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 Installation of SPM, sub-sea pipelines from SPM to Crude Oil Terminal (COT) and shore connecting facilities at Mandvi, Gujarat and transfer of Crude oil Pipeline from COT to HRRL Refinery
Brief summary of projectAnnexure-Brief summary of project
Proposal Number IA/GJ/IND2/84137/2018
Project Cost 348000 lacs
2.
S. No. in the schedule6(a) Oil & gas transportation pipe line (crude and refinery/ petrochemical
6(b)Isolated storage & handling of hazardous chemicals (As per threshold planning
Project Sector Industrial Projects - 2
3. Proposed capacity/area/length/tonnage to be handled/command area/lease area/number or wells to be drilled 300 ha.
4.
New/Expansion/ModernizationNew
5. Existing Capacity/Area etc. 0 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 projectMandvi
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.226, 227, 237
Town / VillageMandvi
State of the projectGujarat
Details of State of the project
S.no State Name District Name Tehsil Name
(1.)GujaratkutchMandvi
10.
Nearest railway station along with distance in kms Bhuj, 58 km
Nearest airport along with distance in kms Bhuj, 59 km
11. Nearest Town/City/District Headquarters along with distance in kms Bhuj , 56 km
12. Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given) Mandvi Municipality
13. Name of the Applicant N
14. Registered Address Tel Bhawan, Sahkar Marg, Lal Kothi Vistar, Jyoti Nagar, Jaipur
15.
Address for correspondance:
Name of the Company HPCL RAJASTHAN REFINERY LIMITED
Name of the Applicant N
Designation (Owner/ Partner/ CEO) CGM
Pin code 342005
E-mail bala@hpcl.in
Telephone No. 22-22863420
Fax No. 22-
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?Yes
StatusApplication for Forest Clearance yet to be submitted
(ii) Whether the proposal involves approval/clearance under the wildlife (Protection) Act,1972?Yes
StatusApplication for Wildlife Clearance yet to be submitted
(iii) Whether the proposal involves approval/clearance under the C.R.Z notification, 2011?Yes
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, land cover or topography is envisaged.
1.2 Clearance of existing land, vegetation and buildings? No Not Applicable
1.3 Creation of new land uses? Yes Existing Waste land will be developed for industrial use.
1.4 Pre-construction investigations e.g. bore houses, soil testing? Yes Topography and geo-tech. survey shall be carried out.
1.5 Construction works? Yes Construction will be carried out at proposed site.
1.6 Demolition works? No Not Applicable
1.7 Temporary sites used for construction works or housing of construction workers? Yes A temporary site near to proposed project area will be suitably created for workers with all adequate infrastructure facilities like potable water, temporary housing, sanitation facilities etc.
1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations Yes Construction of Crude oil tanks, administrative offices etc. will be constructed which will require civil construction including excavation. The crude oil pipeline will be buried below ground.
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? Yes SPM, berthing facility, Sub-sea pipelines from SPM to COT.
1.13 Production and manufacturing processes? Yes Brief process description and capacities of the proposed project is given in PFR attached separately.
1.14 Facilities for storage of goods or materials? Yes Storage facilities will be provided for Crude oil (No. of storage tanks: 14 and 4 nos. Future provision).
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? Yes No solid waste generation is envisaged. Oily effluent drained from Crude storage tanks shall be suitable treated and after treatment will be disposed off suitably meeting the standard as prescribed by MoEFCC/CPCB/SPCB.
1.16 Facilities for long term housing of operational workers? No Not Applicable
1.17 New road, rail or sea traffic during construction or operation? No Existing roads may be used for activities during construction/operation phase.
1.18 New road, rail, air water borne or other transport infrastructure including new or altered routes and stations, ports, airports etc? No Not Applicable
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 Transmission lines to be diverted.
1.21 Impoundment, damming, culverting, realignment or other changes to the hydrology of watercourses or aquifers? Yes Appropriate measures will be taken at the places where pipeline is crossing rivers/ nallahs.
1.22 Stream crossings? Yes Appropriate measures will be taken at the places where pipeline is crossing streams.
1.23 Abstraction or transfers of water from ground or surface waters? No Not Applicable
1.24 Changes in water bodies or the land surface affecting drainage or run-off? No Not Applicable
1.25 Transport of personnel or materials for construction, operation or decommissioning? Yes There will be some increase in transport of materials during Construction and Operational phases.
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 Marginal Increase in influx of people during construction period.
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 Proposed land is waste land and undeveloped.
2.2 Water (expected source & competing users) unit: KLD Yes Fresh water requirement is 240 KLD for COT and it will be sourced from Gujarat Water Supply & Sewerage Board (GWSSB).
2.3 Minerals (MT) No Not Applicable
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) Yes Minimal as it is mostly mechanical erection. Soil for site grading shall be used from the plot 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 Total power requirement is 6.2 MW for COT and will be sourced from State Grid.
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 No Not Applicable
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 During the construction phase, indirect employment will be generated temporarily which will help in welfare of local people.
3.4 Vulnerable groups of people who could be affected by the project e.g. hospital patients, children, the elderly etc. No Not Applicable
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 Yes Soil, overburden generated during excavation will be used for refilling of low lying area and back filling.
4.2 Municipal waste (domestic and or commercial wastes) No There shall be no generation of domestic and commercial waste.
4.3 Hazardous wastes (as per Hazardous Waste Management Rules) No Not Applicable
4.4 Other industrial process wastes No Not Applicable
4.5 Surplus product No Not Applicable
4.6 Sewage sludge or other sludge from effluent treatment Yes Oily sludge from Crude oil tank shall be cleared periodically and will be disposed off as per MoEFCC/CPCB standards.
4.7 Construction or demolition wastes No Not Applicable
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 Yes Metal scraps generated during Construction phase will be sold.
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 No Marginal emission is envisaged from intermittent use of DG sets.
5.2 Emissions from production processes No Refer 5.1.
5.3 Emissions from materials handling including storage or transport Yes Marginal emissions due to vehicular movement for transportation and storage which is reversible.
5.4 Emissions from construction activities including plant and equipment Yes Marginal increase in vehicular emissions which shall be local, marginal and limited to construction period.
5.5 Dust or odours from handling of materials including construction materials, sewage and waste Yes Dust and odor due to construction activities will be localized in nature within the COT complex.
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 All equipment’s are designed to comply with OSHA requirements. Noise level at the battery limit shall comply with stipulated norms.
6.2 From industrial or similar processes Yes The noise levels from all industrial activities would be within permissible limits. Protective gears will be used by the occupational workers.
6.3 From construction or demolition Yes Construction or demolition activities shall be carried out within the complex. Noise level at the battery limit shall comply with stipulated norms.
6.4 From blasting or piling Yes Piling activities shall be carried out as per project requirement. Noise level at the battery limit shall comply with stipulated norms.
6.5 From construction or operational traffic Yes There will be marginal increase in noise due to traffic movement in the project area due to transportation of materials and machine.
6.6 From lighting or cooling systems Yes All equipment’s shall meet the OSHA requirement. Noise level at the battery limit shall comply with stipulated norms.
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 All materials and chemicals will be handled as per best safety practices and in accordance with the applicable rules. All necessary precautions shall be in place to prevent any spill/ contamination. The same shall be addressed during design & engineering stage.
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) Yes The industrial liquid oily effluent expected from the proposed project shall be treated and disposed off suitably after complying with MoEFCC/CPCB/SPCB norms.
7.3 By deposition of pollutants emitted to air into the land or into water No Not Applicable
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? No Not Applicable
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 A well developed Disaster Management Plan (DMP) will be prepared for the complex. Risk Assessment for the complex will be carried out and the recommended risk mitigation measures shall be complied.
8.2 From any other causes Yes All safety measures/standards will be followed. Adequate training shall be imparted to construction workers.
8.3 Could the project be affected by natural disasters causing environmental damage (e.g. floods, earthquakes, landslides, cloudburst etc)? Yes Design & engineering of the project will take consideration of all such eventualities. Proposed COT Complex will be constructed in Seismic Zone V of earthquake 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
 Yes Development of adjoining area to the complex is envisaged.
9.2 Lead to after-use of the site, which could have an impact on the environment No Not Applicable
9.3 Set a precedent for later developments No Not Applicable
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
 Yes There are no eco-sensitive areas surrounding the COT area. However, the pipeline is passing through Wild Ass Sanctuary in Gujarat.
2 Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Yes Pipeline is passing through wetlands, watercourses, coastal zone areas. The pipeline is passing through Wild Ass Sanctuary in Gujarat and reserve forested areas.
3 Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration Yes The pipeline is passing through Wild Ass Sanctuary in Gujarat and reserve forested areas.
4 Inland, coastal, marine or underground waters Yes Arabian sea is 1-2 km from COT location.
5 State, National boundaries Yes Pipeline is passing through two states. i.e. Gujarat & Rajasthan
6 Routes or facilities used by the public for access to recreation or other tourist, pilgrim areas No Not Applicable
7 Defence installations No Not Applicable
8 Densely populated or built-up area Yes Mundra and Bhuj is 30 km & 56 km from proposed COT location.
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 The pipeline is passing through agricultural fields and reserve forested areas.
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 The proposed COT location falls under Seismic Zone-V.
(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
Additional Attachments, if any
Attached File
Reply to MoEFCC query
            Essential Detail Sought:
Sno. EDS Letter Remarks Date of EDS
1.NAThe correction have been made as per the instruction received 19 Nov 2018
2.NAPlease confirm whether the proposed pipeline project attracts the provision of the EIA Notification, 2006, requiring EC. Item listed under 6 (b) requires appraisal at State level by the SEAC/SEIAA 05 Nov 2018
      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 ApplicantN
DesignationCGM
Name of Company (Applicant Name should not be given here)HPCL RAJASTHAN REFINERY LIMITED
AddressTel Bhawan, Sahkar Marg, Lal Kothi Vistar, Jyoti Nagar, Jaipur
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