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 Kadotitola Stone Quarry of Shri. Pradeep Ranglal Agrawal
(ii).Location / site (GPS Co-ordinate) Khasra No. 115 Latitude: 21°14'12.42"N to 21°14'17.18"N Longitude: 80°25'18.42"E to 80°25'21.32"E Khasra No. 244 & 245 Latitude: 21°13'37.20"N to 21°13'40.69"N Longitude: 80°25'15.57"E to 80°25
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)1.0 ha.
(iv).Capacity of the Mining Lease (TPA) 36400
(v).Period of Mining Lease 5
(vi).Expected cost of the Project 35.6
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.1518/SA025 
Name of Consultant/RQPExcel Enviro Tech
Address TF-2, SUN HOUSE NEAR OLD HIGH COURT OFF ASHRAM ROAD
Mobile No.9595688316
Landline No.09595688
Email Idmilind.kundal@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.  1.9 km
2. (ii). Nearest Infrastructural along with distance in kms  0.15 km
(iii). Nearest Railway Line along with distance in kms  8.3 km
(iv). Nearest National Highway along with distance in kms  17.0 km
(v). Nearest State Highway along with distance in kms  35.0 km
(vi). Nearest Major District Road along with distance in kms 1.5 km
(vii). Nearest Any Other Road along with distance in kms  2.6 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.3 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  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
None within 5 km radius
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests None within 5 km radius
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration Reserved Forest: 3.9 km SE Fairly Dense Jungle: 0.9 km, S
6. Inland, coastal, marine or underground waters Pujaritola Dharan Reservoir : Adjacent, E Bagh River: 1.8 Km, E Pujaritola Dam: 1.7 km E Bagh Left Bank canal: 1.8 km NE Bagh Right Bank canal: 1.5 km E Irrigation canal: 1.6 km W
7. State, National boundaries Maharashtra Madhya Pradesh 15 Km, N Maharashtra Chattisgarh 6.8 km, SE
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas NH 6: 17 Km, S SH 249: 35 km NW Amgaon Deori Road: 1.5 Km, W
9. Defence installations None within 10 km radius area
10. Densely populated or built-up area, distance from nearest human habitation Nearest building is located at about 0.3 Km, W Direction. Nearest major habitation (major village) is Sakharitola 2.0 Km ESE.
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) PHC, Hospital, School, Temple, community facilities are present in nearby villages and Salekasa 10 Km N.
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) The applied area consists of good reserves of Stone (Amphibolite & Quartzite). Pujaritola Dharan Reservoir is located adjacent to the applied area. There are no scarce resources such as forest, fishery or tourism spot in the applied mining area or in the vicinity of the project site.
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) There is no such area within 5 km radius of the project site. There are some existing stone quarries in the vicinity of the project.
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 applied area falls in Seismic Zone II, which is least active zone. Pujaritola Dharan Reservoir is located adjacent to the project site.
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/9748/2017
File Number9748/2017
Date of Apply EC09 Oct 2017
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)MaharashtraGondiaSalekasa
(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)
NamePRADEEP RANGLAL AGRAWAL
DesignationLessee
Company PRADEEP RANGLAL AGRAWAL
AddressR/O Sakharitola, Tehsil - Salekasa, District Gondia
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