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 NIRMALSINH RANMALSINH CHAVDA
(ii).Location / site (GPS Co-ordinate) (A) 22 04 01.2”N, 73 29 22.8”E (B) 22 03 56.1”N, 73 29 25.9”E (C) 22 03 54.5”N, 73 29 27.3”E (D) 22 03 56.4”N, 73 29 29.1”E (E) 22 03 57.7”N, 73 29 27.8”E (F) 22 03 02.9”N, 73 29 24.9”E
Annexure-GPS file      
(iii).
Type of LeaseCluster Area
Size of the Mining Lease (in ha.)1.91.00 ha.
(iv).Capacity of the Mining Lease (TPA) 50000
(v).Period of Mining Lease 03
(vi).Expected cost of the Project 10.00
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?No
Reason for not hiring the Consultant/RQP NONE
(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 km
(iii). Nearest Railway Line along with distance in kms  8 km
(iv). Nearest National Highway along with distance in kms  55 km
(v). Nearest State Highway along with distance in kms  7 km
(vi). Nearest Major District Road along with distance in kms 5 km
(vii). Nearest Any Other Road along with distance in kms  0 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  0 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
No such area within five kilometres radius
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests N.A.
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration No such area within five kilometres radius
6. Inland, coastal, marine or underground waters N.A.
7. State, National boundaries N.A.
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas N.A.
9. Defence installations N.A.
10. Densely populated or built-up area, distance from nearest human habitation BHILODIYA - 2.5 About Bhilodiya is a Village in Dabhoi Taluka in Vadodara District of Gujarat State, India. It is located 51 KM towards East from District head quarters Vadodara. 15 KM from . 182 KM from State capital Gandhinagar Bhilodiya Pin code is 391110 and postal head office is Dabhoi . Nagdol ( 2 KM ) , Asgol ( 2 KM ) , Para ( 2 KM ) , Asodara ( 2 KM ) , Surajghoda ( 3 KM ) are the nearby Villages to Bhilodiya. Bhilodiya is surrounded by Tilakwada Taluka towards East , Sankheda Taluka to
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Colleges near Bhilodiya Shri C.n. P. F. Arts And D. N. Science Colege Address : Nr. Bus Stand, Dabhoi Schools in Bhilodiya Bhilodiya Primary School Address : bhilodiya , dabhoi , vadodara , Gujarat . PIN- 391110 , Post - Dabhoi
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) No such area containing important, high quality or scarce resources (Ground water resources, surface resources, forestry, agriculture, fisheries, tourism, minerals) within 500 metres.
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) No such areas already subjected to pollution or environmental damage. (Those where existing legal environmental standards are exceeded) within five KM radius
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 ANY
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/4055/2017
File Number6
Date of Apply EC04 Apr 2017
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)GujaratVadodaraDabhoi
(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.)COVER LATTER16 Jan 2017
(2.)FORM116 Jan 2017
(3.)MING PLAN16 Jan 2017
(4.)FORM 1M16 Jan 2017
(5.)FORM115 Mar 2017
(6.)MPLAN15 Mar 2017
(7.)FORM1 M27 Mar 2017
(8.)COVER LATTER04 Apr 2017
(9.)PFR04 Apr 2017
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameNIRMALSINH RANMALSINH CHAVDA
DesignationOWNER
Company NIRMALSINH RANMALSINH CHAVDA
AddressAT-VAVADLI TA-SANKHEDA DI-CHHOTA UDAIPUR
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