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/CG/MIN/64800/2011    ii. MoEFCC File No. : DGR/LST/MPLN-1085/NGI    iii.Short narrative of the project: 1035    iv. Project Sector : Mining Projects    v. Company/Proponent : JEETENDRA CHANDRAKAR

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Chhattisgarh	Durg	Dhamdha

   vii.Date of TOR Granted 03 Oct 2013 viii.TOR letter issued by Ministry: Annexure-TOR letter ix.Date of Submission for EC: 19 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: 04 Apr 2017   v. Uploaded Additional Report/Study/Document as desired by Ministry/EAC: None   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. : RQP/NGP/225/2000/A    iii. Name of Consultant: ARVIND KUMAR SINGH   iv. Address : 621/3 FIRST FLOOR RAMKUND SAMTA COLONY   v. Mobile No.: 9826142290   vi. Landline No.: 9826142290   vii. Email Id: arvind_geo03@yahoo.co.in

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 : JITENDRA    ii. Designation : Proprietor    iii. Name of Company(Applicant Name should not be given here) : JEETENDRA CHANDRAKAR    iv. Address : Jeetendra Chandrakar, Vill-Nandini Khundini, Tehsil - Dhamdha, Dist.Durg (Chhattisgarh) 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