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 Jotpur Dolomite Mine
(ii).Location / site (GPS Co-ordinate) Longitude E83° 18’ 18.30” to E83°17’35.08”. Latitude N 21° 39’ 10.08” to N 21° 39’ 17.81”.
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)4.260 ha.
(iv).Capacity of the Mining Lease (TPA) 28000.05
(v).Period of Mining Lease 50
(vi).Expected cost of the Project 25
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.RQP/CG/24 
Name of Consultant/RQPDeepak Kumar Sahu
Address Near Hemant Provision Store, Shanti vihar colony , danganiya, raipur
Mobile No.9617160900
Landline No.4070731
Email Idjagmohan11@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.  8 km
2. (ii). Nearest Infrastructural along with distance in kms  0.75 km
(iii). Nearest Railway Line along with distance in kms  40 km
(iv). Nearest National Highway along with distance in kms  8.0 km
(v). Nearest State Highway along with distance in kms  40 km
(vi). Nearest Major District Road along with distance in kms 1.0 km
(vii). Nearest Any Other Road along with distance in kms  0.1 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.75 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  2.5 km
(x). Nearest In-take for drinking water pump house distance in kms  0.75 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  0.7 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
there is no area protected within 15km from the project site under international conventions, national or local legislation for their ecological related value
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests there is no area within 15km from the project site which are sensitive for ecological reasons
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration there is no area within 15km from the project site which are used by protected , important or sensitive species of flora & fauna
6. Inland, coastal, marine or underground waters mahanadi river is approx. 2.5km from the project site
7. State, National boundaries there is no state or national boundaries within 10km from the project site
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas there is no routes or facilities used by the public for access to recreation within 15km from the project site
9. Defence installations there is no defence installation within 10km from the project site
10. Densely populated or built-up area, distance from nearest human habitation raigarh is approx. 40km from the project site
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) katangpali approx 0.7km from the project site
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) there is no area within 15km from the project site which are containing important , highly or scarce resources
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) is no area within 15km from the project site which are already subject to pollution or environmental damage
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) there is no area within 15km from the project site which are susceptible to natural hazard
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/6195/2017
File Number89/RGH/EC/2017
Date of Apply EC21 Apr 2017
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)ChhattisgarhRaigarhSarangarh
(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
NIL
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameBALAJI MINES AND MINERALS
DesignationOwner
Company BALAJI MINES AND MINERALS
AddressVillage: Jotpur Tehsil: Baramkela, Dist: Raigarh
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