FORM-1 TO OBTAIN PRIOR ENVIRONMENT CLEARANCE FOR PROPOSED STONE MINING ACTIVITY UNDER THE EIA NOTIFICATION – 2006 AMENDED ON 31/05/2012 OF M/s. SHREEJEE METALS LOCATED AT B. No. / S. No.: 1670, Vil: Degam, Tal: Chikhli. Dis: Navsari, Gujarat FORM I (See Paragraph – 6) (I) BASIC INFORMATION Sr. Item Details No . 1. Name of the Project “ M/s. Shreejee Metals ” 2. S. number in schedule 1(a) 3. Proposed capacity/area/length/tonnage Proposed Black Trap mining activity (Stone mining) to be handled/command area/lease in the lease area 01-45-68 ha area/number of well to be drilled 4. New/expansion/modernization New 5. Existing capacity/area etc. Proposed project 6. Category of project i.e. “A” or “B” “Category B (B2)” [Mining Area < 50 ha] 7. Does it attract the general condition? If No yes please specify 8. Does it attract the specific condition? If No yes please specify 9. Location Degam-Chikhli Plot/Survey/Khasra No B. No./ S. No.: 1670 Village Degam Tehsil Chikhli District Navsari State Gujarat 10 . Nearest railway station/airport along Bilimora railway station : 15 Km in WSW with distance in Kms. Surat Airport – 50 Km in NW 11 . Nearest town, city, district headquarter along with distance in Kms. 12 . Village Panchayat, Zila Parishad, B. No./ S. No.: 1670, Vil: Degam, Tal: Chikhli. Municipal Corporation, local body Dis: Navsari, Gujarat (Complete postal address with telephone nos. to be given) 13 . Name of the applicant Mr. PINTU K. KALAVADIA 14 . Registered address M/s. Maruti Metals S. No. 1642, Village: Degam, Tal: Chikhli, Dist: Navsari, Gujarat 15 . Address for correspondence As below Name Mr. PINTU K. KALAVADIA Designation Partner Address M/s. Maruti Metals S. No. 1642, Village: Degam, Tal: Chikhli, Dist: Navsari, Gujarat Pin code 396521 E-mail Telephone Mob. No: 9426221598 /800124393 Fax No -- 16 . Details of alternative sites examined, if Location of the site is shown on Topo sheet as Fig -1 in any. Location of these sites should be section-2.0 (Chapter-2) shown on a Topo sheet 17 . Interlinked Project No 18 . Whether separate application for Not Applicable interlinked project has been submitted? 19 . If yes date of submission --- 20 . If no, reason --- 21 . Whether th e proposal involves approval/ No clearance under: if yes, details of the same and their status to be given The Forest (Conservation) Act, 1980 The Wildlife (Protection) Act, 1972 The CRZ Notification 1991 22 . Whether there is any Government The land is Private & owned by the partners of M/s. order/policy relevant/ relating to site Pintubhai K. Kalavadia. Land possession documents (7-12 & NA copy) is compile as per Annexure – 1 23 . Forest Land involved. No 24 . Whether there is any litigation pending No litigation pending against the project and / or land in which the project is propose to be set up Name of court Case no Order/directions of the court, if any and its relevance with the proposed project. (II) Activity 1. Construction, Operation or decommissioning of the project involving activities which will cause physical changes in the locality (topography, land use, changes in water bodies etc.) Sr. Information / Checklist Yes Details there of (with approximate quantities No. Confirmation / No / rates. Wherever possible with sources of information data) 1.1 Permanent or temporary change in Yes For detail of topography please refer Chapter-2 land use, Land cover or (2.2) of PFR (Project Feasibility Report) topography including increase in For land use pattern Please refer Chapter – 4 intensity of land use (with respect (4.6) of PFR (Project Feasibility Report) to local land use pattern) 1.2 Clearance of existing land, No Not Require vegetation and building 1.3 Creation of New land Uses? No Not Applicable 1.4 Pre-Construction Investigations No Not Applicable e.g. Bore house, Soil testing. 1.5 Construction works? No Not Applicable 1.6 Demolition works? No Not Applicable 1.7 Temporary Site use for the No Not required , contruction works housing of construction workers? 1.8 Above Ground Buildings, No Not Applicable structure of earthworks including linear structures, cut and fill or excavations? 1.9 Underground work including No Not Applicable mining and tunneling 1.10 Reclamation Work No Please refer Chapter – 5 (5.9) of PFR (Project Feasibility Report) 1.11 Dredging? No Not Applicable 1.12 Offshore structures? No Not Applicable 1.13 Production and manufacturing Yes Presented in the Chapter – 2 (2.6) of PFR processes? 1.14 Facilities for storage of goods or Yes Please refer Annexure -2 material 1.15 Facilities for treatment or disposal No Not Applicable of solid waste or liquid effluents? 1.16 Facilities for long term housing No Not Require operational workers? 1.17 New road, rail, or sea traffic during No Not Require construction or operations? 1.18 Closure or diversion of existing No Not Required transport routes or infrastructures including new or altered routes and station, port, airports etc.? 1.19 Closure or diversion of existing No Not Required transport routes or infrastructures leading to changes in traffic movement 1.20 New or diverted transmission lines No Not Required or pipelines 1.21 Impoundment, Damming, Culver No Not Applicable ting, realignment or other change to the hydrology of watercourses or aquifers 1.22 Stream crossing? No Not Applicable 1.23 Abstraction or transfer of water Yes Please refer Chapter – 2 (2.8.2) of PFR from ground or surface waters? 1.24 Changes in water bodies or the No Hydrology map of this area is attached presented land surfaces affecting drainages in Chapter – 2 (2.4)of PFR or runoff? Controlled blasting is done. No changes in underground water flow pattern. 1.25 Transport of personnel or No Not Applicable materials for construction operation or decommissi oning? 1.26 Long – term Dismantling or No For Post Mining Plan Please refer Chapter – 5 decommissioning or restoration (5.9) of PFR 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 Not Applicable temporarily or permanently 1.29 Introduction of Alien Species? No Not Applicable 1.30 Loss of native species or genetic No Not Applicable diversity? 1.31 Any other actions? No No ne 2. Use of natural resources for construction or operation of the project (such as land water, material or energy, especially any resources which are nonrenewable or is short of supply): Sr. Information / Checklist Yes Details there of (with approximate quantities / rates. Wherever No. Confirmation / No possible with sources of information data) 2.1 Land especially No The land is Owned by project proponent. underdeveloped or Private land & Non Agriculture land agricultural land (ha) 2.2 Water (expected Yes Please refer Chapter – 2 (2.8.2) of PFR sources & competing users) unit KLD 2.3 Mineral (MT) Yes Total Proposed Mining area is 01-45-68 ha Proposed project Of Black Trap@ 2,00,000 Mt/Year (Approx.) 2.4 Construction material – No Please refer Chapter – 2 (2.4.1) of PFR stone, aggregates / soil Expected Sources – MT) 2.5 Forest and timbers No Not Applicable (Sources – MT) 2.6 Energy including No Not Required electricity and fuels (sources, competing users) Units: fuel (MT), energy (MW) 2.7 Any other natural No --- resources (use 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 concern about actual or perceived risks to human health. Sr. Information / Checklist Yes Details there of (with approximate quantities / No. Confirmation / No rates. Wherever possible with sources of information data) 3.1 Use of substance or material Yes Explosive material will be utilized for blasting. which are hazardous (as per Material Safety Data Sheet of blasting material is MSIHC rules) to human health or summarized in Chapter -8 (Section-8.1) of PFR the environment (Flora, Fauna and water supplies.) 3.2 Change in occurrences of No Not Applicable diseases or affect diseases vectors (e.g. insect or water borne diseases) 3.3 Affect the welfare of people e.g. by Yes People will get job. changing living conditions? 3.4 Vulnerable group of people who No The magnitude of impact on vulnerable group of could be affected by the project people would not be significant as distance from e.g. hospital patients, children, the site is quite far away. elderly etc. Nearest hospital: Alipore hospital: 4.9 Km in WSW Chikhli Civil Hospital: 7.55 km in SW Nearest School: Degam high School: 2.70 Km in W Bamanvel School: 3.78 Km in SSW Nearest population : Sai Temple Degam: 2.73 Km WSW Bamanvel: 4.0 Km in SSW Jama-Masjid Alipore: 4.42 Km WSW Degam mosque: 2.89 Km in WSW Adhar-Peer Masjid: 1.84 Km in SE CNI Church Bamanvel: 3.92 Km in SE For Distance certificate from Village Talati & Forest Pl. refer Annexure-3 3.5 Any others -- 4. Production of solid wastes during construction or operation or decommissioning (MT/Month) Sr. Information / Checklist Yes Details there of (with approximate quantities / No. Confirmation / No rates. Wherever possible with sources of information data) 4.1 Spoil, over burden or mine wastes No No such waste is generated. 4.2 Municipal waste (Domestic and or No Very negligible quantity. commercial wastes) 4.3 Hazardous waste (as per No Not Applicable Hazardous waste Management Rules) 4.4 Other Industrial process waste No Not Applicable 4.5 Surplus Product No Not Applicable 4.6 Sewage sludge or other sludge No No sludge generated.