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 sarita saraf
(ii).Location / site (GPS Co-ordinate) 200 59’ 58.92” 820 0’ 0.02” 200 59’ 58.97” 820 0’ 0.28” 200 59’ 57.78” 820 0’ 0.54” 200 59’ 57.81” 820 0’ 02.03” 200 59’ 56.05” 820 0’ 0.98” 200 59’ 56.46” 820 0’ 0.51” 200 59’ 57.65” 820 0’
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.190 ha.
(iv).Capacity of the Mining Lease (TPA) 300
(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?Yes
Accreditation No.07/2015 
Name of Consultant/RQParvind kumar pandey
Address behind guman sahu atta chakkat new changorabhata ring road n raipur
Mobile No.9827497428
Landline No.241329
Email Idsunil.tamrakar23@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.  30 km
2. (ii). Nearest Infrastructural along with distance in kms  0 km
(iii). Nearest Railway Line along with distance in kms  30 km
(iv). Nearest National Highway along with distance in kms  20 km
(v). Nearest State Highway along with distance in kms  10 km
(vi). Nearest Major District Road along with distance in kms 6 km
(vii). Nearest Any Other Road along with distance in kms  0.08 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  0.15 km
(x). Nearest In-take for drinking water pump house distance in kms  0 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  0 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
N.A.
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Pairi nadi lies within the radius of 10 km at a distance of about 4.0 km Seasonal Nala – 0.15 km (150meter)
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration No, Not Applicable
6. Inland, coastal, marine or underground waters Water can be found ponds in nearby villages
7. State, National boundaries More than 50km
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas Local peoples celebrate festivals in villages, which are connected by tar roads
9. Defence installations N.A.
10. Densely populated or built-up area, distance from nearest human habitation A small village like Bhasera is around 835m.
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) No man-made sensitive area
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Sargi Nallah lies at a distance of about 1.0km towards east direction from lease Area.
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) Negligible, because this is small quarry
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) No
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/698/2016
File Number698/2016
Date of Apply EC25 Aug 2016
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)ChhattisgarhGariabandNo Data
(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)
NameSMT SARITA SARAF FLAGSTONE
Designationowner
Company SMT SARITA SARAF FLAGSTONE
Addressvillage bhasera tehsil rajim district gariyaband cg
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