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 P.Abdulla
(ii).Location / site (GPS Co-ordinate) 12°27'09.37”N to 12°27'10.79” N 75°20'16.35”E to 75°20'18.75” E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.2104 ha.
(iv).Capacity of the Mining Lease (TPA) 3045
(v).Period of Mining Lease 3
(vi).Expected cost of the Project 10
(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 Ponjurmoola(H), Nekraje(Po), Mulleria(Via) Kasaragod
Mobile No.9446679585
Landline No.2663330
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.  0.333 km
2. (ii). Nearest Infrastructural along with distance in kms  0.112 km
(iii). Nearest Railway Line along with distance in kms  41 km
(iv). Nearest National Highway along with distance in kms  40 km
(v). Nearest State Highway along with distance in kms  1 km
(vi). Nearest Major District Road along with distance in kms 1 km
(vii). Nearest Any Other Road along with distance in kms  0.333 km
(viii). Nearest Electric transmission line pole or tower distance in kms  1.5 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  1.5 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
None within 5km radius from the quarry permit boundary
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Chandragiri puzha-4km
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration None within 5km radius from the quarry permit boundary
6. Inland, coastal, marine or underground waters Chandragiri puzha-4km
7. State, National boundaries Karnataka boundary- 300m
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas Road-Mavunkal road-333m Hospital-Panathady hospital-4km School-Cherukadavu-3km Temple-Panathur-4km Mosque-Panathur-4km Church-Panathur-4km
9. Defence installations None within 5km radius from the quarry permit boundary
10. Densely populated or built-up area, distance from nearest human habitation Nearest house-112.5m
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospital-Panathady hospital-4km School-Cherukadavu-3km Temple-Panathur-4km Mosque-Panathur-4km Church-Panathur-4km
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Chandragiri puzha-4km
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) None within 5km radius from the quarry permit boundary
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, This area is generally not prone to any natural disasters
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/15617/2018
File NumberA-7099/18
Date of Apply EC21 Nov 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 Certificate05 Jun 2018
(2.)nabl certificate05 Jun 2018
(3.)LETTER OF INTENT05 Jun 2018
(4.)Proprietorship deed05 Jun 2018
(5.)photo id05 Jun 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameBUILDING STONE QUARRY OF MR ABDULLA P
DesignationProprietor
Company BUILDING STONE QUARRY OF MR ABDULLA P
AddressP. Abdulla Puzhakkara(H) Panathady (Po) kasaragod
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