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 Villages Giroli Taluk Salu District Wardha
(ii).Location / site (GPS Co-ordinate) N20°51'27.43" E78°37'37.80" N20°51'25.85" E78°37'39.20" N20°51'28.14" E78°37'42.42" N20°51'30.60" E78°37'41.21"
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)1 ha.
(iv).Capacity of the Mining Lease (TPA) 12670
(v).Period of Mining Lease 5
(vi).Expected cost of the Project 17
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.13161A001 
Name of Consultant/RQPvardan
Address sector 57 susant lok -iii gurgaon haryana
Mobile No.9953147268
Landline No.4291036
Email Idvardanenviro165@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.  Varud Railway Statio km
2. (ii). Nearest Infrastructural along with distance in kms  Varud Railway Statio km
(iii). Nearest Railway Line along with distance in kms  12.42 Km in SE km
(iv). Nearest National Highway along with distance in kms  10.00 Km in S direct km
(v). Nearest State Highway along with distance in kms  8.6 Km in E directio km
(vi). Nearest Major District Road along with distance in kms 0 km
(vii). Nearest Any Other Road along with distance in kms  0 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  Panchdhara Dam 5.26 km
(x). Nearest In-take for drinking water pump house distance in kms  0 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  0 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
There are no areas which are protected under international conventions within 10 km from the project site
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests There are no areas which are ecologically sensitive within 10 km from the project site.
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration There are no areas which are ecologically sensitive within 10 km from the project site.
6. Inland, coastal, marine or underground waters None
7. State, National boundaries There is no interstate boundary
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas NH 204 10.00 Km in S direction SH-255-8.6 Km in E direction
9. Defence installations No defense installation
10. Densely populated or built-up area, distance from nearest human habitation Wardha 12.00 Km
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Madhavbaug hospital-12.8 Km Primary school Giroli 1.50 Km
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) There is no area falling within 10 km from the project site which contains high quality or scarce resources.
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) There are no areas already subjected to pollution within 10 km from the project site.
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 l e s s susceptible to Earthquake. Project area falls in Zone-III as Moderate Damage Risk 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/7099/2017
File NumberDIA/MH/7099/2017
Date of Apply EC21 Jun 2017
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)MaharashtraWardhaWardha
(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)
NameVILLAGES GIROLI TALUK SALU DISTRICT WARDHA
DesignationPROPONENT
Company VILLAGES GIROLI TALUK SALU DISTRICT WARDHA
AddressPost wadgaon tuluka selu Dst Wardha maharashtra
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