| 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 | | | Is your project Comes under Notified Industrial Area | NA |
| | Whether proposal involved violation of EIA notification | N/A | | Weather Consent to Establishment Obtained | N/A | | Upload copy of CTE | N/A |
| | 1. | |
| Name of the Project/s | Proposed Dyes Manufacturing Unit | Brief summary of project | Annexure-Brief summary of project | | Proposal Number | IA/GJ/IND2/91773/2019 | | Project Cost | 200 lacs | |
| | 2. | |
| S. No. in the schedule | 5(f) Synthetic organic chemicals industry (dyes & dye intermediates; bulk
| Project Sector | Industrial Projects - 2 | |
| | 3. | Proposed capacity/area/length/tonnage to be handled/command area/lease area/number or wells to be drilled | 65 MT ha. |
| | 4. | | New/Expansion/Modernization | New |
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| | 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 |
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| | 9. | |
| Location of the project | Survey No. 358, Vaduchi Mandir Road, Village: Lunej, Taluka: Khambhat, Dist: Anand – 388 620 (Guj.) | | 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. | Survey No. 358 | | Town / Village | Khambhat | | State of the project | Gujarat | |
| | Details of State of the project |
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| S.no | State Name | District Name | Tehsil Name |
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| (1.) | Gujarat | Anand | Khambhat |
| | 10. | |
| Nearest railway station along with distance in kms | Khambhat, 5 km | Nearest airport along with distance in kms | Vadodara, 83 km | |
| | 11. | Nearest Town/City/District Headquarters along with distance in kms | Khambhat , 5 km | | | 12. | Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given) | Village: Lunej, Tal. Khambhat, Dist. Anand, Gujarat. |
| | 13. | Name of the Applicant | Sureshbhai |
| | 14. | Registered Address | Survey No. 358, Vaduchi Mandir Road, Lunej Khambhat, Anand, Gujarat |
| | 15. | |
| Address for correspondance: | | Name of the Company | SHREE SAI INDUSTRIES | | Name of the Applicant | Sureshbhai | | Designation (Owner/ Partner/ CEO) | Proprietor | | Pin code | 382445 | | E-mail | smppatel1968@gmail.com | | Telephone No. | 079-22147550 | | Fax No. | 079- | | 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 |
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| | 17. | Whether part of Interlinked projects? | No |
| | 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 |
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| | | | 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 |
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| | 22. | | Whether there is any Government Order/Policy relevant/relating to the site? | No |
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| | 23. | | Whether any Forest Land Involved? | No | | Area of Forest land Involved (hectares) | N/A |
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| | 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 |
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| 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 activity will be carried out at Survey No. 358, Vaduchi Mandir Road, Village: Lunej, Taluka: Khambhat, Dist: Anand – 388 620 (Guj.) which is NA Land. | | 1.2 | Clearance of existing land, vegetation and buildings? | No | Minor site clearance activities shall be carried out to clear shrubs and weed. | | 1.3 | Creation of new land uses? | No | Proposed activity will be carried out at Survey No. 358, Vaduchi Mandir Road, Village: Lunej, Taluka: Khambhat, Dist: Anand – 388 620 (Guj.) which is NA Land. | | 1.4 | Pre-construction investigations e.g. bore houses, soil testing? | No | -- | | 1.5 | Construction works? | Yes | Plant Layout is attached as Annexure: 2. | | 1.6 | Demolition works? | No | -- | | 1.7 | Temporary sites used for construction works or housing of construction workers? | No | -- | | 1.8 | Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations | Yes | Plant Layout is attached as Annexure: 2. | | 1.9 | Underground works including mining or tunnelling? | No | -- | | 1.10 | Reclamation works? | No | -- | | 1.12 | Offshore structures? | No | -- | | 1.13 | Production and manufacturing processes? | Yes | List of Products is attached as Annexure: 1 and manufacturing process is attached as Annexure: 3. | | 1.14 | Facilities for storage of goods or materials? | Yes | Dedicated storage area for storage of Raw Materials and finished products, solvents, etc. shall be provided. | | 1.15 | Facilities for treatment or disposal of solid waste or liquid effluents? | Yes | For Facilities for treatment or disposal of liquid effluents, please referred Annexure: 5.
For Hazardous waste detail, please refer Annexure: 6. | | 1.16 | Facilities for long term housing of operational workers? | No | -- | | 1.17 | New road, rail or sea traffic during construction or operation? | No | -- | | 1.18 | New road, rail, air water borne or other transport infrastructure including new or altered routes and stations, ports, airports etc? | No | Site is well connected by road. | | 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? | No | -- | | 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? | Yes | Raw water requirement is met through Tankers or Ground Water. | | 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 | Transportation of personnel or raw material and products will be primarily by road only. | | 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? | 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) | No | -- | | 2.2 | Water (expected source & competing users) unit: KLD | Yes | Water requirement will be met through the Water Tankers or Ground Water. Detailed water balance is given as Annexure: 4. | | 2.4 | Construction material – stone, aggregates, sand / soil (expected source – MT) | Yes | Company shall use Sand, Stone, Cement and Structural Steel for Construction as required. | | 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 required from MGVCL will be 60 HP
D. G. Set: 20 HP
Fuel
Imported Coal/PNG Gas/Agro Waste/Bio Coal: 1 MT/Day
HSD: 5 Liter/Hr | | 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 | Please refer Annexure: 8. | | 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? | No | -- | | 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) | No | -- | | 4.3 | Hazardous wastes (as per Hazardous Waste Management Rules) | Yes | Please refer Annexure: 6 | | 4.4 | Other industrial process wastes | Yes | Please refer Annexure: 6 | | 4.5 | Surplus product | No | -- | | 4.6 | Sewage sludge or other sludge from effluent treatment | Yes | Please refer Annexure: 6 | | 4.7 | Construction or demolition wastes | Yes | Construction waste shall be utilized for leveling & land filling in the premises. | | 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 | Please refer Annexure: 6 | |
| 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 | Details of flue & process gas emission are attached as Annexure: 7 | | 5.2 | Emissions from production processes | Yes | Details of emission from process are attached as Annexure: 7.
Details of Air Pollution Control measures are attached as Annexure: 7 | | 5.3 | Emissions from materials handling including storage or transport | Yes | All liquid raw materials shall be procured in bulk tankers and shall be transferred through a closed circuit pipe lines by pumps.
Solid raw material shall be handled in closed charging rooms with proper ventilation and charged through close pipeline into reactors. | | 5.4 | Emissions from construction activities including plant and equipment | Yes | Utmost care will be taken during construction activity and water sprinklers shall be utilized whenever necessary. | | 5.5 | Dust or odours from handling of materials including construction materials, sewage and waste | Yes | All the waste shall be stored in designated places and shall be transported to TSDF or Incineration Site in their own approved closed vehicles. | | 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 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 | All machinery / equipment shall be well maintained, shall have proper foundation with anti vibrating pads wherever applicable and noise levels will be within permissible limits.
Acoustic enclosures shall be provided for DG set. | | 6.3 | From construction or demolition | No | -- | | 6.4 | From blasting or piling | No | -- | | 6.5 | From construction or operational traffic | No | -- | | 6.6 | From lighting or cooling systems | No | -- | | 6.7 | From any other sources | No | Acoustic enclosures shall be provided for DG set. | |
| 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 the raw material shall be stored separately in designated storage area and with safely. Bund walls shall be provided around raw materials storage tanks for containing any liquid spillage.
Other materials shall be stored in bags / drums on pallets with concrete flooring and no spillage is likely to occur. Please refer Annexure : 8. | | 7.2 | From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) | Yes | Sewage is disposed of through septic tank & soak pit & to be done through same way after proposed expansion. | | 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? | Yes | -- | |
| 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 | The risk assessment will be carried out and all mitigative measures shall be taken to avoid accidents. | | 8.2 | From any other causes | No | Not Applicable | | 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
| Yes | Please refer Annexure: 9. | | 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 protected area within 5 km from the proposed project site. | | 2 | Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests | Yes | Sabarmati River – appox. 24 Km away from project site. | | 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 | Sabarmati River – appox. 24 Km away from project site. | | 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 | Khambhat - appox. 5 Km away from project site. | | 9 | Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship, community facilities) | No | -- | | 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 | -- | | | (IV) | Proposed Terms of Reference for EIA studies | | | Essential Detail Sought: |
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| Sno. | EDS Letter | Remarks | Date of EDS |
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| 1. | NA | The correction have been made as per the instruction received | 21 Jan 2019 | | 2. | NA | Kindly provide details of availability of proposed land with the PP and permission for its Industrial use | 18 Jan 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 Applicant | Sureshbhai | | Designation | Proprietor | | Name of Company (Applicant Name should not be given here) | SHREE SAI INDUSTRIES | | Address | Survey No. 358, Vaduchi Mandir Road, Lunej Khambhat, Anand, Gujarat |
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