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 it is a violation case and application is being submitted under Notification No. S.O.804(E) dated 14.03.2017 ? Yes
Type of Violation Started the work onsite without prior EC under EIA notification,2006.
Details of Violation The project authority started construction on 05.06.2001. They applied for Environmental Clearance on 24.04.2013. Based on the MoEF& CC , OM dated 12.12.2012, TNPCB issued show cause notice on 24.03.2014. After the reply to the show cause notice, SEIAA delisted the project on 25.11.2014.
1.
Name of the Project/s Medical College Campus with Hospital at old S. No 68/1, New no 68/1, 68/3, 68/4, 68/5, 68/6, 68/7, 68/8, 68/9, 68/10 & 68/11 of Kesavarayanpettai Village, Cheiyur Taluk and Kancheepuram District, Tamil Nadu
Brief summary of projectAnnexure-Brief summary of project
Proposal Number IA/TN/NCP/67079/2017
Project Cost 24780.76 lacs
2.
S. No. in the schedule8(a) Building and Construction projects
Project Sector INFRA-1
3. Proposed capacity/area/length/tonnage to be handled/command area/lease area/number or wells to be drilled Total Plot Area - 3,46,350 Sqm;Total Built-up Area - 1,33,097 Sqm ha.
4.
New/Expansion/ModernizationNew
5. Existing Capacity/Area etc. 133097 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 projectOld S. No 68/1, New S. No 68/1, 68/3, 68/4, 68/5, 68/6, 68/7, 68/8, 68/9, 68/10 and 68/11 of Kesavarayanpettai Village, Cheiyur Taluk, Kancheepuram District, Tamil Nadu.
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.Old S. No 68/1, New No. 68/1, 68/3, 68/4, 68/5, 68/6, 68/7, 68/8, 68/9, 68/10 and 68/11.
Town / VillageKesavarayanpettai
State of the projectTamil Nadu
Details of State of the project
S.no State Name District Name Tehsil Name
(1.)Tamil NaduKanchipuramCheyyur
10.
Nearest railway station along with distance in kms Melmaruvathur Railway Station, 1.7 km
Nearest airport along with distance in kms Chennai International Airport, 77 km
11. Nearest Town/City/District Headquarters along with distance in kms Acharapakkam , 2 km
12. Village Panchayats, Zila Parishad, Muncipal Corporation, Local body (Complete postal address with telephone nos. to be given) The Village President, Melmaruvathur Village Panchayat, Cheiyur Taluk, Kancheepuram District- 603 319
13. Name of the Applicant Lakshmi
14. Registered Address Melmaruvathur, Kancheepuram District.
15.
Address for correspondance:
Name of the Company ADHIPARASAKTHI CHARITABLE MEDICAL, EDUCATIONAL AND CULTURAL TRUST
Name of the Applicant Lakshmi
Designation (Owner/ Partner/ CEO) VicePresident
Pin code 603319
E-mail srini_sivam@yahoo.co.in
Telephone No. 044-27529313
Fax No. 044-
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 No
17. Whether part of Interlinked projects? No
18. Whether separate application of Interlinked project has been submitted? N/A
19.
If Yes, MoEF file numberN/A
Date of submissionN/A
20. If No, Reason N/A
21.
Whether the proposal involves Approval/ Clearance under: if yes, details of the same and their status to be given
(i) Whether the proposal involves approval/clearance under the Forest (Conservation) Act,1980?No
(ii) Whether the proposal involves approval/clearance under the wildlife (Protection) Act,1972?No
(iii) Whether the proposal involves approval/clearance under the C.R.Z notification, 2011?No
22.
Whether there is any Government Order/Policy relevant/relating to the site?Yes
Uploaded Order/PolicyAnnexure-Uploaded order/policy
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) Yes Project site was an unclassified area. Later, it was declared as Multistoried Building Area. Copy of declaration in Tamil Nadu Gazette Notification by Directorate of Town and Country Planning on 26.03.2014 is enclosed as Annexure III
1.2 Clearance of existing land, vegetation and buildings? Yes The site clearance prior to construction involved the clearance of ground shrubs and trees
1.3 Creation of new land uses? Yes Change in land use from vacant site to Multistoried Building Area
1.4 Pre-construction investigations e.g. bore houses, soil testing? Yes The soil investigation were carried out and it is enclosed as Annexure V
1.5 Construction works? Yes The construction of Medical College Campus with Hospital comprising Medical College, Hospital, Nursing College, Pharmacy College, Physiotherapy College and Hostel blocks with total built-up area of 1,33,097 Sqm
1.6 Demolition works? No No demolition works were carried out
1.7 Temporary sites used for construction works or housing of construction workers? Yes Temporary hutments were provided for the laborers during the construction period. Some permanent hutments were also constructed for the laborers
1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations and fill or excavations Yes The construction of Medical College Campus with Hospital comprising Medical College, Hospital, Nursing College, Pharmacy College, Physiotherapy College and Hostel blocks with total built-up area of 1,33,097 Sqm
1.9 Underground works including mining or tunnelling? No No underground works have been carried out
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 Construction material storage/handling yards were located within the project site and separated by enclosures/barricades. Cement was stored under cover in bales. Sand was stacked under tarpaulin cover. Bricks/blocks and steel were laid in the open.
1.15 Facilities for treatment or disposal of solid waste or liquid effluents? Yes Solid waste Bio degradable wastes - treated in Vermicomposting pits Non Biodegradable wastes - handed over to Authorized recyclers. Biomedical waste- will be given to biomedical waste collection facility Liquid waste Infectious streams - proposed Effluent Treatment Plant Sewage including outlet from ETP - Combined Effluent Treatment Plant
1.16 Facilities for long term housing of operational workers? Yes Permanent hutments with cooking facilities are provided for long term construction workers.
1.17 New road, rail or sea traffic during construction or operation? No -
1.18 New road, rail, air water borne or other transport infrastructure including new or altered routes and stations, ports, airports etc? No -
1.19 Closure or diversion of existing transport routes or infrastructure leading to changes in traffic movements? No -
1.20 New or diverted transmission lines or pipelines? No -
1.21 Impoundment, damming, culverting, realignment or other changes to the hydrology of watercourses or aquifers? Yes The watercourse inside the campus is realigned so that its flow is diverted into adequately designed storm water drains 1 m wide and 1.5 m depth constructed along the periphery of the site. This has its outfall into the Melmaruvathur lake located less than a Km away.
1.22 Stream crossings? No -
1.23 Abstraction or transfers of water from ground or surface waters? Yes There was the abstraction of ground water from the wells during the construction phase.
1.24 Changes in water bodies or the land surface affecting drainage or run-off? Yes The watercourse inside the campus is realigned so that flow is diverted to adequately designed storm water drains.
1.25 Transport of personnel or materials for construction, operation or decommissioning? Yes There was the movement of personnel and transport during the construction period.
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 There was influx of the people (laborers and workers) during the construction phase. Since it is a Hospital & Medical institutional campus there will be a huge influx of people due to medical facilities being provided.
1.29 Introduction of alien species? No -
1.30 Loss of native species or genetic diversity? Yes The site clearance prior to construction involved clearance of ground shrubs. But vast landscaping and green belt is developed in the site which will have a positive impact on the ecosystem.
1.31 Any other actions? No -
2 Use of Natural resources for construction or operation of the Project (such as land, water, materials or energy, especially any resources which are non-renewable or in short supply):
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
2.1 Land especially undeveloped or agricultural land (ha) No The project site is classified as Multi Storied Building Area, declared by Directorate of Town and Country Planning under Tamil Nadu gazette notification on 26.04.02016.
2.2 Water (expected source & competing users) unit: KLD Yes The water requirement of the project is about 497 KLD and it is sourced by Melmaruvathur Village water supply scheme.
2.3 Minerals (MT) No -
2.4 Construction material – stone, aggregates, sand / soil (expected source – MT) Yes Construction materials are sourced from the local market.
2.5 Forests and timber (source – MT) Yes Plywood with good recycled content was used during construction.
2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT),energy (MW) Yes Power requirement during construction phase was sourced from TNEB through a temporary connection and backed by 2-3 nos. of DG sets. The power requirement during the operational phase of the building is about 3500 KVA and will be sourced from the nearby TNEB grid. For power back-up , 5 Nos of DG set with capacities such as 85 kVA, 120 kVA, 280 kVA, 320 kVA and 750 k VA is installed. Low sulphur content HSD is used as fuel for DG sets.
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 No storage and handling of hazardous chemicals (as per MSIHC) will be done apart from diesel. HSD (of low sulphur content) will be used for DG sets.
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? Yes Socio economic conditions of nearby areas will improve due to local employment and easy access for education. Moreover, this project provides employment to local laborers during the construction and operational phases.
3.4 Vulnerable groups of people who could be affected by the project e.g. hospital patients, children, the elderly etc. No There will be no impact on vulnerable groups of people as the project itself is a hospital and medical college campus which will treat such vulnerable groups.
3.5 Any other causes No -
4 Production of solid wastes during construction or operation or decommissioning (MT/month)
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
4.1 Spoil, overburden or mine wastes No -
4.2 Municipal waste (domestic and or commercial wastes) Yes The biodegradable solid waste will be treated through vermicomposting pits. The non-biodegradable solid waste will be handed over to recyclers. The Bio sludge from combined effluent treatment plant is used as manure for gardening.
4.3 Hazardous wastes (as per Hazardous Waste Management Rules) No The spent oil from DG sets is stored in HDPE drums in isolated covered facility with impervious flooring. This will be sold to recyclers authorized by SPCB/MoEF.
4.4 Other industrial process wastes No -
4.5 Surplus product No -
4.6 Sewage sludge or other sludge from effluent treatment Yes The Biosludge is dried and used as the manure for the gardening. The ETP sludge will be disposed through authorized recyclers.
4.7 Construction or demolition wastes Yes The excavated earth and construction debris is used for backfilling and level rising within the project site.
4.8 Redundant machinery or equipment No All machinery / equipment were installed as per the requirement during construction and were removed by the contractors once the construction work was completed.
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 Emission from DG set: • 1 No of 85 kVA • 1 No of 280 kVA • 1 No of 320 kVA • 1 No of 750 kVA • 1 Nos. of 120 kVA
5.2 Emissions from production processes No NA
5.3 Emissions from materials handling including storage or transport Yes There was no major emission from material handling, storage and transport. However adequate control measures were taken care to control vehicular emissions.
5.4 Emissions from construction activities including plant and equipment Yes Dust was generated during construction activity and there were emissions from DG sets which was operated only during power failure.
5.5 Dust or odours from handling of materials including construction materials, sewage and waste Yes Dust generated during construction phase was minimized by using advanced machineries and proper cover of the area was in place during construction.
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 Noise control systems such as equipment foundation pads, dampeners, silencers and acoustic enclosures were used for individual units to minimize the noise & vibration.
6.2 From industrial or similar processes No -
6.3 From construction or demolition Yes No construction activity was carried out during night hours. Noise during the construction activities were kept minimal by proper and regular maintenance of construction machinery.
6.4 From blasting or piling No No blasting was involved. Isolated foundations were made and hence would not have had any significant impact of noise and vibrations.
6.5 From construction or operational traffic Yes During construction activities, care has been taken as explained above to reduce the impacts due to movement of heavy vehicles, while operational traffic (light vehicles) would not contribute much towards noise.
6.6 From lighting or cooling systems Yes Necessary care has been taken at the time of selection of equipment to minimize the noise or heat. Proper preventive maintenance measures were adopted during the operation stage.
6.7 From any other sources No -
7 Risks of contamination of land or water from releases of pollutants into the ground or into sewers, surface waters, groundwater, coastal waters or the sea:
S.No Information/Checklist confirmation Yes/No Details thereof (with approximate quantities/rates, wherever possible) with source of information data
7.1 From handling, storage, use or spillage of hazardous materials No No hazardous materials are used during the construction phase. During the operation phase, the used oil generated from DG sets will be stored in drums and will be disposed to CPCB/ TNPCB authorized waste oil recyclers.
7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) No The wastewater after treatment will be reused for toilet flushing, gardening and in Chiller plants. Hence, there will be no discharge of untreated wastewater from the premises to cause any adverse effect on environment.
7.3 By deposition of pollutants emitted to air into the land or into water No Emissions from DG sets will be minimal and it is let out into the atmosphere by stacks of sufficient height.
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 The project activity does not impose any significant threat of explosions, spillages, fires etc. During construction, all the laborers are provided with personal protective equipment (PPE). Training and awareness about the safety norms will be provided to all supervisors and labors involved in construction activity.
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 may trigger the development of ancillary facilities and other developments. It will improve the supporting infrastructure facilities like roads, water supply and power supply of the nearby villages.
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 This institutional development will set a precedent for later developments.
9.4 Have cumulative effects due to proximity to other existing or planned projects with similar effects No -
(III) Environmental Sensitivity
S.No Areas Name/Identity Aerial distance (within 15km.) Proposed project location boundary
1 Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
Yes Nemmam Gudalore forest lies adjacent to the site in north west direction. Vedanthangal Bird sanctuary lies at the distance of 12 Km from the site in north direction.
2 Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Yes Melmaruvathur lake lies at 0.8 Km in east direction. Mathuranthagam Lake lies at 11.8 Km in north direction. Kadaimalaipudhur lake lies at 8.4 Km in south east direction. Ottakoil lake lies at 10.4 Km in the north west direction. Kodungalur Lake lies at 13.2 Km in west direction
3 Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration Yes Vedanthangal Bird Sanctuary lies at the distance of 12 Km from the site in north direction
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 Melmaruvathur Adhiparasakthi Temple lies at the distance of 1 Km in the east direction, which has its own separate access which is not disturbed due to this project development.
7 Defence installations No -
8 Densely populated or built-up area Yes Melmaruvathur village has total population of 3367 Nos. with 287 Households.
9 Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship, community facilities) Yes The project site is surrounded by sensitive man-made land uses like hospitals, schools, places of worship and community facilities etc.
10 Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) Yes Melmaruvathur Lake lies at an aerial distance of 1 Km in the eastern direction.
11 Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) Yes Brakes India Industry located 5 Km from the project site in the east direction will contribute to the Ambient air quality in this region.
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
Additional Attachments, if any
Attached File
      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 ApplicantLakshmi
DesignationVicePresident
Name of Company (Applicant Name should not be given here)ADHIPARASAKTHI CHARITABLE MEDICAL, EDUCATIONAL AND CULTURAL TRUST
AddressMelmaruvathur, Kancheepuram District.
Print