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 Shri Haridasan T
(ii).Location / site (GPS Co-ordinate) 11 degree 30 min 59.807 sec - 11 degree 30 min 02.040 sec to 75 degree 45 min 51.010 sec - 75 degree 45 min 45.148 sec
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.9611 ha.
(iv).Capacity of the Mining Lease (TPA) 78990
(v).Period of Mining Lease 5
(vi).Expected cost of the Project 85
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.64 
Name of Consultant/RQPGlobal Environment & mining Services
Address HBR layout 5th block 5th main 1st cross 1st stage Bangloore
Mobile No.9880788836
Landline No.25432447
Email Idgem.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.  0.80 km
2. (ii). Nearest Infrastructural along with distance in kms  8 km
(iii). Nearest Railway Line along with distance in kms  8 km
(iv). Nearest National Highway along with distance in kms  8 km
(v). Nearest State Highway along with distance in kms  8 km
(vi). Nearest Major District Road along with distance in kms 1 km
(vii). Nearest Any Other Road along with distance in kms  0.60 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  0.53 km
(x). Nearest In-take for drinking water pump house distance in kms  3 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  4 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
 None
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Forest : Puavatham Kunnu Reserve forest, 12.0Km Pond :Arikkulam,3.00Km River : Muthambi,6.00Km Cost :Koyilandy,10Km
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration None within buffer zone
6. Inland, coastal, marine or underground waters Koyilandy Beach 10 Km from the project site
7. State, National boundaries Karnataka State boundary is 64Kms from the project site
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas National Highway: Koyilandy,8.00Km, NH-42 State high way: Koyilandy-Thmarassery, 8.00Km,
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 Arikkulam Village is located at 0.67km away from the mine.
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospital: Arikkulam,2.00 Km School : L.P School, Arikkulam,2.00 Km Church : St, Mary’s Church,8.00Km Masjid : Jumma Masjid, Arikkulam,1.00 Km Temple : . Nedumbokulengara Temple, Arikkulam, 2.00 Km Anganwadi: Arikkulam,1.00 Km Fire Bridge: Perambra, 13.00Km Police Station: Meppayyoor, 5.00Km Airport: Kozhikkode, 48.00Km
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/14737/2018
File NumberH-3520
Date of Apply EC24 Apr 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaKozhikodeKozhikode
(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 radius certificate24 Apr 2018
(2.)Form1m24 Apr 2018
(3.)Affidavit24 Apr 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameSHRI HARIDASAN T
DesignationOwner
Company SHRI HARIDASAN T
AddressS/o Damodaran Nair, Tharol House, Ekarool P.O Unnikulam, Kozhikode
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