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) Andhra Pradesh District of South India Assemblies of God (b)Name of the Company / Organisation M/S. ANDHRA PRADESH DISTRICT OF SOUTH INDIA ASSEMBLIES OF GOD (c)Registered Address H.Nos. 1-67 & 1-67/1, Sy.No: 206/A & 203, Madinguda Village, Serilingampalli Mandal & Municipality, ranga Reddy District, Telangana State.,,Rangareddi,Telangana-500049 (d)Legal Status of the Company Others (e)Joint Venture No 2. Address for the correspondence: (a)Name of the Applicant ThimothiRao M (b)Designation (Owner/ Partner/ CEO) Superintendent (c)Address REV. Motupalli. Thimothi Rao, Plot No- 31, Sy.No- 40 P, and 41, Kavuri Hills, Guttalabegumpet Village, Serilingampalli mandal, Ranga Reddy District, Telangana State.,,Serilingampalle,Rangareddi,Telangana-500033 (d)Pin code 500033 (e)E-mail apdsiag1@gmail.com (f)STD Code. 0(f)Telephone No. 000 (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/Activity 8(a) Building and Construction projects Minor Activity 8(a) Building and Construction projects (b)Category B2    Reason for Applying at Ministry SEIAA (c)Proposal Number IA/TG/MIS/107592/2019 (d)Master Proposal Number(Single Window) SW/107590/2019 (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. H. Nos.1-67 & 1-67/1 & Sy.No: 206/A & 203 (b)Pincode 500050 (c)Bounded Latitudes (North) From Degree 17.50552 Minutes Second From Degree 17.50652 Minutes Second (d)Bounded Longitudes (East) From Degree 78.36388 Minutes Second From Degree 78.36527 Minutes Second (e)Survey of India Topo Sheet No. 56K/6 & 56K/7 (f)Uploaded Topo Sheet File Copy of Topo Sheet File (g)Maximum Elevation Above Means Sea Level(AMSL) 1938 (h)Uploaded (kml) File Copy of Kml File       (i)Distance of Nearest HFL from the project boundary within the study area 1.5 (j)Seismic Zone 2 5. (a)Number of States in which Project will be Executed 1 (b)Main State of the project Telangana 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 B2-Category Project (c)Supporting Document Copy of Supporting Document 8. Details of Project Configuration/Product:      8.1.       Project Configuration S. No. Plant/Equipment/Facility Configuration Remarks (1.) Residential Apartments 92,995.32 Sq.Mts      8.2.       Product S. No. Product/Activity (Capacity/Area) Quantity Unit Other Unit Mode of Transport / Transmission of Product Other Mode of Transport / Transmission of Product (1.) Residential Apartments 92995.32 Others Sq.Mts Road 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) 95 (b) Funds Allocated for Environment Management (Capital) (in Crores) 0.75 (c) Funds Allocated Towards CER (Corporate Environment Responsibility) (in Crores) 1.9 (d) Funds Allocated for Environment Management Plan (EMP) (Recurring per Annum) (in Crores) 0.16 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 150 (b)Existing quantity of raw material/fuel N/A (c)Total quantity of raw material/fuel 150     13.1.        Raw Material / Fuel Profile S. No. Raw Material / Fuel Quantity Unit Other Unit Source (incase of Import. please specify country and Name of the port from which Raw Material / Fuel is received ) Mode of Transport Other Mode of Transport Distance 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.) HSD 150 Others LPD Local Suppliers Road 2.0 Open Market Copy of Linkage 14. Baseline Data : (a)Period of Base Line Data Collection FROM 07 Jun 2019 To 07 Jun 2019 (b)Season Pre-Monsoon     14.1.     No. of ambient Air Quality (AAQ) monitoring locations : 0 S. No. Criteria Pollutants Other Criteria Pollutants Unit Maximum Value Minimum Value 98 Percentile Value Prescribed Standard (1.) NOx Micro Gram per Meter Cube 0 0 0 80 (2.) PM10 Micro Gram per Meter Cube 0 0 0 100 (3.) PM2.5 Micro Gram per Meter Cube 0 0 0 60 (4.) SO2 Micro Gram per Meter Cube 0 0 0 80     14.2.     No. of Ground Water monitoring locations : 0 S. No. Criteria Pollutants Other Criteria Pollutants Heavy Metal Unit Other Unit Maximum Value Minimum Value Desirable Limit Maximum Permissible Limit (1.) pH NA 0 0 0 8.5 (2.) Chlorides mg/l 0 0 0 250 (3.) Heavy Metals Fe mg/l 0 0 0 0.3 (4.) TDS mg/l 0 0 0 0 (5.) Total Hardness mg/l 0 0 0 200 (6.) TSS mg/l 0 0 0 500 (7.) Fluoride mg/l 0 0 0 1     14.3.     No. of Surface Water monitoring locations : 0 S. No. Criteria Pollutants Other Criteria Pollutants Unit Other Unit Maximum Value Minimum Value Classification of inland water body (1.) pH NA 0 0 A (2.) DO mg/l 0 0 A (3.) BOD mg/l 0 0 A (4.) COD mg/l 0 0 A     14.4.     No. of Ambient Noise monitoring locations : 0 S. No. Parameter Unit Maximum Value Minimum Value Prescribed Standard (1.) Leq(Day) A-weighted decibels(dB(A)) 0 0 IND-75/RES-45 (2.) Leq(Night) A-weighted decibels(dB(A)) 0 0 IND-75/RES-55     14.5.     No. of Soil Sample Monitored locations : 0 S. No. Parameter Unit Other Unit Maximum Value Minimum Value (1.) N(Nitrogen) Kilogram per hectare 0 0 (2.) Electric Conductivity Others MOHS 0 0 (3.) pH 0 0 (4.) P(Phosphorus) Kilogram per hectare 0 0 (5.) K(Potassium) Kilogram per hectare 0 0 14.6. Details of Ground Water Table: (a)Range of Water Table Pre-Monsoon Season (Meters Below Ground Level (m bgl)) From 1.40 To 33.50 (b)Range of Water Table Post-Monsoon Season (Meters Below Ground Level (m bgl)) From 0.20 To 28.32 (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 Source Copy of Permission from Competent Authority Mode of Transport Other Mode of Transport Method of Water Withdrawal Other Method of Water Withdrawal Letter No. Date of Issue Permitted Quantity (1.) Others Municipal Supply 246.0 1.0 Not Appliacble Pipeline Others Pipe Line NA 08 Jun 2019 246.0 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 Method Mode of Disposal Other Mode of Disposal Quantity of Treated Water Used in Recycling/Reuse (Kilolitre per Day) Quantity of Discharged Water (Kilolitre per Day) (1.) Domestic 204 245 SBR Reuse within the Plant & Recycling 204 16.1. (a)Total Waste Water Generation (Kilolitre per Day) 204 (b)Total Discharged Water (Kilolitre per Day) 0 (c)Total Reused Water (Kilolitre per Day) 204     17.       Solid Waste Generation/Management S. No. Name of Waste Item Other Item Quantity per Annum Unit Distance from Site(KM) Mode of Transport Other Mode of Transport Mode of Disposal Other Mode of Disposal (1.) GARBAGE Municipal Solid Waste 473.57 Tons 0 Road Others AS PER SWM RULES 2016 (2.) SW E Waste 0.4 Tons 10 Road Authorized Recyclers 18.     18.1.     Air Quality Impact Prediction S. No. Criteria Pollutants Other Criteria Pollutants Unit Baseline Concentration Distance GLC Incremental Concentration Total GLC Prescribed Standard (1.) PM10 Microgram per Meter Cube 0 10 0 100 0 (2.) PM2.5 Microgram per Meter Cube 0 10 0 60 0 (3.) SO2 Microgram per Meter Cube 0 10 0 80 0 (4.) NOx Microgram per Meter Cube 0 10 0 80 0     18.2.     Stack Details S. No. Source Fuel Stack Height(m) Stack Diameter(m) Pollutants Other Pollutants Emission (GLS) (1.) 2 X500 KVA HSD 35 0.7 PM10 0 19. Power Requirement: (a)Quantity (Kilo Volt Amps (kVA)) 2250 (b)Source TSCPDCL (c)Uploaded Copy of Agreement Not Applicable (d)Standby Arrangement (Details of DG Sets) 2 X 500 KVA & 1 X 82.5 KVA (e)Stack Height (in m) 35 20. Land Ownership Pattern: (a)Forest Land (ha.) 0 (b)Private Land (ha.) 1.4535 (c)Government Land (ha.) 0 (d)Revenue Land (ha.) 0 (e)Other Land (ha.) 0     Total Land (ha.) 1.4535 21. Present Land Use Breakup of the Study Area in Ha: (a)Agriculture Area (ha.) 0 (b)Waste/Barren Land (ha.) 1.4535 (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.) : NA 0     Total (ha.) 1.4535     22.     Land requirement for various activities S. No. Description of Activity / Facility / Plant / Others Others Land Requirement (ha.) Remarks (1.) Built Up Area 1.4535 Total (ha.) 1.4535 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 Name Distance from the Project (Km) Remarks (1.) WLS NA 0 NONE (2.) NPA NA 0 NONE (3.) ESAs NA 0 NONE (4.) Critically Polluted Area NA 0 NONE (5.) ESZs NA 0 NONE (6.) Wildlife Corridors na 0 NONE (7.) Corridors Na 0 NONE     23.2.     Details of Environmental Sensitivity : S. No. Details of Environmental Sensitivity Other Details of Environmental Sensitivity Name Distance from the Project (Km) Remarks (1.) Defence Installations NONE 0 NONE (2.) Forest Kottaguda RF 4.9 Kottaguda RF-4.9 km (S) Kazipalli RF—6.5 km (N) Dundigal RF -8.9 km (NNE) Borampet RF – 6.5 km (NE) Suraram PF -6.5 km (NE) Gajularamaram RF -6.2 km (ENE) Dulapalle RF -8.9 km (ENE) (3.) Archaeological Sites NONE 0 NONE 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) 38 (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) 1.4535 (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 INR) (in Lacs) 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 ? Yes (i)Details of Water Bodies in Buffer Area Miyapur Cheruvu - 0.7 Km (SW) Ameenpur lake - 3.0 Km (NW), Hafeezpet cheruvu - 1.5 Km (SSW) Madinaguda cheruvu - 2.6 Km (SW) (ii)Direction of Water Bodies in Buffer Area South West (iii)Distance of Water Bodies in Buffer Area 0.7 31. Manpower Requirement: (a)Permanent Employment-During Construction 100 (b)Permanent Employment-During Operation 0 (c)Temporary Employment- During Construction 50 (d)Temporary Employment- During Operation 0 (e)No. of working days 365 (f)Total Manpower 150 32. Green Belt in Ha: (a)Total Area of Green Belt 0.2918 (b)Percentage of Total Project Area 20.08 (c)No. of Plants to be Planted 288 (d)Funds Allocated for Plantation 500000 (e)Uploaded Green Belt plan Copy of Green Belt Plan     33.         Project Benefits S. No. Type of Project Benefits Details of Project Benefits (1.) Financial Employment Opportunities (2.) Environmental Greenbelt Development (3.) Social Infrastructure Development    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) 29.99 (b)Total No. of Flats to be Build 450 (c)No. of Buildings 5 (d)Total plot area (sqm) 14535.41 (e)Total built up area (sqm) 92995.32 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 18 (b)Capacity 457.7 (c)No. of Recharge Pits 18 (d)Capacity 457.7 4. Parking: (a)Details of 4 Wheeler/ 2 Wheeler Parking CARS - 772/TWO-WHEELER - 547 5. Energy Saving Measures: (a)Source/Mode LED,Solar street lights & Solar water Heaters (b)Percentage 21.19 (c)Quantity 477 6. Other details: (a)Details of impact on Water Bodies and Drainage patters of catchment area NOT APPLICABLE (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 Industry No. of Units Category 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. NABET/EIA/1922/IA0043 (ii)Name of the EIA Consultant M/s. SPACE ENVIRO SOLUTIONS (iii)Address H. NO: 1-4-69/4, STREET NO:8 HABSIGUDA, HYDERABAD. TELANGANA – 500007 (iv)Mobile No. 9848199516 (v)Landline No. 0404850337 (vi)Email Id info@spaceenviro.com (vii)Category of Accreditation A (viii)Sector of Accreditation INFRA-2 (ix)Validity of Accreditation 05 Mar 2022 (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 (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 ThimothiRao M Designation Superintendent Name of Company (Applicant Name should not be given here) M/S. ANDHRA PRADESH DISTRICT OF SOUTH INDIA ASSEMBLIES OF GOD Address H.Nos. 1-67 & 1-67/1, Sy.No: 206/A & 203, Madinguda Village, Serilingampalli Mandal & Municipality, ranga Reddy District, Telangana State.

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