FORM-I. 13. Name of Applicant District Collector Nasik 14. Registered Address Address : Collector Office, Nasik

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1 FORM-I (I) Basic Information Item Details. 1. Name of the Project Proposal for Sand Quarry in Kas Village, Taluka Trimbakeshwar, District Nasik, State Maharashtra over an area of Ha at Damanganga River 2. S.. in the Schedule 1 (a) 3. Proposed capacity/area/length/tonnage to be Lease area : : Ha, Capacity 2723 Brass handled/command area/lease area/ number of wells to be drilled 4. New/Expansion/Modernization New 5. Existing Capacity/ Area etc. NA 6. Category of Project i.e., `A`or `B` Category B 7. Does it attract general condition? If yes, It does not attract any general condition please specify. 8. Does it attract specific condition? If, It does not attract any Specific condition please specify. 9. Location Plot/Survey/Khasara. Khasra no 4, 5, 6, 21, 23, 24 Village Kas Tehsil Trimbakeshwar District Nasik State Maharashtra 10. Nearest Railway Station/ Airport along with distance in kms. Nasik road Railway station 58.74Km SE Gandhinagar airport 54.60km SE 11. Nearest Town, City, District Nashik 51.26Km SE Headquarters along with distance in kms. 12. Village Panchayats, Zilla Parishad, Municipal Corporation, Local body(complete postal addresses with telephone nos. to be given) Grampanchayat Kas Taluka: Trimbakeshwar District :Nasik, Maharashtra 13. Name of Applicant District Collector Nasik 14. Registered Address Address : Collector Office, Nasik Address for correspondence: As Above Name District Collector Nasik Designation (Owner/Partner/CEO) Owner Address Address : District Collector Nasik Pin Code Page 1

2 Telephone Fax Details of Alternate Sites examined, if any. N/A however, the land is already in possession of the applicant Location of there sites should be shown on a topo sheet 17. Interlinked Projects Nil 18. Whether separate application of t applicable interlinked project has been submitted? 19. If yes, date of submission t applicable 20. If no, reason t 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, 1980? (b) The Wildlife (Protection) Act 1972? (c) The C.R.Z. tification, 1991? 22. Whether there is any Government There is no specific policy of govt. relating to site. Order/Policy relevant/relating to the site? 23. Forest Land involved (hectares) Nil 24. Whether there is any litigation pending against the products and/or land in which the project is propose to set up? (a) Name of the Court (b) Case.. (c) Orders/Directions 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.). 1.1 Permanent or temporary change in land use, land cover or topography including increase in intensity of land use (with / / rates, wherever possible) with source of This is the case of River sand quarry. Temporary use of River bed. Page 2

3 respect to local land use plan). 1.2 Clearance of existing land, vegetation and building? This is case of River sand mining. uprooting of trees or demolition of building is required. 1.3 Creation of new land uses. There is no creation of new land uses. 1.4 Pre-construction NA investigation e.g. bore house, soil testing? 1.5 Construction works? construction will be involved and for the mining of Minor Minerals, Sand from river bed. Temporary Shed on the bank will be constructed which will serve as a rest shelter for the workers as well as store for storing spade/pawda/ghamelas. 1.6 Demolition Works? t required as it does not exist in core zone. 1.7 Temporary sites used for construction works or housing of construction workers? 1.8 Above ground building, structures or earthworks including linear structures, cut and fill or excavations. 1.9 Underground works including mining or tunneling? housing or construction works presently involved and the laborers deployed by nearby villages. Housing or Construction works presently involved. t applicable Reclamation works? During rainy season natural reclamation will take place / 1.11 Dredging? t applicable Offshore structure? t applicable Production and manufacturing process? 1.14 Facilities for storage of goods or materials? 1.15 Facilities for treatment or disposal of solid waste or liquid effluents? 1.16 Facilities for long term housing of operational workers? 1.17 New road, rail or sea traffic t required. rate, wherever possible) with source of information data There is no manufacturing process. There will be extraction of sand from River bed. Transportation of sand will be on daily basis. sand will be stored near bank. t required. housing for operational workers either for short or long term is required. The operational worker will be from nearby villages for which no housing, at the site is required. Page 3

4 during construction of operation? 1.18 New road, rail, air waterborne or other transport infrastructure including new or altered routes and station, ports, airports etc.? 1.19 Closure or diversion of existing transport routes or infrastructure leading to changes in traffic movements? 1.20 New or diverted transmission lines or pipelines? 1.21 Impoundment, damming, culverting, realignment or other changes to the t required. closure or diversion of existing transport routs or infrastructure is necessitated t required. t required. / Hydrology of watercourses or aquifers? 1.22 Stream crossing? t required Abstraction or transfers of water from ground or surface waters? 1.24 Changes in water bodies or the land surface affecting drainage or run-off Transport of personnel or materials for construction, operation or decommissioning 1.26 Long-term dismantling or decommissioning or restoration works? 1.27 Ongoing activity during decommissioning which could have an impact on the environment? Extraction of sand is mainly done in summer season when river bed is exposed. Extraction of sand is mainly done in summer season when river bed is exposed. Workers will come to the site of their own. There is no need to supply them the transport. construction work may be required for the mining purpose and there is no need to transport any material for the purpose. dismantling or restoration will be involved as no structure will come up There is no decommissioning activity impacting environment. Page 4

5 1.28 Influx of people to an area in either temporarily or permanently? 1.29 Introduction of alien species? ne Loss of native species or genetic diversity? 1.31 Any other actions? ne. There will be no influx of people to an area either temporarily or permanently as no satellite project will come up. loss of native species or genetic diversity will occur. Extraction of sand is mainly done in summer season when river bed is exposed. 2. Use of natural resources for construction or operation of project (such as land, water, materials or energy, especially any resources which are non-renewable or in short supply).. / 2.1 Land specially undeveloped or agricultural (ha) This is the case of River sand mining. Applied area is not specifically used for any purpose 2.2 Water (expected source & competing users) unit KLD The necessary water requirement is only for drinking. Drinking water will be provided in earthen pots for the workers. Water sprinkling will be met from hand-pump outside of the quarry area, or from outside nearby Dug well. The water is potable. There are no chances of any contamination as there is no chemical processing etc in the Quarry area. 2.3 Minerals (MT) mineral is required. (Sand will be excavated 2.4 Construction material-sand, aggregates, and /soil (expected source-mt) 2.5 Forests and timber (source- MT) 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) from the river bed). There will not be any permanent construction. construction material will be required at the site. (The yearly expected production will be 2723 brass) t required. Diesel is required by tippers. About 20 to 50 lit may be required. ne Page 5

6 3.0 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 risk to human health. 3.1 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 disease or affect disease vectors (e.g. insect or water borne disease) 3.3 Affect the welfare or people e.g. by changing living conditions? 3.4 Vulnerable groups of people who could be affected by the project e.g. hospital patients, children the elderly etc. / 3.5 Any other causes ne Details there of (with approximate quantities t required. All the environmental parameters will be within control. We do not expect occurrence of disease. Direct employment will improve the living condition of nearby villagers. Welfare facilities will be made available to workers (and to certain extent for local villagers). ne of the vulnerable groups of people will be affected due to mining operation. 4.0 Production of solid wastes during construction or operation or decommissioning (MT/month). / t applicable 4.1 Spoil, overburden or mine wastes 4.2 Municipal waste (domestic There will not be any habitation in the applied and or commercial wastes) area 4.3 Hazardous wastes (as per There will be no production of hazardous waste. hazardous waste management rules) 4.4 Other industrial process Mining activity will not produce any industrial wastes process waste. 4.5 Surplus product There will not be any surplus production or bye product. 4.6 Sewage sludge or other There will be no production of sludge. sludge from effluent Page 6

7 treatment 4.7 Construction or demolition wastes 4.8 Redundant machinery or equipment 4.9 Contaminated soils or other waste due to construction or demolition will be produced. machinery is involved in River sand quarrying contaminated soils or other materials will be generated. materials 4.10 Agricultural wastes Agricultural wastes will be produced Other solid wastes ne 5.0 Release of pollutants or any hazardous, toxic or noxious substances to air (kg/hr). 5.1 Emissions from combustion of fossil fuels from stationary or mobile sources. 5.2 Emission from production processes 5.3 Emissions from materials handling including storage or transport 5.4 Emissions from construction activities including plant and equipment 5.5 Dust or odors from handling materials including construction materials, sewage and waste. 5.6 Emissions from incineration of waste. 5.7 Emissions from burning of waste in open air (e.g. slash material, construction debris) 5.8 Emissions from any other sources / There will be emission of gases from combustion of fuel used in the vehicles (dumpers etc.) used for transporting sand out of zone. However, emission will be of low magnitude. Dust emission from open cast mining activity. However, this will be suppressed with adequate sprinkling system. Dust emission from material handling during storage or transport and gas emission through combustion of fuel used in the vehicles. There will no construction activity i.e. of plant or engagement. Hence, there will be no generation of emission. Dust will be generated mainly during material handling; transportation etc. odors will be developed during mining activity. The intensity is very low. waste will be generated. waste will be generated. ne 6.0 Generation of ise and vibration, and emissions of Light and heat. / Page 7

8 6.1 From operation of equipment e.g. engines, ventilation plant, crushers There will be generation of noise during transportation of trucks and other vehicles. The effect is temporary and occasional. other equipment is used during operation. process which generates noise will be engaged. 6.2 From industrial or similar processes 6.3 From construction or equipment for construction or demolition will demolition be engaged 6.4 From blasting or piling t applicable 6.5 From construction or Sand will be transported by the trucks. ise will operational traffic be generated during the transport activity. 6.6 From lighting or cooling There will be no lighting or cooling system. systems 6.7 From any other sources ne. 7.0 Risks of contamination of land or water from release of pollutants into the ground or into sewers, surface waters, groundwater, coastal wasters or the sea. 7.1 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 water / 7.4 From any other sources ne. 7.5 Is there a risk of long term build up of pollutant in the environment from these sources? NA There is no discharge of effluents or waste water. In buffer zone, transport vehicles emission may contaminate air but pollutant level in air will be within permissible level. pollutants will be emitted into water. Minor mining will generate dust but will be within control. 8.0 Risk of accidents during construction or operation of the project, which could affect human or the environment. / 8.1 From explosion, spillages, t applicable Page 8

9 fires etc from storage, handling, use or production of hazardous substances 8.2 From any other causes. Diesel will be used by trucks. Fire may take places due to unsafe storage, handling and use of diesel. But diesel is not highly flammable. 8.3 Could the project be affected by natural disasters causing environmental damage (e.g. floods, earthquakes, landslides, could burst etc)?. The location of site is such that it will not be affected by earthquake (zone III), floods (working is during dry season), landslides (being plain portion/river bed) Cloud Bursts (not prone due to history of climate). Thus site is free from all the natural disasters. 9.0 Factor which should be considered (such as consequential development) which could lead to environmental effects or the potential for cumulative impact with other existing or planned activities in the locality Lead to development of supporting utilities, ancillary development or development stimulated by 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 site, which could have an impact on the environment. 9.3 Set a precedent for later developments 9.4 Have cumulative effects due to proximity to other existing or planned project with similar effects /. The sand mining will leads to positive development of supporting facilities and will improve socioeconomic aspect of the area. /.. Sand gets replenished naturally depending upon rainfall in the area and flow pattern of the river The excavation will be made in the river bed upto 0.5m depth. Sand gets replenished naturally depending upon rainfall in the area and flow pattern of the river Cumulative effects will be studied during the course of operation and thereafter. Page 9

10 (III) Environmental sensitivity. Areas Name/ Identity Aerial distance (with 15-km) proposed project location boundary 1 Areas protected under. There are no such protected areas or project international conventions, within15 km distance national or local legislation for their ecological, landscape, cultural or other related value 2 Areas which are important or. Water bodies: this is the case of river sand mining sensitive of ecological in Damanganga River bed. reasons- wetlands, water courses or other water bodies, coastal zone, biospheres,mountains,forests 3 Areas used by protected,. ne important or sensitive species of flora or fauna for 4 Inland, coastal, marine or. Damanganga River underground waters 5 State, national boundaries. t applicable 6 Routes or facilities used by SH km (S) the public for access to recreation or other tourist, pilgrim areas 7 Defense installations. ne 8 Densely populated or builtup area Given. Kas village is located approx 0.56km away in the south. 9 Areas occupied by sensitive There are few village dispensaries. Hospitals and man Made land uses Schools envisaged within 10 km radius of the (hospitals, schools, places of mine site but not in core zone. worship, community facilities) 10 Areas containing important,. ne high quality or scarce resources (ground water resources, surface resources, forestry, agriculture, fisheries, tourism, minerals) 11 Areas already subjected to pollution or environmental. ne. damage.(those where existing legal environmental standards are exceeded) 12 Areas susceptible to natural. such area exists nearby. Page 10

11 hazard which could cause the project to present environmental problems (earthquakes, subsidence, landslides, erosion, flooding or extreme or adverse climatic conditions) The location of site is such that it will not be affected by earthquake (zone III), floods (working will be carried out in dry season), landslides (being plain portion/river bed) Cloud Bursts (not prone due to history of climate). Thus site is free from all the natural disasters. (IV) Proposed terms of reference for EIA study I hereby give an 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: Place: Nasik sd /- COLLECTOR NASIK Page 11