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 Sri Sudheesh A T
(ii).Location / site (GPS Co-ordinate) N11°50'37.939"to N11°50'41.476" E76°10'24.226" to E76°10'27.834"
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.9246 ha.
(iv).Capacity of the Mining Lease (TPA) 80939
(v).Period of Mining Lease 6
(vi).Expected cost of the Project 78
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.73 
Name of Consultant/RQPGlobal Environment & Mining Services
Address #394 HBR layou 5th Block 5th main 1st cross 1st stage Bangalore
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.  7.5 km
2. (ii). Nearest Infrastructural along with distance in kms  111 km
(iii). Nearest Railway Line along with distance in kms  111 km
(iv). Nearest National Highway along with distance in kms  21 km
(v). Nearest State Highway along with distance in kms  19 km
(vi). Nearest Major District Road along with distance in kms 1.4 km
(vii). Nearest Any Other Road along with distance in kms  0.06 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.06 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  7 km
(x). Nearest In-take for drinking water pump house distance in kms  1.5 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
Wayanad Wildlife Sanctuary, 7.5 Km Nagarhole Wildlife Sanctuary, 1.03 Km Bandipur Tiger reserve and National Park, 7 Km
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Forest: Padiri Reserve Forest, 3.6 Km River: Kabani, 1.06 Km Coast: Maliyakal Beach – 71 Km Rivulet: Kannarampuzha 3.8 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 Kuruva Island, 20.0 Km
7. State, National boundaries Karnataka State boundary is about 6 Km from the project site.
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas National Highway: Kozhikode- Mysore Highway (NH-766), 21.00 Km State Highway: Manathavady, SH-59, 19.00 Km Major District Road: Marakkadavu-Pulpally Road, 1.40 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 Marakkadavu is located at 0.77 Km away from the mine.
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospital: Govt. Health Centre Padichira, 3.00 Km School: Govt LP School Marakkadavu, 2.00 Km Church: St. Mary’s Church, Kabangiri, 1.2 Km Mosque: Rahmania Juma Masjid, 7.00 Km Temple: Sreemuthappan Temple, 0.25 Km Anganwadi: Marakkadavu Dippo, 0.5 km
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Wayanad Wildlife Sanctuary, 7.5 Km Nagarhole Wildlife Sanctuary, 1.03 Km Bandipur Tiger reserve and National Park, 7 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/17088/2018
File NumberM-1596/2018 (EC 14/2018)
Date of Apply EC25 Oct 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 Certificate03 Sep 2018
(2.)affidavit03 Sep 2018
(3.)NABET03 Sep 2018
(4.)Form1M03 Sep 2018
(5.)annexures25 Oct 2018
(6.)Pre Feasibility Report25 Oct 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameSRI SUDHEESH A T
DesignationOwner
Company SRI SUDHEESH A T
AddressAddakkathohil House Kumbleri P.o Wayanad
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