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 C.P. Thomas
(ii).Location / site (GPS Co-ordinate) 11°4'14.72"N - 11°4'17.35"N 76°1'59.62"E - 76°2'4.46"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.7909 ha.
(iv).Capacity of the Mining Lease (TPA) 15004
(v).Period of Mining Lease 5
(vi).Expected cost of the Project 30
(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 K.V
Address N Square Mining and Environmental Solutions LLP
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.  16 km
2. (ii). Nearest Infrastructural along with distance in kms  0.6 km
(iii). Nearest Railway Line along with distance in kms  16 km
(iv). Nearest National Highway along with distance in kms  12 km
(v). Nearest State Highway along with distance in kms  1 km
(vi). Nearest Major District Road along with distance in kms 0.8 km
(vii). Nearest Any Other Road along with distance in kms  0.1 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  2.5 km
(x). Nearest In-take for drinking water pump house distance in kms  2.5 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  2.5 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
No area protected under international conventions, national or local legislation for their ecological, landscape, cultural or other related value
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Kadalundy River-4Km, Parappanagadi Coastal area -21Km, Kannamangalam Forest Range-8Km
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration No Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration
6. Inland, coastal, marine or underground waters Parappanagadi Coastal area -21Km,
7. State, National boundaries No State, National boundaries within 2Km
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas No tourist,pilgrim area within 1Km radius.
9. Defence installations No Defence installations within 1Km
10. Densely populated or built-up area, distance from nearest human habitation Nearest House is 86.55m
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospital -Primary Health center 3KM, Fathima matha Church-0.6Km, Kadaparamb Juma masjid -1.5Km, Thiruvanthakunnu Temple-3Km, Alphonsa School-0.6Km.
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Kannamangalam Forest Range-8Km Mini ootty View Point-3Km Cheruppadimala-6.5Km
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) No areas already subjected to pollution or environmental damage.
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, areas 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/14655/2018
File NumberDEIAA/MAL/EC/079/2018
Date of Apply EC24 May 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaMalappuramTirurangadi
(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.)500m Quarry Detail Certificate and Mining Plan approval Letter20 Apr 2018
(2.)ID Proof20 Apr 2018
(3.)Form 1M20 Apr 2018
(4.)RQP CERTIFICATE20 Apr 2018
(5.)EC AFFIDAVIT20 Apr 2018
(6.)Letter of Intent21 May 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameBUILDING STONE QUARRY OF CP THOMAS
DesignationOwner
Company BUILDING STONE QUARRY OF CP THOMAS
AddressOorakam Village,Thirurangadi Taluk
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