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/HR/MIN/22660/2013    ii. MoEFCC File No. : J-11015/33/2014-IA.II (M)    iii.Short narrative of the project: Mining of Minor Mineral in the Mines of “Panipat Unit-2” with production capacity of 10 million TPA of Sand Mine (ROM)    iv. Project Sector : Mining Projects    v. Company/Proponent : Shri Sanjay Jaglan

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Haryana	Panipat	Panipat

   vii.Date of TOR Granted 08 Aug 2014 viii.TOR letter issued by Ministry: Annexure-TOR letter ix.Date of Submission for EC: 05 Nov 2014 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: 30 Sep 2014   v. Uploaded Additional Report/Study/Document as desired by Ministry/EAC: Annexure-Additional Report/Study/Document   vi. Uploaded Cover Letter: None   vii.Remarks: NIL

3.	Additional Detail Sought:   NIL

4.	Accredited Consultant Details

   i. Accreditation status : Yes    ii. Accreditation No. : 121    iii. Name of Consultant: udaipurmintech   iv. Address : udaipur   v. Mobile No.: 8295255944   vi. Landline No.: 1204252314   vii. Email Id: jaglansanjay7@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 : Sanjay    ii. Designation : Owner    iii. Name of Company(Applicant Name should not be given here) : Sanjay Jaglan    iv. Address : House No.839 Sector 23A Gurgaon 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