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 Granite Building Stone Quarry of Mr. C.G. George
(ii).Location / site (GPS Co-ordinate) 11degree 47' 23.818" to 11degree 47' 29.488' 75degree 36'47.129" to 75degree 36'52.191"
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.7082 ha.
(iv).Capacity of the Mining Lease (TPA) 154614
(v).Period of Mining Lease 6
(vi).Expected cost of the Project 147
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.sl.no. 71 
Name of Consultant/RQPGlobal Environement & Mining Services
Address HBR Layout, 5th block, 5th main, 1st stage, 1st cross, Bangalore
Mobile No.9880788836
Landline No.25432447
Email Idgems.blr@globalmining.in
(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.  3 km
2. (ii). Nearest Infrastructural along with distance in kms  14 km
(iii). Nearest Railway Line along with distance in kms  14 km
(iv). Nearest National Highway along with distance in kms  14 km
(v). Nearest State Highway along with distance in kms  4.10 km
(vi). Nearest Major District Road along with distance in kms 3.70 km
(vii). Nearest Any Other Road along with distance in kms  0.45 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  28 km
(x). Nearest In-take for drinking water pump house distance in kms  28 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  21 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
 None within 5 Kms of the project site
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Forest Land-Cheruvancherry, 5.0 Kms Aralam Wild Life Sanctuary, 26.0 Kms (NE)
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration None within 5 Km of the project site
6. Inland, coastal, marine or underground waters Coast: Kannur, Payyambalam, 30 Kms (NW)
7. State, National boundaries Karnataka State boundary is about 32.0 Kms (NE) from the project site
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas National Highway: Edapally-Panvel Highway (NH-17), 14.0 Kms (SW). State high way: Puthiyangadi-Kuthuparamba-Chovva bypass (SH-38), 4.10 Kms (SW). Major District Road: Panoor-Puthoor Rd, 3.70 Kms (S).
9. Defence installations None within 5 Km of the project site
10. Densely populated or built-up area, distance from nearest human habitation There is no human settlement in core zone. The nearest inhabitants are more than 100m away from the boundary of the mining lease area. The nearest human settlements are in Puthur Village, which is about 2.0 Kms from the mining lease area.
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospital: Primary Health Centre, Chendayad, 1.30 Kms School : Gurudeva Smarakam UP School, Chendayad, 2.0 Kms Church : St. Mary's Church, Nirmalagiri, 8.50 Kms Mosque : Cheruvanchery Juma Masjid, 2.0 Kms Temple : Sri Puthoor Ambidatt Muthappan Madappura, 2.0 Kms
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) None within 5 Km of the project site
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) Nil
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) No, Lease area is not susceptible to natural hazard, as there is no history of such incidents.
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/11726/2017
File Number218/KNR/2017/DEIAA
Date of Apply EC18 Dec 2017
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaKannurThalasserry
(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.)NABET Certificate18 Dec 2017
(2.)Form1M18 Dec 2017
(3.)500m Certificate18 Dec 2017
(4.)Affidavit for EC18 Dec 2017
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameGRANITE BUILDING STONE QUARRY OF MR C G GEORGE
DesignationOwner
Company GRANITE BUILDING STONE QUARRY OF MR C G GEORGE
AddressChitteth (H), Kuthuparamba P.O., Kannur District,
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