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 Sand Mining, Village - Kamalweli
(ii).Location / site (GPS Co-ordinate) BP1 19°48'22.22"N 78°38'43.01"E BP2 19°48'24.89"N 78°38'44.85"E BP3 19°48'21.39"N 78°38'50.59"E BP4 19°48'18.68"N 78°38'48.71"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)2.0 ha.
(iv).Capacity of the Mining Lease (TPA) 3534
(v).Period of Mining Lease 1
(vi).Expected cost of the Project 1
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.NABET/EIA/1619/RA 0059 
Name of Consultant/RQPANACON LABORATORIES PRIVAE LIMITED
Address 60, BAJIPRABHU NAGAR, NAGPUR
Mobile No.9372404924
Landline No.2242077
Email Idproject@anacon.in
(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.  00.00 km
2. (ii). Nearest Infrastructural along with distance in kms  00.00 km
(iii). Nearest Railway Line along with distance in kms  2 km
(iv). Nearest National Highway along with distance in kms  8 km
(v). Nearest State Highway along with distance in kms  1.15 km
(vi). Nearest Major District Road along with distance in kms 00.00 km
(vii). Nearest Any Other Road along with distance in kms  0.05 km
(viii). Nearest Electric transmission line pole or tower distance in kms  2 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  00.00 km
(x). Nearest In-take for drinking water pump house distance in kms  00.00 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  00.00 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
There are any no international conventions, national or local legislation for their ecological, landscape, cultural or other related value.
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Not present nearby the area
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration There is no any sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration.
6. Inland, coastal, marine or underground waters Coastal, marine water are not present. The sand mining of river bed may encounter underground water, but precautions will be taken not to be disturbing it.
7. State, National boundaries State Boundary of Telangana State is present nearby the sand ghat area
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas Not present
9. Defence installations Not present nearby the area
10. Densely populated or built-up area, distance from nearest human habitation Kamalweli is thinly populated village present nearby the sand ghat area
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Primary schooling, Primary health center, etc. Higher Education facilities are available at Yavatmal City.
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Areas containing important, high quality or scarce resources are not present
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/MH/MIN/18405/2018
File NumberDIA/MH/MIN/18405/2018
Date of Apply EC25 Oct 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)MaharashtraYavatmalZari-Jamani
(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.)Form 1M25 Oct 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameTEHSILDAR YAVATMAL MEHSOOL
DesignationTehsildar
Company TEHSILDAR YAVATMAL MEHSOOL
AddressCollector Office, Yavatmal
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