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 MUHAMMADALI. N, VILLAGE: KARYAVATTOM, TALUK: PERINTHALMANNA, MALAPPURAM
(ii).Location / site (GPS Co-ordinate) 11°0'48.00"N to 11°0'50.50"N 76°15'39.90"E to 76°15'44.80"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.7272 ha.
(iv).Capacity of the Mining Lease (TPA) 24165
(v).Period of Mining Lease 5
(vi).Expected cost of the Project 25
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.DMG/KERALA/RQP/8/2017 
Name of Consultant/RQPDr.SAKKIR.S
Address S/o SHRI.E.SAINUDHEEN PILLAI SHASKANS,THANNIMOODU,IRICHAYAM POST,TRIVANDRUM,KERALA,695561
Mobile No.9497154395
Landline No.281802
Email Idekspertthannimood@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  9 km
(iii). Nearest Railway Line along with distance in kms  5 km
(iv). Nearest National Highway along with distance in kms  9 km
(v). Nearest State Highway along with distance in kms  9 km
(vi). Nearest Major District Road along with distance in kms 1 km
(vii). Nearest Any Other Road along with distance in kms  0.3 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  None within 5km radi km
(x). Nearest In-take for drinking water pump house distance in kms  0.5 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  None within 5km radi 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 None within 5km radius
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 None within 5km radius
7. State, National boundaries TamilNadu 45km
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas Kottakkunnu amusement park 47km, Kodikuthimala 15km ,Mankada Tourism Village 13km Pilgrim areas : Mannarmala juma Masjid 2km,Kariavattam Juma Masjid 1.50km,Vengoor Juma Masjid 1.15km,Poonthanam Sri Krishna Temple 5km,Kulappurath Mana Temple 3km,Vazhangode Shiva Temple 3.5km,Lourde Matha Roman Catholic Church 905km,St.Mary's Church Valambur 8.5km,St.George Orthodox Church 10km
9. Defence installations None within 5km radius
10. Densely populated or built-up area, distance from nearest human habitation Pattikkad 5km
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Schools : GHSS Pattikkad ,Vengoor High School, 2Km,5km,Govt.High School Cheriyam 11km,Silver mount International school 5km Colleges: MEA Engineering College 2.5km,Jamia Nooriyyaa Arabic College 3.6km,Moulana College of Pharmacy 6.5km Hospitals: Govt.Hospital perinthalmanna 9km,Alshifa hospital 5.2km,Maulana Hospital 5.4km Community facilities: Police station (Melattur 8km), Post office Pattikkad 7km
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) None within 5km 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 within 5km 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/19792/2019
File NumberTo be assigned
Date of Apply EC12 Jan 2019
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaMalappuramPerinthalmanna
(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 LETTER &500M12 Jan 2019
(2.)RQP CERTIFICATE12 Jan 2019
(3.)EC AFFIDAVIT12 Jan 2019
(4.)NABL CERTIFICATE12 Jan 2019
(5.)LETTER OF INTENT12 Jan 2019
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameGRANITE(BUILDING STONE) QUARRY OF MR MUHAMMADALI N
DesignationKARYAVATTOM
Company GRANITE(BUILDING STONE) QUARRY OF MR MUHAMMADALI N
AddressS/o HAMSA NARANTHODI HOUSE PATTIKKAD PO MALAPPURAM
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