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 Mr. Mathew Daniel, Building Stone Quarry, 0.98.49 Hectares in S.Y.No. 541 at Erathu Village, Adoor Taluk, Pathanamthitta District, Kerala.
(ii).Location / site (GPS Co-ordinate) 09°06'17.41”N to 09°06'22.05”N 76°44’15.24” E to 76°44’20.53”E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.98.49 ha.
(iv).Capacity of the Mining Lease (TPA) 29901
(v).Period of Mining Lease 5
(vi).Expected cost of the Project 55.25
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.MAS/013/A 
Name of Consultant/RQPMr.S.Suriyakumar
Address No:3/216, KSV Nagar,IIIrd Cross,Narasothipatti,Alagapuram Post,Salem-636004.
Mobile No.9842729655
Landline No.2440446
Email Idsuriyakumarsemban@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.  0.9 km
2. (ii). Nearest Infrastructural along with distance in kms  2 km
(iii). Nearest Railway Line along with distance in kms  10 km
(iv). Nearest National Highway along with distance in kms  1.07 km
(v). Nearest State Highway along with distance in kms  4.4 km
(vi). Nearest Major District Road along with distance in kms 1.1 km
(vii). Nearest Any Other Road along with distance in kms  1.1 km
(viii). Nearest Electric transmission line pole or tower distance in kms  2 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  0.9 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  2.1 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
 There is no reserve forest found within 10 km radius of the lease area.
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests There is no major water resource or other sensitive regions nearby the lease area.
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration None within 10 km
6. Inland, coastal, marine or underground waters Arabian Sea is located about 26 km from the site towards west
7. State, National boundaries Kerala-Tamil Nadu interstate boundary is about 45 km on East
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas Malankavu Park – 3.7km – West Veluthampi Memorial – 1.79km - South
9. Defence installations None within study area and 5 km radius
10. Densely populated or built-up area, distance from nearest human habitation It is not a densely populated area, Nearest habitation is Kadambanadu which is about 1.5 km on the west which holds a population of about 26839.
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) i. Mannady Marothoma Church – 1.45km – South ii. Pattazhy Thekkekara Muslim Jamma – 6.1km – South East iii. Govt.Hospital – Erathu – 2.5km – South iv. School – Choorakkodu – 1.5km - North
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) No other important, high quality or scarce resources (ground water resources, surface resources, forestry, agriculture, fisheries, tourism, minerals)
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) There is no area already subjected to pollution or environmental damage. (those where existing legal environmental standards are exceeded)
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) The area under Zone III - Moderate damage risk zone (MSK VII) 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/8172/2017
File Number14/2017
Date of Apply EC07 Aug 2017
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaPathanamthittaAdoor
(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)
NameMR. MATHEW DANIEL
DesignationOwner
Company MR. MATHEW DANIEL
AddressMangalathu Padijatathil, Adoor, Peringanadu (P), Parakottam, Pathanamthitta District
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