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 PALACHUVATTIL OE MINING PROJECT In Sy no:91/3-3,92/2-6,91/3-2,92/2-5 of Vazhakkulam Village Kunnathunadu Taluk.
(ii).Location / site (GPS Co-ordinate) E76250986,N10054792 E76251056,N10054913 E76251357,N10054684 E76251352,N10054656
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.409 ha.
(iv).Capacity of the Mining Lease (TPA) 10000
(v).Period of Mining Lease 1
(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/4/2016 
Name of Consultant/RQPV.K ROY
Address SARAL,THIRUVANANTHAPURAM
Mobile No.9387805668
Landline No.99611250
Email Idvkroysaral@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.  5 km
2. (ii). Nearest Infrastructural along with distance in kms  2 km
(iii). Nearest Railway Line along with distance in kms  12 km
(iv). Nearest National Highway along with distance in kms  12 km
(v). Nearest State Highway along with distance in kms  2 km
(vi). Nearest Major District Road along with distance in kms 2 km
(vii). Nearest Any Other Road along with distance in kms  1 km
(viii). Nearest Electric transmission line pole or tower distance in kms  2 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  2 km
(x). Nearest In-take for drinking water pump house distance in kms  7 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  7 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
NONE IN 20 KMS RADIUS
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests NONE IN 20 KMS RADIUS
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration NONE IN 20 KMS RADIUS
6. Inland, coastal, marine or underground waters NONE IN 20 KMS RADIUS
7. State, National boundaries NONE IN 20 KMS RADIUS
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas ALUVA MUNNAR ROAD AT CHEMBERAKKY_2 KMS
9. Defence installations NONE IN 20 KMS RADIUS
10. Densely populated or built-up area, distance from nearest human habitation NONE IN 20 KMS RADIUS
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) RAJAGIRI HOSPITAL-06 KMS VAZHAKKULAM SCHOOL-03KMS
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) NONE IN 20 KMS RADIUS
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) NONE IN 20 KMS RADIUS
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) NONE IN 20 KMS RADIUS
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/18858/2018
File NumberTo be assigned
Date of Apply EC08 May 2019
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaErnakulamKunnathunad
(2.)KeralaErnakulamKunnathunad
(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.)WORK ORDER08 May 2019
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameTEAM DEVELOPERS
DesignationManaging Partner
Company TEAM DEVELOPERS
Address1 st floor,Shahin Buildings,West Vengola P.O,Perumbavoor
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