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 Khed Sandghat (Minor Mineral) Mining Project Adjacent Khasra No. 104, 105, 106, 108, 109, 71, 69 for Khed, Tehsil – Moshi, District - Amravati, State - Maharashtra.
(ii).Location / site (GPS Co-ordinate) Sr. No Latitude “N” Longitude “E” 1 21°17'54.98"N 77°52'13.44"E 2 21°17'51.65"N 77°52'13.05"E 3 21°17'50.88"N 77°52'13.58"E 4 21°17'49.28"N 77°52'15.31"E 5 21°17'49.49"N 77°52'16.90"E 6 21°17'49
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.80 ha.
(iv).Capacity of the Mining Lease (TPA) 6358.5
(v).Period of Mining Lease 01
(vi).Expected cost of the Project 50.83
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.NABET/EIA/1619/ IA007 
Name of Consultant/RQPGMEC INTERNATIONAL
Address SAHARAN TOWER 308, 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  1.60 km towards NW km
(iii). Nearest Railway Line along with distance in kms  4.0 km towards SW km
(iv). Nearest National Highway along with distance in kms  0.0 km
(v). Nearest State Highway along with distance in kms  2.40 km towards Sout km
(vi). Nearest Major District Road along with distance in kms 0.0 km
(vii). Nearest Any Other Road along with distance in kms  .70 km towards SE km
(viii). Nearest Electric transmission line pole or tower distance in kms  1.60 km towards NW km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  Chargad River km
(x). Nearest In-take for drinking water pump house distance in kms  1.60 km towards NW 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
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests The quarry area is itself part of water body i.e. Chargad River, there are number of tributes of Chargad 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 The project lies in Chargad River
7. State, National boundaries NO
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas Lehgaon Porgavhan is available at 9.70 km towards South East from the project site.
9. Defence installations NO
10. Densely populated or built-up area, distance from nearest human habitation Khed is available at 1.60 km towards North West and Gokalpur is available at 1.60 km towards East from the project site.
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 – Khed (1.60 km, in North West direction), b) Hospital: -Hospital facility is available Moshi (15.40 Km, in North East direction), c) Temple: Mandir at Khed (1.60 km, in North West direction), from the study area.
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Quarry mine area is falls in Chargad River.
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) NO
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 is falls in Seismic Zone –III
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/15070/2018
File NumberDIA/MH/MIN/15070/2018
Date of Apply EC15 May 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)MaharashtraAmravatiMorshi
(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.)NABET CERTIFICATE15 May 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameTEHSILDAR AMRAVATI
DesignationTehsildar
Company TEHSILDAR AMRAVATI
AddressCollector office Amravati State-Mharashtra
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