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 Joby Jhon
(ii).Location / site (GPS Co-ordinate) N11°50'14.440"to N11°50'16.787" E76°12'02.095" to E76°12'05.706"
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.730 ha.
(iv).Capacity of the Mining Lease (TPA) 39629
(v).Period of Mining Lease 5
(vi).Expected cost of the Project 48
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.73 
Name of Consultant/RQPCyriac Joseph
Address HBR Layout 1st stage 1st cross 5th main 5th block Bangalore-43
Mobile No.9880788836
Landline No.25432447
Email Idgems.blr@globalmining.in
(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  2.45 km
(iii). Nearest Railway Line along with distance in kms  120 km
(iv). Nearest National Highway along with distance in kms  40 km
(v). Nearest State Highway along with distance in kms  5 km
(vi). Nearest Major District Road along with distance in kms 3 km
(vii). Nearest Any Other Road along with distance in kms  0.55 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.55 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  1.3 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  2 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
 Wayanad Wildlife Sanctuary, 3.2 Km Nagarhole Wildlife Sanctuary, 4 Km Bandipur Tiger reserve and National Park, 9 Km
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Forest: Begur State Forest, 0.957 Km River: Kabani, 2.45 Km Coast: Calicut Coast - 125 Km Rivulet: Kannarampuzha 1.00 Km
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration Wayanad Wildlife Sanctuary, 3.2 Km Nagarhole Wildlife Sanctuary, 4 Km Bandipur Tiger reserve and National Park, 9 Km
6. Inland, coastal, marine or underground waters Calicut Coast, 125.0 Km
7. State, National boundaries Karnataka State boundary is about 1.12 Km from the project site.
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas National Highway: Calicut - Sultan Bathery Highway (NH-212), 40.00 Km State Highway: SH-33 Kattikulam-Vadakanmalai, 5.00 Km Major District Road: Pulpally-Mullenkolly Road, 0.50 Km
9. Defence installations None within 5 Km of the project site
10. Densely populated or built-up area, distance from nearest human habitation The nearest human habitant is at Seethamount is located at 0.36 Km away from the mine
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospital: Govt. Hospital Padichira, 2.5 Km School: Govt LP School Kolavally, 1.5 Km Church: St. Joseph, Seethamount, 0.37 Km Mosque: Jumma Masjid, Pulpally, 7.00 Km Temple: Subramanya Swamy Temple, Chamappara, 1.5 Km Anganwadi: Seethamount, 1.50 km
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Wayanad Wildlife Sanctuary, 3.2 Km Nagarhole Wildlife Sanctuary, 4 Km Bandipur Tiger reserve and National Park, 9 Km
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) Not applicable, since this is Fresh proposal
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, Permit area is not susceptible to natural hazard, as there is no history of such incidents.
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/16072/2018
File NumberM-3221/18 (EC 8/18)
Date of Apply EC01 Sep 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaWayanadSulthanbathery
(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.)500m radius certificate29 Jun 2018
(2.)Affidavit29 Jun 2018
(3.)Form1m29 Jun 2018
(4.)NABET certificate29 Jun 2018
(5.)Pre Feasibility Report25 Jul 2018
(6.)annexures 1131 Aug 2018
(7.)witness certficate31 Aug 2018
(8.)PFR31 Aug 2018
(9.)sketches01 Sep 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameSRI JOBY JOHN
DesignationOwner
Company SRI JOBY JOHN
AddressMundokuzhyil Chamappara, Seethamount P.O Padichira, Seethamount, Wayanad District, Kerala-673579
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