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 Shri. Saji Sebastian, Arakkuzha Village, Muvattupuzha Thaluk Ernakulam
(ii).Location / site (GPS Co-ordinate) Latitude:9 55 36.12, Longitude:76 34 44.72
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.9959 ha.
(iv).Capacity of the Mining Lease (TPA) 37836
(v).Period of Mining Lease 1
(vi).Expected cost of the Project 8
(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 House ,Peoli Rad ,Kacheripadi
Mobile No.9446404140
Landline No.2590259
Email Idbalaramc28@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.  5 km
2. (ii). Nearest Infrastructural along with distance in kms  5 km
(iii). Nearest Railway Line along with distance in kms  35 km
(iv). Nearest National Highway along with distance in kms  7 km
(v). Nearest State Highway along with distance in kms  0.120 km
(vi). Nearest Major District Road along with distance in kms 0.120 km
(vii). Nearest Any Other Road along with distance in kms  0.120 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.200 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  5 km
(x). Nearest In-take for drinking water pump house distance in kms  0.500 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  0.80 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
 None within 500 m radius
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Muvattupuzha River ,500m
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration None within 500 m radius
6. Inland, coastal, marine or underground waters None within 500 m radius
7. State, National boundaries None within 500 m radius
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas None within 500 m radius
9. Defence installations None within 500 m radius
10. Densely populated or built-up area, distance from nearest human habitation Muvattupuzha, 5 Km
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Schools & Colleges Little flower Lower Primary School Hospitals Nirmala Medical Centre,Muvattupuzha Muvattupuzha Govt,Hospital Worship Church- St. Joseph's Syro-Malabar Catholic Church
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) Quarrying for building stone is being conducted since many years.
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/9539/2017
File NumberTo be assigned
Date of Apply EC27 Sep 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 1m,Affidavit,Work Order27 Sep 2017
(2.)Tax Receipt,Id Proof27 Sep 2017
(3.)Sketch,Possession27 Sep 2017
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameSAJI SEBASTION
DesignationOwner
Company SAJI SEBASTION
AddressMadeckal House, Kizhakkambalam P O, Ernakulam
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