Form 1- Proposed Government Medical College, Gata No- 2627, Village- Bahraich Khas, Pargana, Tehsil & District- Bahraich, U.P

APPENDIX I (See paragraph – 6) FORM 1 (I) Basic Information S. Item Details NO. 1. Name of the project/s Govt. Medical College, Bahraich Distt. – U.P. 2. S.No. in the schedule Schedule 8 (b) 3. Proposed capacity/ area/length/ tonnage to be Total Plot Area : 40500 m2 handled/ command area/ lease area/ number of Built Up Area :39680 m2 wells to be drilled 4. New/ Expansion/ Modernization New 5. Existing Capacity/ Area etc. Not Applicable 6. Category of Project i.e. ‘A’ or ‘B’ Category B2 7. Does it attract the general condition? If yes, please Not Applicable specify. 8. Does it attract the specific condition? If yes, Not Applicable please specify. Plot/ Survey/ Khasra No.- 2627 Village Bahraich Khas District Bahraich State Uttar Pradesh 10. Nearest Railway Station/ Airport along with The nearest railway stations Bahraich at 2.5 Kms distance in km in NE. The nearest Airport is at Lucknow at about 130 Kms. 11. Nearest Town, city, District Headquarters along The site is located within Bahraich with distance in Kms. Township.The District Head quarters are at 1.25 Kms in North. 12. Village Panchayats, Zilla Parishad, Municipal Bahraich Municipal Corporation Corporation, Local body (complete postal addresses with telephone nos. to be given) 13. Name of the applicant CMO- Dr. Professor P.K. Singh

14. Registered Address B.R.D. Medical College Principal Gorakhpur Uttar Pradesh 15. Address for correspondence B.R.D. Medical College Principal Gorakhpur Uttar Pradesh Name Dr. Professor P.K. Singh Designation (Owner/Partner/ CEO) CMO Address Bahraich

Environmental Consultant- M/s Sawen Consultancy Services Pvt. Ltd., Lucknow 1 Form 1- Proposed Government Medical College, Gata No- 2627, Village- Bahraich Khas, Pargana, Tehsil & District- Bahraich, U.P

Pin Code 273013 E-mail [email protected] Mobile No. 05512501736 Fax No. - 16. Details of Alternative Sites examined, if any. Not Applicable Location of these sites should be shown on a topo sheet. 17. Interlinked Projects None 18. Whether separate application of interlinked No project has been submitted? 19. If yes, date of submission Not applicable 20. If no, reason Not applicable 21. Whether the proposal involves approval/clearance Not Applicable under: if yes, details of the same and their status to be given. (a) The Forest (Conservation) Act, 1980? (b) The Wildlife (Protection) Act, 1972? (c) The C.R.Z. Notification, 1991? 22. Whether there is any Government Order/ Policy Not Applicable relevant/ relating to the site? 23. Forest land involved (hectares) No 24. Whether there is any litigation pending against the No project and/ or land in which the project is propose to be set up? (a) Name of the Court (b) Case No. (c) Orders/ directions of the Court, if any and its relevance with the proposed project.

(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 Yes/N Details thereof (with approximate quantities confirmation o /rates, wherever possible) with source of information data 1.1 Permanent or temporary change in No The total plot area of 40500 m2 has been proposed, land use, land cover or topography for the Govt. Medical College of Bahraich located including increase in intensity of at Gata No- 2627, Village- Bahraich Khas, Pargana, land use (with respect to local land Tehsil & District- Bahraich, U.P. It is about 100 m in use plan) east of Kisan Gun House in Bahraich City. 1.2 Clearance of existing land, No The proposed project is on fully vacant govt. land. vegetation and buildings?

Environmental Consultant- M/s Sawen Consultancy Services Pvt. Ltd., Lucknow 2 Form 1- Proposed Government Medical College, Gata No- 2627, Village- Bahraich Khas, Pargana, Tehsil & District- Bahraich, U.P

S.No. Information/Checklist Yes/N Details thereof (with approximate quantities confirmation o /rates, wherever possible) with source of information data 1.3 Creation of new land uses? yes Land is earmarked for the development and construction of the Govt. Medical College; hence it would be used as an Institution for teachings and patient care. 1.4 Pre-construction investigations e.g. Yes Pre-construction investigation regarding sub soil bore houses, soil testing? exploration and testing has been carried out at the proposed project site to study the pertinent physical and mechanical properties of soil underlying the site. The major position of district is occupied by soils locally known as “Bhur” or “Silty Sand” on the ridges. “Matiyar or Clayey soils” occur along the topographic lows and “Dumat or Loamy soils” in the level lands. Clay is dominant in the areas where “Reh” (Usar) prevails. Along the river valleys, a very fertile soil called “Dumat” is prevalent which is youngest. The design load has therefore to ensure safety against failure due to shear as well as total settlement. The site condition is suitable for framed type of structures. 1.5 Construction works? Yes As per Building Plan. 1.6 Demolition works? No The project site is a vacant land; hence no demolition work will be done. 1.7 Temporary sites used for No Local labors shall be hired from nearby areas that construction works or housing of will work and go away in the evening to their construction workers? places. 1.8 Above ground buildings, structures Yes As per building plan (During the project construction or earthworks including linear phase, excavation will be required only during structures, cut and fill or excavations construction of foundations and for basement. However, the soil excavated will be reused for back filling; landscaping and the fertile top soil will be reused for horticulture purpose). 1.9 Underground works including No Not applicable mining or tunneling? 1.10 Reclamation works? No Not applicable 1.11 Dredging? No Not applicable 1.12 Off shore structures? No Not applicable 1.13 Production and manufacturing No It is a construction project hence no production processes? and manufacturing processes shall be carried out.

Environmental Consultant- M/s Sawen Consultancy Services Pvt. Ltd., Lucknow 3 Form 1- Proposed Government Medical College, Gata No- 2627, Village- Bahraich Khas, Pargana, Tehsil & District- Bahraich, U.P

S.No. Information/Checklist Yes/N Details thereof (with approximate quantities confirmation o /rates, wherever possible) with source of information data 1.14 Facilities for storage of goods or Yes Separate raw material yard will be made. Cement materials? will be separately stored under cover in bales. Sand will be stacked nearby under tarpaulin cover. Bricks and steel will be laid in open. The raw material yard will be located within the project site. 1.15 Facilities for treatment or disposal of Yes Total Grey and Black water shall be disposed to 1 solid waste or liquid effluents? MLD STP on FAB based Technology. About 6.87 KLD water shall be reused for gardening. Effluents shall be treated in 30 KLD capacities ETP. Here the treated Effluents will be used for cleaning the floors, drains and road etc. The detail of Solid Waste Management Plan is enclosed in Conceptual Plan. 1.16 Facilities for long term housing of No The workers during operational phase will be hired operational workers? from nearby areas and hence no need of long term housing for operational workers is required. 1.17 New road, rail or sea traffic during No No, New roads, rail or sea traffic will be hired. construction or operation? 1.18 New road, rail, air waterborne or No No alteration in existing transport infrastructure is other transport infrastructure anticipated. including new or altered routes and stations, ports, airports etc? 1.19 Closure or diversion of existing No The project site has good road connectivity transport routes or infrastructure  NH-28C leading to changes in traffic  SH- 26, 13 & 30 movements? 1.20 New or diverted transmission lines No No new or diverted transmission lines or pipelines or pipelines? will be done. 1.21 Impoundment, damming, culverting, No No impoundment, damming, culverting, realignment or other changes to the realignment or other changes to the hydrology of hydrology of watercourses or surface water courses or aquifers is proposed. aquifers? 1.22 Stream crossings? No No Stream is crossing at project site 1.23 Abstraction or transfers of water Yes Ground Water: It is estimated that the total water from ground or surface waters? requirement would be approx. 135.42 KLD of which total domestic water requirement would be around 56.45 KLD. The abstraction shall be done with 2 nos. of tube well. 1.24 Changes in water bodies or the land No Neither surface drainage will be affected with the surface affecting drainage or run- proposed project nor will the water bodies be

Environmental Consultant- M/s Sawen Consultancy Services Pvt. Ltd., Lucknow 4 Form 1- Proposed Government Medical College, Gata No- 2627, Village- Bahraich Khas, Pargana, Tehsil & District- Bahraich, U.P

S.No. Information/Checklist Yes/N Details thereof (with approximate quantities confirmation o /rates, wherever possible) with source of information data off? affected. 1.25 Transport of personnel or materials Yes Transport of personnel or materials for for construction, operation or construction, operation or decommissioning shall decommissioning? be done by road transport. 1.26 Long-term dismantling or No Not Applicable decommissioning or restoration works? 1.27 Ongoing activity during No Not Applicable decommissioning which could have an impact on the environment? 1.28 Influx of people to an area in either No Local labors from nearby area will be hired in the temporarily or permanently? construction phase per day. Thus no influx of people is envisaged. 1.29 Introduction of alien species? No As on date, there is no history of alien species at the proposed site. 1.30 Loss of native species or genetic No There will be no loss of native species or genetic diversity? diversity. 1.31 Any other actions? No None

2. Use of Natural resources for construction or operation of the Project (such as land, water, materials or energy, especially any resources which are non-renewable or in short supply)

S.No. Information/checklist Yes/ Details thereof (with approximate quantities confirmation No /rates, wherever possible) with source of information data. 2.1 Land especially undeveloped or Yes Total Plot Area – 40500 m2. agricultural land (ha) Water (expected source & Yes Source of Ground Water through 02 nos. tube wells 2.2 competing users) unit: KLD Total Water Requirement 135.42 Total Domestic Water Requirement 56.45 KLD Water requirement for laboratory and Kitchen 30 KLD Gardening 6.87 KLD Flushing 36.70 KLD

2.3 Minerals (Tonnes) No Not applicable 2.4 Construction material–stone, Yes Material from excavation at the project site will be aggregates, sand / soil (expected used for construction purposes. Additional source –Tonnes) construction material like stones, aggregates, sand

Environmental Consultant- M/s Sawen Consultancy Services Pvt. Ltd., Lucknow 5 Form 1- Proposed Government Medical College, Gata No- 2627, Village- Bahraich Khas, Pargana, Tehsil & District- Bahraich, U.P

S.No. Information/checklist Yes/ Details thereof (with approximate quantities confirmation No /rates, wherever possible) with source of information data. will be procured from nearby area.

2.5 Forests and timber (source– MT) No Not Applicable 2.6 Energy including electricity and Yes Power supply will be required for the proposed fuels (source, competing users) building which will be supplied by Uttar Pradesh Unit: fuel (MT), energy (MW) State Electricity Board. 2.7 Any other natural resources (use No None appropriate standard units)

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 Yes/ Details thereof (with approximate confirmation No quantities/rates, wherever possible) with source of information data 3.1 Use of substances or materials, Yes This is as construction project so there is no which are hazardous (as per storage of hazardous chemical (as per MSIHC MSIHC rules) to human health or rules), apart from used oil. the environment (flora, fauna, and Suitable management practice will be adopted water supplies) for the same. 3.2 Changes in occurrence of disease or No Suitable drainage and waste management affect disease vectors (e.g. insect or measures will be adopted in both the water borne diseases) construction and operational phase which will restrict stagnation or accumulation of water. This will effectively restrict the reproduction and growth of disease vectors. 3.3 Affect the welfare of people e.g. by Yes Socio Economic conditions will be affected in changing living conditions? a positive way. Moreover this project will provide employment to about 300 local labors in construction phase. During the operational phase this Institution is going to produce qualified Doctors every year and is also going to help sick people who wander and travel long distances seeking medical help. This project will open several opportunities for business through Medical shops, General merchants, Pathological and Medical Centers etc. Thus the proposed project has major

Environmental Consultant- M/s Sawen Consultancy Services Pvt. Ltd., Lucknow 6 Form 1- Proposed Government Medical College, Gata No- 2627, Village- Bahraich Khas, Pargana, Tehsil & District- Bahraich, U.P

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

3.4 Vulnerable groups of people who No No, vulnerable group of people will be could be affected by the project e.g. affected by the project. hospital patients, children, the elderly etc., 3.5 Any other causes No None

4. Production of solid wastes during construction or operation or decommissioning (MT/month) S.No. Information/Checklist Yes/ Details thereof (with approximate confirmation No quantities/rates, wherever possible) with source of information data 4.1 Spoil, overburden or mine wastes No Not applicable 4.2 Municipal waste (domestic and or Yes 737.5 Kg/ Day solid waste will be generated commercial wastes) during operation phase. Detail of Solid Waste Management is given in Conceptual Plan. 4.3 Hazardous wastes (as per Yes Safe stack heights have been proposed for Hazardous Waste D.G. Set emissions in the project, suitable Management Rules) care will be taken to avoid spills/ leaks of used oil during storage. Mercury contaminated waste would not be mixed with other biomedical waste or with general waste. It would not be swept down the drain and wherever possible, it would be disposed off at a hazardous waste facility or given to a mercury based equipment manufacturer. 4.4 Other industrial process wastes No This is a construction project; hence there will be no other industrial process waste. 4.5 Surplus product No Not Applicable 4.6 Sewage sludge or other sludge Yes Sludge generated from STP will be passed from effluent treatment through filter press where it will be dried to form a cake and then it shall be used as manure in the proposed green belt areas of the site. 4.7 Construction or demolition wastes Yes Construction waste will be generated which shall be used for flooring & Back filling in roads etc. 4.8 Redundant machinery or No Not applicable

Environmental Consultant- M/s Sawen Consultancy Services Pvt. Ltd., Lucknow 7 Form 1- Proposed Government Medical College, Gata No- 2627, Village- Bahraich Khas, Pargana, Tehsil & District- Bahraich, U.P

equipment 4.9 Contaminated soils or other No Not applicable materials 4.10 Agricultural wastes No Not applicable 4.11 Other solid wastes No N.A.

5. Release of Pollutants or any Hazardous, Toxic or Noxious substances to Air (Kg/hr)

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

5.1 Emissions from combustion of Yes HC - 1.3 0 g/KW -hr fossil fuels from stationary or PM - 0.30 g/KW-hr

mobile sources NOx – 9.20 g/KW-hr CO - 3.50 g/KW-hr 5.2 Emissions from production No Not applicable processes 5.3 Emissions from materials Yes This will be restricted to the construction phase handling including storage or and to the construction site only. transport 5.4 Emissions from construction Yes This will be restricted to the construction phase activities including plant and and to the construction site only. equipment 5.5 Dust or odors from handling of Yes Dust is likely to be generated during materials including construction construction. Water will be sprinkled and materials, sewage and waste tarpaulin cover will be provided over stored raw material to reduce dust emission. All grey and black waste water generated will be treated through the proposed 1 MLD sewage treatment plant. 5.6 Emissions from incineration of No Not Applicable. waste 5.7 Emissions from burning of waste No Open burning of biomass/ other material will be in open air (e.g. slash materials, prohibited. construction debris) 5.8 Emissions from any other No Not applicable sources

6. Generation of Noise and Vibration, and Emissions of Light and Heat:

S.No. Information/Checklist Yes/ Details thereof (with approximate confirmation No quantities/rates, wherever possible) with

Environmental Consultant- M/s Sawen Consultancy Services Pvt. Ltd., Lucknow 8 Form 1- Proposed Government Medical College, Gata No- 2627, Village- Bahraich Khas, Pargana, Tehsil & District- Bahraich, U.P

source of information data with source of information data 6.1 From operation of equipment e.g. No During construction the machinery used for engines, ventilation plant, construction will be of highest standard of crushers reputed make and will adhere to international standards. These standards itself take care of noise pollution control / vibration control and air emission control. Hence insignificant impacts due to construction machinery are envisaged. Apart from this, the construction activities will be restricted to day time only. Source of noise in the operational phase will be D.G. Sets only if there is any. 6.2 From industrial or similar No Not applicable processes 6.3 From construction or demolition Yes Due to the various construction activities there will be short-term noise impacts in the immediate vicinity of the project site. The construction activities will include;- Operation of D.G. Sets, concrete mixers and excavation etc. 6.4 From blasting or piling No No blasting or piling will be done. 6.5 From construction or operational Yes Some amount of noise 60-65 db (A) will be traffic generated from vehicular movement in the construction and operational phase within premises of proposed site. 6.6 From lighting or cooling systems No None 6.7 From any other sources No None

7. Risks of contamination of land or water from releases of pollutants into the ground or into sewers, surface waters, groundwater, coastal waters or the sea: S.No. Information/Checklist Yes/ Details thereof (with approximate confirmation No quantities/rates, wherever possible) with source of information data 7.1 From handling, storage, use or Yes Used Oil Filter will be stored on PACCA pit spillage of hazardous materials after filling them in HDPE bags. Later on they will be disposed off at nominated site from pollution control board for land fill as per the norms. Used oil and oil containing sludge will be stored at nominated PACCA area and will be

Environmental Consultant- M/s Sawen Consultancy Services Pvt. Ltd., Lucknow 9 Form 1- Proposed Government Medical College, Gata No- 2627, Village- Bahraich Khas, Pargana, Tehsil & District- Bahraich, U.P

S.No. Information/Checklist Yes/ Details thereof (with approximate confirmation No quantities/rates, wherever possible) with source of information data disposed off through authorized recycler by CPCB & MOEF. Hence no risk of contamination is envisaged. 7.2 From discharge of sewage or other No The Grey and Black water generated from effluents to water or the land domestic requirement shall be treated in the (expected mode and place of proposed 1 MLD STP based on FAB discharge) technology. And a 30 KLD ETP is being proposed details of which are given in Conceptual Plan. 7.3 By deposition of pollutants No The 1 MLD STP at the Project site shall treat emitted to air into the land or into the waste water, and 30 KLD ETP will treat the water effluents. About 74.52 KLD sewage water will go to the STP for getting treated 6.87 KLD grey water shall be utilized for gardening. 7.4 From any other sources No Not applicable 7.5 Is there a risk of long term build No Not applicable up of pollutants in the environment from these sources?

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

S.No. Information/Checklist Yes/No Details thereof (with approximate confirmation quantities/rates, wherever possible) with source of information data 8.1 From explosions, spillages, fires No This is govt. medical college project and does etc from storage, handling, use or not involve major hazardous construction production of hazardous activity. Hence chances of explosions, substances spillages, fires are minimal. During Construction 300 Nos. of labors will be provided with suitable personal protective equipment (PPE) as required under the health & safety norms. Training and awareness about the safety norms will be provided to all supervisors and labors involved in construction activity. An agreement will be signed with the contractor, which will clearly deal with the safety aspects during construction.

Environmental Consultant- M/s Sawen Consultancy Services Pvt. Ltd., Lucknow 10 Form 1- Proposed Government Medical College, Gata No- 2627, Village- Bahraich Khas, Pargana, Tehsil & District- Bahraich, U.P

S.No. Information/Checklist Yes/No Details thereof (with approximate confirmation quantities/rates, wherever possible) with source of information data No major hazardous waste is being stored within the project site. No Industrial or process activity is involved in this project hence chances of chemical hazards and accidents are minimal. However, suitable fire fighting measures will be provided 8.2 From any other causes No None 8.3 Could the project be affected by No The area under study falls in Zone-III, natural disasters causing according to the Indian Standard Seismic environmental damage (e.g. Zoning Map. Suitable seismic coefficients floods, earthquakes, landslides, in horizontal and vertical directions cloudburst etc)? respectively, will be adopted while designing the structure. There are no chances of flood and landslide ...

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

9.1 Lead to development of Development of Govt. Medical College supporting. Utilities, Bahraich will require :- ancillary development or Power Demand: UPSEB (5000) KV) D.G. Set development stimulated by the for Power Back up 1500 KVA. project which could have impact Development of 1 MLD STP for sewage Yes on the environment e.g.: treatment and 30 KLD ETP for hospital effluent

• Supporting infrastructure treatment.

(roads, power supply, waste or Not applicable

waste water treatment, etc.) No • Housing development Not Applicable.

No • Extractive industries Not Applicable.

No • Supply industries Not Applicable. Well spacious medical college, with Parking • Other Yes facilities as per requirement. 9.2 Lead to after-use of the site, No Proper care shall be taken to avoid any which could have an impact on impact on the environment.

Environmental Consultant- M/s Sawen Consultancy Services Pvt. Ltd., Lucknow 11 Form 1- Proposed Government Medical College, Gata No- 2627, Village- Bahraich Khas, Pargana, Tehsil & District- Bahraich, U.P

the environment 9.3 Set a precedent for later Yes Infrastructure Development and improvement developments in living standard of the area. Socio Economic conditions will improve. 9.4 Have cumulative effects due to No At present the 500 m radius covers proximity to other existing or preexisting institutional and residential planned projects with similar projects and Gun factory at 100 m distance. effects. Hence no cumulative impact is envisaged. However the existing structures are anticipated to be affected during construction phase of the project from dust emission, traffic load on the approach road. Adequate provisions as per proposed Environment Management Plan will be ensured to be implemented.

III Environmental Sensitivity S. Areas Name Aerial distance (within 15 km.) N / Proposed project location boundary o. Identity 1 Areas protected under international No Not Applicable conventions, national or local legislation for their ecological, landscape, cultural or other related value. 2 Areas which are important or No Watercourses- sensitive for ecological reasons - Saryu river is the main surface water source which Wetlands, watercourses or other is at about 1.88 Kms in west of the proposed water bodies, coastal zone, project site. There are no sensitive areas for ecological reasons – Wetlands, water courses etc. biospheres, mountains, forests etc in the nearby. 3 Areas used by protected, important No No protected or sensitive area is located within or sensitive species of flora or 15 km radius of the proposed project. fauna for breeding, nesting, foraging, resting, over wintering, migration. 4 Inland, coastal, marine or No None underground waters 5 State, National boundaries No None 6 Routes or facilities used by the Yes  NH-28C public for access to recreation or  SH – 13, 26 & 30 other tourist, pilgrim areas. 7 Defense installations No None

Environmental Consultant- M/s Sawen Consultancy Services Pvt. Ltd., Lucknow 12 Form 1- Proposed Government Medical College, Gata No- 2627, Village- Bahraich Khas, Pargana, Tehsil & District- Bahraich, U.P

S. Areas Name Aerial distance (within 15 km.) N / Proposed project location boundary o. Identity 8 Densely populated or built-up area Yes The project site is located on the south western part of the Bahraich town which is moderately populated. 9 Areas occupied by sensitive man- Yes . made land uses (hospitals, schools, Kms Distances and Directions from the places of worship, community Proposed Site: facilities) Schools & Colleges: Kisan Degree College 0.450 Km SSW Barrow Blue Bells School 0.771 Kms WSW Jaipuria School 1.284 Kms NE Buddha Public School 1.372 Kms NNE Seventh Day Adventist College 1.692 Kms ENE BAL Siksha Niketan 2.222 Kms ENE Police Modern School 2.613 Kms NE Galaxy English School 2.184 Kms NNW Railway Station: Bahraich Railway Station 2.552 Kms NE Hospitals: Malia Hospital & Research Center - 1.140 Kms NW Sanjeevni Hospital 1.570 Kms NE Kedia Hospital 1.054 Kms E District Hospital 1.692 Kms NE Drolia Hospital 2.562 Kms NE Kanti Kuber Hospital 2.484 Kms NE Divya Drishti Hospital 2.648 Kms NE Fatima Hospital 3.715 Kms NE Inhabitations: Nazipurwa 0.739 Kms SW Madhawpuri 0.782 Kms SE Kapoorthala 0.387 Kms N Bashir Ganj 1.461 Kms NNW Sakha 1.718 Kms ENE Places of worship: Sri Sidhnath Mahadev Mandir 1.24 Kms NNE Musafir khana Masjid 1.21 Kms N Ram Janki Panchayati Mandir 1.66 Kms N Dargah Shareef 3.84 Kms NE 10 Areas containing important, high No Surface Water Resources: quality or scarce resources Ghagra River 25.84 Kms in west. The Bahraich

(Ground water resources, surface city is located on Saryu River which is a resources, forestry, agriculture, tributary to the Ghagra River. Saryu River 1.44 fisheries, tourism, minerals) Kms in west.

Environmental Consultant- M/s Sawen Consultancy Services Pvt. Ltd., Lucknow 13 Form 1- Proposed Government Medical College, Gata No- 2627, Village- Bahraich Khas, Pargana, Tehsil & District- Bahraich, U.P

S. Areas Name Aerial distance (within 15 km.) N / Proposed project location boundary o. Identity 11 Areas already subjected to pollution No There will be no adverse impact from proposed or environmental damage. (Those project. Necessary provisions as per proposed where existing legal environmental Environment Management Plan will be taken standards are exceeded) due care for implementation to mitigate adverse impact on environment. 12 Areas susceptible to natural hazard No The area under study falls in Zone-III, which could cause the project to accordingly to the Indian Standards Seismic present environmental problems Zone Map. Suitable seismic coefficients in (Earthquakes, subsidence, horizontal and vertical directions respectively landslides, erosion, flooding or will be adopted while designing the structures. extreme or adverse climatic There are no possibilities of the proposed conditions) project site getting flooded as per records available.

(IV) Proposed Terms of Reference for EIA Studies “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: 05.03.2018 Place: Bahraich

(Authorized Signatory)

Environmental Consultant- M/s Sawen Consultancy Services Pvt. Ltd., Lucknow 14