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 Sand Mining Project at Pipari 2 Tehsil – Sadak Arjuni, District - Gondia, State - Maharashtra
(ii).Location / site (GPS Co-ordinate) Pipari 2 Sand Quarry area is situated in Tehsil Sadak Arjuni , District- Gondia, Maharashtra, Area : 0.75 Ha, Coordinates:- Sr. No Latitude “N” Longitude “E” 1 21° 2'36.95" 80° 4'41.65" 2 21° 2'3
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.75 ha.
(iv).Capacity of the Mining Lease (TPA) 5962.5
(v).Period of Mining Lease 1.0
(vi).Expected cost of the Project 5.0
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.NABET/EIA/1619/IA 007 
Name of Consultant/RQPGMEC INTERNATIONAL
Address 308, SAHARAN TOWER, OFFICERS CAMPUS EXTENSION, NEAR SANSKAR SCHOOL, SIRSI ROAD KHATIPURA JAIPUR - 302012
Mobile No.9928793002
Landline No.2353241
Email Idinfo@gmecinternational.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.  0.0 km
2. (ii). Nearest Infrastructural along with distance in kms  Nearest Railway Stat km
(iii). Nearest Railway Line along with distance in kms  at a distance of ~ 4 km
(iv). Nearest National Highway along with distance in kms  is 4.50 km in North km
(v). Nearest State Highway along with distance in kms  0.0 km
(vi). Nearest Major District Road along with distance in kms is 4.50 km in North km
(vii). Nearest Any Other Road along with distance in kms  0.0 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.0 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  0.0 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
Not Found
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests PIPARI -2 - Mining lease allocated on the inactive channel of the mentioned river.
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration There is no such area within 15 km from the site.
6. Inland, coastal, marine or underground waters Not present
7. State, National boundaries Not within 15 km from the project site.
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas NH-6 is 4.50 km in North direction from Project Site.
9. Defence installations There is no such area within 15 km from the site.
10. Densely populated or built-up area, distance from nearest human habitation Village Pipari at 0.50 Km towards South. Village Parsodi at 1.70 Km towards NW
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) a) School:- The Primary school facility is available at village – Pipari( 0.50 Km, South), Middle & High school facility is available at Sadak Arjuni (10.0 km, NE), while college is available at Sadak Arjuni (10.0 km, NE). a) Hospital: - Hospital facility is available Sadak Arjuni (10.0 km, NE) from M.L. area. b) Temple: Ganesh ka Mandir at Pipari (0.50 Km, South),from the lease area.
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Not present
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) Area is susceptible to Earthquake. Project area falls in Zone- II (Least Active) This is said to be the least active seismic zone.
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/13301/2018
File NumberTo be assigned
Date of Apply EC27 Feb 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)MaharashtraGondiaSadak-Arjuni
(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.)khasra map27 Feb 2018
(2.)MINING PLAN SUBMISSION LETTER27 Feb 2018
(3.)JAMABANDI27 Feb 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameADDITIONAL COLLECTOR GONDIA
DesignationResident Deputy Collector
Company ADDITIONAL COLLECTOR GONDIA
AddressCollector office Gondia
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