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) Expansion of Guru Teg Bahadur Government Hospital/College at Dilshad Garden Delhi
(b)Name of the Company / Organisation PUBLIC WORKS DEPARTMENT DELHI
(c)Registered Address rajiv gandhi superspeciality hospital tahirpur delhi,,North East,Delhi-110093
(d)Legal Status of the Company State Government
(e)Joint Venture No
2.
Address for the correspondence:
(a)Name of the Applicant pradeep kumar
(b)Designation (Owner/ Partner/ CEO) EE
(c)Address GTB governement hospital dilshad garden delhi,,Shahdara,North East,Delhi-110095
(d)Pin code 110095
(e)E-mail gtbhosppwd@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(b) Townships and Area Development projects.
Minor Activity1(a) Mining of minerals
(b)Category B1
   Reason for Applying at Ministry SEIAA
(c)Proposal Number IA/DL/MIS/109087/2019
(d)Master Proposal Number(Single Window) SW/109084/2019
(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. Dilshad garden
(b)Pincode 110095
(c)Bounded Latitudes (North)
From
Degree 28411.83
Minutes
Second
From
Degree 28411.89
Minutes
Second
(d)Bounded Longitudes (East)
From
Degree 771834.4
Minutes
Second
From
Degree 771834.50
Minutes
Second
(e)Survey of India Topo Sheet No. 1
(f)Uploaded Topo Sheet File Copy of Topo Sheet File
(g)Maximum Elevation Above Means Sea Level(AMSL) 218
(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 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 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.)11Tons 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 01 Jun 2019
(iv)Valid Upto 01 Jun 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) 200
(b) Funds Allocated for Environment Management (Capital) (in Crores) 1000000
(c) Funds Allocated Towards CER (Corporate Environment Responsibility) (in Crores) 20000000
(d) Funds Allocated for Environment Management Plan (EMP) (Recurring per Annum) (in Crores) 100000
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 1
(b)Existing quantity of raw material/fuel N/A
(c)Total quantity of raw material/fuel 1
    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.)001Tons per AnnumindiaRoad1 LinkageCopy of Linkage
14.
Baseline Data :
(a)Period of Base Line Data Collection FROM 15 Sep 2018 To 15 Dec 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.)PM2.5Micro Gram per Meter Cube22022018060
(2.)NOxMicro Gram per Meter Cube78584880
(3.)PM10Micro Gram per Meter Cube280280180100
(4.)SO2Micro Gram per Meter Cube40123080
    14.2.     No. of Ground Water monitoring locations : 1
S. No.Criteria Pollutants Other Criteria PollutantsHeavy MetalUnitOther UnitMaximum ValueMinimum ValueDesirable LimitMaximum Permissible Limit
(1.)Total Hardnessmg/l0000
(2.)Chloridesmg/l0000
(3.)Fluoridemg/l0000
(4.)TSSmg/l0000
(5.)pHNA7.87.888
(6.)Heavy Metalsarmg/l0000
(7.)TDSmg/l0000
    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/l00C
(2.)Othersmmg/l00C
(3.)CODmg/l00C
(4.)DOmg/l00C
(5.)BODmg/l00C
    14.4.     No. of Ambient Noise monitoring locations : 1
S. No.Parameter UnitMaximum ValueMinimum ValuePrescribed Standard
(1.)Leq(Day)A-weighted decibels(dB(A))111
(2.)Leq(Night)A-weighted decibels(dB(A))111
    14.5.     No. of Soil Sample Monitored locations : 1
S. No.Parameter UnitOther UnitMaximum ValueMinimum Value
(1.)pH11
(2.)P(Phosphorus)Kilogram per hectare11
(3.)Electric ConductivityMilliequivalents per 100 Gram11
(4.)N(Nitrogen)Kilogram per hectare11
(5.)K(Potassium)Kilogram per hectare11
14.6.
Details of Ground Water Table:
(a)Range of Water Table Pre-Monsoon Season (Meters Below Ground Level (m bgl)) From 20 To 30
(b)Range of Water Table Post-Monsoon Season (Meters Below Ground Level (m bgl)) From 15 To 20
(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.)OthersDJB18441Copy of Permission LetterPipelineOthersDJB connection12301 Jun 20191844
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.)domestic9991200STP ETPReuse within the Plant & Recycling999
16.1.
(a)Total Waste Water Generation (Kilolitre per Day) 999
(b)Total Discharged Water (Kilolitre per Day) 0
(c)Total Reused Water (Kilolitre per Day) 999
    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.)wasteMunicipal Solid Waste9Tons1RoadAuthorized Recyclers
18.
    18.1.     Air Quality Impact Prediction
S. No.Criteria Pollutants Other Criteria PollutantsUnitBaseline ConcentrationDistance GLCIncremental ConcentrationTotal GLCPrescribed Standard
(1.)NOxMicrogram per Meter Cube11151
(2.)PM10Microgram per Meter Cube01151
(3.)PM2.5Microgram per Meter Cube11510100
(4.)SO2Microgram per Meter Cube1115100
    18.2.     Stack Details
S. No.Source FuelStack Height(m)Stack Diameter(m)PollutantsOther PollutantsEmission (GLS)
(1.)1dg460.3PM101
19.
Power Requirement:
(a)Quantity (Kilo Volt Amps (kVA)) 8000
(b)Source BSES
(c)Uploaded Copy of Agreement Copy of Agreement
(d)Standby Arrangement (Details of DG Sets) 5000
(e)Stack Height (in m) 40
20.
Land Ownership Pattern:
(a)Forest Land (ha.) 0
(b)Private Land (ha.) 0
(c)Government Land (ha.) 33.52
(d)Revenue Land (ha.) 0
(e)Other Land (ha.) 0
    Total Land (ha.) 33.52
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 33.52
    Total (ha.) 33.52
    22.     Land requirement for various activities
S. No.Description of Activity / Facility / Plant / Others OthersLand Requirement (ha.)Remarks
(1.)Others33.520no
Total (ha.) 0
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.)ESZsnone0none
(2.)Corridors000
(3.)WLSnone15none
(4.)Wildlife Corridors000
(5.)Critically Polluted Areaanand parbat9site does not fall in pollutes area
(6.)ESAsnone15none
(7.)NPAnone15none
    23.2.     Details of Environmental Sensitivity :
S. No.Details of Environmental Sensitivity Other Details of Environmental Sensitivity NameDistance from the Project (Km)Remarks
(1.)Forest000
(2.)Archaeological Sites000
(3.)Defence Installations000
(4.)Othersv000
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) 0
(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 50
(b)Permanent Employment-During Operation 100
(c)Temporary Employment- During Construction 10
(d)Temporary Employment- During Operation 190
(e)No. of working days 365
(f)Total Manpower 350
32.
Green Belt in Ha:
(a)Total Area of Green Belt 17.79
(b)Percentage of Total Project Area 53.07
(c)No. of Plants to be Planted 1550
(d)Funds Allocated for Plantation 200000
(e)Uploaded Green Belt plan Copy of Green Belt Plan
    33.         Project Benefits
S. No.Type of Project Benefits Details of Project Benefits
(1.)EnvironmentalETP STP Greenbelt
(2.)Socialhealthcare facility
(3.)Financialemployment
   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) 40
(b)Total No. of Flats to be Build 0
(c)No. of Buildings 2
(d)Total plot area (sqm) 335281.02
(e)Total built up area (sqm) 232190.43
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 83
(d)Capacity 1758.77
4.
Parking:
(a)Details of 4 Wheeler/ 2 Wheeler Parking 1020
5.
Energy Saving Measures:
(a)Source/Mode solar
(b)Percentage 1
(c)Quantity 8
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-III
(ii)Name of the EIA Consultant Amaltas Enviro Industrial consultant
(iii)Address Noida
(iv)Mobile No. 9810085736
(v)Landline No. 0120435288
(vi)Email Id gilbertmervyn@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:
Sno. EDS Letter Remarks Date of EDS
1.NAKindly submit the revised EIA/EMP Report by adding the following: (i) Point wise ToR compliance along with all the Annexure. (ii) Plan for Corporate Environment Responsibility (CER) as specified under Ministry’s Office Memorandum vide F.No. 22-65/2017-IA.III dated 1st May 2018. 07 Aug 2019
2.NAThe correction have been made as per the instruction received 03 Sep 2019
      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 Applicantpradeep kumar
DesignationEE
Name of Company (Applicant Name should not be given here)PUBLIC WORKS DEPARTMENT DELHI
Addressrajiv gandhi superspeciality hospital tahirpur delhi
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