Sl. No. 1. Name of the Project/s : Chudeshwar Gravel Deposit (Narmada River) 2. Sl. No. of the Schedule : Category B-2 of Activity 1(A)

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1 Form-I (APPENDIX-, PARAGRAPH-6) I. BASIC INFORMATION. Item Details. Name of the Project/s : Chudeshwar Gravel Deposit (Narmada River) 2.. of the Schedule : Category B-2 of Activity (A) 3. Proposed capacity / area / length / : a. Mine Lease Area : 5.00 Hectare tonnage to be handled / command b. Production Capacity:,00,000 TPA area / lease area / lease area / Production,00,000 TPA number of wells to be drilled 4. New / Expansion / Modernization : New 5. Existing Capacity / Area etc. : (New Project) 6. Category of Project i.e. A or B B 7. Does it attract the general condition? If yes please specify. 8. Does it attract the specific condition? If yes please specify. 9. Location : i Plot/Survey/Khasra. 35, 44, 45, 70 TO 73, 79,80 ii Mouza Chudeshwar iii Thana Tilakwada, iv District Narmada v State 0. Nearest Railway Station / Airport along with distance in kms.. Nearest Town, city, District Headquarters along with distance in kms. : Gujarat Facility Airport Railway Station Name Vadodara Airport Rajpipla Railway Station Aerial Distance Direction 53 km NWW.0 km N Facility Name Distance Direction : Town/City Vadodara 55 N District HQ Vadodara 55 N 2. Mouza Panchayats, Zila Parishad, Municipal Corporation, Local body : Mouza Panchayat: Chudeshwar (complete postal addresses with telephone nos. to be given) 3. Name of the Applicant : Ritwik Project Pvt. Ltd.

2 FOR Chudeshwar Gravel Deposit, Near Village- Chudeshwar, Tehsil- Tilakwada, District- Narmada, State-Gujarat 4. Registered Address : Add. Block. 23, Room. 33, Category-3, Kewadiya Colony, Taluka-Nandod District. Narmada (Gujarat) 5. Address for correspondence : Add. Block. 23, Room. 33, Category-3, Kewadiya Colony, Taluka-Nandod District. Narmada (Gujarat) Name : Shri Rakesh Designation (Owner / Partner / CEO) : Owner ritwikproject@yahoo.in Telephone. : Details of alternative Sites examined, if any Location of these sites should be shown on a topo sheet. : Mine block is allotted to Ritwik project pvt ltd for mining of gravel As mining of minerals is site specific, no alternative sites are considered. 7. Interlinked Projects : There is no interlinked project involved to this project 8. Whether separate application of : There is no interlinked project. interlinked project has been submitted? 9. If yes, date of submission : t Applicable 20. If no, reason : t Applicable 2. Whether the proposal involves approval / clearance under: if yes, details of the same and their status to be given. (i) The Forest (Conservation) Act, 980. (ii) The wildlife (Protection) Act, 972 (iii) The C.R.Z. tification, Whether there is any Government Order / Policy relevant / relating to the site? : Act Name (i) The Forest (Conservation) Act, 980 Approval required (/) Status forest land within the mine lease area. Some RF and PF are located within the study area. (ii)the Wildlife National park/ (Protection) Act, Wildlife Sanctuary/ 972 animal reserve within a distance of 5km from the mine site. (iii) The C.R.Z. tification, The mine lease area is not coming under 99 Coastal Regulation Zone : There are no such Government order /policy relevant to this site till date. 23. Forest Land involved (hectares) : There is no forest land (Revenue/Reserve/Protected Forest) in the mining leas area. 2

3 FOR Chudeshwar Gravel Deposit, Near Village- Chudeshwar, Tehsil- Tilakwada, District- Narmada, State-Gujarat Whether there is any litigation pending against the project and/or land in which the project is propose to be set up? (a) Name of the court (b) Case. (c) Orders / directions of Court, if any and its relevance with the proposed project. : There is no litigation pending against this project. II. ACTIVITY. 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.).. Permanent or temporary change in land use, land cover or topography including increase in intensity of land use (with respect to local land use plan) / quantities/rates, wherever possible) with source of information data. The land use of the mine lease area is the river bed of Narmada and there will be no change in land use after operation. The mineral Gravel will be replenished every year during the monsoon season. The ultimate land use of the mine lease area will not be change. The depth of the mining will be up to 3 m..2 Clearance of existing land, vegetation and buildings?.3 Creation of new land uses?.4 Pre-Construction investigations e.g. bore houses, soil testing? Existing Land Government Waste Land Vegetation Permanent vegetation is less prominent Buildings Mine lease area is free from construction activity. The mining activity will result no change in land use and also no new land use will be created because mineral Gravel replenished every year during monsoon season. There are no construction will be done so no need of Preconstruction investigation.5 Construction works? The opencast manual working in the river bed does not involve any construction work.6 Demolition works? demolition activities are proposed..7 Temporary sites used for construction or housing of As there will be no construction activities involved in the project, there will be only a mobile shelter, restroom etc. with 3

4 FOR Chudeshwar Gravel Deposit, Near Village- Chudeshwar, Tehsil- Tilakwada, District- Narmada, State-Gujarat. / quantities/rates, wherever possible) with source of information data. construction workers? facilities for drinking water and toilets..8 Above ground buildings, Extraction of minerals shall be restricted in the river bed only structures, cut or fill or excavations.9 Underground works including mining or Proposed mining activity will be done in open cast method for minor mineral. underground works are proposed. tunneling?.0 Reclamation works? Trees will be planted on the part of mine contract area at upper elevation i.e. river bank and along approach road to mine as per approved mining plan, Mining pits area will be replenished during monsoon on yearly basis.. Dredging? dredging will be required for opencast mine.2 Offshore Structures? There is no requirement of Offshore structure..3 Production and manufacturing processes?.4 Facilities for storage of goods or materials?.5 Facilities for treatment or disposal of solid waste or liquid effluents?.6 Facilities for long term housing of operational workers?.7 New road, rail or sea traffic during construction or operation?.8 New road, rail, air, waterborne or other transport infrastructure Proposed rate of production, 00,000 TPA. The minor mineral (Gravel) shall be extracted from the Riverbed by adopting manual opencast mining method with the help of spade, hand shovel etc. and ultimately loaded in tippers manually. manufacturing process is implicated and the excreted mineral shall be transported directly to the market. storage facility is required as mineral will be transported simultaneously to the market. Solid Waste Generation (For the 3 year Plan Period) such solid wastes are proposed to be generated in Gravel mining. Liquid Effluent: Liquid effluent= Drinking and domestic 80%of 7.70 KLD. housing facility will be provided to the workers as mining operation will only be done during day hours and workers will be hired from nearby villages Construction Phase This is a Gravel mining project so, no construction activity is involved Operational Phase Existing road will be used for transportation of minerals outside the mines, The trucks carrying Gravel will be the additional traffic load on the existing road. Existing roads is well connected to the project and are adequate for the movement of additional traffic. 4

5 FOR Chudeshwar Gravel Deposit, Near Village- Chudeshwar, Tehsil- Tilakwada, District- Narmada, State-Gujarat 68. including new or altered routes and stations, ports, airports etc.?.9 Closure or diversion of existing transport routes or infrastructure leading to changes in traffic movements?.20 New or diverted transmission lines or pipelines?.2 Impoundment, damming, culverting, realignment or other changes to the hydrology of neither watercourses nor aquifers? /.22 Stream crossings? Mining is in the river bed..23 Abstraction or transfers of water from ground or surface water?.24 Changes in water bodies or the land surface affecting drainage or run off?.25 Transport of personnel or materials for construction, operation or decommissioning? quantities/rates, wherever possible) with source of information data. There will be no closure or diversion of existing routes which would change the traffic movements. As there will be no electricity or large scale water requirement for the project, therefore no new or diverted transmission lines or pipelines in the project site. As there will be no mining during the monsoon periods, there will be no occasion for impounding or damming the river water. As mining will be done for 3m depth, there is no chance of any adverse impact on the ground water aquifer. About 7.7 KLD of water will be sourced (Domestic, Dust suppression and Plantation Purposes) from nearby wells. Surface run-off in the mine contract area will flow conforming to the general slope of the river bed. During the operation phase, personnel who will be recruited locally will use own transport or public transport to reach site..26 Long-term dismantling or decommissioning or restoration works?.27 Ongoing activity during decommissioning, which could have impact on the environment?.28 Influx of people to an area in either temporarily or permanently? Long term dismantling or decommissioning or restoration works are not involved. There is no structure presented so no decommissioning is done. The required workers shall be recruited from the nearby villages. 5

6 FOR Chudeshwar Gravel Deposit, Near Village- Chudeshwar, Tehsil- Tilakwada, District- Narmada, State-Gujarat. / quantities/rates, wherever possible) with source of information data..29 Introduction of alien There would be no introduction of any alien species since species? local species will be planted..30 Loss of native species or loss of native species or genetic diversity due to proposed genetic diversity? project activities is expected..3 Any other actions? any other action noticed which should be explained 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).. Information/Checklist 2. Land especially undeveloped or agricultural (ha) 2.2 Water (expected source & competing users) unit: KLD / quantities / rates, wherever possible) with source of information data Mine lease area is Government (GM) Land- and is part of the river bed. (5.00 Ha) About 7.70 KLD of water will be sourced (Domestic, Dust suppression and Plantation Purposes) from nearby wells and stored in a tank proposed on the office premise.. Purpose Water requirement (KLD) Drinking & domestic Green Belt Dust Suppression.50 Total Minerals (MT) raw minerals are required for mining operation. 2.4 Construction material- stone, construction material is required for this project. aggregates, and/ soil (expected Only temporary office, rest shelter will be provided. source- MT) 2.5 Forest and Timber (source MT) t required for this project 2.6 Energy including electricity and fuels (source, competing users) Unit: fuel (MT), Energy(MW) 2.7 Any other natural resources (use appropriate standard units) electricity is required as the mining activity is manual with the help of spade and hand shovel and also during day time i.e. general shift. other natural resources will be used. 3. Use, storage, transport, handling or production of substances or 6

7 FOR Chudeshwar Gravel Deposit, Near Village- Chudeshwar, Tehsil- Tilakwada, District- Narmada, State-Gujarat 68 materials, which could be harmful to human health or the environment or raise concerns about actual or perceived risks to human health.. 3. Use of substances or 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 diseases or affect disease vectors (e.g. insect or waterborne diseases)? 3.3 Affect the welfare of people e.g. by changing living condition? 3.4 Vulnerable groups of people who could be affected by the project e.g. hospital patients, children, the elderly etc. / quantities /rates, wherever possible) with source of information data. hazardous, toxic, semi- toxic or any other material is used or generated. Proper hygienic condition will be maintained in and around the ML Area in order to avoid incidence of any vector-borne diseases. Project will encourage the economy of the local people by direct and indirect employment opportunity. This project will provide livelihood to the local people during the operation which will help in improving their living conditions. Social welfare measures shall be undertaken as CSR/EMP activity which will ameliorate the economic status of the people around the project area. hospital, school exists nearby the mine lease area. 3.5 Any other causes t Applicable 4. Production of solid wastes during construction or operation or decommissioning (MT / month). Information / Checklist confirmatio n 4. Spoil, overburden mine wastes or / quantities wherever possible) with the source of information. Top soil will be generated. Less amount of waste will be generated 7

8 FOR Chudeshwar Gravel Deposit, Near Village- Chudeshwar, Tehsil- Tilakwada, District- Narmada, State-Gujarat. Information / Checklist confirmatio n 4.2 Municipal waste (domestic and or commercial wastes) 4.3 Hazardous waste (as per Hazardous Waste Management Rules ) 4.4 Other industrial process wastes / quantities wherever possible) with the source of information. Municipal Solid Waste will be generated as there will be no residence in the area. Municipal Solid Waste will be generated as there will be no residence in the area. There is no industrial process involved in the project. 4.5 Surplus product The entire mined out product will be sold to the consumer. surplus products are expected. 4.6 Sewage sludge or other sludge There is no effluent treatment plant in the proposed project. from effluent treatment 4.7 Construction or construction or demolition work involved demolition wastes 4.8 Redundant machinery or equipment The mining activity is manual type so no machinery equipment is proposed to be used. 4.9 Contaminated soils or other materials 4.0 Agricultural wastes 4. Other solid wastes contamination of soil or other material will be involved as this is an opencast mining. There will be no agricultural waste involved. other solid waste will be generated 5. Release of pollutants or any hazardous, toxic or noxious substances to air (kg/hr). / quantities wherever possible) with the source of information. 8

9 FOR Chudeshwar Gravel Deposit, Near Village- Chudeshwar, Tehsil- Tilakwada, District- Narmada, State-Gujarat Emissions from combustion of fossil fuels from stationary or mobile sources / quantities wherever possible) with the source of information. There will be emission of SOx, NOx and CO due to fuel consumption in various vehicles during mining activities. The Automotive Research Association of India (ARAI, Pune) finalized the standard emission factor in respect of different types of vehicles. Due to the Gravel mining project, only Heavy Commercial Vehicle (HCV) Diesel Truck will be used. The emissions from the vehicles for PM, NOx and CO will be as below; PM:-.24 gm/km NOx: 9.3 gm/km CO: 6.0 gm/km 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. 5.2 Emission from production Process There will be dust emission from loading process in tippers for dispatch as well as fugitive emission during loading and transportation. However, mitigation measures such as water sprinkling and plantation would be done to control dust pollution. 5.3 Emission from materials handling including storage or transport Fugitive emission during material handling and particulates/gaseous emission from transport vehicles will occur. Water sprinkling will be done regularly to control the fugitive dust. As it is a Gravel mining project thus the construction activity will not be proposed. As it is a Gravel mining project thus the construction activity will not be proposed. 5.4 Emission from construction activities including plant and Equipment 5.5 Dust or odours from handling of materials including construction materials, Sewage and waste 5.6 Emissions from incineration of waste such waste will be generated, which needs to be incinerated. 5.7 Emissions from burning of waste in waste of any kind will be burnt in the open air. open air (e.g. slash materials, construction debris). 5.8 Emissions from any other sources There is no other source of emission. 9

10 FOR Chudeshwar Gravel Deposit, Near Village- Chudeshwar, Tehsil- Tilakwada, District- Narmada, State-Gujarat 6. Generation of ise and Vibration, and emissions of light and heat. 6. From operation of equipment e.g. engines, ventilation plant, crushers / quantities wherever possible) with the source of information. The noise generation may occur due to vehicle movement only during dispatch of minerals since mining method is manual. 6.2 From industrial or similar processes There will not be any industrial process involved. 6.3 From construction or demolition construction or demolition is involved. 6.4 From blasting or piling As the mineral is Gravel i.e. soft in nature so no drilling & blasting is required. 6.5 From construction or operational traffic ise will be generated from vehicular movement during transportation which will be within prescribed limit. 6.6 From lighting or cooling systems lighting or cooling systems are involved. 6.7 From any other sources other source generates noise & vibration, 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. 7. From handling, storage, use or spillage of hazardous materials 7.2 From discharge of sewage or other effluents to water or the land (expected mode and place of discharge) 7.3 By deposition of pollutants emitted to air into the land or into the water / quantities wherever possible) with the source of information. Since no hazardous material will be used or produced at the site, no risk of contamination of land or water envisaged. Domestic sewage will be generated and disposed into septic tank/soak pits. The ground level concentration of PM0 and PM2.5 will be kept within the permissible limit. Water sprinkling system will be provided on haul roads for dust suppression. 7.4 From any other sources There is no other source from which risk of 7.5 Is there a risk of long term build up of pollutants in the environment from these sources? contamination is anticipated. Since mine shall be worked up for 3 years so risk of long term buildup of pollutants in the environment from the proposed project operations 0

11 FOR Chudeshwar Gravel Deposit, Near Village- Chudeshwar, Tehsil- Tilakwada, District- Narmada, State-Gujarat 68. / quantities wherever possible) with the source of information. is not anticipated.. 8. Risk of accidents during construction or operation of the Project, which could affect human health or the environment: 8. From explosions, spillages, fires etc from storage, handling, use or production of hazardous substances / quantities/rates, wherever possible) with the source of information. hazardous substance will be used or produced during the proposed mining operations. 8.2 From any other causes Risk of accidents are expected:. During loading of minerals into truck/tractorstrolley. 2. During transportation Accidents can be avoided by taking good safety practices. 8.3 Could the project be affected by natural disaster causing environmental damage (e.g. floods, earthquakes, landslides, cloudburst etc)? The topography of the project area lying in river plain is such that it can be affected due to disaster in the form of flash flood during monsoon period. However during monsoon period no mining activities have been envisaged, thus the attendant risk to the mine workers is non-existent. The lease area lies within Seismic Zone- III i.e Moderate as per the seismic zoning map of India (IS: 893: 2002) i.e. least active. 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:. / quantities/rates, wherever possible) with the source of information. 9. 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 (roads, The project site is already linked up with pakka

12 FOR Chudeshwar Gravel Deposit, Near Village- Chudeshwar, Tehsil- Tilakwada, District- Narmada, State-Gujarat. power supply, waste or waste water treatment, etc.) / quantities/rates, wherever possible) with the source of information. road so there is no further construction proposed. ii. Housing development The Workers shall be employed from the nearby Mouzas. Hence no housing development plan envisaged. iii. Extractive industries extractive industries will be there. iv. Supply industries Installation/ Creation of new supply industries envisaged for the project v. Other t envisaged 9.2 Lead to after-use of the site, which could have an impact on the environment 9.3 Set up precedent for later developments 9.4 Have cumulative effects due to proximity to other existing or planned projects with similar effects Gravel is replenished during monsoon to almost equal the extracted level hence the ultimate land use of the mine contract area will not change after systematic mining. t Applicable Apparently. Other projects for Gravel mining in the other reaches of the river in the district have been allotted. There will be increased road traffic for material transport/dispatch. 2

13 FOR Chudeshwar Gravel Deposit, Near Village- Chudeshwar, Tehsil- Tilakwada, District- Narmada, State-Gujarat 68 III. ENVIRONMENTAL SENSITIVITY. Areas Areas protected under international conventions, national or local legislation for their ecological landscape, cultural or other related value 2 Areas which are important or sensitive for ecological rearadu River & Kanchis Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests 3 Areas used by protected, important or sensitive species of flora and fauna for breeding, nesting, foraging, resting, over wintering, migration 4 Inland, coastal, marine or underground waters Name/ Identity Aerial distance (within 5 km.) Proposed project location boundary t Applicable Water Bodies Name Distance Protected Forest/ Reserved Forest Narmada River (in km) On site Direction Aswan nadi 0.3 Aswan nadi Meh Nadi 3.0 Meh Nadi Shamariyakhadi 0.6 Shamariyak hadi Dhamani Khadi 9.8 Dhamani Khadi Sukli Khadi 4.4 Sukli Khadi Makhodi Nadi 7.9 Makhodi Nadi Karjan River 0.3 SW Damni Khadi 4. SE Name Distance (in km) Rajpipla RF 3.8 S Gagarrf 4.7 SSW RF near Vensalpura 3.4 SSW Direction There are no such kind of species within lease area such area present 5 State, National boundaries State, and no national boundary present within the study area.. 6 Routes or facilities used by the public for access to recreation or Temple matatemple about at 6.37 km in SW Direction other tourist, pilgrim areas 7 Defense installations ne defense installation 8 Densely populated or built-up area Name Distance (in Direction km) Chudeswar SW 890m 3

14 FOR Chudeshwar Gravel Deposit, Near Village- Chudeshwar, Tehsil- Tilakwada, District- Narmada, State-Gujarat. Areas 9 Areas occupied by sensitive manmade land uses (hospitals, schools, places of worship, community facilities) 0 Areas containing important, high quality or scarce resources (ground water resources, surface resources, forestry, agriculture, fisheries, tourism, minerals) Areas already subjected to pollution or environmental damage. (Those where existing legal environmental standards are exceeded) 2 Areas susceptible to natural hazard which cause the project to present environmental problems (earthquakes, subsidence, landslides, erosion, flooding or extreme or adverse climatic conditions) Name/ Identity ne Aerial distance (within 5 km.) Proposed project location boundary village Gansinda village NW 600m such area is present such condition is present such condition occur Area falls under Seismic Zone-III, i.e. Moderate risk zone. Other natural hazard is also not expected because of the location of the project. 4

15 FOR Chudeshwar Gravel Deposit, Near Village- Chudeshwar, Tehsil- Tilakwada, District- Narmada, State-Gujarat 68 UNDERTAKING BY PROJECT PROPONENT 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 : / 0 4 / 5 Place : Tilakwada Name of Authorized Signatory : RITWIK PROJECT PVT. LTD Full Address : ADD. BLOCK. 23, ROOM. 33, CATEGORY-3 KEWADIYA COLONY, TALUKA- NANDOD DISST. NARMADA (GUJARAT) te:. The projects involving clearance under Coastal Regulation Zone tification, 99 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 CRZ notifications, 99 for the activities to be located in the CRZ. 2. The Projects to be located within 0km 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 of the Chief Wildlife Warden thereon (at the stage of EC). 3. All correspondence with Ministry of Environment & Forests including submission of application for the TOR/Environment Clearance, subsequent clarifications, as may be required from time to time, participation in the EAC Meeting on behalf of the project proponent shall be made by the authorized signatory only. The authorised signatory should also submit a document in support of his claim of being an authorised signatory for the specific project. 5