1.	Project Details

   Whether it is a violation case and application is being submitted under Notification No. S.O.804(E) dated 14.03.2017 ? : No

1.	Project Details

   i. Proposal No. : IA/MH/MIN/19384/2013    ii. MoEFCC File No. : J-11015/284/2013-IA-II(M)    iii.Short narrative of the project: Limestone and Dolomite Mine    iv. Project Sector : Mining Projects    v. Company/Proponent : M/s Rajakhanderao Deshmukh

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Maharashtra	Yavatmal	Zari-Jamani

   vii.Date of TOR Granted 13 Feb 2015 viii.TOR letter issued by Ministry: Annexure-TOR letter ix.Date of Submission for EC: 23 Jul 2018 x.Project Type: New

2.	Uploaded Documents of EIA/EMP,Risk Assessment,Public Hearing etc.

i.EIA/EMP: Annexure-EIA/EMP ii.Risk Assessment: Annexure-Risk Assessment iii.Public Hearing: Annexure-Public Hearing    iv. Date of Public Hearing: 16 May 2017   v. Uploaded Additional Report/Study/Document as desired by Ministry/EAC: None   vi. Uploaded Cover Letter: Annexure-Cover Letter   vii.Remarks: NIL

Additional Attachments, if any
S.no.	Attached File	Date of Submission
1.	Covering Letter	23 Jul 2018
2.	Updated Form 1	23 Jul 2018
3.	Justification for TOR extension	23 Jul 2018

3.	Additional Detail Sought:   NIL

4.	Accredited Consultant Details

   i. Accreditation status : Yes    ii. Accreditation No. : NABET/EIA/1518/RA027    iii. Name of Consultant: SRUSHTI SEVA PRIVATE LIMITED   iv. Address : Harihar Niwas, Near Adivasi Bhavan, Giripeth, Nagpur-440010   v. Mobile No.: 9422108095   vi. Landline No.: 2542426   vii. Email Id: rajakhanderaodeshmukh@gmail.com

5.	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 at any stage, the project will be rejected and clearance given, if any to the project will be revoked at our risk and cost.

   i. Name of Applicant : Raja    ii. Designation : Owner    iii. Name of Company(Applicant Name should not be given here) : SHRI RAJA KHANDERAO DESHMUKH PALSIKAR    iv. Address : 5, Parth Sankul,Kailah Nagar, Nanded, Dist Nanded, Maharashtra. v. 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: Annexure-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