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 Gurukrupa Stone
(ii).Location / site (GPS Co-ordinate) Latitude : N23 11 08.50” N23 10 59.00” Longitude: E73 19 23.94” E73 19 17.50”
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)3.50 ha.
(iv).Capacity of the Mining Lease (TPA) 175000
(v).Period of Mining Lease 10
(vi).Expected cost of the Project 30
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?No
Reason for not hiring the Consultant/RQP For B-2 Category
(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.  13 km
2. (ii). Nearest Infrastructural along with distance in kms  1.2 km
(iii). Nearest Railway Line along with distance in kms  1.3 km
(iv). Nearest National Highway along with distance in kms  10.4 km
(v). Nearest State Highway along with distance in kms  1.20 km
(vi). Nearest Major District Road along with distance in kms 0 km
(vii). Nearest Any Other Road along with distance in kms  420 km
(viii). Nearest Electric transmission line pole or tower distance in kms  00 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  00 km
(x). Nearest In-take for drinking water pump house distance in kms  00 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  00 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
 NIL
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests No any eco sensitive area is nearby 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 occur any protected important or sensitive species of flora or fauna withing 500 mtr buffer zone
6. Inland, coastal, marine or underground waters No any inland,coastal , marine or underground waters withing 500 meter buffer area
7. State, National boundaries there is no such state and national boundaries adjoining to this lease area.
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas the village road used as a route by the local public to access other roads and towns.
9. Defence installations No any defense installations nearby area.
10. Densely populated or built-up area, distance from nearest human habitation kalajina Muvada 1.20 Km.
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Primary school and PHC are there in nearby villages which are facilitating to mine workers.
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) only blacktrap mineral exist in this area.
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) no
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 possible
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/GJ/MIN/13206/2018
File NumberARVALLI/0023
Date of Apply EC12 Apr 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)GujaratArvalliBayad
(2.)GujaratArvalliBayad
(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.)Gurukrupa Stone23 Feb 2018
(2.)Form M12 Apr 2018
(3.)Project details12 Apr 2018
(4.)Mining plan letter12 Apr 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameSHREEJI MINING
DesignationPartner
Company SHREEJI MINING
AddressAdiran, Vadodara
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