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Form-4

APPLICATION FOR AMENDMENT IN ENVIRONMENTAL CLEARANCE

(To be filled up by User Agency)

1.	Details of Project

Proposal No. : SIA/OR/MIN/303965/2023
(a) Name of the project : Balada Sand Quarry over an area of 12.00 Acre or 4.85 Ha under Kantapada Tahasil of Cuttack District Odisha
(b) Name of Company / Organisation. : GANESH KAR
(c) Registered Address. : Suryavanshi Earth Movers Sibanarayanpur Orissa 758030
(d) Legal Status of the Company. : Individual
(e) Joint Venture (Yes/No) : No

2.	Address for the Correspondence

(a) Name of the Applicant. : GANESH KAR
(b) Designation (Owner/Partner/CEO) : No
(c) Address :-
       State : Orissa
       District : Kendujhar
       Town / Village : No
(d) Pin Code : 758030
(e) Email : ganeshpkarec@gmail.com
(f) Telephone no : No
(g) Fax no : No
(h) Mobile no : 9437962511
(i) Contact Person. : GANESH KAR
(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 : No
      Major Sub Activity. : No
      Minor Sub Activity : No
(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 : Khata No- 331, Plot No- 128
(b) Village : Balada
(c) Tehsil : kantapada
(d) District : Cuttack
(e) State : Orissa
(f) Pin Code : 754018
(g) Bounded Latitudes (North) : Yes
        From : Degree:20, Minutes : 16, Seconds :22
        To    : Degree:20, Minutes : 16, Seconds :28
(h) Bounded Longitudes (East) : Yes
        From : Degree:86, Minutes : 02, Seconds :53
        To    : Degree:86, Minutes : 03, Seconds :03
(i) Survey of India Topo Sheet No : F45U3

5	Details of Environmental Clearance

(a) Project Name : Balada Sand Quarry over an area of 12.00 Acre or 4.85 Ha under Kantapada Tahasil of Cuttack District Odisha
(b) MoEF&CC / SEIAA File No : SEIAA-1322/02-2021
(c) Date of issue of EC : 05/08/2021 (d) Uploaded EC letter :

6	Details of Consent to Operate

(i) Whether Consent to operate obtained (Yes/No) ? : No

7	Amendment Sought for

Amendment in Configuration/ Amendments in Clearance condition/ Other (specify) : 25000 cum per annum

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
1	River Sand	25000 Cum	Others	Road

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
1	River Sand	25000	25000	25000	NA

10	Reasons for Amendment

Reasons for Amendment : Submission of Replenishment Study Report

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
1	2042/SEIAA	25000 cum per annum	25000 cum per annum	NA

12	Details of EIA Consultant

Have you hired Consultant for preparing document (Yes/No) ? : No
(i)Reason for not engaging the Consultant : NA

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):

(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.	16/09/2023	1). The project proponent ask to submit the earlier EC compliance with year wise production details. 2). Submit either proforma-1 or Profoma-2 as applicable and also submit KML file of the lease area send to SEIAA, Odisha Email-info.seiaaodisha@gmail.com 3). Submit replenishment study report of sand through ORSAC empanel agency. 4). The PP may clarify that the transfer of EC was issued in favour of M/s.Suryavanshi Earth Movers and the Authorized person is Sri Bubekanda Dash but here Amendment of EC application applied by Sri Ganesh Kar that may clarify.
2.	13/10/2023	The corrections have been made as per the instruction received.
3.	28/10/2023	The PP ask to comply EDS correctly.
4.	06/03/2024	The corrections have been made as per the instruction received.

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 : GANESH KAR (c)Designation: No (d)Company: GANESH KAR (e)Address: Suryavanshi Earth Movers Sibanarayanpur Orissa 758030