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) Construction of High Altitude Roads in the State of Sikkim for project road Toong-Partem-PT-4865
(b)Name of the Company / Organisation ITBP GANGTOK
(c)Registered Address Sector Head Quarter ITBP,Metro Point Tadong,Gangtok,Sikkim-737102
(d)Legal Status of the Company Central Government
(e)Joint Venture No
2.
Address for the correspondence:
(a)Name of the Applicant Shiv Charan Lal Meena
(b)Designation (Owner/ Partner/ CEO) ExecutiveEngineer
(c)Address BRPD- 1, CPWD, Opp- Post Office,S. T. Lama Building, 3rd Floor, Chungthang,Chungthang,Mangan,Sikkim-737120
(d)Pin code 737120
(e)E-mail eeccdsikkim@gmail.com
(f)STD Code. 3592(f)Telephone No. 252527
(g)Fax No. 03592252528
(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/Activity7(f) Highways
Minor Activity
(b)Category A
(c)Proposal Number IA/SK/NCP/124404/2019
(d)Master Proposal Number(Single Window) SW/124384/2019
(e)EAC concerned (for category A Projects only) INFRA-1
(f)Project Type Fresh EC
4.
Location of the Project:
(a)Plot/Survey/Khasra No. Toong to PT PT 4865
(b)Pincode 737120
(c)Bounded Latitudes (North)
From
Degree 27.460410
Minutes
Second
From
Degree 27.548972
Minutes
Second
(d)Bounded Longitudes (East)
From
Degree 88.643130
Minutes
Second
From
Degree 88.771845
Minutes
Second
(e)Survey of India Topo Sheet No. 0
(f)Uploaded Topo Sheet File Copy of Topo Sheet File
(g)Maximum Elevation Above Means Sea Level(AMSL) 3379
(h)Uploaded (kml) File Copy of Kml File      
(i)Distance of Nearest HFL from the project boundary within the study area 0.00
(j)Seismic Zone 4
5.
(a)Number of States in which Project will be Executed 1
(b)Main State of the project Sikkim
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 Border State Highway
(c)Supporting Document Copy of Supporting Document
8.
Details of Project Configuration/Product:
     8.1.       Project Configuration
S. No.Plant/Equipment/FacilityConfigurationRemarks
(1.)NANANA
     8.2.       Product
S. No.Product/Activity (Capacity/Area)QuantityUnitOther UnitMode of Transport / Transmission of ProductOther Mode of Transport / Transmission of Product
(1.)NA0Tons 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 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) 1498.89
(b) Funds Allocated for Environment Management (Capital) (in Crores) 1156
(c) Funds Allocated Towards CER (Corporate Environment Responsibility) (in Crores) 0.00
(d) Funds Allocated for Environment Management Plan (EMP) (Recurring per Annum) (in Crores) 0.00
11.
Whether project attracts the General Condition specified in the Schedule of EIA Notification ? Yes
d)Inter-State boundaries and international boundaries Yes
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.)NA0Tons per AnnumNARoad0 Open MarketCopy of Linkage
14.
Baseline Data :
(a)Period of Base Line Data Collection FROM 05 May 2018 To 09 May 2018
(b)Season Summer
    14.1.     No. of ambient Air Quality (AAQ) monitoring locations : 2
S. No.Criteria Pollutants Other Criteria PollutantsUnitMaximum ValueMinimum Value98 Percentile ValuePrescribed Standard
(1.)PM10Micro Gram per Meter Cube48.642.342.426100
(2.)PM2.5Micro Gram per Meter Cube22.719.719.7660
(3.)NOxMicro Gram per Meter Cube13.812.113.5280
(4.)SO2Micro Gram per Meter Cube5.03.43.43280
    14.2.     No. of Ground Water monitoring locations : 1
S. No.Criteria Pollutants Other Criteria PollutantsHeavy MetalUnitOther UnitMaximum ValueMinimum ValueDesirable LimitMaximum Permissible Limit
(1.)pHNA6.766.7050
(2.)TDSOthersNTU1.51.0510
(3.)Fluoridemg/l1111.5
(4.)TSSmg/l250200450500
(5.)Total Hardnessmg/l271271300600
(6.)Chloridesmg/l21.0321.032501000
(7.)Heavy MetalsLeadmg/l110.51.5
    14.3.     No. of Surface Water monitoring locations : 1
S. No.Criteria Pollutants Other Criteria PollutantsUnitOther UnitMaximum ValueMinimum ValueClassification of inland water body
(1.)pHNA5.635.0C
(2.)DOmg/l6.05.9C
(3.)BODmg/l5.25.2C
(4.)CODmg/l9.49.4C
    14.4.     No. of Ambient Noise monitoring locations : 2
S. No.Parameter UnitMaximum ValueMinimum ValuePrescribed Standard
(1.)Leq(Night)A-weighted decibels(dB(A))29.527.140
(2.)Leq(Day)A-weighted decibels(dB(A))32.525.850
    14.5.     No. of Soil Sample Monitored locations : 2
S. No.Parameter UnitOther UnitMaximum ValueMinimum Value
(1.)pH0.640.52
(2.)N(Nitrogen)Milligram per Litre3229
(3.)P(Phosphorus)Milligram per Litre3633
(4.)Electric ConductivityMillisiemens per Centimetre0.640.52
(5.)K(Potassium)Milligram per Litre7771
14.6.
Details of Ground Water Table:
(a)Range of Water Table Pre-Monsoon Season (Meters Below Ground Level (m bgl)) From 4 To 5
(b)Range of Water Table Post-Monsoon Season (Meters Below Ground Level (m bgl)) From 5 To 8
(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.)GroundWater501.5Copy of Permission LetterPipelineOpen Well008 Jul 20190
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.)NA00NAOthersNA00
16.1.
(a)Total Waste Water Generation (Kilolitre per Day) 0
(b)Total Discharged Water (Kilolitre per Day) 0
(c)Total Reused Water (Kilolitre per Day) 0
    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.)Construction wasteConstruction & Demolition Waste0Tons2.0RoadTreatment, 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.)PM10Microgram per Meter Cube48.600.248.9100
(2.)PM2.5Microgram per Meter Cube19.700.1519.960
(3.)SO2Microgram per Meter Cube13.800.114.080
(4.)NOxMicrogram per Meter Cube5.000.45.580
    18.2.     Stack Details
S. No.Source FuelStack Height(m)Stack Diameter(m)PollutantsOther PollutantsEmission (GLS)
(1.)NANA00OthersNA0
19.
Power Requirement:
(a)Quantity (Kilo Volt Amps (kVA)) 0
(b)Source 0
(c)Uploaded Copy of Agreement Not Applicable
(d)Standby Arrangement (Details of DG Sets) 0
(e)Stack Height (in m) 0
20.
Land Ownership Pattern:
(a)Forest Land (ha.) 141.0
(b)Private Land (ha.) 16.145
(c)Government Land (ha.) 0
(d)Revenue Land (ha.) 0
(e)Other Land (ha.) 0
    Total Land (ha.) 157.145
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.) 141.0
(h)Mangroves (ha.) 0
(i)Marine Area (ha.) 0
(j)Others (ha.) : Private Land 16.145
    Total (ha.) 157.145
    22.     Land requirement for various activities
S. No.Description of Activity / Facility / Plant / Others OthersLand Requirement (ha.)Remarks
(1.)Built Up Area157.145
Total (ha.) 157.145
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.)Critically Polluted AreaNA00NA
(2.)WLSNA00NA
(3.)NPANA00NA
(4.)ESZsNA00NA
(5.)CorridorsNA00NA
(6.)ESAsNA00NA
(7.)Wildlife CorridorsNA00NA
    23.2.     Details of Environmental Sensitivity :
S. No.Details of Environmental Sensitivity Other Details of Environmental Sensitivity NameDistance from the Project (Km)Remarks
(1.)ForestNaga Forest Block0NA
(2.)Archaeological SitesNA0NA
(3.)OthersInternational Borderindia-China Border0NA
(4.)Defence InstallationsNA0NA
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) 58835768
(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) 157.14
(b)Land yet to be acquired(Ha) 00
(c)Status of Land acquisition if not acquired 00
27.
Rehabilitation and Resettlement (R&R):
(a)No. of Villages 00
(b)No. of Households 00
(c)No. of PDFs (Project Displaced Families) 00
(d)No. of PAFs (Project Affected Families) 00
(e)Funds Allocated for R&R(in INR) (in Lacs) 00
(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 Lachung River
(ii)Direction of Water Bodies in Buffer Area North West
(iii)Distance of Water Bodies in Buffer Area 0.00
31.
Manpower Requirement:
(a)Permanent Employment-During Construction 0
(b)Permanent Employment-During Operation 0
(c)Temporary Employment- During Construction 100
(d)Temporary Employment- During Operation 100
(e)No. of working days 300
(f)Total Manpower 200
32.
Green Belt in Ha:
(a)Total Area of Green Belt 00
(b)Percentage of Total Project Area 0.00
(c)No. of Plants to be Planted 00
(d)Funds Allocated for Plantation 11000000000
(e)Uploaded Green Belt plan Copy of Green Belt Plan
    33.         Project Benefits
S. No.Type of Project Benefits Details of Project Benefits
(1.)SocialArea development and improve transportation facility
   34.   CRZ Specific Details : Not Applicable
   35.   Sector Specific Details For INFRA-1
S. No.Item Details
1.
Details of Building Construction:
(a)Maximum Height of the Building (Meters) 00
(b)Total No. of Flats to be Build 00
(c)No. of Buildings 00
(d)Total plot area (sqm) 00
(e)Total built up area (sqm) 00
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 00
(b)Capacity 00
(c)No. of Recharge Pits 00
(d)Capacity 00
4.
Parking:
(a)Details of 4 Wheeler/ 2 Wheeler Parking 00
5.
Energy Saving Measures:
(a)Source/Mode NA
(b)Percentage 00
(c)Quantity 00
6.
Other details:
(a)Details of impact on Water Bodies and Drainage patters of catchment area No water body affected, not disturbed to drainage
(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 00
9.
Details Bridges/ROB/Interchanges,Flyovers,Vehicle Underpass and Pedestrian Underpass
(a)Total No. of Bridges 00
(b)Total No. of ROB 00
(c)Total No. of Interchanges 00
(d)Total No. of Flyovers 00
(e)Total No. of Vehicle Underpass 00
(f)Total No. of Pedestrian Underpass 00
(g)Details of other utilities rail and road corridors 00
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/1619/ IA 007
(ii)Name of the EIA Consultant Global Management and Engineering Consultants
(iii)Address Saharan Tower, 308, Officer campus Extension,Sirsi Road, Khatipura Jaipur
(iv)Mobile No. 9928793002
(v)Landline No. 0141235324
(vi)Email Id info@gmecinternational.com
(vii)Category of Accreditation A
(viii)Sector of Accreditation INFRA-1
(ix)Validity of Accreditation 03 Aug 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:
Sno. EDS Letter Remarks Date of EDS
1.NAPlease submit final EIA/EMP report as per generic structure of EIA Notification, 2006 (Appendix-III) 09 Dec 2019
2.NAThe correction have been made as per the instruction received 23 Jan 2020
3.NAplease submit declaration of EIA consultant organization with signatures regarding experts involved in preparation of EIA/EMP report(Coordinator and FAE'S) in chapter-12 as per the QCI/NABET proforma. 12 Feb 2020
4.NAThe correction have been made as per the instruction received 21 Feb 2020
5.NAIncorporate the signed copy of EIA Consultant disclosure in chapter-12 of EIA/EMP report and revise the report accordingly and upload in Form-2 application. 03 Mar 2020
6.NAThe correction have been made as per the instruction received 12 Mar 2020
      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 ApplicantShiv Charan Lal Meena
DesignationExecutiveEngineer
Name of Company (Applicant Name should not be given here)ITBP GANGTOK
AddressSector Head Quarter ITBP
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