Report Part 1

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

	Whether proposal involved violation of EIA notification	N/A
	Weather Consent to Establishment Obtained	N/A
	Upload copy of CTE	N/A

Name of the Project/s	Proposed Bulk drug and Specialty chemicals manufacturing plant in existing distillation Unit
Brief summary of project	Annexure-Brief summary of project
Proposal Number	IA/GJ/IND2/83728/2018
Project Cost	2500 lacs

S. No. in the schedule	5(f) Synthetic organic chemicals industry (dyes & dye intermediates; bulk
Project Sector	Industrial Projects - 2

Proposed capacity/area/length/tonnage to be handled/command area/lease area/number or wells to be drilled

1300 ha.

New/Expansion/Modernization	Expansion
Proposal Number	IA/GJ/IND2/83726/2017
MoEFCC file number(Previous EC)	AWH-88314
Uploaded EC letter	Annexure-Uploaded EC letter

Existing Capacity/Area etc.

600 ha.

Category of project i.e. 'A' or 'B'

Does it attract the general condition? If yes, please specify

Does it attract the specific condition? If yes, please specify

Location of the project	Village: Gothsa
Shape of the project land	Block (Polygon)
Uploaded GPS file	Annexure-GPS file
Uploaded copy of survey of India Toposheet	Annexure-Survey of india toposheet
Plot/Survey/Khasra No.	Village: Gothda
Town / Village	1761-P
State of the project	Gujarat

Details of State of the project
S.no	State Name	District Name	Tehsil Name
(1.)	Gujarat	Vadodara	Savli

10.

Nearest railway station along with distance in kms	Vadodara, 21 km
Nearest airport along with distance in kms	Vadodara, 21 km

11.

Nearest Town/City/District Headquarters along with distance in kms

Gothda , 2 km

12.

Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given)

Savli

13.

Name of the Applicant

14.

Registered Address

Plot No. 1761-P, Village: Gothda, Taluka: Savli, Dist: Vadodara

15.

Address for correspondance:
Name of the Company	SHIVAM PETROCHEM INDUSTRIES
Name of the Applicant	S
Designation (Owner/ Partner/ CEO)	Partner
Pin code	391770
E-mail	ehs@sscplin.com
Telephone No.	0265-233647
Fax No.	0265-
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

17.

Whether part of Interlinked projects?

18.

Whether separate application of Interlinked project has been submitted?

N/A

19.

If Yes, MoEF file number	N/A
Date of submission	N/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?

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 Court	N/A
(b) Name of the Sub court	N/A
(c) Case No.	N/A
(d) Orders/directions of the court, if any and relevance with the proposed project	N/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)

1.2

Clearance of existing land, vegetation and buildings?

Yes

Minor site clearance activities shall be carried out to clear shrubs and weed.

1.3

Creation of new land uses?

1.4

Pre-construction investigations e.g. bore houses, soil testing?

1.5

Construction works?

Yes

Please refer Annexure – II.

1.6

Demolition works?

1.7

Temporary sites used for construction works or 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

Please refer Annexure – II.

1.9

Underground works including mining or tunnelling?

1.10

Reclamation works?

1.11

Dredging?

1.12

Offshore structures?

1.13

Production and manufacturing processes?

Yes

Please refer Annexure –III.

1.14

Facilities for storage of goods or materials?

Yes

Proposed Expansion project activity is within existing plant premises, additional raw material & finished products storage area will be developed.

1.15

Facilities for treatment or disposal of solid waste or liquid effluents?

Yes

For details please refer Annexure-V. For Hazardous waste detail please refer Annexure – VI.

1.16

Facilities for long term housing of operational workers?

1.17

New road, rail or sea traffic during construction or operation?

Yes

Addition of very few 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?

1.19

Closure or diversion of existing transport routes or infrastructure leading to changes in traffic movements?

1.20

New or diverted transmission lines or pipelines?

1.21

Impoundment, damming, culverting, realignment or other changes to the hydrology of watercourses or aquifers?

1.22

Stream crossings?

1.23

Abstraction or transfers of water from ground or surface waters?

Yes

Water requirement will be met through ground water.

1.24

Changes in water bodies or the land surface affecting drainage or run-off?

1.25

Transport of personnel or materials for construction, operation or decommissioning?

Yes

Transportation of personnel or raw material and products will be primarily by road only.

1.26

Long-term dismantling or decommissioning or restoration works?

1.27

Ongoing activity during decommissioning which could have an impact on the environment?

1.28

Influx of people to an area in either temporarily or permanently?

1.29

Introduction of alien species?

1.30

Loss of native species or genetic diversity?

1.31

Any other actions?

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)

2.2

Water (expected source & competing users) unit: KLD

Yes

Water Source: Ground Water For details please refer Annexure – IV.

2.3

Minerals (MT)

2.4

Construction material – stone, aggregates, sand / soil (expected source – MT)

Yes

Small Quantity of construction material will be required for expansion and addition of few equipments. Construction materials, like steel, cement, crushed stones, sand, rubble, etc. required for the project shall be procured from the local market of the region.

2.5

Forests and timber (source – MT)

2.6

Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW)

Yes

Please refer Annexure – VII.

2.7

Any other natural resources (use appropriate standard units)

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

Please refer Annexure –VIII.

3.2

Changes in occurrence of disease or affect disease vectors (e.g. insect or water borne diseases)

3.3

Affect the welfare of people e.g. by changing living conditions?

3.4

Vulnerable groups of people who could be affected by the project e.g. hospital patients, children, the elderly etc.

3.5

Any other causes

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

4.2

Municipal waste (domestic and or commercial wastes)

4.3

Hazardous wastes (as per Hazardous Waste Management Rules)

Yes

Please refer Annexure – VI.

4.4

Other industrial process wastes

Yes

Please refer Annexure – VI.

4.5

Surplus product

4.6

Sewage sludge or other sludge from effluent treatment

4.7

Construction or demolition wastes

4.8

Redundant machinery or equipment

4.9

Contaminated soils or other materials

4.10

Agricultural wastes

4.11

Other solid wastes

Yes

Please refer Annexure – VI.

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

Please refer Annexure – VII.

5.2

Emissions from production processes

Yes

Please refer Annexure – VII.

5.3

Emissions from materials handling including storage or transport

5.4

Emissions from construction activities including plant and equipment

5.5

Dust or odours from handling of materials including construction materials, sewage and waste

5.6

Emissions from incineration of waste

5.7

Emissions from burning of waste in open air (e.g. slash materials, construction debris)

5.8

Emissions from any other sources

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 will be within the prescribed limit. At noisy areas adequate preventive & control measures will be taken. No significant noise, vibration or emission of light & heat from the unit.

6.2

From industrial or similar processes

Yes

The Noise level will be within the prescribed limit. At noisy areas adequate preventive & control measures will be taken. No significant noise, vibration or emission of light & heat from the unit.

6.3

From construction or demolition

6.4

From blasting or piling

6.5

From construction or operational traffic

6.6

From lighting or cooling systems

6.7

From any other sources

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

All hazardous chemicals will be stored in drums.

7.2

From discharge of sewage or other effluents to water or the land (expected mode and place of discharge)

Yes

For details please refer Annexure – IV.

7.3

By deposition of pollutants emitted to air into the land or into water

7.4

From any other sources

7.5

Is there a risk of long term build up of pollutants in the environment from these sources?

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

All hazardous chemicals will be stored in drums.

8.2

From any other causes

8.3

Could the project be affected by natural disasters causing environmental damage (e.g. floods, earthquakes, landslides, cloudburst etc)?

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

Please refer Annexure – VIII.

9.2

Lead to after-use of the site, which could have an impact on the environment

9.3

Set a precedent for later developments

9.4

Have cumulative effects due to proximity to other existing or planned projects with similar effects

(III)

Environmental Sensitivity

S.No

Areas

Name/Identity

Aerial distance (within 15km.) Proposed project location boundary

Areas protected under international conventions, national or local legislation for their ecological, landscape, cultural or other related value

Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests

Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration

Inland, coastal, marine or underground waters

State, National boundaries

Routes or facilities used by the public for access to recreation or other tourist, pilgrim areas

Yes

Public transportation

Defence installations

Yes

Savli

Densely populated or built-up area

Yes

Savli 4 km and Manjusar around 9 km from the proposed project site.

Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship, community facilities)

Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals)

Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded)

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

(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)	NIL

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 Applicant	S
Designation	Partner
Name of Company (Applicant Name should not be given here)	SHIVAM PETROCHEM INDUSTRIES
Address	Plot No. 1761-P, Village: Gothda, Taluka: Savli, Dist: Vadodara