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 Parwan Major Multipurpose Irrigation Project (Phase II )
Brief summary of projectAnnexure-Brief summary of project
Proposal Number IA/RJ/RIV/75576/2018
Project Cost 68298 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 201650 ha.
4.
New/Expansion/ModernizationExpansion
Proposal NumberIA/RJ/RIV/75574/2007
MoEFCC file number(Previous EC)j12011
Uploaded EC letterAnnexure-Uploaded EC letter
5. Existing Capacity/Area etc. 131400 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 projectJhalawar
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.54D10
Town / VillageJhalawar, Baran, Kota
State of the projectRajasthan
Details of State of the project
S.no State Name District Name Tehsil Name
(1.)RajasthanJhalawarKhanpur
10.
Nearest railway station along with distance in kms jhalawar, 50 km
Nearest airport along with distance in kms Indore, 250 km
11. Nearest Town/City/District Headquarters along with distance in kms Jhalawar , 50 km
12. Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given) Panchyat Samiti Diogod,Sangod, Panchyat Samiti Kishanganj, Baran, Mangrol, Chipabarod, Atru, PS Khanpur
13. Name of the Applicant Dheeraj
14. Registered Address Parwan Dam Division I, J PAtan Road near Jawahar colony Jhalawar
15.
Address for correspondance:
Name of the Company PARWAN DAM DIVISION I JHALAWAR
Name of the Applicant Dheeraj
Designation (Owner/ Partner/ CEO) EE
Pin code 326001
E-mail eewrparwan@gmail.com
Telephone No. 7432-233385
Fax No. 7432-
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 Irrigation potential in 70,000 Ha land will change status of land from un-irrigated to irrigated land.
1.2 Clearance of existing land, vegetation and buildings? Yes Mostly existing drainage land is proposed to be used in Phase II. Other land will be acquired as per prevailing LA Act.
1.3 Creation of new land uses? No No new land use is proposed in the project.
1.4 Pre-construction investigations e.g. bore houses, soil testing? Yes Pre construction investigations like survey of potential area for irrigation have been done. Similarly major construction activity in the form of construction of Dam is under progress.
1.5 Construction works? Yes Major construction works are under progress.
1.6 Demolition works? No
1.7 Temporary sites used for construction works or housing of construction workers? No Temporary sites for major construction workers have already been established at land allotted to department for the purpose.
1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations Yes Project comprises mainly in terms of Earthwork, construction of linear structures for canal network etc will be carried out.
1.9 Underground works including mining or tunnelling? No No mining or tunneling works are proposed in Phase II of the project.
1.10 Reclamation works? No Not required
1.11 Dredging? No Not required
1.12 Offshore structures? No Not required
1.13 Production and manufacturing processes? No Not required
1.14 Facilities for storage of goods or materials? No Not required
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? No Not required
1.16 Facilities for long term housing of operational workers? Yes Housing u nits considered at Pump Houses proposed in project Phase II
1.17 New road, rail or sea traffic during construction or operation? No Not required
1.18 New road, rail, air water borne or other transport infrastructure including new or altered routes and stations, ports, airports etc? No Not required
1.19 Closure or diversion of existing transport routes or infrastructure leading to changes in traffic movements? No Not required
1.20 New or diverted transmission lines or pipelines? No Not required
1.21 Impoundment, damming, culverting, realignment or other changes to the hydrology of watercourses or aquifers? No No changes to hydrology is expected/ anticipated in this Phase II of the project. No new dam is proposed in this phase.
1.22 Stream crossings? Yes Aquaducts are proposed where ever proposed canal network crosses natural stream, nallah or river.
1.23 Abstraction or transfers of water from ground or surface waters? Yes By introducing canal irrigation in the area, not only groundwater recharge will increase but also extraction of groundwater for irrigation will reduce. Both these will help aquifer in transforming from Dark Zone to safe zone.
1.24 Changes in water bodies or the land surface affecting drainage or run-off? No Only approved & Potential Water yield will be harnessed.
1.25 Transport of personnel or materials for construction, operation or decommissioning? No The major construction work is already in progress. Now this second phase is a linear project & does not involve mass transport of personnel or material for construction.
1.26 Long-term dismantling or decommissioning or restoration works? No Not required
1.27 Ongoing activity during decommissioning which could have an impact on the environment? No Not required
1.28 Influx of people to an area in either temporarily or permanently? No No temporarily or permanently influx of people is anticipated.
1.29 Introduction of alien species? No
1.30 Loss of native species or genetic diversity? No
1.31 Any other actions? Yes The project will bring water to the water deficit areas & will result in increase in vegetation cover, environment and socio-economic conditions of the habitats.
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 Project does not involves any physical changes in the locality in terms of topography, land use etc. Rather project will improve existing land use by introduction of irrigation in the area.
2.2 Water (expected source & competing users) unit: KLD Yes Water is required only for construction purposes which will be met through adjoining rivers. The project will enable water availability for irrigation, drinking & other intended usages.
2.3 Minerals (MT) Yes Minerals like stone, aggregates, sand, cement & steel will be used for construction purposes.
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) Yes Stone, aggregates & sand will be required & as project is in the vicinity of town area, these materials will be made available from market. The approximate requirement of materials is as under: Stone: 7000 MT Aggregates: 55000 MT Sand: 60000 MT
2.5 Forests and timber (source – MT) No There is no requirement of forest & timber.
2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW) Yes Energy will be required for construction purposes only in the form of fuel i.e. Diesel which is readily available in open market for O&M of plant & machinery.
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 Project does not include use of any hazardous material.
3.2 Changes in occurrence of disease or affect disease vectors (e.g. insect or water borne diseases) No
3.3 Affect the welfare of people e.g. by changing living conditions? Yes By introducing irrigation is the area, living conditions of the people will improve.
3.4 Vulnerable groups of people who could be affected by the project e.g. hospital patients, children, the elderly etc. No
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 No Major construction works have already under execution. In present project phase construction is mainly for canal construction which does not involve too much mining activity.
4.2 Municipal waste (domestic and or commercial wastes) No
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 No
4.7 Construction or demolition wastes No
4.8 Redundant machinery or equipment No
4.9 Contaminated soils or other materials No
4.10 Agricultural wastes No
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 No
5.2 Emissions from production processes No
5.3 Emissions from materials handling including storage or transport No
5.4 Emissions from construction activities including plant and equipment Yes Minor emissions are anticipated due to O&M of construction plant & machinery.
5.5 Dust or odours from handling of materials including construction materials, sewage and waste Yes Minor dust may be possible due to O&M of construction plant & machinery.
5.6 Emissions from incineration of waste No Minor dust may be possible due to O&M of construction plant & machinery.
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 Minor generation of noise, vibrations etc may be possible due to O&M of construction plant & machinery.
6.2 From industrial or similar processes No
6.3 From construction or demolition Yes Minor generation of noise, vibrations etc may be possible due to O&M of construction plant & machinery.
6.4 From blasting or piling Yes Minor generation of noise, vibrations etc may be possible due to O&M of construction plant & machinery.
6.5 From construction or operational traffic Yes Minor generation of noise, vibrations etc may be possible due to O&M of construction plant & machinery.
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 No use of any hazardous materials is proposed.
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) No No use of any hazardous materials is proposed.
7.3 By deposition of pollutants emitted to air into the land or into water No No use of any hazardous materials is proposed.
7.4 From any other sources No No use of any hazardous materials is proposed.
7.5 Is there a risk of long term build up of pollutants in the environment from these sources? No No use of any hazardous materials is proposed.
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 No use of any hazardous materials is proposed.
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 The project is situated in earthquake Zone II. Project area is generally free from floods, earthquakes, landslides, cloudburst 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
 No
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 No
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 No
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 No
5 State, National boundaries No
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) No
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 ApplicantDheeraj
DesignationEE
Name of Company (Applicant Name should not be given here)PARWAN DAM DIVISION I JHALAWAR
AddressParwan Dam Division I, J PAtan Road near Jawahar colony Jhalawar
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