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 Saj Quarry
(ii).Location / site (GPS Co-ordinate) Latitude 12° 8'16.15"N Longitude 75°30'38.33"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)4.5337 ha.
(iv).Capacity of the Mining Lease (TPA) 100000
(v).Period of Mining Lease 10
(vi).Expected cost of the Project 20
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.362/2015/A 
Name of Consultant/RQPKorah A G
Address Anteril House, Mooledom P.O. Nattakam, Kottayam, Kerala, 686012
Mobile No.9447889626
Landline No.2360994
Email Idkorahag@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.  16 km
2. (ii). Nearest Infrastructural along with distance in kms  1.5 km
(iii). Nearest Railway Line along with distance in kms  42 km
(iv). Nearest National Highway along with distance in kms  29 km
(v). Nearest State Highway along with distance in kms  28 km
(vi). Nearest Major District Road along with distance in kms 7.5 km
(vii). Nearest Any Other Road along with distance in kms  7.5 km
(viii). Nearest Electric transmission line pole or tower distance in kms  1.5 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  0 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
 Nil
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Nil
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration Nil
6. Inland, coastal, marine or underground waters Nil
7. State, National boundaries Karnataka (State Boundary)
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas Palakkayam Thattu (Naduvil-Mandalam-Chettadi-Mykkad-Kottayamthattu)
9. Defence installations Nil
10. Densely populated or built-up area, distance from nearest human habitation Mavunchal (1.5 KM)
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Tourist & Pilgrim areas Anakuzhi Mosque, Anakuzhi 6 Sri Mahadeva Temple, Vellad 5 St. George Church, Mavunchal 1.5 Mannankundu Mosque, Mannankundu 5.50 St. Thomas Church, Asankavala 2.5 St. Alphonsa’s Church, Thermala 3.0 St. Sebastian’s Church, Vellad 5.0 Schools & Colleges Govt. U.P. School, Vellad 4.5 Mary Matha Arts & Science College, Alakode 8 Little Flower H.S. School, Karuvanchal 7 Vimal Jyothi Engg. College, Chemperi 10 St. Sebastian U.P. School, Vellad 5 Hospitals
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Nil
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) Nil
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, This area is generally not prone to any natural disasters.
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/5304/2017
File NumberTo be assigned
Date of Apply EC09 Mar 2017
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.)Letter Of Intent09 Mar 2017
(2.)500m Certificate09 Mar 2017
(3.)Approval Letter09 Mar 2017
(4.)Risk Assessment09 Mar 2017
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameU SAEED
DesignationOwner
Company U SAEED
AddressSaj Mahal, Pushpagiri, Taliparamba, Kannur, Kerala.
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