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/MH/MIS/65034/2017    ii. MoEFCC File No. : 11-23/2017-IA.III    iii.Short narrative of the project: CRZ Clearance for the proposed natural gas pipeline crossing (6” NB & 4” NB pipeline) near to Khadi bridge, Bhakti park.    iv. Project Sector : INFRA-2    v. Company/Proponent : MAHANAGAR GAS LIMITED (MGL)

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Maharashtra	Mumbai City	Mumbai

   vii.Date of TOR Granted N/A viii.TOR letter issued by Ministry: N/A ix.Date of Submission for EC: 30 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: 16 May 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: This EC online submission is only for CRZ clearence.

3.	Additional Detail Sought:   NIL

4.	Accredited Consultant Details

   i. Accreditation status : Yes    ii. Accreditation No. : NABET/EIA/1417/ SA 2 002    iii. Name of Consultant: Eco Chem Sales & Services   iv. Address : Office floor, Ashoka Pavilion ’A’, New Civil Road, Surat, 395001.   v. Mobile No.: 9428351794   vi. Landline No.: 02612231630   vii. Email Id: victor.mahanagar@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 : J    ii. Designation : Manager    iii. Name of Company(Applicant Name should not be given here) : MAHANAGAR GAS LIMITED (MGL)    iv. Address : MGL House, Block G-33, Bandra Kurla Complex, BandraEast, Mumbai-51 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