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 Drilling activities in block: CB-ONN- 2010/5
Brief summary of projectAnnexure-Brief summary of project
Proposal Number IA/GJ/IND2/101010/2019
Project Cost 4400 lacs
2.
S. No. in the schedule1(b) Offshore and onshore oil and gas exploration, development & production
Project Sector Industrial Projects - 2
3. Proposed capacity/area/length/tonnage to be handled/command area/lease area/number or wells to be drilled Drill site area – 15,000 m2. For production facility area – 900 m2. a. Drilling of 08 wells (Depending upon discovery). b. Production from 08 wells: - Expected production from each well: Crude Oil : 20 m3/day and Associated Gas: 10,000 m3/day. c. Commissioning/set up of production facilities at propose or any existing well locations depending on Oil/Gas Discovery. ha.
4.
New/Expansion/ModernizationExpansion
Proposal NumberIA/GJ/IND2/29629/2014
MoEFCC file number(Previous EC)J-11011/276/2014-IA-II (I)
Uploaded EC letterAnnexure-Uploaded EC letter
5. Existing Capacity/Area etc. 4900 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 projectBLOCK NO. CB-ONN-2010/5, Patan and Mehsana district of Gujarat
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.BLOCK NO. CB-ONN-2010/5
Town / VillageJasalpur, Dharnodharda, Jitoda, Keshani, Jiliya,Pimpal, Rampura, Chaveli, Mervada, Sunsar, Mithadharwa, Kharadharava,Danodarda, Bhalgamda, Gambhu, Dharpuri, Ranasan, Vadavli,Kharoda, Chanasma, Jel, Da
State of the projectGujarat
Details of State of the project
S.no State Name District Name Tehsil Name
(1.)GujaratPatanChanasma
(2.)GujaratMahesanaBecharaji
10.
Nearest railway station along with distance in kms Chanasma Junction, 0.97 km
Nearest airport along with distance in kms Sardar Vallabhbhai Patel Airport, Ahmedabad, 73.50 km
11. Nearest Town/City/District Headquarters along with distance in kms Patan , 12 km
12. Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given) Block area consists of more than 22 villages.
13. Name of the Applicant Naresh
14. Registered Address Office No.1, D-4, Commercial Area, Vasant Kunj, New Delhi- 110070
15.
Address for correspondance:
Name of the Company Mr. Ajay K Malhotra
Name of the Applicant Naresh
Designation (Owner/ Partner/ CEO) General Manager
Pin code 122015
E-mail nmspl@panindiagroup.com
Telephone No. 124-2343883
Fax No. 124-0911242346646
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
16.
Details of Alternative Sites examined, if any. Location of these sites should be shown on a toposheet No
17. Whether part of Interlinked projects? No
18. Whether separate application of Interlinked project has been submitted? N/A
19.
If Yes, MoEF file numberN/A
Date of submissionN/A
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?No
(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?No
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 The land acquisition will lead to temporary change of land use from agricultural to non-agricultural use. Adequate compensation will be made to landowners as per GoG policy.
1.2 Clearance of existing land, vegetation and buildings? Yes The entire field has a flat terrain and has no significant vegetation cover and has no buildings exist on land. The land is used for agricultural use. Partly clearance of vegetation required for installation of drilling ring.
1.3 Creation of new land uses? Yes During Drilling : 15,000 m2 During operation: 900 m2 Well site having 30m x 30m (900 m2) area for establishment of Early Production system will be developed under industrial land use depending on discovery of oil and gas.
1.4 Pre-construction investigations e.g. bore houses, soil testing? No --
1.5 Construction works? Yes Minor RCC platform for drilling rig. Construction during operation phase for Oil &storage tank platform.
1.6 Demolition works? No There is no demolition work at site required.
1.7 Temporary sites used for construction works or housing of construction workers? Yes During drilling of new wells & working over existing wells, 15-20 local workers will work in 12 hour shift and return home or to base camp at night.
1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations No During Drilling: Portable-cabins will be set up on-site temporarily. During operation Phase: Oil storage tank will be installed.
1.9 Underground works including mining or tunnelling? Yes Wells will be drilled up to 1500 m depth below the ground level.
1.10 Reclamation works? No --
1.11 Dredging? No --
1.12 Offshore structures? No Onshore block
1.13 Production and manufacturing processes? No There is no manufacturing process involved in the drilling and work-over activities.
1.14 Facilities for storage of goods or materials? Yes Storage : (a) Drilling of new wells: Raw material for drilling fluid/mud preparation water for mud preparation & fire fighting, fuels &lubricant used for equipment & engines. (b) During operation phase: Separated Oil will be stored in tank of 45 m3. Fuels, lubricant, & de-emulsification chemicals will be stored in drums at site. Produced water prior to treatment will be collected in a pit. (c) Work over existing wells: Chemical used will be stored in drums / bags in separate area in shed.
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? Yes During drilling activity, wastewater generated due to washing of drilling cutting and mud will be allowed in scientifically designed open pit having impervious layer at bottom in which water will be totally absorbed in drilling cuttings and mud. After drilling operation the said drilling cutting and mud will be dried and it will be disposed at TSDF site (provisional membership is obtained from M/s. SEPPL. Please refer Annexure-2. Please refer PFR report.
1.16 Facilities for long term housing of operational workers? No No long term housing facilities are required for the proposed activities.
1.17 New road, rail or sea traffic during construction or operation? Yes There will be temporarily increase in road traffic during proposed activities.
1.18 New road, rail, air water borne or other transport infrastructure including new or altered routes and stations, ports, airports etc? No Due to proposed activities, no additional transport infrastructure facilities are required. Access to the site is already available through minor all-weather roads. For the work over activities in the existing well no additional infrastructure is needed and for new wells drilling an approach road from the main road might be needed to be laid but no existing infrastructure shall be altered.
1.19 Closure or diversion of existing transport routes or infrastructure leading to changes in traffic movements? No Not required.
1.20 New or diverted transmission lines or pipelines? No Not required in drilling phase. However, during commercial development of hydrocarbon, Surface Production Facility (EPS) will be developed at one of the existing or proposed well site location. Produced Hydrocarbons from wells is being allowed at storage tank and well site from where it will be loaded in tankers via the tanker loading point and transported to delivery point of ONGC.
1.21 Impoundment, damming, culverting, realignment or other changes to the hydrology of watercourses or aquifers? No --
1.22 Stream crossings? No --
1.23 Abstraction or transfers of water from ground or surface waters? No Tanker water will also be used for work over of existing wells & during drilling of new well. Tanker water will be used during operation phase.
1.24 Changes in water bodies or the land surface affecting drainage or run-off? No --
1.25 Transport of personnel or materials for construction, operation or decommissioning? Yes Material for construction and decommissioning shall be transported through trucks. During drilling of new wells: workers will go back to home as they are local worker and will use their own transportation. During the operation phase:03 security guard will be employed whom will use their own transportation while existing technical person working near for other well site will take care of production on frequent site visit basis.
1.26 Long-term dismantling or decommissioning or restoration works? No --
1.27 Ongoing activity during decommissioning which could have an impact on the environment? No --
1.28 Influx of people to an area in either temporarily or permanently? Yes During drilling operation, 15 - 20 local workers will work in 12 hour shift. During operation phase: 03 security guards will be there.
1.29 Introduction of alien species? No --
1.30 Loss of native species or genetic diversity? No --
1.31 Any other actions? No --
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 Agricultural land 15,000 m2per well. Each drill site will be mostly agriculture land. TOP soil will be stored temporarily.
2.2 Water (expected source & competing users) unit: KLD Yes Source: Tanker Please refer PFR report.
2.3 Minerals (MT) Yes During the operation, project will lead to development &production which will increase the new mineral reserves [hydrocarbons] of the country.
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) Yes Construction material such as stone, cement, sand and aggregates will be transported from local market, in very minor quantities.
2.5 Forests and timber (source – MT) No --
2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW) Yes Please refer PFR Report.
2.7 Any other natural resources (use appropriate standard units) No --
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 HSD will be used to run DG sets power generator &drilling rig. Storage of chemicals & additives will also be required for drilling mud preparation. All quantities will be below specified thresholds for storage permits under the MSHIC Rules. Precautionary measures will be taken as per Hazardous Waste Management & Handling Rules, amended up to 2016.
3.2 Changes in occurrence of disease or affect disease vectors (e.g. insect or water borne diseases) No --
3.3 Affect the welfare of people e.g. by changing living conditions? Yes During drilling of new wells about20 local worker will be employed in 12 hour shift. The proposed activities will generate indirect employment in the region due to the requirement of workers in site preparation activities, supply of raw material, auxiliary & ancillary works, which would marginally improve the economic status of the people. The activities would result in an increase in local skill levels through exposure to drilling activities & technology.
3.4 Vulnerable groups of people who could be affected by the project e.g. hospital patients, children, the elderly etc. No --
3.5 Any other causes No --
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 Yes Soil generated during excavation will be back filled wherever required within the project site. Top soil will be preserved at one identified site within premises & again restore it if HC discovery not found.
4.2 Municipal waste (domestic and or commercial wastes) Yes Domestic solid waste will be disposed to nearest gram panchayat dust bin after getting their prior permission.
4.3 Hazardous wastes (as per Hazardous Waste Management Rules) Yes Major waste during the drilling of new well will be: • Drill cuttings [which comprise of natural earth materials like clay, shale, silt, sand, coal etc. and are inert in nature]. The generation of drill cuttings depends on depth and formation. The estimated generation of formation cuttings will be about 150m3per well. • Drilling mud and other drilling wastes [only if found hazardous after testing]. • Sludge containing oil if hydrocarbon is discovered.
4.4 Other industrial process wastes No --
4.5 Surplus product No --
4.6 Sewage sludge or other sludge from effluent treatment Yes Please refer PFR report.
4.7 Construction or demolition wastes No --
4.8 Redundant machinery or equipment No --
4.9 Contaminated soils or other materials Yes Solid waste such as drill cuttings and mud, contaminated soil will be temporarily stored/ packed in pits/ bags and then disposed off to the authorized landfill site permitted by State Pollution Control Board [GPCB].
4.10 Agricultural wastes No --
4.11 Other solid wastes No --
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 HSD will be used to run DG sets during drilling operation & during establishment of operation phase. Following cumulative pollutants will release temporary in the atmosphere. PM :< 150 mg/m3 SO2 : < 100 mg/m3 NOx : < 50 mg/m3
5.2 Emissions from production processes No Low pressure gas may be flared in to atmosphere through adequate heightof flare stack.
5.3 Emissions from materials handling including storage or transport Yes Fugitive emissions may result from handling and storage of hydrocarbons, diesels,bentonite which are very minor. At the time of transportation dust will be generated. This emission will be temporary.
5.4 Emissions from construction activities including plant and equipment Yes Dust will be generated during installation and decommissioning of drill rig equipment while during operation, construction of pits and site clearing. This dust emission will be for a very short period only.
5.5 Dust or odours from handling of materials including construction materials, sewage and waste Yes For a short period as mentioned above in 5.4.
5.6 Emissions from incineration of waste No Incineration is not required.
5.7 Emissions from burning of waste in open air (e.g. slash materials, construction debris) No There will be no burning of waste in open.
5.8 Emissions from any other sources Yes Associated low pressure gas may be flared through 9 m height flare stack during drilling of new wells. During operation phase, No emission to be occurred.
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 During the drilling of new wells the noise will be due to equipment & machinery, diesel generating sets. Besides, certain pumps are expected to be in operation for mud circulation. During operation, no chance of generation except transportation activity. Diesel engines will be located in acoustic enclosures at the rig to reduce the noise levels. The exhausts of the engines will be provided with silencers. Adequate stack height will be provided.
6.2 From industrial or similar processes No --
6.3 From construction or demolition No --
6.4 From blasting or piling No --
6.5 From construction or operational traffic Yes Noise will be generated due to construction activity but it will be short term. Even During work over and drilling operation & at a time of operation phase temporary noise will be generated due to traffic movement & operation of D.G Sets.
6.6 From lighting or cooling systems No --
6.7 From any other sources No --
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 All the Hazardous wastes will be disposed off to the authorized landfill site permitted by State Pollution Control Board. [GPCB] so there will be no degradation of land or ground water and handled as per applicable norm.
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) No Sewage will be allowed in soak pit/ septic tank.
7.3 By deposition of pollutants emitted to air into the land or into water No Flare stack will be kept 9 m above the ground level as per OMR, 1984/DGMS guidelines. The gas will have high temperature and emission velocity. During Drilling and operation phase dust will be deposited on nearby land due to transportation activity.
7.4 From any other sources No --
7.5 Is there a risk of long term build up of pollutants in the environment from these sources? No --
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 • HSD will be stored in 200 L drum. • Blow-out of hydrocarbons from a well occurs when mud balance is not kept in the well in anticipation of encountering a pressured layer of sand containing hydrocarbons. A blow out, if ignited, is the most hazardous possibility in drilling activity. • Number of blow-out prevention techniques are standard as part of drilling rig unit.
8.2 From any other causes Yes Risk to human health and safety due to human error cannot be ruled out. Apart from the regular drilling contractor’s inspections and safety systems, the project proponent will conduct pre-hire rig inspections, safety meetings, toolbox meetings, Job Safety Analysis and audits to identify hidden/ potential hazards. All personnel will be provided with necessary personal protective equipment.
8.3 Could the project be affected by natural disasters causing environmental damage (e.g. floods, earthquakes, landslides, cloudburst etc)? No Block area is categorized in the seismic zone which is classified as having Low Damage Risk Zone– III.
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 In case of commercial discovery of hydrocarbon, Oil will be stored in 45 m3 tank at any one well / EPS site. The stored Oil will be transported to ONGC by road tanker.
9.2 Lead to after-use of the site, which could have an impact on the environment No The site will be reinstated to its original status after drilling activities will be over. In case of commercial discovery a small patch of 30mx30m shall be retained.
9.3 Set a precedent for later developments No --
9.4 Have cumulative effects due to proximity to other existing or planned projects with similar effects No There are existing wells in the project vicinity which are producing hydrocarbons. Cumulative effect will be only produced water generation at a later stage of production.
(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 --
2 Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Yes Two Seasonal River Khari & Pushpawati is passing across block area.
3 Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration No The study area does not contain any particularly sensitive species of flora or fauna than normally observed. Thol Bird Sanctuary is located at 55.50 km in S direction.
4 Inland, coastal, marine or underground waters No No ground water will be use. ZLD will be maintained.
5 State, National boundaries No Rajsthan state boundary is passing at 81.50 km in North direction.
6 Routes or facilities used by the public for access to recreation or other tourist, pilgrim areas No No route or facility used by public for access to recreation, tourist or pilgrim areas lie within the vicinity of well sites. There is no conceivable impact on these locations due to project activities. • Block area consists of more than 22 villages.
7 Defence installations No --
8 Densely populated or built-up area Yes Block area consists of more than 22 villages.
9 Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship, community facilities) Yes 22 villages are located in the block area but proposed selection of any drill site will be consider not close proximity of population.
10 Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) No --
11 Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) No Not observed within 10 km of block area.
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 Gujarat is categorized in the seismic zone III, which is classified as having a Low Damage Risk Zone.
(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
Query reply updated herewith.
            Essential Detail Sought:
Sno. EDS Letter Remarks Date of EDS
1.NAThe correction have been made as per the instruction received 12 Apr 2019
2.NAPlease inform the following: (1) Whether the activity is proposed in the area for which EC has been granted? (2) Please provide name of the company properly in Form 1 03 Apr 2019
      Additional Detail Sought : NIL
(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 ApplicantNaresh
DesignationGeneral Manager
Name of Company (Applicant Name should not be given here)Mr. Ajay K Malhotra
AddressOffice No.1, D-4, Commercial Area, Vasant Kunj, New Delhi- 110070
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