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 : Started the work onsite without prior EC under EIA notification,2006.    Details of Violation : The hospital construction work started without obtaining prior Environment Clearance   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) : None   Upload EC Letter(if issued earlier) : None

1.	Project Details

   i. Proposal No. : IA/KL/NCP/64827/2017    ii. MoEFCC File No. : NIL    iii.Short narrative of the project: Expansion of existing hospital project of M/s St. Gregorios International Cancer Care Centre at Kadapra Village, Pathanamthitta, Kerala    iv. Project Sector : INFRA-1    v. Company/Proponent : ST. GREGORIOS INTERNATIONAL CANCER CARE CENTRE

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Kerala	Pathanamthitta	Thiruvalla

   vii.Date of TOR Granted N/A viii.TOR letter issued by Ministry: N/A ix.Date of Submission for EC: 20 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: 13 Apr 2017   v. Uploaded Additional Report/Study/Document as desired by Ministry/EAC: None   vi. Uploaded Cover Letter: Annexure-Cover Letter   vii.Remarks: The hospital project is applied under MoEF Notification No. 804 (E) dt. 14/03/2017 as violation case.

3.	Additional Detail Sought:   NIL

4.	Accredited Consultant Details

   i. Accreditation status : Yes    ii. Accreditation No. : NABET/EIA/1518/RA010    iii. Name of Consultant: M/s Environmental Engineers & Consultants Pvt. Ltd.   iv. Address : A1-198, Janak Puri, New Delhi-58   v. Mobile No.: 9350873385   vi. Landline No.: 01125507190   vii. Email Id: eecnewdelhi@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 : POULOSE    ii. Designation : CEO    iii. Name of Company(Applicant Name should not be given here) : ST. GREGORIOS INTERNATIONAL CANCER CARE CENTRE    iv. Address : M/s St. Gregorios International Cancer Care Centre, Parumala P.O., Thiruvalla, Pathanamthitta District, Kerala-689626 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