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.Subin.PP
(ii).Location / site (GPS Co-ordinate) 11°47'46.95"N to 11°47'49.26"N 75°39'36.34"E to 75°39'40.04"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.4774 ha.
(iv).Capacity of the Mining Lease (TPA) 22559
(v).Period of Mining Lease 5
(vi).Expected cost of the Project 40
(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 Idgeologistna@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.  25 km
2. (ii). Nearest Infrastructural along with distance in kms  2 km
(iii). Nearest Railway Line along with distance in kms  25 km
(iv). Nearest National Highway along with distance in kms  25 km
(v). Nearest State Highway along with distance in kms  13 km
(vi). Nearest Major District Road along with distance in kms 5 km
(vii). Nearest Any Other Road along with distance in kms  4 km
(viii). Nearest Electric transmission line pole or tower distance in kms  2 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  17.5 km
(x). Nearest In-take for drinking water pump house distance in kms  8 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  8 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 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 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 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 None 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 5Km radius from the project site.
9. Defence installations No Defence installations within the 5 km radius from the proposed mining area.
10. Densely populated or built-up area, distance from nearest human habitation Nearest House is 1.5 km from the project site
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospital-Govt Ayurveda Dispensary Poyiloor(4Km), School-Govt LP Narikkod Mala(3Km),Church-Vazhamala(1Km),Mosque-Cheruparamba(5Km),Temple-Pathikkal(2.5Km).
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) None within the 5 km 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 5 km 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 5 km 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/11760/2017
File Number120/KNR/2017/DEIAA
Date of Apply EC19 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.)RQP Certificate19 Dec 2017
(2.)LOI19 Dec 2017
(3.)ID proof attested19 Dec 2017
(4.)Mining Plan Approval Letter & 500m Quarry Details19 Dec 2017
(5.)Possession & Tax19 Dec 2017
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameBUILDING STONE QUARRY OF MR SUBIN PP
DesignationProprietor
Company BUILDING STONE QUARRY OF MR SUBIN PP
AddressS/o Rajan Babu,Nisha Nivas Narikottumala
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