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 Environmental Clearence for Quarrying of Multi colour Granite of M/s Chikkamudawadi Cluster Sri. Sangram S Savanth & others over an extent of 1.5479 Ha in Sy no 63/3,4., 97/3,6,12,13 & 100/2 of Chikka
(ii).Location / site (GPS Co-ordinate) Point No. Latitude Longitude A1 N 120 36.968 E 770 22.766 A2 N 120 36. 930 E 770 22.770 A3 N 120 36. 904 E 770 22.788 A4 N 120 36. 895 E 770 22.761 A5 N 120 36. 960 E 770 22.739 A6 N 1
Annexure-GPS file      
(iii).
Type of LeaseCluster Area
Size of the Mining Lease (in ha.)1.5479 ha.
(iv).Capacity of the Mining Lease (TPA) 4730
(v).Period of Mining Lease 20
(vi).Expected cost of the Project 15
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.284/2011A 
Name of Consultant/RQPH.V.SUBBAN DR. P. VIRUPAKSHI
Address No. 273, 8th Main, BCC Layout, Chandra Layout, Vijayanagar
Mobile No.9986749095
Landline No.08023218
Email Idvirupaksha_abhi@yahoomail.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.  16 km
2. (ii). Nearest Infrastructural along with distance in kms  0.50 km
(iii). Nearest Railway Line along with distance in kms  16.00 km
(iv). Nearest National Highway along with distance in kms  16.50 km
(v). Nearest State Highway along with distance in kms  0.250 km
(vi). Nearest Major District Road along with distance in kms 0.250 km
(vii). Nearest Any Other Road along with distance in kms  0.00 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.50 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  0.00 km
(x). Nearest In-take for drinking water pump house distance in kms  0.50 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  0.750 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
Not applicable
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests No
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration Not Applicable
6. Inland, coastal, marine or underground waters Not applicable
7. State, National boundaries Not applicable
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas No
9. Defence installations No
10. Densely populated or built-up area, distance from nearest human habitation Kanakapura Town 10.00 Km
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Not applicable
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Not Applicable
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 Applicable
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/9886/2017
File NumberDEIAA/009/2017/RMN
Date of Apply EC19 Oct 2017
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KarnatakaRamanagaraKanakapura
(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)
NameSUMERU CHIKKAMUDAWADI CLUSTER ASSOCIATION
DesignationRepresentative
Company SUMERU CHIKKAMUDAWADI CLUSTER ASSOCIATION
AddressNo.237 32nd cross 7th block jayanagara bangalore-80
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