APPENDIX I
(See Paragraph-6)
FORM 1
Note : If space provided against any parameter is inadequate, Kindly upload supporting document under 'Additional Attachments if any'  at the last part of the Form1. Please note that all such Annexures must be part of single pdf document.
(I) Basic Information
S.No.Item Details
Is your project Comes under Notified Industrial Area NA
Whether it is a violation case and application is being submitted under Notification No. S.O.804(E) dated 14.03.2017 ? Yes
Type of Violation Started the work onsite without prior EC under EIA notification,2006.
Details of Violation 804(E) dated 14.03.2017
1.
Name of the Project/s Black Granite Quarry (Operating) in 4.470 Ha. of Govt. Land bearing Sy. No. 240 of 73 Thirumalakonda Mambagaripet Village, Karvetinagar Mandal, Chittoor District, A.P.
Brief summary of projectAnnexure-Brief summary of project
Proposal Number IA/AP/CMIN/73276/2018
Project Cost 25 lacs
2.
S. No. in the schedule1(a) Mining of minerals
Project Sector Coal Mining
3. Proposed capacity/area/length/tonnage to be handled/command area/lease area/number or wells to be drilled 8350 ha.
4.
New/Expansion/ModernizationNew
5. Existing Capacity/Area etc. 731712 ha.
6. Category of project i.e. 'A' or 'B' A
7.
Does it attract the general condition? If yes, please specify No
8.
Does it attract the specific condition? If yes, please specify No
9.
Location of the projectSy. No. 240 of 73 Thirumalakonda Mambagaripet Village, Karvetinagar Mandal, Chittoor District, A.P.
Shape of the project landBlock (Polygon)
Uploaded GPS fileAnnexure-GPS file      
Uploaded copy of survey of India ToposheetAnnexure-Survey of india toposheet
Plot/Survey/Khasra No.240 of 73
Town / VillageThirumalakonda Mambagaripet Village, Karvetinagar Mandal, Chittoor District, A.P.
State of the projectAndhra Pradesh
Details of State of the project
S.no State Name District Name Tehsil Name
(1.)Andhra PradeshChittoorKarvetinagar
10.
Nearest railway station along with distance in kms Renigunta, 25.0 km
Nearest airport along with distance in kms Renihunta, 25.0 km
11. Nearest Town/City/District Headquarters along with distance in kms Karvetinagar , 6.0 km
12. Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given) Thirumalakonda Mambagaripet Karvetinagar Mandal
13. Name of the Applicant Sri
14. Registered Address D.No.9/1,C.K. Srinivasa Rao Street Dharmapuri-636701 Tamilanadu
15.
Address for correspondance:
Name of the Company M/S RAJ ROCKS INDUSTRIES, PROP: SRI. KR SATHISH KUMAR
Name of the Applicant Sri
Designation (Owner/ Partner/ CEO) Propriter
Pin code 517582
E-mail rajrocksindustriestms@gmail.com
Telephone No. 040-256356
Fax No. 040-
Copy of documents in support of the competence/authority of the person making this application to make application on behalf of the User Agency . Annexure-Uploaded Copy of documents in support of the competence/authority
16.
Details of Alternative Sites examined, if any. Location of these sites should be shown on a toposheet No
17. Whether part of Interlinked projects? No
18. Whether separate application of Interlinked project has been submitted? N/A
19.
If Yes, MoEF file numberN/A
Date of submissionN/A
20. If No, Reason N/A
21.
Whether the proposal involves Approval/ Clearance under: if yes, details of the same and their status to be given
(i) Whether the proposal involves approval/clearance under the Forest (Conservation) Act,1980?No
(ii) Whether the proposal involves approval/clearance under the wildlife (Protection) Act,1972?No
(iii) Whether the proposal involves approval/clearance under the C.R.Z notification, 2011?No
22.
Whether there is any Government Order/Policy relevant/relating to the site?No
23.
Whether any Forest Land Involved?No
Area of Forest land Involved (hectares)N/A
24.
Whether there is any litigation pending against the project and/or land in which the project is proposed to be set up?No
(a) Name of the CourtN/A
(b) Name of the Sub courtN/A
(c) Case No.N/A
(d) Orders/directions of the court, if any and relevance with the proposed projectN/A
(II) Activity
1 Construction, operation or decommissioning of the Project involving actions, which will cause physical changes in the locality (topography, land use, changes in water bodies, etc.)
S.No Information/Checklist confirmation Yes/No Details there of (with approximate quantities/rates, wherever possible) with source of information data
1.1 Permanent or temporary change in land use, land cover or topography including increase in intensity of land use (with respect to local land use plan) Yes Permanent Change in land use
1.2 Clearance of existing land, vegetation and buildings? Yes Clearing existing minor vegetation in the shaft area
1.3 Creation of new land uses? Yes Mining Activity
1.4 Pre-construction investigations e.g. bore houses, soil testing? Yes None
1.5 Construction works? No None
1.6 Demolition works? No None
1.7 Temporary sites used for construction works or housing of construction workers? No Local labours only
1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations Yes Excavations will be done
1.9 Underground works including mining or tunnelling? Yes Black Granite Quarrying by Open-cast method
1.10 Reclamation works? No NA
1.11 Dredging? No NA
1.12 Offshore structures? No NA
1.13 Production and manufacturing processes? Yes Total Saleable For 5 Years : 8350 Tons, Avg.: 1670 m3/ Annum
1.14 Facilities for storage of goods or materials? Yes Open yard Storage.
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? Yes Solid waste will be stored in open yards
1.16 Facilities for long term housing of operational workers? No Only local workers
1.17 New road, rail or sea traffic during construction or operation? Yes Marginally increase
1.18 New road, rail, air water borne or other transport infrastructure including new or altered routes and stations, ports, airports etc? No No need
1.19 Closure or diversion of existing transport routes or infrastructure leading to changes in traffic movements? No None
1.20 New or diverted transmission lines or pipelines? No NA
1.21 Impoundment, damming, culverting, realignment or other changes to the hydrology of watercourses or aquifers? No NA
1.22 Stream crossings? No None
1.23 Abstraction or transfers of water from ground or surface waters? No Purchased locally
1.24 Changes in water bodies or the land surface affecting drainage or run-off? No NA
1.25 Transport of personnel or materials for construction, operation or decommissioning? Yes Quarried products will be transported through covered trucks.
1.26 Long-term dismantling or decommissioning or restoration works? No NA
1.27 Ongoing activity during decommissioning which could have an impact on the environment? No Positive impact on environment, due to tree plantation
1.28 Influx of people to an area in either temporarily or permanently? No NA
1.29 Introduction of alien species? No None
1.30 Loss of native species or genetic diversity? No Native species will be planted
1.31 Any other actions? No NA
2 Use of Natural resources for construction or operation of the Project (such as land, water, materials or energy, especially any resources which are non-renewable or in short supply):
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
2.1 Land especially undeveloped or agricultural land (ha) No Govt. Waste Land.
2.2 Water (expected source & competing users) unit: KLD Yes 5,000 L/d for dust suppression
2.3 Minerals (MT) No The proposal itself is for mineral extraction
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) No NA
2.5 Forests and timber (source – MT) No NA
2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW) No Only diesel for the machineries
2.7 Any other natural resources (use appropriate standard units) No None
3 Use, storage, transport, handling or production of substances or materials, which could be harmful to human health or the environment or raise concerns about actual or perceived risks to human health
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
3.1 Use of substances or materials, which are hazardous (as per MSIHC rules) to human health or the environment (flora, fauna, and water supplies No Only diesel & lubricating oils will be used for machinery and vehicles.
3.2 Changes in occurrence of disease or affect disease vectors (e.g. insect or water borne diseases) Yes No Shafts will be Provided in Black Granite quarry at the end of the period. Water logging should be avoided
3.3 Affect the welfare of people e.g. by changing living conditions? Yes Living conditions will be improved due to the proposed CSR activities
3.4 Vulnerable groups of people who could be affected by the project e.g. hospital patients, children, the elderly etc. No None
3.5 Any other causes No None
4 Production of solid wastes during construction or operation or decommissioning (MT/month)
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
4.1 Spoil, overburden or mine wastes Yes 43850 m3 for 5 years
4.2 Municipal waste (domestic and or commercial wastes) No NA
4.3 Hazardous wastes (as per Hazardous Waste Management Rules) No NA
4.4 Other industrial process wastes No Waste will be used for road works
4.5 Surplus product No NA
4.6 Sewage sludge or other sludge from effluent treatment No NA
4.7 Construction or demolition wastes No None
4.8 Redundant machinery or equipment No NA
4.9 Contaminated soils or other materials No NA
4.10 Agricultural wastes No NA
4.11 Other solid wastes No NA
5 Release of pollutants or any hazardous, toxic or noxious substances to air(Kg/hr)
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
5.1 Emissions from combustion of fossil fuels from stationary or mobile sources No Combustion of HSD, by mining machinery will result in emissions, whenever operated
5.2 Emissions from production processes Yes Fugitive emissions from the process
5.3 Emissions from materials handling including storage or transport Yes Emissions from material handling including storage or transport is expected
5.4 Emissions from construction activities including plant and equipment No None
5.5 Dust or odours from handling of materials including construction materials, sewage and waste Yes Increase in dust concentration due to Fugitive emission and vehicle movement
5.6 Emissions from incineration of waste No Not applicable
5.7 Emissions from burning of waste in open air (e.g. slash materials, construction debris) No Not applicable
5.8 Emissions from any other sources No None
6 Generation of Noise and Vibration, and Emissions of Light and Heat:
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
6.1 From operation of equipment e.g. engines, ventilation plant, crushers Yes Noise levels up to 80 dB (A) are anticipated during operation stage.
6.2 From industrial or similar processes No As above
6.3 From construction or demolition No None
6.4 From blasting or piling No No Blasting Or Piling
6.5 From construction or operational traffic Yes Noise levels in the range of 60-80 dB (A) at source due to operational traffic for
6.6 From lighting or cooling systems No Not Applicable
6.7 From any other sources No Not Applicable
7 Risks of contamination of land or water from releases of pollutants into the ground or into sewers, surface waters, groundwater, coastal waters or the sea:
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
7.1 From handling, storage, use or spillage of hazardous materials No NA
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) No NA
7.3 By deposition of pollutants emitted to air into the land or into water No Only SPM
7.4 From any other sources No NA
7.5 Is there a risk of long term build up of pollutants in the environment from these sources? No NA
8 Risk of accidents during construction or operation of the Project, which could affect human health or the environment
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
8.1 From explosions, spillages, fires etc from storage, handling, use or production of hazardous substances No NA
8.2 From any other causes No NA
8.3 Could the project be affected by natural disasters causing environmental damage (e.g. floods, earthquakes, landslides, cloudburst etc)? No NA
9 Factors which should be considered (such as consequential development) which could lead to environmental effects or the potential for cumulative impacts with other existing or planned activities in the locality
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
9.1 Lead to development of supporting utilities, ancillary development or development stimulated   by the project which could have impact on the environment e.g.:
  • Supporting infrastructure (roads, power supply,waste or waste water treatment, etc.)
  • housing development
  • extractive industries
  • supply industries
  • Other
Yes Supporting infrastructure like roads, alternative business opportunities etc may improve.
9.2 Lead to after-use of the site, which could have an impact on the environment Yes Plantation of the greenery, after closure of mine, will improve the vegetation cover of the area
9.3 Set a precedent for later developments Yes Some employment opportunity will be generated.
9.4 Have cumulative effects due to proximity to other existing or planned projects with similar effects No NA
(III) Environmental Sensitivity
S.No Areas Name/Identity Aerial distance (within 15km.) Proposed project location boundary
1 Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
No The area is not covered under any international conventions
2 Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests No TKM puram pond 2.6 Km N Tirumalarajapuram pond 1.57 Km NW Yerramarajupalle pond 2.9 Km WS Kundeti vanka 5.7 Km S Mangunta East RF 9.6 Km WS Ammapalle PF 0.8 Kms SW Rayalacheruvu PF 5.2 Km NW Karvetnagar PF 4.1 Km NE Surendranagram PF 6.8 Km E
3 Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration No None
4 Inland, coastal, marine or underground waters No NA
5 State, National boundaries No NH-716 (Chennai- Tirupati Hwy) towards east side about 19.0 Kms.
6 Routes or facilities used by the public for access to recreation or other tourist, pilgrim areas No NIl
7 Defence installations No NIl
8 Densely populated or built-up area Yes Karvetinagar 6.98 Km
9 Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship, community facilities) No None
10 Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) No None
11 Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) No Not Applicable
12 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) similar effects No Not Applicable
(IV) Proposed Terms of Reference for EIA studies
1 Uploaded Proposed TOR File Annexure-TOR file
2 Uploaded scanned copy of covering letter Annexure-scanned copy of covering letter
3 Uploaded Pre-Feasibility report(PFR) Annexure-PFR
4 Uploaded additional attachments(only single pdf file) Annexure-Additional attachments
5Uploaded Approval of mining PlanN/A
      Essential Detail Sought : NIL
      Additional Detail Sought : NIL
(V) Undertaking
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.
V.(i)
Name of ApplicantSri
DesignationPropriter
Name of Company (Applicant Name should not be given here)M/S RAJ ROCKS INDUSTRIES, PROP: SRI. KR SATHISH KUMAR
AddressD.No.9/1,C.K. Srinivasa Rao Street Dharmapuri-636701 Tamilanadu
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