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/GJ/IND/26202/2013    ii. MoEFCC File No. : J-11011/378/2013- IA II (I) t    iii.Short narrative of the project: Hemani Intermediates Pvt Ltd.    iv. Project Sector : Industrial Projects-2    v. Company/Proponent : Hemani Intermediates Pvt. Ltd.

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Gujarat	Bharuch	Vagra
2.	Gujarat	Bharuch	Vagra

   vii.Date of TOR Granted 28 Apr 2014 viii.TOR letter issued by Ministry: Annexure-TOR letter ix.Date of Submission for EC: 05 Jan 2017 x.Project Type: New

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: 28 Sep 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. : Stay Order against QCI/NABET    iii. Name of Consultant: Aqua-Air Environmental Engineers Pvt. Ltd.   iv. Address : 403, Centre Point, Nr. Kadiwala School, Ring Road, Surat   v. Mobile No.: 9099069611   vi. Landline No.: 02612460854   vii. Email Id: aqua_eia@yahoo.com

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 : D    ii. Designation : General Manager    iii. Name of Company(Applicant Name should not be given here) : Hemani Intermediates Pvt. Ltd.    iv. Address : Plot No. 3208, GIDC Estate Ankleshwar, Dist: Bharcuh, GUJARAT 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