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 Building Stone Quarry of Mr. Sundaresan
(ii).Location / site (GPS Co-ordinate) 9° 2'9.37"N to 9° 2'11.54"N 76°44'52.84"E to 76°44'54.73"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.4705 ha.
(iv).Capacity of the Mining Lease (TPA) 43120
(v).Period of Mining Lease 1
(vi).Expected cost of the Project 20
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.RQP/7/2016 
Name of Consultant/RQPNazar Ahamed K.V
Address Karuveetil House,Veliancode,Malappuram
Mobile No.9447177533
Landline No.2677533
Email Idmailnsquaresolutions@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.  5 km
2. (ii). Nearest Infrastructural along with distance in kms  2 km
(iii). Nearest Railway Line along with distance in kms  5 km
(iv). Nearest National Highway along with distance in kms  5 km
(v). Nearest State Highway along with distance in kms  5 km
(vi). Nearest Major District Road along with distance in kms 1.5 km
(vii). Nearest Any Other Road along with distance in kms  0.250 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.250 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  5 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  4 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
 There are no such protected areas like ecological landscape, cultural area etc. identified within the 0.5 km radius.
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests There is no eco-sensitive area (ESA) or Protected Area (PA) within the 0.5 km radius from the proposed area.
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration There is no protected sensitive species are identified within the 0.5 km radius.
6. Inland, coastal, marine or underground waters There is no Inland, coastal, and marine or underground water around the site.
7. State, National boundaries No State and National boundaries within the 5Km radius from the project site.
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas None within the 0.5Km radius from the project site.
9. Defence installations No Defence installations within the 0.5 km radius from the proposed mining area.
10. Densely populated or built-up area, distance from nearest human habitation Nearest House is more than 50 Meter
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospital-Kottarakkara(5Km),School-Kottathala(2Km), Church-Kottarakkara(5Km),Mosque-Kottarakkara(5Km),Temple-Kottathala(3Km)
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) None within the 0.5Km radius from the project site.
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) None within the 0.5Km radius from the project site.
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 within the 0.5Km radius from the project site.
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/KL/MIN/11682/2017
File NumberB/DEIAA/27006/17
Date of Apply EC04 May 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaKollamKottarakkara
(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.)RQP Certificate15 Dec 2017
(2.)Possession15 Dec 2017
(3.)EC Affidavit15 Dec 2017
(4.)Mining Plan Approval Letter15 Dec 2017
(5.)ID proof attested & LOI15 Dec 2017
(6.)Chalan Copy12 Apr 2018
(7.)Form 1M12 Apr 2018
(8.)Possession for DEIAA04 May 2018
(9.)Encumbrance certificate For DEIAA04 May 2018
(10.)Consent from land owners04 May 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameBUILDING STONE QUARRY OF MR SUNDARESAN
DesignationProprietor
Company BUILDING STONE QUARRY OF MR SUNDARESAN
AddressPadmadeepam House, Mylamkulam,Puthoor,Kottarakkara,Kollam
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