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 Kuriakose Ordinary Earth Mining Project
(ii).Location / site (GPS Co-ordinate) 1.9°53'8.84"N 76°33'06.71"E 2. 9°53'7.84"N 76°33'06.96"E 3.9°53'7.42"N 76°33'10.72"E 4.9°53'7.23"N 76°33'11.96"E 5.9°53'8.72"N 76°33'12.22"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.6313 ha.
(iv).Capacity of the Mining Lease (TPA) 14000
(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/7/2016 
Name of Consultant/RQPNAZAR AHAMED KV
Address N SQURE MINIG & ENVIORNMENTAL SOLUTION LLP, EDAPPAL, MALAPPURAM
Mobile No.9447177533
Landline No.48975949
Email Idgeologistna@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  30 km
(iii). Nearest Railway Line along with distance in kms  20 km
(iv). Nearest National Highway along with distance in kms  20 km
(v). Nearest State Highway along with distance in kms  5 km
(vi). Nearest Major District Road along with distance in kms 0.060 km
(vii). Nearest Any Other Road along with distance in kms  0.060 km
(viii). Nearest Electric transmission line pole or tower distance in kms  5 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  3 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
None within 5 Km radius
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests None within 5 Km radius
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration None within 5 Km radius
6. Inland, coastal, marine or underground waters None within 5 Km radius
7. State, National boundaries None within 5 Km radius
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas None within 5 Km radius
9. Defence installations None within 5 Km radius
10. Densely populated or built-up area, distance from nearest human habitation Piravom-5 Km
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) 1. Govt U P school Onakkoor-1 Km 2. St. Mariy’s Orthodox Church Onakkoor-1 Km 3. Mahadeva Temple Onakkoor-1 KM 4. Post Office Onakkoor- 1 KM 5. St. Joseph HSS piravom -4 Km
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) No
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) No
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
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/19624/2018
File NumberTo be assigned
Date of Apply EC13 Dec 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaErnakulamMuvattupuzha
(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.)Simplified application Part 114 Dec 2018
(2.)Simplified application Part 2 & work order14 Dec 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameV K KURIAKOSE
DesignationShri
Company V K KURIAKOSE
AddressVettiloth House, Onakkoor P. O, Ernakulam
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