Form-1
APPLICATION FOR PRIOR ENVIRONMENTAL CLEARANCE
1. Basic Informations
Project Name Proposed of All India Institute of Ayurveda (AIIA) Company/Organisation Name M/S. SAROJINI ENTERPRISES LTD.,
Registered Address M/s. Sarojini Enterprises Ltd., Partner: Smt. S. Bhagyalakshmi D.No. 20-436, ASM Street, Muttnoor, Chittoor District, AP Andhra Pradesh 517125 Legal Status of the Company State Government
2.
Address for the correspondence:
(a)Name of the Applicant Tanuja Manoj Nesari
(b)Designation (Owner/ Partner/ CEO) Director
(c)Address Dhargal in Pernem Taluka, Goa,North East,Delhi-110076
(d)Pin code 110076
(e)E-mail goaayurveda11@gmail.com
(f)Telephone No. 4353009
(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/Activity8(a) Building and Construction projects
(b)Minor Project/Activity8(a) Building and Construction projects
(c)Category B2
(d)Proposal Number SIA/GA/MIS/121537/2019
(e)Master Proposal Number(Single Window) SW/121505/2019
(f)EAC concerned (for category A Projects only) Infrastructure and Miscellaneous Projects  +  CRZ
(g)Project Type(New/Expansion/Modernization) Fresh EC
4.
(a)Number of States in which Project will be Executed 1
(b)Main State of the project Goa
Details of State(s) of the project
S. No. State Name District Name Tehsil Name Village Name
(1.)GoaNorth GoaPernemDhargal in pernem taluka
5.
Details of Public Consultation:
(a)Whether the Project Exempted from Public Hearing?No
(b)Whether details of Public Hearing available? No
(c)Reason Building construction
(d)Supporting Document Copy of Supporting Document
Project Profile
Location of the project Dhargal in Pernem Taluka, Goa
Town / Village
(Name of more than one town may be entered by separating with)
Dhargal, Pernem Plot/Survey/Khasra No.
(Name of more than one town may be entered by separating with)
Dhargal in Pernem Taluka
State Goa District North Goa
Tehshil Pernem Pincode 403519
Nearest railway station Pernem railway station Distance from the project site 2.7
Nearest airport GMR Goa International Airport Distance from the project site 6.04
Nearest Town/City/District Headquarters Dhargal Distance from the project site 2.62
Village Panchayats, Zila Parishad, Municipal Corporation, Local body(Complete postal addresses with telephone nos. to be given) Municipal Corporation of Panaji, North Goa Dr. Panurang, Pissurlekar Rd, Altinho, Panaji, Goa-4033001 Upload GPS file Uploaded GPS file
Shape of the project land Block (Polygon) Site alternative under consideration(If any) Uploaded Site alternative under consideration
Brief summary of project Uploaded Brief summary of project
Does your project location falls under out of any following areas None of above Areas
Proposed Built up area (Built up area or covered area on all the floors puttogether including its basement and other service areas which are proposed in the building or construction projects)(In Meter /Sqr) 47483.165 Existing Built Up Area(In Meter /Sqr) 0
Does it attract any of the general conditions given below? No
Does it attract the specific condition given below? No
Interlinked Projects No
Whether separate application of interlinked projects has been submitted? Date of Submission
Whether the proposal involves approval/clearance under the Forest (Conservation) Act,1980? No
Whether the proposal involves approval/clearance under the wildlife (Protection) Act,1972? No
Whether the proposal involves approval/clearance under the C.R.Z notification,2011? No
Whether there is any Government Order/Policy relevent/relating to the site? No
Forest land involved(hectares) 0
Is there any litigation pending against the project? No


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 Currently site is vacant plot, which shall be developed for providing medical facility to the locals, so there shall be change in land use.
1.2 Clearance of existing land, vegetation and buildings? Yes As the construction is being planned, So clearance of existing vegetation will take place, Clearance of vegetation will take place after obtain proper permission, if needed
1.3 Creation of new land uses? Yes New All India Institute of Ayurveda (AIIA) building along with is proposed on vacant plot so new land use shall be created.
1.4 Pre-construction investigations e.g. bore houses, soil testing? Yes Geo technical investigation has been done to find the suitability of soil for providing for adequate foundations for the proposed structure.
1.5 Construction works? Yes All construction activities of area will be confined within the project premises; there will be no physical changes outside the project boundary. Construction of building will be done systematically, with economy of materials and with due care on environmental protection.
1.6 Demolition works? No The project site has no pre-existing structures in area So demolition is not required.
1.7 Temporary sites used for construction works or housing of construction workers? Yes All the construction activity including stocking of raw materials will be confined within the project site only. Inside the proposed site, a small area will be utilized temporarily for construction of sheds for the labor. Local labors from nearby area will be hired. Sanitation facilities will be developed at site.
1.8 Above ground buildings, structures or earthworks including linear structures,cut and fill or excavations and fill or excavations Yes Excavation will be carried out for foundation of building and basement. The total excavated quantity of earth material for site area will be approx. 1, 15,779.195 m3. The excavated soil will be re used in backfilling and other area development activities.
1.9 Underground works including mining or tunneling? No No underground works including mining/ tunnelling is required except excavation of earth.
1.10 Reclamation works? No No reclamation work required.
1.11 Dredging? No No reclamation work required.
1.12 Offshore structures? No No offshore structures required.
1.13 Production and manufacturing processes? No No production/manufacturing process involved as it is building construction project.
1.14 Facilities for storage of goods or materials? Yes During construction stage, the following raw material handling methods are being adopted: • Cement shall be separately stored under cover in bales • Sand & aggregates shall be stacked neatly under tarpaulin cover • Bricks and steel shall be laid in open • Finishing materials like tiles, sanitary fixtures, etc. Shall be stored in closed rooms. Material storage yard has been developed for storage of construction materials.
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? Yes Solid Waste: The solid waste generated from the project will be in the form of: Construction Waste: Left over cement and mortars, cement concrete blocks, aggregate, sand and other inorganic material will be recycled and reused as granular sub-base (GSB) layer of pavement. Earth rendered surplus from the excavation will be utilized in the embankment works. Operational Phase: The solid waste generated from proposedproject will be mainly hospital, and domestic in nature and the quantity of t
1.16 Facilities for long term housing of operational workers? No Local labourers will be hired from nearby areas during construction phase. So, there will be no need to create permanent facilities for long-term housing of operational workers.
1.17 New road, rail or sea traffic during construction or operation? No Project site is adjacent to the Dadachiwadi Road and Edapally- Panvel Hwy; NH17/NH66 is nearby 0.44km, SW. Only internal roads; paths will be developed for vehicular movements for transportation of construction material during construction phase whereas internal tracks and paths will be developed for traffic circulation (to avoid any congestion) during operational phase.
1.18 New road, rail, air water borne or other transport infrastructure including new or altered routes and stations, ports, airports etc? No Project site is adjacent to the Dadachiwadi Road and near to Pernem Railway Station (2.70km, NW).
1.19 Closure or diversion of existing transport routes or infrastructure leading to changes in traffic movements? No Since the site has good connectivity to sector road. Site has low traffic density; there will be no need for diversion or closure of existing traffic routes.
1.20 New or diverted transmission lines or pipelines? No There will not be any new/diverted transmission lines or pipelines around the hospital facility.
1.21 Impoundment, damming, culverting, realignment or other changes to the hydrology of watercourses or aquifers? No No impoundment, damming, culverting, realignment or other changes to the hydrology of surface watercourses is proposed.
1.22 Stream crossings? No There are no streams running across the site.
1.23 Abstraction or transfers of water from ground or surface waters? Yes Construction Phase : During the construction phase the water requirement (approx. 1,310.725 ML) will be met from Private water. No ground water will be extracted. Hence, there will be no impacts on ground water environment during construction phase. Operational Phase : Total water requirement for AIIA shall be approx. 614 KLD. The fresh water will be obtained from Municipal water supply. Detail of water requirements for various uses is given conceptual plan. Efficient dual flushing fixtures
1.24 Changes in water bodies or the land surface affecting drainage or run-off? Yes Runoff will increase due to increased paved surface. However, increased runoff will be managed by well-designed rainwater harvesting system and storm water management plan.
1.25 Transport of personnel or materials for construction, operation or decommissioning? Yes During the construction phase, about 15-20 trucks are estimated per week. Adequate parking space within the project site for loading and unloading of materials will be provided. Adequate parking space (1,176 ECS) will be provided in operational phase.
1.26 Long-term dismantling or decommissioning or restoration works? No No Long term dismantling or decommissioning or restoration works will be involved.
1.27 Ongoing activity during decommissioning which could have an impact on the environment? No None
1.28 Influx of people to an area in either temporarily or permanently? No Local labourers from nearby area will be employed during the construction phase. In the operation phase, most of the expected occupants will be from the surrounding areas. Hence, the project will lead to a redistribution of occupants within the city. Thus, no significant influx of people is envisaged.
1.29 Introduction of alien species? No The landscaping will be carried out with mainly local species with a few ornamental varieties of flora that are well suited to the local conditions like Bottle Palm(Hyophorbe lagenicaulis)andAshoka (Saraca asoca) etc.
1.30 Loss of native species or genetic diversity? Yes Tree cutting at the site shall involve loss of native species which will be temporary as the green belt shall be developed during the operational stage.
1.31 Any other actions? No No Not Applicable.
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 No undeveloped or agricultural land is present.
2.2 Water (expected source & competing users) unit: KLD Yes During construction phase approx. 1,310.725 ML amount of water will be required which will be provided by Private tanker supplier. During operation phase, water supply will be provided through Municipal. The proposed area is 614KLD
2.3 Minerals (MT) Yes Minerals such as sand and aggregates will be required during the construction phase.
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) Yes All materials for construction will be arranged through select suppliers.
2.5 Forests and timber (source – MT) Yes All material forests and timber will be provided by selected suppliers. However steel frames etc shall be used to minimize the use of timber.
2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW) Yes Maximum Electrical load requirement after overall diversity factor works out to 4,103.53 KW. Considering power factor of 90%. Source of power supply shall be GED. Power shall be received at 11 KV Voltage level. The Power shall be stepped down to 33 KV through 33KV/11KV oil filled Transformer with automatic on load tap charger. DG proposed 3*1010Kva each, 1*625Kva, 1*500Kva.
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 Diesel for DG sets will be stored in drums in earmarked locations. It shall also be handled as per The Manufacture, Storage and Import of Hazardous Chemical Rules, 1989 and Material Safety Data Sheet.
3.2 Changes in occurrence of disease or affect disease vectors (e.g. insect or water borne diseases) No Suitable drainage and waste management measures (with frequent spray of insecticides etc.) will be adopted in both the construction and operational phase such that there will be no stagnation of water or accumulation of waste. This will effectively restrict the reproduction and growth of disease vectors.
3.3 Affect the welfare of people e.g. by changing living conditions? Yes This is AIIA project availed by An Autonomous Organization under the Ministry of AYUSH, Govt. of India.
3.4 Vulnerable groups of people who could be affected by the project e.g. hospital patients, children, the elderly etc. No Impacts of this type are not expected as it is AIIA project.
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 No such spoil, overburden or mine wastes will be generated.
4.2 Municipal waste (domestic and or commercial wastes) Yes Category Counts (heads) Waste Generated (kg/day) Hospital and Residential Building’s Waste Patient 250 @ 1.5 kg/day 375 Regular staff (Doctors, Administrative Staff, Nurses/Ward Boys, Housekeeping n Engineering Staff) 1,000 @ 0.25 kg/day 250 Attendants + visitors 113 @ 0.15 kg/day 16.95 OPD 750 @ 0.15 kg/day 112.5 Residential Residential population 862 @0.5kg/day 431 Staff 68@0.25kg/day 17 Visitors 86 @0.15kg/day 12.9 Landscape Waste (14.82 Acre) @0.2kg/acre 2.97 Total Waste Generat
4.3 Hazardous wastes (as per Hazardous Waste Management Rules) Yes The hazardous wastes along with other wastes in the project will be used oil from DG sets, which is classified as per The Hazardous Waste Category 5.1 as per The Hazardous Wastes (Management & Handling) Rules, 1989. Used oil from DG sets will be stored in HDPE drums in isolated covered facility. This used oil will be sold to authorized recyclers. Suitable care will be taken so that spills/leaks of used oil from storage are avoided.
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 Yes Sludge generated from the STP plant will be dried and later will be used as manure for green belt development.
4.7 Construction or demolition wastes Yes The construction waste will consist of excess earth and construction debris along with cement bags, steel in bits and pieces, insulating and packaging materials etc. Recyclable waste construction materials will be sold to recyclers. Unusable and excess construction debris will be disposed at designated places in tune with the local norms.
4.8 Redundant machinery or equipment No Redundant machinery will not be generated.
4.9 Contaminated soils or other materials No Contaminated soils or other materials will not be generated.
4.10 Agricultural wastes Yes Landscape wastes of 2.97 kg/day will be generated.
4.11 Other solid wastes No Not other solids will be produced.
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 project does not envisage any major air pollution sources except operation of DG sets during power failure and vehicular traffic.
5.2 Emissions from production processes No No production processes involved. Hence, there will be no such emissions.
5.3 Emissions from materials handling including storage or transport Yes Small quantities of fugitive emissions are envisaged during transport and handling of construction materials. Such emissions will be temporary and controlled by the use of sprinkling and other viable techniques like covering of loose material.
5.4 Emissions from construction activities including plant and equipment Yes This will be restricted to the construction phase and the construction site only.
5.5 Dust or odours from handling of materials including construction materials, sewage and waste Yes Dust is anticipated during loading and unloading of construction material and excavation of upper earth surface. These will however be temporary in nature, which will be controlled by providing water sprinklers. Tarpaulin cover will be provided on stored loose materials to reduce the dust emission.
5.6 Emissions from incineration of waste No No incineration of wastes is proposed.
5.7 Emissions from burning of waste in open air (e.g. slash materials, construction debris) No Open burning of biomass/other material will be prohibited on site.
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 Source of noise in the operational phase will be from backup DG sets (which will be in operation only during power failure) and pumps & motors. All the machinery will be of highest standard of reputed make and will comply with standard i.e. The DG set room will be provided with acoustic enclosure to have minimum 25 dB (A) insertion loss or for meeting the ambient noise standard whichever is on higher side as per E (P) Act, GSR 371 (E) and its amendments. Therefore, no significant impact due to o
6.2 From industrial or similar processes No No industrial processes will be carried out in the AIIA project.
6.3 From construction or demolition Yes Due to various construction activities, there will be short-term noise impacts in the immediate vicinity of the project site. The construction activities will include the following noise generating activities: • Concreting, mixing & operation of DG sets. • Construction plant and heavy vehicle movement.
6.4 From blasting or piling No No blasting or mechanized piling will be done.
6.5 From construction or operational traffic Yes Some noise will be generated from vehicular movement in the construction and operational phase but that will be mitigated with green belt.
6.6 From lighting or cooling systems No Some noise will be generated from vehicular movement in the construction and operational phase but that will be mitigated with green belt.
6.7 From any other sources No Not Applicable
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 The used oil from DG sets will be carefully stored in HDPE drums at isolated storage, and periodically sold to authorized recyclers. All precautions will be taken to avoid spillage from storage as per The Hazardous Wastes (Management & Handling) Rules, 1989.
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) No There will be no risk to the water or land from the wastewater discharge from the site because no raw wastewater shall be discharge, All the sewage coming from the site shall be treated in house STP of capacities, 335KLD (STP1-225KLD), (STP2-110KLD) based on MBBR technology, along with ETP of 30 KLD, After proper treatment, surplus treated water shall be discharge , if any
7.3 By deposition of pollutants emitted to air into the land or into water No The DG Sets will be provided with stacks of adequate height. Hence dispersion will be achieved and avoid deposition of pollutants in significant concentrations at any single location.
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 Not Applicable
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 To deal with any fire related accident, firefighting facility of single handed hydrant valve, long hose reel, and portable fire extinguisher shall be provided.
8.2 From any other causes No Not Applicable
8.3 Could the project be affected by natural disasters causing environmental damage (e.g. floods, earthquakes, landslides, cloudburst etc)? Yes The project falls under seismic active Zone IV indicating high damage risk zone. The buildings will be designed as earthquake resistant and comply with the required IS specifications.
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 Appropriate infrastructure like roads, power supply, waste management and waste water treatment will be developed within the project site. - A medical facility is being provided and will be given to the people.
9.2 Lead to after-use of the site, which could have an impact on the environment No Not Anticipated
9.3 Set a precedent for later developments Yes The project will provide good health facilities to the people and better life style and will set an example for later developments in the areas.
9.4 Have cumulative effects due to proximity to other existing or planned projects with similar effects No Not Applicable
(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 No areas protected under international conventions, national or local legislation for their ecological, landscape, cultural or other related value falls within 15 km from project boundary
2 Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Yes • Chapora River-2.63km, SE; • Terekhol River-6.49km,NW • Assonora River-11.02km, SE; • Nanoda River-11.64km, ESE; • PandirPirna National Forest-6.74km in ESE.
3 Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration No No such areas present within 15 km from project boundary
4 Inland, coastal, marine or underground waters Yes Groundwater present at approx. 20-25 mbgl
5 State, National boundaries Yes Goa-Maharashtra-Approx. 5.84km, NNE from the project site
6 Routes or facilities used by the public for access to recreation or other tourist, pilgrim areas Yes • Dadachiwadi-Rd- At Adjacent,SE • Edapally-PanvelHwy;NH17/NH66- 0.44km, SW • State Highway-1- 7.49km, SSE • State Highway-2- 11.05KM, SE
7 Defence installations No There are no such areas.
8 Densely populated or built-up area Yes • Dhargal Industrial Estate- 2.75km, S • Tuem Industrial Estate- 4.03km,W • Pernem- 4.90km, WNW • Colvale Industrial Estate- 5.41km, SSW • Nanerwada- 5.37km, NW • Menkurem- 6.95km, E
9 Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship, community facilities) Yes • RedkarHopital and Research Center- 0.39km, SW • Community Health Center, MurmusheTuemPernem Goa- 4.31 km, S • Revora Health Centre- 3.30km,SE • Health Centre Pirna- 6.12km,SE • Malpe Primary School- 3.42km, NW • Vikas High School-2.06km,NW • SantSohirobanathAmbiye Government College of Arts & Commerce-2.15km, NW • Shree Bhagwati High School- 4.88km, WNW • Shree Saptakoteshwar Temple-1.97km, S • Shri Rastroli Brahman Devastna, Kasule-5.80km, N • VasdevMandir, Tulaskarwadi- 4.26km, NE
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 Yes The site falls under the zone IV as per the Seismic Zone Map of India. Adequate measures will be taken during the construction of the proposed project.
Document to be attached
1. Upload a copy of PFR Uploaded a copy of PFR.
2. Upload a copy of EMP Uploaded a copy of EMP.
3. Upload Scanned copy of covering letter. Uploaded Scanned copy of covering letter..
4. Upload Additional attached if any(Single PDF) Uploaded Additional attached if any(Single PDF).
5. Whether it is a violation case and application is being submitted under Notification No. S.O.804(E) dated 14.03.2017 ? No
           Essential Details Sought
S. No.EDS Sought DateEDS SoughtLetter
NO Record
           Additional 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 ApplicantTanuja Manoj Nesari
DesignationDirector
Name of Company (Applicant Name should not be given here)ALL INDIA INSTITUTE OF AYURVEDA (AIIA)
AddressDhargal in Pernem Taluka, Goa
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