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 Mr Pushparajan T
(ii).Location / site (GPS Co-ordinate) 11 degree 45 min 20.70 sec to 11 degree 45 min 17.62 sec to 75 degree 39 min 27.28 sec to 75 degree 39 min 22.19 sec
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.9155 ha.
(iv).Capacity of the Mining Lease (TPA) 62114
(v).Period of Mining Lease 7
(vi).Expected cost of the Project 92
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.74 
Name of Consultant/RQPGlobal Environment & Mining Services
Address Hbr Layout 5th block 5th main 1st cross 1st stage Bnagalore
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.  8 km
2. (ii). Nearest Infrastructural along with distance in kms  19 km
(iii). Nearest Railway Line along with distance in kms  19 km
(iv). Nearest National Highway along with distance in kms  14 km
(v). Nearest State Highway along with distance in kms  11 km
(vi). Nearest Major District Road along with distance in kms 3 km
(vii). Nearest Any Other Road along with distance in kms  0.08 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.07 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  6 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  6 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 Kannavam forest 10 Km from project site
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 Thalassery Coast 18 Km from the Project Site
7. State, National boundaries Karnataka State boundary is about 28 Kms (E) from the project site.
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas National Highway: Edapally-Panvell High Way, 14Km, NH-17(W) State high way: Thalassery- Coorg , 11Km, SH-30 (NW)
9. Defence installations None within 5 Km of the project site
10. Densely populated or built-up area, distance from nearest human habitation The nearest human settlements is at Tripangottu Village is located at 0.5 km (S) away from the mine.
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospital: 8.0 Km, Panoor Govt Hospital School : 3.5 km., Poyiloor L PSchool Church : 9 km., (NE) & St. Alphonsa Roman Cathalic Chruch Mosque : 3. km., (Sw) & Poyiloor Masjid Temple : .1.5 km, Sremuthaphen Madapura Poyiloor temple
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) Not applicable, since this is Fresh proposal
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/11904/2017
File Number225/KNR/2017/DEIAA
Date of Apply EC27 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.)Form1m27 Dec 2017
(2.)NABET certificate27 Dec 2017
(3.)500 m Radius Certificate27 Dec 2017
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameMR PUSHPARAJAN T
DesignationOwner
Company MR PUSHPARAJAN T
AddressParayil Parabath, Kulavalloor P.O, Cheruparamba, Kannur District
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