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 (Minor Mineral) Mining Project for Pujaritola (Kansha), Tehsil – Gondia, District - Gondia, State - Maharashtra.
(ii).Location / site (GPS Co-ordinate) Sr. No Latitude “N” Longitude “E” 1 21°36'45.64"N 80° 9'44.21"E 2 21°36'56.72"N 80° 9'51.52"E 3 21°36'58.62"N 80° 9'48.99"E 4 21°36'47.55"N 80° 9'41.88"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)3.60 ha.
(iv).Capacity of the Mining Lease (TPA) 57600.68
(v).Period of Mining Lease 1
(vi).Expected cost of the Project 60.8
(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, Officer Campus Extension, Sirsi Road, Jaipur (RAJ)
Mobile No.9928793002
Landline No.02353241
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.  4.5 km
2. (ii). Nearest Infrastructural along with distance in kms  2.2 km
(iii). Nearest Railway Line along with distance in kms  4.0 km
(iv). Nearest National Highway along with distance in kms  0.0 km
(v). Nearest State Highway along with distance in kms  8.5 km
(vi). Nearest Major District Road along with distance in kms 8.5 km
(vii). Nearest Any Other Road along with distance in kms  1.2 km
(viii). Nearest Electric transmission line pole or tower distance in kms  1.5 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  00 km
(x). Nearest In-take for drinking water pump house distance in kms  0.3 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  1.25 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
NO. No such area is located within the 15 km radius of the mining lease area.
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Yes, The quarry area is itself part of water body i.e. River- Wainganga river, there are number of tributes of River Wainganga river is also available in Study Area.
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration No.
6. Inland, coastal, marine or underground waters Yes, The project lies in Wainganga, River.
7. State, National boundaries Yes, MP State boundary.
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas SH- 11 is 9.0 km in East direction from Project Site. (Source : -Google Earth)
9. Defence installations no.
10. Densely populated or built-up area, distance from nearest human habitation Yes, Village Pujaritola (Kansha) at 2.0 Km towards SE. Village Beni at 1.0 Km towards NW. Village Kasa at 2.50 Km towards East.
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Yes, a) School:- The Primary school facility is available at village – Pujaritola (Kansha) (2.0 Km, SE), Middle & High school facility is available at Gondia (17.0 km, South), while college is available at Gondia (20.0 km, South). a) Hospital: - Hospital facility is available Gondia (17.0 km, South) from M.L. area. b) Temple: Ganesh ka Mandir at Pujaritola (Kansha) (2.0 Km, SE), from the lease area. c) (Source : -Google Earth)
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) No, Applied mine area is falls in river Wainganga,
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) No, The area is not subjected to the pollution or environmental damage.
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) Yes, The area is prone to flooding during heavy rains.
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/13390/2018
File NumberTo be assigned
Date of Apply EC01 Mar 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)MaharashtraGondiaGondiya
(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 Map01 Mar 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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