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 of proposed Group Housing/Mixed Land Use Project on area measuring 70.26 Acres at Sector-65, Village Maidawas, Gurugram, Haryana
Brief summary of projectAnnexure-Brief summary of project
Proposal Number IA/HR/NCP/91530/2019
Project Cost 1809850000000 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 .. ha.
4.
New/Expansion/ModernizationExpansion
Proposal NumberIA/HR/NCP/91529/2010
MoEFCC file number(Previous EC)SEIAA/HR/2018/1018
Uploaded EC letterAnnexure-Uploaded EC letter
5. Existing Capacity/Area etc. ... 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 projectSector-65, Village Maidawas, Gurugram, Haryana
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...
Town / VillageSector-65, Village Maidawas, Gurugram, Haryana
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 Gurgaon Railway Station, 10.91 km
Nearest airport along with distance in kms Indira Gandhi International Airport, 15.50 km
11. Nearest Town/City/District Headquarters along with distance in kms Gurgaon , .. km
12. Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given) Gurgaon
13. Name of the Applicant Satya
14. Registered Address C-13, Sushantlok, Phase-1, Gurgaon
15.
Address for correspondance:
Name of the Company M/S MANGALAM MULTIPLEX PVT. LTD.
Name of the Applicant Satya
Designation (Owner/ Partner/ CEO) Manager
Pin code 122002
E-mail manglammultiplex01@gmail.com
Telephone No. 011-27571410
Fax No. 011-
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 Proposed development is as per local development plan of HUDA.
1.2 Clearance of existing land, vegetation and buildings? No Since the project site was vacant, no clearance of existing land and vegetation & buildings was required as the land was free from any vegetation & structure.
1.3 Creation of new land uses? No The proposed site is for Mix Land use development.
1.4 Pre-construction investigations e.g. bore houses, soil testing? Yes Geotechnical Soil investigation has already been carried out.
1.5 Construction works? Yes The major construction works are given below: Site Development Road Development • Internal roads Utilities/Services • Water Supply • Sewerage • Drainage • Rain Water Harvesting Structures and Pits • Power supply and back up facility, Buildings • Residential • Commercial • Community Hall • Primary and High School & Temple • Parking Provisions
1.6 Demolition works? No Demolition work is not involved in the project, as the site has no existing building or constructed area.
1.7 Temporary sites used for construction works or housing of construction workers? No Mostly, local labors will be employed.
1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations Yes Above ground building structures will include building for Mix land use. The earthwork is involved for foundation and laying of underground services etc. Excavated soil will beused for site leveling, back filling/filling and road construction. Top 200 mm layer of soil will be separately stored and used for landscaping/horticulture development work.
1.9 Underground works including mining or tunnelling? Yes Underground works includes excavation of earth for construction of foundation, water storage tank and STP
1.10 Reclamation works? No Not involved.
1.11 Dredging? No Not involved.
1.12 Offshore structures? No Not involved.
1.13 Production and manufacturing processes? No This is a Residential/ Mix land use project hence, no production or manufacturing activities will be involved.
1.14 Facilities for storage of goods or materials? Yes Temporary storage facilities will be created during construction phase for storage of construction materials.
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? Yes Solid Waste Construction Stage : During construction stage generated solid waste will comprise mainly of construction waste. The construction waste will be reused within the site for various constructions filling work. In addition to that there will be generation of small quantity of municipal waste (78 Kg/Day) from approx. 320 construction labors. It will be ensured that the generated waste will be sent to nearest designated waste storage bins. Operation Stage: Solid waste generation
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 Not applicable
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? 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? No No ground water will be extracted during the construction of the project. Water will be sourced through tanker supplies and treated water will be used after testing and confirmation of fitness for construction. During operation phase, water will be supplied by HUDA.
1.24 Changes in water bodies or the land surface affecting drainage or run-off? Yes Surface drainage may affect due to construction of the project. By considering run off prior to development & run off after development there is some increment in storm water runoff. However runoff generated from the project site during monsoon season will be used to recharge ground aquifer. Network of drainage system developed in the site will be used to collect roof as well as surface runoff. Potential Quantity of runoff will be 49079.34 KL on annual basis which will be recharged to gro
1.25 Transport of personnel or materials for construction, operation or decommissioning? Yes During construction phase transport of personnel as well as construction materials would be required. The personnel would preferably be engaged from nearby areas. Precaution will be taken to reduce the impact of vehicular movement by trying to avoid the vehicular trips during peak hours. Parking will be provided in basement and on surface for the operation phase.
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 Construction phase – Temporary influx of 320 people from the nearby areas is expected. Operation phase – 20369 persons residential + 21922 floating. Total population will be 42291 Nos.
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 None
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 proposed project site has been designated for Residential/ Mix land use development.
2.2 Water (expected source & competing users) unit: KLD Yes Water requirement during construction phase will be met through tanker water supply from nearby STP. During operation phase fresh water demand will be met from Haryana Urban Development Authority (HUDA). Treated water demand for flushing, gardening and DG Set cooling shall be met from treated water from STP installed at Site. 1280 KLD treated water will be used within site premises from STP installed at site.
2.3 Minerals (MT) No Not applicable
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) Yes Construction materials such as Cement, Steel, Bricks, Stone aggregates, and Sand would be required for the project. These will be preferably procured from local reputed licensed vendors.
2.5 Forests and timber (source – MT) No Limited use of timber will be done and it will be restricted to selected locations.
2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW) Yes Power for the proposed project will be supplied by Dakshin Haryana Bijli Vitran Nigam Limited (DHBVNL). Maximum power Demand for the proposed project is 35376 KW. DG sets 43310 KVA(7x2000+13x1500+7x1010+3x750+1x500) will be used as power backup during power failure. HSD (ultra low sulphur variety as per availability) fuel will be used for DG sets.
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 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? No Not applicable.
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 Top soil, generated during earth excavation, will be stacked, covered and preserved for reuse. Top layer of the soil will be used in horticulture development. Remaining soil will be used for site leveling, back filling/filling in raft and road construction.
4.2 Municipal waste (domestic and or commercial wastes) Yes Construction Phase: Municipal solid waste – 78.0 kg/day Operation Phase: Municipal solid wastes – 14.70 TPD The solid waste includes paper, card board, plastic cans etc. and kitchen wastes from houses. Recyclable wastes like card boards and plastic cans will be sold to vendors. There will not be any commercial waste, as this is a Mix land use.
4.3 Hazardous wastes (as per Hazardous Waste Management Rules) Yes Waste oil 41.11 Lts on daily basis from DG sets will be the only hazardous waste generated from the project. This waste oil will be carefully stored in HDPE drums in isolated covered space and sold to recyclers authorized by CPCB/SPCB. Suitable care will be taken so as to prevent spills/ leaks of used oil from storage.
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 Dried sludge from the STP will be used as manure for horticulture development. Surplus manure will be sold to end users: farmers/Nursery.
4.7 Construction or demolition wastes Yes Demolition work is not involved. Construction Work: Excavated soil will be used for back filling. Other construction waste like bricks, concrete etc will be used in sunder/roadworks/manholes etc. Gunny bags, cardboards will be sent to authorize recycler. The inert waste will be sent to land fill site.
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 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 Emission will be from ? Stationary Sources: DG sets of 43310 KVA (7X2000 + 13X1500 + 7X1010 + 3X750 + 1X500) ? Mobile Sources: Vehicular emissions CPCB approved DG sets with acoustic canopy will be used only during power failure.
5.2 Emissions from production processes No Not applicable
5.3 Emissions from materials handling including storage or transport No Fugitive dust emission due to handling and loading - unloading activities is envisaged during construction. Frequent water sprinkling will be done to minimize the fugitive emissions.
5.4 Emissions from construction activities including plant and equipment Yes During the construction phase, major emission will be in the form of fugitive dust, use of DG sets and transportation of construction material.
5.5 Dust or odours from handling of materials including construction materials, sewage and waste Yes The project may cause rise in dust levels during construction phase. Precautions would be taken to reduce dust generation during construction phase: • RMC use will reduce the handling of cement, sand and concrete thus dust emission will be minimized. • Tarpaulins will be used to cover trucks carrying debris. • Water sprinkling will be practiced at regular intervals to reduce dust emissions. • Dust is likely to be generated during operation phase due to movement of vehicles and blowing of ai
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 Burning of any substances including biomass, slash materials and/ or construction debris will be prohibited
5.8 Emissions from any other sources No Nil
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 Noise is expected to be generated during construction phase mainly from operation of heavy machinery, DG sets, and traffic. The indicated noise levels from certain construction plants/equipment are indicated below: ? Concrete Mixer - 85 dBA ? Generator - 95 dBA ? Pumps - 90 - 95 dBA ? Trucks - 85 – 90 dBA For control of noise following measures shall be adopted: • Properly maintained equipment with mufflers will be used. • High noise generat
6.2 From industrial or similar processes No Not applicable
6.3 From construction or demolition Yes Noise Pollution Control: Noise pollution will be due to operation of machinery as well as transportation vehicles. As there is no habitation in nearby area hence there will be negligible impact. However following precautions shall be taken to control noise pollution : High noise generating construction activities would be carried out only during day time. Installation, use and maintenance of mufflers on equipment. Workers working near high noise construction machinery would be supplied
6.4 From blasting or piling No Blasting & piling work is not involved in the project.
6.5 From construction or operational traffic Yes Construction Phase: Welding is light and heat generating activity during construction. Appropriate safety measures will be taken as per I.S. code and CPWD work manual. Materials for construction work. Precautions will be taken to reduce the impact of the vehicular movement such as vehicular trips will not be at peak traffic hours. Operation Phase: Parking is provided in basement and on surface. Vehicular movement is restricted to roads and parking areas. Provision of soft
6.6 From lighting or cooling systems No Nil
6.7 From any other sources No Nil
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 The waste oil generated during operation phase from the DG sets will be collected and separately stored in HDPE drums over concrete floor within the premises before final disposal. All precautionary steps will be taken to avoid spillage It will be directly transferred to authorized recyclers.
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) No Generated Sewage from the project will be treated in the STP proposed onsite, and recycled within the proposed project facility for gardening DG cooling, etc. No surplus treated water will be left for discharging into public sewer. However, during monsoon surplus treated water will be discharged after prior permission from the authority.
7.3 By deposition of pollutants emitted to air into the land or into water No Dust generation during construction phase from earthworks and movement of vehicles is a temporary phenomenon and will have short term impact during construction phase. Appropriate fugitive dust control measures, including water sprinkling of exposed areas and dust covers for trucks, will be provided to minimize any impacts. DG exhaust will be discharged at height stipulated by CPCB.
7.4 From any other sources No Nil
7.5 Is there a risk of long term build up of pollutants in the environment from these sources? No Nil
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 During construction phase, no such risk is anticipated. However, the contractors shall comply with the safety procedures, norms and guidelines as applicable) mentioned in the National Building Code of India and Bureau of Indian Standards. During Operation Phase, all precautionary and safety measures will be taken to minimize any accident hazard.
8.2 From any other causes No Nil
8.3 Could the project be affected by natural disasters causing environmental damage (e.g. floods, earthquakes, landslides, cloudburst etc)? Yes Gurgaon district has no history of natural disasters such as Floods, landslides, cloudburst etc. The site lies in Seismic Zone IV. The construction will be carried out as per the guidelines prescribed for Seismic Zone IV. All the civil structures will be seismically resistant and designed in accordance with provisions recommended related IS codes: IS 4326: 1993 IS 1893 (Part I),2002
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 The project will be equipped with dedicated internal road, parking, internal water distribution system, fire fighting system, internal sewage collection network, lighting facilities, solar lighting, and power backup facility. Increase in water and power demand
9.2 Lead to after-use of the site, which could have an impact on the environment No No
9.3 Set a precedent for later developments Yes This is residential/ Mix land Use development; there will be generation of employment during construction & operation phase.
9.4 Have cumulative effects due to proximity to other existing or planned projects with similar effects Yes Impacts on water availability, storm water drainage, availability of electricity, traffic congestion etc.
(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 Asola wildlife sanctuary: 14.19 Km/NE Aravali Biodiversity Park: 9.70 Km/NE
2 Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests No Does not fall within 15 Km radius.
3 Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration Yes Asola wildlife sanctuary: 14.19 Km/NE Aravali Biodiversity Park: 9.70 Km/NE
4 Inland, coastal, marine or underground waters No Not located within 15 km of the proposed project location.
5 State, National boundaries Yes Delhi Haryana border is at 6.75 km, North-East from the project site .
6 Routes or facilities used by the public for access to recreation or other tourist, pilgrim areas Yes NH-8: 6.53 Km/NW NH-236: 8.48 km/NE SH-13: 1.70 km/W SH-15A: 5.60 Km/NW
7 Defence installations Yes CRPF Kadarpur : 3.15 km/SE
8 Densely populated or built-up area Yes Density of surrounding development is as per master plan and Gurgaon city is 7.0 Km NW direction.
9 Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship, community facilities) Yes Manmade community facilities such as, schools, places of worship areplanned but are not close to the site. These installations will not have any impact due to construction of proposed project.
10 Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Yes Ground water resource in Gurgaon is depleting at very fast rate. The region is declared as a region of scarce ground water resource region.
11 Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) No Nothing specific
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 project is located at Seismic Zone-IV according to Indian Standard Seismic Zoning Map. Structural design will be done for this seismic zone as per code. There are no possibilities of the proposed project site getting flooded and landslidesas per available records.
(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
      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 ApplicantSatya
DesignationManager
Name of Company (Applicant Name should not be given here)M/S MANGALAM MULTIPLEX PVT. LTD.
AddressC-13, Sushantlok, Phase-1, Gurgaon
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