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 Malhanwada Crusher Stone Quarry at Village- Malhanwada, Tehsil- Keolari, District- Seoni (M.P.)
(ii).Location / site (GPS Co-ordinate) A 22°31'57.33"N 79°59'35.38"E B. 22°31'56.48"N 79°59'39.31"E C. 22°31'54.00"N 79°59'38.10"E D. 22°31'54.24"N 79°59'35.58"E E 22°31'52.45"N 79°59'35.42"E F 22°31'53.73"N 79°59'31.49"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)1.44 ha.
(iv).Capacity of the Mining Lease (TPA) 14655
(v).Period of Mining Lease 10
(vi).Expected cost of the Project 15
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.RQP/DGMMP/65/2013 
Name of Consultant/RQPMANISH KHATRI
Address 1413/B-1, GUPTESHWAR RAOD, MADAN MAHAL, JABALPUR (M.P.)
Mobile No.9425325422
Landline No.2425051
Email Idmanish_jal@rediffmail.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.  8 km
2. (ii). Nearest Infrastructural along with distance in kms  20 km
(iii). Nearest Railway Line along with distance in kms  8 km
(iv). Nearest National Highway along with distance in kms  36 km
(v). Nearest State Highway along with distance in kms  13 km
(vi). Nearest Major District Road along with distance in kms 13 km
(vii). Nearest Any Other Road along with distance in kms  0.90 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.5 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  0.40 km
(x). Nearest In-take for drinking water pump house distance in kms  0.90 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
 No such area is located within the 10 km radius of the mining lease area.
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests No such area is located within the 10 km radius of the mining lease area.
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration No such area is located within the 10 km radius of the mining lease area.
6. Inland, coastal, marine or underground waters Not likelihood in this Stone project.
7. State, National boundaries MP CG Border approx 110 km (Aerial dist) East Direction
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas SH 40 Approx 13 Km
9. Defence installations Not Applicable
10. Densely populated or built-up area, distance from nearest human habitation Malhanwada approx-900 mt (Aerial Dist) East Direction
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) All facilities are available in Tehsil Keolari approx 20 Km
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Areas not containing important, high quality or scarce resources
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) The area is neither subjected to the pollution nor 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) No likelihood
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/MP/MIN/14767/2018
File Number166-02/05/2018
Date of Apply EC25 Apr 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)Madhya PradeshSeoniKeolari
(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.)Relevant Documents25 Apr 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameRAJESH KUMAR TEHSIL NAINPUR MANDLA
DesignationLessee
Company RAJESH KUMAR TEHSIL NAINPUR MANDLA
AddressPindrai, Tehsil- Nainpur, Mandla
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