STONE MINE PROJECT IN VILLAGE – KULKULIDANGAL OVER AN AREA- 2.47 ACRES OR 1.00 HA IN, P.S- SHIKARIPARA, DISTRICT – DUMKA, JHARKHAND. APPLICANT: AZAD ALI Form- 1

FORM-1

- 0 - STONE MINE PROJECT IN VILLAGE – KULKULIDANGAL OVER AN AREA- 2.47 ACRES OR 1.00 HA IN, P.S- SHIKARIPARA, DISTRICT – DUMKA, JHARKHAND. APPLICANT: AZAD ALI Form- 1

APPENDIX -I (See Paragraph – 6) FORM 1 (I) Basic Information

Sl. Item Details No. 1 Name of the project/s KULKULIDANGAL STONE MINE

2 Sl. No. of the schedule 1(a) 3 Proposed capacity /area/ length/ tonnage Proposed Capacity : 12231 TPA to be handled/command area / lease Proposed Capacity : 41 TPD Lease Area : area/number of wells to be drilled 2.47 Acres (1.00 Ha) 4 New/Expansion/Modernization Renewal (Lease Period from 03.09.2004 to 02.09.2014) 5 Existing Capacity/Area etc. 2.47 Acres (1.00 Ha) 6 Category of project i.e. “A” or “B” B-2 7 Does it attract the general condition? If yes No please specify 8 Does it attract the specific condition? If No yes please specify 9 Location N 24°08’16.6’’ TO N 24°08’20.2’’ E 87°34’13.9’’ TO 87°34'20.2"E Plot/Survey/Khasra No. Plot No.- 362(P), 363(P) & 364(P) Khata No.- 02 & 05 Village Kulkulidangal Thana Shikaripara District Dumka State Jharkhand 10 Nearest railway station/airport along with Dumka Railway Station at the distance of approx. 37 km distance in kms. in North- West direction. Birsa Munda Airport, Ranchi is at the distance of approx. 247 km in South-West Direction.

- 1 - STONE MINE PROJECT IN VILLAGE – KULKULIDANGAL OVER AN AREA- 2.47 ACRES OR 1.00 HA IN, P.S- SHIKARIPARA, DISTRICT – DUMKA, JHARKHAND. APPLICANT: AZAD ALI Form- 1 11 Nearest Town, City, District Headquarters The nearest town Mohammad Bazar is about 15 Km in along with distance in kms. South direction 12 Villages Panchayats, Zila Parisad, Village- Kulkulidangal Municipal Corporation, Local body Thana- Shikaripara (complete postal address with telephone District- Dumka nos. to be given) State- Jharkhand 13 Name of the applicant Azad Ali 14 Registered address S/o Late Jafar Ali, Vill- Kapasdanga Post- Bharkatha, P.S- Md. Bazar Dist- Birbhum, State- West Bengal 15 Address for correspondence: Name Azad Ali Designation (Owner/Partner/CEO) Owner

Address S/o Late Jafar Ali, Vill- Kapasdanga Post- Bharkatha, P.S- Md. Bazar Dist- Birbhum, State- West Bengal Pin Code 731216 E-mail [email protected] Telephone No. Mob.- +91-7563048389 Fax No. None 16 Details of alternative sites examined, if The mineral is site specific & the lessee has applied any. Location of these sites should be mining lease to mine stone for the specified lease area. shown on a topo sheet. Thus no alternatives site is proposed. 17 Interlinked Projects No, Project does not have any interlinked projects. 18 Whether a separate application of Not Applicable interlinked project has been submitted? 19 If yes, date of submission Not Applicable 20 If no, reason The product will meet the local demand and consumed in local construction activities. 21 Whether the proposal involves

- 2 - STONE MINE PROJECT IN VILLAGE – KULKULIDANGAL OVER AN AREA- 2.47 ACRES OR 1.00 HA IN, P.S- SHIKARIPARA, DISTRICT – DUMKA, JHARKHAND. APPLICANT: AZAD ALI Form- 1 approval/clearance under: if yes, details of The project area does not involve forest area, wild life the same and their status to be given. sanctuary or coastal zone. (a) The Forest (Conservation) Act, 1980? (b) The Wildlife (Protection) Act, 1972? (c) The C.R.Z. Notification, 1991? 22 Whether there is any Governmental Order/ Honorable Supreme Court has given the ruling, Policy relevant/ relating to the site? dated 27.02.12, for obtaining prior EC of the mining lease area of less than five hectares (< 5 Ha) also. The gist of the ruling is as under: “We in the meanwhile, order that leases of minor mineral including their renewal for an area of less than five hectares be granted by the State/Union Territories only after getting environmental clearance from the MoEF ordered accordingly.” 23 Forest land involved (hectares) No Forest Land involved 24 Whether there is any litigation pending No litigation pending against the project. against the project and/or land in which the project is propose to be set up? (a) Name of the Court (b) Case No. (c) Order/directions of the court, if any and its relevance with the proposed projects. 25 Project Cost 19,30,000.00  Capacity corresponding to sectoral activity (such as production capacity for manufacturing, mining lease area and production capacity for mineral production, area for mineral exploration, length for linear transport infrastructure, generation capacity for power generation etc.,)

- 3 - STONE MINE PROJECT IN VILLAGE – KULKULIDANGAL OVER AN AREA- 2.47 ACRES OR 1.00 HA IN, P.S- SHIKARIPARA, DISTRICT – DUMKA, JHARKHAND. APPLICANT: AZAD ALI Form- 1

(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.)

Yes/ Details thereof (with approximate quantities /rates, wherever Sl. Information/Checklist No possible) with source of information data No. confirmation 1.1 Permanent or temporary Yes Current Balance At the end Plan Description Period of Life %age change in land use, land period (Acres) (Acres) cover or topography (Acres) including increase in Mining Activities 1.65 0.00 1.65 intensity of land use Offices/Stores 0.01 0.00 0.01 71.65 (with respect to local Dumping/road/infrastr 0.10 0.00 0.10 ucture land use plan) Garland Drain 0.01 0.02 0.01

Green belt/ safety zone 0.70 0.00 0.70 28.35

Stone stock yards 0.00 0.00 0.00 0

Unutilized 0.00 0.00 0.00 0

Total 2.47 0.00 2.47 0

1.2 Clearance of existing No Existing Land Raiyati Land land, vegetation and Vegetation Permanent vegetation is less prominent buildings? Buildings Mine lease area is free from construction activity.

1.3 Creation of new land Yes The mining activity will result in pits. The land will be reclaimed uses? and put for productive use like afforestation or water harvesting or pisciculture. Proper drainage and water harvesting systems will be constructed to channelize the surface run-off. 1.4 Pre-construction Yes No clearance of the existing mine lease area will be required. investigations e.g. bore houses, soil testing? 1.5 Construction works? Yes Only temporary structures like shades and office will be provided,

- 4 - STONE MINE PROJECT IN VILLAGE – KULKULIDANGAL OVER AN AREA- 2.47 ACRES OR 1.00 HA IN, P.S- SHIKARIPARA, DISTRICT – DUMKA, JHARKHAND. APPLICANT: AZAD ALI Form- 1 which will be removed after completion of mining operation. 1.6 Demolition works? Yes Only temporary structures like shades and office will be provided, which will be demolished after the closure of the mines. 1.7 Temporary sites used No Workers will be hired from nearby villages, so no housing facility is for construction works required. However, temporary rest shelters/shades will be provided or housing of at the site. construction workers? 1.8 Above ground No It’s a mining project and excavation will be done only for mining buildings, structures or activities. earthworks including linear structures, cut and fill or excavations 1.9 Underground works No Only open cast mining will be done. including mining or tunneling? 1.10 Reclamation works? Yes The entire area will be reclaimed by plantations and water harvesting structures will be constructed to intercept the runoff. 1.11 Dredging? No No dredging will be involved 1.12 Offshore structures? No There will be no off-shore structures. 1.13 Production and Yes This is an opencast Semi Mechanized mining method and the manufacturing production will cause change in land use due to excavation of processes? mineral but the land will be reclaimed after the mining is over. No manufacturing process is involved. 1.14 Facilities for storage of No Mined material will be loaded in trucks and will be sent to approved goods or materials? crusher and final product will be dispatched for consumer use. 1.15 Facilities for treatment Yes During the current Plan period, the planned total O.B. removal will or disposal of solid be nil. waste or liquid effluents?

- 5 - STONE MINE PROJECT IN VILLAGE – KULKULIDANGAL OVER AN AREA- 2.47 ACRES OR 1.00 HA IN, P.S- SHIKARIPARA, DISTRICT – DUMKA, JHARKHAND. APPLICANT: AZAD ALI Form- 1 1.16 Facilities for long term No Workers will be hired from the nearby villages; hence no housing housing of operational facility is required. workers? 1.17 New road, rail or sea No No new road, rail is proposed. Only exiting transport network will be traffic during used. construction or operation? 1.18 New road, rail, air No Existing facilities are sufficient. No new road/rail will be required. waterborne or other transport infrastructure including new or altered routes and stations, ports, airports etc.? 1.19 Closure or diversion of No There is no closure or diversion of existing routes or infrastructure existing transport routes for the proposed project. or infrastructure leading to changes in traffic movements? 1.20 New or diverted No There are no new or diverted transmission lines or pipelines in the transmission lines or project site. pipelines? 1.21 Impoundment, No No impoundment, damming, culvert, realignment or other changes to damming, culvert, the hydrology of surface watercourse is required. realignment or other changes to the hydrology of watercourses or aquifers? 1.22 Stream crossings? No There is no stream crossing the mine lease area.

- 6 - STONE MINE PROJECT IN VILLAGE – KULKULIDANGAL OVER AN AREA- 2.47 ACRES OR 1.00 HA IN, P.S- SHIKARIPARA, DISTRICT – DUMKA, JHARKHAND. APPLICANT: AZAD ALI Form- 1 1.23 Abstraction or transfers Water for drinking purpose will be taken out by dug wells/ bore of water form ground or wells. For sprinkling & plantation water will be taken from private surface waters? tanker. Sl. Water requirement No. Purpose Yes (KLD)

1 Drinking & domestic 0.50 2 Afforestation / Greenbelt 1.00 3 Dust Suppression 1.00 Total 2.50

1.24 Changes in water No No effect on water bodies since there is no surface drainage existing bodies or the land within mine lease area surface affecting drainage or run-off? 1.25 Transport of personnel Yes Transport arrangement will be made for staff coming from distant or materials for villages/towns when they commute for work and mined minerals construction, operation will be transported by trucks. or decommissioning? 1.26 Long-term dismantling Yes After mining operations, the mined out area would be reclaimed & or decommissioning or tree plantation will be done. Rain water harvesting structures will be restoration works? constructed to intercept rain water in the mine site for recharging and other domestic uses. Temporary structures will be removed. 1.27 Ongoing activity during Yes The excavated mine area will be progressively reclaimed. Fencing decommissioning which will be done for safety of humans& animals in the mine pits. could have an impact on Temporary structures will be removed. the environment? 1.28 Influx of people to an No Locals would be preferred. This would have a positive impact on the area in either socio economic status of the people. Indirect employment temporarily or opportunities would also be generated in the area from the existing permanently? mine site. 1.29 Introduction of alien No There would be no introduction of any alien species since local species? species would be preferred for the plantation.

- 7 - STONE MINE PROJECT IN VILLAGE – KULKULIDANGAL OVER AN AREA- 2.47 ACRES OR 1.00 HA IN, P.S- SHIKARIPARA, DISTRICT – DUMKA, JHARKHAND. APPLICANT: AZAD ALI Form- 1 1.30 Loss of native species No There will not be any loss of native species or genetic diversity as or genetic diversity? there is no vegetation or forest cover within the ML area. 1.31 Any other actions? No No other actions would be involved for the excavation of the mineral.

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): Details thereof (with approximate Sl. Yes/ Information/checklist confirmation quantities/ rates, wherever possible) with No. No source of information data 2.1 Land especially undeveloped or agricultural No It is undeveloped land and an existing land (ha) mining area. 2.2 Water (expected source & competing users) Yes Total water requirement is about 2.50 KLD unit: KLD (0.5KLD Domestic Uses) + 1.00 KLD (Dust Suppression) & 1.00 KLD (Green Belt) from nearby water sources. Water for drinking purpose will be taken out by dug wells/ bore wells. For sprinkling & plantation water will be taken from private tanker. 2.3 Minerals (MT) No No minerals are required for execution of this project. 2.4 Construction material – stone, aggregates, No No construction material is required for this sand / soil (expected source – MT) project. On the other hand, construction material will be produced. 2.5 Forests and timber (source – MT) No No forest and timber products involved in the proposed project. 2.6 Energy including electricity and fuels (source, No No electrical energy will be required for competing users) Unit: fuel (MT), energy operation as the whole mining operation is (MW) carried out manually. For operation of the machines like jack hammer, rock breaker etc. 100 liters/day of HSD will be required. 2.7 Any other natural resources (use appropriate No No other natural resources will be used. standard units)

- 8 - STONE MINE PROJECT IN VILLAGE – KULKULIDANGAL OVER AN AREA- 2.47 ACRES OR 1.00 HA IN, P.S- SHIKARIPARA, DISTRICT – DUMKA, JHARKHAND. APPLICANT: AZAD ALI Form- 1 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. Details thereof (with approximate Sl. Yes/ Information/Checklist confirmation quantities/rates, wherever possible) with No. No source of information data 3.1 Use of substances or materials, which are No This project operation will not involve use of hazardous (as per MSIHC rules) to human any hazardous materials as per MSIHC rules. health or the environment (flora, fauna, and water supplies). 3.2 Changes in occurrence of disease or affect No Not applicable disease vectors (e.g. insect or water borne diseases). 3.3 Affect the welfare of people e.g. by Yes The project will help in improving the socio- changing living conditions? economic condition of the region through direct and indirect employment. From this mining project 7 persons will get direct employment. 3.4 Vulnerable groups of people who could be No No Vulnerable groups of people will be affected by the project e.g. hospital patients, affected by the project. children, the elderly etc.,

3.5 Any other causes No All occupational hazard precautions will be taken care during the mining operation. Medical checkup as par DGMS statutory rule and regulation will be conducted.

- 9 - STONE MINE PROJECT IN VILLAGE – KULKULIDANGAL OVER AN AREA- 2.47 ACRES OR 1.00 HA IN, P.S- SHIKARIPARA, DISTRICT – DUMKA, JHARKHAND. APPLICANT: AZAD ALI Form- 1

4. Production of solid wastes during construction or operation or decommissioning (MT/month) Details thereof (with approximate Sl. Yes/ Information/Checklist confirmation quantities/rates, wherever possible) with source No. No of information data 4.1 Spoil, overburden or mine wastes No During the current Plan period, the planned total O.B. removal will be nil. 4.2 Municipal waste (domestic and or commercial Yes Negligible amount of sewage will be produced in wastes) the mining facility 4.3 Hazardous wastes (as per Hazardous Waste No The vehicle used for transportation is in good Management Rules) condition, so that no oil leaks will take place during transportation. No Hazardous waste (as per Hazardous Waste Management Rules) will be generated. 4.4 Other industrial process wastes No There is no industrial process involved in the project. 4.5 Surplus product No The entire mined out product will be sold to the consumers. 4.6 Sewage sludge or other sludge from effluent No There is no effluent treatment plant in the treatment proposed project.

4.7 Construction or demolition wastes No No permanent construction or demolition work involved. 4.8 Redundant machinery or equipment No The machineries/equipments will be on hire basis or in-house depending upon requirement 4.9 Contaminated soils or other materials No No contamination of soil or other material will be involved. 4.10 Agricultural wastes No Not applicable 4.11 Other solid wastes No No other solid waste is generated.

- 10 - STONE MINE PROJECT IN VILLAGE – KULKULIDANGAL OVER AN AREA- 2.47 ACRES OR 1.00 HA IN, P.S- SHIKARIPARA, DISTRICT – DUMKA, JHARKHAND. APPLICANT: AZAD ALI Form- 1

5. Release of pollutants or any hazardous, toxic or noxious substances to air (Kg/hr)

Details thereof (with approximate Sl. Yes/ Information/Checklist confirmation quantities/rates, wherever possible) with No. No source of information data 5.1 Emissions from combustion of fossil fuels Yes Fuel 100 lit/day, HSD

from stationary or mobile sources. SOX 0.213 kg/hr.

NOX 0.446 kg/hr. 5.2 Emissions from production processes Yes Controlled blasting: - 0.02348 Kg/hr. Loading of materials:- 0.095 Kg/hr Transportation of materials: - 1.26 Kg/hr. Therefore a total of 1.378 Kg/hr. dust will be generated from the production process. Out of this 80% of the dust will be suppressed and controlled by water sprinkling and covering the trucks with tarpaulin covers. 5.3 Emissions from materials handling Yes There will be some fugitive emission during including storage or transport loading and transport of material. The fugitive emission during loading and transportation on haul road will be suppressed by

water spray. The emission of SOx and NOx may be due to use of diesel-operated excavator/ crusher/ Loader/ Dumper/ Truck etc. The better maintenance of equipment will help to reduce such emissions and maintain their level below permissible limit and all the trucks will have valid PUC certificate. 5.4 Emissions from construction activities No No construction activity will be carried out at including plant and equipment site so there will be no emission from any such activities.

- 11 - STONE MINE PROJECT IN VILLAGE – KULKULIDANGAL OVER AN AREA- 2.47 ACRES OR 1.00 HA IN, P.S- SHIKARIPARA, DISTRICT – DUMKA, JHARKHAND. APPLICANT: AZAD ALI Form- 1 5.5 Dust or odors from handling of materials Yes Dust will be generated during drilling, blasting, including construction materials, sewage crushing and loading. Dust suppression will be and waste done by sprinkling of water. 5.6 Emissions from incineration of waste No No such activity is proposed at site. 5.7 Emissions from burning of waste in open No There is no other source of emission. air (e.g. slash materials, construction debris) 5.8 Emissions from any other sources No There is no other source of emission.

6. Generation of Noise and Vibration, and Emissions of Light and Heat: Details thereof (with approximate Sl. Yes/ quantities/rates, wherever possible) with Information/Checklist confirmation No. No source of information data with source of information data 6.1 From operation of equipment e.g. engines, Yes Noise level in the working areas of quarry would ventilation plant, crushers increase to some extent and the impact will be negligible. 6.2 From industrial or similar processes No There will not be any industrial process 6.3 From construction or demolition No involved.No construction or demolition is involved.

6.4 From blasting or piling Yes Occasional controlled shot hole blasting for fracturing of rocks will be done. 6.5 From construction or operational traffic Yes Trucks will be used for transportation of mined material. Proper maintenance of vehicles will be taken into consideration and only PUC holder trucks will be allowed for transportation purpose. 6.6 From lighting or cooling systems No Mining will be carried during day time. Thus there is no need for lighting and cooling systems.

6.7 From any other sources No None

- 12 - STONE MINE PROJECT IN VILLAGE – KULKULIDANGAL OVER AN AREA- 2.47 ACRES OR 1.00 HA IN, P.S- SHIKARIPARA, DISTRICT – DUMKA, JHARKHAND. APPLICANT: AZAD ALI Form- 1 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: Details thereof (with approximate Sl. Yes/ Information/Checklist confirmation quantities/rates, wherever possible) with No. No source of information data 7.1 From handling, storage, use or spillage of No No Hazardous waste (as per Hazardous Waste hazardous materials Management Rules) will be generated. 7.2 From discharge of sewage or other No Soak pit will be provided at site for disposal of effluents to water or the land (expected wastewater. mode and place of discharge) 7.3 By deposition of pollutants emitted to air Yes Small quantity of dust will be generated and into the land or into water. dust suppression measure has been proposed. 7.4 From any other sources No There is no other source from which risk of contamination is anticipated. 7.5 Is there a risk of long term buildup of No There is no risk of long term buildup of pollutants in the environment from these pollutants in the environment from the proposed sources? project operations as frequent dust suppression would be done in mining area and surrounding roads.

8. Risk of accidents during construction or operation of the Project, which could affect human health or the environment

Details thereof (with approximate Sl. Yes/ Information/Checklist confirmation quantities/rates, wherever possible) with No. No source of information data

8.1 From explosions, spillages, fires etc. from No No such hazardous substance will be used. storage, handling, use or production of hazardous substances. 8.2 From any other causes No Not Applicable 8.3 Could the project be affected by natural Yes Project area falls in Zone-III which is under the disasters causing environmental damage (e.g. moderate risk zone. floods, earthquakes, landslides, cloudburst etc.)?

- 13 - STONE MINE PROJECT IN VILLAGE – KULKULIDANGAL OVER AN AREA- 2.47 ACRES OR 1.00 HA IN, P.S- SHIKARIPARA, DISTRICT – DUMKA, JHARKHAND. APPLICANT: AZAD ALI Form- 1 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 Details thereof (with approximate Sl. Yes/ Information/Checklist confirmation quantities/rates, wherever possible) with No. No source of information data 9.1 Lead to development of supporting Yes Proposed project will result in further growth facilities, ancillary development or of the surrounding area by increasing direct development stimulated by the project and indirect employment opportunities in the which could have impact on the region. environment e.g.:  Supporting infrastructure (roads, power supply, waste or waste water treatment, etc.)  Housing development  Extractive industries  Supply industries  Other 9.2 Lead to after-use of the site, which could Yes At the end of the life of the mine it is proposed have an impact on the environment. that the abandoned pits to be water filled surrounded by tree plantations that can be used for pisciculture and for irrigation purposes 9.3 Set a precedent for later developments Yes A better after use scenario, which is likely to increase aesthetic beauty of the area by doing plantation on reclaimed area, mine pit will be used to construct water harvesting structures to increase the ground water level. 9.4 Have cumulative effects due to proximity No There is no other such mining project in the to other existing or planned projects with area which will have cumulative effects. similar effects

- 14 - STONE MINE PROJECT IN VILLAGE – KULKULIDANGAL OVER AN AREA- 2.47 ACRES OR 1.00 HA IN, P.S- SHIKARIPARA, DISTRICT – DUMKA, JHARKHAND. APPLICANT: AZAD ALI Form- 1

(III) Environmental Sensitivity Aerial distance (within Name/ 15 km.) Proposed S. No. Areas Identity project location boundary Areas protected under international conventions, national or local 1 legislation for their ecological, None None landscape, cultural or other related value Areas which are important or sensitive for ecological reasons - Wetlands, 2 watercourses or other water bodies, None None coastal zone, biospheres, mountains, forests. Areas used by protected, important or sensitive species of flora or fauna for 3 None None breeding, nesting, foraging, resting, over wintering, migration. Inland, coastal, marine or underground 4 None None waters State Boundary beyond 5 State, National boundaries West Bengal 500 m Routes or facilities used by the public No None 6 for access to recreation or other tourist,

pilgrim areas 7 Defense installations None None 8 Densely populated or built-up area Mohammad Bazar 15.00 Km S

- 15 - STONE MINE PROJECT IN VILLAGE – KULKULIDANGAL OVER AN AREA- 2.47 ACRES OR 1.00 HA IN, P.S- SHIKARIPARA, DISTRICT – DUMKA, JHARKHAND. APPLICANT: AZAD ALI Form- 1 Educational Institutions:-

Govt. Primary School, Approx 1.5 km, S Areas occupied by sensitive man-made Kulkulidangal

9 land uses (hospitals, schools, places of Suri College Approx 25.0 km S worship, community facilities) Hospital:-

Health Center, Mohammad Approx 15.0 km S Bazar Areas containing important, high quality or scarce resources (Ground No such high quality or 10 water resources, surface resources, None scarce resources present forestry, agriculture, fisheries, tourism, in the lease area. minerals) Areas already subjected to pollution or There is no such area environmental damage. (Those where 11 None within 10 km radius of existing legal environmental standards the lease. are exceeded) Areas susceptible to natural hazard The area is under which could cause the project to The site comes under moderate risk seismic present environmental problems seismic zone III according to zone. No natural 12 (Earthquakes, subsidence, landslides, Indian Standard Seismic casualties have been erosion, flooding or extreme or adverse Zone. reported due to natural climatic conditions) hazards till date.

The project area is in Less than 25 hectares and is treated as B-2 project. Pre – Feasibility Report Enclosed.

- 16 - STONE MINE PROJECT IN VILLAGE – KULKULIDANGAL OVER AN AREA- 2.47 ACRES OR 1.00 HA IN, P.S- SHIKARIPARA, DISTRICT – DUMKA, JHARKHAND. APPLICANT: AZAD ALI Form- 1 UNDERTAKING BY PROJECT PROPONENT I hereby given undertaking that the data and information given in the application and enclosures are true to the best of my knowledge and belief and I am aware that if any part of the data and information submitted is 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. Date :

Place : GIRIDIH

Name of Authorized Signatory : Azad Ali

S/o Late Jafar Ali, Vill- Kapasdanga Full Address : Post- Bharkatha, P.S- Md. Bazar Dist- Birbhum, State- West Bengal

Note: 1. The projects involving clearance under Coastal Regulation Zone Notification, 1991 shall submit with the application a C.R.Z map duly demarcated by one of the authorized agencies, showing the project activities, w.r.t C.R.Z (at the stage of TOR) and the recommendations of the State Coastal Zone Management Authority (at the stage of EC). Simultaneous action shall also be taken to obtain the requisite clearance under the provisions of the CRZ notifications, 1991 for the activities to be located in the CRZ. 2. The Projects to be located within 10 km of the National Parks, Sanctuaries, Biosphere Reserves, Migratory Corridors of Wild Animals, the project proponent shall submit the map duly authenticated by Chief wildlife Warden showing these features vis-a-vis the project location and the recommendations or comments of the Chief Wildlife Warden thereon (at the stage of EC). 3. All correspondence with Ministry of Environment & Forests including submission of application for the TOR/Environment Clearance, subsequent clarifications, as may be required from time to time, participation in the EAC Meeting on behalf of the project proponent shall be made by the authorized signatory only. The authorized signatory should also submit a document in support of his claim of being an authorized signatory for the specific project.

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