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 Mr. Varghese A.C
(ii).Location / site (GPS Co-ordinate) 12°22'09.26” N to 12°22'14.72”N 75°10'53.17”E to 75°10'56.85”E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.9290 ha.
(iv).Capacity of the Mining Lease (TPA) 31244
(v).Period of Mining Lease 5
(vi).Expected cost of the Project 25
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.DMG/KERALA/RQP/2/2016 
Name of Consultant/RQPA.MAHAMMED KUNHI
Address S/O Abdulrahaman, Pomjurmoola(H),Nekraje(PO) Mulleria (Via) Kasaragod
Mobile No.9446679585
Landline No.2663330
Email Idmohdkunia@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.  1 km
2. (ii). Nearest Infrastructural along with distance in kms  0.127 km
(iii). Nearest Railway Line along with distance in kms  18 km
(iv). Nearest National Highway along with distance in kms  10 km
(v). Nearest State Highway along with distance in kms  5 km
(vi). Nearest Major District Road along with distance in kms 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  2 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  20 km
(x). Nearest In-take for drinking water pump house distance in kms  1 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  10 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
none within 5 km radius from the permit area
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Nileswaram Puzha-18km
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 radius from the permit area
6. Inland, coastal, marine or underground waters Nileswaram Puzha-18km
7. State, National boundaries none within 5 km radius from the permit area
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas Hospital-Anandashram Hospital-14km School-Thayanoor School-6km Temple-Iriya-5km Mosque-Pokulam-2km Church-Ennapara-18km
9. Defence installations none within 5 km radius from the permit area
10. Densely populated or built-up area, distance from nearest human habitation Nearest House-127.4m
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospital-Anandashram Hospital-14km School-Thayanoor School-6km Temple-Iriya-5km Mosque-Pokulam-2km Church-Ennapara-18km
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Nileswaram Puzha-18km
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) none within 5 km radius from the permit area
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 radius from the permit area
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/15237/2018
File NumberA-6792/2018/DEIAA
Date of Apply EC31 Aug 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaKasaragodKasaragod
(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.)RQP Certificate17 May 2018
(2.)LETTER OF INTENT17 May 2018
(3.)nabl certificate17 May 2018
(4.)Proprietorship deed17 May 2018
(5.)RQP Certificate31 Aug 2018
(6.)nabl certificate31 Aug 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameBUILDING STONE QUARRY OF MR VARGHESE AC
DesignationOWNER
Company BUILDING STONE QUARRY OF MR VARGHESE AC
AddressMr. Varghese A.C Ethackadu-H Thayannur-Po Kasaragod
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