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 Building Stone Quarry Of Krishnadas K
(ii).Location / site (GPS Co-ordinate) 10 38 41.08 N TO 10 38 44.65 N 76 37 20.05 E TO 76 37 24.23 E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.7953 ha.
(iv).Capacity of the Mining Lease (TPA) 50885
(v).Period of Mining Lease 5
(vi).Expected cost of the Project 35
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.RQP/BNG/2296/2013/A 
Name of Consultant/RQPHAREESH G THAMPY
Address 905 D-9th Street, Sankar Nagar, Kaimanam PO, Thiruvananthapuram
Mobile No.938738782
Landline No.04912505
Email Idgt.hareesh@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.  3 km
2. (ii). Nearest Infrastructural along with distance in kms  0.5 km
(iii). Nearest Railway Line along with distance in kms  3 km
(iv). Nearest National Highway along with distance in kms  5.4 km
(v). Nearest State Highway along with distance in kms  1.9 km
(vi). Nearest Major District Road along with distance in kms 0.8 km
(vii). Nearest Any Other Road along with distance in kms  1.3 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.244 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  2.5 km
(x). Nearest In-take for drinking water pump house distance in kms  0.25 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  2.5 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
 None with in 5 KM radius
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Dhoni water Falls – 8.2 KM N NW
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration None within 10 KM radius
6. Inland, coastal, marine or underground waters Bharathapuzha – 5 KM N
7. State, National boundaries Kerala Tamilnadu Boundaries – 32 KM E
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas Fantastic Park – 7.4 KM N Malampuzha Rock Garden - 9 KM N NE Malampuzha Dam – 3.8 KM N NE Railway Park – 4.1 KM N
9. Defence installations None within 10 KM radius
10. Densely populated or built-up area, distance from nearest human habitation Palakkad – 3.5 KM NE
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Pirayiri Village office on Melamuri Pudurkottaya – 1.9 KM SW Puthuppariyaram1 Village office – 2 KM N Olavakkodu High Post office – 2.8 KM N NE Kuzhalmanam Police Station – 7.6 KM S SE Hemambika Nagar Police station – 4.1 KM N NW KSEB office – 2.7 KM N NE Railway Reservation office palakkad jn - 2.7 KM N NE Palakkad Block Panchyath office – 0.7 KM E Hospitals Karuna Hospital – 2.8 KM E Thangam Hospital – 4.3 KM E SE Malabar Hospital- 6.5 KM E Lekshmi Hospital – 5.7 KM E
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Fantastic Park – 7.4 KM N Malampuzha Rock Garden - 9 KM N NE Malampuzha Dam – 3.8 KM N NE Railway Park – 4.1 KM N Bharathapuzha – 3.5 KM S Valayar River –180 M N
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) NIL
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) NIL
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/15989/2018
File NumberDIA/KL/PL/30/2018
Date of Apply EC28 Jun 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaPalakkadPalakkad
(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.)FORM I M24 Jun 2018
(2.)Check List24 Jun 2018
(3.)Cluster Certificate24 Jun 2018
(4.)Pan AND ADHAAR24 Jun 2018
(5.)Form 26 AS24 Jun 2018
(6.)Attested photo on eds26 Jun 2018
(7.)COVER LETTER ON EDS26 Jun 2018
(8.)LAND DOCUMENT26 Jun 2018
(9.)Photo attested by a gazetted officer28 Jun 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameBUILDING STONE QUARRY OF MR KRISHNADAS K
DesignationProponent
Company BUILDING STONE QUARRY OF MR KRISHNADAS K
AddressKrishnadas K, 3/244 17 Krishnaa, Krishna Nagar,CN Puram PO, Palakkad
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