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 Kamarpalli Tin Mining Project Proposed by M/s Koustuv Mining and Smelting Pvt. Ltd.
Brief summary of projectAnnexure-Brief summary of project
Proposal Number IA/OR/MIN/85913/2018
Project Cost 80 lacs
2.
S. No. in the schedule1(a) Mining of minerals
Project Sector Non-Coal Mining
3. Proposed capacity/area/length/tonnage to be handled/command area/lease area/number or wells to be drilled Proposed production is 9 MTPA ha.
4.
New/Expansion/ModernizationNew
5. Existing Capacity/Area etc. 19 ha.
6. Category of project i.e. 'A' or 'B' A
7.
Does it attract the general condition? If yes, please specify Yes
d) Inter-State boundaries and international boundaries
8.
Does it attract the specific condition? If yes, please specify No
9.
Location of the projectNear Village Kamarpalli under P.S Mathili, Tehsil Malkangiri, District Malkangiri, and State Odisha
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.Plot No. N-2/17
Town / VillageKamarpalli under P.S Mathili
State of the projectOrissa
Details of State of the project
S.no State Name District Name Tehsil Name
(1.)OrissaMalkangiriMalkangiri
10.
Nearest railway station along with distance in kms Jeypore Railway Station, 72.67 km
Nearest airport along with distance in kms Jeypore Airport, 72 km
11. Nearest Town/City/District Headquarters along with distance in kms Malkangiri District , 32 km
12. Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given) Village : Kamarpalli under P.S Mathili Tehsil : Malkangiri District : Malkangiri State : Odisha
13. Name of the Applicant Prabhat
14. Registered Address Plot No N-2/17, IRC Village, Nayapalli Bhubaneswar, Odisha
15.
Address for correspondance:
Name of the Company KOUSTUV MINING AND SMELTING PRIVATE LIMITED
Name of the Applicant Prabhat
Designation (Owner/ Partner/ CEO) ManagingDirector
Pin code 751015
E-mail koustuvmining1@gmail.com
Telephone No. 0674-2740133
Fax No. 0674-
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) Yes The existing terrestrial configuration will undergo progressive changes due to mine development (as per the approved Mining Plan).
1.2 Clearance of existing land, vegetation and buildings? Yes No clearance of existing land, vegetation & building is involved.
1.3 Creation of new land uses? Yes Present land use will undergo gradual changes during mine life due to mine development, tin ore extraction, storage, loading/ unloading, transportation, reclamation and rehabilitation. The new land use at the end of mine life will be as follows: 1. Infrastructure like office, first aid center, road and rest shelter etc. 2. Plantation in the safety zone and worked out pit. At the conceptual stage, total excavated area will be back filled and plantation will be done as per CPCB guidelines.
1.4 Pre-construction investigations e.g. bore houses, soil testing? Yes Preconstruction investigations have already been carried out.
1.5 Construction works? Yes The statutory requirements like mine office, store, first aid station, rest shelter; urinals etc. will be constructed in the applied lease area.
1.6 Demolition works? No No demolition works are involved.
1.7 Temporary sites used for construction works or housing of construction workers? Yes All the services and facilities required under the Mine Act (Regulations, Rules and Bye-laws made there under) have been provided at the Koustuv Mine. These include Rest Shelters, First Aid center etc. In addition, a site office is also provided at the site.
1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations Yes The statutory requirements like mine office, store, first aid station, rest shelter; urinals etc. is already present in the applied area.
1.9 Underground works including mining or tunnelling? No No underground working/mining is involved in lease area.
1.10 Reclamation works? Yes At the conceptual stage, total excavated area will be backfilled and plantation will be done as per CPCB guidelines
1.11 Dredging? No No dredging will be involved.
1.12 Offshore structures? No No offshore structure will be involved.
1.13 Production and manufacturing processes? Yes The project involves opencast mining. The production of tin ore involves excavation, loading, unloading & transportation activities.
1.14 Facilities for storage of goods or materials? No No permanent storage is required, as the mineral which is excavated will be transported from mine site to required destination.No permanent storage is required, as the mineral which is excavated will be transported from mine site to required destination.
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? Yes The waste generated during mining will be utilized for backfilling of the mined out land which will commence after the completion of the exploration proposal. There will not be any kind of liquid waste generation from the mine.
1.16 Facilities for long term housing of operational workers? Yes All the Services and facilities required under the Mine Act (Regulations, Rules and Bye-laws made there under) have been provided at the Koustuv Mine. These include a Rest Shelters, First Aid Center. In addition, a site office and public conveniences are also provided.
1.17 New road, rail or sea traffic during construction or operation? No Existing road infrastructure meets the requirement. Hence, no new road, rail or sea traffic is proposed.
1.18 New road, rail, air water borne or other transport infrastructure including new or altered routes and stations, ports, airports etc? No The area is well connected by road. It has been proposed to connect the network of mine roads for all activities concerning the mining operation.
1.19 Closure or diversion of existing transport routes or infrastructure leading to changes in traffic movements? No There is no closure or diversion of existing routes or infrastructure for the proposed project
1.20 New or diverted transmission lines or pipelines? No There are no new or diverted transmission lines or pipelines in the project site.
1.21 Impoundment, damming, culverting, realignment or other changes to the hydrology of watercourses or aquifers? No There is no water course falling in the applied area.
1.22 Stream crossings? No There is no stream (perennial or seasonal) present within the applied area.
1.23 Abstraction or transfers of water from ground or surface waters? Yes Total water requirement will be 22.0 KLD. Out of which, 4.0 KLD will be used for domestic purpose, 10 KLD for dust suppression (water sprinkling on haulage roads) and rest (8.0 KLD) will be used for plantation. Source: Water will be made available through by nearby village. Rain water collected in the mine pits will also be utilized for plantation and dust suppression.
1.24 Changes in water bodies or the land surface affecting drainage or run-off? No Surface and ground water will not be affected due to mining activity. There is no perennial source of water within the leasehold area. Further there is no cause of contamination of water, as no industrial effluent will be discharged.
1.25 Transport of personnel or materials for construction, operation or decommissioning? Yes The staff and the workers involved in the project will use the local transport for commutation to the project area. Overburden will be carried to the waste dump by a 10 t dumpers and the tin bearing gravel material will also be transported to the stack as well as to the washing plant by the dumpers for panning to recover tin ore. Tippers of 10 tonne capacity will be deployed on hire basis for transportation of salable tin ore to the destination point
1.26 Long-term dismantling or decommissioning or restoration works? Yes Mine will be systematically closed as per approved closure plan.
1.27 Ongoing activity during decommissioning which could have an impact on the environment? No Not envisaged.
1.28 Influx of people to an area in either temporarily or permanently? No Mostly local people/villagers will be deployed to carry out mineral extraction. So influx of people is envisaged temporarily.
1.29 Introduction of alien species? No There would be no introduction of any alien species since local species would be preferred for the plantation.
1.30 Loss of native species or genetic diversity? No Loss of native species or genetic diversity is not envisaged. Plantation will be done as per guidelines of CPCB.
1.31 Any other actions? No Not envisaged.
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 total land is 19.0 Ha, out of which 11.80 is agricultural land and 7.20 Ha is waste land.
2.2 Water (expected source & competing users) unit: KLD Yes Total water requirement will be 22.0 KLD. Out of which, 4.0 KLD will be used for domestic purpose, 10 KLD for dust suppression (water sprinkling on haulage roads) and rest (8.0 KLD) will be used for plantation. Source: Water will be made available through by nearby village. Rain water collected in the mine pits will also be utilized for plantation and dust suppression.
2.3 Minerals (MT) No No raw materials are required for mining operation.
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) No There is no permanent construction needed in the lease area hence no construction material will be used.
2.5 Forests and timber (source – MT) No No use of timber is envisaged.
2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW) Yes No Electricity is required as the machinery used in the mining operations will be diesel operated.
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 No No such hazardous substances or materials is expected which will impose ill effect to human health and environment.
3.2 Changes in occurrence of disease or affect disease vectors (e.g. insect or water borne diseases) No No such diseases envisaged.
3.3 Affect the welfare of people e.g. by changing living conditions? Yes The project will provide direct as well as indirect employment to the local people. It will help in improving socio- economic status and the living standards of people. CSR activity will help in infrastructure development, and improve educational & medical facilities. A positive effect is envisaged in the elevation of living standards of the people by generating employment and several other indirect opportunities.
3.4 Vulnerable groups of people who could be affected by the project e.g. hospital patients, children, the elderly etc. No No vulnerable groups of people will be affected by the project.
3.5 Any other causes No Nil
4 Production of solid wastes during construction or operation or decommissioning (MT/month)
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
4.1 Spoil, overburden or mine wastes Yes A quantity of 156384 m3 OB waste will be generated during the first five year period. Waste generated from the pit is proposed to be dumped in the north-eastern side of the lease. However, to prove the barrenness of dumping ground borehole 1, 2 & 3 will be put in the first year of the plan period. If the area is found to be potential, then waste will be used for reclamation purpose as soon as the excavated mine is exhausted.
4.2 Municipal waste (domestic and or commercial wastes) Yes Very insignificant quantity of domestic wastes will be generated by the labors at the project site.
4.3 Hazardous wastes (as per Hazardous Waste Management Rules) No No Hazardous waste will be generated. In case, if generated Hazardous Waste management rules will be followed.
4.4 Other industrial process wastes No There is no industrial process involved in the project.
4.5 Surplus product No There is no surplus products will be generated.
4.6 Sewage sludge or other sludge from effluent treatment No There is no effluent treatment plant in the proposed project
4.7 Construction or demolition wastes No No construction or demolition waste is envisaged.
4.8 Redundant machinery or equipment No There is no redundancy of machineries involved, as the machinery are movable and will be removed from the mine lease area after the mining is over and will be used elsewhere.
4.9 Contaminated soils or other materials No No contamination of soil or other material is expected.
4.10 Agricultural wastes No There are no agricultural wastes involved.
4.11 Other solid wastes No No other solid waste will be generated.
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 There will be emissions from vehicles & machineries, engaged for excavation and transportation. It will be managed by the following methods: Proper maintenance of vehicles and machines. PUC certified vehicles will be allowed for transportation purposes.
5.2 Emissions from production processes Yes There will be some dust emission from production process. However, imitative measures such as water sprinkling and plantation would be taken to control dust pollution.
5.3 Emissions from materials handling including storage or transport Yes The loading of materials and transportation will lead to generation of dust pollutants.
5.4 Emissions from construction activities including plant and equipment Yes There will be no emission from any such activity namely construction, plant and machinery equipment.
5.5 Dust or odours from handling of materials including construction materials, sewage and waste Yes Dust will get generated during loading/unloading operations. Dust suppression will be done.
5.6 Emissions from incineration of waste No No incineration activity is involved in the proposed mining project.
5.7 Emissions from burning of waste in open air (e.g. slash materials, construction debris) No No waste of any kind will be burnt in the open air.
5.8 Emissions from any other sources No There is no other source of emission.
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 will be generated due to machineries deployed in the area. Precaution and regular maintenance of excavator, replacement of damaged/ worn out parts when ever required will be taken up. Ear plugs will be provided to the persons exposed to high noise level.
6.2 From industrial or similar processes No There will not be any industrial process involved.
6.3 From construction or demolition No No construction or demolition is involved
6.4 From blasting or piling No Overburden as well as tin bearing gravel horizon both are soft in nature, therefore by using crowbar, pickaxe, spade, chisel, hand shovel etc by hence, no drilling/blasting are required for excavation.
6.5 From construction or operational traffic Yes Due to vehicular traffic and material transportation within applied area, noise will be generated but measures will be taken up to control the noise levels within the DGMS & CPCB norms.
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 No Nil
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) No No effluent and sewage will be generated from the proposed project operations. The rain water stored in the mine pits will be utilized for water spraying, plantation and other mining work.
7.3 By deposition of pollutants emitted to air into the land or into water No The insignificant dust emission will be generated in the mine site & surrounding, which shall be suppressed by the water sprinkling during mining, on haul roads & on transportation roads. This insignificant dust emission will not cause any contamination into land or water.
7.4 From any other sources No There is no other source from which risk of contamination is anticipated.
7.5 Is there a risk of long term build up of pollutants in the environment from these sources? No There is no risk of long term buildup of pollutants in the environment from the proposed project operations
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 Not applicable.
8.2 From any other causes Yes Accidents due to human error may occur while operating the machineries. However, adequate training will be given to the workers for safe handling of the machinery. The workers will be trained to ensure safe driving.
8.3 Could the project be affected by natural disasters causing environmental damage (e.g. floods, earthquakes, landslides, cloudburst etc)? No The project is under Seismic Zone II. Therefore it has less risk from earthquake. The project area is not prone to floods, landslides or cloudbursts etc.
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 proposed project will result to the development of better living standards of the surrounding areas by increasing direct and indirect employment opportunities for the local job seekers.
9.2 Lead to after-use of the site, which could have an impact on the environment Yes The mine will be systematically and scientifically closed as per mine closure plan. Plantation will also be carried out which will improve the green coverage
9.3 Set a precedent for later developments Yes The mine will be developed in an ideal manner causing no harm to environment.
9.4 Have cumulative effects due to proximity to other existing or planned projects with similar effects Yes No major industry except few mines of minerals is located in the 10 km area. Thus there is likelihood of cumulative effect due to transportation of mineral.
(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 Kanger Valley National Park is present within 15 Km of the project site.
2 Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Yes Sabari River is about 2.50 km in South direction.
3 Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration No Nil
4 Inland, coastal, marine or underground waters No No such area is located within 15 km radius
5 State, National boundaries Yes Interstate Boundary of Chattishgarh and Odisha in 0.50 km in North direction
6 Routes or facilities used by the public for access to recreation or other tourist, pilgrim areas Yes NH-221 is about 11.18 km in NW direction.
7 Defence installations No No such defense installation exists.
8 Densely populated or built-up area Yes Chitalner is about 11.18 km in NW direction Talnat is about 8 km in North direction Akuru is about 12.5 km in SE direction Tongpal is about about 13.23 km in South direction
9 Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship, community facilities) Yes School temple Chitalner is about 11.18 km in NW direction
10 Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) No No such area is located within 15 km radius
11 Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) No No such area is located within 15 km radius
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 Earthquake : Zone II Low Damage Risk Zone Flood : No Flood Zone Wind & Cyclone : Moderate Damage Risk Zone (Source: Envis Center of Odisha State Government 2017)
(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
5Uploaded Approval of mining PlanN/A
            Essential Detail Sought:
Sno. EDS Letter Remarks Date of EDS
1.NAThe pp has earlier applied vide proposal No. IA/OR/MIN/69739/2017. The Ministry has sought certain information with regard to validity of mine documents howover pp has not submitted the information. Further now pp is applied with different proposal no. and also not uploaded the lease related documents which were sought earlier also. Therefore pp is requested to submit for justification for applying new proposal, when already a proposal submitted to ministry along with above mentioned documents. Further pp also need to submit i) Details of past production of mine since its inception, duly authenticated by Department of Mines & Geology, State Govt. (ii) Compliance of order dated 2.8.2017 in CWP No. 114/2014 of Hon'ble Supreme Court Judgement in Common Cause Matter (iii) Details of demand if any raised by Department of Mining and Geology, State Govt. (iv) Details of payment, if any made to Department of Mines & Geology, State Govt. 07 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 ApplicantPrabhat
DesignationManagingDirector
Name of Company (Applicant Name should not be given here)KOUSTUV MINING AND SMELTING PRIVATE LIMITED
AddressPlot No N-2/17, IRC Village, Nayapalli Bhubaneswar, Odisha
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