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 Sanjayan Paramban, Managing Director M/s Kunnathoor Stone Crusher Pvt Ltd Payyavoor Village Thaliparamba Thaluk Kannur
(ii).Location / site (GPS Co-ordinate) Lattitude : 12 7 44.37 Longitude : 75 38 30.59
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)2.1924 ha.
(iv).Capacity of the Mining Lease (TPA) 46246
(v).Period of Mining Lease 12
(vi).Expected cost of the Project 850
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.369/2016/A 
Name of Consultant/RQPC BALARAMAN
Address Paliam,Peoli Road,Kacheripadi,Kochi
Mobile No.9446404140
Landline No.2590259
Email Idbalramc28@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.  68 km
2. (ii). Nearest Infrastructural along with distance in kms  4 km
(iii). Nearest Railway Line along with distance in kms  68 km
(iv). Nearest National Highway along with distance in kms  32 km
(v). Nearest State Highway along with distance in kms  10 km
(vi). Nearest Major District Road along with distance in kms 13 km
(vii). Nearest Any Other Road along with distance in kms  .105 km
(viii). Nearest Electric transmission line pole or tower distance in kms  .500 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  .145 km
(x). Nearest In-take for drinking water pump house distance in kms  .150 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  .145 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
None within study area, 500 m radius
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Forest 300m
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration None within study area, 500 m radius
6. Inland, coastal, marine or underground waters None within study area, 500 m radius
7. State, National boundaries Within 1 Km Karnataka State Boundary
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas None within study area, 500 m radius
9. Defence installations None within study area, 500 m radius
10. Densely populated or built-up area, distance from nearest human habitation Kanjirakolli,7 Km
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Schools & Colleges 1.School- Khader Khaji Memorial School, Kanjirakolli – 5Km 2.St. Thomas School, Manikadavu Hospital Mercy Hospital- Payyavoor – 10 Km Post Office Kanjirakolli -5Km Worship Church-Vimalambika Church,Kanjirakolli -5Km Temple-Siva Temple, Payyavoor, 10 Km Mosque- Kanjirakolli -5Km
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) 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) Earth Quake Zone-III, Moderate damage risk zone as per BMTPC, Vulnerability atlas Seismic zone of India IS: 1893-2002
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/8150/2017
File NumberTo be assigned
Date of Apply EC19 Aug 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.)Approval Certificate, Cadastral map,Cluster Certificate,Affidavit04 Aug 2017
(2.)Land Classification certificate, Land Tax Receipt,Photo04 Aug 2017
(3.)Land Documents04 Aug 2017
(4.)LAB REPORT04 Aug 2017
(5.)Checklist and Questionaire,Lab Report04 Aug 2017
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameJ R ASSOCIATES
DesignationManagingDirector
Company J R ASSOCIATES
AddressJR ASSOCIATES
Print