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 Laying of Natural Gas transportation pipeline including spur line for Hardwar-Rishikesh-Dehradun pipeline section for approx. length 66.07km with 8” Dia with associated facilities along the pipeline route i.e. SV/DT/RT Stations.
Brief summary of projectAnnexure-Brief summary of project
Proposal Number IA/UK/IND2/111429/2019
Project Cost 10747 lacs
2.
S. No. in the schedule6(a) Oil & gas transportation pipe line (crude and refinery/ petrochemical
Project Sector Industrial Projects - 2
3. Proposed capacity/area/length/tonnage to be handled/command area/lease area/number or wells to be drilled 66.07Km length of Natural Gas transportation Pipeline with 8"/12"/14" Dia with flow capacity 1.2 MMSCMD 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 Yes
a) Protected areas notified under the wildlife (Protection) Act, 1972
c) Notified Eco-sensitive areas
8.
Does it attract the specific condition? If yes, please specify No
9.
Location of the projectUttarakhand
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.As per route map attached
Town / VillageHaridwar, Rishikesh, Dehradun
State of the projectUttarakhand
Details of State of the project
S.no State Name District Name Tehsil Name
(1.)UttarakhandDehradunDehradun
(2.)UttarakhandDehradunDehradun
(3.)UttarakhandDehradunRishikesh
(4.)UttarakhandHaridwarHardiwar
10.
Nearest railway station along with distance in kms Jwalapur Railway Station, 0.7 km
Nearest airport along with distance in kms Joly Grant Airport, Dehradun, 5.0 km
11. Nearest Town/City/District Headquarters along with distance in kms Haridwar , 0.0 km
12. Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given) Natural Gas transportation pipeline starting from Village Balajipuram, District Haridwar to ending at Village Majra, District Dehradun in Uttarakhand State for approx.. length 62.24kmincluding Spur line from Tap off point (TOP) Dehradun to Receiving
13. Name of the Applicant Ram
14. Registered Address 8th Floor, GAIL Jubilee Tower, B 35 and 36, Sector - 1, Noida, District G B Nagar, UP
15.
Address for correspondance:
Name of the Company GAIL INDIA LIMITED U P
Name of the Applicant Ram
Designation (Owner/ Partner/ CEO) DGM
Pin code 201301
E-mail gil.kirtibhatt@gmail.com
Telephone No. 0120-2446400
Fax No. 0120-
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 Yes
Uploaded detailsAnnexure-Uploaded details
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?Yes
Area of Forest land Involved (hectares)3.5817 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 Temporary change in land use will take place due to development of preliminary site preparation, excavation, underground laying of pipeline, campsites etc. Total length of pipeline Network is approximately 36km. The land will be reinstated to its near original position once pipeline/spur line laying is completed. Thus, impact on land use will be marginal, temporary and reversible.
1.2 Clearance of existing land, vegetation and buildings? Yes Temporary Change Temporary change in land use will take place due to development of preliminary site preparation, excavation, underground laying of pipeline, campsites etc. Total length of pipeline Network is approximately 36km. The land will be reinstated to its near original position once pipeline/spur line laying is completed. Thus, impact on land use will be marginal, temporary and reversible.
1.3 Creation of new land uses? Yes No change in land use pattern along the pipeline route is envisaged as the land will be restored to its near original condition after laying the pipeline. There will be temporary change in land use for a short period. However, permanent new land uses required for associated facilities those are 03 Sectionalized Valve(SV) Stations, 01 Dispatch Terminal (DT) Station & 01 Receiving Terminal(RT) Station
1.4 Pre-construction investigations e.g. bore houses, soil testing? Yes The soil investigations such as resistivity, temperature etc. will be undertaken during/before commencement of construction work of station and along the Pipe line route.
1.5 Construction works? Yes Laying of Underground Pipeline and associated facilities i.e. 03 Sectionalized Valve(SV) Stations, 01 Dispatch Terminal (DT) Station & 01 Receiving Terminal(RT) Station
1.6 Demolition works? No Not Applicable
1.7 Temporary sites used for construction works or housing of construction workers? No Not Applicable
1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations No The proposed surface structures include associated facilities like control room, electrical room, DG room,administrative building and sign boards along the pipeline route etc at DT, SVs and RT.
1.9 Underground works including mining or tunnelling? No No mining and tunneling will be required. However, Pipeline will be buried at a minimum cover of 1.2 meters from natural contour level. After laying of the pipeline, land will be reinstated to its near original position.
1.10 Reclamation works? Yes Once laying of proposed pipeline is completed, restoration will be carried out for the buried pipeline.
1.11 Dredging? No Not Applicable
1.12 Offshore structures? No Not Applicable
1.13 Production and manufacturing processes? No Not applicable. No production and manufacturing is involved as the project is for the transportation of Natural Gas.
1.14 Facilities for storage of goods or materials? Yes Temporary warehouse will be developed for storage of construction materials, Steel pipes, tools and other equipments, etc. for laying of Pipeline activities. The warehouse will be dismantled later on.
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? Yes Solid waste will be collected and segregated in the form of Bio degradable and non Bio degradable like Cement, stone cutting etc. will be suitably disposed as per SPCB/CPCB guidelines. The domestic liquid waste from the labour camp will be generated if any will be treated in septic tanks & soak pits.
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. Existing road network will be used for mobilization of man and construction materials.
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? Yes As per Annexure VI
1.23 Abstraction or transfers of water from ground or surface waters? Yes Temporary water requirement will be only during construction phase and will be met with by tanker supply from nearby municipal source. Water requirement for associated facilities if any will be full fill by near by municipal sources as available.
1.24 Changes in water bodies or the land surface affecting drainage or run-off? No All major water body/Canals crossing will be carried out by Horizontal Directional Drilling method. Hence there will be no effect on permanent bodies. There will not be any change in the drainage pattern, as the top Surface will not be disturbed. After laying the pipeline the soil surface will be reinstated its original condition so there will be no disturbance in surface run-off.
1.25 Transport of personnel or materials for construction, operation or decommissioning? Yes Vehicles will be used for carrying equipment and required manpower.
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? No Not applicable. Only 80 laborers are envisaged during construction phase only and will be sourced from nearby villages
1.29 Introduction of alien species? No Not Envisaged
1.30 Loss of native species or genetic diversity? No Not envisaged significantly or minimized by strictly observing and executing EMP as suggested in EIA and guidelines of forest department.
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) Yes Approximately 6.607 ha or Agricultural Land (RoU) will be used for laying of pipeline. After laying of pipeline, the land will be restored back and handed over to land owners for agricultural purpose.
2.2 Water (expected source & competing users) unit: KLD Yes Water will be required for various activities during construction phase of pipeline which includes Water consumption for laying by HDD Method, Water consumption for Watering & compaction of the Trench, Hydro testing, gardening, dust suppression, Water consumption for domestic use. Total water consumption will be 50 KLD during construction period and 10 KLD during operational phase of pipeline
2.3 Minerals (MT) No Not Applicable
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) Yes Considering the construction of Sectionalized Valve stations, Dispatch Station,Tap off Station, Receiving Terminal. The construction materials such as cement, steel, sand, soil, diesel oil etc. will be procured from local sources.
2.5 Forests and timber (source – MT) No Not Applicable
2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW) Yes Required power for Sectionalized Valve stations, Dispatch Station, Tap off Station, Receiving Terminal shall be drawn from nearest local power source of the state Electricity Boards.
2.7 Any other natural resources (use appropriate standard units) No Not Applicable
3 Use, storage, transport, handling or production of substances or materials, which could be harmful to human health or the environment or raise concerns about actual or perceived risks to human health
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
3.1 Use of substances or materials, which are hazardous (as per MSIHC rules) to human health or the environment (flora, fauna, and water supplies Yes This is only underground buried at the depth of 1 to 1.2 meter natural gas transportation pipeline for domestic and industrial end users. However, significant hazards are envisaged to human health, environment( flora, fauna and water supplied). It is green category of project.
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? Yes There will not be any major changes to the living conditions from the project. However, local workforce will be utilized during construction period. Hence the project will lead to the employment generation of locals and also help in improvement of the existing socio-economic status.
3.4 Vulnerable groups of people who could be affected by the project e.g. hospital patients, children, the elderly etc. Yes There will be a positive impact on Hospitals, Schools, Religious places due to reliable and uninterrupted eco-friendly fuel supply of natural gas
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 will be stored separately and spread upon completion of laying of Pipeline
4.2 Municipal waste (domestic and or commercial wastes) Yes Domestic waste during construction & operation will be limited to labour camps. These wastes will be disposed off at approved municipal sites. Toilets will be connected to septic tank & soak pit for disposal of domestic waste.
4.3 Hazardous wastes (as per Hazardous Waste Management Rules) Yes Recyclable hazardous waste may be generated in the form of spent oil from DG sets, Equipment etc. if any and will be disposed of to the SPCB / CPCB approved recycler.
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 No Not applicable
4.7 Construction or demolition wastes No Not applicable
4.8 Redundant machinery or equipment No No Envisaged
4.9 Contaminated soils or other materials No No Envisaged
4.10 Agricultural wastes No No Envisaged
4.11 Other solid wastes No No Envisaged
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 DG Sets if any, will be primarily contributing to point source air pollutant emissions. Fugitive emissions sources include moving vehicles and construction machineries/equipments. However, the impact will be temporary, marginal and reversible.
5.2 Emissions from production processes No Not applicable
5.3 Emissions from materials handling including storage or transport Yes Temporary fugitive emissions sources include moving vehicles and construction machineries/equipments in marginal amount. However, the impact will be temporary, marginal and reversible.
5.4 Emissions from construction activities including plant and equipment Yes Temporary emissions are likely to occur during site preparation due to operation of construction equipments. However, the impact will be temporary, marginal and reversible.
5.5 Dust or odours from handling of materials including construction materials, sewage and waste Yes Dust is likely to be generated from the handling of construction materials viz. cement, sand, aggregates etc. which will be suppressed by water sprinkling. No odor is envisaged. However, the impact will be temporary, marginal and reversible.
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 Not applicable
5.8 Emissions from any other sources No Not applicable
6 Generation of Noise and Vibration, and Emissions of Light and Heat:
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
6.1 From operation of equipment e.g. engines, ventilation plant, crushers Yes The noise generation sources from the proposed activities include : Construction: Construction and transport equipment. The expected noise levels will be in the range of 70-85 dB (A). Operation: During Operational Phase Noise will not be significantly generated and expected noise levels will be in the range of permissible limit of the MoEF & CC. There will not be any increase in noise during operation phase of the pipeline project.
6.2 From industrial or similar processes No Not applicable
6.3 From construction or demolition Yes Noise levels will be within standards stipulated by CPCB and will be temporary in nature; hence it will not cause any impact
6.4 From blasting or piling No Not applicable
6.5 From construction or operational traffic Yes Vehicle movement etc. during construction. The noise levels will be less than 75 dB(A)
6.6 From lighting or cooling systems No Not Envisaged
6.7 From any other sources No Not Envisaged
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 Not applicable.
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) No The domestic sewage will be treated in septic tanks and soak pits. Wherever possible the sewage waste water will be collected and disposed suitably in municipal drains or as per guidelines of SPCB. No waste water will be allow to mix up with natural streams of water body.
7.3 By deposition of pollutants emitted to air into the land or into water No The DG set if any will be provided with adequate stack height as per CPCB requirement to disperse the pollutants effectively; hence any resultant contamination of land or water would be unlikely.
7.4 From any other sources No Not applicable
7.5 Is there a risk of long term build up of pollutants in the environment from these sources? No No long term cumulative impact is envisaged because of pipeline is buried underground and after laying of pipeline land will be reinstated to its near original position
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 During construction stage, it is Nil. During operations stage the hazards will be thoroughly identified and would be adequately addressed at the design stage itself to bring them as low as reasonably practicable. No firewood will be allowed as fuel in the camp site. LPG supply will be provided.
8.2 From any other causes Yes Natural gas releases are addressed as part of design and planning process. However, company has well defined HSE policy and well documented operational protocol frame work. All health safety and environmental protection actions suggested there in, PNGRB and OISD guidelines over and above MoEF & CC and SPCB shall be strictly practiced.
8.3 Could the project be affected by natural disasters causing environmental damage (e.g. floods, earthquakes, landslides, cloudburst etc)? Yes Natural disasters in form of earthquakes can take place as the site area falls under the high risk seismic zone(Zone IV)
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 Project may increase the industrial growth of the area. It will support infrastructure facilities, housing, development and supply industry by fulfilling their requirement of cleaner fuel in form of Natural gas
9.2 Lead to after-use of the site, which could have an impact on the environment No Not applicable
9.3 Set a precedent for later developments No Not applicable
9.4 Have cumulative effects due to proximity to other existing or planned projects with similar effects No Not envisaged
(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 Proposed pipeline route passes through Rajaji National park within the RoW of NH-58 & NH-72 for 0.483 ha forest land. The necessary permission obtained from the Forest Conservator, Rajaji National Park, Dehradun and Supreme court. The necessary Stage –I Forest permission for use of 3.5817ha forest land for non - forest purpose obtained from MoEF, Dehradun. (Annexure II and III) The pipeline will cross 8 rivers including Gana( 4 times). Ganga has a very high Religious and cultural values
2 Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Yes The pipeline will cross 8 rivers including Gana( 4 times). The pipeline passes through foot hils of Himalayan mountains and forest area of Himalayan i.e. Rajaji National Park
3 Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration Yes Rajaji National Park established as a part of the Rajaji-Corbett Elephant Reserve and it is in the Shiwalik range and its Piedmont region of the Himalaya of the Uttarakhand state and RJNP was also declared a Tiger Reserve in 2015 by the National Tiger Conservation Authority,under MoEF & CC
4 Inland, coastal, marine or underground waters Yes The pipeline will cross 8 rivers including Gana( 4 times). However, the pipeline will be crossed by HDD method to cross the rivers without disturbing River/water body natural flow. So, the impact on water body will be temporary, marginal and reversible.
5 State, National boundaries Yes Not applicable
6 Routes or facilities used by the public for access to recreation or other tourist, pilgrim areas Yes River Ganga, Hridwar, Rishikesh & Dehradun are world famous religious pilgrims recreational and tourist places and also en-route to Massuri and Char Dham in Uttarakhand
7 Defence installations Yes The defence installations from the pipeline route boundary are as given below: 1. Defence Electronics Application Laboratory (DEAL), Dehradun: 3.9Km 2. Instruments Research & Development Establishment (IRDE), Dehradun: 3.5Km 3. Indian Military Academy, Dehradun: 5.5km
8 Densely populated or built-up area Yes Haridwar, Rishikesh & Dehradun with their religious, cultural and Pilgrims important and tourist places
9 Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship, community facilities) Yes As per route map attached as Annexure I
10 Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Yes The pipeline will cross 8 rivers including Gana( 4 times). However, the pipeline will be crossed by HDD method to cross the rivers without disturbing River/water body natural flow. So, the impact on water body will be temporary, marginal and reversible.
11 Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) Yes To make cleaning of river water Ganga, National Mission for Clean Ganga was implemented in 2016 under under the River Ganga (Rejuvenation, Protection and Management) Authorities order 2016
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 Not applicable
(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 ApplicantRam
DesignationDGM
Name of Company (Applicant Name should not be given here)GAIL INDIA LIMITED U P
Address8th Floor, GAIL Jubilee Tower, B 35 and 36, Sector - 1, Noida, District G B Nagar, UP
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