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 Shri Sunil Kumar Yadav S/o Shri Tejram Yadav Masonry Stone Mining Project, M. L. No. 201/2006, M. L. Area 1.00 ha. with Stone Crusher (Capacity-250TPH) Near Village: Nawal Kushalpura , Tehsil-Kotputl
(ii).Location / site (GPS Co-ordinate) Latitude- 27°44'28.03"N to 27°44'31.93"N Longitude-76° 5'26.8"E to 76° 5'20.39"E
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) 211800
(v).Period of Mining Lease 20
(vi).Expected cost of the Project 20
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.135/2001/A 
Name of Consultant/RQPS.N. Sharma
Address H.No-2181, Sector-16 Faridabad, Haryana
Mobile No.9560848579
Landline No.94608485
Email Idsn_sharma1959@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.  5 km
2. (ii). Nearest Infrastructural along with distance in kms  2 km
(iii). Nearest Railway Line along with distance in kms  25 km
(iv). Nearest National Highway along with distance in kms  10 km
(v). Nearest State Highway along with distance in kms  1 km
(vi). Nearest Major District Road along with distance in kms 0 km
(vii). Nearest Any Other Road along with distance in kms  1 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  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
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 • Sota Nadi at a distance of ~3.0 km in East direction from the mine site. • Krishnawati/Kasaunti Nadi at a distance of ~9.0 km in NW direction from the mine site. ? Baneti Protected Forest at a distance of ~4.0 km in North direction from the mine site. ? Bhopiya Protected Forest at a distance of ~5.0 km in NW direction from the mine site. ? Protected Forest at a distance of ~2.0 km in North direction from the mine site. ? Hasampur Protected Forest at a distance of ~6.0
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 Interstate Boundry at a distance of ~10.0 km from the mine site.
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas NH-8 located at a distance of ~9.0 km in SE direction from mine site. SH 37B at a distance of ~1.0 km in SW Direction From the mine site.
9. Defence installations None
10. Densely populated or built-up area, distance from nearest human habitation Densely populated or built up area exists at Kotputli
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Primary Schools, Dispensaries, Small Hospitals, Places of Worship all facilities are within 15 km radius.
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Mineral Resources, Water Resources: ground water, Agricultural Resources
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) No
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/7970/2017
File NumberTo be assigned
Date of Apply EC29 Jul 2017
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)RajasthanJaipurKotputli
(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)
NameM/S TOMAR STONE CRUSHER
DesignationPOA
Company M/S TOMAR STONE CRUSHER
AddressNarhera, Kotaputli,
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