APPENDIX I (See paragraph – 6) FORM I (I) Basic Information

S. Item Details No 1. Name of the project/s Banjara Tola Crusher Stone Quarry (7.7 0 Ha)

2. S. No. in the schedule 1(a) mining of mineral

3. Proposed capacity /area /length 80,000 Cubic Met er/ Year, Quarry Lease Area -7.7 0 Ha /tonnage to be handled/command area/lease area/number of wells to be drilled 4. New/Expansion/Modernization New (Fresh Application for Environmental Clearance)

5. Existing Capacity/Area etc. Not Applicable

6. Category of Project i.e. ‘A’ or ‘B’ Category ‘B’

7. Does it attract the general No condition? If yes, please specify. 8. Does it attract the specific No condition? If yes, please specify. 9. Location Latitude Longitude 22o33’7.31 ” N 80 o13’28.48 ” E

Plot/Survey/Khasra No. 147 Part

Village Banjara Tola

Tehsil Nainpur

District Mandla (M.P.)

State Madhya Pradesh

10. Nearest railway station/airport Mandla Railway Station (Narrow Gauge) approx -21. 5 along with distance in km. Km (Road Dist) NE Direction. Jabalpur Railway Station approx-111.0 Km (Road Dist) NW Direction.(Broad Gauge), Jabalpur Airport approx-115.0 Km(Road Dist)NW Direction

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11. Nearest Town, city, District Nearest Village: Khursipar approx -790 mt (Aerial Dist) Headquarters along with distance NE Direction in kms. Nearest Town: Nainpur approx-22.6 Kms (Road Dist) SW Direction Nearest City : Mandla approx-25.2 Km(Road Dist)NE Direction

Village Panchayats, Zilla Parishad, Village Panchayats –Khursipar 12 . Municipal Corporation, Local body (complete postal addresses with telephone nos. to be given) 13. Name of applicant Shri Arun Agrawal, S/o Shri Shyam Sundar Agrawal

14. Registered Address Bamhani Banjar Mandla, Teh sil & District - Mandla(M.P.)481661 15. Address for correspondenc e Name Shri Arun Agrawal, S/o Shri Shyam Sundar Agrawal Designation lessee (Owner/Partner/CEO) Address Bamhani Banjar Mandla, Thesil & District - Mandla(M.P.)481661 Pin Code 481661

E-mail [email protected]

Telephone No. OR Mobile No. +91 - 8269245456

Fax No. -

16. Details of Alternative Sites Village District State examined, if any. Location of these Not Examined Not Examined Not Examined sites should be shown on a Not Examined Not Examined Not Examined toposheet Not Examined Not Examined Not Examined. 17. Interlinked Projects Not Applicable Not Applicable

18. Whether separate application of Not Applicable interlinked project has been submitted? 19. If yes date of submission Not Applicable

20. If no , reason Not Applicable

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21. Whether the proposal involves Not Applicable approval/clearance 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 Quarry Lease area sanctioned by Govt. of Madhya Order/policy relevant/relating to Pradesh the site? 23. Forest land involved (Hectares) Not Applicable

24. Whether there is any litigation Not Applicable pending 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) Orders/direction 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. Information/Checklist Yes Details there of (with approximate No. confirmation /No quantities /rates, wherever possible) with source of information data 1.1 Permanent or temporary change in Yes Land Use - As per revenue record the kind of land is Govt. Land land use, land cover or topography Land Cover- The mining activity will have including increase in intensity of localized impact and create physical change in the existing environment due to the change in land use (with respect to local land the existing land use. use plan) Topography- The topography of the area is generally slopping and rocky. 1.2 Clearance of existing land, No The mining lease area is Govt. Land. Mining lease area generally rocky and has poor vegetation and buildings? vegetation and no buildings in the area. So no clearance will be required for existing land, vegetation, and building. 1.3 Creation of new land uses? Yes Creation of land in the form of pits and dumps due to mining activity. Stabilization of the

dump will be done by growing vegetation over it. 1.4 Pre -construction investigations e.g. No Prop osed project is for mining of "Stone minor minerals" already present in the undulating

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bore houses, soil testing? topography. 1.5 Construction works? No The Semi -mechanized opencast working in the Undulating does not involve any construction work 1.6 Demolition works? No No

1.7 Temporary sites used for No No . construction works or housing of construction workers? 1.8 Above ground buildings, structures No No. . or earthworks including linear structures, cut and fill or excavations 1.9 Underground works including No No . mining or tunneling? 1.10 Reclamation works? No No .

1.11 Dredging? Yes During lease Period 3.4464 Ha area will be excavated 1.12 Offshore structures? No As it is a Stone mining and these are not required for this project. 1.13 Production and manufacturing Yes Semi Mechanized method of mining will be adopted for open cast mining processes? 1.14 Facilities for storage of goods or No Stone will be loaded directly into trucks, dumpers then it directly transport to crusher materials? unit, and hence no storage facility at the mine site will be required. 1.15 Facilities for treatment or disposal No During propos ed period 21,050 cubic meter of solid waste or liquid effluents? waste will be generated. Generated Quantity of waste and soil will be used in Plantation and the mine road maintenance, hence no waste dumps are available at the end Mining plan period 1.16 Facilities for long term housing of No The mine workers will be from nearby villages so no long term housing facility is required. operational workers? 1.17 New road, rail or sea traffic during No There is no need to construct new road, as existing facilities are sufficient during construction or operation operation of mine site. Existing Kachha road will be maintain for Material transport.

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1.18 New road, rail, air waterborne or No No additional infrastructure facilities are . other transport infrastructure required including new or altered routes and stations, ports, airports etc? 1.19 Closure or diversion of existing No No closure/ diversion of existing transport transport routes or infrastructure routes or infrastructure is required.. leading to changes in traffic movements? 1.20 New or diverted transmission lines No As there will be no electricity or large scale or pipelines? water requirement for the project, therefore no transmission lines or pipelines are involved 1.21 Impoundment, damming, culver No In view of neither any Impoundment through ting, realignment or other changes damming or realignment of the stream/river is envisaged in the mine area, there will not be to the hydrology of watercourses any changed in surface hydrology. Mining will or aquifers? be done above ground water table. Water table will not intersect during mining. 1.22 Stream crossings? No Neither any surface drain nor any water course (minor) passes through the mine area 1.23 Abstraction or transfers of water No No abstraction of natural flow of water in the from ground or surface waters? form of ground or surface water in the lease area and working will be done above water table.

1.24 Changes in water bodies or the No No change in water bodies, drainage or runoff land surface affecting drainage or is anticipated. run-off? 1.25 Transport of personnel or Yes Road transportation for person nel will be materials for construction, arranged by lessee's vehicles and material will operation or decommissioning? be transported by Tippers/dumpers.

1.26 Long -term dismantling or No Long -term dismantling or decommissioning or decommissioning or restoration restoration works are not involved. works? 1.27 Ongoing activity during No Not Applicable decommissioning which could have an impact on the

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environment? 1.28 Influx of people to an area in either No The work will be carried out during day time by deploying local labour, which will come to temporarily or permanently? the work in the lease area and return to their home. 1.29 Introduction of alien species? No No such introduction of alien species is foreseen 1.30 Loss of native species or genetic No No loss of native species or genetic diversity is diversity? expected. 1.31 Any other actions? No Not Applicable

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 confirmation /No quantities /rates, wherever possible) with source of information data 2.1 Land especially undeveloped or Yes No agricultural land is involved agricultural land (ha) 2.2 Water (expected source & Yes About 1.0 KLD of water will be required for domestic use and 58.0 KLD for dust competing users) unit: KLD suppression and 1.0 KLD for plantations. This water will be supplied from the nearby tube wells through tankers, with proper permission. 2.3 Minerals (MT) No As this is Stone along with associated minor mineral mining project, so no other minerals are used in it. 2.4 Construction material – stone, No No construction material is required for this project. Only temporary office, rest shelters aggregates, sand / soil (expected will be provided. source – MT)

2.5 Forests and timber (source – MT) No Not required for this project.

2.6 Energy including electricity and Yes The mine will operate in shifts and operational fuels (source, competing users) machinery is diesel operated which will be Unit: fuel (MT), energy (MW) sourced from nearby outlet and required electricity for lighting arrangement will be made as per MMR 1961, Regulation 146.

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2.7 Any other natural resources (use No No other natural resources will be used. 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/No Details thereof (with approximate confirmation quantities/rates, wherever possible) with source of information data 3.1 Use of substances or materials, No Drill hole will be filled with slurry explosive for column charge & booster and blasting which are hazardous (as per with excel. Explosive will be handled and MSIHC rules) to human health or used by persons certified under MMR 1961. the environment (flora, fauna, and Water supplies) 3.2 Changes in occurrence of disease No No change in occurrence of diseases, due to mining of stone along with associated Minor or affect disease vectors (e.g. insect mineral. or water borne diseases) 3.3 Affect the welfare of people e.g. by Yes Project will encourage the economy of the local people by direct and indirect changing living conditions? employment opportunity. Besides this, social welfare measures shall be undertaken as CSR/EMP activity which will ameliorate the economic status of the people around the project area. 3.4 Vulnerable groups of people who No No Hospital, S chool exists within 500 mt from mine lease area. could be affected by the project e.g. hospital patients, children, the elderly etc., 3.5 Any other causes No No 4. Production of solid wastes during construction or operation or decommissioning (MT/month) S. Information/Checklist Yes/N Details thereof (with approximate quantities /rates, wherever possible) with source of No. confirmation o information data 4.1 Spoil, overburden or mine wastes No No 4.2 Municipal waste (domestic and or No No commercial wastes)

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4.3 Hazardous wastes (as per No No Hazardous Waste Management Rules) 4.4 Other industrial process wastes No No 4.5 Surplus product No No 4.6 Sewage sludge or other sludge No No from effluent treatment 4.7 Construction or demolition wastes No No

4.8 Redundant machinery or No No equipment 4.9 Contaminated soils or other No No materials 4.10 Agricultural wastes No No

4.11 Other solid wastes No No 5. Release of pollutants or any hazardous, toxic or noxious substances to air (Kg/hr) S. Information/Checklist Yes/N Details thereof (with approximate No. confirmation o quantities/rates, wherever possible) with source of information data 5.1 Emissions from combustion of No No fossil fuels from stationary or mobile sources 5.2 Emissions from production Yes The production process will involve excavation and loading which will generate processes emissions and will cause little impact. 5.3 Emissions from materials handling Yes transport, which will be very less and cause very less impact. including storage or transport

5.4 Emissions from construction No No construction will be done at the mining site. Hence, no emissions are anticipated. activities including plant and equipment 5.5 Dust or odors from handling of Yes Only dust emission from handling of material, which will very less and not cause any materials including construction negative impact. No odor will develop. materials, sewage and waste 5.6 Emissions from incineration of No No incineration of waste will be done. waste

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5.7 Emissions from burning of waste No No burning of waste is done, hence no emission is expected. in open air (e.g. slash materials, construction debris) 5.8 Emissions from any other sources No None

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

S. Information/Checklist Yes/ Details thereof (with approximate No. confirmation No quantities/rates, wherever possible) with source of information data 6.1 From operation of equipment e.g. Yes Mining operations will require equipment such as excavator, loader (JCB), dumpers etc. engines, ventilation plant, all the equipments will be of highest crushers standard of reputed make. This manufacturer itself will take significant care of noise pollution control. Further, a vegetative barrier is also proposed for the purpose. All the equipment's will be regularly maintained to keep noise level within the prescribed limit of 65 dB (A). 6.2 From industrial or similar No No industr ial process is involved at mine lease area. processes 6.3 From construction or demolition No No construction or demolition is proposed. 6.4 From blasting or piling Yes Noise from blasting is momentarily and vibration with controlled and scientific blasting. There will be vibrations from blasting but no long term impact on nearby area will be anticipated. 6.5 From construction or operational Yes During operational stage running of dumpers/tippers will produce very less traffic noise, which will not cause any impact. 6.6 From lighting or cooling systems No No 6.7 From any other sources No 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. Information/Checklist Yes/No Details thereof (with approximate No. confirmation quantities/rates, wherever possible) with source of information data 7.1 From handling, storage, use or No No spillage of hazardous materials 7.2 From discharge of sewage or No No other effluents to water or the

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land (expected mode and place of discharge)

7.3 By deposition of pollutants No No emitted to air into the land or into water 7.4 From any other sources No No

7.5 Is there a risk of long term build No No 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. Information/Checklist Yes/N Details thereof (with approximate No. confirmation o quantities/rates, wherever possible) with source of information data 8.1 From explosions, spillages, fires Yes Mining will be done by semi mechanized open cast in a safe and scientific manner and etc from storage, handling, use or precautions will be taken against all risks as production of hazardous per norms prescribed by DGMS. substances 8.2 From any other causes No No

8.3 Could the project be affected by No No natural disasters causing environmental damage (e.g. floods, earthquakes, landslides, cloudburst etc)? 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. Information/Checklist Yes/ Details there of (with approximate No. confirmation No quantities/rates, wherever possible) with source of information data 9.1 Lead to development of supporting No No facilities ancillary development or development stimulated by the project which could have impact on

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the 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 No The top mined out benches will be converted into green belt which will have positive could have an impact on the impact on environment. environment 9.3 Set a precedent for later No No developments 9.4 Have cumulative effects due to No No proximity to other existing or planned projects with similar effects. (III) Environmental Sensitivity S. Areas Name/ Aerial distance (within 15 km.) No. Identity Proposed project location boundary

1 Areas protected under No No international conventions, national or local legislation for their ecological, landscape, cultural or other related value 2 Areas which are important or Yes Banjar River approx -12.52 Km (Aerial sensitive for ecological reasons - Dist) SE Direction Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests 3 Areas used by protected, No No important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration

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4 Inland, coastal, marine or No No underground waters 5 State, National boundaries No No 6 Routes or facilities used by the Yes SH -40 approx -6.36 Km (Aerial Dist) N Direction public for access to recreation or other tourist, pilgrim areas 7 Defense installations No No 8 Densely populated or built -up Yes Khursipar Village approx -790 mt (Aerial Dist)NE Direction area 9 Areas occupied by sensitive man - No No made land uses (hospitals, schools, places of worship, community facilities) 10 Areas containing important, high No No quality or scarce resources (ground water resources, surface resources, forestry, agriculture, fisheries, tourism, minerals) 11 Areas already subjected to No No pollution or environmental damage. (those where existing legal environmental standards are exceeded) 12 Areas susceptible to natural No No hazard which could cause the project to present environmental problems ( earthquakes, subsidence, landslides, erosion, flooding or extreme or adverse climatic conditions )

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“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 give, if any to the project will be my risk and cost”.

Mail: [email protected] Telephone No. +91- 8269245456

(Authorized Signatory)

Date: 30 -07-2018 M Shri Arun Agrawal, S/o Shri Shyam Sundar Agrawal Place: Mandla Bamhani Banjar Mandla, Thesil & District- Mandla(M.P.)481661 E-mail: [email protected] Telephone No. +91- 8269245456

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