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/KA/IND2/75099/2017    ii. MoEFCC File No. : IA-J--11011/380/2017-IA-II(I)    iii.Short narrative of the project: Setting up of 5000 TCD Sugar cane crushing unit, Co Generation plant of 30MW and 60 KLPD Distillery unit by M/s Mellbro Sugar Pvt Ltd    iv. Project Sector : Industrial Projects-2    v. Company/Proponent : M/S MELLBRO SUGARS PRIVATE LIMITED

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Karnataka	Bagalkot	Bagalkot

   vii.Date of TOR Granted 11 Sep 2017 viii.TOR letter issued by Ministry: Annexure-TOR letter ix.Date of Submission for EC: 15 Jun 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: 14 Mar 2018   v. Uploaded Additional Report/Study/Document as desired by Ministry/EAC: Annexure-Additional Report/Study/Document   vi. Uploaded Cover Letter: Annexure-Cover Letter   vii.Remarks: NIL

3.	Additional Detail Sought

Additional Detail Sought
Sno.	ADS Letter	Remarks	Date of ADS
1.	NA	Deferred	06 Aug 2018
2.	ADS Letter	The additional details sought by the EAC is herewith furnished.	23 Mar 2019

4.	Accredited Consultant Details

   i. Accreditation status : Yes    ii. Accreditation No. : NABET/EIA1017/RA010    iii. Name of Consultant: M/s Ultra Tech Consultancy   iv. Address : Thane, Maharashtra   v. Mobile No.: 9448900761   vi. Landline No.: 08354221408   vii. Email Id: questconsultancy08@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 : SANTOSH    ii. Designation : MD    iii. Name of Company(Applicant Name should not be given here) : M/S MELLBRO SUGARS PRIVATE LIMITED    iv. Address : Melligere Complex,Kaladgi Road,Bagalkot 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