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.C.Krishnapillai, Granite Building Stone, 0.37.42 Hectares in S.Y.No. 243/3, 243/4, 244/16-2, Erathu Village, Adoor Taluk, Pathanamthitta District, Kerala.
(ii).Location / site (GPS Co-ordinate) 9° 6'50.24"N to 9° 6'53.21"N 76°48'13.82"E to 76°48'19.58"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.37.42 ha.
(iv).Capacity of the Mining Lease (TPA) 12187
(v).Period of Mining Lease 1
(vi).Expected cost of the Project 19.86
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.RQP/MAS/013/87/A 
Name of Consultant/RQPS.Suriyakumar
Address No:3/216, KSV Nagar, Narasothipatti, Salem-4
Mobile No.9842729655
Landline No.2440446
Email Idsuriyakumarsemban@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.  2.8 km
2. (ii). Nearest Infrastructural along with distance in kms  2.5 km
(iii). Nearest Railway Line along with distance in kms  11 km
(iv). Nearest National Highway along with distance in kms  4.1 km
(v). Nearest State Highway along with distance in kms  1.4 km
(vi). Nearest Major District Road along with distance in kms 0.23 km
(vii). Nearest Any Other Road along with distance in kms  0.12 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  2.8 km
(x). Nearest In-take for drinking water pump house distance in kms  4 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  3.1 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
 There is 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 There are no area which are important or sensitive for ecological reasons – Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration There is no area 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 Coastal zone is 30km western side from site. Ground water table is found at a depth of 12m bgl.
7. State, National boundaries Kerala-Tamil Nadu-43 km on Southeast
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas There are no routes or facilities used by the public for access to recreation or other tourist, pilgrim areas
9. Defence installations None around 10km
10. Densely populated or built-up area, distance from nearest human habitation Adoor is a nearest densely populated area which is 4.6km North from the site.
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Adoor area (4.6 km N) is occupied by sensitive man-made land uses like hospitals, schools, places of worship & community facilities
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) No other important, high quality or scarce resources (ground water resources, surface resources, forestry, agriculture, fisheries, tourism, minerals)
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) There is no area already subjected to pollution or environmental damage. (those where existing legal environmental standards are exceeded)
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) The area under zone III (moderate intensity zone)
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/14860/2018
File Number46/2018
Date of Apply EC03 May 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaPathanamthittaAdoor
(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.)SoilReport01 May 2018
(2.)WaterTestReport01 May 2018
(3.)ApprovalLetter01 May 2018
(4.)ApprovalLetter03 May 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameABM ENVIRO TECH PRIVATE LTD
DesignationConsultant
Company ABM ENVIRO TECH PRIVATE LTD
Address3/216, K.S.V. Nagar, Narasothipatti, Salem-636004
Print