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 Proposed Installation of Single Point Mooring & Associated Infrastructure by Coviva Energy Terminals Limited. (a subsidiary of Nayara Energy Ltd. Company)
Brief summary of projectAnnexure-Brief summary of project
Proposal Number IA/GJ/MIS/113096/2019
Project Cost 50000 lacs
2.
S. No. in the schedule7(e) Ports, Harbours
Project Sector INFRA-2
3. Proposed capacity/area/length/tonnage to be handled/command area/lease area/number or wells to be drilled SPM capable of handling up to 350,000 DWT Ships. ha.
4.
New/Expansion/ModernizationNew
5. Existing Capacity/Area etc. 0 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 projectVadinar
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.Not Applicable
Town / VillageVadinar
State of the projectGujarat
Details of State of the project
S.no State Name District Name Tehsil Name
(1.)GujaratDevbhumi DwarkaKhambhalia
10.
Nearest railway station along with distance in kms khambhalia, 34 km
Nearest airport along with distance in kms Jamnagar, 50 km
11. Nearest Town/City/District Headquarters along with distance in kms khambhaliya , 34 km
12. Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given) Vadinar gram Panchayat, Ta-Khambhalia, District-Devbhumi Dwarka
13. Name of the Applicant Sachin
14. Registered Address Khambhalia, Post Box No.24, District Devbhumi Dwarka
15.
Address for correspondance:
Name of the Company COVIVA ENERGY TERMINALS LIMITED
Name of the Applicant Sachin
Designation (Owner/ Partner/ CEO) LeadHSEF
Pin code 361305
E-mail sachin.shah@nayaraenergy.com
Telephone No. 02833-661385
Fax No. 02833-
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 Yes
Uploaded detailsAnnexure-Uploaded details
17. Whether part of Interlinked projects? Yes
18. Whether separate application of Interlinked project has been submitted? Yes
19.
If Yes, MoEF file numberF. No. 10-121/2008-IA- III. for Environment Clearance for Berth C&D- EC granted
Date of submission22/08/2008
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?Yes
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) No Proposed SPM-2 will be installed in offshore area at sea. Associated sub sea pipeline will be laid in sea area connecting existing SPM-1 with SPM-2 and SPM-2 to Berth-D.
1.2 Clearance of existing land, vegetation and buildings? No Not applicable
1.3 Creation of new land uses? No Not applicable
1.4 Pre-construction investigations e.g. bore houses, soil testing? No Geotechnical Investigation data for existing offshore area is available for reference.
1.5 Construction works? Yes Proposed SPM-2 will be installed in offshore area at sea. Associated subsea pipeline will be laid in sea area connecting existing SPM-1 with SPM-2 and SPM-2 to Berth-D.
1.6 Demolition works? No No demolition is envisaged
1.7 Temporary sites used for construction works or housing of construction workers? No Not applicable
1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations No Not applicable
1.9 Underground works including mining or tunnelling? No Not Applicable
1.10 Reclamation works? No Not Applicable
1.11 Dredging? No No, The Crude pipeline will be laid on the Sea bed, However trench may have to be made for laying the pipeline depending upon the seabed profile.
1.12 Offshore structures? Yes The SPM will be a floating body anchored through 6 chains fixed with piles on Sea bed
1.13 Production and manufacturing processes? No No production and manufacturing process, However SPM and Pipelines will be used to handle Crude.
1.14 Facilities for storage of goods or materials? No Only Transfer of crude is envisaged through the SPM and pipeline.
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? No Not applicable.
1.16 Facilities for long term housing of operational workers? No Not Required.
1.17 New road, rail or sea traffic during construction or operation? Yes Sea traffic will increase during operation.
1.18 New road, rail, air water borne or other transport infrastructure including new or altered routes and stations, ports, airports etc? No Not Applicable
1.19 Closure or diversion of existing transport routes or infrastructure leading to changes in traffic movements? No Not Applicable
1.20 New or diverted transmission lines or pipelines? No Not Applicable
1.21 Impoundment, damming, culverting, realignment or other changes to the hydrology of watercourses or aquifers? No Not Applicable
1.22 Stream crossings? No Not Applicable
1.23 Abstraction or transfers of water from ground or surface waters? No No abstraction of ground or surface water.
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 increase in transport of personnel and material during construction stage but will be marginal & reversible.
1.26 Long-term dismantling or decommissioning or restoration works? No Not Applicable
1.27 Ongoing activity during decommissioning which could have an impact on the environment? No Not Applicable
1.28 Influx of people to an area in either temporarily or permanently? Yes SPM Installation & laying of Pipelines activities may lead to temporary nominal influx of people
1.29 Introduction of alien species? No Not Applicable
1.30 Loss of native species or genetic diversity? No Not Applicable
1.31 Any other actions? No Not Applicable
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 Not Applicable
2.2 Water (expected source & competing users) unit: KLD No Not Applicable
2.3 Minerals (MT) No Not Applicable
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) Yes All construction material will be brought from local sources.
2.5 Forests and timber (source – MT) No Not Applicable
2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW) No Not Applicable
2.7 Any other natural resources (use appropriate standard units) No Not Applicable
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 Project involves crude oil handling facility and crude transfer pipelines.
3.2 Changes in occurrence of disease or affect disease vectors (e.g. insect or water borne diseases) No Not Applicable
3.3 Affect the welfare of people e.g. by changing living conditions? Yes The impact would be positive impact, as the project will create/increase employment both during construction and operation phase of the project. Various ongoing welfare activities will be extended by the industry in consultation with the local administration.
3.4 Vulnerable groups of people who could be affected by the project e.g. hospital patients, children, the elderly etc. No Not Applicable
3.5 Any other causes No Not Applicable
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 Not Applicable
4.2 Municipal waste (domestic and or commercial wastes) Yes Domestic waste (garbage) will be generated during construction and operation phase and this will be handled within the existing solid waste treatment facility. Commercial waste will be disposed as scrap.
4.3 Hazardous wastes (as per Hazardous Waste Management Rules) No Not Applicable
4.4 Other industrial process wastes No Not Applicable
4.5 Surplus product No Not Applicable
4.6 Sewage sludge or other sludge from effluent treatment No Not Applicable
4.7 Construction or demolition wastes No Not Applicable
4.8 Redundant machinery or equipment No Not Applicable
4.9 Contaminated soils or other materials No Not Applicable
4.10 Agricultural wastes No Not Applicable
4.11 Other solid wastes No Not Applicable
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 Not Applicable.
5.2 Emissions from production processes No Not Applicable.
5.3 Emissions from materials handling including storage or transport Yes Marginal emission due to vehicular/marine movement for transportation.
5.4 Emissions from construction activities including plant and equipment No Not Applicable.
5.5 Dust or odours from handling of materials including construction materials, sewage and waste No Not Applicable.
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 Not Applicable.
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 No Not Applicable
6.2 From industrial or similar processes No Not Applicable
6.3 From construction or demolition No Not Applicable
6.4 From blasting or piling Yes Limited piling activities shall be carried out during proposed project as per requirement.
6.5 From construction or operational traffic Yes During construction phase, there will be marginal increase in noise due to traffic movement in the project area due to transportation of man and machinery.
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 All material will be handled as per best safety practices and in accordance with the applicable rules. All necessary precautions shall be in place to prevent any spill/ contamination. The same shall be addressed during design & engineering stage. All material transfer will be done using closed system pipelines.
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) No Not applicable.
7.3 By deposition of pollutants emitted to air into the land or into water No Not applicable.
7.4 From any other sources No Not applicable.
7.5 Is there a risk of long term build up of pollutants in the environment from these sources? No Not applicable.
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 Risk Assessment shall be carried out accordingly risk Management Plan and Emergency Preparedness Plan already in place at Refinery will be updated. All appropriate measures will be taken for safe handling of materials.
8.2 From any other causes No Not Applicable
8.3 Could the project be affected by natural disasters causing environmental damage (e.g. floods, earthquakes, landslides, cloudburst etc)? No Sufficient provisions are provided in the design to take care of natural disasters that are commonly known/recorded in the area.
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 This project will increase direct and indirect employment opportunities in the area. Ancillary units for maintenance and supply of materials have a potential for development due to the project.
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 Yes IOCL, BORL & Reliance SPMs including existing SPM-1 of the company are available in the vicinity of the project
(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 Not Applicable
2 Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Yes CRZ area, Marine National Park & Marine Sanctuary in 10 Km radius.
3 Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration No Not Applicable
4 Inland, coastal, marine or underground waters Yes Work inside Deendayal Port Trust (DPT) waters. Area falls in Gulf of Kutch.
5 State, National boundaries No Not Applicable
6 Routes or facilities used by the public for access to recreation or other tourist, pilgrim areas No Not Applicable
7 Defence installations No Not Applicable
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 No The region is rated IV in seismic rating and has experienced earthquake with epicenter at Bhuj in 2001. Cyclone was experienced in 1998. The project will be designed to resist the natural calamities.
(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
Additional Attachments, if any
Attached File
EDS Clarification
            Essential Detail Sought:
Sno. EDS Letter Remarks Date of EDS
1.NAThe correction have been made as per the instruction received 20 Sep 2019
2.NAAs per the information submitted in the Form-1, the project is for expansion, however, the category mentioned in Form-1 is ‘NEW’. Kindly clarify the same and submit revised Form-1. 09 Sep 2019
      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 ApplicantSachin
DesignationLeadHSEF
Name of Company (Applicant Name should not be given here)COVIVA ENERGY TERMINALS LIMITED
AddressKhambhalia, Post Box No.24, District Devbhumi Dwarka
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