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 CH Sakariyya in S No:208
(ii).Location / site (GPS Co-ordinate) 11 3 45.61 N to 11 03 49.97 E 76 21 29.34 N to 76 21 33.70 E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.9653 ha.
(iv).Capacity of the Mining Lease (TPA) 20000
(v).Period of Mining Lease 1
(vi).Expected cost of the Project 50
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.RQP/BNG/2296/2013/A 
Name of Consultant/RQPHareesh G Thampy
Address Hareesh G Thampy 905-D-9th Street, Sankar Nagar, Kaimanam PO, Thiruvananthapuram-695040
Mobile No.9387838782
Landline No.04916666
Email Idgt.hareesh@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.  12 km
2. (ii). Nearest Infrastructural along with distance in kms  50 km
(iii). Nearest Railway Line along with distance in kms  12 km
(iv). Nearest National Highway along with distance in kms  44 km
(v). Nearest State Highway along with distance in kms  7.7 km
(vi). Nearest Major District Road along with distance in kms 0.5 km
(vii). Nearest Any Other Road along with distance in kms  1 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.1 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  0 km
(x). Nearest In-take for drinking water pump house distance in kms  .500 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  .25 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
Nil
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Nil
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration Nil
6. Inland, coastal, marine or underground waters Kunthipuzha - 8.3 KM E
7. State, National boundaries Nil
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas Kulathippara view Point - 2.3 KM NE Ponpara water falls-3.5 km-NE
9. Defence installations Non with in 10 KM area
10. Densely populated or built-up area, distance from nearest human habitation Edathanattukkara – 1 KM SW Ambalappara - 2.7 KM E Thiruvizhamkunnu - 3.6 KM SE
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospitals Primary Health centre – 1.4 KM SW MES Hospital - 1.6 KM W KIMS Al-Shifa Super speciality hospital - 7 KM SW Temples Pathiramanna Siva temple – 2.1 KM S Pulakkurassy Siva temple – 1.6 KM S Chavala Temple – 1.6 KM NW Church St. William Church – 2.0 KM N Mosque Kilayapadam Masjid – 1.5 KM N Masjid Umarul Farooq – 1.8 KM N Chuyikunnu Masjid -1.9 KM N Thodukadu Salafi Masjid - 2.1 KM E Masjid - 2.2 KM E Tullakallu Masjid – 2.1 KM SE Thiruvizh
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Old quarry -1.60m S Old quarry -70m SW Old quarry -2.7 KM NW
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) Nil
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/14560/2018
File NumberDIA/KL/PL/18/2018
Date of Apply EC16 Apr 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaPalakkadMannarkad
(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.)Appendix VII(1) Form Annexure16 Apr 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameSAKARIYYA MANNARKKAD
DesignationPROPONENT
Company SAKARIYYA MANNARKKAD
AddressCH SAKARIYYA, PRESIDENT, MANNARKKAD KARINGAL QUARRY OPERETERSINDUSTRIAL COPERATIVE SOCIETY LTD,NO.S.IND(P)179, VIYAKARUSSI PO,MANNARKKAD,PALAKKAD DISTRICT
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