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 Bhukhand/Khasra No./Plot No.- 282mi, Area- 3.50 ha. (8.65 Acres) at Village– Bargadi, Tehsil- Bara, District- Allahabad, Uttar Pradesh
(ii).Location / site (GPS Co-ordinate) A 250 14.272' 810 35.241' B 250 14.270' 810 35.425' C 250 14.354' 810 35.449' D 250 14.317' 810 35.249'
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)3.50 ha.
(iv).Capacity of the Mining Lease (TPA) 98000
(v).Period of Mining Lease 1
(vi).Expected cost of the Project 85.00
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.106 
Name of Consultant/RQPPankaj Pande
Address B-1/67, Sec G, Jankipuram, Lucknow
Mobile No.9335881715
Landline No.4114250
Email Idparamarsh.env@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.  about 7.61 km (SE) km
2. (ii). Nearest Infrastructural along with distance in kms  4.29 km (S) km
(iii). Nearest Railway Line along with distance in kms  about 7.61 km (SE) km
(iv). Nearest National Highway along with distance in kms  7.61 km (SE) km
(v). Nearest State Highway along with distance in kms  00 km
(vi). Nearest Major District Road along with distance in kms 00 km
(vii). Nearest Any Other Road along with distance in kms  00 km
(viii). Nearest Electric transmission line pole or tower distance in kms  00 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  00 km
(x). Nearest In-take for drinking water pump house distance in kms  00 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  00 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
Yamuna River – 6.46 km (N)
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Yamuna River – 6.46 km (N)
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration Yamuna River – 6.46 km (N)
6. Inland, coastal, marine or underground waters Yamuna River – 6.46 km (N)
7. State, National boundaries
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas
9. Defence installations
10. Densely populated or built-up area, distance from nearest human habitation Bargari – 1.01 Km (SE)
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Shankargarh – 7.13 km (SW)
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Yamuna River – 6.46 km (N)
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) None in 5.0 km radius
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 in 5.0 km radius
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/UP/MIN/16747/2018
File NumberTo be assigned
Date of Apply EC11 Aug 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)Uttar PradeshPRAYAGRAJBara
(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.)500m radius map11 Aug 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameSHRI AVANISH SHUKLA
DesignationOwner
Company SHRI AVANISH SHUKLA
AddressArazi No. 282 mi, vill- Bargadi, Tehsil-Bara, allahabad
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