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/HR/IND2/71780/2017    ii. MoEFCC File No. : NIL    iii.Short narrative of the project: NIL    iv. Project Sector : Industrial Projects - 2    v. Company/Proponent : CRYSTAL CROP PROTECTION PVT LTD

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Haryana	Sonipat	Sonipat

   vii.Date of TOR Granted N/A viii.TOR letter issued by Ministry: N/A ix.Date of Submission for EC: 22 Dec 2017 x.Project Type: Change of Product Mix under para 7(ii)

2.	Uploaded Documents of EIA/EMP,Risk Assessment,Public Hearing etc.

i. Uploaded EC Compliance report by rigional office of MoEFCC: Annexure-Uploaded EC Compliance report ii. Certified Monitoring report by RoMoEF: Annexure-Uploaded Monitoring report iii. Uploaded Form I: NIL   iv. Uploaded Additional Report/Study/Document as desired by Ministry/EAC: None   v. Uploaded Cover Letter: Annexure-Cover Letter   vi.Remarks: NIL

3.	Additional Detail Sought:   NIL

4.	Accredited Consultant Details

   i. Accreditation status : Yes    ii. Accreditation No. : 7th December, Revision 60, Serial No. 109    iii. Name of Consultant: Perfact Envirosolutions Private limited   iv. Address : PERFACT GROUP, 5th Floor, Front Wing, NN Mall, Sector-3, Rohini, New Delhi-110085|   v. Mobile No.: 9818362330   vi. Landline No.: 01149281360   vii. Email Id: virendra.chaudhary@crystalcrop.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 : Alakh Tripathi    ii. Designation : AVP-Technical Manufacturing/Unit Head    iii. Name of Company(Applicant Name should not be given here) : CRYSTAL CROP PROTECTION PVT LTD    iv. Address : Plot No. D2/CH-14, Dahej-II, Dahej Industrial Estate, Tal: Vagra, Dist: Bharuch 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