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 Stone Quarry Proposed by Haridasan
(ii).Location / site (GPS Co-ordinate) 11°29’26.3” to 11°29’34.7” N 75°52’42.1” to 75°52’46.8” E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)1.9271 ha.
(iv).Capacity of the Mining Lease (TPA) 21000
(v).Period of Mining Lease 18
(vi).Expected cost of the Project 180
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.338/2014/A 
Name of Consultant/RQPMahesh.S
Address Navadeepam,S.N Nagar,Petta, TVM
Mobile No.9446303422
Landline No.2202679
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.  4 km
2. (ii). Nearest Infrastructural along with distance in kms  3 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  10 km
(vi). Nearest Major District Road along with distance in kms 1 km
(vii). Nearest Any Other Road along with distance in kms  1 km
(viii). Nearest Electric transmission line pole or tower distance in kms  4 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  12 km
(x). Nearest In-take for drinking water pump house distance in kms  12 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  40 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
 Not available with in the Study Area
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Not available with in the Study Area
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration Not available with in the Study Area
6. Inland, coastal, marine or underground waters Not available with in the Study Area
7. State, National boundaries Not available with in the Study Area
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas Vayanada 10 km away from the site is a local tourist place
9. Defence installations Not available with in the Study Area
10. Densely populated or built-up area, distance from nearest human habitation Mankayam Town, 01 km away from the site
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) at a distance of 01 km , Mankayam there is one Homeo Clinic ,all other public facilities like schools ,Hospital...etc are at Balusseri or around places at a distance of 10 km
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Nearest ground water source is at residence of Mr. Sajeevan, at a distance of 500 m from the site, River or surfce water are available at a distance of 10 km commonly known as Manjapuzha
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) Not available with in the Study Area
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) Not available with in the Study Area
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/5709/2017
File NumberH 3937/2017
Date of Apply EC02 Apr 2017
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaKozhikodeQuilandy
(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
NIL
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameHARIDASAN
DesignationOwner
Company HARIDASAN
AddressTharol Ekarool,Unnikulam
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