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 Access Controlled Nagpur Mumbai Expressway
Brief summary of projectAnnexure-Brief summary of project
Proposal Number IA/MH/MIS/61955/2017
Project Cost 310500 lacs
2.
S. No. in the schedule7(f) Highways
Project Sector INFRA-2
3. Proposed capacity/area/length/tonnage to be handled/command area/lease area/number or wells to be drilled 77.98 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
c) Notified Eco-sensitive areas
8.
Does it attract the specific condition? If yes, please specify No
9.
Location of the projectMaharashtra
Shape of the project landStrip
Uploaded GPS fileAnnexure-GPS file      
Uploaded copy of survey of India ToposheetAnnexure-Survey of india toposheet
Plot/Survey/Khasra No.Taraganpada in Nashik to Amane in Thane
Town / VillageTaraganpada in Nashik to Amane in Thane
State of the projectMaharashtra
Details of State of the project
S.no State Name District Name Tehsil Name
(1.)MaharashtraNashikIgatpuri
(2.)MaharashtraNashikIgatpuri
(3.)MaharashtraNashikIgatpuri
(4.)MaharashtraNashikIgatpuri
(5.)MaharashtraThaneBhiwandi
(6.)MaharashtraThaneBhiwandi
(7.)MaharashtraThaneBhiwandi
(8.)MaharashtraThaneShahapur
(9.)MaharashtraThaneShahapur
(10.)MaharashtraThaneShahapur
(11.)MaharashtraThaneKalyan
(12.)MaharashtraThaneKalyan
(13.)MaharashtraThaneKalyan
10.
Nearest railway station along with distance in kms Khardi Railway Station, 1.07 km
Nearest airport along with distance in kms Gandhinagar Airport, 38 km
11. Nearest Town/City/District Headquarters along with distance in kms Thane , 20 km
12. Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given)
13. Name of the Applicant S
14. Registered Address Maharashtra state road development corporation opposite Bandra Reclamation bus depot Bandra (W) Mumbai
15.
Address for correspondance:
Name of the Company MAHARASHTRA STATE ROAD DEVELOPMENT CORPORATION
Name of the Applicant S
Designation (Owner/ Partner/ CEO) Executive Engineer
Pin code 400050
E-mail cgmenv@msrdc.in
Telephone No. 22-26558175
Fax No. 22-022-26417893
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
StatusForest Clearance Under Process
MoEF file numberFP/MH/ROAD/21003/2016
MoEF file number163.748ha.
(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?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) Yes There will be both temporary and permanent change in the land use of the area. Change of land use will be in the area falling in the proposed Right of Way (RoW). The land will be utilized for highway construction that may spur economic development in the surrounding areas.
1.2 Clearance of existing land, vegetation and buildings? Yes Vegetation clearance will take place as some part of the highway traverses through the forest (233.823 ha), agricultural land (437.246ha) and natural vegetation. Detailed enumeration will be carried out during EIA.
1.3 Creation of new land uses? Yes The land will be utilized for highway construction that may spur economic development in the surrounding areas.
1.4 Pre-construction investigations e.g. bore houses, soil testing? Yes Preconstruction investigations viz., topographical surveys, traffic survey, sub grade soil investigation, subsurface investigation using bore logs for structures, Geophysical investigation, existing pavement composition, existing road strength and roughness surveys, Groundwater investigations, Laboratory testing of material will be carried out during preconstruction stage.
1.5 Construction works? Yes Construction of Toll Plaza, labor camps, material storage yard, Batch Plants, Mobile toilet and STPs / Soak pits etc. will be carried out at the site. Along with this construction will also include construction of road, cross drainage structures, interchanges, etc.
1.6 Demolition works? Yes There is a possibility of demolition work of existing structures within the project alignment prior to the construction. (The extent of demolition will be quantified in EIA).
1.7 Temporary sites used for construction works or housing of construction workers? Yes Temporary sites for construction works, material storage and housing of construction workers will be provided with prior investigation by properly addressing environmental concerns.
1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations Yes Construction of Toll Plaza, labor camps, material storage yard, Batch Plants, Mobile toilet and STPs / Soak pits, construction of road, cross drainage structures, interchanges, etc. will be carried out at the site. As some part of the stretch is in hilly terrain, excavations and cut fill will be needed. (Quantities will be calculated during detailed EIA).
1.9 Underground works including mining or tunnelling? Yes Offsite work includes, quarrying from nearby quarry sites for construction material. Tunneling, via ducts and underpasses, cross drainage at some part of the stretch. (Exact location and its size will be presented in EIA).
1.10 Reclamation works? No
1.11 Dredging? Yes Possibly at crossing over Stream / River .
1.12 Offshore structures? No
1.13 Production and manufacturing processes? No
1.14 Facilities for storage of goods or materials? Yes Facilities shall be created for on- site storage of raw material, testing laboratory and parking yard for construction machinery during the construction phase only with prior investigation.
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? Yes Waste management during construction and operational phase shall be done as per MoEF&CC norms. Organic and inorganic wastes will be segregated and disposed of according to the MSW Rules and Regulations. Solid waste generated from construction & allied activities would mainly consist of earth materials. These materials will be reused for rehabilitation of borrow area / quarry sites, camp sites and slopes. Soak pits & septic tanks will be provided at labor camps.
1.16 Facilities for long term housing of operational workers? Yes Temporary sites for construction works and Housing of construction workers will be provided with prior investigation. Long term housing of operational workers, if deemed necessary, shall be provided nearby project site.
1.17 New road, rail or sea traffic during construction or operation? Yes The project itself is a construction of new Express highway.
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
1.22 Stream crossings? Yes Proposed project will cross the Bhatsa River near Vashala, Kasara, Arjunali, Chiradpada Village and Darna river near Pimpri Sadroddin Village.
1.23 Abstraction or transfers of water from ground or surface waters? Yes Abstraction of ground and surface water for construction work with prior Consent and NOC.
1.24 Changes in water bodies or the land surface affecting drainage or run-off? Yes Changes in existing drainage pattern are expected cutting, filling, and tunneling, via-duct construction. However, Natural drainage pattern shall be maintained throughout the project by providing necessary cross drainage structures.
1.25 Transport of personnel or materials for construction, operation or decommissioning? Yes Demand of Personnel & construction materials will be fulfilled from nearby sources / areas.
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? Yes Impacts on Environment during decommissioning are expected which are temporary in nature, for which proper environmental management plan will be prepared and implemented.
1.28 Influx of people to an area in either temporarily or permanently? Yes During construction phase, majority of labours will be locally and temporarily hired; hence there will not be major influx of people anticipated during construction phase of project. About 6000 persons per day for 36 months during construction phase. During operation stage, there shall be more influx of people. About 600 people are envisaged to be involved in post construction activities.
1.29 Introduction of alien species? No
1.30 Loss of native species or genetic diversity? Yes During construction clearance of the forest area, vegetation is expected; for which proper Environmental Management plan will be prepared and implemented. Compensatory afforestation plan will be prepared.
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 About 47.24% i.e. 437.246 Ha of land is undeveloped or agricultural land
2.2 Water (expected source & competing users) unit: KLD Yes Water: 90 lpcd will be required for onsite workers, while water for expressway construction and sprinkling for dust suppression will also be needed. Approximately 540 kld of water would be required for daily uses in labor camps. The water shall be obtained from nearby surface/ ground water with prior consent.
2.3 Minerals (MT) No The expressway construction will require minor minerals like stones, gravel, ordinary clay, ordinary sand, limestone, boulders, kankar, murum, brick earth, bentonite, road metals. As per MINES AND MINERALS (DEVELOPMENT AND REGULATION) ACT, 1957, excavation of minor minerals during construction of roads shall be executed after prior permit.
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) Yes Broadly, the estimated construction material requirement per kilometer is as follows: 1. Earth work- 60,000 mt/ km 2. Stone ballast-8000 mt/ km 3. Grit- 6000 mt/ km 4. Cement concrete- 50,000 mt/km
2.5 Forests and timber (source – MT) No
2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW) Yes LSD D.G sets shall be used for power for onsite construction and labor camps, wherever grid power supply is not available.
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 LSD, lubricants, paints, etc. shall be required for which necessary safety & environmental protection measures would be devised in Environmental Management Plan.
3.2 Changes in occurrence of disease or affect disease vectors (e.g. insect or water borne diseases) Yes Construction management plan will be prepared. Proper safety and hygiene measures will be implemented in the construction area to prevent spread of vector borne disease
3.3 Affect the welfare of people e.g. by changing living conditions? Yes Construction of proposed highway shall spur economic development in the project corridor having a positive impact on the welfare of the surrounding areas. During construction and operation phase skilled, semi-skilled and unskilled labors will be employed form nearby villages which will increase socio economic life of people living in nearby villages.
3.4 Vulnerable groups of people who could be affected by the project e.g. hospital patients, children, the elderly etc. Yes Detailed survey will be carried out for socio economic impact assessment including vulnerable groups. Impact Assessment for such sensitive receptors will be a part of SIA.
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 Waste material generation during the course of an excavation, quarrying, dredging operation and construction is expected for which proper disposal measures shall be ensured.
4.2 Municipal waste (domestic and or commercial wastes) Yes Wastes generated during construction and operation would be of food items, paints, cement, grit, bitumen, tar, cement, concrete, oil & grease etc. This would be segregated and collected in separate bins and disposed of according to MoEF&CC regulations
4.3 Hazardous wastes (as per Hazardous Waste Management Rules) Yes During construction and operation hazardous waste maybe generated which will be managed as per Hazardous Waste Management Rules 2008.
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 will be generated form labor camps, construction sites. Septic tanks will be provided. During operation phase sewage will be generated by road side amenities for which proper sewerage system and wastewater treatment plant will be provided.
4.7 Construction or demolition wastes Yes There is a possibility of demolition work of existing structures coming along the project alignment prior to the construction. (Quantification of wastes will be done during EIA)
4.8 Redundant machinery or equipment Yes Equipment like drills, cranes etc. Would be used during construction which would create noise during construction phase.
4.9 Contaminated soils or other materials Yes Excavated soil, cut and fill material will be produced. (Quantification of wastes will be done during EIA)
4.10 Agricultural wastes Yes Agricultural wastes will be generated from the agricultural lands from where the alignment will pass.
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 Emission of SOX, NOX, CO, PM10 and PM2.5 from DG sets and construction vehicles are expected. (Quantification will be presented in EIA).
5.2 Emissions from production processes No
5.3 Emissions from materials handling including storage or transport Yes Emission of SOX, NOX, CO, PM10 and PM2.5 from construction vehicles and fugitive dust emission from material handling is expected. (Quantification will be presented in EIA).
5.4 Emissions from construction activities including plant and equipment Yes Emission of SOX, NOX, CO, PM10 and PM2.5 from DG sets, construction vehicles and handling of construction materials is expected. (Quantification will be presented in EIA)
5.5 Dust or odours from handling of materials including construction materials, sewage and waste Yes Fugitive dust emission from material handling, construction vehicles is expected. Odour from sewage and municipal waste during construction. (Quantification will be presented in EIA)
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 Equipment like drills, cranes etc. Would be used during construction which would create noise during construction phase. (Details will be presented in EIA)
6.2 From industrial or similar processes Yes During operation phase.
6.3 From construction or demolition Yes Noise and vibration generation during construction, tunneling or demolition. (Quantification will be presented in EIA)
6.4 From blasting or piling Yes Construction, levelling, Piling is proposed wherever required for bridge construction. (Quantification will be presented in EIA)
6.5 From construction or operational traffic Yes Heavy Vehicles carrying construction material and other equipment’s will create noise and vibration; quantification shall be done during EIA stage.
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 Contamination of land / soil and water due to handling and storage, use of Hazardous materials during construction and operation phase is expected. Proper environmental management plan will be prepared and implemented. Details will be furnished in EIA.
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) Yes In construction phase Sewage will be generated form labor camps, construction sites. Septic tanks will be provided. Details will be furnished in EIA.
7.3 By deposition of pollutants emitted to air into the land or into water Yes Emission of SOX, NOX, CO, PM10 and PM2.5 from construction vehicles and fugitive dust emission from material handling is expected. Sewage will be generated form labor camps, construction sites. Septic tanks will be provided. Proper environmental management plan will be prepared and implemented. Details will be furnished in EIA.
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 Expected during construction phase for which necessary measures shall be devised in EMP.
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 No such incidents for last 50 yrs. have been recorded. The project falls under moderate risk Seismic Zone - III. Design of structure will comply with the required IS specification. Proper measures shall be taken in detailed design to minimize the impact of any such disaster. Necessary measures for safeguarding against landslides shall be incorporated during design and construction stages.
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 Following proposed development along the stretch of Expressway of Package V; • Supporting infrastructure / facilities like emergency landing of plane, medical facilities, food courts, amenities, police stations, public toilets, petrol pumps, etc. • Economic activities that may spur on completion of proposed 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 Yes Package V is part of the entire stretch of 705.68 kms of Access Controlled Nagpur-Mumbai Expressway which shall set precedence for subsequent developments at regional and national levels.
9.4 Have cumulative effects due to proximity to other existing or planned projects with similar effects Yes National and State highways along with MDR and village roads are existing in close proximity of the project. Separate proposals are being submitted for remaining Packages - I, II, III and IV. Development of these projects simultaneously can have a cumulative effect on environment.
(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 Particulars Average Distance in Km Tansa Wildlife Sanctuary : 1.475 Kms Kalsubai Harichandragad Wildlife Sanctuary & ESZ : 6.66 kms
2 Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Yes Water Body Average Distance in Km Tansa Lake : 7.00 Bhatsa Reservior: 0.68 Upper Vaitrana Reservior : 13.6 Modak Sagar : 9.0 Mukne dam : 12.7 Barvi Dam : 14.2 Bhavali Dam : 1.5 Lake Arthus : 16.0 Lake Beale : 10.0
3 Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration Yes There are reserved and protected forest lands through which the alignment is passing.
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 • Titwala Mahaganapati at 3 kms from NH222. • Jivdani Temple and Vajreshwari Mandir at about 38 and 23 kms from Amane end. • Vasai fort at about 36 kms from Bhiwandi end by NH8. • SGNP and Kanheri caves at 23 kms from Bhiwandi end by Mumbai Nashik Expressway. • Anuayee Eco Tourism at 1.3 kms from proposed alignment approached by SH79. • Pandava caves in at 32 kms from Igatpuri end. • Trimbakeshwar Temple at 27.5 kms, Panchavati at 40 kms & Kalsubai Temple 15 km from Taranganpada.
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 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) NIL
      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 ApplicantS
DesignationExecutive Engineer
Name of Company (Applicant Name should not be given here)MAHARASHTRA STATE ROAD DEVELOPMENT CORPORATION
AddressMaharashtra state road development corporation opposite Bandra Reclamation bus depot Bandra (W) Mumbai
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