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 Stone Quarry
(ii).Location / site (GPS Co-ordinate) Latitude Longitude 1 200 53’ 18.0”N 780 54’ 39.20”E 2 200 53’ 16.93”N 780 54’ 48.45”E 3 200 53’ 17.42”N 780 54’ 48.63”E 4 200 53’ 17.70”N 780 54’ 47.82”E 5 200 53’ 18.54”N 780 54’ 46.77”E 6 200
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)1.47 ha.
(iv).Capacity of the Mining Lease (TPA) 31696
(v).Period of Mining Lease 5
(vi).Expected cost of the Project 20
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.1316/IA001 
Name of Consultant/RQPVardan Environet
Address D-142 Shushant lok -III Gurugram
Mobile No.9422108968
Landline No.2983404
Email Idvardan.jaipur@gmail.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.  None km
2. (ii). Nearest Infrastructural along with distance in kms  Approx 1.6 Km toward km
(iii). Nearest Railway Line along with distance in kms  Approx 7.20 Km in ES km
(iv). Nearest National Highway along with distance in kms  Approx 6.45 Km towa km
(v). Nearest State Highway along with distance in kms  Approx 2.5 Km toward km
(vi). Nearest Major District Road along with distance in kms None km
(vii). Nearest Any Other Road along with distance in kms  Approx 0.40 Km towar km
(viii). Nearest Electric transmission line pole or tower distance in kms  Approx 1.6 Km toward km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  Approx 10 Km in NNE km
(x). Nearest In-take for drinking water pump house distance in kms  Approx 1.6 Km toward km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  Approx 1.6 Km toward km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
 None, within 10 km distance from the periphery of lease area.
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Vadgaon lake Approx 10 Km in NNE Direction
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration None, within 10 km distance from the periphery of lease area.
6. Inland, coastal, marine or underground waters None, within 10 km distance from the periphery of lease area.
7. State, National boundaries None, within 10 km distance from the periphery of lease area.
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas NH-7 Approx 6.45 Km towards ESE. SH-3 Approx 2.5 Km towards S Internal road Approx 0.40 Km towards E
9. Defence installations None, within 10 km distance from the periphery of lease area.
10. Densely populated or built-up area, distance from nearest human habitation Khapri Approx 1.6 Km towards NE
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Post and Telegraph, Hospital, Bank, Education and all market facilities are available at nearby Khapri and Ghodeghat
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Vadgaon lake Approx 10 Km in NNE Direction
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) None, within 10 km distance from the periphery of lease area.
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) None, within 10 km distance from the periphery of lease area.
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/6904/2017
File NumberDEIAA/5/J17/08
Date of Apply EC08 Jun 2017
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)MaharashtraNagpurHingna
(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
NIL
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameAASHISH ANANDRAO DURUGKAR
Designationonwer
Company AASHISH ANANDRAO DURUGKAR
AddressBajajnagar
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