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 ? : Yes    Type of Violation : Expanded the production beyond the limit of EC.    Details of Violation : previous EC vide no. SEAC-2012/CR-118/TC-2 having building configuration 2B + LG +G +8 floors. Now in expansion project building configuration is 2B + LG +G +10 floors   Upload document of Damage Assessment Report : Annexure-Damage Assessment Report   Upload document of Remediation Plan and Natural & Community augmentation plan : Annexure-Damage Assessment Report   Upload TOR Letter(if issued earlier) : Annexure-Uploaded TOR Letter   Upload EC Letter(if issued earlier) : Annexure-Uploaded EC Letter

1.	Project Details

   i. Proposal No. : IA/MH/NCP/64001/2017    ii. MoEFCC File No. : NIL    iii.Short narrative of the project: Jupiter Hospital    iv. Project Sector : INFRA-1    v. Company/Proponent : JUPITER LIFELINE HOSPITAL

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Maharashtra	Pune	Haveli

vii. Uploaded EC Compliance report by rigional office of MoEFCC: Annexure-Uploaded EC Compliance report viii. Certified Monitoring report by RoMoEF: Annexure-Uploaded Monitoring report    ix.Date of TOR Granted N/A ix.Date of Submission for EC: 15 Apr 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: 15 Apr 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: not applicable

3.	Additional Detail Sought:   NIL

4.	Accredited Consultant Details

   i. Accreditation status : No    ii. Reason for not hiring the Consultant : not required

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 : Devang    ii. Designation : Director    iii. Name of Company(Applicant Name should not be given here) : JUPITER LIFELINE HOSPITAL    iv. Address : S. No.142/143,Baner-Pimple Nilakh Road,Baner,Pune 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