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/UP/MIN/69365/2017    ii. MoEFCC File No. : XYZ    iii.Short narrative of the project: Riverbed Sand/Morrum Mining at Gata No. 747/16, Village- Patharehta, Tehsil- Kalpi, District- Jalaun, U.P. Area: 22 Acres (8.90 Ha)    iv. Project Sector : Mining Projects    v. Company/Proponent : MS ASSOCIATED COMMERCE

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Uttar Pradesh	Jalaun	Kalpi

   vii.Date of TOR Granted 14 Sep 2017 viii.TOR letter issued by Ministry: Annexure-TOR letter ix.Date of Submission for EC: 15 Sep 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: 14 Sep 2017   v. Uploaded Additional Report/Study/Document as desired by Ministry/EAC: None   vi. Uploaded Cover Letter: Annexure-Cover Letter   vii.Remarks: EIA/EMP is compilation of Form 1, PFR along with EMP as it is Category B2 project.

Additional Attachments, if any
S.no.	Attached File	Date of Submission
1.	QCI Accreditation Certificate of Consultant	14 Sep 2017
2.	Form1	14 Sep 2017
3.	PFR	14 Sep 2017

3.	Additional Detail Sought:   NIL

4.	Accredited Consultant Details

   i. Accreditation status : Yes    ii. Accreditation No. : NABET/EIA/1518/RA 013    iii. Name of Consultant: M/s ENV Developmental Assistance Systems (I) Pvt. Ltd.   iv. Address : D-2247, Indira Nagar, Lucknow (U.P.)-226016   v. Mobile No.: 9450367469   vi. Landline No.: 05224007470   vii. Email Id: associatedcommerce9@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 : Vishwas    ii. Designation : Partner    iii. Name of Company(Applicant Name should not be given here) : MS ASSOCIATED COMMERCE    iv. Address : D-2247, Indira Nagar, Lucknow 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