G.N. Construction – Plot A

APPENDIX - I FORM 1 (I) Basic Information

Sr. Item Details No. 1. Name of the project/s G.N. Construction – Plot A 2. S. No. in the schedule 8 (a)

3. Proposed capacity/ area/ length/ Total Plot Area:- 26839.00 m2 tonnage to be handled/ command area/ lease area/ number of wells to be Proposed Built Up Area:39179.85 m2 drilled 4. New/ Expansion/Modernization New Not Applicable 5. Existing Capacity/Area etc.

Category of Project i.e. ‘A’ or ‘B’ B2 6.

7. Does it attract the general condition? No If yes, please specify. 8. Does it attract the specific condition? No If yes, please specify. 9. Plot/ Survey/ Khasra No. Plot A of Survey no. 31/1-A-1 Village Tehsil Taluka District North State 10. Nearest railway station/airport along Aerial Distances with distance in kms. Thivim Railway Station – 12.66 Km – 16.57 Km 11. Nearest Town, City, District Aerial Distances Headquarters along with distance in – 4.65 Km kms. 12. Village Panchayats, Zilla Parishad, Village Panchayat Pilerne – Marra Municipal Corporation, Local body Address: Betim–Verem– Rd, Pilerne, (complete postal addresses with Bardez, Marra, Goa 403507 telephone nos. to be given) 13. Name of the applicant Uday Ghanashyam Naik and Sir Biotech Ltd 14. Registered Address Plot A of Survey no. 31/1-A-1, Pilerne, Bardez Taluka, Goa. 15. Name Uday Ghanashyam Naik and Sir Biotech India Ltd

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G.N. Construction – Plot A

Designation (Owner/Partner/CEO) Owner Address Gera Imperium II, 415, Patto, Panaji Pin Code 403001 Telephone no. 9987585868 Email [email protected] 16. Details of Alternative Sites examined, No alternative if any. Location of these sites should be shown on a topo sheet. 17. Interlinked Projects No interlinked project 18. Whether separate application of Not applicable interlinked project has been submitted? 19. If yes, date of submission No 20. If no, reason Not applicable 21. Whether the proposal involves approval/ clearance under: if yes, details of the same and their status to be given. (a) The Forest (Conservation) Act, No 1980? (b) The Wildlife (Protection) Act, 1972? No (c) The C.R.Z Notification, 1991? No 22. Whether there is any Government No Order/ Policy relevant/ relating to the site? 23. Forest land involved (hectares) No forest land involved. The copy of Sanad is enclosed as Annexure 1. 24. Whether there is any litigation No pending against the project and/or land in which the project is proposed 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.

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G.N. Construction – Plot 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.)

Sr. Information/Checklist Yes/No Details thereof (with approximate quantities No confirmation /rates, wherever possible) with source of information data 1.1 Permanent or temporary Yes The present land will be used for construction change in land use, land of proposed buildings causing permanent cover or topography change in the present land use pattern. The including increase in Office of District Collector, North Goa has intensity of land use (with given permission for use of land for respect to local land use construction purpose. The copy of Sanad is plan) enclosed as Annexure 1.

1.2 Clearance of existing Yes The project site has very few tree cover. The Land, vegetation and exact numbering of trees and its species will be building? documented and presented in Biodiversity survey report. The study for Biodiversity is in process. 1.3 Creation of new land uses? No Not applicable 1.4 Pre-construction No No pre-construction investigation has been investigation e.g. borehole, undertaken. soil testing? 1.5 Construction works Yes The estimated quantities of construction materials is presented in prefeasibility report. Please refer section II E, Pg. no. 5 of Annexure 2. 1.6 Demolition work No No demolition work is involved. 1.7 Temporary sites used for Yes Temporary housing sheds/camps for construction works or construction workers and site office for staff housing of construction and security persons within the plot premises workers? is proposed. 1.8 Above ground buildings, Yes Above ground buildings, structures are structures or earthworks proposed. including linear structures, cut and fill or excavations 1.9 Underground works No Not applicable including mining or tunneling? 1.10 Reclamation works? No No reclamation is required 1.11 Dredging? No Not applicable 1.12 Offshore structures? No Not applicable 1.13 Production and No Not applicable manufacturing processes?

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1.14 Facilities for storage of Yes All the goods or materials required for goods or materials? construction will be stored on site. 1.15 Facilities for treatment or Yes Construction phase disposal of solid waste or Facility for treatment of solid waste: liquid effluent? Composting Facility for treatment of Liquid waste: Septic tank followed by soak pit Operation phase Facility for treatment of solid waste: Organic waste convertor (1nos. X 150 Kg/day and 110 Kg/day X 1 no.) Facility for treatment of Liquid waste: STP (1no. X 160 KLD)

A detailed calculation and management plan is presented in prefeasibility report attached as Annexure 2. 1.16 Facilities for long term No Temporary sheds will be provided to the housing of operational construction workers during the construction workers? period. 1.17 New road, rail or sea traffic No No new mode of traffic is envisaged. during construction or operation? 1.18 New road, rail, air No Existing infrastructure will be used. waterborne or other transport infrastructure including new or altered routes and stations, ports, airports etc? 1.19 Closure or diversion of No Existing approach road will be used for existing transport routes or transportation of construction materials to the infrastructure leading to site. charges in traffic movements? 1.20 New or diverted No Not applicable transmission lines or pipelines? 1.21 Impoundment, damming, No Not applicable culverting, realignment or other changes to the hydrology of watercourses or aquifers? 1.22 Stream crossing? No Not applicable 1.23 Abstraction or transfers of No Use of ground water is not planned at this water from ground or stage of development. Please refer surface waters? prefeasibility report attached as Annexure 2 for expected source of water.

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1.24 Changes in water bodies or No Natural Drainage will not be altered. Rain the land surface affecting water recharging system is proposed. drainage or run-off? 1.25 Transport of personnel or Yes Trucks/ Tempos will be used for transportation. materials for construction, operation or decommissioning? 1.26 Long-term dismantling or No Not applicable decommissioning or restoration works? 1.27 Ongoing activity during No Not envisaged decommissioning which could have an impact on the environment? 1.28 Influx of people to an area Yes About 25 persons are proposed to work during either temporarily or construction phase. permanently? About 1362 occupants are estimated at full occupancy during operation phase. A detail calculation of occupancy is presented in prefeasibility report attached as Annexure 2 (Section II – A and Section III – A) 1.29 Introduction of alien No Not applicable species? 1.30 Loss of native species or No Not applicable genetic diversity? 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):

Sr. Information/checklist Yes/No Details thereof (with approximate quantities No. confirmation /rates, wherever possible) with source of information data 2.1 Land especially undeveloped No The land is undeveloped. The Survey plan for or agricultural land (ha) the land is enclosed as Annexure 3. 2.2 Water (expected source & Yes The primary supply of water will be PWD. competing users) unit: KLD Tanker water will also be availed during insufficient supply of PWD water. During operation phase the total maximum expected occupancy (including visitors) is 1362 for which estimated water requirement is 110 KLD. 2.3 Minerals (MT) No Not applicable

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2.4 Construction material – stone, Yes The estimated construction materials are aggregates, sand / soil presented in Pre-feasibility report attached as (expected source – MT) Annexure 2. 2.5 Forests and timber (source – Yes Use of timber shall be minimal and will be MT) used only for making doors and window panes. 2.6 Energy including electricity Yes During construction and fuels (source, competing Power Requirement: 100 KVA users) Unit: fuel (MT), energy Source – Goa Electricity Department. (MW) During operation phase Power Requirement: 3000 KVA Source – Goa Electricity Department Back up source – D.G. Set (1 x 160 KVA capacity) 2.7 Any other natural resources No Not envisaged (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 concerns about actual or perceived risks to human health.

Sr. Information/Checklist Yes/No Details thereof (with approximate quantities/ No. confirmation rates, wherever possible) with source of information data 3.1 Use of substances or Yes Used oil from D.G sets materials, which are hazardous (as per MSIHC rules) to human health or the environment (flora, fauna and water supplies) 3.2 Changes in occurrence of No Safe working environment for onsite workers disease or affect disease will be ensured. Regular health for vectors (e.g. insect or water construction workers will be done during borne diseases) construction phase of project. 3.3 Affect the welfare of people Yes Indirect employment to the local people as the e.g. by changing living project will create additional demand for civic conditions? amenities and other daily needs. 3.4 Vulnerable groups of people No Not envisaged who could be affected by the project e.g. hospital patients, children, the elderly etc., 3.5 Any other causes No Not envisaged

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4. Production of solid wastes during Construction or Operation or Decommissioning (MT/month)

Sr. Information/Checklist Yes/No Details thereof (with approximate quantities/ No. confirmation rates, wherever possible) with source of information data 4.1 Spoil, overburden or mine No Not applicable wastes 4.2 Municipal waste (domestic Yes Please refer the details of Solid waste in and/ or commercial wastes) Prefeasibility reports attached as Annexure 2. 4.3 Hazardous waste(as per Yes Operation phase – Approx. 8 —10 Kg/month Hazardous Waste of used oil from D.G sets and STP equipments. Management Rules) 4.4 Other industrial process No Not applicable wastes

4.5 Surplus product No Not applicable 4.6 Sewage sludge or other sludge Yes The sewage sludge from STP will be generated from effluent treatment and is estimated to be 16 Kg per day. The sludge generated will be dewatered in sludge drying bed. Dewatered sludge will be used as Bio-fertilizer for landscape development. 4.7 Construction or demolition Yes No demolition work is involved. wastes 4.8 Redundant machinery and No Not applicable equipments 4.9 Contaminated soils or other No Not applicable materials 4.10 Agriculture waste No Not applicable 4.11 Any other wastes No Not envisaged

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

Sr. Information/Checklist Yes/No Details thereof (with approximate quantities/ No. confirmation rates, wherever possible) with source of information data 5.1 Emissions from combustion of Yes Construction phase – Emissions from use of fossil fuels from stationary or D.G, JCB, Poclain etc. mobile sources Operation phase – D.G sets during power failure. 5.2 Emissions from production No Not applicable processes 5.3 Emissions from materials Yes Handling of construction material. handling including storage or

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transport 5.4 Emissions from construction Yes Fugitive emissions in form of dust during activities including plant and loading/unloading equipment 5.5 Dust or odors from handling Yes No odour from sewage as it will be carried out of materials including through closed pipelines. No odour from solid construction materials, waste as it will be segregated into wet and dry sewage and waste waste. 5.6 Emissions from incineration No Waste will not be incinerated of waste 5.7 Emissions from burning of No Waste will not be burned in open air waste in open air (e.g. slash materials, construction debris) 5.8 Emissions from any other No Not envisaged sources

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

Sr. Information/Checklist Yes/No Details thereof (with approximate quantities/ No. confirmation rates, wherever possible) with source of information data 6.1 From operation of Yes Operation phase – Noise level of about 65-75 equipment e.g. engines, dB (A) from operation of D.G sets and STP ventilation plant, crushers equipment is envisaged. 6.2 From industrial or similar No Not applicable processes 6.3 From construction or Yes Generation of Noise level of about 65-75 dB (A) demolition is envisaged from construction activities 6.4 From blasting or piling No Not applicable 6.5 From construction or Yes About 60 to 65 dB (A) noise level due to operational traffic movement of vehicles during construction and operation phase. 6.6 From lighting or cooling No Not applicable systems 6.7 From any other sources No Not envisaged

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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:

Sr. Information/Checklist Yes/No Details thereof (with approximate quantities/ No. confirmation rates, wherever possible) with source of information data 7.1 From handling, storage, use No Diesel, lubricant, used oil will be stored at or spillage of hazardous identified area. materials Used oil will be disposed off through authorized recycler as CPCB guidelines. 7.2 From discharge of sewage No No sewage will be discharge on land without or other effluents to water treatment. During construction phase mobile or the land (expected mode sanitation facilities will be provided to the and place of discharge) construction workers. Sewage generated will be collected in septic tank for treatment and discharge through temporary soak pit arrangement on site. During operation phase STP will be installed for treatment of sewage. Treated sewage will be used for flushing, landscaping, internal road washing. 7.3 By deposition of pollutants No No risk is envisaged emitted to air into the land or into water 7.4 From any other sources No Not envisaged 7.5 Is there a risk of long term No Not applicable build 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:

Sr. No. Information/Checklist Yes/No Details thereof (with approximate quantities/ confirmation rates, wherever possible) with source of information data 8.1 From explosions, spillages, No Not envisaged. All the safety measures will be fires etc. from storage, followed. NOC prior to commencement of handling, use or construction will be taken from Directorate of production of hazardous Fire and Emergency substances 8.2 From any other causes No Not envisaged 8.3 Could the project be No Not envisaged affected by natural disasters causing environmental damage

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(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:

Sr. 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 Yes The project will have positive impact on the supporting. facilities, Socio Economic parameter of Environment. ancillary development or Supporting infrastructure facilities are already development stimulated by in existence. 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 9.2 Lead to after-use of the No Not applicable site, which could have an impact on the environment 9.3 Set a precedent for later No Not applicable developments 9.4 Have cumulative effects No Not applicable due to proximity to other existing or planned projects with similar effects

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(III) Environmental Sensitivity

Aerial distance Name/ (within 15 km) Sr. No. Areas Identity Proposed project location boundary 1 Areas protected under -- No protected area international conventions, under international national or local legislation for conventions, national their ecological, landscape, or local legislation. cultural or other related value 2 Areas which are important or Salim Ali Bird Sanctuary Approx. 3.68 km to sensitive for ecological reasons - South East. Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests 3 Areas used by protected, Salim Ali Bird Sanctuary Approx. 3.68 km to important or sensitive species of South East. flora or fauna for breeding, nesting, foraging, resting, over wintering, migration 4 Inland, coastal, marine or Approx. 2.40 to underground waters South 5 State/ National boundaries NH-17 (Edapally-Panvel Approx. 0.8 km to National Highway) East. 6 Routes or facilities used by the Yes Chogam Road approx. public for access to recreation or 0.72 km to East. other tourist, pilgrim areas 7 Defense installations -- No defense installation within 15 Km radius 8 Densely populated or built-up Yes Panaji City at 4.65 area km South 9 Areas occupied by sensitive man- Yes The project is located made land uses (hospitals, in Pilerne. Area is schools, places of worship, occupied by hospitals, community facilities) community facilities and schools. 10 Areas containing important, high No No areas within 15 quality or scarce resources Km containing any (ground water resources, surface important,/high resources, forestry, agriculture, quality/scarce fisheries, tourism, minerals) resources.

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11 Areas already subjected to No Area is not subjected pollution or environmental to pollution or damage. (Those where existing environmental legal environmental standards damage. are exceeded)

12 Areas susceptible to natural No Goa lies in Zone-III hazard which could cause the (Moderate) of seismic project to present environmental region and designing problems (earthquakes, and construction will subsidence, landslides, erosion, be done accordingly. flooding or extreme or adverse climatic conditions)

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 C.R.Z Notification, 1991 for the activities to be located in the CRZ.Not applicable Not applicable

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 or the Chief Wildlife Warden thereon (at the stage of EC). Not applicable

3. All correspondence with the Ministry of Environment & Forests including submission of application for TOR/ Environmental Clearance, subsequent clarifications, as may be required form 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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Undertaking

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 revoked at our risk and cost.

Date: 21.11.2016 Place: Goa

Uday Ghanashyam Naik Project Proponent

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