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/AP/MIN/30272/2015    ii. MoEFCC File No. : J-11015/309/2015-IA-II(M)    iii.Short narrative of the project: Siddavaram Silica sand Mine (Consultant: Perfact Enviro Solutions Pvt Ltd)    iv. Project Sector : Mining Projects    v. Company/Proponent : SMT RAMA S MENDON

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Andhra Pradesh	Nellore	Kota

   vii.Date of TOR Granted 02 Nov 2015 viii.TOR letter issued by Ministry: Annexure-TOR letter ix.Date of Submission for EC: 16 May 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: 17 Jan 2017   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: EDS reply sought by MS on 15.05.2017

3.	Additional Detail Sought:   NIL

4.	Accredited Consultant Details

   i. Accreditation status : Yes    ii. Accreditation No. : S.No. 114, Rev 51, March 7, 2017    iii. Name of Consultant: Perfact Envirosolutions Pvt Ltd   iv. Address : 5th Floor, NN Mall, Mangalam Palace, Sector-3, Rohini, New Delhi   v. Mobile No.: 9818346370   vi. Landline No.: 01147528467   vii. Email Id: mmpl@mangaloreminerals.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 : Santhosh    ii. Designation : Authorized Signatory    iii. Name of Company(Applicant Name should not be given here) : SMT RAMA S MENDON    iv. Address : Registered Add: Smt. Rama S.Mendon 1st Floor, Mineral House, Hampanakatta Mangalore-575001 Karnataka 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: Annexure-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