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 proposal involved violation of EIA notificationN/A
Weather Consent to Establishment ObtainedN/A
Upload copy of CTE N/A
1.
Name of the Project/s Installation of LPG Mounded Bullet, Facility upgradation of Exist. LPG Bottling Plant & Complete Euro-IV HSD Project at Numaligarh refinery Limited
Brief summary of projectAnnexure-Brief summary of project
Proposal Number IA/AS/IND2/27791/2015
Project Cost 157855 lacs
2.
S. No. in the schedule5(e) Petrochemical based processing (processes other than cracking &
6(a) Oil & gas transportation pipe line (crude and refinery/ petrochemical
6(b)Isolated storage & handling of hazardous chemicals (As per threshold planning
Project Sector Industrial Projects - 2
3. Proposed capacity/area/length/tonnage to be handled/command area/lease area/number or wells to be drilled 1582 KTPA Euro IV HSD & 360 KTPA Euro V HSD & 4000 MT of LPG ha.
4.
New/Expansion/ModernizationNew
5. Existing Capacity/Area etc. a 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 projectNumaligarh Refinery Limited, Numaligarh ; Location co-ordinates : Logtitude 93 degrees 43'30" & latitude 26 degrees 37'30"N
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.Plot No. 94 Sub Dag No. 219
Town / VillagePankagrant, Numaligarh
State of the projectAssam
Details of State of the project
S.no State Name District Name Tehsil Name
(1.)AssamGolaghatBokakhat
(2.)AssamGolaghatGolaghat
10.
Nearest railway station along with distance in kms Numaligarh Railway Station, 11 km
Nearest airport along with distance in kms Jorhat, 65 km
11. Nearest Town/City/District Headquarters along with distance in kms Golaghat , 26 km
12. Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given)
13. Name of the Applicant Gopal Sarma
14. Registered Address 122A,G.S.Road Christian Basti Guwahati-781005
15.
Address for correspondance:
Name of the Company NUMALIGARH REFINERY LIMITED
Name of the Applicant Gopal Sarma
Designation (Owner/ Partner/ CEO) DGM(HSE)
Pin code 785699
E-mail baby.deori@nrl.co.in
Telephone No. 03776-265592
Fax No. 03776-
Copy of documents in support of the competence/authority of the person making this application to make application on behalf of the User Agency . NIL
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?
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) No The proposed project shall be implemented within the vacant space of existing Refinery premises. Hence there is no change in land use.
1.2 Clearance of existing land, vegetation and buildings? No The proposed projects shall be installed within the vacant space of existing refinery premises.
1.3 Creation of new land uses? No The proposed project shall be installed within the vacant of existing Refinery premises.
1.4 Pre-construction investigations e.g. bore houses, soil testing? Yes Soil investigation has been done
1.5 Construction works? Yes Construction of 4 Nos. of Mounded Bullets, Facility Upgradation of LPG Bottling plant and Construction of new units for Complete Euro-IV HSD Project.
1.6 Demolition works? Yes Dismantling of existing LPG storage spheres, bullet and pump house etc.
1.7 Temporary sites used for construction works or housing of construction workers? No Construction workers are being from nearby locality, no temporary housing will be necessary.
1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations Yes Construction of new units will require civil construction including excavation /fill.
1.9 Underground works including mining or tunnelling? No
1.10 Reclamation works? No
1.11 Dredging? No
1.12 Offshore structures? No
1.13 Production and manufacturing processes? Yes Mounded Bullet is a LPG storage facility, LPG Bottling plant invloves facility Upgradation and Complete Euro-IV HSD project will yield Euro-IV & Euro-V HSD.
1.14 Facilities for storage of goods or materials? No Existing Euro-III storage tank shall be used for storage of Euro-IV HSD product. Mounded Bullets are safer utility for LPG storage.
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? Yes There is no disposal of solid waste or liquid effluent from the Mounded Bullet project.Water coming with LPG shall be drained to drain vessel and any dissolve LPG in drain water shall be vented to flare. LPG Bottling Up gradation facility will have no additional impact on land, water or air. Liquid effluent from Complete Euro-IV HSD will be intermittent and very less and shall be accommodated in the existing ETP. Spent catalyst shall be recycled to the manufacturer/approved recycler.
1.16 Facilities for long term housing of operational workers? Yes The existing township shall accommodate few additional manpower required for Complete Euro-IV HSD project.There is no requirement of additional manpower for Mounded Bullet and Facility Upgradation project of LPG Bottling plant.
1.17 New road, rail or sea traffic during construction or operation? No
1.18 New road, rail, air water borne or other transport infrastructure including new or altered routes and stations, ports, airports etc? No
1.19 Closure or diversion of existing transport routes or infrastructure leading to changes in traffic movements? No
1.20 New or diverted transmission lines or pipelines? No
1.21 Impoundment, damming, culverting, realignment or other changes to the hydrology of watercourses or aquifers? No No changes to hydrology or water course due to new projects as the make up water required for the new project is very less.
1.22 Stream crossings? No
1.23 Abstraction or transfers of water from ground or surface waters? Yes The required make up water shall be utilised from existing surface water thru' Dhansiri river intake system for Euro-IV HSD project.
1.24 Changes in water bodies or the land surface affecting drainage or run-off? No
1.25 Transport of personnel or materials for construction, operation or decommissioning? Yes There will be marginal increase in transport of personnel & material during construction. However existing infrastructure is adequate to cater the same.
1.26 Long-term dismantling or decommissioning or restoration works? No
1.27 Ongoing activity during decommissioning which could have an impact on the environment? No
1.28 Influx of people to an area in either temporarily or permanently? Yes During construction stage , the construction workers primarily from local area will be involved.
1.29 Introduction of alien species? No
1.30 Loss of native species or genetic diversity? No
1.31 Any other actions? No
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 The proposed projects shall be installed within the existing Refinery premises.
2.2 Water (expected source & competing users) unit: KLD Yes Approx. 3240 KLD of raw water from river Dhansiri will be drawn to meet the water demand of the Euro-IV HSD project.No extra water is required for Mounded Bullet and Facility Upgradation project of LPG Bottling plant.
2.3 Minerals (MT) No
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) Yes Brick/stone and sand will be locally available.
2.5 Forests and timber (source – MT) No
2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW) Yes The power requirement for Mounded Bullet project is 0.15 MW; 0.274 MW power shall be required for Bottling plant facility upgradation project ; Power requirement for Complete Euro-IV HSD project is estimated as 7.545 MW. Fuel requirement as 44.82 TPH. No fuel is required for Bottling plant facility upgradation & Mounded Bullet project.
2.7 Any other natural resources (use appropriate standard units) No
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 Yes Chemical and catalyst will be used as per the requirement in the Euro-IV project/unit. These materials will be properly transported, stored and used as per the statutory rules and regulations. Solid waste materials generated from proposed project will be handled as per the Hazardous waste management rules as applicable. No hazardous substances shall be used in Mounded Bullet and LPG Bottling upgradation facility project.
3.2 Changes in occurrence of disease or affect disease vectors (e.g. insect or water borne diseases) No
3.3 Affect the welfare of people e.g. by changing living conditions? No
3.4 Vulnerable groups of people who could be affected by the project e.g. hospital patients, children, the elderly etc. No
3.5 Any other causes No
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 No
4.2 Municipal waste (domestic and or commercial wastes) Yes The domestic waste will be collected systematically for treatment.
4.3 Hazardous wastes (as per Hazardous Waste Management Rules) Yes Spent catalyst generated will be sent back to the original supplier/ approved recycler for reprocessing. The liquid effluent is intermittent and shall be accommodated in existing ETP.
4.4 Other industrial process wastes No
4.5 Surplus product No
4.6 Sewage sludge or other sludge from effluent treatment Yes Sewage sludge or other effluent sludge which will be intermittent and small in qty. shall be treated in existing ETP.
4.7 Construction or demolition wastes No Minimal quantity of construction and demolition waste will be generated. However, the same will be used for filling up low lying areas inside the refinery area.
4.8 Redundant machinery or equipment No
4.9 Contaminated soils or other materials No
4.10 Agricultural wastes No
4.11 Other solid wastes No
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 Yes Sox emission from use of Natural Gas in GEG and heater of Complete Euro-IV HSD Project/unit is very small and estimated to be less than 250 kg/day. There is no emission from other two projects.
5.2 Emissions from production processes Yes Sox emission from use of Natural Gas in GEG and heater is very small and estimated to be less than 250 kg/day.
5.3 Emissions from materials handling including storage or transport Yes For fugitive emission in storage tanks, inside battery limit of new units, mitigatory steps like leak detection and repair (LDAR) program shall be in place.
5.4 Emissions from construction activities including plant and equipment Yes There will be emission from construction equipment/vehicle during construction. The effect will be local and marginal.
5.5 Dust or odours from handling of materials including construction materials, sewage and waste Yes Dust generated due to construction activities will be localized in nature within the existing refinery complex. Water will be sprinkled to mitigate the dust formation.
5.6 Emissions from incineration of waste No
5.7 Emissions from burning of waste in open air (e.g. slash materials, construction debris) No
5.8 Emissions from any other sources No
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 All equipments are designed to comply with standard requirement. Noise level at the battery limit shall comply with stipulated norms.
6.2 From industrial or similar processes Yes The noise levels from all industrial activities would be within permissible limits. Hearing protectors will be used by the occupational workers.
6.3 From construction or demolition Yes During construction activities, there would be small increase in the noise levels within the project area. However, all suitable measures will be taken, so that noise level do not increase beyond prescribed limits in the project boundary. Hearing protections will be used by the occupational workers.
6.4 From blasting or piling Yes No blasting activity will be carried out. Limited piling activities may be required to be carried out during proposed project construction.
6.5 From construction or operational traffic Yes During construction phase, there will be marginal increase in noise level due to increased traffic movement in the project area. However this effect will be marginal and reversible.
6.6 From lighting or cooling systems Yes All equipments shall meet the standard requirement. Noise level at the battery limit shall comply with stipulated norms.
6.7 From any other sources No
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 All the hazardous materials will be handled as per best safety practices and in accordance with the applicable statutory rules. All necessary precautions shall be in place to prevent any spill/contamination.
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) No The industrial effluent is minimal and shall be accommodated in existing ETP.Treated effluent will be recycled and reused for internal consumption.
7.3 By deposition of pollutants emitted to air into the land or into water No All emissions from proposed projects will comply with the applicable regulatory standards.Emissions/discharge of pollutants shall be minimized by adopting best available technology and engineering practices.
7.4 From any other sources No
7.5 Is there a risk of long term build up of pollutants in the environment from these sources? No
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 Yes All the necessary engineering and administrative measures will be taken in accordance with the rules and procedures and a structured monitoring system will be implemented to prevent accidents due to handling of hazardous substances. Risk Assessment study will also be carried out for the proposed projects and proposed risk mitigation measures will be complied.
8.2 From any other causes Yes All existing safety procedures will be followed for the projects. Adequate safety training will be provided to the employees to the employees during both construction and operational phases.
8.3 Could the project be affected by natural disasters causing environmental damage (e.g. floods, earthquakes, landslides, cloudburst etc)? Yes Design and engineering of the project will take suitable considerations of all such eventualities.
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
No The proposed projects will come up inside existing refinery premises.
9.2 Lead to after-use of the site, which could have an impact on the environment No
9.3 Set a precedent for later developments No
9.4 Have cumulative effects due to proximity to other existing or planned projects with similar effects No
(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
Yes Deopahar historical site is situated 5 km from the refinery boundary.
2 Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Yes Kaziranga National Park and Garampani & Wildlife sanctuaries are situated at an aerial distance of 22.5 km north-west and 20 km south -east from the refinery boundary respectively.
3 Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration No The surrounding site of refinery is not mentioned an important Bird Areas by BNHS.
4 Inland, coastal, marine or underground waters No
5 State, National boundaries Yes
6 Routes or facilities used by the public for access to recreation or other tourist, pilgrim areas No
7 Defence installations No
8 Densely populated or built-up area No
9 Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship, community facilities) No
10 Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) No
11 Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) No
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 Yes The site falls under zone-v category as per Seismic map of India
(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
      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 ApplicantGopal Sarma
DesignationDGM(HSE)
Name of Company (Applicant Name should not be given here)NUMALIGARH REFINERY LIMITED
Address122A,G.S.Road Christian Basti Guwahati-781005
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