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 Tel Integrated Multipurpose Project
Brief summary of projectAnnexure-Brief summary of project
Proposal Number IA/OR/RIV/81538/2018
Project Cost 174920 lacs
2.
S. No. in the schedule1(c) River Valley projects
Project Sector River Valley and Hydroelectric Projects
3. Proposed capacity/area/length/tonnage to be handled/command area/lease area/number or wells to be drilled 1636.6 ha.
4.
New/Expansion/ModernizationNew
5. Existing Capacity/Area etc. 0 ha.
6. Category of project i.e. 'A' or 'B' A
7.
Does it attract the general condition? If yes, please specify No
8.
Does it attract the specific condition? If yes, please specify No
9.
Location of the projectOrissa
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.65I1,65I2,65I5,65I6
Town / VillagePhatki
State of the projectOrissa
Details of State of the project
S.no State Name District Name Tehsil Name
(1.)OrissaNabarangpurChandahandi
10.
Nearest railway station along with distance in kms Jeypore, 95 km
Nearest airport along with distance in kms Visakhapatnam, 260 km
11. Nearest Town/City/District Headquarters along with distance in kms Chandanhandi , 20 km
12. Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given) Executive Engineer,Kalahandi Investigation Division, Bhawanipatna,766001 Ph:06670-234055, 9437877776
13. Name of the Applicant Ramesh
14. Registered Address Executive Engineer, Kalahandi Investigation Division, Bhawanipatna
15.
Address for correspondance:
Name of the Company EXECUTIVE ENGINEER KALAHANDI INVESTIGATION DIVISION
Name of the Applicant Ramesh
Designation (Owner/ Partner/ CEO) Executive Engineer
Pin code 766001
E-mail eekalahandienvironment@gmail.com
Telephone No. 06770-234055
Fax No. 06770-
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?Yes
StatusApplication for Forest Clearance yet to be submitted
(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?Yes
Area of Forest land Involved (hectares)637.6 ha.
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 Tel Integrated project envisages to create irrigation potential and generate hydro-power. It is proposed to construct a dam across river Tel, a tributary of Mahanadi with a submergence area of 1330 ha. The water from reservoir will be carried through Power House - 1 & 2 located at lower altitude on the right side of Tel River near village Phatki in Orissa. The water released from power house will be picked up by proposed Barrage with FRL 320m and from there a canal of length about 23.395 km w
1.2 Clearance of existing land, vegetation and buildings? Yes About 637.6 ha of forest land will be acquired for the project, which will be cleared. Likewise, homesteads, buildings, etc. would also be cleaned prior to start of construction.
1.3 Creation of new land uses? Yes The proposed project will provide irrigation over an area of 9903 ha. The area under barren land will be converted to agricultural land. Land will be acquired for construction of various project appurtenances including water conveyance system, canal network etc.
1.4 Pre-construction investigations e.g. bore houses, soil testing? Yes Bore hole drilling, soil sampling etc. are proposed as a part of investigations activities.
1.5 Construction works? Yes • • Earth and Rockfill Dam across Tel River, a tributary of Mahanadi Riverdam • Chute spillway of length 197.5 m and crest level at 494 m. • Intake Structure designed for 13.6 m3/s discharge having Intake gate, stop log gate, Trash rack • Pressure Conduit 2.5 m square section • Head Race tunnel 2.5 m finished dia., Horse Shoe shaped-270 m long • Penstock 100 m long, 2.0 m dia. bifurcating to two unit penstocks of 1.40 m dia. • Reducer from 1.40 m dia. to 1.22 m dia. at D-line of Power h
1.6 Demolition works? Yes Acquired structures, if any, to be demolished to the extent required. The details shall be assessed during investigation stage as a part of preparation of Detailed Project Report and CEIA Report.
1.7 Temporary sites used for construction works or housing of construction workers? Yes A colony will be constructed for labour and technical staff involve in construction activities.
1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations Yes • Earthen Dam of length 3682 m and maximum height of 87 m. • Chute spillway of length 197.5 m and crest level at 494 m. • Barrage of height 5.4 m and length 79 m. • Two surface Power house having installed capacity of 18 MW. • A main canal of length 23.395 Km will take off from the Barrage at Phatki with FSL 324.5 m and it will cross over the Banjari Nallah through an aqueduct.
1.9 Underground works including mining or tunnelling? No
1.10 Reclamation works? Yes The site shall be suitably landscaped so that it integrates with the natural surroundings.
1.11 Dredging? No
1.12 Offshore structures? No
1.13 Production and manufacturing processes? No
1.14 Facilities for storage of goods or materials? Yes Facility for temporary storage of cement, steel, E&M, HM equipment, aggregate / sand etc shall be created
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? Yes During construction phase, labour colonies are proposed to be located at various locations close to major construction sites. About 500 labour and 100 technical staff are likely to congregate in the area during construction phase. The increase in population is expected to be of the order of 2400. The average per capita solid waste generated is of the order of 210 gm/day/person. The solid waste likely to be generated from labour camps shall be of the order of 0.50 tonne/day. Adequate facilitie
1.16 Facilities for long term housing of operational workers? Yes A colony of about 50 quarters for operation phase besides Infrastructure facilities, like potable water supply, sewage treatment, solid waste management etc shall be provided.
1.17 New road, rail or sea traffic during construction or operation? Yes The dam site is approachable from 20 miles of Umerkota-Chandahandi road. There is no road to the dam site. One temporary road is maintained for investigation purpose. A road for a length of 4 km has to be constructed with a number of CD works to make the site approachable throughout the year.
1.18 New road, rail, air water borne or other transport infrastructure including new or altered routes and stations, ports, airports etc? Yes Roads will be constructed as a part of the project, as per the requirement. The details shall be given in the DPR and suitably covered in the CEIA report.
1.19 Closure or diversion of existing transport routes or infrastructure leading to changes in traffic movements? No
1.20 New or diverted transmission lines or pipelines? No
1.21 Impoundment, damming, culverting, realignment or other changes to the hydrology of watercourses or aquifers? Yes The Tel Integrated Multipurpose Project system involves a large storage (dam), a diversion structure, two new irrigation command areas and a command area for stabilization. The FRL of the dam is proposed at RL 500m with maximum height of dam is proposed to be 87 m to have water spread area of 1330 ha. The gross storage capacity of the proposed reservoir is 238.76 mcm measures, for amelioration of adverse impacts on riverine fishes including migratory fish species shall be suggested as a part o
1.22 Stream crossings? Yes A main canal of length 23.395 km will off take from the Barrage at Phatki with FSL 324.5 m and will cross over the Banjari Nallah through an aqueduct.
1.23 Abstraction or transfers of water from ground or surface waters? Yes The proposed project will carry water of river Tel, a tributary of river Mahanadi for irrigation of a command area of 9903 ha and generation of 18 MW power.
1.24 Changes in water bodies or the land surface affecting drainage or run-off? Yes The proposed project shall lead to the submergence over an area of the 1330 ha land. The area under forests, settlements, agriculture will be submerged, resulting in its pre-project change in land use. The command area of proposed project is 9903 ha. The land use will change on account of increased water availability for irrigation. Vegetal cover will improve on account of increased moisture availability. The increased water availability could lead to increased waterlogging. The above aspects
1.25 Transport of personnel or materials for construction, operation or decommissioning? Yes The earth required for the dam will be available in the reservoir area within a lead of 5 km. Stone can be quarried from the surrounding hills within a lead of 5 km miles. The sand shall be collected and quarried from river Tel after it has entered the plains and will be available within 19 km distance from the dam site. For canal works, sand will be available within an average lead of 6.5 km and stone products within a lead of 8 km.
1.26 Long-term dismantling or decommissioning or restoration works? Yes During decommissioning or restoration works, air water and noise pollution is expected to be generated. Likewise, large quantum of solid waste is expected to be generated. The norms for environmental management at the time of dismantling or decommissioning shall be followed. A detailed plan for restoration of construction sites shall be prepared as a part of EMP Report
1.27 Ongoing activity during decommissioning which could have an impact on the environment? Yes During decommissioning phase, air, water and noise pollution is expected to be generated. Likewise, large quantum of solid waste mainly construction waste is expected to be generated. The norms for environmental management, i.e., air, water, noise and solid waste management at the time of decommissioning shall be followed.
1.28 Influx of people to an area in either temporarily or permanently? Yes About 100 technical and 500 construction staff will be employed during construction phase. The labour population and technical staff shall stay in various camps or colonies close to the major construction sites. Most of the workers will migrate form out side areas. Only few workers amongst local population in unskilled category may be deployed during construction phase, who shall come from the nearby areas.
1.29 Introduction of alien species? No
1.30 Loss of native species or genetic diversity? Yes About 637.6 ha of forest area shall be acquired for various project appurtenances. The impacts on native species or genetic diversity shall be studied as a part of CEIA study. If required, appropriate management measures shall also be suggested as a part of the EMP Report
1.31 Any other actions? No
2 Use of Natural resources for construction or operation of the Project (such as land, water, materials or energy, especially any resources which are non-renewable or in short supply):
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
2.1 Land especially undeveloped or agricultural land (ha) Yes The command area of proposed project is 9903 ha. The proposed project shall cause the submergence of 1330 ha land. Land will be acquired for construction of various project appurtenances including submergence area, water conveyance system, canal network etc. The details of land to be acquired for the project shall be assessed as a part of the CEIA study.
2.2 Water (expected source & competing users) unit: KLD Yes The quantity of water required during construction and operation phases would be 0.32 mld and 0.075 mld respectively. During construction and operation phases, of water would be required for meeting domestic requirements for construction staff / technical staff. The water would be analyzed and would be disinfected, if required.
2.3 Minerals (MT) No
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) Yes The earth required for the dam will be available in the reservoir area within a lead of 5 km. Stone is proposed to be quarried from the surrounding hills within a lead of 5 km. The sand shall be collected and quarried from river Tel after it has entered the plains and will be available within 20 km distance from the dam site. For construction of canal, sand will be available within an average lead of 6.5 km and stone products within a lead of 8 km.
2.5 Forests and timber (source – MT) Yes Forest land will be acquired for the project. However use of timber shall be discouraged and alternatives will be provided.
2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW) Yes The power supply shall be met from 33 KV available at Jharigaon and Chandahandi. DG sets of adequate capacity shall be installed for use in the event of power failure.
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
3.2 Changes in occurrence of disease or affect disease vectors (e.g. insect or water borne diseases) Yes Normally an irrigation and hydroelectric project increases the incidence of vector-borne diseases on account of increased water availability, which leads to formation of stagnant pools of water in command area, canal etc. This could lead to increase in proliferation of mosquitoes, which leads to increased incidence of vector-borne diseases, namely malaria. This aspect will be studied as a part of CEIA study and adequate measures shall be implemented during project construction and operation
3.3 Affect the welfare of people e.g. by changing living conditions? Yes The details of various welfare schemes for locals shall be outlined as a part of Local Area Development Plan (LADP). The LADP shall be outlined in the Comprehensive EIA Report.
3.4 Vulnerable groups of people who could be affected by the project e.g. hospital patients, children, the elderly etc. Yes This aspect will be covered in detail as a part of the CEIA study.
3.5 Any other causes No
4 Production of solid wastes during construction or operation or decommissioning (MT/month)
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
4.1 Spoil, overburden or mine wastes Yes In the proposed project, it is proposed to collect the construction waste from various construction sites, and disposed off at sites identified in consultation with the district administration. Various construction sites would be properly levelled. The levelling or reclamation of various construction sites, shall be made mandatory for the contractor, involved in the construction work. The details of the same shall be covered as a part of EMP to be presented as a part of the CEIA study.
4.2 Municipal waste (domestic and or commercial wastes) Yes About 500 labour and 100 technical staffs are likely to congregate in the area during construction phase. The increase in population is expected to be of the order of 2400. The average per capita solid waste generated is of the order of 210 gm/day/person. The solid waste likely to be generated from labour camps shall be of the order of 10.5 tonne/day. Adequate facilities for collection, conveyance and disposal of solid waste shall be developed. For solid waste collection, number of masonry st
4.3 Hazardous wastes (as per Hazardous Waste Management Rules) No
4.4 Other industrial process wastes No
4.5 Surplus product No
4.6 Sewage sludge or other sludge from effluent treatment Yes During construction phase, sludge generated from secondary settling tank shall be dried in sludge drying beds. The dried sludge shall be disposed off by land filling or sold to the farmers who can use the same as fertilizer.
4.7 Construction or demolition wastes No
4.8 Redundant machinery or equipment Yes Redundant machinery/ equipment shall be taken back out of the project on completion of construction activities.
4.9 Contaminated soils or other materials No
4.10 Agricultural wastes Yes The proposed project shall provide irrigation over an area of 9903 ha. The increased agriculture production would lead to generation of increased agricultural waste. Appropriate measures for their reuse and disposal of agricultural waste shall be suggested as a part of the EIA study.
4.11 Other solid wastes No
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 operation of various construction equipment requires combustion of fuel. Normally diesel is used in such equipments. The major pollutant which gets emitted as a result of fuel combustion is SO2. The SPM emission is minimum due to low ash content in diesel. The short term increase in SO2, even assuming all the equipment are operating at a common point is expected to be quite low. Thus, no major adverse impact on ambient air quality is anticipated during construction phase
5.2 Emissions from production processes No
5.3 Emissions from materials handling including storage or transport Yes During construction phase there will be increase in vehicular movement. Construction material will be brought and stored at various sites. Due to blowing of wind especially when environment is dry, some of the stored material can get entrained in the atmosphere. However, impact on this account is not expected to be significant.
5.4 Emissions from construction activities including plant and equipment Yes The operation of various construction equipments require combustion of fuel. Normally diesel is used in such equipments. The major pollutant which gets emitted as a result is SO2. The SPM emission is minimum due to low ash content in diesel. The short term increase in SO2, even assuming all the equipment are operating at a common point is expected to be quite low. Thus, no adverse impacts on ambient air quality is anticipated
5.5 Dust or odours from handling of materials including construction materials, sewage and waste No
5.6 Emissions from incineration of waste No
5.7 Emissions from burning of waste in open air (e.g. slash materials, construction debris) No
5.8 Emissions from any other sources No
6 Generation of Noise and Vibration, and Emissions of Light and Heat:
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
6.1 From operation of equipment e.g. engines, ventilation plant, crushers Yes Noise will be generated during construction phase as a result of operation of construction equipment. As a part of the CEIA study, detailed noise modeling study shall be conducted to predict the increase in noise level due to various construction activities including operation of various construction equipment, increased vehicular movement, etc.
6.2 From industrial or similar processes No
6.3 From construction or demolition Yes Noise will be generated during construction phase as a result of operation of construction equipment. As a part of the CEIA study, detailed noise modeling study shall be conducted to predict the increase in noise level due to various construction activities including operation of various construction equipment, increased vehicular movement, etc.
6.4 From blasting or piling Yes 80 to 90 dB(A)
6.5 From construction or operational traffic Yes During construction phase, there will be increase in vehicular movement for transportation of construction material. Based on past experience, impacts on ambient noise levels due to operation of construction equipment, and increased vehicular movement is not expected to be significant. However, this aspect shall be covered in detail though detailed modeling study as a part of the CEIA study.
6.6 From lighting or cooling systems No
6.7 From any other sources No
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
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) Yes Sewage generated from labour camp shall be treated in a sewage treatment plant and secondary settling tank and disposed on land or water at sites identified in consultation with the respective district administration.
7.3 By deposition of pollutants emitted to air into the land or into water Yes The solid waste generated from the labour camps shall be suitably collected and disposed by land filling and composting as mentioned in response to earlier question. The details of the solid waste disposal facilities shall be covered as a part of the EIA study.
7.4 From any other sources No
7.5 Is there a risk of long term build up of pollutants in the environment from these sources? No
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 Explosives shall be used very carefully by the experienced and certified persons. Blasting shall be done in accordance with the rule applicable of such work confirming all codes in respect of safety of human being and other objects.
8.2 From any other causes No
8.3 Could the project be affected by natural disasters causing environmental damage (e.g. floods, earthquakes, landslides, cloudburst etc)? No
9 Factors which should be considered (such as consequential development) which could lead to environmental effects or the potential for cumulative impacts with other existing or planned activities in the locality
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
9.1 Lead to development of supporting utilities, ancillary development or development stimulated   by the project which could have impact on the environment e.g.:
  • Supporting infrastructure (roads, power supply,waste or waste water treatment, etc.)
  • housing development
  • extractive industries
  • supply industries
  • Other
Yes About 2400 labour population and technical staff and their families are likely to deploy during construction phase. The availability of infrastructure could be a problem during the initial construction phase. As a part of Environmental Management Plan, following facilities shall be developed for the construction staff/ technical staff likely to be deployed during project construction phase : • Potable water supply • Community toilets and sewage treatment • Free fuel like LPG/ Ke
9.2 Lead to after-use of the site, which could have an impact on the environment No
9.3 Set a precedent for later developments Yes Increase in agriculture production Improvement in livestock Employment generation Urbanization Industrialization Power Generation Other changes
9.4 Have cumulative effects due to proximity to other existing or planned projects with similar effects No
(III) Environmental Sensitivity
S.No Areas Name/Identity Aerial distance (within 15km.) Proposed project location boundary
1 Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
No
2 Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Yes A detailed ecological survey shall be conducted for three seasons as a part of the CEIA study to assess the status of flora and fauna in the project area. Based on impacts assessment, appropriate management measures too will be suggested as part of EMP.
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 project is to be developed on river Tel, a tributary of Mahanadi
5 State, National boundaries No The boundary of the state of Chattisgarh is located within 1.5 km from the project site
6 Routes or facilities used by the public for access to recreation or other tourist, pilgrim areas No
7 Defence installations No
8 Densely populated or built-up area No
9 Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship, community facilities) Yes The details of sensitive man-made land uses, i.e., hospitals, schools, places of worship, community facilities will be collected as a part of the CEIA study.
10 Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) No
11 Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) No
12 Areas susceptible to natural hazard which could cause the project to present environmental problems (earthquakes, subsidence, landslides, erosion, flooding or extreme or adverse climatic conditions) similar effects No
(IV) Proposed Terms of Reference for EIA studies
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 ApplicantRamesh
DesignationExecutive Engineer
Name of Company (Applicant Name should not be given here)EXECUTIVE ENGINEER KALAHANDI INVESTIGATION DIVISION
AddressExecutive Engineer, Kalahandi Investigation Division, Bhawanipatna
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