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) Group Housing Colony
(b)Name of the Company / Organisation
(c)Registered Address NIL
(d)Legal Status of the Company NIL
(e)Joint Venture No
2.
Address for the correspondence:
(a)Name of the Applicant
(b)Designation (Owner/ Partner/ CEO)
(c)Address NIL
(d)Pin code
(e)E-mail
(f)STD Code. (f)Telephone No.
(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.I)Project/Activity8(a) Building and Construction projects
Minor Activity
(b)Category B2
   Reason for Applying at Ministry SEIAA
(c)Proposal Number IA/HR/MIS/80112/2018
(d)Master Proposal Number(Single Window) SW/80094/2018
(e)EAC concerned (for category A Projects only) INFRA-2
(f)Project Type Fresh EC
4.
Location of the Project:
(a)Plot/Survey/Khasra No. Khasra No. 364, 3317/365, 3318/365, 4103/368, 7784
(b)Pincode 122006
(c)Bounded Latitudes (North)
From
Degree 3152483.62
Minutes
Second
From
Degree 3152695.29
Minutes
Second
(d)Bounded Longitudes (East)
From
Degree 697043.80
Minutes
Second
From
Degree 697394.57
Minutes
Second
(e)Survey of India Topo Sheet No. 53H/03
(f)Uploaded Topo Sheet File Copy of Topo Sheet File
(g)Maximum Elevation Above Means Sea Level(AMSL) 219
(h)Uploaded (kml) File Copy of Kml File      
(i)Distance of Nearest HFL from the project boundary within the study area 214
(j)Seismic Zone 4
5.
(a)Number of States in which Project will be Executed 1
(b)Main State of the project Haryana
Details of State of the project
S. No. State Name District Name Tehsil Name Village Name
NIL
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 All building construction projects are exempted fr
(c)Supporting Document Copy of Supporting Document
8.
Details of Project Configuration/Product:
     8.1.       Project Configuration
S. No.Plant/Equipment/FacilityConfigurationRemarks
(1.)Servant Units44
(2.)Club1
(3.)Commercial Building1
(4.)Dwelling Units432
(5.)EWS77
     8.2.       Product
S. No.Product/Activity (Capacity/Area)QuantityUnitOther UnitMode of Transport / Transmission of ProductOther Mode of Transport / Transmission of Product
(1.)Total Plot area30225Otherssquare meterOthersNot Applicable
(2.)Built-up area101185.30Otherssquare meterOthersNot Applicable
(3.)Net plot area27202.5Otherssquare meterOthersNot Applicable
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 N/A
(iv)Valid Upto N/A
(v)File No. NA
(vi)Application No. NA
(vii)Copy of Consent to operate valid as on date NA
10.
Project Cost:
(a)Total Cost of the Project at current price level (in Crores) 290
(b) Funds Allocated for Environment Management (Capital) (in Crores) 2.86
(c) Funds Allocated Towards CER (Corporate Environment Responsibility) (in Crores) 4.35
(d) Funds Allocated for Environment Management Plan (EMP) (Recurring per Annum) (in Crores) 0.21
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 106.75
(b)Existing quantity of raw material/fuel N/A
(c)Total quantity of raw material/fuel 106
    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.)cement12.77Cubic Meter per DayLocal Nearby MarketRoad200 Othersraw materialCopy of Linkage
(2.)Coarse Aggregate78.50Cubic Meter per DayLocal Nearby MarketRoad200 Othersraw materialCopy of Linkage
(3.)Diesel95Kilo Litre per DayLocal Nearby MarketRoad200 Othersraw materialCopy of Linkage
(4.)Aggregate15.48Cubic Meter per DayLocal Nearby MarketRoad200 Othersraw materialCopy of Linkage
14.
Baseline Data :
(a)Period of Base Line Data Collection FROM 18 Sep 2018 To 23 Sep 2018
(b)Season Post-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 Cube101.488.795.1100
(2.)NOxMicro Gram per Meter Cube18.415.216.780
(3.)PM2.5Micro Gram per Meter Cube60.350.556.160
(4.)SO2Micro Gram per Meter Cube7.76.97.280
    14.2.     No. of Ground Water monitoring locations : 1
S. No.Criteria Pollutants Other Criteria PollutantsHeavy MetalUnitOther UnitMaximum ValueMinimum ValueDesirable LimitMaximum Permissible Limit
(1.)Chloridesmg/l529.84529.84250250
(2.)TSSmg/l0000
(3.)pHNA6.96.98.58.5
(4.)TDSmg/l17201720500500
(5.)Fluoridemg/l0.80.81.01.0
(6.)OthersAlkalinitymg/l532532200200
(7.)Total Hardnessmg/l820820200200
    14.3.     No. of Surface Water monitoring locations : 1
S. No.Criteria Pollutants Other Criteria PollutantsUnitOther UnitMaximum ValueMinimum ValueClassification of inland water body
(1.)CODmg/l4848D
(2.)pHNA8.28.2D
(3.)BODmg/l3.53.5D
(4.)DOmg/l4.64.6D
(5.)OthersTSSmg/l8080D
    14.4.     No. of Ambient Noise monitoring locations : 1
S. No.Parameter UnitMaximum ValueMinimum ValuePrescribed Standard
(1.)Leq(Day)A-weighted decibels(dB(A))56.856.855
(2.)Leq(Night)A-weighted decibels(dB(A))46.846.845
    14.5.     No. of Soil Sample Monitored locations : 1
S. No.Parameter UnitOther UnitMaximum ValueMinimum Value
(1.)pHOthersN/A8.248.24
(2.)P(Phosphorus)Milligram per Kilogram16.116.1
(3.)Electric ConductivityOthersmicro seimen per centimeter148.5148.5
(4.)N(Nitrogen)Milligram per Kilogram88.688.6
(5.)K(Potassium)Milligram per Kilogram5.15.1
14.6.
Details of Ground Water Table:
(a)Range of Water Table Pre-Monsoon Season (Meters Below Ground Level (m bgl)) From 3.3 To 79.70
(b)Range of Water Table Post-Monsoon Season (Meters Below Ground Level (m bgl)) From 3.05 To 77.53
(c)Whether Ground Water Intersection will be there ? No
     15.      Details of Water Requirement (During Operation)
S. No.Source Source Other Required Quantity (Kilolitre per Day (Kld))Distance 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.)OthersHUDA supply4170 Not Appliacble PipelineOthersHUDA Supply18857118 Sep 2018300
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.)Flushing, Gardening & miscellaneous319380STPReuse within the Plant & Recycling,Green Belt Renewal Plant,OthersTo sewer line179140
16.1.
(a)Total Waste Water Generation (Kilolitre per Day) 319
(b)Total Discharged Water (Kilolitre per Day) 140
(c)Total Reused Water (Kilolitre per Day) 179
    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.)BiodegradableMunicipal Solid Waste269Tons0RoadOthersOrganic Waste Converter
(2.)Used OilHazardous Waste (as per Hazardous and Other Waste Management rules 2016)0.348Kilolitre10RoadAuthorized Recyclers
(3.)E-wasteE Waste0.024Tons10RoadAuthorized Recyclers
(4.)Non-biodegradableMunicipal Solid Waste90Tons10RoadAuthorized Recyclers
(5.)Plastic WasteMunicipal Solid Waste90Tons10RoadAuthorized Recyclers
18.
    18.1.     Air Quality Impact Prediction
S. No.Criteria Pollutants Other Criteria PollutantsUnitBaseline ConcentrationDistance GLCIncremental ConcentrationTotal GLCPrescribed Standard
(1.)PM10Microgram per Meter Cube89.450.900.35589.805100
(2.)PM2.5Microgram per Meter Cube53.30.900.48053.7860
(3.)NOxMicrogram per Meter Cube16.80.900.8017.680
(4.)SO2Microgram per Meter Cube70.900.2097.20980
    18.2.     Stack Details
S. No.Source FuelStack Height(m)Stack Diameter(m)PollutantsOther PollutantsEmission (GLS)
(1.)1 x 500diesel65.750.30PM100.025
(2.)1 x 500diesel65.750.30SO20.09
(3.)2 x 1250diesel65.750.55NOx0.258
(4.)1 x 500diesel65.750.30NOx0.175
(5.)2 x 1250diesel65.750.55PM100.042
(6.)2 x 1250diesel65.750.55SO20.15
(7.)2 x 1250diesel65.750.55OthersPM2.50.017
(8.)1 x 500diesel65.750.30OthersPM2.50.010
19.
Power Requirement:
(a)Quantity (Kilo Volt Amps (kVA)) 3382
(b)Source Dakshin Haryana Bijli Vitran Nigam
(c)Uploaded Copy of Agreement Copy of Agreement
(d)Standby Arrangement (Details of DG Sets) 2 x 1250 KVA & 1 x 500 KVA
(e)Stack Height (in m) 65.75
20.
Land Ownership Pattern:
(a)Forest Land (ha.) 0
(b)Private Land (ha.) 3.0225
(c)Government Land (ha.) 0
(d)Revenue Land (ha.) 0
(e)Other Land (ha.) 0
    Total Land (ha.) 3.0225
21.
Present Land Use Breakup of the Study Area in Ha:
(a)Agriculture Area (ha.) 0
(b)Waste/Barren Land (ha.) 0
(c)Grazing/ Community Land (ha.) 0
(d)Surface Water Bodies (ha.) 0
(e)Settlements (ha.) 0
(f)Industrial (ha.) 0
(g)Forest (ha.) 0
(h)Mangroves (ha.) 0
(i)Marine Area (ha.) 0
(j)Others (ha.) : At present the land is vacant land with no habitat 3.0225
    Total (ha.) 3.0225
    22.     Land requirement for various activities
S. No.Description of Activity / Facility / Plant / Others OthersLand Requirement (ha.)Remarks
(1.)Built Up Area10.1185
Total (ha.) 10.1185
23.
Ecological and Environmental Sensitivity (Within 10 Km):- WLS-Wild Life Sanctuaries; 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.)WLSnot applicable0Not Applicable
(2.)NPAnot applicable0Not Applicable
(3.)Critically Polluted Areanone within 15 km radius15Not Applicable
(4.)Corridorsnone0Not Applicable
(5.)ESAsnot applicable0Not Applicable
(6.)Wildlife Corridorsnone0Not Applicable
(7.)ESZsSultanpur National Park & Bird Sanctuary11.38it is in SWW of the project site
    23.2.     Details of Environmental Sensitivity :
S. No.Details of Environmental Sensitivity Other Details of Environmental Sensitivity NameDistance from the Project (Km)Remarks
(1.)ForestNone within 15 km radius0not applicable
(2.)Archaeological SitesSarai Allawardi Masjid, Gurgaon1.47It is in NNE direction of the project site
(3.)Defence InstallationsArjangarh Air Force Station10.74It is in SEE direction of the project site
(4.)OthersState BoundaryDelhi- Haryana3.14It is NNW direction of the project site
23.3.
(a)Whether Noc / Permission from the competent authority is required? Yes
(i)Uploaded Noc / Permission from the competent authority Copy of Noc / Permission from the competent authority
(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) 69
(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) 3.0225
(b)Land yet to be acquired(Ha) 0
(c)Status of Land acquisition if not acquired Not applicable
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) 487
(e)Funds Allocated for R&R(in INR) (in Lacs) 24.5
(f)Status of R&R Completed
28.
Details of Presence of Schedule-I Species:
(a)Whether there is Presence of Schedule-I Species ? Yes
(i)Details of Schedule-I Species Indian Peafowl (Pavo cristatus)
(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 ? Yes
(i)Details of Water Bodies in Buffer Area Water Pond near Tech Chand Nagar, Najafgarh Jheel
(ii)Direction of Water Bodies in Buffer Area South West
(iii)Distance of Water Bodies in Buffer Area 2.19
31.
Manpower Requirement:
(a)Permanent Employment-During Construction 0
(b)Permanent Employment-During Operation 50
(c)Temporary Employment- During Construction 500
(d)Temporary Employment- During Operation 0
(e)No. of working days 300
(f)Total Manpower 550
32.
Green Belt in Ha:
(a)Total Area of Green Belt 0.8160
(b)Percentage of Total Project Area 27.00
(c)No. of Plants to be Planted 400
(d)Funds Allocated for Plantation 0.65
(e)Uploaded Green Belt plan Copy of Green Belt Plan
    33.         Project Benefits
S. No.Type of Project Benefits Details of Project Benefits
(1.)Environmental30 % of net plot area will be developed as green area.
(2.)FinancialRevenue through Taxes.
(3.)SocialIt will provide employment opportunities to locals
   34.   CRZ Specific Details : Not Applicable
   35.   Sector Specific Details For INFRA-2
S. No.Item Details
1.
Details of Building Construction:
(a)Maximum Height of the Building (Meters) 59.75
(b)Total No. of Flats to be Build 509
(c)No. of Buildings 5
(d)Total plot area (sqm) 30225
(e)Total built up area (sqm) 101185.30
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 14
(d)Capacity 238
4.
Parking:
(a)Details of 4 Wheeler/ 2 Wheeler Parking 780
5.
Energy Saving Measures:
(a)Source/Mode Solar & LED
(b)Percentage 11.14
(c)Quantity 377
6.
Other details:
(a)Details of impact on Water Bodies and Drainage patters of catchment area There will be no extraction of Ground water. STP o
(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
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. Rev 69, 5th September 2018 at S. No. 116
(ii)Name of the EIA Consultant Perfact Enviro Solutions Pvt. Ltd.
(iii)Address Perfact Group, 5th Floor|Front Wing|NN Mall|Sector-3|Rohini|New Delhi-110085|
(iv)Mobile No. 9818362330
(v)Landline No. 49281360
(vi)Email Id info@perfactgroup.in
(vii)Category of Accreditation A
(viii)Sector of Accreditation INFRA-2
(ix)Validity of Accreditation 27 Oct 2018
(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 NA
(h)Uploaded Proposal Presentation (To be given in EAC meeting) NA
      Essential Detail Sought : NIL
      Additional Detail Sought : NIL
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 Applicant
Designation
Name of Company (Applicant Name should not be given here)
Address
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