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 Granite Building Stone Quarry of M/s KURISSUMMOOTTIL STONE QUARRY
(ii).Location / site (GPS Co-ordinate) N : 12° 05’ 16.4’’ , E : 75° 37’ 17.1’’
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)4.4520 ha.
(iv).Capacity of the Mining Lease (TPA) 150000
(v).Period of Mining Lease 12
(vi).Expected cost of the Project 388
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.040/88/A 
Name of Consultant/RQPK.T RAMACHANDRA
Address ULTRA-TECH ENVIRONMENTAL CONSULTANCY & LABORATORY DOOR NO. 27/2957 A1, VANIAMPILLY, K.P VALLON ROAD, KADAVANTHRA, KOCHI- 682020
Mobile No.9895200526
Landline No.4011173
Email Idkochi@ultratech.in
(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.  4.6 km
2. (ii). Nearest Infrastructural along with distance in kms  0 km
(iii). Nearest Railway Line along with distance in kms  37 km
(iv). Nearest National Highway along with distance in kms  29 km
(v). Nearest State Highway along with distance in kms  5.4 km
(vi). Nearest Major District Road along with distance in kms 1.8 km
(vii). Nearest Any Other Road along with distance in kms  0.3 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  1.8 km
(x). Nearest In-take for drinking water pump house distance in kms  0 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  0 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
Bhramagiri Wild Life Sanctuary at an Aerial Distance of 10km
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests None within 15 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 15 km radius
6. Inland, coastal, marine or underground waters Payyavoor River at an aerial distance of 1.8 Km
7. State, National boundaries Kerala – Karnataka State boundary at an aerial distance of 4 km
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas None within 15 km radius
9. Defence installations None within 15 km radius
10. Densely populated or built-up area, distance from nearest human habitation Payyavoor at an aerial distance of 5 Km
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospitals 1. Mercy Hospital , Payyavoor- 5.3km 2. Government Hospital, vayathur- 5.4 Km 3. Government Hospital, Pooparamba- 6.6 Km 4. Vimala Hospital, Chemperi- 6.6 Km 5. Government Hospital, Iratty- 12.9 Km Schools 1. Deva Matha School, Paisakary- 2Km 2. Cherupushpam High School- 2.9 Km 3. St. Thomas Higher Secondary School- 3.7 Km 4. Sacred Heart High School-4.6 Km 5. St. Anns English Medium School- 5 Km 6. Govt. U P School, Payyavoor- 6.6 Km 7. Perfect English School- 6 Km 8. Fu
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) None within 15km radius
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) Quarrying for building stone is being conducted since many years.
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, lease area is not susceptible to natural hazard, as there is no history of such incidents.
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/3153/2016
File Number08/KNR/2017/DEIAA
Date of Apply EC03 Dec 2016
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaKannurTaliparamba
(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.)Additional Attachment03 Dec 2016
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameKURISSUMMOOTTIL STONE QUARRY
DesignationProprietor
Company KURISSUMMOOTTIL STONE QUARRY
AddressKurissummoottil House, Madathil P O, Iritty, Kannur
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