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 Penta Granites
(ii).Location / site (GPS Co-ordinate) Latitude - 10°31'10.80"N Longitude - 76°30'12.24"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)4.1371 ha.
(iv).Capacity of the Mining Lease (TPA) 100000
(v).Period of Mining Lease 12
(vi).Expected cost of the Project 74
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.RQP/4/2016 
Name of Consultant/RQPV.K Roy
Address Saral, TC27/487(2), Swaraj Lane, RC Junction, Kunnukuzhy, Thiruvananthapuram.
Mobile No.9387805668
Landline No.4014111
Email Idvkroysaral@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.  12 km
2. (ii). Nearest Infrastructural along with distance in kms  12 km
(iii). Nearest Railway Line along with distance in kms  55 km
(iv). Nearest National Highway along with distance in kms  12 km
(v). Nearest State Highway along with distance in kms  40 km
(vi). Nearest Major District Road along with distance in kms 12 km
(vii). Nearest Any Other Road along with distance in kms  12 km
(viii). Nearest Electric transmission line pole or tower distance in kms  1 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  7 km
(x). Nearest In-take for drinking water pump house distance in kms  10 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  200 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 Govindapuram(State)-60Km
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas MangalamDam,5Km
9. Defence installations Nil
10. Densely populated or built-up area, distance from nearest human habitation Ambattentharisu 1Km Neethipuram 1Km
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Tourist & Pilgrim areas Malampuzha Dam 50km MangalamDam 5km Mudappallur Temple 12km Chittadi RC Church 10km Chittadi Mosque 10km Schools & Colleges LMHSS Mangalam Dam 6Km Aided Upper Primary School Moolamcode 5Km Nemmara Gangothri English medium School 20Km NSS College,Nemmara 20Km Hospitals Karuna Hospital,Vadakkencherry 10Km Valliyode Hospital 8Km St.Joseph Hospital, Mangalam dam 6Km
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) No notified / Recognized polluted area within 15km distance
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/6633/2017
File NumberDIA/KL/PL/10/2017
Date of Apply EC24 May 2017
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaPalakkadAlathur
(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.)Partners ID Proof24 May 2017
(2.)Firm Registration24 May 2017
(3.)Mining Plan approval letter24 May 2017
(4.)Letter of Intent24 May 2017
(5.)NABL Certificate24 May 2017
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NamePEEJAY GRANITES
DesignationManagingpartner
Company PEEJAY GRANITES
AddressChittadi P.O, Palakkad.
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