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/KA/IND2/31793/2015    ii. MoEFCC File No. : J-11011/269/2015-IA II (I)    iii.Short narrative of the project: SOUBHAGYA LAXMI SUGARS LTD    iv. Project Sector : Industrial Projects-2    v. Company/Proponent : SOUBHAGYA LAXMI SUGARS LTD

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Karnataka	Belgaum	Gokak
2.	Karnataka	Belgaum	Gokak

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: 30 Jan 2017 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: 19 Oct 2016   v. Uploaded Additional Report/Study/Document as desired by Ministry/EAC: Annexure-Additional Report/Study/Document   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. : Sl. No. 51, Revision 48, 16th, December 2016    iii. Name of Consultant: ENVIRONMENTAL HEALTH & SAFETY CONSULTANTS PVT LTD   iv. Address : No. 13/2, 1st Main Road, Near Fire Station, Industrial Town, Rajajinagar, Bangalore – 560010.   v. Mobile No.: 8971871282   vi. Landline No.: 08023012100   vii. Email Id: slsugars123@gmail.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 : General Manager    ii. Designation : General Manager    iii. Name of Company(Applicant Name should not be given here) : SOUBHAGYA LAXMI SUGARS LTD    iv. Address : Soubhagya laxmi Sugars Ltd Gokak Dist: Belgam 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