 23°28'7.39"N 82°46'8.80"E F 23°28'7.50"N 82°46'9.82"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)1.42 ha.
(iv).Capacity of the Mining Lease (TPA) 18404.1
(v).Period of Mining Lease 10
(vi).Expected cost of the Project 20
(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.  2 km
2. (ii). Nearest Infrastructural along with distance in kms  00.00 km
(iii). Nearest Railway Line along with distance in kms  30 km
(iv). Nearest National Highway along with distance in kms  00.00 km
(v). Nearest State Highway along with distance in kms  00.00 km
(vi). Nearest Major District Road along with distance in kms 00.00 km
(vii). Nearest Any Other Road along with distance in kms  0.10 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  00.00 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
There is no international convention, 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 Gokhnai river is present at a distance of about 1.5km in north of the lease area Bagahiya nala is present at a distance of about 4km in south west of the lease area Small seasonal nala is present at a distance of about 1km in north east of the lease area Chapda Protected Forest is present at a distance of about 0.30km in south of the lease area Kudargarh Protected Forest is present at a distance of about 2km in north 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 Data is not available Regarding sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration
6. Inland, coastal, marine or underground waters Areas like Inland, coastal, marine are not present within the 5km radius of the mine area
7. State, National boundaries Not present within 10 km radius
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas Routes or facilities used by the public for access to recreation or other tourist, pilgrim areas are not present
9. Defence installations Not nearby the area
10. Densely populated or built-up area, distance from nearest human habitation Indarpur is thinly populated village present at the distance of about 0.2 km in north west of the lease area
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Primary school, small temple and market in village Indarpur at a distance of 0.2km
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Areas containing important, high quality or scarce resources are not present
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) Areas already subjected to pollution or environmental damage is not present
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) Not Nearby the 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/3876/2017
File Number040/EC/Surajpur
Date of Apply EC09 Jan 2017
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 1 M09 Jan 2017
(2.)EMP09 Jan 2017
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameSHRI VIJAY PRATAP SINGH
DesignationOwner
Company SHRI VIJAY PRATAP SINGH
AddressShri Vijay Pratap Singh Village - Indarpur Tehsil and District - Surajpur
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