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 "Granite Building Stone Quarry" of Moni Yohannan
(ii).Location / site (GPS Co-ordinate) Latitude : 12°24'1.88"N to 12°24'6.50"N Longitude : 75°12'52.81"E to 75°12'57.18"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.8358 ha.
(iv).Capacity of the Mining Lease (TPA) 14393
(v).Period of Mining Lease 5
(vi).Expected cost of the Project 40
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.RQP/2/2016 
Name of Consultant/RQPA Mahammad Kunhi
Address Pomjurmoola House, Nekraje P.O, Mulleria, Kasaragod, Kerala
Mobile No.9446679585
Landline No.2246114
Email Idmohdkunhia@yahoo.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.  1 km
2. (ii). Nearest Infrastructural along with distance in kms  1 km
(iii). Nearest Railway Line along with distance in kms  20 km
(iv). Nearest National Highway along with distance in kms  17 km
(v). Nearest State Highway along with distance in kms  1 km
(vi). Nearest Major District Road along with distance in kms 1.3 km
(vii). Nearest Any Other Road along with distance in kms  0.3 km
(viii). Nearest Electric transmission line pole or tower distance in kms  3 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  5 km
(x). Nearest In-take for drinking water pump house distance in kms  5 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  5 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
Bekal fort – 33 Km
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests None within 5 Km of 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 5 Km of the project site
6. Inland, coastal, marine or underground waters kanjangad Beach-20 km
7. State, National boundaries Karnataka State boundary is 24Kms from the project site.
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas Thalakkaveri ,Panathoor- madikkeri – 60km
9. Defence installations Ezhimala Naval Base – 60 Km
10. Densely populated or built-up area, distance from nearest human habitation Odayamchal-1km, Aladakam-1km
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospital: Aladakam Health Centre,Cherupuzha – 5 km. Vellarikund taluk hospital koodankallu- 5km, School: 1.GHSS Attaganam – 4Km , 2.Ambedkar GHSS kodam – 3km. Church : 1.St. George church odayamchal-2 km, 2.St. Sebastian church padimaruth-2 km, Temple : 1.Siva temple belur-4km 2.Bhagavathi temple kadam-3km, . Mosque/Masjid : 1.Juma masjid odayamchal2km, 2.Jumamasjid chullikara-2.5km
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) None within 5 Km of the project site
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) None within 5 Km of the project site
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/15125/2018
File NumberA-6791/18/DEIAA
Date of Apply EC20 Nov 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaKasaragodHosdurg
(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.)LOI12 May 2018
(2.)POSSESSION&TAX12 May 2018
(3.)NABL12 May 2018
(4.)IDPROOF12 May 2018
(5.)RQPCERTIFICATE12 May 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameBUILDING STONE QUARRY OF SMT MONI YOHANAN
DesignationPropritor
Company BUILDING STONE QUARRY OF SMT MONI YOHANAN
AddressSmt Moni Yohanan
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