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 Ms HINDUSTAN STONE CRUSHER AND HOLLOW BRICKS UNIT
(ii).Location / site (GPS Co-ordinate) 12° 5'45.04"N to 12° 5'49.70"N 75°41'41.74"E to 75°41'48.29"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)1.9976 ha.
(iv).Capacity of the Mining Lease (TPA) 50417
(v).Period of Mining Lease 10
(vi).Expected cost of the Project 50
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.DMG/KERALA/RQP/7/2016 
Name of Consultant/RQPNAZAR AHAMED
Address KARUVEETIL,VELIANCODE PO,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.  44 km
2. (ii). Nearest Infrastructural along with distance in kms  3 km
(iii). Nearest Railway Line along with distance in kms  44 km
(iv). Nearest National Highway along with distance in kms  15 km
(v). Nearest State Highway along with distance in kms  7 km
(vi). Nearest Major District Road along with distance in kms 2.5 km
(vii). Nearest Any Other Road along with distance in kms  2.5 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  15 km
(x). Nearest In-take for drinking water pump house distance in kms  15 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  15 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
NONE WITHIN 500 M FROM THE PROJECT SITE
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests NONE WITHIN 500 M FROM THE 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 500 M FROM THE PROJECT SITE
6. Inland, coastal, marine or underground waters NONE WITHIN 500 M FROM THE PROJECT SITE
7. State, National boundaries NONE WITHIN 500 M FROM THE PROJECT SITE
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas NONE WITHIN 500 M FROM THE PROJECT SITE
9. Defence installations NONE WITHIN 500 M FROM THE PROJECT SITE
10. Densely populated or built-up area, distance from nearest human habitation 117 M FROM THE PROJECT SITE
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) HOSPITAL- ULIKKAL HOSPITAL 10KM, SCHOOL- KALANJI SCHOOL 2KM, TEMPLE- KALANJI TEMPLE 1KM, MOSQUE- KOLITHATTU MOSQUE 2.5KM, CHURCH- KALANJIPALLY 3KM,
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) NONE WITHIN 500 M FROM THE PROJECT SITE
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) NO
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/12938/2018
File Number86/ECA/KNR/2018/DEIAA
Date of Apply EC09 Feb 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaKannurTaliparamba
(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.)500 M QUARRY DETAILS09 Feb 2018
(2.)ID Proof09 Feb 2018
(3.)LOI&L09 Feb 2018
(4.)RQP Certificate09 Feb 2018
(5.)Tax&Possession09 Feb 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameMS HINDUSTAN STONE CRUSHER AND HOLLOW BRICKS UNIT
DesignationMANAGINGPARTNER
Company MS HINDUSTAN STONE CRUSHER AND HOLLOW BRICKS UNIT
AddressVAYATHUR VILLAGE,IRITTY TALUK,KANNUR
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