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 Pipari 2 ,Tehsil – Sadak Arjuni, District - Gondia, State - Maharashtra.
(ii).Location / site (GPS Co-ordinate) Sr. No Latitude “N” Longitude “E” 1 21° 2'37.08"N 80° 4'41.49"E 2 21° 2'28.12"N 80° 4'38.11"E 3 21° 2'28.36"N 80° 4'37.27"E 4 21° 2'37.49"N 80° 4'40.80"E
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) 5999.6
(v).Period of Mining Lease 01
(vi).Expected cost of the Project 7.11
(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 saharan tower, 308, officers campus ext. sirsi rord, khatipura, jaipur. 302012
Mobile No.9928793002
Landline No.353241
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.  4.0 km
2. (ii). Nearest Infrastructural along with distance in kms  0.50 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  4.50 km
(v). Nearest State Highway along with distance in kms  4.0 km
(vi). Nearest Major District Road along with distance in kms 0.0 km
(vii). Nearest Any Other Road along with distance in kms  1.0 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.50 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  Drinking water facil 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
 No such area is located within the study Quarry area.
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests
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 Chulband, River.
7. State, National boundaries No None
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas NH-6 is about 4.50 km in North direction from Project Site.
9. Defence installations No, Defence Installations.
10. Densely populated or built-up area, distance from nearest human habitation Yes 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) Yes 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 the quarry area. b) Temple: Ganesh ka Mandir at Pipari (0.50 Km, South), from the quarry 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 Chulband,
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 falls in Seismic Zone –II (Source: National Disaster Management Authority, www.ndma.gov.in/en/zone-map.html, ) Quarry area is part of River Bed thus possibility of flooding or extreme or adverse climatic conditions applied
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/13398/2018
File Number13398/2018
Date of Apply EC03 Mar 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.)JAMABANDI01 Mar 2018
(2.)khasra map01 Mar 2018
(3.)QCI Nabet Critificate03 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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