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 Saiki Stone Quarry
(ii).Location / site (GPS Co-ordinate) BP1 20°55'39.13"N 79°11'51.59"E BP2 20°55'37.54"N 79°11'56.02"E BP3 20°55'26.33"N 79°11'52.17"E BP4 20°55'28.28"N 79°11'48.18"E BP5 20°55'35.21"N 79°11'50.17"E
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)4.80 ha.
(iv).Capacity of the Mining Lease (TPA) 300000
(v).Period of Mining Lease 5
(vi).Expected cost of the Project 20
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.NABET/EIA/1619/RA 0037 
Name of Consultant/RQPVARDAN ENVIRONET
Address D-142, Golf Course, Ext. Road, Sushant Lok-III, Sector 57, Gurgaon, Haryana
Mobile No.9595773278
Landline No.0959577
Email Idnilesh26lax@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.  00.00 km
2. (ii). Nearest Infrastructural along with distance in kms  00.00 km
(iii). Nearest Railway Line along with distance in kms  10 km
(iv). Nearest National Highway along with distance in kms  00.00 km
(v). Nearest State Highway along with distance in kms  4 km
(vi). Nearest Major District Road along with distance in kms 4 km
(vii). Nearest Any Other Road along with distance in kms  0.430 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.050 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  2.25 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 • Paradgaon Lake is situated at a distance of 2.25 km in east of the area. • Saiki Dam & Reservoir is situated at a distance of 1.15 km in west of the mine area. • Canal is present at a distance of 1.0 km in SW direction.
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 Not present nearby the area
7. State, National boundaries There is no any State and National Boundary is present nearby the 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
10. Densely populated or built-up area, distance from nearest human habitation The Saiki village is thinly populated village which is present at a distance of about 1.30 km from area.
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Medical Facility: - Primary Health Centre at Saiki village at a distance of 1.30 km from mining site. School: - In Primary School in Saiki Village. (1.30 Km.) Post office: - Saiki Pin code is 441204 and postal head office is Umred.
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) Areas containing important, high quality or scarce resources are not present
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/19345/2018
File NumberTo be assigned
Date of Apply EC01 Dec 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)MaharashtraNagpurUmred
(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 1M01 Dec 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameMS PAWANPUTRA CONCRETE SOLUTIONS PRIVATE LIMITED SHRI AMIT GHANSHYAM TAORI
DesignationOwner
Company MS PAWANPUTRA CONCRETE SOLUTIONS PRIVATE LIMITED SHRI AMIT GHANSHYAM TAORI
AddressM/s. Pawanputra Concrete Solutions Private Limited Shri Amit Ghanshyam Taori 35, Sarika Corporate 202-203, 2nd Floor, Pande Layout Khamla Nagpur.
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