APPENDIX I
(See Paragraph-6)
FORM 1
Note : If space provided against any parameter is inadequate, Kindly upload supporting document under 'Additional Attachments if any'  at the last part of the Form1. Please note that all such Annexures must be part of single pdf document.
(I) Basic Information
S.No.Item Details
Is your project Comes under Notified Industrial Area NA
Whether proposal involved violation of EIA notificationN/A
Weather Consent to Establishment ObtainedN/A
Upload copy of CTE N/A
1.
Name of the Project/s Surguja Power Private Limited.
Brief summary of projectAnnexure-Brief summary of project
Proposal Number IA/CG/THE/62318/2017
Project Cost 499800 lacs
2.
S. No. in the schedule1(d) Thermal Power Plants
Project Sector Thermal Projects
3. Proposed capacity/area/length/tonnage to be handled/command area/lease area/number or wells to be drilled 600 (4x150) MW TPP ha.
4.
New/Expansion/ModernizationNew
5. Existing Capacity/Area etc. -1 ha.
6. Category of project i.e. 'A' or 'B' A
7.
Does it attract the general condition? If yes, please specify No
8.
Does it attract the specific condition? If yes, please specify No
9.
Location of the projectSurguja, Chhattisgarh
Shape of the project landBlock (Polygon)
Uploaded GPS fileAnnexure-GPS file      
Uploaded copy of survey of India ToposheetAnnexure-Survey of india toposheet
Plot/Survey/Khasra No.1/1, 6(P),15,16,23721/8
Town / VillageVillage Panchayat- Parsa Gram Panchayat Taluka Udaypur District Surguja Chhattisgarh Zila Parishad-Surguja
State of the projectChhattisgarh
Details of State of the project
S.no State Name District Name Tehsil Name
(1.)ChhattisgarhSurgujaAmbikapur
10.
Nearest railway station along with distance in kms Ambikapur, 60 km
Nearest airport along with distance in kms Raipur, 220 km
11. Nearest Town/City/District Headquarters along with distance in kms Ambikapur , 60 km
12. Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given)
13. Name of the Applicant Santosh
14. Registered Address Adani House, Nr Mithakhali Circle Navrangpura, Ahmedabad. Pin- 380009.
15.
Address for correspondance:
Name of the Company Adani Power Ltd.
Name of the Applicant Santosh
Designation (Owner/ Partner/ CEO) Head - ESG & Environment
Pin code 380015
E-mail santosh.singh1@adani.com
Telephone No. 79-25557289
Fax No. 79-25557401
Copy of documents in support of the competence/authority of the person making this application to make application on behalf of the User Agency . NIL
16.
Details of Alternative Sites examined, if any. Location of these sites should be shown on a toposheet Yes
Uploaded detailsAnnexure-Uploaded details
17. Whether part of Interlinked projects? Yes
18. Whether separate application of Interlinked project has been submitted? Yes
19.
If Yes, MoEF file numberJ/11015/03/2008-IA II (M)
Date of submission21/12/2011
20. If No, Reason N/A
21.
Whether the proposal involves Approval/ Clearance under: if yes, details of the same and their status to be given
(i) Whether the proposal involves approval/clearance under the Forest (Conservation) Act,1980?Yes
StatusFinal(Stage-II) Approval Obtained
MoEF file numberF.NO. 8-31/2010 FC
Date of In-Principle06/07/2011
Date of final approval06/07/2011
Area diverted1898.328 ha.
Uploaded Clearance LetterAnnexure-Uploaded clearance letter
(ii) Whether the proposal involves approval/clearance under the wildlife (Protection) Act,1972?No
(iii) Whether the proposal involves approval/clearance under the C.R.Z notification, 2011?No
22.
Whether there is any Government Order/Policy relevant/relating to the site?No
23.
Whether any Forest Land Involved?
Area of Forest land Involved (hectares)N/A
24.
Whether there is any litigation pending against the project and/or land in which the project is proposed to be set up?No
(a) Name of the CourtN/A
(b) Name of the Sub courtN/A
(c) Case No.N/A
(d) Orders/directions of the court, if any and relevance with the proposed projectN/A
(II) Activity
1 Construction, operation or decommissioning of the Project involving actions, which will cause physical changes in the locality (topography, land use, changes in water bodies, etc.)
S.No Information/Checklist confirmation Yes/No Details there of (with approximate quantities/rates, wherever possible) with source of information data
1.1 Permanent or temporary change in land use, land cover or topography including increase in intensity of land use (with respect to local land use plan) Yes Permanent change of present land use at project site is expected for setting up of Power Plant. The total area of 42.57 ha includes Main plant, water reservoir, switchyards, green-belt, etc. Presently 13.48 ha is Private Tenancy Land, which has been acquired for Mining Project. The land use at the time of acquisition was Single Cropping Rainfed Agricultural Land, which is now under Mining Project. 19.64 ha is Protected Forest Land and 9.45 ha is Revenue Forest Land, for which final approval
1.2 Clearance of existing land, vegetation and buildings? Yes Plant layout will be done in such a way that it will create minimum disturbance to existing land, vegetation and habitation.
1.3 Creation of new land uses? Yes Change from exiting landuse to Industrial land use for Power Plant & its auxiliary facilities.
1.4 Pre-construction investigations e.g. bore houses, soil testing? Yes Soil investigation will be carried-out at the proposed site.
1.5 Construction works? Yes Construction of Power Plant & its auxiliary facilities.
1.6 Demolition works? No Not Applicable
1.7 Temporary sites used for construction works or housing of construction workers? Yes Temporary sites would be used for housing of construction workers.
1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations Yes The entire Power Plant will be constructed above ground. There will be some cut and fill for foundations, leveling, etc.
1.9 Underground works including mining or tunnelling? No Not Applicable
1.10 Reclamation works? No Not Applicable
1.11 Dredging? No Not Applicable
1.12 Offshore structures? No Not Applicable
1.13 Production and manufacturing processes? Yes Generation of Electricity from combustion of coal washery rejects as fuel.
1.14 Facilities for storage of goods or materials? Yes Coal Stockyard for storage of coal, Storage tanks for LDO/HFO, Closed Storage yard for chemicals, spare parts, equipments, maintenance tools, etc.
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? Yes For solid waste, it is proposed to dispose / reuse as per plan stated below. Ash Disposal System: About 68 Million Tons of ash will be generated over the life of the project of 25 years. It is proposed to use ash to the extent possible for manufacturing of Cement, Building Material, Road Construction, etc. Unutilized ash is proposed to be used for mine backfilling in Slurry/ HCSD (High Concentration Slurry Disposal) form. For liquid wastes: The Clarifier underflow of Pre-Treatmen
1.16 Facilities for long term housing of operational workers? Yes Staff Colony will be developed for operation workers along with the colony for Mining Project and is not part of this proposal
1.17 New road, rail or sea traffic during construction or operation? Yes Approach for the plant from the nearby Bilaspur-Ambikapur road. Conveyor system for coal washery rejects transportation. Railway being developed for the mining project.
1.18 New road, rail, air water borne or other transport infrastructure including new or altered routes and stations, ports, airports etc? Yes •Conveyor system for coal washery rejects and railway line for coal transportation •Water pipeline from Rehar / Atem river to the plant site •Approach Road for Construction Material Transportation.
1.19 Closure or diversion of existing transport routes or infrastructure leading to changes in traffic movements? No Not Applicable
1.20 New or diverted transmission lines or pipelines? Yes New transmission line is proposed from power station to nearest STU / CTU.
1.21 Impoundment, damming, culverting, realignment or other changes to the hydrology of watercourses or aquifers? No Not Applicable
1.22 Stream crossings? No Not Applicable
1.23 Abstraction or transfers of water from ground or surface waters? Yes Abstraction of surface water from Atem / Rehar River @ 13.14 MCM per year 1000 KLD of Groundwater abstraction is proposed for domestic and construction purpose.
1.24 Changes in water bodies or the land surface affecting drainage or run-off? No Not significant as water study report of Atem / Rehar River basin, indicates sufficient water is available to cater the need of the project.
1.25 Transport of personnel or materials for construction, operation or decommissioning? Yes Transport of construction materials from nearby sources to construction work area during construction and transport of coal from washery to the plant site during operation.
1.26 Long-term dismantling or decommissioning or restoration works? No Not Applicable
1.27 Ongoing activity during decommissioning which could have an impact on the environment? No Not Applicable
1.28 Influx of people to an area in either temporarily or permanently? Yes Since industry attracts both skilled and unskilled labours, influx of population will be there to some extent.
1.29 Introduction of alien species? No Not Applicable
1.30 Loss of native species or genetic diversity? No Not Applicable
1.31 Any other actions? No Not Applicable
2 Use of Natural resources for construction or operation of the Project (such as land, water, materials or energy, especially any resources which are non-renewable or in short supply):
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
2.1 Land especially undeveloped or agricultural land (ha) Yes Presently the entire land has been acquired for the Mining Project, which will be transferred/leased for the Thermal Power Project. Plant layout will be based on minimum disturbance to existing vegetation.
2.2 Water (expected source & competing users) unit: KLD Yes Water of Atem / Rehar River to be used @ approx. 13.14 MCM per year. 1000 KLD of Groundwater abstraction is proposed for domestic and construction purpose, after obtaining permission
2.3 Minerals (MT) Yes Coal Washery Reject will be used for the Project. The total requirement is estimated at 4.5 MTPA at PLF of 75%.
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) Yes Stone, aggregate, soil, sand etc. from nearby area.
2.5 Forests and timber (source – MT) No Not Applicable
2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW) Yes •Coal Washery Reject: 4.5 MMTPA (75% PLF) with a average GCV of 2000 kcal/kg. •LDO& HFO will be used as secondary fuel
2.7 Any other natural resources (use appropriate standard units) No Not Applicable
3 Use, storage, transport, handling or production of substances or materials, which could be harmful to human health or the environment or raise concerns about actual or perceived risks to human health
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
3.1 Use of substances or materials, which are hazardous (as per MSIHC rules) to human health or the environment (flora, fauna, and water supplies Yes 1. LDO 2. HFO. 3. Chlorine.
3.2 Changes in occurrence of disease or affect disease vectors (e.g. insect or water borne diseases) No Not Applicable
3.3 Affect the welfare of people e.g. by changing living conditions? Yes The region will turn to industrial and commercial zone from agricultural and rural economy. The industrial and commercial development is expected to have beneficial impact on the local people in terms of commercial and employment.
3.4 Vulnerable groups of people who could be affected by the project e.g. hospital patients, children, the elderly etc. No Hospitals, schools, road etc. will be developed under CSR activity of the Project Proponent.
3.5 Any other causes No Not Applicable
4 Production of solid wastes during construction or operation or decommissioning (MT/month)
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
4.1 Spoil, overburden or mine wastes No Not Applicable
4.2 Municipal waste (domestic and or commercial wastes) Yes Will be minimum, since generation will be there from colony area only and the colony is not a part of this proposal.
4.3 Hazardous wastes (as per Hazardous Waste Management Rules) Yes Oily waste & sludge will be disposed off as per CPCB/MoEF guidelines.
4.4 Other industrial process wastes Yes Ash Only
4.5 Surplus product No Not Applicable
4.6 Sewage sludge or other sludge from effluent treatment Yes STP Sludge will be used as manure after disinfection.
4.7 Construction or demolition wastes No Construction wastes, if any, will be used for landfill.
4.8 Redundant machinery or equipment No Not Applicable
4.9 Contaminated soils or other materials No Not Applicable
4.10 Agricultural wastes No Not Applicable
4.11 Other solid wastes No Not Applicable
5 Release of pollutants or any hazardous, toxic or noxious substances to air(Kg/hr)
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
5.1 Emissions from combustion of fossil fuels from stationary or mobile sources Yes Emission of dust and gases like NO2, SO2 etc. ESP, Low NOx burners and other measures will be taken care to limit the emission within the prescribed norms.
5.2 Emissions from production processes Yes Emission of dust and gases Like NOX, SO2 etc. as per notification of MoEFCC. 1 RCC Stacks of 275 m height, with 4 Steel Flues are proposed for wider dispersion of the pollutants.
5.3 Emissions from materials handling including storage or transport Yes Not anticipated with usage of dust extraction and suppression system in ash silo, coal transfer point and coal bunkers. Also closed coal conveyors will be used in coal transportations.
5.4 Emissions from construction activities including plant and equipment Yes Regular water sprinkling will be done at the project to minimize the dust emission during construction phase.
5.5 Dust or odours from handling of materials including construction materials, sewage and waste Yes Some dust will be emitted while handling the construction materials like cement or bricks.
5.6 Emissions from incineration of waste No Not Applicable
5.7 Emissions from burning of waste in open air (e.g. slash materials, construction debris) No Not Applicable
5.8 Emissions from any other sources No Not Applicable
6 Generation of Noise and Vibration, and Emissions of Light and Heat:
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
6.1 From operation of equipment e.g. engines, ventilation plant, crushers Yes Noise would be generated generally from steam turbine, generator, compressors, pumps, fans, coal handling plant etc. but all the equipment will be designed and if required acoustic materials will be provided to have the noise level not to exceed the values as stipulated in CPCB/MoEF norms.
6.2 From industrial or similar processes Yes Noise would be generated from transportation of material / machine.
6.3 From construction or demolition Yes Some noise would be generated during construction phase but it will be limited to the site only.
6.4 From blasting or piling No Not Applicable
6.5 From construction or operational traffic Yes During construction and coal transportation traffic
6.6 From lighting or cooling systems Yes Indirect process cooling, direct water spraying
6.7 From any other sources No Not Applicable
7 Risks of contamination of land or water from releases of pollutants into the ground or into sewers, surface waters, groundwater, coastal waters or the sea:
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
7.1 From handling, storage, use or spillage of hazardous materials No Not Applicable
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) No Plant will follow the Zero Discharge concept.
7.3 By deposition of pollutants emitted to air into the land or into water Yes Installing ESP and other air pollution control equipment will minimize the impact. Similarly COC maximization along with reuse will generate minimum discharge. ETP will be designed to meet stipulated standards. Treated effluent will be reused within the plant. So there will be no significant impact.
7.4 From any other sources No Not Applicable
7.5 Is there a risk of long term build up of pollutants in the environment from these sources? Yes Minimum impact on land and water due to state of art technology. The plant will be designed, constructed and operated to maintain all parameters within statutory limits.
8 Risk of accidents during construction or operation of the Project, which could affect human health or the environment
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
8.1 From explosions, spillages, fires etc from storage, handling, use or production of hazardous substances Yes An assessment of conceptual design will be conducted to minimize the risk of fire at the coal stockyard, LDO & HFO storage tank, chlorine gas leaks from the pipeline/ tonner, breaching of ash pond due to failure of ash pond bound.
8.2 From any other causes No Not Applicable
8.3 Could the project be affected by natural disasters causing environmental damage (e.g. floods, earthquakes, landslides, cloudburst etc)? No The Project is proposed in Seismic Zone-III. At the time of construction work the regulations for the seismic zone III will be taken into consideration for designing and setting up the project.
9 Factors which should be considered (such as consequential development) which could lead to environmental effects or the potential for cumulative impacts with other existing or planned activities in the locality
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
9.1 Lead to development of supporting utilities, ancillary development or development stimulated   by the project which could have impact on the environment e.g.:
  • Supporting infrastructure (roads, power supply,waste or waste water treatment, etc.)
  • housing development
  • extractive industries
  • supply industries
  • Other
 Yes Roads, railway line, housing development for company workers etc. This will bring mostly positive change on the site. Roads, infrastructure and housing development in the surrounding area. The project will also undertake local community development under its CSR plan focusing on Education, Health & Sanitation, Livelihood development and Rural Infrastructure Development.
9.2 Lead to after-use of the site, which could have an impact on the environment Yes It would be an industrially planned area.
9.3 Set a precedent for later developments Yes Later development will be taken into consideration.
9.4 Have cumulative effects due to proximity to other existing or planned projects with similar effects No Not Applicable
(III) Environmental Sensitivity
S.No Areas Name/Identity Aerial distance (within 15km.) Proposed project location boundary
1 Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
 No No ecological sensitive zone except Protected Forests and Reserve Forests.
2 Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests No Only Protected Forests and Reserve Forests within 10 km radius of area and Atem River.
3 Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration No No ecological sensitive zone except Protected Forests and Reserve Forests.
4 Inland, coastal, marine or underground waters Yes Atem River - 4 KM
5 State, National boundaries No Not Applicable
6 Routes or facilities used by the public for access to recreation or other tourist, pilgrim areas No No tourist or heritage site within 10 Km radius.
7 Defence installations No Not Applicable
8 Densely populated or built-up area No No major cities within 10 km radius
9 Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship, community facilities) No Not Applicable
10 Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) No Only Protected Forests and Reserve Forests within 10 km radius from the site.
11 Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) No Not Applicable
12 Areas susceptible to natural hazard which could cause the project to present environmental problems (earthquakes, subsidence, landslides, erosion, flooding or extreme or adverse climatic conditions) similar effects No Not Applicable. Not The site comes under the Seismic Zone III. Therefore, consideration will be taken care during design and construction stages.
(IV) Proposed Terms of Reference for EIA studies
1 Uploaded Proposed TOR File Annexure-TOR file
2 Uploaded scanned copy of covering letter Annexure-scanned copy of covering letter
3 Uploaded Pre-Feasibility report(PFR) Annexure-PFR
4 Uploaded additional attachments(only single pdf file) Annexure-Additional attachments
Additional Attachments, if any
Attached File
ADS Letter
ADS Letter
ADS Letter
      Essential Detail Sought : NIL
            Additional Detail Sought:
Sno. ADS Letter Remarks Date of ADS
1. ADS Reply LetterR/Sir, with reference ADS letter dated 06.07.17, we hereby submitting our reply for proposed 4x150 MW TPP at Surguja in Chhattisgarh, for kind consideration. Surguja Power 16 Jan 2018
2. ADS Raise Letterplease submit the information as per enclosed letter. 06 Jul 2017
3. ADS Raise Letterplease submit the information as per enclosed letter. 06 Jul 2017
(V) 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 any stage, the project will be rejected and clearance given, if any to the project will be revoked at our risk and cost.
V.(i)
Name of ApplicantSantosh
DesignationHead - ESG & Environment
Name of Company (Applicant Name should not be given here)Adani Power Ltd.
AddressAdani House, Nr Mithakhali Circle Navrangpura, Ahmedabad. Pin- 380009.
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