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 Hosakeri Building Stone Quarry
(ii).Location / site (GPS Co-ordinate) N14 59 46.7 to 14 59 52.8 E76 17 36.4 to 76 17 43.8
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)2.225 ha.
(iv).Capacity of the Mining Lease (TPA) 100022
(v).Period of Mining Lease 20
(vi).Expected cost of the Project 50
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.264/2009/A 
Name of Consultant/RQPSANJAY KUMAR
Address M/s Sri Tech Engineers, H.No.762, Ashirwad Nilaya, Vivekanand Nagar, Hospet
Mobile No.9845982019
Landline No.274982
Email Idsritechmining@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.  36 km
2. (ii). Nearest Infrastructural along with distance in kms  1.1 km
(iii). Nearest Railway Line along with distance in kms  36 km
(iv). Nearest National Highway along with distance in kms  8 km
(v). Nearest State Highway along with distance in kms  0.6 km
(vi). Nearest Major District Road along with distance in kms 1.33 km
(vii). Nearest Any Other Road along with distance in kms  2.9 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.5 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  1.8 km
(x). Nearest In-take for drinking water pump house distance in kms  1.1 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  32 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
No such areas within 5.0 Km buffer zone
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Shivapura Reserved forest situated at 4.8 Km in the western direction of the notified quarry area.
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration Not within 5.0 Km buffer zone
6. Inland, coastal, marine or underground waters None
7. State, National boundaries Not within 10.00 Km distance
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas No such routes or facilities nearby, which were used by the public for access to recreation or other tourist, pilgrim areas.
9. Defence installations Not within 10.0 Km buffer zone
10. Densely populated or built-up area, distance from nearest human habitation Metri is the nearest habitation, situated at an aerial distance of 1.10 Km
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Areas occupied by sensitive manmade land uses situated more than 1.10 Km away from the proposed project area.
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) No such areas within 500 meters; containing important, high quality or scarce resources (Ground water resources, surface resources, forestry, agriculture, fisheries, tourism, minerals).
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 5.0 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) None
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/KA/MIN/7410/2017
File NumberREV/DEIAA/EC/05/2017-18
Date of Apply EC27 Jul 2017
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KarnatakaBellaryHagaribommanahalli
(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.)Key Plan08 Jul 2017
(2.)Acknowledgement of hard copy submission27 Jul 2017
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameAROGYADAS A
DesignationProponent
Company AROGYADAS A
Address#43, H.E.S. COLONY, Main road, T.B. Dam, Hospet, Bellari District.
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