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 BUILDING STONE QUARRY OF Smt. SHIJI THOMAS
(ii).Location / site (GPS Co-ordinate) 10° 3’ 3.48’’ to 10° 3’ 8.66’’ 76° 33’ 5.82’’ to 76° 33’ 0.19’’
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.8970 ha.
(iv).Capacity of the Mining Lease (TPA) 40000
(v).Period of Mining Lease 3
(vi).Expected cost of the Project 25
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.2296/13/A 
Name of Consultant/RQPHAREESHG THAMPY
Address 905 D, 9TH STREET, SANKAR NAGAR, KAIMANAM POST, TRIVANDRUM
Mobile No.8089999774
Landline No.509824
Email Idgt.hareesh@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.  7.6 km
2. (ii). Nearest Infrastructural along with distance in kms  4.5 km
(iii). Nearest Railway Line along with distance in kms  27 km
(iv). Nearest National Highway along with distance in kms  44 km
(v). Nearest State Highway along with distance in kms  2.5 km
(vi). Nearest Major District Road along with distance in kms 4.5 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  0.101 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  0.9 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  10 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
NONE WITHIN 15KM RADIUS
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests NONE WITHIN 15KM RADIUS
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration NONE WITHIN 15KM RADIUS
6. Inland, coastal, marine or underground waters Muvattupuzha River - 7.6 KM E & S
7. State, National boundaries NONE WITHIN 15KM RADIUS
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas NONE WITHIN 15KM RADIUS
9. Defence installations NONE WITHIN 15KM RADIUS
10. Densely populated or built-up area, distance from nearest human habitation Mannoor – 2.2 KM W
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospitals Govt PHC, Thrikkalathur – 2.0 KM SW Parathuvayalil Hospital Keezhilllam 3.0 KM - NW Schools / Colleges St Thomas Nursery School Keezhillam – 2.4 KM W St Thomas HSS, Keezillam 3.0 KM W Got. HS Payipra - 3.0 KM Ilahiya College - 4.0 KM SE Churches 1.St Marys Church, Bathaniyakunnu–0.6 KM N NW 1. Mar Grigorious Orthodox Church – 2.0 KM N-NW 2. Payipra Manari Kanjirakattu – 1.5 KM S SE
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. The quarry is located over a crust of elevated rock formation. No geological fissure / fracture is observed. Quarrying will help to bring down the ground level and help to recharge the area / store with rain water.
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/7476/2017
File Number5707/2017/P
Date of Apply EC12 Jul 2017
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaErnakulamMuvattupuzha
(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.)FORM I M12 Jul 2017
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameBUILDING STONE QUARRY OF SHIJI THOMAS
DesignationPROPRIETOR
Company BUILDING STONE QUARRY OF SHIJI THOMAS
AddressKATTADY HOUSE, KIZHILLAM POST, ERNAKULAM
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