Form-4

APPLICATION FOR AMENDMENT IN ENVIRONMENTAL CLEARANCE

(To be filled up by User Agency)
1. Details of Project
 
 Proposal No. : SIA/OR/MIN/298120/2023  
 (a) Name of the project : NEW PROPOSAL FOR AMENDMENT EC OF NAIKPARHA SAND BED NAIKPARHA OVER AN AREA 4.856 HECTARES OR 12.00 ACRES IN VILLAGE NAIKPARHA UNDER ATHMALLIK TAHASIL OF ANGUL DISTRICT ODISHA  
 (b) Name of Company / Organisation. : MOHINUUDDIN KHAN  
 (c) Registered Address. : S/O- KAMANULLAH, RUGUDISAHI, ATHAMALLIK, ANGUL, ODISHA, 759125 Orissa 759125  
 (d) Legal Status of the Company. : Individual  
 (e) Joint Venture (Yes/No) : No
2. Address for the Correspondence
 
 (a) Name of the Applicant. : MOHINUUDDIN KHAN  
 (b) Designation (Owner/Partner/CEO) : No  
 (c) Address :-  
        State : Orissa  
        District : Angul  
        Town / Village : No  
 (d) Pin Code : 759125  
 (e) Email : moinuddin700@gmail.com  
 (f) Telephone no : No  
 (g) Fax no : No  
 (h) Mobile no : 7682959665  
 (i) Contact Person. : MOHINUUDDIN KHAN  
 (j) Website (if any) : No
3. Category of the Project/Activity as per Schedule of EIA Notification,2006
 
 (a). Major Activity. : 1(a) Mining of minerals
                                 
       Minor Activity : 1(a) Mining of minerals
                                 
       Major Sub Activity. : No  
       Minor Sub Activity : Open Cast Mining  
 (b). Category : B2  
       Reason for applicant at central level/state level(in case of B1 and B2 ): No  
 (c). Reason : No  
       EAC Concerned (for category A Projects Only ): No
4. Location of the Project
 
 (a) Plot No/Survey No/Khasra No : PLOT NO-349/P, KHATA NO-67  
 (b) Village : No  
 (c) Tehsil : No  
 (d) District : No  
 (e) State : No  
 (f) Pin Code : 759126  
 (g) Bounded Latitudes (North) : Yes  
         From : Degree:20, Minutes : 53, Seconds :08  
         To    : Degree:20, Minutes : 53, Seconds :06  
 (h) Bounded Longitudes (East) : Yes  
         From : Degree:84, Minutes : 16, Seconds :174  
         To    : Degree:84, Minutes : 16, Seconds :23  
 (i) Survey of India Topo Sheet No : F45S/5
5 Details of Environmental Clearance
 
 (a) Project Name : NEW PROPOSAL FOR AMENDMENT OF EC NAIKPADA SAND BED, NAIKPARHA OVER AN AREA 4.856 HECTARES IN VILLAGE NAIKPARHA ATHAMALLIK TAHASIL ANGUL DISTRICT ODISHA  
 (b) MoEF&CC / SEIAA File No : SIA/OR/MIN/287792/2022  
 (c) Date of issue of EC : 19/08/2022   (d) Uploaded EC letter :
6 Details of Consent to Operate
 
 (i) Whether Consent to operate obtained (Yes/No) ? : Yes   (ii) Uploaded copies of all Consent to operate obtained since inception:  
 (iii)Date of issue : 28/12/2021  
 (iv)Valid Upto: 28/12/2026  
 (v)File No : 3938  
 (vi)Application No : 3903543   (vii)Uploaded copy of Consent to operate valid as on Date:
7 Amendment Sought for
 
 Amendment in Configuration/ Amendments in Clearance condition/ Other (specify) : NA
8 Details of Product (as per the approved EC)
Details of Products
S.no Product / Activity (Capacity/ Area). Quantity Unit Mode of Transport/ Transmission of Product
1SAND/4.856/HA7500/CUMOthersRoad
9 Details of Configuration (Multiple Entries Allowed)
Details of Configurations
S.no Plant/ Equipment/ Facility Existing Configuration Proposed Configuration Final configuration after Amendment Remarks if Any
1SAND/4.856/HA7500/CUM53801/MINEABLE RESERVE53801/MINEABLE RESERVETHERE IS SUFFICIENT SAND RESERVE IN THE MINE LEASE AREA TO FULFIL THE PRODUCATION NEED.
10 Reasons for Amendment
 
 Reasons for Amendment : DUE TO INCREASE IN SAND DIPOSITS
11 Any Other Amendment required
Any Other Amendment Required
S.no Reference of Approved EC Description as per Approved EC Description as per Proposal. Remarks
1NANANA
12 Details of EIA Consultant
 
 Have you hired Consultant for preparing document (Yes/No) ? : No  
 (i)Reason for not engaging the Consultant : SELF PERPARED
13. Documents to be Attached
  (a) Uploaded addendum to EIA/EMP Report:  
 (b) Uploaded Copy of revised -Feasibility Report /Detailed Project Report (DPR) / Detailed Engineering Report / Detailed Conceptual Plan / Approved Mining Plan (in case of mining proposals) : No Data  
 (c) Uploaded Copy of final Layout Plan : No Data   (d)Uploaded Cover Letter duly signed by the project proponent or authorized person:   (e)Uploaded a copy of authorization duly signed by the project proponent in support of the person making this application on behalf of the User Agency:  
 (f)Uploaded Additional File, If any : No Data
Essential Details Sought
Essential Details Sought
S.no. EDS Sought Date EDS Sought Letter
1.15/03/20231). The project proponent ask to submit the self-declaration through undertaking either in Proforma 1(for non-violation) or 2(violation) as per SEIAA Office order dated 15.12.2022 which is already uploaded in the SEIAA, Odisha web sites.
 
Additional Detail Sought:   NIL
14. Undertaking
(a): 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. (b)Name : MOHINUUDDIN KHAN (c)Designation: No (d)Company: MOHINUUDDIN KHAN (e)Address: S/O- KAMANULLAH, RUGUDISAHI, ATHAMALLIK, ANGUL, ODISHA, 759125 Orissa 759125