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 (WITH MLCP ) BUILDING AT HASTSAL, WEST DELHI
(b)Name of the Company / Organisation PUBLIC WORKS DEPARTMENT, GNCTD
(c)Registered Address Executive Engineer Health Project division West, PWD, GNCTD Sector-9 Dwarka, New Delhi,,West,Delhi-110077
(d)Legal Status of the Company State Government
(e)Joint Venture No
2.
Address for the correspondence:
(a)Name of the Applicant Mukesh kumar
(b)Designation (Owner/ Partner/ CEO) EE
(c)Address Health Project Division West , PWD, West,Sector-9 Dwarka New Delhi,Patel Nagar,West,Delhi-110077
(d)Pin code 110077
(e)E-mail pwddelhi4@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.I)Project/Activity8(a) Building and Construction projects
Minor Activity1(a) Mining of minerals
(b)Category B2
   Reason for Applying at Ministry SEIAA
(c)Proposal Number IA/DL/MIS/108292/2019
(d)Master Proposal Number(Single Window) SW/108288/2019
(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. Hastsal
(b)Pincode 110059
(c)Bounded Latitudes (North)
From
Degree 28375829
Minutes
Second
From
Degree 28375832
Minutes
Second
(d)Bounded Longitudes (East)
From
Degree 2834128
Minutes
Second
From
Degree 2834129
Minutes
Second
(e)Survey of India Topo Sheet No. t
(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.)DelhiWestPatel NagarHastsal
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.)no0no
     8.2.       Product
S. No.Product/Activity (Capacity/Area)QuantityUnitOther UnitMode of Transport / Transmission of ProductOther Mode of Transport / Transmission of Product
(1.)none0Tons 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 04 Jun 2019
(iv)Valid Upto 04 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) 466.69
(b) Funds Allocated for Environment Management (Capital) (in Crores) 1.2
(c) Funds Allocated Towards CER (Corporate Environment Responsibility) (in Crores) 7
(d) Funds Allocated for Environment Management Plan (EMP) (Recurring per Annum) (in Crores) 0.25
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 0
(b)Existing quantity of raw material/fuel N/A
(c)Total quantity of raw material/fuel 0
    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.)000Tons per AnnumindiaRoad0 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 Cube203203185100
(2.)NOxMicro Gram per Meter Cube30302580
(3.)PM2.5Micro Gram per Meter Cube1101109560
(4.)SO2Micro Gram per Meter Cube15151080
    14.2.     No. of Ground Water monitoring locations : 1
S. No.Criteria Pollutants Other Criteria PollutantsHeavy MetalUnitOther UnitMaximum ValueMinimum ValueDesirable LimitMaximum Permissible Limit
(1.)pHmg/l8.028.028.58.5
(2.)TSSmg/l1115
(3.)Total Hardnessmg/l432432200600
(4.)Fluoridemg/l0.70.711.5
(5.)Heavy Metalsleadmg/l0.010.0100
(6.)Chloridesmg/l4124122501000
(7.)TDSmg/l134813485002000
    14.3.     No. of Surface Water monitoring locations : 1
S. No.Criteria Pollutants Other Criteria PollutantsUnitOther UnitMaximum ValueMinimum ValueClassification of inland water body
(1.)pHmg/l88C
(2.)BODmg/l250249C
(3.)CODmg/l310302C
(4.)DOmg/l22C
    14.4.     No. of Ambient Noise monitoring locations : 1
S. No.Parameter UnitMaximum ValueMinimum ValuePrescribed Standard
(1.)Leq(Day)A-weighted decibels(dB(A))52.352.350
(2.)Leq(Night)A-weighted decibels(dB(A))43.243.240
    14.5.     No. of Soil Sample Monitored locations : 1
S. No.Parameter UnitOther UnitMaximum ValueMinimum Value
(1.)N(Nitrogen)Kilogram per hectare224224
(2.)P(Phosphorus)Kilogram per hectare14.814.8
(3.)K(Potassium)Kilogram per hectare186186
(4.)Electric ConductivityMillisiemens per Centimetre362362
(5.)pH8.028.02
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 28 To 30
(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.)OthersDJB6561Copy of Permission LetterPipelineOthersDJB connection12301 Feb 2019656
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.)domestic clinical351430STP ETPReuse within the Plant & Recycling351
16.1.
(a)Total Waste Water Generation (Kilolitre per Day) 351
(b)Total Discharged Water (Kilolitre per Day) 0
(c)Total Reused Water (Kilolitre per Day) 351
    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 Waste2.7Tons2RoadOthersOWC
(2.)otherBio-Medical Waste0.9Tons1RoadTreatment, 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.)NOxMicrogram per Meter Cube40255080
(2.)PM10Microgram per Meter Cube35025360100
(3.)PM2.5Microgram per Meter Cube902510060
(4.)SO2Microgram per Meter Cube20253080
    18.2.     Stack Details
S. No.Source FuelStack Height(m)Stack Diameter(m)PollutantsOther PollutantsEmission (GLS)
(1.)dgdiesel550.3PM103.5
19.
Power Requirement:
(a)Quantity (Kilo Volt Amps (kVA)) 3675
(b)Source BSES
(c)Uploaded Copy of Agreement Copy of Agreement
(d)Standby Arrangement (Details of DG Sets) 2020
(e)Stack Height (in m) 55
20.
Land Ownership Pattern:
(a)Forest Land (ha.) 0
(b)Private Land (ha.) 0
(c)Government Land (ha.) 1.51
(d)Revenue Land (ha.) 0
(e)Other Land (ha.) 0
    Total Land (ha.) 1.51
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.) : Govt. land 1.51
    Total (ha.) 1.51
    22.     Land requirement for various activities
S. No.Description of Activity / Facility / Plant / Others OthersLand Requirement (ha.)Remarks
(1.)Othersplot area1.51no
Total (ha.) 1.51
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.)Corridorsnone43none
(2.)ESZsnone43none
(3.)Critically Polluted AreaNazafgarh industrial9.5site does not fall in polluted area
(4.)NPAnone43none
(5.)ESAsnone43none
(6.)Wildlife Corridorsnone43none
(7.)WLSnone43none
    23.2.     Details of Environmental Sensitivity :
S. No.Details of Environmental Sensitivity Other Details of Environmental Sensitivity NameDistance from the Project (Km)Remarks
(1.)Archaeological Sitesno43no
(2.)Defence Installationsnone43no
(3.)ForestCentral Ridge Forest11none
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) 1.51
(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 ? No
31.
Manpower Requirement:
(a)Permanent Employment-During Construction 100
(b)Permanent Employment-During Operation 2300
(c)Temporary Employment- During Construction 50
(d)Temporary Employment- During Operation 100
(e)No. of working days 365
(f)Total Manpower 2550
32.
Green Belt in Ha:
(a)Total Area of Green Belt 0.53
(b)Percentage of Total Project Area 35.10
(c)No. of Plants to be Planted 200
(d)Funds Allocated for Plantation 200000
(e)Uploaded Green Belt plan Copy of Green Belt Plan
    33.       Project Benefits
S. No. Type of Project BenefitsDetails of Project Benefits
NIL
   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) 48
(b)Total No. of Flats to be Build 0
(c)No. of Buildings 2
(d)Total plot area (sqm) 15175.65
(e)Total built up area (sqm) 46183.57
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 4
(d)Capacity 84.76
4.
Parking:
(a)Details of 4 Wheeler/ 2 Wheeler Parking 788
5.
Energy Saving Measures:
(a)Source/Mode solar
(b)Percentage 1
(c)Quantity 3.6
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
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 INFRA-2
(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
(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 ApplicantMukesh kumar
DesignationEE
Name of Company (Applicant Name should not be given here)PUBLIC WORKS DEPARTMENT, GNCTD
AddressExecutive Engineer Health Project division West, PWD, GNCTD Sector-9 Dwarka, New Delhi
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