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 Masonry Stone & Marble Mining Project (M.L. No.571/07)
(ii).Location / site (GPS Co-ordinate) Latitude - 27°54’6.64” N to 27°54’13.66” N Longitude - 75°48’22.57” E to 75°48’30.52” E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)2.50 ha.
(iv).Capacity of the Mining Lease (TPA) 170000
(v).Period of Mining Lease 20
(vi).Expected cost of the Project 60
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?No
Reason for not hiring the Consultant/RQP NA
(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.  Approx 9.5 km toward km
2. (ii). Nearest Infrastructural along with distance in kms  Approx.1.0 Km toward km
(iii). Nearest Railway Line along with distance in kms  Approx 9.5 km toward km
(iv). Nearest National Highway along with distance in kms  Approx 44.0 Km towar km
(v). Nearest State Highway along with distance in kms  Approx1.4 Km towards km
(vi). Nearest Major District Road along with distance in kms None km
(vii). Nearest Any Other Road along with distance in kms  None km
(viii). Nearest Electric transmission line pole or tower distance in kms  approx 1.0 km toward km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  Approx 2.0 km toward km
(x). Nearest In-take for drinking water pump house distance in kms  Not applicable km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  Not applicable 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 15 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 ? Deharwala dam Approx 2.0 km towards SSE direction. ? Dogarwala dam Approx 2.4 km towards W direction. ? Kantli River Approx 14.0 km towards SW direction. ? Chandrawati River Approx 7.8 km towards E direction. ? Khetri P.F. Approx 1.8 km towards NW direction. ? Bansiyal P.F. Approx 2.6 km towards N direction. ? Dokan P.F. Approx 10.6 km towards SE direction. ? Partappur P.F. Approx 2.6 km towards SW direction. ? Mehara P.F. Approx 10.5 km towards NE direction.
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 15 km radius of the mining lease area.
6. Inland, coastal, marine or underground waters No such area is located within the 15 km radius of the mining lease area.
7. State, National boundaries Not Applicable
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas ? Jeelo Railway Station Approx 9.5 km towards SE direction. ? SH-13 Approx1.4 Km towards NW direction. ? NH-8 Approx 44.0 Km towards E direction.
9. Defence installations None
10. Densely populated or built-up area, distance from nearest human habitation Meena Ki Dhani Approx.1.0 Km towards NE direction.
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) ? School, Karmadi Approx 1.6 km towards NW direction. ? Hospital, Babai Approx 4.0 km towards SW direction. ? Places of worship, Babai Approx 4.0 km towards SW direction. ? Community facilities, Babai Approx 4.0 km towards SW direction.
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Same as item No.-2
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) The area is not subjected to the pollution or 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) Seismic Zone- II
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/RJ/MIN/16701/2018
File NumberTo be assigned
Date of Apply EC09 Aug 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)RajasthanJhunjhunuKhetri
(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)
NameRATNI DEVI
DesignationLessee
Company RATNI DEVI
AddressNear Village- Meena Ki Dhani, Tehsil Khetri, Distt- Jhunjhunu
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