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 Expansion Affordable Group Housing
Brief summary of projectAnnexure-Brief summary of project
Proposal Number IA/HR/NCP/89722/2018
Project Cost 6000000000 lacs
2.
S. No. in the schedule8(b) Townships and Area Development projects.
Project Sector INFRA-1
3. Proposed capacity/area/length/tonnage to be handled/command area/lease area/number or wells to be drilled 0 ha.
4.
New/Expansion/ModernizationExpansion
Proposal NumberIA/HR/NCP/89721/2018
MoEFCC file number(Previous EC)SEIAA/HR/2018/576
Uploaded EC letterAnnexure-Uploaded EC letter
5. Existing Capacity/Area etc. 4.0342 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 projectBadshahpur, Sector- 68
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.Rect no. 138, Killa no. 24, 25, Rect no. 150, Killa no. 10/1, Rect no. 151, Killa no. 3/2, 4, 5, 6/1/2, 6/2, 7, 14, Rect no. 152, Killa no. 14, 15, Rect no. 151, Killa no. 11/1, 11/3, 12, 13,137//25/2(0-4),151//1(8-0),2(8-0),3/1(4-0)152//4(8-0)5(7-16),6/1(6-14)7/1(1-2)7/2(6-18)
Town / VillageBadshahpur,
State of the projectHaryana
Details of State of the project
S.no State Name District Name Tehsil Name
(1.)HaryanaGurgaonGurgaon
10.
Nearest railway station along with distance in kms Basai Dhankot Railway Station, 11.40 km
Nearest airport along with distance in kms IGI Airport, 18.50 km
11. Nearest Town/City/District Headquarters along with distance in kms Gurgaon Headquarter , 09.32 km
12. Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given) Municipal Corporation, Gurgaon Opposite Civil Hospital (General) A-10, Block A, Sector 34, Gurugram, Haryana - 122 001 Phone: 0124-2220011 Email: contact@mcg.gov.in
13. Name of the Applicant SIKANDER
14. Registered Address 302-A Global Foyer , sector 43 golf course road , gurugram
15.
Address for correspondance:
Name of the Company M/S SAI AAINA FARMS PVT. LTD.
Name of the Applicant SIKANDER
Designation (Owner/ Partner/ CEO) Director
Pin code 122009
E-mail sai672005@gmail.com
Telephone No. 0124-4369749
Fax No. 0124-
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 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 Land has been allotted for Expansion of Affordable Group Housing colony purposes under Master Plan of Gurgaon-Manesar Urban Complex 2031.
1.2 Clearance of existing land, vegetation and buildings? No The construction of project does not require any clearance of existing Land, Vegetation & Building
1.3 Creation of new land uses? No Land has been earmarked for residential development as per Master Plan of Gurgaon-Manesar urban complex 2031, so there will be no creation of new land use.
1.4 Pre-construction investigations e.g. bore houses, soil testing? Yes Pre-construction investigations has been done.
1.5 Construction works? No All construction activities will be confined within the project premises; there will be no physical changes outside the project boundary.
1.6 Demolition works? No As the proposed project is Expansion. Demolition is not required.
1.7 Temporary sites used for construction works or housing of construction workers? Yes All the construction activity including stocking of raw materials will be confined within the project site only. Temporary labor hutments are proposed. Local labors from nearby area will be hired. Sanitation facilities will be developed at site.
1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations Yes Excavation will be carried out for foundation of buildings and basements. The excavated soil will be used in backfilling and other area development activities
1.9 Underground works including mining or tunnelling? No No underground works including mining/ tunneling is required except excavation of earth that shall be required for the purpose of laying foundation and for basement.
1.10 Reclamation works? No No reclamation work required
1.11 Dredging? No No dredging required.
1.12 Offshore structures? No No offshore structures required.
1.13 Production and manufacturing processes? No No production/manufacturing process involved as the project is an Expansion of Affordable Group Housing colony project.
1.14 Facilities for storage of goods or materials? Yes Temporary stores shall be constructed for storing various construction materials within the site premises
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? Yes The solid waste generated from project will be mainly domestic in nature and the quantity of the waste will be 6,425 kg/day . The waste water in operation phase will be treated up to tertiary level in a STP of 1,150 KLD capacity and the treated sewage will be reused for toilet flushing, cooling and horticulture.
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 The site has good connectivity to SH-13 at a distance of approximately 0.39 km towards East.
1.18 New road, rail, air water borne or other transport infrastructure including new or altered routes and stations, ports, airports etc? No Since the site has good connectivity to SH-13 which has high traffic density; the diversion or closure of existing traffic routes is not required
1.19 Closure or diversion of existing transport routes or infrastructure leading to changes in traffic movements? No Existing infrastructural facilities will be used for the Expansion of Affordable Group Housing Colony project, no alteration of existing facilities
1.20 New or diverted transmission lines or pipelines? No Not Applicable
1.21 Impoundment, damming, culverting, realignment or other changes to the hydrology of watercourses or aquifers? No Not Applicable
1.22 Stream crossings? No Not Applicable
1.23 Abstraction or transfers of water from ground or surface waters? Yes The water supply will be provided through HUDA. About 753 KLD of fresh water will be required during operation phase of the project
1.24 Changes in water bodies or the land surface affecting drainage or run-off? Yes Runoff will increase due to increased paved surface. However, increased runoff will be managed by well-designed rainwater harvesting system and storm water management plan.
1.25 Transport of personnel or materials for construction, operation or decommissioning? Yes Transportation of materials and movement of manpower to and from the project during construction. It is a long term project, no decommissioning is envisaged. Adequate parking space (1,485 ECS) will be proposed operational phase to the residents & commercial occupants of the premises.
1.26 Long-term dismantling or decommissioning or restoration works? No No Long term dismantling or decommissioning or restoration works will be involved
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? No Local laborers from nearby area will be employed during the construction phase. In the operation phase, most of the expected occupants will be from the surrounding areas. Hence, the project will lead to a redistribution of occupants within the city.
1.29 Introduction of alien species? No Only indigenous species will be planted in the green area of the development plan.
1.30 Loss of native species or genetic diversity? No There will be no significant impact on the native species or genetic diversity.
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) No The project is as per the designated landuse under Master/ Development Plan of Gurgaon-Manesar Urban complex-2031.
2.2 Water (expected source & competing users) unit: KLD Yes During construction phase, 370 ML amount of water will be required which will be provided by treated water from STP of HUDA. During operation phase, water supply will be provided through the HUDA About 753 KLD of fresh water will be required during operation phase of the project.
2.3 Minerals (MT) Yes Minerals such as sand and aggregates will be required during the construction phase.
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) Yes All materials for construction will be arranged through select suppliers.
2.5 Forests and timber (source – MT) No Timber usage shall be minimal
2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW) Yes The connected load for the Group Housing colony will be approx. (EC Accorded + Expansion) 6,620 KVA. which shall be supplied by 6 transformers of Total 7,500 kVA (2X1500 + 2X1250 + 2X1000).
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 Yes Low Sulphur Diesel and lubricating oil will be handled as per The Manufacture, Storage and Import of Hazardous Chemical Rules, 1989 and Material Safety Data Sheet.
3.2 Changes in occurrence of disease or affect disease vectors (e.g. insect or water borne diseases) No Suitable drainage and waste management measures will be adopted in both the construction and operational phase such that there will be no stagnation of water or accumulation of waste. This will effectively restrict the reproduction and growth of disease vectors.
3.3 Affect the welfare of people e.g. by changing living conditions? Yes Socio-economic standard of people will increase due to increased employment opportunities provided by this project. This will lead to better quality of life and will also set a standard for future developments in the area.
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 No such spoil, overburden or mine wastes will be generated.
4.2 Municipal waste (domestic and or commercial wastes) Yes The total municipal (domestic + landscape) solid waste to be generated is approx. 6,425 kg/day.
4.3 Hazardous wastes (as per Hazardous Waste Management Rules) Yes The hazardous wastes along with other wastes in the project will be used oil from DG sets, which is classified as per The Hazardous Waste Category 5.1 as per The Hazardous Wastes (Management & Handling) Rules, 2016. Used oil from DG sets will be stored in HDPE drums in isolated covered facility. This used oil will be sold to authorized recyclers. Suitable care will be taken so that spills/leaks of used oil from storage is avoided.
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 64.75 kg/day Sludge generated from STP will be used in Horticulture as manure
4.7 Construction or demolition wastes Yes The construction waste will consist of excess earth and construction debris along with cement bags, steel in bits and pieces, insulating and packaging materials etc.
4.8 Redundant machinery or equipment No Redundant machinery will not be generated.
4.9 Contaminated soils or other materials No Contaminated soils or other materials will not be generated.
4.10 Agricultural wastes Yes Landscape wastes of 2.998 kg/day will be generated
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 The project does not envisage any major air pollution sources except operation of DG sets during power failure and vehicular traffic.
5.2 Emissions from production processes No No production processes involved. Hence, there will be no such emissions
5.3 Emissions from materials handling including storage or transport Yes Small quantities of fugitive emissions are envisaged during transport and handling of construction materials. Such emissions will be temporary and controlled by the use of sprinkling and other viable techniques.
5.4 Emissions from construction activities including plant and equipment Yes This will be restricted to the construction phase and the construction site only.
5.5 Dust or odours from handling of materials including construction materials, sewage and waste Yes Dust is anticipated during loading and unloading of construction material and excavation of upper earth surface. These will however be temporary in nature, which will be controlled by providing water sprinklers. Tarpaulin cover will be provided on stored loose materials to reduce the dust emission.
5.6 Emissions from incineration of waste No No incineration of wastes is proposed.
5.7 Emissions from burning of waste in open air (e.g. slash materials, construction debris) No Open burning of biomass/other material will be prohibited on site.
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 Source of noise in the operational phase will be from backup DG sets (which will be in operation only during power failure) and pumps & motors. All the machinery will be of highest standard of reputed make and will comply with standard i.e. The DG set room will be provided with acoustic enclosure to have minimum 25 dB(A) insertion loss or for meeting the ambient noise standard whichever is on higher side as per E (P) Act, GSR 371 (E) and its amendments. Therefore, no significant impact due to op
6.2 From industrial or similar processes No No industrial processes will be carried out in the project.
6.3 From construction or demolition Yes Due to various construction activities, there will be short-term noise impacts in the immediate vicinity of the project site. The construction activities will include the following noise generating activities: • Concreting, mixing & operation of DG sets. • Construction plant and heavy vehicle movement
6.4 From blasting or piling No No blasting or mechanized piling will be done.
6.5 From construction or operational traffic Yes The traffic during construction phase shall not have any significant impact. During the operational phase only personal vehicles as cars/ two wheelers shall be used by the flat owners for which adequate parking will be provided. In addition, adequate green area will also act as a sink, so that noise impact will be minimized.
6.6 From lighting or cooling systems No Not Applicable
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 The used oil from DG sets will be carefully stored in HDPE drums at isolated storage, and periodically sold to authorized recyclers. All precautions will be taken to avoid spillage from storage as per The Hazardous Wastes (Management & Handling) Rules, 2016.
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) No There will be no discharge of untreated sewage on land or into water bodies. Adequate treatment of sewage will be carried out in a STP of capacity 1,150 KLD, proposed within the project premises. Treated sewage will be re-used for flushing, landscaping. Excess treated water will be used in site by construction as per The Water (Prevention and Control of Pollution) Act, 1974.
7.3 By deposition of pollutants emitted to air into the land or into water No The DG Sets will be provided with stacks of adequate height as per CPCB norms. Hence dispersion will be achieved and avoid deposition of pollutants in significant concentrations at any single location
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 To deal with any fire related accident, fire fighting system shall be provided as per NBC 2016 part IV & relevant BIS codes
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)? Yes The project falls under seismic active Zone IV indicating high damage risk zone. The buildings will be designed as earthquake resistant and comply with the required IS specifications
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 Appropriate infrastructure like roads, power supply, waste management and waste water treatment will be developed within the project site. Expansion of Affordable Group Housing Colony development will take place. No Extractive industries No Supply industries N.A
9.2 Lead to after-use of the site, which could have an impact on the environment Yes Not Anticipated
9.3 Set a precedent for later developments Yes The project will provide good infrastructure and better life style and will set an example for later developments in the areas
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
No
2 Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Yes Damdama lake 10.40 in SE
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 The depth of groundwater is 9-11 meter below the ground level.
5 State, National boundaries No Haryana-Delhi Border Approx. 10.25 Km in NE.
6 Routes or facilities used by the public for access to recreation or other tourist, pilgrim areas Yes SH 13 Approx. 250 m in E direction of the project site. NH 8 Approx. 6.50 Km in WNW direction
7 Defence installations No
8 Densely populated or built-up area Yes Gurgaon Approx. 9.32 km from project site in NNW direction. Badshahpur villageApprox. 1.32 km from project site in NNW direction
9 Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship, community facilities) Yes Hospital Ekta Hospital 0.75 km (North) Kamal Hospital 1.10 KM Schools SBM Gurgaon 2.11 km (SE) Alpine Convent School, Sector 67 Gurgaon 1.15 in NNE Govt. sr. sec. school in sec-77 4.17 in N College KIIT College of Education, 3.58 km (North) Religious places Masjid- Peer Baba, 1.99 km (NW) Hanuman temple 1.87 km in N
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 Yes The site falls under the zone IV as per the Seismic Zone Map of India and is thus prone to high damage risk zone. Adequate measures will be taken during the construction of the project.
(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 ApplicantSIKANDER
DesignationDirector
Name of Company (Applicant Name should not be given here)M/S SAI AAINA FARMS PVT. LTD.
Address302-A Global Foyer , sector 43 golf course road , gurugram
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