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 No
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 Ghatti Basavanna Drinking Water Supply Project
Brief summary of projectAnnexure-Brief summary of project
Proposal Number IA/KA/RIV/185340/2020
Project Cost 990 cr
2.
S. No. in the schedule1(c) River Valley projects
Project Sector River Valley and Hydroelectric Projects
3. Proposed capacity/area/length/tonnage to be handled/command area/lease area/number or wells to be drilled Construction of concrete gravity dam across Markandeya river to store 6 TMC of water for providing drinking water facilities to Gokak town and surrounding villages including Hukkeri Taluk, Bailahongala Taluk and Savadatti Taluk. The project also envisages filling up of MI tanks and providing water to industrial needs. 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 Yes
a) Protected areas notified under the wildlife (Protection) Act, 1972
8.
Does it attract the specific condition? If yes, please specify No
9.
Location of the projectGokak
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.--
Town / VillageGodachinamalki, Mavanura, Byadarahatti, Konnur
State of the projectKarnataka
Details of State of the project
S.no State Name District Name Tehsil Name
NIL
10.
Nearest railway station along with distance in kms Gokak Road (Konnur) Railway station, 7.70 km
Nearest airport along with distance in kms Belgaum Airport, 37.79 km
11. Nearest Town/City/District Headquarters along with distance in kms Gokak town , 2 km
12. Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given) Gokak Taluk Panchayat Office No: 08332 225063/ Gokak Municipal Corporation Sangoli Rayana circle Gokak – 591307 Ph: 08332 227336
13. Name of the Applicant U G
14. Registered Address Executive Engineer, KNNL, GRBCC Division 3 Gokak
15.
Address for correspondance:
Name of the Company KARNATAKA NEERAVARI NIGAM LIMITED
Name of the Applicant U G
Designation (Owner/ Partner/ CEO) Executive Engineer
Pin code 591307
E-mail eegrbcc.fc@gmail.com
Telephone No. 80-23016200
Fax No. 80-
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? 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?Yes
StatusForest Clearance Under Process(Stage-I)
(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?Yes
Uploaded Order/PolicyAnnexure-Uploaded order/policy
23.
Whether any Forest Land Involved?Yes
Area of Forest land Involved (hectares)553.96 ha.
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 Construction of Ghatti Basavanna dam involves diversion of 553.96 Ha of forest land which includes submergence of 513.44 Ha of forest land will be a permanent change in land use, land cover and topography.
1.2 Clearance of existing land, vegetation and buildings? Yes The proposed project requires a total land of 638.07 Ha of land: • Forest land: 553.96 Ha (includes submergence area) and • Revenue land: 84.11 Ha.
1.3 Creation of new land uses? Yes The existing forest and riverine land use will be converted to submergence.
1.4 Pre-construction investigations e.g. bore houses, soil testing? Yes It involves geo-technical investigations and soil testing before constructing the project.
1.5 Construction works? Yes The scope of the project includes seating of Dam, retaining wall, construction of dam office, guest office, view point, WTP, Colony, approach roads, steps, rehabilitation center, etc
1.6 Demolition works? Yes R&R is involved in the project. However, the same will be acquired as per the Right to Fair Compensation and Transparency in Land Acquisition Rehabilitation and Resettlement Act, 2013.
1.7 Temporary sites used for construction works or housing of construction workers? Yes Temporary sheds for labourers will be constructed during construction phase.
1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations Yes Dam, retaining wall, construction of dam office, guest office, view point, WTP, Colony, approach roads, steps, rehabilitation center are the above ground structures. Excavation quantity of 119237.749 cum (All kinds of soil), 13387.747 cum (Soft rock) and 430028.166 cum (Hard rock) is estimated to be generated during construction phase. The excavated muck shall be stored in designated places and covered with green mesh. The same shall be reused for construction activities.
1.9 Underground works including mining or tunnelling? No Nil
1.10 Reclamation works? No Nil
1.11 Dredging? No Nil
1.12 Offshore structures? No Nil
1.13 Production and manufacturing processes? No Nil
1.14 Facilities for storage of goods or materials? Yes Temporary sheds will be constructed for storage of construction materials.
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? Yes Sewage generated from the labour camps will be treated in mobile STP which will be installed at labor camps and domestic solid waste will be disposed to nearby municipal authorities.
1.16 Facilities for long term housing of operational workers? Yes Facilities of housing such as dam office and guest office will be provided for Operation and Maintenance staff after the construction of the project.
1.17 New road, rail or sea traffic during construction or operation? Yes Existing roads will be utilized of construction purpose. However, approach roads will be constructed for easy access to the dam site.
1.18 New road, rail, air water borne or other transport infrastructure including new or altered routes and stations, ports, airports etc? Yes Existing roads will be utilized of construction purpose. However, new approach roads will be constructed for easy access to the dam site. There is no rail, air waterborne or other transport infrastructure.
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? Yes New substation and transmission lines will be installed which do not affect the existing.
1.21 Impoundment, damming, culverting, realignment or other changes to the hydrology of watercourses or aquifers? Yes Proposed dam is planned to be constructed along Markandeya River for storage of 6 TMC of water. This alters hydrology of Markandeya River.
1.22 Stream crossings? Yes Cross drainages will be envisaged.
1.23 Abstraction or transfers of water from ground or surface waters? Yes The project involves storage of 6 TMC of water from Markandeya River and providing drinking water facilities to Gokak town and surrounding villages including Hukkeri Taluk, Bailahongala Taluk and Savadatti Taluk.
1.24 Changes in water bodies or the land surface affecting drainage or run-off? No The project involves storage of 6 TMC of water from Markandeya River and providing drinking water facilities to Gokak town and surrounding villages including Hukkeri Taluk, Bailahongala Taluk and Savadatti Taluk.
1.25 Transport of personnel or materials for construction, operation or decommissioning? Yes Temporary labor camps & storage yards will be constructed near construction area
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? Yes None
1.28 Influx of people to an area in either temporarily or permanently? Yes Influx of labourers will be only during construction phase, minimal manpower will be employed for operation and maintenance of the project.
1.29 Introduction of alien species? No None
1.30 Loss of native species or genetic diversity? Yes Construction of Ghatti Basavanna dam involves diversion of 553.96 Ha of forest land which includes submergence of 513.44 Ha of forest land which leads to the loss of native species such as Acacia Arabica, Albizzia amara, Albizzia lebbek, Albizzia odartissima, etc
1.31 Any other actions? No None
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) Yes The proposed project requires a total land of 638.07 Ha of land: • Forest land: 553.96 Ha (includes submergence area) and • Revenue land: 84.11 Ha. The private land will be acquired as per the Right to Fair Compensation and Transparency in Land Acquisition Act, 2013. Whereas, the forest land will be diverted as per the provisions of Forest (Conservation) Act, 1980.
2.2 Water (expected source & competing users) unit: KLD Yes Water quantity: 25.5 KLD during construction phase (340 labourers) Source: River Markandeya
2.3 Minerals (MT) No None
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) Yes Explosive: 150 MT Sand: 4,25,000 cum Coarse Aggregate: 7,25,000 cum Cement: 2,50,000 MT Reinforced steel: 5,500 MT Structural Steel: 1.560 MT
2.5 Forests and timber (source – MT) No None
2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW) Yes Construction phase: 10 MVA
2.7 Any other natural resources (use appropriate standard units) Yes Construction of Ghatti Basavanna dam involves diversion of 553.96Ha of forest land which includes submergence of 513.44 Ha of forest land
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 None
3.2 Changes in occurrence of disease or affect disease vectors (e.g. insect or water borne diseases) No None
3.3 Affect the welfare of people e.g. by changing living conditions? Yes The Gokak Town is located at a distance of 2 Km from the proposed Ghatti Basavanna dam. The construction activities will affect the people of Gokak town temporarily. However, it will benefit the locals and improve the standard of living by providing drinking water facilities to Gokak and surrounding villages.
3.4 Vulnerable groups of people who could be affected by the project e.g. hospital patients, children, the elderly etc. Yes The project involves Rehabilitation and Resettlement of Yogikolla Village. The Vulnerable groups or tribal community in this village will be affected.
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 Excavated soil will be dumped at the designated site and will be reused for construction activities.
4.2 Municipal waste (domestic and or commercial wastes) Yes Domestic solid wastes (153 Kgs/Day) will be generated from labour camps (340 labourers). The same will be segregated into organic and inorganic wastes and will be disposed to nearby Municipal authorities.
4.3 Hazardous wastes (as per Hazardous Waste Management Rules) Yes Used Oil from the use of DG Sets during the construction stage will be stored in leak proof drums/ barrels and will be disposed to KSPCB authorized re-processors/ dealers.
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 Yes Sludge from the proposed STP of capacity 25.5 KLD from the labour camps area.
4.7 Construction or demolition wastes Yes No demolition wastes involved. Construction wastes such as excavated earth, steel remains, rocks, gravel, concrete, etc will be generated.
4.8 Redundant machinery or equipment No None
4.9 Contaminated soils or other materials No None
4.10 Agricultural wastes No None
4.11 Other solid wastes No None
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 Air pollutants such as Particulate Matter, SO2 and NO2 will be emitted by the use of LSD fuel in D.G Sets during the Construction stage of the project and vehicular movements. Besides this, air pollutants like PM10, PM2.5, SO2 and NOx are also expected to be emitted by the vehicular movement during the construction stage of the project which will transport construction materials to the proposed project site.
5.2 Emissions from production processes No None
5.3 Emissions from materials handling including storage or transport No Transportation of construction materials will be done mainly through trucks and this vehicular movement results in emissions of particulate matter and fugitive emissions.
5.4 Emissions from construction activities including plant and equipment Yes Dust will be generated due to various construction activities.
5.5 Dust or odours from handling of materials including construction materials, sewage and waste No Dust is expected during unloading of construction materials, but there will be no odour. Sewage generated from the labour camps area will be treated in proposed 25.5 KLD STP and treated sewage (25 KLD) will be reused for dust suppression purpose. Domestic wastes will be collected in bins and disposed to nearby municipal authorities.
5.6 Emissions from incineration of waste No Nil
5.7 Emissions from burning of waste in open air (e.g. slash materials, construction debris) No Nil
5.8 Emissions from any other sources No Nil
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 There will be increase in noise and vibration due to blasting and drilling operations during the construction stage of the project works.
6.2 From industrial or similar processes No None
6.3 From construction or demolition Yes Noise during construction phase will be generated during operation of construction machines/equipments and from vehicular movement carrying construction materials to the site. This will affect the movement of wild animals.
6.4 From blasting or piling Yes There will be increase in noise level due to blasting and drilling operations during the construction phase of the project which is temporary in nature.
6.5 From construction or operational traffic Yes Vehicles transporting construction materials will generate noise but this will be temporary.
6.6 From lighting or cooling systems No Not applicable
6.7 From any other sources No None
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 Yes Hazardous waste like used oil will be generated from the use of LSD (Low Sulphur Diesel) in DG Sets during the construction stage of the project which will be stored in leak proof drums/barrels and the same will be disposed to KSPCB authorized re-processors/dealers.
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) Yes Discharge of sewage from Belagavi city into the Bellary Nala has been observed. Further, Government of Karnataka has proposed a Sewage Treatment Plant to treat the existing sewage water of Bellary nala. Further, KNNL is constructing a barrage across Bellary nala to irrigate 16,000 Ha of the command area belonging to Gokak and Saundatti Taluks of Belagavi.
7.3 By deposition of pollutants emitted to air into the land or into water No None
7.4 From any other sources No None
7.5 Is there a risk of long term build up of pollutants in the environment from these sources? No None
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 None
8.2 From any other causes No None
8.3 Could the project be affected by natural disasters causing environmental damage (e.g. floods, earthquakes, landslides, cloudburst etc)? No The proposed project area is situated in Seismic Zone III and is considered as a moderate damage risk zone. Dam break event may occur for which Disaster Management Plan and Emergency Action Plan will be implemented.
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 The project provides drinking water facilities to Gokak town and surrounding villages including Hukkeri Taluk, Bailahongala Taluk and Savadatti Taluk. Construction of dam will enhance tourism activities. The project also involves construction of dam office and housing (guest house) for operational workers.
9.2 Lead to after-use of the site, which could have an impact on the environment No None
9.3 Set a precedent for later developments No None
9.4 Have cumulative effects due to proximity to other existing or planned projects with similar effects Yes Discharge of sewage from Belagavi city into the Bellary Nala has been observed. Further, Government of Karnataka has proposed a Sewage Treatment Plant to treat the existing sewage water of Bellary nala. Further, KNNL is constructing a barrage across Bellary nala to irrigate 16,000 Ha of the command area belonging to Gokak and Saundatti Taluks of Belagavi. Therefore, the presence of Bellary Nala is observed to have a cumulative effect on the water quality of the Markandeya River.
(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 The proposed Ghatti Basavanna Dam is located at a distance of 2.94 km from the ESZ of Ghataprabha Bird Sanctuary and 3.10 km from the boundary of Ghataprabha Bird Sanctuary.
2 Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Yes River Markandeya, River Ghataprabha, Ghataprabha Bird Sanctuary are ecologically sensitive areas.
3 Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration Yes • Ghataprabha Bird Sanctuary is known for migratory birds such as the Demoiselle crane and European white stork, along with other endemic birds. • The avifauna found in the sanctuary area Baya weaver bird, Black capped king fisher, Blue Rock Pigeon, Black drongo, Cattle egret, Common Myna, Darter or Snake bird, Demoiselle crane, Europian white storks, Fish owls, Francolinus Grey partridge, House crow, House Sparrow, etc.
4 Inland, coastal, marine or underground waters No NA
5 State, National boundaries Yes Maharashtra state boundary is at distance of 29.83 km from the proposed dam.
6 Routes or facilities used by the public for access to recreation or other tourist, pilgrim areas Yes Approach roads will be constructed for easy access to the dam site, guest house and other project components.
7 Defence installations No None
8 Densely populated or built-up area Yes Gokak town 2 km
9 Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship, community facilities) Yes Gokak town 2 km
10 Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Yes The proposed Ghatti Basavanna Dam is located at a distance of 2.94 km from the ESZ of Ghataprabha Bird Sanctuary and 3.10 km from the boundary of Ghataprabha Bird Sanctuary.
11 Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) No None
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 None
(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 ApplicantU G
DesignationExecutive Engineer
Name of Company (Applicant Name should not be given here)KARNATAKA NEERAVARI NIGAM LIMITED
AddressExecutive Engineer, KNNL, GRBCC Division 3 Gokak
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