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/GJ/MIS/70542/2017    ii. MoEFCC File No. : 11-45/2017-IA.III    iii.Short narrative of the project: Berthing jetty and allied infrastructure for Indian Coast Guard vessels located at pathfinder inlet creek, of Gulf of Kachchh, Vadinar, Devbhoomi Dwarka District Gujarat state.    iv. Project Sector : INFRA-2    v. Company/Proponent : INDIAN COAST GUARD STATION VADINAR

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Gujarat	Devbhumi Dwarka	Khambhalia

   vii.Date of TOR Granted N/A viii.TOR letter issued by Ministry: N/A ix.Date of Submission for EC: 27 Oct 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 Oct 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: Not applicable only CRZ Clearnce

Additional Attachments, if any
S.no.	Attached File	Date of Submission
1.	NABET Certificate	25 Oct 2017
2.	Form1 a	25 Oct 2017
3.	Land use Map	25 Oct 2017

3.	Additional Detail Sought

Additional Detail Sought
Sno.	ADS Letter	Remarks	Date of ADS
1.	NA	DEFERRED SUBJECT TO SOME CLARIFICATION	07 Dec 2017

4.	Accredited Consultant Details

   i. Accreditation status : Yes    ii. Accreditation No. : NABET/EIA/1619/RA0062    iii. Name of Consultant: Detox Corporation PVT.LTD   iv. Address : Detox Corporation PVT.LTD.,K.G. Chambers, Udhana Darwaja, Ring Road, Surat   v. Mobile No.: 9898102231   vi. Landline No.: 9824103434   vii. Email Id: cgsvadinar@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 : RAHUL    ii. Designation : stationworksofficer    iii. Name of Company(Applicant Name should not be given here) : INDIAN COAST GUARD STATION VADINAR    iv. Address : Indian Coast Guard Station Vadinar, Vadinar (PO) 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