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 Proposed Expansion of Carbon Black Manufacturing Plant along with Waste Gas Based Co-Generation Power Plant at Survey No. 47, SH-46, Village Mokha, Taluka Mundra, District Kutch, State Gujarat
Brief summary of projectAnnexure-Brief summary of project
Proposal Number IA/GJ/IND2/111876/2019
Project Cost 71000 lacs
2.
S. No. in the schedule5(e) Petrochemical based processing (processes other than cracking &
Project Sector Industrial Projects - 2
3. Proposed capacity/area/length/tonnage to be handled/command area/lease area/number or wells to be drilled Carbon Black: 15900 MT/Month Co-Generation Power (waste gas based): 32 MW ha.
4.
New/Expansion/ModernizationExpansion
Proposal NumberIA/GJ/IND2/58103/2016
MoEFCC file number(Previous EC)J-11011/195/2016- IA II(I)
Uploaded EC letterAnnexure-Uploaded EC letter
5. Existing Capacity/Area etc. 15750 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 projectSurvey No. 47, SH-46
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.Survey No. 47
Town / VillageMokha
State of the projectGujarat
Details of State of the project
S.no State Name District Name Tehsil Name
(1.)GujaratkutchMundra
10.
Nearest railway station along with distance in kms Bhadreshwar Railway station, 5 km
Nearest airport along with distance in kms Bhuj, 43 km
11. Nearest Town/City/District Headquarters along with distance in kms Mundra , 14 km
12. Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given) Mokha Gram Panchayat
13. Name of the Applicant Girish
14. Registered Address Survey No.47, Village: Mokha, Taluka: Mundra, Dist: Kutchh
15.
Address for correspondance:
Name of the Company PHILLIPS CARBON BLACK LTD
Name of the Applicant Girish
Designation (Owner/ Partner/ CEO) Chief Projects Spe. Process & Technology
Pin code 370421
E-mail girish.singh@rp-sg.in
Telephone No. 2838-619203
Fax No. 2838-02838283635
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) No Proposed expansion is within the existing unit
1.2 Clearance of existing land, vegetation and buildings? No Clearance of vegetation will not be required only few shrubs will be removed.
1.3 Creation of new land uses? No The designated land use is industrial.
1.4 Pre-construction investigations e.g. bore houses, soil testing? No -
1.5 Construction works? Yes Construction work will be done for establishment of proposed production units.
1.6 Demolition works? No -
1.7 Temporary sites used for construction works or housing of construction workers? No As workers employed will be local, temporary sites will not be required.
1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations Yes Above ground buildings & structures Please refer Annexure 7 for site lay out map. Tentative construction statement is given in Table 1 in additional attachments.
1.9 Underground works including mining or tunnelling? No -
1.10 Reclamation works? No -
1.11 Dredging? No -
1.12 Offshore structures? No -
1.13 Production and manufacturing processes? Yes Manufacturing process along with material balance is given vide Annexure 8 in additional attachments.
1.14 Facilities for storage of goods or materials? Yes Storage details of raw materials are given in Annexure 9 in additional attachments.
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? Yes Wastewater generation: Existing: 394 KLD; Proposed: 297 KLD; Total: 691 KLD There is ZLD facility as described below; 1. 42 KLD sent to Soak pit 2. 120 KLD use for Gardening 3. 408 KLD utility blow downs from boiler and cooling tower will send to WTP/ZLD and further reuse in process, boiler and cooling tower make up water. 4. 115 KLD treated water from washing reuse in cooling tower make up 5. 6 KLD salts with moisture from WTP/ZLD will send to TSDF for disposal Water balance is given vi
1.16 Facilities for long term housing of operational workers? No Employees will be hired from nearby city & towns. If necessary the flats or houses will be taken on rent.
1.17 New road, rail or sea traffic during construction or operation? Yes Construction Phase: Road traffic will be increased during construction phase. There will not be increase in rail and sea traffic during construction phase. Operation Phase: Additional movement of 50-52 trucks per day
1.18 New road, rail, air water borne or other transport infrastructure including new or altered routes and stations, ports, airports etc? No No additional transport infrastructure is required as the existing infrastructure is adequate.
1.19 Closure or diversion of existing transport routes or infrastructure leading to changes in traffic movements? No It is not required to close or divert existing transport routes and infrastructure.
1.20 New or diverted transmission lines or pipelines? No -
1.21 Impoundment, damming, culverting, realignment or other changes to the hydrology of watercourses or aquifers? No -
1.22 Stream crossings? No Site does not involve any stream crossing.
1.23 Abstraction or transfers of water from ground or surface waters? Yes Water is sourced from GWIL & Bore well. Total Water Consumption: Existing: 2021 KLD; Proposed 2407 KLD; After proposed expansion: 4428 KLD Recycle Water from RO: Existing: 338 KLD; Proposed 292 KLD; After proposed expansion: 630 KLD Fresh water consumption: Existing: 1683 KLD; Proposed 2115 KLD; After proposed expansion: 3798 KLD. Agreement with GWIL is attached in Annexure 10 in additional attachments. And CGWA water withdrawal is given as Annexure 10 in additional attachments. Water Co
1.24 Changes in water bodies or the land surface affecting drainage or run-off? No The site will be leveled and filled properly in the construction phase and surface run off from site will be channelized through storm water drains hence no change in drainage pattern envisaged.
1.25 Transport of personnel or materials for construction, operation or decommissioning? Yes For construction Transport of personnel: by road Construction workers: 500 (for a few months only when construction takes place) Transport of materials: by road For Operation Transport of personnel: by road Employment Total 320; Permanent = 80, Contractual = 240 Transport of materials: by road and pipeline Additional movement of 50-52 trucks per day
1.26 Long-term dismantling or decommissioning or restoration works? No Proposed project does not involve any long term dismantling or decommissioning or restoration works.
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? No Construction Phase Construction workers as also plant workers will mainly be sourced locally. Construction workers: 500 (for a few months only when construction takes place) Operation Phase Employment Total 320; Permanent = 80, Contractual = 240
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) No Proposed expansion is within the existing unit
2.2 Water (expected source & competing users) unit: KLD Yes Fresh water consumption will be 3798 KLD after proposed expansion. Water will be sourced from GWIL & Bore well. Water Consumption is given vide Annexure 10 in additional attachments.
2.3 Minerals (MT) No -
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) Yes Construction material such as steel, cement will be purchased from local market.
2.5 Forests and timber (source – MT) No -
2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW) Yes Power: During Construction Phase 200 kVA power will be sourced from existing co-generation power plant. During Operation Phase: Existing: 8.3 MW Proposed: 9.5 MW In case of emergency power will be sourced from Grid of Pashchim Gujarat Vij Company Limited (PGVCL). Fuel sourcing and consumption details are given in Annexure 12 in additional attachments.
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 Hazardous chemicals like LDO and HSD are flammable material which stored at site.
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 Direct and indirect Employment
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 No other causes identified.
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 -
4.2 Municipal waste (domestic and or commercial wastes) Yes Stationary (paper) waste is recycled back. Organic waste will be used to prepare compost.
4.3 Hazardous wastes (as per Hazardous Waste Management Rules) Yes Hazardous Waste generation and disposal details are vide Annexure 13 in additional attachments.
4.4 Other industrial process wastes No -
4.5 Surplus product No -
4.6 Sewage sludge or other sludge from effluent treatment Yes Sludge generated from water treatment plant is listed in Annexure 13 in additional attachments
4.7 Construction or demolition wastes Yes During construction phase some debris will be generated.
4.8 Redundant machinery or equipment No -
4.9 Contaminated soils or other materials No -
4.10 Agricultural wastes No -
4.11 Other solid wastes Yes Solid Waste generation and disposal details are vide Annexure 13 in additional attachments.
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 Construction phase Emission of Fossil fuels shall be from use of Construction machineries, vehicles. Operation Phase Adequate stack height is provided to flue gas stacks of all flue gas stacks and will also be provided to all proposed flue gas stacks. Stack emission quality is being maintained as per the SPCB norms and the same practice will be continued after proposed expansion. Stack details are given in Annexure 14 in additional attachments.
5.2 Emissions from production processes Yes Details of process vents are given in Annexure 14 in additional attachments.
5.3 Emissions from materials handling including storage or transport Yes Details of process vents are given in Annexure 14 in additional attachments.
5.4 Emissions from construction activities including plant and equipment Yes During the construction activities, minor emissions will be in the form of dust. Apart from it, application of heavy machinery and earthmovers will generate emission. Suitable dust suppression techniques like water sprinkling will be adopted.
5.5 Dust or odours from handling of materials including construction materials, sewage and waste Yes Construction Phase: as per 5.4 above. Odor problem is not envisaged.
5.6 Emissions from incineration of waste No No Incineration facility at site
5.7 Emissions from burning of waste in open air (e.g. slash materials, construction debris) No No waste will be burnt in open air.
5.8 Emissions from any other sources No There will be no other emission source.
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 The Noise level is within the prescribed limit. At noisy area, adequate preventive & control measures are taken. No significant noise, vibration or emission of light & heat from the unit.
6.2 From industrial or similar processes Yes The Noise level is within the prescribed limit. At noisy area, adequate preventive & control measures are taken. No significant noise, vibration or emission of light heat from the unit.
6.3 From construction or demolition Yes Noise During construction phase, noise will be generated due to construction equipments for a short duration of time. Demolition work is not envisaged. Vibration During piling in construction phase, vibration will occur. Emission of Light and Heat There will not be emission of light and heat during construction phase.
6.4 From blasting or piling Yes Noise & Vibration During piling in construction phase, noise and vibration will occur for a short duration of time.
6.5 From construction or operational traffic Yes During construction and operational phase noise will be generated due to traffic influx in the company premises due to material and personal transport. But it will be minimal and for a short term only.
6.6 From lighting or cooling systems Yes Minor noise will be generated from operation of cooling towers.
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 Yes Occasional & minor fuel/ chemicals spills may occur. These will not affect water or land because of appropriate flooring & presence of spill control procedures. Moreover, all of the hazardous waste is disposed as per guidance of State Pollution Control Board.
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) Yes Domestic Sewage water will be sent to STP and after treatment 42 KLD sent to soak pit and 55 KLD used for gardening. Industrial wastewater will be used as make-up water and used for gardening after treatment. Hence, there will not be contamination of land, groundwater or surface water.
7.3 By deposition of pollutants emitted to air into the land or into water No All air pollutants are controlled properly through stacks. The norms will be maintained within the stipulated norms set by Pollution Control Board.
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 Same as 7.1 & 7.2
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 Adequate control measures and levels of protection will be implemented to avoid spillages.
8.2 From any other causes Yes Common risks in factories such as: • Electric Shock • Hit by Objects • Fall / Slips • Hot Work such as Welding and Cutting • Traffic movement Permitting system and SOP will be followed.
8.3 Could the project be affected by natural disasters causing environmental damage (e.g. floods, earthquakes, landslides, cloudburst etc)? No Earthquakes The project area lies in the seismic intensity Zone V, which is classified as very high risk zone. Building design shall be as per seismic zone.
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
No Not likely since the product is sold to different industries for making products.
9.2 Lead to after-use of the site, which could have an impact on the environment No Not envisaged
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 -
(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 such area exist within 15 km.
2 Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Yes Mitti River@~0.77 km in ENE Babia River@~3.74 km in NNW Ruparel River@ ~7.44 km in NE Bhukhi River@ ~9.79 km in W Sakara River@ ~7.24 km in E Wadala Pond @ ~2.95 km in ESE Kandoria Pond@ ~4.80 km in NW Bagda Pond @ ~6.93 km in NNW Nr. Vovar Reservoir @ ~5.04 km in NE Bhadreswar Pond@ ~7.67 km in ESE Nr. Bharudia Reservoir @ ~8.16 km in ENE Nr. Ratadia Reservoir@ ~8.37 km in WNW Gulf Of Kuchh@ ~6.91 km in SSE All river is Non-perennial in Nature.
3 Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration No -
4 Inland, coastal, marine or underground waters Yes Gulf of Kutch @ ~ 6.91 km in SSE
5 State, National boundaries No -
6 Routes or facilities used by the public for access to recreation or other tourist, pilgrim areas No -
7 Defence installations No -
8 Densely populated or built-up area Yes Mokha @ ~1.48 km in NNW Bhadreswar @ ~7.47 km in ESE
9 Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship, community facilities) Yes Vasai Jain Tirth @ 8.13 Km in ESE Masjid E Rabbani @ 6.73Km in WSW Hanuman Mandir @6.97 Km in WSW Mokha Jain Tirth @1.61 Km in NNW Adani Hospital @15.69 Km In SW Vaanki Primary School @14.44 Km in WNW St. Xavier’s English Medium High School @13.20Km In SW Sheth R.D. High School @13.71 Km in SW Sadau Primary School @10.18 Km in SW
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 -
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 Yes The project area lies in the seismic intensity Zone V, which is classified as highest 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
Reply of EDS raised on 22/07/19
            Essential Detail Sought:
Sno. EDS Letter Remarks Date of EDS
1.NAThe correction have been made as per the instruction received 24 Jul 2019
2.NAPlease provide the status of the unit as per the EC granted during the year 2018 and amended on 2019. 22 Jul 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 ApplicantGirish
DesignationChief Projects Spe. Process & Technology
Name of Company (Applicant Name should not be given here)PHILLIPS CARBON BLACK LTD
AddressSurvey No.47, Village: Mokha, Taluka: Mundra, Dist: Kutchh
Print