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Form-6

APPLICATION FOR EXTENSION OF VALIDITY OF ENVIRONMENTAL CLEARANCE

(To be filled up by User Agency)

1.	Details of Project

Proposal No. : SIA/MH/MIN/308050/2024
(a) Name of the project : Shri. Nandkumar Gopalrao Kulkarni
(b) Name of Company / Organisation. : NANDKUMAR KULKARNI
(c) Registered Address. : Gat No. 4 Part, Village- Nandoshi , Taluka- Haveli, District- Pune Maharashtra 411024
(d) Legal Status of the Company. : Individual
(e) Joint Venture (Yes/No) : No

2.	Address for the Correspondence

(a) Name of the Applicant. : NANDKUMAR KULKARNI
(b) Designation (Owner/Partner/CEO) : No
(c) Address :-
       State : Maharashtra
       District : Pune
       Town / Village : No
(d) Pin Code : 411024
(e) Email : ngkulkarni7@gmail.com
(f) Telephone no : No
(g) Fax no : No
(h) Mobile no : 9822454966
(i) Contact Person. : NANDKUMAR KULKARNI
(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 : 4 Part
(b) Village : Nandoshi
(c) Tehsil : Haveli
(d) District : Pune
(e) State : Maharashtra
(f) Pin Code : 411041
(g) Bounded Latitudes (North) : Yes
        From : Degree:18, Minutes : 25, Seconds :7
        To    : Degree:18, Minutes : 25, Seconds :15
(h) Bounded Longitudes (East) : Yes
        From : Degree:73, Minutes : 48, Seconds :14
        To    : Degree:73, Minutes : 48, Seconds :51
(i) Survey of India Topo Sheet No : 47 F/15

5.	Details of Environmental Clearance

(a) Project Name : Shri. Nandkumar Gopalrao Kulkarni
(b) MoEF&CC / SEIAA File No : SIA/MH/MIN/160411/2020
(c) Date of issue of EC : 30/04/2021 (d) Uploaded EC letter :

6.	Details of Consent to Establishment

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

7	Whether Amendment is environmental clearance is also sought for ?:-

Amendment in Configuration/ Amendments in Clearance condition/ Other (specify) : No

8	Details of Production (as per the approved EC ):-

Details of Products
S.no	Product / Activity (Capacity/ Area).	Quantity	Unit	Mode of Transport/ Transmission of Product
1	Basalt Stone	32016	Tons per Annun(TPA)	Road

9	Details of Amendment in Configuration sought(Multiple Entries Allowed):-

Details of Configurations
S.no	Plant/ Equipment/ Facility	Existing Configuration	Proposed Configuration	Final configuration after Amendment	Remarks if Any
1	Air Compressor, Jack Hammer, Excavator, Tippers etc	1 set of each	-	1 set of each

10	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	NA	NA	NA	NA

11	Reason for Seeking Extension of Validity of the Environmental Clearance:-

Uploaded substantiating the reason of the delay in implementation :

12	Progress of Implementation of the Project /Facilities /Activities:-

Progress of implementation of the project /facilities /activity for which environmental clearance was granted (Physical Progress) : The Minng activity is beeing carried out as per approved Mining Plan.

13	Schedule of the Completion of the Balance Activity / Project:-

Uploaded bar chart of schedule of implementation:

14	Details of EIA Consultant

Have you hired Consultant for preparing document (Yes/No) ? : Yes
(i) Accereditation No : NABET/EIA/2225/R02622
(ii) Name of EIA Consultant : Aditya Environemnta Sevrices Pvt Ltd
(iii)Address : 110, Hiren light Industrial estate, Mahim, Mumbai
(iv)Mobile No: 9821513367
(v)Landline No : 8600107678
(vi)E-mail Id : rajiv@aespl.co.in
(vii)Category of Accreditation : Both
(viii)Sector of Accreditation : 1 (a) Non coal Mining project
(ix)Validity of Accreditation : 01/05/2025 (x)Uploaded certificate of Accreditation certified by QCI/NABET :

15.	Documents to be attached

(a) Uploaded addendum to EIA/EMP Report (in case of Amendment in environmental clearance also sought):

(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)(in case of Amendment in environmental clearance also sought):

(c) Uploaded Copy of final Layout Plan (in case of Amendment in environmental clearance also sought):

(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:

Essential Details Sought

Essential Details Sought
S.no.	EDS Sought Date	EDS Sought	Letter
NIL

Additional Detail Sought: NIL

16.	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 : NANDKUMAR KULKARNI (c)Designation: No (d)Company: NANDKUMAR KULKARNI (e)Address: Gat No. 4 Part, Village- Nandoshi , Taluka- Haveli, District- Pune Maharashtra 411024