Form-2
APPLICATION FOR PRIOR ENVIRONMENTAL CLEARANCE
S. No.Item Details
1.
Whether it is a violation case and application is being submitted under Notification No. S.O.804(E) dated 14.03.2017 ? No
Details of Project:
(a)Name of the project(s) Proposed Common Biomedical Waste Treatment Facility at Kahara Pathar village, Barpeta district, Assam by Ksepya Environment Management Private Limited
(b)Name of the Company / Organisation KSEPYA ENVIRONMENT MANAGEMENT PRIVATE 1 LIMITED
(c)Registered Address Kahara Pathar, Bhawanipur, Dist Barpeta, Assam,,Barpeta,Assam-781352
(d)Legal Status of the Company Private
2.
Address for the correspondence:
(a)Name of the Applicant Golam Mustafa Kamal
(b)Designation (Owner/ Partner/ CEO) Partner
(c)Address 293, Helanarpam, Howly, District- Barpeta,,,Sarthebari,Barpeta,Assam-781316
(d)Pin code 781316
(e)E-mail ksepyabmw@gmail.com
(f)Telephone No. 361-2517840
(g)Fax No.
(h)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
3.
Category of the Project/Activity as per Schedule of EIA Notification,2006:
(a)Major Project/Activity7(d)(a)Common Bio-Medical Waste Treatment Facility
(b)Minor Project/ActivityNIL
(c)Category B1
(d)Proposal Number SIA/AS/MIS/49659/2020
(e)Master Proposal Number(Single Window) SW/226464/2021
(f)EAC concerned (for category A Projects only) INFRA-1
(g)Project Type Fresh EC
4.
Location of the Project:
(a)Plot/Survey/Khasra No. Dag No 69,576,571,572; Patta No. 26,91,87
(b)Pincode 781316
(c)Bounded Latitudes (North)
From
Degree 91
Minutes 05
Second 33.3
From
Degree 91
Minutes 05
Second 37.2
(d)Bounded Longitudes (East)
From
Degree 26
Minutes 28
Second 15.9
From
Degree 26
Minutes 28
Second 17.4
(e)Survey of India Topo Sheet No. 78J14,78J15,78N2,78N3
(f)Uploaded Topo Sheet File Copy of Topo Sheet File
(g)Maximum Elevation Above Means Sea Level(AMSL) 42.97
(h)Uploaded (kml) File Copy of Kml File     
(i)Distance of Nearest HFL from the project boundary within the study area 0.5
(j)Seismic Zone 5
5.
(a)Number of States in which Project will be Executed 1
(b)Main State of the project Assam
Details of State(s) of the project
S. No. State Name District Name Tehsil Name Village Name
(1.)AssamBarpetaSarupetaKahara Pathar
6.
Details of Terms of Reference (ToR):
(a)Whether TOR is mandatory for submitting application Yes
(b)MoEF&CC / SEIAA File Number
(c)Date of Apply of TOR 10 Jan 2020
(d)Date of Issue of TOR / Standard ToR 29 Feb 2020
(e)Previous TOR Letter Copy of Previous TOR letter
7.
Details of Public Consultation:
(a)Whether the Project Exempted from Public Hearing?No
(b)Whether details of Public Hearing available? Yes
(c)Whether Public hearing was presided over by an officer of the rank of Additional District Magistrate or above Yes
     7.1.       Details of Public Hearing
S. No.Details of Advertisement Details of Public Hearing Venue Location DetailsNo. of People AttendedIssues RaisedDesignation of Presiding OfficerOther Designation of Presiding Officer
(1.)
Date of Advertisement :18 Nov 2020
Copy of advertisement :Copy of Advertisement
Copy of Public Hearing :Copy of Public Hearing
Date :22 Dec 2020
Distance of Public Hearing Venue from the Proposed Project :1
Sri Rabendra Baishya’s land, village Banglipara, P.O Bhawanipur, Dist Barpeta, Assam
State :Assam
District :Barpeta
Tehsil :Sarupeta
Village :Banglipara
40disposal of waste material from the proposed project and Green Belt development in proposed siteDistrict Magistrate
8.
Details of Project Configuration/Product:
     8.1.       Project Configuration
S. No.Plant/Equipment/FacilityConfigurationRemarks
(1.)Incinerator- 1+150 kg/hr1+1 (Standby Incinerator)
     8.2.       Product
S. No.Product/Activity (Capacity/Area)QuantityUnitOther UnitMode of Transport / Transmission of ProductOther Mode of Transport / Transmission of Product
(1.)Biomedical Waste from HCFs within 75 Km10000OthersBedsRoad
9.
In case of Expansion / Modernisation / One Time Capacity Expansion (only for Coal Mining) / Expansion under Clause 7(ii) / Modernisation under Clause 7(ii) / Change of Product Mix under Clause 7(ii):
Details Not Applicable
9.1.
Details of Consent to Operate
(i)Whether Consent to operate obtained ? NA
(ii)Copies of all Consent to operate obtained since inception NA
(iii)Date of Issue N/A
(iv)Valid Upto N/A
(v)File No. NA
(vi)Application No. NA
(vii)Copy of Consent to operate valid as on date NA
10.
Project Cost:
(a)Total Cost of the Project at current price level (in crores) 0.48
(b) Funds Allocated for Environment Management (Capital) (in crores) 0.25
(c) Funds Allocated Towards ESC (Entrepreneur Social Responsibility) (in crores) 0.0625
(d) Funds Allocated for Environment Management Plan (EMP) (Recurring per Annum) (in crores) 0.045
(e) Funds Allocated for Environment Management Capital(%) 52.08
11.
Whether project attracts the General Condition specified in the Schedule of EIA Notification ? No
12.
Whether project attract the Specific Condition specified in the Schedule of EIA Notification ? No
13.
Raw Material / Fuel Requirement:
(a)Proposed quantity of raw material/fuel 10000
(b)Existing quantity of raw material/fuel N/A
(c)Total quantity of raw material/fuel 10000
    13.1.        Raw Material / Fuel Profile
S. No.Raw Material / Fuel QuantityUnitOther UnitSource (incase of Import. please specify country and Name of the port from which Raw Material / Fuel is received )Mode of TransportOther Mode of TransportDistance of Source from Project Site (in Kilometres) (In case of import, distance from the port from which the raw material / fuel is received)Type of Linkage Other Type of Linkage Uploaded Copy of Linkage
(1.)Biomedical Waste10000OthersBedsHCFs within 75 KmRoad75 MoUCopy of Linkage
14.
Baseline Data :
(a)Period of Base Line Data Collection FROM 01 Mar 2021 To 31 May 2021
(b)Season Pre-Monsoon
    14.1.     No. of ambient Air Quality (AAQ) Monitoring Locations : 6
S. No.Criteria Pollutants Other Criteria PollutantsUnitMaximum ValueMinimum Value98 Percentile ValuePrescribed Standard
(1.)PM2.5Micro Gram per Meter Cube45.3224.5344.6160
(2.)NOxMicro Gram per Meter Cube22.8911.2521.8680
(3.)SO2Micro Gram per Meter Cube8.33.98.0980
(4.)PM10Micro Gram per Meter Cube85.9650.2485.81100
    14.2.     No. of Ground Water Monitoring Locations : 6
S. No.Criteria Pollutants Other Criteria PollutantsHeavy MetalUnitOther UnitMaximum ValueMinimum ValueDesirable LimitMaximum Permissible Limit
(1.)TSSmg/l0000
(2.)Total Hardnessmg/l11295200600
(3.)Chloridesmg/l17.2314.052501000
(4.)Heavy Metalscdmg/l000.0030.003
(5.)TDSmg/l372.42455002000
(6.)pHNA7.587.186.58.5
(7.)Fluoridemg/l0.230.1811.5
    14.3.     No. of Surface Water Monitoring Locations : 3
S. No.Criteria Pollutants Other Criteria PollutantsUnitOther UnitMaximum ValueMinimum ValueClassification of inland water body
(1.)BODmg/l22C
(2.)CODmg/l12.510C
(3.)pHNA7.577.33C
(4.)DOmg/l8.68.2C
    14.4.     No. of Ambient Noise Monitoring Locations : 6
S. No.Parameter UnitMaximum ValueMinimum ValuePrescribed Standard
(1.)Leq(Day)A-weighted decibels(dB(A))58.650.265
(2.)Leq(Night)A-weighted decibels(dB(A))47.838.855
    14.5.     No. of Soil Sample Monitored Locations : 6
S. No.Parameter UnitOther UnitMaximum ValueMinimum Value
(1.)pH7.566.9
(2.)P(Phosphorus)Kilogram per hectare142.532.5
(3.)K(Potassium)Kilogram per hectare260.589.5
(4.)N(Nitrogen)Kilogram per hectare88.545.4
(5.)Electric ConductivityOthersµmhos/cm758356
14.6.
Details of Ground Water Table:
(a)Range of Water Table Pre-Monsoon Season (Meters Below Ground Level (m bgl)) From 1.83 To 6.55
(b)Range of Water Table Post-Monsoon Season (Meters Below Ground Level (m bgl)) From 0.52 To 5.92
(c)Whether Ground Water Intersection will be there ? No
     15.      Details of Water Requirement (During Operation)
S. No.Source Source Other Required QuantityDistance from SourceCopy of Permission from Competent Authority Mode of TransportOther Mode of TransportMethod of Water WithdrawalOther Method of Water WithdrawalLetter No.Date of IssuePermitted Quantity
(1.)GroundWater30Copy of Permission LettermodeOthersTube wellTube WellNOC will be applied after EC application27 Aug 20213
15.1.
(a)Whether Desalination is proposed No
    16.       Waste Water Management(During Operation)
S. No.Type/Source Quantity of Waste Water Generated (Kilolitre per Day)Treatment Capacity (Kilolitre per Day) Treatment MethodMode of DisposalOther Mode of DisposalQuantity of Treated Water Used in Recycling/Reuse (Kilolitre per Day)Quantity of Discharged Water (Kilolitre per Day)
(1.)Floor Wash, Vehicle Wash, Process0.53ETPReuse within the Plant & Recycling0.5
(2.)Domestic Waste water0.81Soak pitOthersSoak pit0.80
16.1.
(a)Total Waste Water Generation 1.3
(b)Total Discharged Water 0
(c)Total Reused Water 1.3
    17.       Solid Waste Generation/Management
S. No.Name of Waste Item Other ItemQuantity per AnnumUnitDistance from Site(KM)Mode of TransportOther Mode of TransportMode of DisposalOther Mode of Disposal
(1.)Incineration AshBottom Ash18.2Tons75RoadTreatment, Storage and Disposal Facility(TSDF)
18.
    18.1.     Air Quality Impact Prediction
S. No.Criteria Pollutants Other Criteria PollutantsUnitBaseline ConcentrationDistance GLCIncremental ConcentrationTotal GLCPrescribed Standard
(1.)NOxMicrogram per Meter Cube22.8910.0122.8980
(2.)PM10Microgram per Meter Cube85.9610.0185.97100
(3.)SO2Microgram per Meter Cube8.350.018.3180
(4.)PM2.5Microgram per Meter Cube45.3210.0145.3360
    18.2.     Stack Details
S. No.Source FuelStack Height(m)Stack Diameter(m)PollutantsOther PollutantsEmission (GLS)
(1.)Incinerator stackDiesal301.5PM100.01
(2.)DG setDiesal60.1PM100.01
19.
Power Requirement:
(a)Quantity (Kilo Volt Amps (kVA)) 250
(b)Source APDCL
(c)Uploaded Copy of Agreement Not Applicable
(d)Standby Arrangement (Details of DG Sets) 250
(e)Stack Height (in m) 6
20.
Land Ownership Pattern:
(a)Forest Land 0
(b)Private Land 0.98
(c)Government Land 0
(d)Revenue Land 0
(e)Other Land 0
    Total Land 0.98
21.
Present Land Use Breakup of the Study Area in Ha:
(a)Agriculture Area 26289
(b)Waste/Barren Land 0
(c)Grazing/ Community Land 0
(d)Surface Water Bodies 821
(e)Settlements 4305
(f)Industrial 0
(g)Forest 0
(h)Mangroves 0
(i)Marine Area 0
(j)Others : 0 0
    Total 31415
    22.     Land Requirement for Various Activities
S. No.Description of Activity / Facility / Plant / Others OthersLand RequirementRemarks
(1.)Main Plant0.2
(2.)Green belt0.35
(3.)Othersopen area0.43
Total 0.98
23.
Ecological and Environmental Sensitivity (Within 10 Km):- WLS-Wild Life Species; NPA-Notified Protected Area; ESAs-Eco Sensitive Areas; ESZs-Eco Sensitive Zones :
    23.1.     Details of Ecological Sensitivity :
S. No.Details of Ecological Sensitivity NameDistance from the Project (Km)Remarks
(1.)Critically Polluted AreaNA0NA
(2.)ESZsNA0NA
(3.)ESAsNA0NA
(4.)NPANA0NA
(5.)CorridorsNA0NA
(6.)Wildlife CorridorsNA0NA
(7.)WLSNA0NA
    23.2.     Details of Environmental Sensitivity :
S. No.Details of Environmental Sensitivity Other Details of Environmental Sensitivity NameDistance from the Project (Km)Remarks
(1.)Defence InstallationsNA0NA
(2.)Archaeological SitesNA0NA
(3.)ForestNA0NA
23.3.
(a)Whether Noc / Permission from the competent authority is required? No
(b)Whether NBWL recommendation is required? No
24.
Forest Land:
Whether any Forest Land involved? No
25.
Tree Cutting:
(a)No. of Trees Cut for the Project (if Forest Land not Involved) 0
(b)Details of Tree Cutting and Planting of Trees Copy of Details of Tree Cutting and Planting of Trees
26.
Land Acquisition Status:
(a)Acquired Land(Ha) 0
(b)Land yet to be acquired(Ha) 0
(c)Status of Land acquisition if not acquired NA
27.
Rehabilitation and Resettlement (R&R):
(a)No. of Villages 0
(b)No. of Households 0
(c)No. of PDFs (Project Displaced Families) 0
(d)No. of PAFs (Project Affected Families) 0
(e)Funds Allocated for R&R(in Rs) 0
(f)Status of R&R Completed
28.
Details of Presence of Schedule-I Species:
(a)Whether there is Presence of Schedule-I Species ? No
(b)Whether conservation plan for Schedule-I Species has been prepared ? No
(c)Whether conservation plan for Schedule-I Species has been approved by competent authority ? No
29.
Details of Presence of Water Bodies in Core Area:
(a)Whether there is Presence of Water Bodies in Core Area ? No
(b)Whether there is Diversion Required ? No
(c)Whether permission has been obtained from competent authority ? No
30.
Details of Presence of Water Bodies in Buffer Area:
(a)Whether there is Presence of Water Bodies in Buffer Area ? Yes
(i)Details of Water Bodies in Buffer Area Pahumara River
(ii)Direction of Water Bodies in Buffer Area South
(iii)Distance of Water Bodies in Buffer Area 0.5
31.
Manpower Requirement:
(a)Permanent Employment-During Construction 5
(b)Permanent Employment-During Operation 16
(c)Temporary Employment- During Construction 0
(d)Temporary Employment- During Operation 0
(e)No. of working days 365
(f)Total Manpower 21
32.
Green Belt in Ha:
(a)Total Area of Green Belt (in hectare) 0.35
(b)Percentage of Total Project Area 35.71
(c)No. of Plants to be Planted 1000
(d)Funds Allocated for Plantation 50000
(e)Uploaded Green Belt plan Copy of Green Belt Plan
    33.         Project Benefits
S. No.Type of Project Benefits Details of Project Benefits
(1.)EnvironmentalScientific Management of BMW
(2.)EnvironmentalScientific Management of BMW
(3.)SocialEmployment generation
(4.)SocialEmployment generation
(5.)SocialEmployment generation
(6.)SocialEmployment generation
(7.)SocialEmployment generation
(8.)EnvironmentalScientific Management of BMW
(9.)EnvironmentalScientific Management of BMW
(10.)EnvironmentalScientific Management of BMW
(11.)EnvironmentalScientific Management of BMW
(12.)EnvironmentalScientific Management of BMW
(13.)EnvironmentalScientific Management of BMW
(14.)EnvironmentalScientific Management of BMW
(15.)EnvironmentalScientific Management of BMW
(16.)EnvironmentalScientific Management of BMW
(17.)EnvironmentalScientific Management of BMW
(18.)EnvironmentalScientific Management of BMW
(19.)EnvironmentalScientific Management of BMW
(20.)EnvironmentalScientific Management of BMW
(21.)SocialEmployment generation
(22.)SocialEmployment generation
   34.   CRZ Specific Details : Not Applicable
   35.   Sector Specific Details For INFRA-1
S. No.Item Details
1.
Details of Building Construction:
(a)Maximum Height of the Building (Meters) 0
(b)Total No. of Flats to be Build 0
(c)No. of Buildings 0
(d)Total plot area (sqm) 0.98
(e)Total built up area (sqm) 0.2
2.
Foreshore Facilities and/or Marine Disposal:
(a)Whether Project Involves Foreshore Activities and/or marine Disposal? No
3.
Rain Water Harvesting:
(a)No. of Storage 1
    Capacity 1000
(b)No. of Recharge Pits 1
    Capacity 1000
4.
Parking:
(a)Details of 4 Wheeler/ 2 Wheeler Parking 0.43 hectare open space is available
5.
Energy Saving Measures:
(a)Source/Mode LED light, Solar Lights
(b)Percentage 20
(c)Quantity 50
6.
Other details:
(a)Details of impact on Water Bodies and Drainage patters of catchment area NA
(b)Details of Traffic Density Impact Assessment and Modelling Study Copy of Details of Traffic Density Impact Assessment and Modelling Study
(c)In case Underground Tunnel Project below the Forest Land - Subsidence Impact Study report Copy of Underground Tunnel Project below the Forest Land - Subsidence Impact Study report
     7.       Type of Industries to be established with Industrial Estate as per their category A/B
S. No.Type of IndustryNo. of UnitsCategory A/B
NIL
8.
Length of the alignment N/A
9.
Details Bridges/ROB/Interchanges,Flyovers,Vehicle Underpass and Pedestrian Underpass
Details Not Applicable
S. No.Item Details
36.
Details of Court Cases:
(a)Whether there is any Court Cases pending against the project and/or land in which the project is proposed to be set up ? No
37.
Details of Direction Issued under Environment (Protection) Act / Air (Prevention & Control of Pollution)) Act / Water (Prevention & Control of Pollution) Act:
(a)Whether any Direction issued under EPA Act/Air Act/Water Act ? No
38.
Details of EIA Consultant:
(a)Have you hired Consultant for preparing document? Yes
(i)Accreditation No. NABET/EIA/1922/RA 0128 REV 01
(ii)Name of the EIA Consultant Shivalik Solid Waste Management Limited
(iii)Address SCO 20-21, Ist Floor,Baltana, Zirakpur, 140604
(iv)Mobile No. 9417746337
(v)Landline No. 0176250949
(vi)Email Id drranjnasswm@gmail.com
(vii)Category of Accreditation A
(viii)Sector of Accreditation INFRA-1
(ix)Validity of Accreditation 16 Feb 2022
(x)Uploaded Certificate of Accreditation certified by QCI/NABET Copy of Certificate of Accreditation
39.
Documents to be Attached:
(a.I)Upload Copy of EIA/EMP(Text) Copy of EIA/EMP(Text)
(a.II)Upload Copy of EIA/EMP(Annexures) Report Copy of EIA/EMP(Annexures)
(a.III)Upload Copy of EIA/EMP(Maps/Plans/Figures only) Copy of EIA/EMP(Maps/Plans/Figures only)
(b)Uploaded Copy of Risk Assessment Report Copy of Risk Assessment
(c)Uploaded Copy of Feasibility Report/ Detailed Project Report(DPR) /Detailed Engineering Report /Detailed Conceptual Plan /Approved Mining Plan Copy of Feasibility Report/ Detailed Project Report(DPR) /Detailed Engineering Report /Detailed Conceptual Plan /Approved Mining Plan
(d)Uploaded Copy of Final Layout Plan Copy of Final Layout Plan
(e)Uploaded Cover Letter Copy of Cover Letter
(f)Uploaded Copy of documents in support of the competence/authority of the person making this application to make application on behalf of the User Agency Copy of documents in support of the competence/authority of the person making this application to make application on behalf of the User Agency
(i)Uploaded Additional File Copy of Additional File
(j)Uploaded Proposal Presentation (To be given in EAC/SEIAA/SEAC meeting) NA
(k)Uploaded Updated Form1 NA
           Essential Details Sought
S. No.EDS Sought DateEDS SoughtLetter
(1.)07/11/2022Land use map and cartosat/IKONOS satellite images of the area from which land use map is prepared. A write up on the classes required. •Correct names of the Board of Directors. •Flood inundation map for 100 years return period. •Details of residential and other houses within 500 mt. radius from the proposed location. The Site visit has been attached please furnished all the documents which is asked in page- 6 of site visit.EDS Letter
(2.)30/01/2023The correction have been made as per the instruction received
           Addtional Details Sought
S. No.ADS Sought DateADS SoughtLetter
NO Record
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. In addition to above, I hereby give undertaking that no activity/ construction/ expansion has since been taken up.
Name of ApplicantGolam Mustafa Kamal
DesignationPartner
Name of Company (Applicant Name should not be given here)KSEPYA ENVIRONMENT MANAGEMENT PRIVATE 1 LIMITED
AddressKahara Pathar, Bhawanipur, Dist Barpeta, Assam
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