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 : we have constructed 27,731.9 sqm on site. as per mom Committee decided to refer the matter to Environment Department/SEIAA for action on alleged violation.   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/MH/NCP/64931/2017    ii. MoEFCC File No. : NIL    iii.Short narrative of the project: “PROPOSED GENERAL CUM MULTI SUPER SPECIALTY HOSPITAL AND ALLIED BUILDING” AT PLOT NO. 46, SECTOR 30, VASHI, NAVI MUMBAI by Mahatma Gandhi Mission Trust    iv. Project Sector : INFRA-1    v. Company/Proponent : MAHATMA GANDHI MISSION TRUST

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Maharashtra	Raigad	Panvel

   vii.Date of TOR Granted N/A viii.TOR letter issued by Ministry: N/A ix.Date of Submission for EC: 25 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: 01 Jan 1900   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: This a violation project. we have constructed 27,731.9 sqm on site.

Additional Attachments, if any
S.no.	Attached File	Date of Submission
1.	forms 1 and 1 A	25 May 2017

3.	Additional Detail Sought:   NIL

4.	Accredited Consultant Details

   i. Accreditation status : Yes    ii. Accreditation No. : 48    iii. Name of Consultant: Enviro Analysts and Engineers Private Limited.   iv. Address : Enviro Analysts and Engineers Private Limited. B-1003,Enviro House,10th floor| Western Edge-II, W.E Highway|Borivali(E),Mumbai-400066   v. Mobile No.: 9321619749   vi. Landline No.: 22 2854 1647   vii. Email Id: mgmhospital2016@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 : DrSudhir Chandra    ii. Designation : Dean- Trustee & treasurer, MGM    iii. Name of Company(Applicant Name should not be given here) : MAHATMA GANDHI MISSION TRUST    iv. Address : M.G.M college Hospital on Junction of NH4& Sion Panvel Expressway, Plot No-1, Sector-1, Kamothe, Navi Mumbai 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