1.	Project Details

   Whether it is a violation case and application is being submitted under Notification No. S.O.804(E) dated 14.03.2017 ? : No

1.	Project Details

   i. Proposal No. : IA/TG/IND2/32978/2015    ii. MoEFCC File No. : J-11011/302/2015-IA.II(I)    iii.Short narrative of the project: FMC India Private Limited    iv. Project Sector : Industrial Projects-2    v. Company/Proponent : FMC INDIA PRIVATE LIMITED

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Telangana	Medak	Patancheru
2.	Telangana	Medak	Patancheru

vii. Uploaded EC Compliance report by rigional office of MoEFCC: NIL viii. Certified Monitoring report by RoMoEF: Annexure-Uploaded Monitoring report    ix.Date of TOR Granted 05 Mar 2016 x.TOR letter issued by Ministry: Annexure-TOR letter ix.Date of Submission for EC: 29 Sep 2016 x.Project Type: Expansion

2.	Uploaded Documents of EIA/EMP,Risk Assessment,Public Hearing etc.

i.EIA/EMP: Annexure-EIA/EMP ii.Risk Assessment: Annexure-Risk Assessment iii.Public Hearing: Annexure-Public Hearing    iv. Date of Public Hearing: 14 Jul 2016   v. Uploaded Additional Report/Study/Document as desired by Ministry/EAC: None   vi. Uploaded Cover Letter: Annexure-Cover Letter   vii.Remarks: NIL

3.	Additional Detail Sought:   NIL

4.	Accredited Consultant Details

   i. Accreditation status : Yes    ii. Accreditation No. : 20    iii. Name of Consultant: Right Source Industrial Solutions Pvt. Ltds   iv. Address : Plot No: 203, H.No:5-36/203, Prashanthi Nagar, IDA, Kukatpally, Hyderabad – 500072.   v. Mobile No.: 9885560011   vi. Landline No.: 040-23070602   vii. Email Id: info@rightsource.co.in

5.	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 at any stage, the project will be rejected and clearance given, if any to the project will be revoked at our risk and cost.

   i. Name of Applicant : Murgesh    ii. Designation : Plant Manager    iii. Name of Company(Applicant Name should not be given here) : FMC INDIA PRIVATE LIMITED    iv. Address : Plot No:17 D, Phase -1,IDA Patancheru, Medak Dist, Telangana State v. 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: NIL