Form-4

APPLICATION FOR AMENDMENT IN ENVIRONMENTAL CLEARANCE

(To be filled up by User Agency)
1. Details of Project
 
 Proposal No. : SIA/OR/MIN/307609/2023  
 (a) Name of the project : BOMIKA SAND BED  
 (b) Name of Company / Organisation. : ANITA MAHANKUDO  
 (c) Registered Address. : At-Ankasahi, Parlakhemundi Orissa 761200  
 (d) Legal Status of the Company. : Individual  
 (e) Joint Venture (Yes/No) : No
2. Address for the Correspondence
 
 (a) Name of the Applicant. : ANITA MAHANKUDO  
 (b) Designation (Owner/Partner/CEO) : No  
 (c) Address :-  
        State : Orissa  
        District : Gajapati  
        Town / Village : No  
 (d) Pin Code : 761200  
 (e) Email : bomikasand@gmail.com  
 (f) Telephone no : No  
 (g) Fax no : No  
 (h) Mobile no : 6371069576  
 (i) Contact Person. : ANITA MAHANKUDO  
 (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. - 152 and Plot No.- 454, 195 & 201/731  
 (b) Village : Bomika  
 (c) Tehsil : Parlakhemundi  
 (d) District : Gajapati  
 (e) State : Orissa  
 (f) Pin Code : 761200  
 (g) Bounded Latitudes (North) : Yes  
         From : Degree:18, Minutes : 52, Seconds :14  
         To    : Degree:18, Minutes : 52, Seconds :38  
 (h) Bounded Longitudes (East) : Yes  
         From : Degree:84, Minutes : 10, Seconds :05  
         To    : Degree:84, Minutes : 10, Seconds :11  
 (i) Survey of India Topo Sheet No : 74B/1
5 Details of Environmental Clearance
 
 (a) Project Name : BOMIKA SAND BED  
 (b) MoEF&CC / SEIAA File No : SEIAA-1236/01-2021  
 (c) Date of issue of EC : 01/07/2021   (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 : 13/03/2023  
 (iv)Valid Upto: 31/03/2026  
 (v)File No : No  
 (vi)Application No : 767   (vii)Uploaded copy of Consent to operate valid as on Date:
7 Amendment Sought for
 
 Amendment in Configuration/ Amendments in Clearance condition/ Other (specify) : SUBMISSION OF SAND REPLENISHMENT REPORT.
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
1SAND20Cubic meter per DayRoad
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
1MINING OF SAND540054005400
10 Reasons for Amendment
 
 Reasons for Amendment : FOR APPROVAL OF SAND REPLENISHMENT 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
1EC GRANTED WITH THE SUBMIISION OF REPLENISHMENT REPORTAPPROVED QUANTITY IS 5400CUM WITH THE DEPTH OF MINSUBMISSION OF REPLENISHMENT REPORT.
12 Details of EIA Consultant
 
 Have you hired Consultant for preparing document (Yes/No) ? : No  
 (i)Reason for not engaging the Consultant : AS IT IS A B2 CATEGORY PROJECT.
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
1.26/12/2023). The project proponent ask to submit KML file of the proposed lease area and send it to SEIAA, Odisha Email-info.seiaaodisha@gmail.com 2). The PP also required to submit compliance of EC conditions with mentioning year-wise production details. 3). There is no forwarding letter from concerned lease granting Authority and no signature in Replenishment study report that may be clarified and submit reply accordingly.
2.03/01/2024The 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 : ANITA MAHANKUDO (c)Designation: No (d)Company: ANITA MAHANKUDO (e)Address: At-Ankasahi, Parlakhemundi Orissa 761200