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 SAHAKAR BRICKS
(ii).Location / site (GPS Co-ordinate) 23.488778,72.595959
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)4.56 ha.
(iv).Capacity of the Mining Lease (TPA) 6
(v).Period of Mining Lease 5
(vi).Expected cost of the Project 80
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?No
Reason for not hiring the Consultant/RQP NA
(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.  20 km
2. (ii). Nearest Infrastructural along with distance in kms  20 km
(iii). Nearest Railway Line along with distance in kms  20 km
(iv). Nearest National Highway along with distance in kms  20 km
(v). Nearest State Highway along with distance in kms  20 km
(vi). Nearest Major District Road along with distance in kms 20 km
(vii). Nearest Any Other Road along with distance in kms  20 km
(viii). Nearest Electric transmission line pole or tower distance in kms  5 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  10 km
(x). Nearest In-take for drinking water pump house distance in kms  10 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  15 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
NA
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests NA
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration NA
6. Inland, coastal, marine or underground waters NA
7. State, National boundaries NA
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas NA
9. Defence installations NA
10. Densely populated or built-up area, distance from nearest human habitation NA
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) NA
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) NA
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) NA
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) NA
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/19948/2019
File NumberTo be assigned
Date of Apply EC29 Apr 2019
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)GujaratVadodaraSavli
(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)
NameSAHAKAR BRICKS
Designationowner
Company SAHAKAR BRICKS
Addresssavli
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