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. Shivraj Komal Singh
(ii).Location / site (GPS Co-ordinate) 1. 18°45.543’ N 73°15.548’ E 2. 18° 45.549'N 73° 15.517'E 3. 18° 45.552'N 73° 15.569'E 4. 18° 45.534'N 73° 15.554'E 5. 18° 45.511'N 73° 15.548'E 6. 18° 45.518'N 73° 15.507'E 7. 18° 45.523'N 73°
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.97 ha.
(iv).Capacity of the Mining Lease (TPA) 70000
(v).Period of Mining Lease 5
(vi).Expected cost of the Project 400
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.NABET/EIA/1518/SA021 
Name of Consultant/RQPM/s Sadekar Enviro Engineer Pvt Ltd
Address 310, Dempo Tower, EDC Patto, Panaji - 403001, Goa State.
Mobile No.9820144125
Landline No.08322437048
Email Idprs@sadekarenviro.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.  1.81 km
2. (ii). Nearest Infrastructural along with distance in kms  2.0 km
(iii). Nearest Railway Line along with distance in kms  9.8 km
(iv). Nearest National Highway along with distance in kms  5.0 km
(v). Nearest State Highway along with distance in kms  2.3 km
(vi). Nearest Major District Road along with distance in kms 0.0 km
(vii). Nearest Any Other Road along with distance in kms  0.8 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.6 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  1.5 km
(x). Nearest In-take for drinking water pump house distance in kms  0.0 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  0.0 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
Karnala Bird Sanctuary is at a distance of 15.8 kms from the quarry area.
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Karnala Bird Sanctuary is at a distance of 15.8 kms from the quarry area.
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration Not Applicable
6. Inland, coastal, marine or underground waters Approx. 2.5 kms from Donvat Reservoir in the North Direction. Irrigation tank near Usroli village at a distance of 1.5 kms in south direction. Baanganga river is at a distance of 1.5 kms from quarry site at a distance of NNW direction.
7. State, National boundaries Not Applicable.
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas Not Applicable.
9. Defence installations Not Applicable.
10. Densely populated or built-up area, distance from nearest human habitation Nearest habitation is Tondali village at a distance of 600 m from the quarry site
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) School and small temples are present in Tondali village.
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Not Applicable
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) Not Applicable
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 falls in Zone 3 as per Seismic zone Classification. No Historical Data suggests evidence for Earthquakes, subsidence, landslides, erosion, flooding or extreme or adverse climatic conditions.
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/MH/MIN/12692/2018
File NumberDIA/MH/MIN/12692/2018
Date of Apply EC31 Jan 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)MaharashtraRaigadKhalapur
(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.)Grampanchayat NOC31 Jan 2018
(2.)7/12 a31 Jan 2018
(3.)7/12 b31 Jan 2018
(4.)7-12 a31 Jan 2018
(5.)7-12 b31 Jan 2018
(6.)Grampanchayat NOC31 Jan 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameM/S SHIVRAJ SINGH KOMAL
Designationproprietor
Company M/S SHIVRAJ SINGH KOMAL
AddressSurvey No. 10/6/A/B, Village: Tondali,Taluka : Khalapur , District : Raigad , State : Maharashtra.
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