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/IND2/27299/2015    ii. MoEFCC File No. : J-11011/82/2015-IA-II(I)    iii.Short narrative of the project: Resin Manufacturing Unit (12000 MTPA) within existing plant    iv. Project Sector : Industrial Projects-2    v. Company/Proponent : CENTURY PLYBOARDS INDIA LIMITED

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Gujarat	kutch	Bhachau

   vii.Date of TOR Granted 06 Aug 2015 viii.TOR letter issued by Ministry: Annexure-TOR letter ix.Date of Submission for EC: 26 Apr 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: 21 Mar 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: NIL

Additional Attachments, if any
S.no.	Attached File	Date of Submission
1.	Signed copy of TOR	26 Apr 2017

3.	Additional Detail Sought:   NIL

4.	Accredited Consultant Details

   i. Accreditation status : Yes    ii. Accreditation No. : 133    iii. Name of Consultant: SGS INDIA PRIVATE LIMITED   iv. Address : 226 UDYOG VIHAR PHASE I GURAON HARIYANA STATE   v. Mobile No.: 9871794628   vi. Landline No.: 1246776300   vii. Email Id: vivek.centuryply@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 : Vivek    ii. Designation : General Manager    iii. Name of Company(Applicant Name should not be given here) : CENTURY PLYBOARDS INDIA LIMITED    iv. Address : Survey No. 145, 147 Paiky and 148 Village – Moti Chirai 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