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 Water Re-circulation and Environmental Sustainability Project for Jog Falls, Shivamogga District, Karnataka.
Brief summary of projectAnnexure-Brief summary of project
Proposal Number IA/KA/RIV/62455/2017
Project Cost 4080 lacs
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 33.22 MW hydro power generation ha.
4.
New/Expansion/ModernizationNew
5. Existing Capacity/Area etc. -1 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 projectJog Falls, Shivamogga District, Karnataka.
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.Jog- Kargal village, Sagar taluk, Shivamogga District
Town / VillageJog- Kargal village, Sagar taluk, Shivamogga District
State of the projectKarnataka
Details of State of the project
S.no State Name District Name Tehsil Name
(1.)KarnatakaShimogaSagar
10.
Nearest railway station along with distance in kms Talguppa, 13 km
Nearest airport along with distance in kms Mangalore, 216 km
11. Nearest Town/City/District Headquarters along with distance in kms Sagara , 30 km
12. Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given)
13. Name of the Applicant Deputy
14. Registered Address Deputy commisioner shimoga district pin 577 201
15.
Address for correspondance:
Name of the Company DEPUTY COMMISSIONER AND CHIEF EXECUTIVE OFFICER JOG MANAGEMENT AUTHORITY SHIMOGA
Name of the Applicant Deputy
Designation (Owner/ Partner/ CEO) DC
Pin code 577201
E-mail jma.jogfalls@gmail.com
Telephone No. 8182-271101
Fax No. 8182-
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 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
StatusApplication for Forest Clearance yet to be submitted
(ii) Whether the proposal involves approval/clearance under the wildlife (Protection) Act,1972?Yes
StatusApplication for Wildlife Clearance yet to be submitted
(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?
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 The proposed project is located in Western Ghats. Construction of pump house, laying pipeline and construction of tunnel in Western Ghats leads to permanent change in topography and land use of the area.
1.2 Clearance of existing land, vegetation and buildings? Yes The project require clearances of land and vegetation for construction of pump house, pipeline and tunnel. Further, for construction of vented barrage and retaining wall (within the river course) requires clearing of vegetation. No buildings will be cleared for the project
1.3 Creation of new land uses? Yes Proposed Construction activities in Western Ghats creates new land uses.
1.4 Pre-construction investigations e.g. bore houses, soil testing? Yes Bore drilling, soil testing, etc are proposed as part of investigation activities.
1.5 Construction works? Yes The construction work for the project mainly involves pump house, pipeline and tunnel, vented barrage and retaining wall (within the course).
1.6 Demolition works? No --
1.7 Temporary sites used for construction works or housing of construction workers? Yes Temporary sheds for laborers will be constructed at Jog which is 10 Km away from project area.
1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations Yes The project involves construction of pump house within the river (above ground structure) and a linear pipeline upto a tunnel (above ground) and a tunnel of 2.6 Km underground.
1.9 Underground works including mining or tunnelling? Yes The project involves construction of tunnel at 2.6 Km to accommodate pipelines inside.
1.10 Reclamation works? No --
1.11 Dredging? No --
1.12 Offshore structures? No --
1.13 Production and manufacturing processes? No --
1.14 Facilities for storage of goods or materials? Yes Temporary sheds for laborers will be constructed at Jog which is 10 Km away from project area. Goods and materials will not be stored near project area. There is a facility of trolley to carry construction materials to the site. Hence, the same will be utilised for the project purpose.
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? Yes Sewage generated from the labour camps will be connected to sewer line of Jog-Kargal town.
1.16 Facilities for long term housing of operational workers? No --
1.17 New road, rail or sea traffic during construction or operation? Yes Approach roads and a bridge to the construction site will be formed and there is no new rail or sea traffic.
1.18 New road, rail, air water borne or other transport infrastructure including new or altered routes and stations, ports, airports etc? Yes Approach roads and a bridge to the construction site will be formed and there is no new rail or sea traffic.
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? Yes Water will be re-circulated through new pipeline. Existing grid next to MGHE power station will be make use to connect the power generated during monsoon months.
1.21 Impoundment, damming, culverting, realignment or other changes to the hydrology of watercourses or aquifers? Yes 400 cusecs of water will be re-circulated continuously in the natural river course. Further, retaining wall (within the course) for 3 Km of river course will be constructed to store the water.
1.22 Stream crossings? Yes Vented barrage will be constructed to store the water. Further, a bridge will be constructed near MGHE for access to pump house.
1.23 Abstraction or transfers of water from ground or surface waters? Yes 400 cusecs of water will be re-circulated continuously in the natural river course.
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 Goods and materials will not be stored near project area. There is a facility of trolley to carry construction materials to the site. Hence, the same will be utilised for the project purpose. Temporary sheds for laborers will be constructed at Jog which is 10 Km away from project area. Vehicle arrangements will be made for labors pick and drop to construction area.
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 The influx of construction laborers will be anticipated for temporary period
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) Yes 1 ha for power house, tunnel construction & Muck disposal and 35 Ha of river portion for weir construction is required.
2.2 Water (expected source & competing users) unit: KLD Yes Construction period - 11 KLD per day (considering 150 labors) Source - Bore wells Competing users - Nil
2.3 Minerals (MT) No --
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) Yes All the construction materials will be sourced from Government approved quarries / sites. Aggregates - 22,525 Cum Sand - 10,510 Cum Steel - 1485 Tonnes Excavated soil from tunnel - 43,000 Cum
2.5 Forests and timber (source – MT) No --
2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW) Yes Power house with two generators will be installed with a capacity of 16.61 MW each in Monsoon months (totaling to 47.84 million units) and the power consumed in non-monsoon months would be 24.74 MW (amounting to 47.80 million units).
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 No --
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 Yes Excavated soil earth of 43,000 Cum will be stored separately and reused for construction of retaining wall (within the river course).
4.2 Municipal waste (domestic and or commercial wastes) Yes Domestic solid wastes generated from labour camps will be disposed to Jog-Kargal Town Panchayath
4.3 Hazardous wastes (as per Hazardous Waste Management Rules) Yes Used Oil from the use of DG Sets during the construction stage. This will be stored in leak proof drums/barrels and will be disposed to KSPCB authorized reprocessors/dealers.
4.4 Other industrial process wastes No --
4.5 Surplus product No --
4.6 Sewage sludge or other sludge from effluent treatment No --
4.7 Construction or demolition wastes Yes Excavated soil earth of 43,000 Cum will be stored separately and reused for construction of retaining wall (within the river course). The proposal doesn't involve demolition
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 Air pollutants such as Particulate Matter, SO2 and NO2 will be emitted by the use of LSD fuel in D.G Sets during Construction phase of the project. Besides, air pollutants like CO, CO2 and NO2 are also expected by the vehicular movement during Construction phase of the project.
5.2 Emissions from production processes Yes --
5.3 Emissions from materials handling including storage or transport Yes Transportation of construction materials will be done mainly through trucks which are a source to fugitive emissions.
5.4 Emissions from construction activities including plant and equipment Yes Dust will be generated during transportation and tunneling works.
5.5 Dust or odours from handling of materials including construction materials, sewage and waste Yes Dust is expected during unloading of construction materials.
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 There will be increase in noise and vibration due to tunneling operations during construction phase of the project. Controlled blasting will be undertaken to reduce the impact of noise and vibration while undertaking construction of tunnel.
6.2 From industrial or similar processes No --
6.3 From construction or demolition Yes Noise during construction phase will be generated during tunneling works, from operating machines/equipments, from vehicular movement etc., Controlled blasting will be undertaken to reduce the impact of noise and vibration while undertaking construction of tunnel.
6.4 From blasting or piling Yes Controlled blasting will be undertaken to reduce the impact of noise and vibration while undertaking construction of tunnel.
6.5 From construction or operational traffic Yes Vehicles transporting construction materials will generate noise.
6.6 From lighting or cooling systems No --
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 Yes Hazardous waste like used oil will be generated from the use of LSD (Low Sulphur Diesel) in DG Sets during construction stage of the project. It will be stored in leak proof drums/barrels and the same will be disposed to KSPCB authorized reprocessors/dealers.
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) No --
7.3 By deposition of pollutants emitted to air into the land or into water No --
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 No Controlled blasting will be undertaken to reduce the impact of noise and vibration while undertaking construction of tunnel.
8.2 From any other causes No --
8.3 Could the project be affected by natural disasters causing environmental damage (e.g. floods, earthquakes, landslides, cloudburst etc)? No --
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 will bring substantial tourism and ancillary development in and around the Jog Falls.
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 Yes --
9.4 Have cumulative effects due to proximity to other existing or planned projects with similar effects No The project will bring substantial tourism and ancillary development in and around the Jog Falls.
(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 1. Sharavathi Valley Wildlife Sanctuary notified under Wildlife (Protection) Act, 1972 is located at a distance of 6.69 Km from Pump House and 7.14 Km from Tunnel. 2. Aghanashini Lion Tailed Macaque Conservation Reserve notified under Wildlife (Protection) Act, 1972 is located at a distance of 3.6 Km from Pump House.
2 Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Yes Water will be pumped and re-circulated in Sharavathi river itself.
3 Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration Yes As detailed in DPR, the catchment area of Sharavathi river receives mean annual rainfall of 4150.76±876.08mm (1981 – 2000) in Mavingundi Catchment. The catchment has diverse vegetation ranging from tropical evergreen to semi-evergreen forests hill ranges to moist/dry deciduous forests in undulating plains due to selective tree felling for various reasons. Earlier studies with 26 sampling localities in the downstream of Sharavathi (Ramachandra et al, 2007), showed that tree count per hectare in e
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 Yes Jog Falls is the highest plunge waterfall in India. It is a segmented waterfall which, depending on rain and season, becomes a plunge waterfall. The falls are a major tourist attraction and is ranked 13th in the world by the waterfall database. The proposed project is a part of Jog Falls tourism development.
7 Defence installations No --
8 Densely populated or built-up area Yes Jog-Kargal village
9 Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship, community facilities) Yes Jog-Kargal village
10 Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Yes The proposed project will be undertaking in Western Ghats areas which is declared as an ecologically sensitive area .
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 --
(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 ApplicantDeputy
DesignationDC
Name of Company (Applicant Name should not be given here)DEPUTY COMMISSIONER AND CHIEF EXECUTIVE OFFICER JOG MANAGEMENT AUTHORITY SHIMOGA
AddressDeputy commisioner shimoga district pin 577 201
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