Form-2
APPLICATION FOR PRIOR ENVIRONMENTAL CLEARANCE
S. No.Item Details
1.
Whether it is a violation case and application is being submitted under Notification No. S.O.804(E) dated 14.03.2017 ? No
Details of Project:
(a)Name of the project(s) Proposed Government Hospital (includes MLCP) Building at Sarita vihar
(b)Name of the Company / Organisation PUBLIC WORKS DEPARTMENT NCTD
(c)Registered Address Rajiv Gandhi Super Specialty Hospital, Campus, Tahirpur, Delhi.,East,Delhi-110093
(d)Legal Status of the Company State Government
(e)Joint Venture No
2.
Address for the correspondence:
(a)Name of the Applicant Pradeep Kumar
(b)Designation (Owner/ Partner/ CEO) EE
(c)Address Health Project Division East Rajiv Gandhi Super Specialty Hospital,Campus, Tahirpur, Delhi,Preet Vihar,East,Delhi-110093
(d)Pin code 110093
(e)E-mail rananishi96@gmail.com
(f)STD Code. 120(f)Telephone No. 4352889
(g)Fax No.
(h)Copy of documents in support of the competence/authority of the person making this application to make application on behalf of the User Agency . Annexure-Uploaded Copy of documents in support of the competence/authority
3.
Category of the Project/Activity as per Schedule of EIA Notification,2006:
(a)Project/Activity8(a) Building and Construction projects
(b)Category B2
   Reason for Applying at Ministry SEIAA
(c)Proposal Number IA/DL/MIS/108517/2019
(d)Master Proposal Number(Single Window) SW/108513/2019
(e)EAC concerned (for category A Projects only) Infrastructure and Miscellaneous Projects  +  CRZ
(f)Project Type Fresh EC
4.
Location of the Project:
(a)Plot/Survey/Khasra No. Block KL
(b)Pincode 110076
(c)Bounded Latitudes (North) FROM 28321583 To 28321584
(d)Bounded Longitudes (East) FROM 77175247 To 77175248
(e)Survey of India Topo Sheet No. 1
(f)Uploaded Topo Sheet File Copy of Topo Sheet File
(g)Maximum Elevation Above Means Sea Level(AMSL) 618
(h)Uploaded (kml) File Copy of Kml File      
(i)Distance of Nearest HFL from the project boundary within the study area 1
(j)Seismic Zone 4
5.
(a)Number of States in which Project will be Executed 1
(b)Main State of the project Delhi
Details of State(s) of the project
S. No. State Name District Name Tehsil Name Village Name
(1.)DelhiSouth EastNo Datasarita vihar
6.
Details of Terms of Reference (ToR):
(a)Whether TOR is mandatory for submitting application No
7.
Details of Public Consultation:
(a)Whether the Project Exempted from Public Hearing?Yes
(b)Reason it is building construction project
(c)Supporting Document Copy of Supporting Document
8.
Details of Project Configuration/Product:
     8.1.       Project Configuration
S. No.Plant/Equipment/FacilityConfigurationRemarks
(1.)Not applicableNot applicableNot applicable
     8.2.       Product
S. No.Product/Activity (Capacity/Area)QuantityUnitOther UnitMode of Transport / Transmission of ProductOther Mode of Transport / Transmission of Product
(1.)Not applicable1Tons per AnnumRoad
9.
In case of Expansion / Modernisation / One Time Capacity Expansion (only for Coal Mining) / Expansion under Clause 7(ii) / Modernisation under Clause 7(ii) / Change of Product Mix under Clause 7(ii):
Details Not Applicable
9.1.
Details of Consent to Operate
(i)Whether Consent to operate obtained ? NA
(ii)Copies of all Consent to operate obtained since inception NA
(iii)Date of Issue 01 Jun 2019
(iv)Valid Upto 05 Dec 2019
(v)File No. 123
(vi)Application No. CTO
(vii)Copy of Consent to operate valid as on date Copy of Consent to Operate
10.
Project Cost:
(a)Total Cost of the Project at current price level (in Crores) 300.77
(b) Funds Allocated for Environment Management (Capital) (in Crores) 1
(c) Funds Allocated Towards CER (Corporate Environment Responsibility) (in Crores) 4.51
(d) Funds Allocated for Environment Management Plan (EMP) (Recurring per Annum) (in Crores) 2000
11.
Whether project attracts the General Condition specified in the Schedule of EIA Notification ? No
12.
Whether project attract the Specific Condition specified in the Schedule of EIA Notification ? No
13.
Raw Material / Fuel Requirement:
(a)Proposed quantity of raw material/fuel 1
(b)Existing quantity of raw material/fuel N/A
(c)Total quantity of raw material/fuel 1
    13.1.        Raw Material / Fuel Profile
S. No.Raw Material / Fuel QuantityUnitOther UnitSource (incase of Import. please specify country and Name of the port from which Raw Material / Fuel is received )Mode of TransportOther Mode of TransportDistance of Source from Project Site (in Kilometres) (In case of import, distance from the port from which the raw material / fuel is received)Type of Linkage Other Type of Linkage Uploaded Copy of Linkage
(1.)001Tons per AnnumNot applicableRoad1 LinkageCopy of Linkage
14.
Baseline Data :
(a)Period of Base Line Data Collection FROM 01 May 2019 To 31 May 2019
(b)Season Pre-Monsoon
    14.1.     No. of ambient Air Quality (AAQ) monitoring locations : 1
S. No.Criteria Pollutants Other Criteria PollutantsUnitMaximum ValueMinimum Value98 Percentile ValuePrescribed Standard
(1.)PM10Micro Gram per Meter Cube413203308100
(2.)PM2.5Micro Gram per Meter Cube138.770.4104.560
(3.)NOxMicro Gram per Meter Cube54.626.440.580
(4.)SO2Micro Gram per Meter Cube21.415.118.2580
    14.2.     No. of Ground Water monitoring locations : 1
S. No.Criteria Pollutants Other Criteria PollutantsHeavy MetalUnitOther UnitMaximum ValueMinimum ValueDesirable LimitMaximum Permissible Limit
(1.)TDSmg/l135013485002000
(2.)Chloridesmg/l4204122501000
(3.)Fluoridemg/l0.80.711.5
(4.)TSSmg/l6005505001000
(5.)Heavy MetalsIron (as Fe)mg/l0.150.140.91.0
(6.)pHNA8.567.566.58.5
(7.)Total Hardnessmg/l450432200600
    14.3.     No. of Surface Water monitoring locations : 1
S. No.Criteria Pollutants Other Criteria PollutantsUnitOther UnitMaximum ValueMinimum ValueClassification of inland water body
(1.)BODmg/l32A
(2.)pHmg/l8.56.5A
(3.)CODmg/l250230A
(4.)DOmg/l94A
    14.4.     No. of Ambient Noise monitoring locations : 1
S. No.Parameter UnitMaximum ValueMinimum ValuePrescribed Standard
(1.)Leq(Night)A-weighted decibels(dB(A))44.043.543.9
(2.)Leq(Day)A-weighted decibels(dB(A))52.852.552.3
    14.5.     No. of Soil Sample Monitored locations : 1
S. No.Parameter UnitOther UnitMaximum ValueMinimum Value
(1.)pH8.028.01
(2.)P(Phosphorus)Kilogram per hectare14.814.5
(3.)K(Potassium)Kilogram per hectare186185
(4.)Electric Conductivity362361
(5.)N(Nitrogen)Kilogram per hectare224223
14.6.
Details of Ground Water Table:
(a)Range of Water Table Pre-Monsoon Season (Meters Below Ground Level (m bgl)) From 32 To 35
(b)Range of Water Table Post-Monsoon Season (Meters Below Ground Level (m bgl)) From 25 To 28
(c)Whether Ground Water Intersection will be there ? No
     15.      Details of Water Requirement (During Operation)
S. No.Source Source Other Required QuantityDistance from SourceCopy of Permission from Competent Authority Mode of TransportOther Mode of TransportMethod of Water WithdrawalOther Method of Water WithdrawalLetter No.Date of IssuePermitted Quantity
(1.)Othersmunicipal4022Copy of Permission LetterPipelineOthersDJB12311 Jun 2019402
15.1.
(a)Whether Desalination is proposed No
    16.       Waste Water Management(During Operation)
S. No.Type/Source Quantity of Waste Water Generated (Kilolitre per Day)Treatment Capacity (Kilolitre per Day) Treatment MethodMode of DisposalOther Mode of DisposalQuantity of Treated Water Used in Recycling/Reuse (Kilolitre per Day)Quantity of Discharged Water (Kilolitre per Day)
(1.)domestic244412STP ETPReuse within the Plant & Recycling244
16.1.
(a)Total Waste Water Generation 244
(b)Total Discharged Water 0
(c)Total Reused Water 244
    17.       Solid Waste Generation/Management
S. No.Name of Waste Item Other ItemQuantity per AnnumUnitDistance from Site(KM)Mode of TransportOther Mode of TransportMode of DisposalOther Mode of Disposal
(1.)generalMunicipal Solid Waste1.1Tons2RoadOthersOWC
(2.)hospitalBio-Medical Waste0.52Tons2RoadTreatment, Storage and Disposal Facility(TSDF)
18.
    18.1.     Air Quality Impact Prediction
S. No.Criteria Pollutants Other Criteria PollutantsUnitBaseline ConcentrationDistance GLCIncremental ConcentrationTotal GLCPrescribed Standard
(1.)PM10Microgram per Meter Cube413252065100
(2.)PM2.5Microgram per Meter Cube138.725693.560
(3.)SO2Microgram per Meter Cube21.42510780
(4.)NOxMicrogram per Meter Cube54.62527380
    18.2.     Stack Details
S. No.Source FuelStack Height(m)Stack Diameter(m)PollutantsOther PollutantsEmission (GLS)
(1.)DG SetDiesel52.10.3PM102065
19.
Power Requirement:
(a)Quantity (Kilo Volt Amps (kVA)) 2697
(b)Source BSES
(c)Uploaded Copy of Agreement Copy of Agreement
(d)Standby Arrangement (Details of DG Sets) 2500
(e)Stack Height (in m) 58
20.
Land Ownership Pattern:
(a)Forest Land 0
(b)Private Land 0
(c)Government Land 0.6727
(d)Revenue Land 0
(e)Other Land 0
    Total Land 0.6727
21.
Present Land Use Breakup of the Study Area in Ha:
(a)Agriculture Area 0
(b)Waste/Barren Land 0
(c)Grazing/ Community Land 0
(d)Surface Water Bodies 0
(e)Settlements 0
(f)Industrial 0
(g)Forest 0
(h)Mangroves 0
(i)Marine Area 0
(j)Others : Govt. land 0.6727
    Total 0.6727
    22.     Land requirement for various activities
S. No.Description of Activity / Facility / Plant / Others OthersLand RequirementRemarks
(1.)Othersplot area0.6727
Total 0.6727
23.
Ecological and Environmental Sensitivity (Within 10 Km):- WLS-Wild Life Species; NPA-Notified Protected Area; ESAs-Eco Sensitive Areas; ESZs-Eco Sensitive Zones :
    23.1.     Details of Ecological Sensitivity :
S. No.Details of Ecological Sensitivity NameDistance from the Project (Km)Remarks
(1.)WLSnone00
(2.)Critically Polluted Areanone00
(3.)ESZsnone00
(4.)ESAsokhla bird sanctury3Away from marked area
(5.)NPAnone00
(6.)Corridorsnone00
(7.)Wildlife Corridorsnone00
    23.2.     Details of Environmental Sensitivity :
S. No.Details of Environmental Sensitivity Other Details of Environmental Sensitivity NameDistance from the Project (Km)Remarks
(1.)ForestCentral Ridge Forest11reserve
(2.)Archaeological Sitesnone00
(3.)Defence Installationsnone00
23.3.
(a)Whether Noc / Permission from the competent authority is required? No
(b)Whether NBWL recommendation is required? No
24.
Forest Land:
Whether any Forest Land involved? No
25.
Tree Cutting:
(a)No. of Trees Cut for the Project (if Forest Land not Involved) 0
(b)Details of Tree Cutting and Planting of Trees Copy of Details of Tree Cutting and Planting of Trees
26.
Land Acquisition Status:
(a)Acquired Land(Ha) 0
(b)Land yet to be acquired(Ha) 0
(c)Status of Land acquisition if not acquired 0
27.
Rehabilitation and Resettlement (R&R):
(a)No. of Villages 0
(b)No. of Households 0
(c)No. of PDFs (Project Displaced Families) 0
(d)No. of PAFs (Project Affected Families) 0
(e)Funds Allocated for R&R(in Rs) 0
(f)Status of R&R Completed
28.
Details of Presence of Schedule-I Species:
(a)Whether there is Presence of Schedule-I Species ? No
(b)Whether conservation plan for Schedule-I Species has been prepared ? No
(c)Whether conservation plan for Schedule-I Species has been approved by competent authority ? No
29.
Details of Presence of Water Bodies in Core Area:
(a)Whether there is Presence of Water Bodies in Core Area ? No
(b)Whether there is Diversion Required ? No
(c)Whether permission has been obtained from competent authority ? No
30.
Details of Presence of Water Bodies in Buffer Area:
(a)Whether there is Presence of Water Bodies in Buffer Area ? No
31.
Manpower Requirement:
(a)Permanent Employment-During Construction 100
(b)Permanent Employment-During Operation 970
(c)Temporary Employment- During Construction 50
(d)Temporary Employment- During Operation 40
(e)No. of working days 365
(f)Total Manpower 1160
32.
Green Belt in Ha:
(a)Total Area of Green Belt 0.076
(b)Percentage of Total Project Area 11.30
(c)No. of Plants to be Planted 95
(d)Funds Allocated for Plantation 20000
(e)Uploaded Green Belt plan Copy of Green Belt Plan
    33.         Project Benefits
S. No.Type of Project Benefits Details of Project Benefits
(1.)EnvironmentalSTP ETP Greenbelt
(2.)SocialHealthcare medical facility
   34.   CRZ Specific Details : Not Applicable
   35.   Sector Specific Details For Infrastructure and Miscellaneous Projects  +  CRZ
S. No.Item Details
1.
Details of Building Construction:
(a)Maximum Height of the Building (Meters) 46.10
(b)Total No. of Flats to be Build 0
(c)No. of Buildings 2
(d)Total plot area (sqm) 6727.8
(e)Total built up area (sqm) 34147.32
2.
Foreshore Facilities and/or Marine Disposal:
(a)Whether Project Involves Foreshore Activities and/or marine Disposal? No
3.
Rain Water Harvesting:
(a)No. of Storage 0
(b)Capacity 0
(c)No. of Recharge Pits 2
(d)Capacity 42.38
4.
Parking:
(a)Details of 4 Wheeler/ 2 Wheeler Parking 437
5.
Energy Saving Measures:
(a)Source/Mode solar
(b)Percentage 1
(c)Quantity 2.6
6.
Other details:
(a)Details of impact on Water Bodies and Drainage patters of catchment area no
(b)Details of Traffic Density Impact Assessment and Modelling Study Copy of Details of Traffic Density Impact Assessment and Modelling Study
(c)In case Underground Tunnel Project below the Forest Land - Subsidence Impact Study report Copy of Underground Tunnel Project below the Forest Land - Subsidence Impact Study report
     7.       Type of Industries to be established with Industrial Estate as per their category A/B
S. No.Type of IndustryNo. of UnitsCategory A/B
NIL
8.
Length of the alignment N/A
9.
Details Bridges/ROB/Interchanges,Flyovers,Vehicle Underpass and Pedestrian Underpass
Details Not Applicable
Additional Detail Sought:   NIL ,w ,3.NIL
S. No.Item Details
36.
Details of Court Cases:
(a)Whether there is any Court Cases pending against the project and/or land in which the project is proposed to be set up ? No
37.
Details of Direction Issued under Environment (Protection) Act / Air (Prevention & Control of Pollution)) Act / Water (Prevention & Control of Pollution) Act:
(a)Whether any Direction issued under EPA Act/Air Act/Water Act ? No
38.
Details of EIA Consultant:
(a)Have you hired Consultant for preparing document? Yes
(i)Accreditation No. NABET/EIA/1518
(ii)Name of the EIA Consultant Amaltas Enviro Industrial consultant
(iii)Address Noida
(iv)Mobile No. 9810085736
(v)Landline No. 0120435288
(vi)Email Id mervyn.atmos@gmail.com
(vii)Category of Accreditation A
(viii)Sector of Accreditation Infrastructure and Miscellaneous Projects  +  CRZ
(ix)Validity of Accreditation 27 Dec 2019
(x)Uploaded Certificate of Accreditation certified by QCI/NABET Copy of Certificate of Accreditation
39.
Documents to be Attached:
(a)Uploaded Copy of EIA/EMP Report Copy of EIA/EMP
Copy of EIA/EMP(Annexures)
Copy of EIA/EMP(Plans/Figures)
(b)Uploaded Copy of Risk Assessment Report Copy of Risk Assessment
(c)Uploaded Copy of Feasibility Report/ Detailed Project Report(DPR) /Detailed Engineering Report /Detailed Conceptual Plan /Approved Mining Plan Copy of Feasibility Report/ Detailed Project Report(DPR) /Detailed Engineering Report /Detailed Conceptual Plan /Approved Mining Plan
(d)Uploaded Copy of Final Layout Plan Copy of Final Layout Plan
(e)Uploaded Cover Letter Copy of Cover Letter
(f)Uploaded Copy of documents in support of the competence/authority of the person making this application to make application on behalf of the User Agency Copy of documents in support of the competence/authority of the person making this application to make application on behalf of the User Agency
(g)Uploaded Additional File Copy of Additional File
Undertaking
I hereby give undertaking that the data and information given in the application and enclosures are true to be best of my knowledge and belief. And I am aware that if any part of the data and information found to be false or misleading at any stage, the project will be rejected and clearance given, if any to the project will be revoked at our risk and cost. In addition to above, I hereby give undertaking that no activity/ construction/ expansion has since been taken up.
Name of ApplicantPradeep Kumar
DesignationEE
Name of Company (Applicant Name should not be given here)PUBLIC WORKS DEPARTMENT NCTD
AddressRajiv Gandhi Super Specialty Hospital, Campus, Tahirpur, Delhi.
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