APPENDIX I
(See Paragraph-6)
FORM 1M
Note : If space provided against any parameter is inadequate,Kindly upload supporting document under 'Additional Attachments if any'  at the last part of the Form 1M. Please note that all such Annexures must be part of single pdf document.
(I)Basic Informations
S.No.Item Details
(i).Name of the Mining Lease site M/s Kumbidi Granites
(ii).Location / site (GPS Co-ordinate) Latitude :- 10°49'12.35"N Longitude :- 76° 2'53.12"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)0.9912 ha.
(iv).Capacity of the Mining Lease (TPA) 41200
(v).Period of Mining Lease 5
(vi).Expected cost of the Project 45
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.RQP/BNG/338/2014/A 
Name of Consultant/RQPMahesh.S
Address TC 31/580,Navadeepam,S.N Nagar,House No:24,Pettah (p.o),Trivandrum
Mobile No.9446303422
Landline No.2456333
Email Idmaheshsurendranpillai@gmail.com
(II) Environmental Sensitivity
S.No Areas Distance in kilometer / Details
1. (i).  Nearest rail or road bridge over the concerned river,rivulet,nallah etc. in kms.  7 km
2. (ii). Nearest Infrastructural along with distance in kms  7 km
(iii). Nearest Railway Line along with distance in kms  8 km
(iv). Nearest National Highway along with distance in kms  8 km
(v). Nearest State Highway along with distance in kms  8 km
(vi). Nearest Major District Road along with distance in kms 2 km
(vii). Nearest Any Other Road along with distance in kms  2 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.8 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  2 km
(x). Nearest In-take for drinking water pump house distance in kms  3 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  2 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
None within 5km radius
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Kulappully, 30km
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration None within 5km radius
6. Inland, coastal, marine or underground waters Ponnani-22Km
7. State, National boundaries Valayar-86km
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas Malampuzha – Ottapalam79km
9. Defence installations KINFRA Defence park- 27km
10. Densely populated or built-up area, distance from nearest human habitation Kumbidi-1.5km Anakkara-3km Kuttipuram-7km
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Tourist & Pilgrim areas:- Velliamkallu-10km KumbidiJumamasjid-2Km Panniyur-Varahamoorthy Panniyur-Varahamoorthy-3km Kuttipuram-7 KM Schools & Colleges:- Anakkara High School-2km ParakulamNss-4km Hospitals:- PhcKuttipuram Taluk Hospital-7km
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) None within 5km radius
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) No
14. 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) No
15.
Is proposed mining site located over or near fissure/fracture for ground water recharge?No
16.
Whether the proposal involves approval or clearance under the following Regulations or Acts namely?
(a).
The Forest (Conservation) Act,1980?No
(b).
The Wildlife (Protection) Act,1972?No
(c).
The Coastal Regulation Zone (C.R.Z) notification,2011?No
17.
Is forest land involved (ha)?No
18.
Whether there is any litigation pending against the project and/or land in which the project is proposed to be set up?No
19.
New/Expansion/ModernizationNew
Proposal NumberDIA/KL/MIN/19291/2018
File NumberDIA/KL/PL/62/2018
Date of Apply EC04 Dec 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaPalakkadOttappalam
(III) EC Attachments
1 Uploaded PFR (Pre Feasibility Report) File Annexure-PFR file
2 Uploaded Approved Mining Plan File Annexure-Approved Mining Plan file
3 Uploaded District survey report Annexure-District Survey Report
4 Uploaded Cover Letter Annexure-Cover Letter
Uploaded Additional attachments, if any
S.No. Attached File Date of Submission
(1.)Approval Letter30 Nov 2018
(2.)500m certificate30 Nov 2018
(3.)Letter of Intent30 Nov 2018
(4.)ID Proof30 Nov 2018
(5.)From 26AS30 Nov 2018
(6.)Form-26AS Traces04 Dec 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameM/S KUMBIDI GRANITES
DesignationManagingpartner
Company M/S KUMBIDI GRANITES
AddressMalamakkavu(p.o),Anakkara, Palakkad District,Kerala-679 554
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