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 Manufacturing of different types of Resins by M/s. Shri Sairaj Enterprise
Brief summary of projectAnnexure-Brief summary of project
Proposal Number IA/GJ/IND2/92425/2019
Project Cost 274.5 lacs
2.
S. No. in the schedule5(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 2730.13m2 ha.
4.
New/Expansion/ModernizationNew
5. Existing Capacity/Area etc. 0.2730 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 projectVillage : Bhunava, Taluka : Gondal, District : Rajkot, in the state of Gujarat
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. 82
Town / VillageBhunava
State of the projectGujarat
Details of State of the project
S.no State Name District Name Tehsil Name
(1.)GujaratRajkotGondal
(2.)GujaratRajkotGondal
10.
Nearest railway station along with distance in kms Rajkot Junction, 27.4 km
Nearest airport along with distance in kms Rajkot, 26.7 km
11. Nearest Town/City/District Headquarters along with distance in kms Gondal , 15.6 km
12. Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given) Village: Bhunava, Taluka: Gondal, District: Rajkot.
13. Name of the Applicant Iteshkumar
14. Registered Address Survey No. 81, plot no.14,15,16 At.Bhuvana, Ta.Gondal Dis. Rajkot, Gujarat
15.
Address for correspondance:
Name of the Company M/S. SHREESAIRAJ
Name of the Applicant Iteshkumar
Designation (Owner/ Partner/ CEO) TEC
Pin code 36011
E-mail shreesairaj990@gmail.com
Telephone No. 0281-2233
Fax No. 0281-
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 The existing land and building will be utilized for the proposed project with slight modifications in the existing building.
1.2 Clearance of existing land, vegetation and buildings? No No requirement
1.3 Creation of new land uses? No No need of creation of new land.
1.4 Pre-construction investigations e.g. bore houses, soil testing? No The entire existing infrastructure will be utilized for the proposed project with minor changes and no new heavy structure shall be carried-out.
1.5 Construction works? No The entire existing infrastructure will be utilized for the proposed project with minor changes and no new heavy structure shall be carried-out. Installation of machinery and equipment required for the proposed project shall be installed
1.6 Demolition works? Yes Minor changes in the existing building structure is expected
1.7 Temporary sites used for construction works or housing of construction workers? No No major construction activity is proposed. Local construction labours will be utilized for the same.
1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations No The existing building will be brought into the use. Only minor alterations in the existing building will be required
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? No Not Applicable
1.13 Production and manufacturing processes? Yes As per Prefeasibility Report, Section
1.14 Facilities for storage of goods or materials? Yes Proper storage facilities for raw material and finished goods will be provided
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? Yes Solid Waste : Safe collection, storage, transportation and secured disposal eliminate the impact on water and soil environment Liquid Effluents : Domestic wastewater will be suitably treated and disposed off via Septic Tank / Soak Pit system. Industrial wastewater will be treated in effluent treatment plant comprising of primary treatment units and evaporated through in-house Evaporator, thus achieving “Zero Discharge”.
1.16 Facilities for long term housing of operational workers? No No facilities of housing of operational workers will be required as local labours will be utilized.
1.17 New road, rail or sea traffic during construction or operation? No Not Applicable as the project proponent will be utilizing the existing infrastructure available in and around the project site.
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 as the project proponent will be utilizing the existing infrastructure available in and around the project site.
1.19 Closure or diversion of existing transport routes or infrastructure leading to changes in traffic movements? No Not Applicable as the project proponent will be utilizing the existing infrastructure available in and around the project site.
1.20 New or diverted transmission lines or pipelines? No Nil
1.21 Impoundment, damming, culverting, realignment or other changes to the hydrology of watercourses or aquifers? No Nil
1.22 Stream crossings? No No stream crossing is involved
1.23 Abstraction or transfers of water from ground or surface waters? Yes Ground water will be extracted to meet with the water requirements of the project.
1.24 Changes in water bodies or the land surface affecting drainage or run-off? No No change is envisaged as the extracted ground water quantity is not huge.
1.25 Transport of personnel or materials for construction, operation or decommissioning? Yes `Transportation of personnel or materials will be carried out by road transport. Traffic due to movement of employees to & from the industry during the operation phase which will not have any major impact on the existing traffic in the region.
1.26 Long-term dismantling or decommissioning or restoration works? No The 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 Not Applicable
1.28 Influx of people to an area in either temporarily or permanently? Yes There will be influx of people during the operational phase.
1.29 Introduction of alien species? No Not Applicable
1.30 Loss of native species or genetic diversity? No No loss of native species or genetic diversity is envisaged due to the proposed project.
1.31 Any other actions? No Nil
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 Please refer above serial number 1.1.
2.2 Water (expected source & competing users) unit: KLD Yes As per Prefeasibility Report, Section IX
2.3 Minerals (MT) No Not Applicable
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) Yes Construction materials will be procured from the local market as and when required
2.5 Forests and timber (source – MT) Yes Not Applicable
2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW) Yes As per Prefeasibility Report, Section VIII
2.7 Any other natural resources (use appropriate standard units) No No other natural resources will be used.
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 raw materials will be handled as per MSIHC rules, 1989 and amendment rules, 2000
3.2 Changes in occurrence of disease or affect disease vectors (e.g. insect or water borne diseases) No There will not be any occurrence of disease or disease vector by the project.
3.3 Affect the welfare of people e.g. by changing living conditions? Yes There will be more employment opportunity due to expansion of the project. There will be improvement in the socio- economic condition of the local population. Ancillary development near the project site will additionally improve the economic status of nearby villages.
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 No There will be no spoil; overburden or mine waste in the proposed expansion project
4.2 Municipal waste (domestic and or commercial wastes) Yes There will marginal waste from the proposed project.
4.3 Hazardous wastes (as per Hazardous Waste Management Rules) Yes As per Prefeasibility Report, Section Table 4
4.4 Other industrial process wastes Yes As per Prefeasibility Report
4.5 Surplus product No There will be no surplus product
4.6 Sewage sludge or other sludge from effluent treatment Yes Sludge from ETP will be sent to TSDF site/Co-processing for disposal
4.7 Construction or demolition wastes No Minimal construction wastes will be generated.
4.8 Redundant machinery or equipment No There will be no redundant machinery or equipment.
4.9 Contaminated soils or other materials No There will be no contamination of soil.
4.10 Agricultural wastes No Not Applicable
4.11 Other solid wastes No Not Applicable
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 Flue Gas Emissions : Stack attached to : a) Boiler : PM < 150 mg/ Nm b) D. G. Set (Only for emergency) : 3 SOx < 100 ppm NOx < 50 ppm PM < 150 mg/ Nm 3 SOx < 100 ppm NOx < 50 ppm Vehicular Emissions : Heavy vehicles coming in and out of the plant of receipt of raw materials and fuel and dispatch of finished goods leads to emissions of Hydrocarbons and Carbon Monoxide.
5.2 Emissions from production processes No There are no process emissions.
5.3 Emissions from materials handling including storage or transport Yes Heavy vehicles coming in and out of the plant of receipt of raw materials and fuel and dispatch of finished goods leads to emissions of Hydrocarbons and Carbon Monoxide
5.4 Emissions from construction activities including plant and equipment Yes Fugitive dust from construction activities due to loosening of soil. Sprinkling of water shall be carried out to limit / reduce dust emissions
5.5 Dust or odours from handling of materials including construction materials, sewage and waste Yes During construction phase, nominal dust will be generated. Sprinkling of water shall be carried out to limit / reduce dust emissions
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 No waste is proposed to be brunt in open air.
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 There will be minimal increment in noise level during operation due to operation of DG set which will be used as power break-up. Noise level will be maintained within permissible limit as per Noise Rule 2000.
6.2 From industrial or similar processes Yes Processing will be under closed system so noise pollution will be controlled
6.3 From construction or demolition No Not Applicable.
6.4 From blasting or piling No There will be no blasting and piling activity in the proposed project
6.5 From construction or operational traffic Yes There will be marginal noise generation from vehicle movement especially due to movement of trucks for transportation of raw materials and finished products. However, the noise levels will be less than the prescribed limit. Vehicles with inbuilt silencer will be allowed. Further suitable mitigation measures including greenbelt have already been provided to reduce the noise emissions.
6.6 From lighting or cooling systems No Not applicable
6.7 From any other sources Yes 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 Yes All precautionary measures shall be taken to minimize such risks
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) No Sewage is being disposed into soak pit / septic tank.
7.3 By deposition of pollutants emitted to air into the land or into water No The gaseous emissions will be well within the prescribed limits. Periodic monitoring of stacks will be carried out
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 No Adequate fire fighting and safety measures have already been installed in the plant to prevent & control risks / 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 The project falls under seismic zone-III Further it is not flood or landslide prone area. Hence, risk due to natural hazards is not envisaged.
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 Will improve the supporting infrastructure • Not envisaged • Not envisaged • Will improve Ancillary units will be benefited
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 Not envisaged
9.4 Have cumulative effects due to proximity to other existing or planned projects with similar effects No Not envisaged
(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 There are no archeologically notified places within 15 km. radius of the project site as centre.
2 Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests No There are no archeologically notified places within 15 km. radius of the project site as centre.
3 Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration Yes There are no protected important or sensitive species of flora and fauna within 10 km. radius of the project site as centre.
4 Inland, coastal, marine or underground waters No There are no such water bodies within 10 km. radius of the project site as centre.
5 State, National boundaries No There are no State or National boundaries within 15 km. radius of the project site as centre.
6 Routes or facilities used by the public for access to recreation or other tourist, pilgrim areas No No such route is within proposed project area
7 Defence installations No There are no defence installations within 15 km. radius of the project site as centre.
8 Densely populated or built-up area Yes Village: Bhunava
9 Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship, community facilities) Yes Public Health Centres (PHCs), schools, places of worship, etc. are available within 15 km of the project site.
10 Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) No There are no areas with high quality or scarce resources within 15 km. radius of the project site as centre
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 area falls in Seismic Zone – 3, as per IS : 1893 (Part – 1) : 2002
(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
Land Document of NA
            Essential Detail Sought:
Sno. EDS Letter Remarks Date of EDS
1.NAThe correction have been made as per the instruction received 28 Jan 2019
2.NAPlease mention project name correctly in Form 1. Please provide the copy for permission for industrial use of the land. Effluent treatment mechanism. 23 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 ApplicantIteshkumar
DesignationTEC
Name of Company (Applicant Name should not be given here)M/S. SHREESAIRAJ
AddressSurvey No. 81, plot no.14,15,16 At.Bhuvana, Ta.Gondal Dis. Rajkot, Gujarat
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