“Doull Stone Quarry” located at Khasra No –57, near Village – Doull, Tehsil- Dharampuri District – , FORM 1

FORM-I

I. BASIC INFORMATION

S. Item Details No. 1. Name of the project/s “Doull Stone Quarry” 2. Sl. No. of the schedule Category ‘B1’

3. Proposed capacity / area / Proposed capacity : Basalt Stone: 19030 cum/year length / tonnage to be Lease Area : 4.0 Ha handled / command area / lease area / lease area / number of wells to be drilled 4. New / Expansion / New Modernization 5. Existing Capacity / Area Nil etc. 6. Category of Project i.e. ‘A’ B1 or ‘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 Pillar No N E 1 22015’05.51” 75026’17.74” 2 22015’07.29” 75026’21.05” 3 22015’07.97” 75026’28.19” 4 22015’05.97” 75026’28.19” 5 22015’01.45” 75026’27.72”

Rakesh Patidar

“Doull Stone Quarry” located at Khasra No –57, near Village – Doull, Tehsil- Dharampuri District – Dhar, Madhya Pradesh FORM 1

S. Item Details No. 6 22015’03.97” 75026’22.69” 7 22015’01.57” 75026’20.01”

i. Plot/Survey/Khasra No. 46 N/7 ii. Village Doull iii. Tehsil Dharampuri iv. District Dhar v. State Madhya Pradesh 10. Nearest Railway Station / Devi Ahilyabai Holkar International Airport, Airport along with distance Approx. 64.3 km in NE direction in kms. Railway Station - Approx. 47.8 km in NE direction 11. Nearest Town, city, District Nearest Town-Mehgaon, Approx. 1.9 km in WSW Headquarters along with direction distance in kms. 12. Village Panchayats, Zila Gram Panchayat- Pandhaniya, Tehsil-Dharampuri, Parishad, Municipal District-Dhar, M.P Corporation, Local body (complete postal addresses with telephone nos. to be given) 13. Name of the Applicant Rakesh Patidar 14. Registered Address Jawahar Marg, , District-Dhar, State-Madhya Pradesh 15. Address for correspondence Jawahar Marg, Dhamnod, District-Dhar, State-Madhya Pradesh Name Rakesh Patidar Designation (Owner / Lease Owner Partner / CEO) Address Jawahar Marg, Dhamnod, District-Dhar, State-Madhya Pradesh

Rakesh Patidar

“Doull Stone Quarry” located at Khasra No –57, near Village – Doull, Tehsil- Dharampuri District – Dhar, Madhya Pradesh FORM 1

S. Item Details No. Pin Code 454552 E-mail [email protected] Telephone No. + 91-9425101274 16. Details of alternative Sites No alternative site examined, if any Location of these sites should be shown on a topo sheet. 17. Interlinked Projects No 18. Whether separate Not Applicable application of interlinked project has been submitted? 19. If yes, date of submission Not Applicable 20. If no, reason Not Applicable 21. Whether the proposal The forest (conservation) Act, 1980: No Conserved involves approval / forest is present in the mining site. clearance under: if yes, details of the same and their The wildlife (protection) Act, 1972: There is no status to be given. involvement of the any wildlife area within the 15 km of (i) The Forest the mining site. (Conservation) Act, 1980. (ii) The wildlife (Protection) The coastal regulation zone Notification, 2011: There is Act, 1972 no coastal area hence the CRZ notification is not (iii) The C.R.Z. applicable on our project proposal. Notification, 1991 22. Whether there is any None Government Order / Policy relevant / relating to the site? 23. Forest Land involved No forest land involved (hectares)

Rakesh Patidar

“Doull Stone Quarry” located at Khasra No –57, near Village – Doull, Tehsil- Dharampuri District – Dhar, Madhya Pradesh FORM 1

S. Item Details No. 24. Whether there is any No litigation is pending against the project or the project litigation pending against land in any court of law to the best of knowledge. 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 / directions of 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.)

Sl. Information / Checklist Yes/No Details thereof (with approximate No. confirmation quantities/rates, wherever possible) with source of information data. 1.1 Permanent or temporary Yes The mining will be done by Opencast semi- change in land use, land mechanized method. The land is barren non cover or topography forest land (waste land) of MP govt. The including increase in landscape of the area will change due to the intensity of land use (with mining. respect to local land use plan)

Rakesh Patidar

“Doull Stone Quarry” located at Khasra No –57, near Village – Doull, Tehsil- Dharampuri District – Dhar, Madhya Pradesh FORM 1

1.2 Clearance of existing land, No Not applicable. The land is barren non forest vegetation and buildings? land of MP govt. 1.3 Creation of new land Yes Creation of land in the form of pits and uses? dumps due to mining activity. Stabilization of dump will be done by growing vegetation over it. 1.4 Pre-Construction Yes Details of exploration already been carried investigations e.g. bore out in the lease area. houses, soil testing? 1.5 Construction works? No Not Applicable 1.6 Demolition works? No Not Applicable 1.7 Temporary sites used for No No need for construction of housing of construction or housing of workers. The labour will come from the construction works? nearby villages. 1.8 Above ground buildings, Yes Only excavations related to mining structures, cut or fill or operations will be carried out. excavations 1.9 Underground works No Not Applicable including mining or tunneling? 1.10 Reclamation works? No Reclamation is not proposed existence of mineral at depth is anticipated. 1.11 Dredging? No No dredging will be involved. 1.12 Offshore Structures? No No offshore structure will be involved. 1.13 Production and Yes The proposed mining activity will be done in manufacturing processes? open cast semi mechanized method. Proposed rate of production is : Basaltstone: 19030 cum/year

1.14 Facilities for storage of Yes Temporary storage of mineral may be goods or materials? required in the quarry, before the same is transported to its destination/mined out areas.

Rakesh Patidar

“Doull Stone Quarry” located at Khasra No –57, near Village – Doull, Tehsil- Dharampuri District – Dhar, Madhya Pradesh FORM 1

1.15 Facilities for treatment or Yes Solid waste: disposal of solid waste or Small quantity of soil , overburden/waste and liquid effluents? quarry reject in form of small chips generation during the blasting and sizing of large Basalt boulders , can be called as rejects . The thickness of soil or overburden is almost nil. So no question arise of additional waste management in large scale prior to the quarry. Liquid Effluent: There is no liquid effluent is discharge from the lease area. 1.16 Facilities for long term No Workers will be hired locally from the nearby housing of operational villages, for the mining activity. workers? Thus no housing facility will be developed near mine site. 1.17 New road, rail or sea No No new roads, rail or sea trafficking will be trafficking during involved in the project. During the operation construction or operation? phase traffic will be increased. However the road already existing is sufficient to cater the increased traffic. Haul road is well maintained and water sprinkling carried out time to time to maintain the road condition. 1.18 New road, rail, air, No Existing facilities are sufficient. No new waterborne or other road/rail will be required. 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 existing transport routes or routes or infrastructure for the proposed infrastructure leading to project.

Rakesh Patidar

“Doull Stone Quarry” located at Khasra No –57, near Village – Doull, Tehsil- Dharampuri District – Dhar, Madhya Pradesh FORM 1

changes in traffic movements? 1.20 New or diverted No There are no new or diverted transmission transmission lines or lines or pipelines in the project site. pipelines? 1.21 Impoundment, damming, No Not Applicable culverting, realignment or other changes to the hydrology of neither watercourses nor aquifers? 1.22 Stream crossings? No There is no stream crossing in the mine lease area. 1.23 Abstraction or transfers of No Water requirement for drinking, plantation water from ground or and dust suppression met from Tanker supply surface water? during operation phase. Total water requirement will be approx. 2.0 KLD. 1.24 Changes in water bodies No No change in water bodies, drainage or or the land surface runoff is anticipated. affecting drainage or run off? 1.25 Transport of personnel or Yes Mine workers will be from nearby villages materials for construction, and will come by own means hence does not operation or require any transport. Materials will be decommissioning? transported by vehicles. 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 impact on the environment? 1.28 Influx of people to an area Yes About 31 (Unskilled 20 and skilled labours -

Rakesh Patidar

“Doull Stone Quarry” located at Khasra No –57, near Village – Doull, Tehsil- Dharampuri District – Dhar, Madhya Pradesh FORM 1

in either temporarily or 11 permanently? Most of the people will be employed from nearby villages. 1.29 Introduction of alien No There would be no introduction of any alien species? species since local species would be preferred for the plantation. 1.30 Loss of native species or No There will be no loss of native species or genetic diversity? genetic diversity due to proposed project activities. 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 quantities Sl. Information/Checklist Yes/ / rates, wherever possible) with source of No. confirmation No information data 2.1 Land especially undeveloped Yes The applied area is Govt. revenue non -forest or agricultural (ha) land. 2.2 Water (expected source & Yes Total water requirement will be 2.0 KLD. Only competing users) unit: KLD source of water is private tankers. 2.3 Minerals (MT) Yes The production of Basaltstone will be 19030 cum/year

2.4 Construction material- stone, No Not Applicable aggregates, and/ soil (expected source- MT) 2.5 Forest and Timber (source – No Not Applicable MT) 2.6 Energy including electricity No The operations and allied activities shall be

Rakesh Patidar

“Doull Stone Quarry” located at Khasra No –57, near Village – Doull, Tehsil- Dharampuri District – Dhar, Madhya Pradesh FORM 1

Details thereof (with approximate quantities Sl. Information/Checklist Yes/ / rates, wherever possible) with source of No. confirmation No information data and fuels (source, competing carried out in day time but some electric driven users) Unit: fuel (MT), machine will be used which will be driven by Energy(MW) DG sets.

2.7 Any other natural resources No No other natural resources will be used. (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.

Details thereof (with approximate Sl. Information / Checklist Yes/ quantities /rates, wherever possible) with No. confirmation No source of information data. 3.1 Use of substances or materials, Yes No hazardous substance or material shall be which are hazardous (as per used during the mining except blasting. MSIHC rules) to human health Blasting will be done by approved agencies and or the environment (flora, proper mitigation measures will be taken. Fauna, and water supplies)? 3.2 Changes in occurrence of No Proper hygienic environment will be diseases or affect disease maintained. vectors (e.g. insect or waterborne diseases)? 3.3 Affect the welfare of people Yes This project will provide livelihood to the e.g. by changing living workforce during the operation which will help condition? in improving their living conditions.

Rakesh Patidar

“Doull Stone Quarry” located at Khasra No –57, near Village – Doull, Tehsil- Dharampuri District – Dhar, Madhya Pradesh FORM 1

3.4 Vulnerable groups of people No No vulnerable groups of people will be affected who could be affected by the by the project as entry of unauthorized person project e.g. hospital patients, in the mining lease area will be prohibited. children, the elderly etc. 3.5 Any other causes No There will be no effect due to other causes.

4. Production of solid wastes during construction or operation or decommissioning (MT / month)

Details thereof (with approximate quantities Sl. Information / Checklist Yes/ wherever possible) with the source of No. confirmation No information. 4.1 Spoil, overburden or mine Yes Quantity of soil , overburden/waste and quarry wastes reject in form of small chips generation during the blasting and sizing of large Basalt boulders , can be called as rejects . The thickness of soil or overburden is almost nil. So no question arise of additional waste management in large scale prior to the quarry. Details are given in PFR. 4.2 Municipal waste (domestic and Yes Insignificant amount of domestic waste will be or commercial wastes) generated by the labours at site which will be treated in septic tank followed by soak pit. 4.3 Hazardous waste (as per The vehicle used for transportation is in good Hazardous Waste Management condition, so that no oil leaks will take place Rules ) No during transportation. No Hazardous waste (as per Hazardous Waste Management Rules) will be generated. 4.4 Other industrial process wastes There is no industrial process involved in the No project. 4.5 Surplus product No The entire mined out product will be sold to the

Rakesh Patidar

“Doull Stone Quarry” located at Khasra No –57, near Village – Doull, Tehsil- Dharampuri District – Dhar, Madhya Pradesh FORM 1

Details thereof (with approximate quantities Sl. Information / Checklist Yes/ wherever possible) with the source of No. confirmation No information. consumer. 4.6 Sewage sludge or other sludge There is no effluent treatment plant in the No from effluent treatment proposed project. 4.7 Construction or demolition No No construction or demolition work involved. wastes 4.8 Redundant machinery or The machineries/equipments will be on hire No equipment basis or in-house depending upon requirement. 4.9 Contaminated soils or other No contamination of soil or other material will No materials be involved. 4.1 Agricultural wastes There is no agricultural waste involved. No 0 4.1 Other solid wastes No other solid waste is generated. No 1

5. Release of pollutants or any hazardous, toxic or noxious substances to air (kg/m3)

Details thereof (with approximate Sl. Information / Checklist Yes/ quantities wherever possible) with the No. confirmation No source of information. 5.1 Emissions from combustion of Yes Mostly mobile equipments and their fossil fuels from stationary or expected emission will be very less and will mobile sources have less impact. However proper mitigation measures will be taken to reduce impacts from such emissions. It will be managed by the following methods:- • Proper maintenance of vehicles and machines. • PUC certified vehicles will be allowed for transportation purposes.

Rakesh Patidar

“Doull Stone Quarry” located at Khasra No –57, near Village – Doull, Tehsil- Dharampuri District – Dhar, Madhya Pradesh FORM 1

Details thereof (with approximate Sl. Information / Checklist Yes/ quantities wherever possible) with the No. confirmation No source of information. 5.2 Emission from production There will be some dust emission from Process production process as well as fugitive emission during loading and transportation. Yes However, mitigative measures such as water sprinkling and plantation would be done to control dust pollution. 5.3 Emission from materials Minor fugitive dust and particulates/gaseous handling including storage or emission from transport vehicles which will Yes transport be used to transport the mineral from mining area to market. 5.4 Emission from construction No It is a mining project thus it is not applicable. activities including plant and Equipment 5.5 Dust or odors from handling of No Fugitive dust emission during collection & materials including construction transportation of minor mineral. materials, Sewage and waste 5.6 Emissions from incineration of No Not Applicable waste 5.7 Emissions from burning of waste No No waste of any kind will be burnt in the in open air (e.g. slash materials, open air. construction debris). 5.8 Emissions from any other No There is no other source of emission. sources

6. Generation of Noise and Vibration, and emissions of light and heat

Rakesh Patidar

“Doull Stone Quarry” located at Khasra No –57, near Village – Doull, Tehsil- Dharampuri District – Dhar, Madhya Pradesh FORM 1

Details thereof (with approximate Sl. Information / Checklist Yes/ quantities wherever possible) with the No. confirmation No source of information. 6.1 From operation of equipment Noise from operation of drill machine, e.g. engines, ventilation plant, excavation, dumpers etc. Their expected Yes crushers emission will be very less and will have less impact. 6.2 From industrial or similar There will not be any industrial process No processes involved. 6.3 From construction or demolition No No construction or demolition is involved. 6.4 From blasting or piling Noise & vibration will generated during blasting work and it will be undertaken in Yes mining area only. It will be done by approved agency. 6.5 From construction or operational Noise & vibration will be generated from traffic Yes vehicular movement during transportation which will be within prescribed limit. 6.6 From lighting or cooling systems No No lighting or cooling systems are involved. 6.7 From any other sources No other source generates noise & vibration, No heat etc.

7. Risks of contamination of land or water from release of pollutants into the ground or into sewers, surface waters, groundwater, coastal waters or the sea

Details thereof (with approximate Sl. Information / Checklist Yes/ quantities wherever possible) with the No. confirmation No source of information. 7.1 From handling, storage, use or There will be no handling, storage, use or No spillage of hazardous materials spillage of hazardous materials. 7.2 From discharge of sewage or No effluent and sewage will be generated No other effluents to water or the from the proposed project operations.

Rakesh Patidar

“Doull Stone Quarry” located at Khasra No –57, near Village – Doull, Tehsil- Dharampuri District – Dhar, Madhya Pradesh FORM 1

Details thereof (with approximate Sl. Information / Checklist Yes/ quantities wherever possible) with the No. confirmation No source of information. land (expected mode and place of discharge) 7.3 By deposition of pollutants Not Applicable emitted to air into the land or No into the water 7.4 From any other sources There is no other source from which risk of No contamination is anticipated. 7.5 Is there a risk of long term build There is no risk of long term buildup of up of pollutants in the pollutants in the environment from the environment from these sources? No proposed 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. Information / Checklist Yes/ quantities/rates, wherever possible) with No. confirmation No the source of information. 8.1 From explosions, spillages, fires There is possibility of accident due to etc from storage, handling, use handling/use of explosive material. The risk Yes or production of hazardous will be mitigated by following the procedure substances and precautions as per MMR 1961. 8.2 From any other causes Risk of accidents is envisaged due to operation of equipments. However, proper communication facilities will be given to all Yes supervisory staff. To deal with minor accidents, first aid facility will be provided at site.

Rakesh Patidar

“Doull Stone Quarry” located at Khasra No –57, near Village – Doull, Tehsil- Dharampuri District – Dhar, Madhya Pradesh FORM 1

Details thereof (with approximate Sl. Information / Checklist Yes/ quantities/rates, wherever possible) with No. confirmation No the source of information. 8.3 Could the project be affected by The level in water bodies may fluctuate natural disaster causing depending on rainfall intensity. However, environmental damage (e.g. Yes mining will not be carried out during floods, earthquakes, landslides, monsoon season. cloudburst etc)? The project falls under seismic zone III.

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. Information / Checklist Yes/ quantities/rates, wherever possible) with No. confirmation No the source of information. 9.1 Lead to development of supporting utilities, ancillary development or development stimulated by the project which could have impact on the environment e.g. i. Supporting infrastructure The project will indirectly develop the area by (roads, power supply, waste or providing employment opportunities. The waste water treatment, etc.) already existing approach roads to the site Yes will be further strengthened by the proponent. There is no provision for waste water treatment due to minimum water requirement. ii. Housing development No Not Applicable iii. Extractive industries No Not Applicable iv. Supply industries No Not Applicable v. Other No Not Applicable 9.2 Lead to after-use of the site, There is likely to be positive impact on the which could have an impact on Yes environment as mining pit. the environment 9.3 Set up precedent for later Yes A better after use scenario, which is likely to

Rakesh Patidar

“Doull Stone Quarry” located at Khasra No –57, near Village – Doull, Tehsil- Dharampuri District – Dhar, Madhya Pradesh FORM 1

Details thereof (with approximate Sl. Information / Checklist Yes/ quantities/rates, wherever possible) with No. confirmation No the source of information. developments increase aesthetic beauty of the area. 9.4 Have cumulative effects due to There can be cumulative positive impact due proximity to other existing or to proximity to other existing or planned Yes planed projects which similar projects with similar effects. effects

III. ENVIRONMENTAL SENSITIVITY

Sl Aerial distance (within 15 . Areas Name/ Identity km.) Proposed project N location boundary o. 1 Areas protected under Mandu Bawanipuri Approx. 5.2 km in NNW international conventions, national Reserve Forest, direction or local legislation for their ecological landscape, cultural or Mandu Reserve Forest, Approx. 7.4 km in NNW other related value direction

Asapur Reserve Forest, Approx. 13.5 km in East direction

Jakota Reserve Forest, Approx. 11.6 km in SSE direction

Maheshwar Reserve Approx. 11.9 km in NE Forest, direction

Khargaon Reserve Forest, Approx. 14.4 km in NE direction

Rakesh Patidar

“Doull Stone Quarry” located at Khasra No –57, near Village – Doull, Tehsil- Dharampuri District – Dhar, Madhya Pradesh FORM 1

Sl Aerial distance (within 15 . Areas Name/ Identity km.) Proposed project N location boundary o.

Bharudpura Reserve Approx. 9.6 km in NNE Forest, direction 2 Areas which are important or Semalda- Mehgaon Talab, Approx.1.3 km in NW sensitive for ecological reasons – Bagwanya direction Wetlands, watercourses or other water bodies, coastal zone, Kunda Talab, Approx. 2.4 km in ENE biospheres, mountains, forests direction

Sagar Talab, Approx. 8.8. km in NW direction

Narmada River, Approx.12.3 km in SSE direction

Karam River, Approx. 9.5 km in ENE direction

3 Areas used by protected, important No Not Applicable or sensitive species of flora and fauna for breeding, nesting, foraging, resting, over wintering, migration 4 Inland, coastal, marine or No Not Applicable underground waters 5 State, National boundaries No Not Applicable 6 Routes or facilities used by the No Not Applicable public for access to recreation or other tourist, pilgrim areas

Rakesh Patidar

“Doull Stone Quarry” located at Khasra No –57, near Village – Doull, Tehsil- Dharampuri District – Dhar, Madhya Pradesh FORM 1

Sl Aerial distance (within 15 . Areas Name/ Identity km.) Proposed project N location boundary o. 7 Defense installations No Not Applicable 8 Densely populated or built-up area Doull village Approx 1.2 km in SW direction

9 Areas occupied by sensitive man- Hanuman Mandir, Doull Approx. 1.6 km in SW made land uses (hospitals, schools, direction places of worship, community facilities) Adarsh Academy, Eklara Approx. 3.9 km in ESE Khurd direction

Primary health Centre, Approx. 3.6 km in NE Dhapla direction 10 Areas containing important, high No Not Applicable quality or scarce resources (ground water resources, surface resources, forestry, agriculture, fisheries, tourism, minerals) 11 Areas already subjected to No Not Applicable pollution or environmental damage. (Those where existing legal environmental standards are exceeded) 12 Areas susceptible to natural hazard No Area falls under Seismic which cause the project to present Zone-III. environmental problems (earthquakes, subsidence, landslides, erosion, flooding or extreme or adverse climatic

Rakesh Patidar

“Doull Stone Quarry” located at Khasra No –57, near Village – Doull, Tehsil- Dharampuri District – Dhar, Madhya Pradesh FORM 1

Sl Aerial distance (within 15 . Areas Name/ Identity km.) Proposed project N location boundary o. conditions)

UNDERTAKING “I hereby undertake that the data and the 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-15/02/2019

Rakesh patidar Jawahar Marg, Dhamnod, District-Dhar, State-Madhya Pradesh

Rakesh Patidar