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 CBM Mehsana
Brief summary of projectAnnexure-Brief summary of project
Proposal Number IA/GJ/IND2/83297/2018
Project Cost 330800 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 0.5 TCF from 439 CBM well ha.
4.
New/Expansion/ModernizationNew
5. Existing Capacity/Area etc. 14000 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 projectMehsana
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
Town / VillageKamaliwada
State of the projectGujarat
Details of State of the project
S.no State Name District Name Tehsil Name
(1.)GujaratMahesanaMahesana
10.
Nearest railway station along with distance in kms Meshana, 10 km
Nearest airport along with distance in kms Ahmedabad, 70 km
11. Nearest Town/City/District Headquarters along with distance in kms Meshana , 10 km
12. Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given) Mehsana , Visnagar and Unjha of Mehsana district and talukas Patan and Sidhpur of Patan
13. Name of the Applicant Sanjay Kumar
14. Registered Address 2nd Floor Essar House, 11 K K Marg, Mahalaxmi, Mumbai
15.
Address for correspondance:
Name of the Company ESSAR OIL AND GAS EXPLORATION AND PRODUCTION LIMITED
Name of the Applicant Sanjay Kumar
Designation (Owner/ Partner/ CEO) Vice president
Pin code 713212
E-mail hsecbmraniganj@essarenp.co.in
Telephone No. 91-3432532202
Fax No. 91-
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 • Temporary change in land use during drilling operations; • Permanent change in case of CBM production
1.2 Clearance of existing land, vegetation and buildings? Yes About 2 acres of land will be cleared for each well and about 5 acres of land during GGS/MCS construction. No buildings will be cleared in this project.
1.3 Creation of new land uses? Yes Minor change in land use during CBM production
1.4 Pre-construction investigations e.g. bore houses, soil testing? Yes Prior to commencement of site preparation and construction activities, some initial soil testing and sub-surface profiling may be done to find soil properties.
1.5 Construction works? Yes Construction for the CBM project will involve the following • Development of well sites and drilling of wells with casing and cement lining upto the target depth of ~ 2000 m • Installation of Surface facilities (gas-water Separator, pumps, Panal Room etc) • Gas Gathering Stations (5 nos.), with pipeline network of 4” to 18” diameter.
1.6 Demolition works? No
1.7 Temporary sites used for construction works or housing of construction workers? No No construction of houses is envisaged for workers as they are employed from local villages.
1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations Yes This will include: • Strengthening /construction of earthen access road • Site preparation like levelling and grading of land of drilling site, GGS.
1.9 Underground works including mining or tunnelling? Yes The project will involve drilling of 443 wells to a target depth of ~2000 m.
1.10 Reclamation works? No
1.11 Dredging? No
1.12 Offshore structures? No
1.13 Production and manufacturing processes? Yes The project will produce CBM gas.
1.14 Facilities for storage of goods or materials? Yes The project includes following storage facilities: • Warehouse; • Lay down areas; • Storage sheds;
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? Yes • ~ 250 MT per well of drill cuttings are likely to be generated and will be stored in HDPE lined pits. • Average of 50 m3 of produced water per day/ per well will be generated. This water will be adequately treated and disposed/recycled in compliance with regulatory requirements.
1.16 Facilities for long term housing of operational workers? No
1.17 New road, rail or sea traffic during construction or operation? Yes Approach roads leading to the proposed well sites to be constructed.
1.18 New road, rail, air water borne or other transport infrastructure including new or altered routes and stations, ports, airports etc? Yes Approach roads leading to the proposed well sites to be constructed.
1.19 Closure or diversion of existing transport routes or infrastructure leading to changes in traffic movements? No
1.20 New or diverted transmission lines or pipelines? Yes Interconnecting and transportation pipeline network to prospective customers.
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
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 Construction machinery viz JCB, Hydra, cranes, dumpers, road rollers and light vehicles for staff movement.
1.26 Long-term dismantling or decommissioning or restoration works? Yes Long term dismantling will be carried out at the end of project activity on all the 8 GGS & 1 MCS installations & site will be restored to its original use.
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
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 Combination of undeveloped and agricultural land.
2.2 Water (expected source & competing users) unit: KLD Yes Water will be procured through approved local water suppliers and also treated Produced water will be used.
2.3 Minerals (MT) No
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) Yes All Well, GGS & MCS sites • Cement ~ 4350 MT • Sand ~ 6500 M3 • Earth/ Fill material ~ 568500 M3
2.5 Forests and timber (source – MT) No
2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW) Yes In Drilling operation maximum 1500 KVA to 250 KVA Dg set will be used on the basis of Rig type and depth of the well. It is estimated that ~5.5 KLD of HSD per well will be for drilling operations. Once CBM is produced the DG sets will be replaced by CBM fired 40/50 KVA for well site and GG Set of 180 KVA for GGS.
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 Fuel: Approx 5.5 KLD HSD per well will required for drilling operations. It will be procured locally. Proper storage arrangements of the hazardous materials will be done to prevent accidental spillages.
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 There may not be major changes to living conditions but employment of local workforce during construction period may improve socioeconomic status.
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 No
4.2 Municipal waste (domestic and or commercial wastes) Yes Small amount of domestic and industrial solid waste will be generated. This will be disposed through local contractors at approved municipal sites.
4.3 Hazardous wastes (as per Hazardous Waste Management Rules) Yes The following potential hazardous waste are likely to be generated: • Oil contaminated material & Filter: ~1 Tons/month • Waste oil/used oil: ~500 litres/month
4.4 Other industrial process wastes Yes Around 250 Tons/well drill cutting (nonhazardous waste) will be generated and disposed Onsite.
4.5 Surplus product No
4.6 Sewage sludge or other sludge from effluent treatment Yes Domestic sewage would be treated in soak pits.
4.7 Construction or demolition wastes No
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 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 DG & GG sets will be primarily contributing to air pollution emissions. Fugitive emissions sources include moving vehicles & construction machineries /equipment
5.2 Emissions from production processes Yes Gas flaring will be resorted to only during process upset conditions • Flare stack height at well site and at GGS will be erected as applicable standards.
5.3 Emissions from materials handling including storage or transport No
5.4 Emissions from construction activities including plant and equipment Yes Airborne dust emissions likely to occur during site construction activities.
5.5 Dust or odours from handling of materials including construction materials, sewage and waste Yes Dust is likely to be generated from the handling of construction materials viz. cement, sand, aggregates etc.
5.6 Emissions from incineration of waste No
5.7 Emissions from burning of waste in open air (e.g. slash materials, construction debris) No
5.8 Emissions from any other sources No
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 levels near machinery would be around 95 dB (A). Silent DG sets will be used.
6.2 From industrial or similar processes No
6.3 From construction or demolition Yes Noise & vibration will be generated during operation of loaders, JCB, Hydra, Crane, drilling rig and Hydro Frac rig etc.
6.4 From blasting or piling No
6.5 From construction or operational traffic Yes Movement of vehicular traffic on the site approach & access roads will result in increased noise levels.
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
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) No
7.3 By deposition of pollutants emitted to air into the land or into water No
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 No
8.2 From any other causes No
8.3 Could the project be affected by natural disasters causing environmental damage (e.g. floods, earthquakes, landslides, cloudburst etc)? No
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
9.2 Lead to after-use of the site, which could have an impact on the environment No
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 ecological sensitive areas viz. wild life sanctuaries, reserve forest etc exist within the block
2 Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests No The block is not characterized by any identified sensitive ecological habitat. The Rupen, Pushpavati, Khari and Srasawati rivers drain the block. All rives area seasonal and flow only during rainy season.
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 No
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 No
9 Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship, community facilities) Yes Spread out in the block area and outside in small villages, towns and Mehsana City.
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 No Project area falls in the Seismic Zone III
(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
      Essential Detail Sought : NIL
      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 ApplicantSanjay Kumar
DesignationVice president
Name of Company (Applicant Name should not be given here)ESSAR OIL AND GAS EXPLORATION AND PRODUCTION LIMITED
Address2nd Floor Essar House, 11 K K Marg, Mahalaxmi, Mumbai
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