(See Paragraph-6)
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 Usman Pathalayintavida
(ii).Location / site (GPS Co-ordinate) Latitude(N)- 12° 2'47.32"N to 12° 2'49.70"N Longitude(E)– 75°46'20.15"E to 75°46'26.77"E
Annexure-GPS file      
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.9941 ha.
(iv).Capacity of the Mining Lease (TPA) 34600
(v).Period of Mining Lease 5
(vi).Expected cost of the Project 40
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.RQP/2/2016 
Name of Consultant/RQPA Mahammad Kunhi
Address Ponjurmoola House, Nekraje PO, Mulleria (via), Kasaragod District, Kerala.
Mobile No.9446679585
Landline No.2456333
(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.  55 km
2. (ii). Nearest Infrastructural along with distance in kms  55 km
(iii). Nearest Railway Line along with distance in kms  55 km
(iv). Nearest National Highway along with distance in kms  17 km
(v). Nearest State Highway along with distance in kms  8 km
(vi). Nearest Major District Road along with distance in kms 16 km
(vii). Nearest Any Other Road along with distance in kms  6 km
(viii). Nearest Electric transmission line pole or tower distance in kms  1 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  25 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  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
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Kalithattumpara 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
6. Inland, coastal, marine or underground waters Thalassery 55 km
7. State, National boundaries Karnadaka 10km
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas Midumpoyil - Waynad
9. Defence installations Kannur- 58km
10. Densely populated or built-up area, distance from nearest human habitation Vaniyappara - 3km, Mundayamparambu - 6km, Irtty - 17km
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospitals: Iritty Thaluk Hospital - 17km Schools & Colleges: LP School Randamkadave - 1.5km, Don Bosco collage angadikkadave - 6km Tourist & Pilgrim areas: Wayannad - 70km, Stjosaph churchRandamkadave - 2km
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) None within 5km radius
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) No notified / Recognized polluted area within 15km distance.
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.
Is proposed mining site located over or near fissure/fracture for ground water recharge?No
Whether the proposal involves approval or clearance under the following Regulations or Acts namely?
The Forest (Conservation) Act,1980?No
The Wildlife (Protection) Act,1972?No
The Coastal Regulation Zone (C.R.Z) notification,2011?No
Is forest land involved (ha)?No
Whether there is any litigation pending against the project and/or land in which the project is proposed to be set up?No
Proposal NumberDIA/KL/MIN/18289/2018
File Number361/ECA/KNR/2018/DEIAA
Date of Apply EC18 Oct 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(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.)Letter Of Intent18 Oct 2018
(2.)ApprovalLetter&500mCertificate18 Oct 2018
(3.)Form 1M18 Oct 2018
(4.)Proponent Affidavits18 Oct 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
AddressKavil House, Puthur PO, Kannur District, Kerala.