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 masonary stone mine
(ii).Location / site (GPS Co-ordinate) 26055'24.03" 76037'49.466"
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) 95000
(v).Period of Mining Lease 50
(vi).Expected cost of the Project 20
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.913/2017 
Name of Consultant/RQPshivdayal godara
Address 27 kailashpuri tonk road jaipur
Mobile No.9549956601
Landline No.5102765
Email Idsgodara332@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.  25.1 KM km
2. (ii). Nearest Infrastructural along with distance in kms  1.2 km
(iii). Nearest Railway Line along with distance in kms  25.1 km
(iv). Nearest National Highway along with distance in kms  5.8 KM km
(v). Nearest State Highway along with distance in kms  4 KM 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  1.2 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  9.5 km km
(x). Nearest In-take for drinking water pump house distance in kms  1.2 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, 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 None, 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 None, No such area is located within the 10 km radius of the mining lease area
6. Inland, coastal, marine or underground waters None, No such area is located within the 10 km radius of the mining lease area
7. State, National boundaries None, No such area is located within the 10 km radius of the mining lease area
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas None, No such area is located within the 10 km radius of the mining lease area
9. Defence installations None, No such area is located within the 10 km radius of the mining lease area
10. Densely populated or built-up area, distance from nearest human habitation Village Population Distance From mine Direction Kalwan 634 1.2 Km NE Gilari 513 1.5Km S ParliBarh 676 2.5Km SW Rajpura 1123 2.9 Km NW Seekri 689 2.5 Km NE Sanwas 563 3.35 N Dhulkot 712 5.8 NE Achalpura 783 6.3 SW Bamapura 2249 7.4 NW Jaisinghpura 2567 8 S
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Village Hospital School Kalwan Primary Health Center Primary Rajpura Primary Health Center Primary Sikarai Hospital Secondary National Highway NH 11 5.8 KM SW DIrection
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) None, no such area is located within the 10 km radius of the mining lease area.
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) None, no such area is located within the 10 km radius of the mining 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, no such area is located within the 10 km radius of the mining 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/RJ/MIN/6191/2017
File Number6191/2017
Date of Apply EC21 Apr 2017
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)RajasthanDausaSikrai
(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)
NameSHANKAR LAL AGARWAL
DesignationOwner
Company SHANKAR LAL AGARWAL
Address3/296, vidhya dhar nagar, jaipur
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