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 Quarry Owned by Sudheesh A T
(ii).Location / site (GPS Co-ordinate) Latitude (N) : 11037’37.81”to 11037’48.36” N Longitude (E) : 7602’38.36” to 7602’45.42” E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)2.7513 ha.
(iv).Capacity of the Mining Lease (TPA) 120118.1
(v).Period of Mining Lease 10
(vi).Expected cost of the Project 85
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.RQP/BNG/338/2014/A 
Name of Consultant/RQPMAHESH S
Address T.C 31/580,NAVADEEPAM,S.N NAGAR,PETTAH(P.O),TRIVANDRUM
Mobile No.9446303422
Landline No.2405383
Email Idmaheshsurendranpillai@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.  3.48 km
2. (ii). Nearest Infrastructural along with distance in kms  2.7 km
(iii). Nearest Railway Line along with distance in kms  43.4 km
(iv). Nearest National Highway along with distance in kms  4.76 km
(v). Nearest State Highway along with distance in kms  1.27 km
(vi). Nearest Major District Road along with distance in kms 1.8 km
(vii). Nearest Any Other Road along with distance in kms  0.32 km
(viii). Nearest Electric transmission line pole or tower distance in kms  2.29 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  7.2 km
(x). Nearest In-take for drinking water pump house distance in kms  12.7 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  3.5 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
None within 1KM from project site
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Mavoor Wetlands- 42.2 km- SW Chembra Peak-13.6km -SE Banasura Hills -16.7km-NW Ambukuthimala -20.5km-E Brahmagiri Peak -34.1km-NW Nilgiris Biosphere Reserve-27.6km-NE Bandipur Tiger Reserve & National Park-45.6km-NE Nagarhole National Park & Tiger Reserve-45.2km-NE Mudumalai National Park-53.7km-SE Soochipara Waterfalls-18.2km-SE Kanthanpara Waterfalls-16.4km-SE Banasuramala Meenmutty Waterfalls-13.1km-NW Chethalayam Waterfalls-27.4km-NE Chaliyar River-33.6km- SW
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration None within 1KM from project site
6. Inland, coastal, marine or underground waters Soochipara Waterfalls-18.2km-SE Kanthanpara Waterfalls-16.4km-SE Banasuramala Meenmutty Waterfalls-13.1km-NW Chethalayam Waterfalls-27.4km-NE Chaliyar River-33.6km- SW Thalur Pond-23.1km-SE Karlad Lake-7.2km-NW Pookode Lake-9.56km-SW Hridaya Saras Lake -9.74km-SE Kozhippara Lake-29.6km-SE
7. State, National boundaries Kerala-Karnataka Border-30.7km -E Kerala-Tamilnadu Border-21.5km-SE
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas NH 766(Kozhikode-Karnataka)-4.76km E SH 54(Kozhikode-Kalpetta)-1.27km-SW
9. Defence installations None within 1KM from project site
10. Densely populated or built-up area, distance from nearest human habitation Vengappally-1.17 km NW Nearest human habitation-52.7m NE
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospital:- Fathima Mata Mission Hospital – 3.94 km SE Airport:- Calicut International Airport -54.9km SW School:-W.O.H.S.S Pinangode –2.88km W Church:- St. Mary’s Church,Puzhamudi, 1.9 km SE Mosque:- Chooriyatta Juma Masjid , 0.48 km NW Temple:-Bhagavathi Temple, Thekkumthara, 2.05 km NW
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Chaliyar River-33.6km- SW Wayanad Wildlife Sanctuary-35.5km-NE Muthanga Forest-36.1km-E Wayanad Forest-30.5km-N Padiri Reserve Forest-19.5km-NE Kuruva Reserve Forest--21.9km-NE
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/19786/2019
File NumberTo be assigned
Date of Apply EC08 Jan 2019
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaWayanadVythiri
(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.)APPROVAL LETTER08 Jan 2019
(2.)500M CERTIFICATE08 Jan 2019
(3.)EC AFFIDAVIT08 Jan 2019
(4.)RQP08 Jan 2019
(5.)FORM 1M08 Jan 2019
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameMR SUDHEESH A T
DesignationOWNER
Company MR SUDHEESH A T
AddressADAKKATHOTTATHIL HOUSE RATTAKUNDU KUMBLERI P.O WAYANAD
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