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APPENDIX I (See Paragraph 6) FORM 1 (I) Basic Information Item Details 1 Name of the Project Satva Shiva Gold 2 S. in the Schedule 8(a) 3 Proposed capacity/ area/ length/ tonnage to be handled/ command area/ lease area/ number of wells to be drilled 4 New/ Expansion/ Modernization New Plot Area: 5160.00 m 2 Built-up Area: 26953.09 m 2 5 Existing capacity/ Area etc. t Applicable 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: Plot/ Survey/ Khasra Survey. 394, F.P. 27, O.P 27, T.P.S 110, Nikol, Kathwada, Ta- Asarwa, Dist- Ahmedabad Village Tehsil District State 10 Nearest railway station/ airport along with distance in km Nikol Asarwa Ahmedabad Gujarat Kalupur (Ahmedabad) Railway Station @ 8.10 km, WSW S. V. P. International Airport, Ahmedabad @ 4.10 km, WNW 11 Nearest Town, City, District Headquarters City/District: Ahmedabad @ 8.0 km, WSW along with distance in km 12 Village panchayats, ZillaParishad, Municipal Ahmedabad Municipal Corporation (East)

Item Details Corporation, Local Body (Complete postal addresses with telephone nos. to be given) Tel: +91-79-25391811 to 25391830 Fax: +91-79-25350926 13 Name of the applicant For Satva Shiva Gold Vijaybhai Chaganbhai Kothiya 14 Registered Address Satva Shiva Gold 15 Address for correspondence: Satva Shiva Gold Name Designation (Owner/ Partner/ CEO) Address Survey. 394, F.P. 27, O.P 27, T.P.S 110, Nikol, Kathwada, Ta- Asarwas, Dist- Ahmedabad Survey. 394, F.P. 27, O.P 27, T.P.S 110, Nikol, Kathwada, Ta- Asarwas, Dist- Ahmedabad Vijaybhai Chaganbhai Kothiya Partner Pin Code 382350 E-mail 26, Sadguru Vatika, Opp. Sargam Vatika, Mahatma Gandhi Road, New NikolDist. Ahmedabad satvashivagold.env@gmail.com Telephone Landline: (079)40325141 Fax --- 16 Details of Alternative Sites examined, if any. Location of these sites should be shown on a topo sheet Mo: 9998176628 ne 17 Interlinked Projects ne 18 Whether separate application of interlinked project has been submitted? t Applicable 19 If, date of submission t Applicable 20 If, Reason t Applicable 21 Whether the proposal involves approval/ clearance under: (a) The Forest (Conservation) Act, 1980? (b) The Wildlife (Protection) Act, 1972?

Item (c) The C.R.Z tification, 1991? If yes, details of the same and their status to be given. 22 Whether there is any Government Order/ Policy relevant/ related to the site? 23 Forest land involved (Hectare) 24 Whether there is any litigation pending against the project and/or land in which the project is propose to be setup? (a) Name of the Court (b) Case (c) Orders/ Directions of the Court, if any and its relevance with the proposed project. Details (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.) Information/ Checklist 1.1 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) 1.2 Clearance of existing land, vegetation and buildings? / Details thereof (with approximate quantities / rates, wherever possible) with Change in the topography of land during the construction activities (Excavation for Proposed Built up area) of proposed project and it will be a permanent effect due to proposed construction activity. However, the same will not crate any adverse impact on the environment. t Applicable due to the fact that the proposed project will be developed on an open land area. 1.3 Creation of new land uses? The land area of Survey. 394, F.P. 27, O.P 27, T.P.S 110, Nikol, Kathwada, Ta- Asarwas, Dist- Ahmedabad Satva Shiva Gold for the development of new residential building.

1.4 Pre-construction investigations e.g. bore houses, soil testing? Soil testing has been done. Soil testing report attached as Annexure 12. 1.5 Construction works? There will be construction of new residential buildings named Satva Shiva Gold developed by K V Developers 1.6 Demolition works? t Applicable 1.7 Temporary sites used for construction works or housing of construction workers? 1.8 Above ground buildings, structures or earthworks including linear structures, cut and fill or excavations 1.9 Underground works including mining or tunneling? (Total Built-up area: 26953.09 m 2 ) Residential Apartments: 213 s. The construction works will be done by the workers from the nearby area and hence there will be no need for temporary housing of construction workers. The proposed project of residential building development includes above & below ground structures. Hence, excavation will be required. Please refer the drawings attached for more details. t Required 1.10 Reclamation works? t Required 1.11 Dredging? t Required 1.12 Offshore structures? t Required 1.13 Production and manufacturing processes? 1.14 Facilities for storage of goods or materials? 1.15 Facilities for treatment or disposal of solid waste or liquid effluents? t Applicable Construction Phase: Minimum bulk material for construction will be bought as and when required and will be temporarily stored at site with proper arrangement of storage and under proper coverage. Solid Wastes: Solid waste generated in Project area will be mainly of domestic nature. The solid wastes generation in the construction phase will be 20 kg/day and will be stored in municipal bins before it s collection by AMC. While the solid waste generation in the operation phase will be 615 kg/day and

1.16 Facilities for long term housing of operational workers? 1.17 New road, rail or sea traffic during construction or operation? 1.18 New road, rail, air waterborne or other transport infrastructure including new or altered routes and stations, 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 hydrology of watercourses or aquifers? the same will be collected & stored in the community bins from where it will be collected by the AMC. Please refer Annexure 5 for more details. Liquid Effluent: On site sanitation facilities will be provided for proper disposal of liquid effluent @ 3.6 KLD during the construction phase which will be disposed off through the septic tank/soak pit system. The total domestic wastewater generation during the operation phase will be 128.0 KLD which will be disposed off in to the AMC under drainage line. Please refer Annexure v- 4 for more details. Workers & staff will be recruited from the nearby areas. The existing road network will be adequate for the additional traffic load. t envisaged t Required t Required 1.22 Stream crossings? t Applicable 1.23 Abstraction or transfers of water form ground or surface waters? There will not be any changes occurred to the hydrology of watercourses or aquifers due to the proposed project. Construction Phase: During a construction phase the fresh water requirement 11.5 KLD will be met by bore well water.

1.24 Changes in water bodies or the land surface affecting drainage or run-off? 1.25 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? 1.28 Influx of people to an area in either temporarily or permanently? Operation Phase: During an operation phase the total fresh water requirement of 165.00 KLD will be met by AMC water supply / bore well (stand-by). t Applicable Transportation of personal/materials will be required in both construction and operation phases. However, it will be transported by the existing road facilities. t Required t Applicable 1.29 Introduction of alien species? t Applicable 1.30 Loss of native species or genetic diversity? 1.31 Any other actions? ne During the construction phase, 100 workers will be employed temporarily and hired from nearby local areas. During the operation phase, there will be around 504 people. t 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 not-renewable or in short supply) Information/Checklist confirmation 2.1 Land especially undeveloped or agricultural land (ha) / Details thereof(with approximate quantities/rate, wherever possible) with The total land area of proposed project site is 0.5160 ha. which is already converted into non-agricultural land.

2.2 Water (Expected source & competing users) Unit: KLD Water requirement will be as follows: Construction phase Maximum Quantity: 11.5 KLD Source: Bore well Operation phase Maximum Quantity: 165.0 KLD Source: AMC water supply / Bore well (Standby) 2.3 Minerals (MT) t Applicable 2.4 Construction material stone, aggregates, and/ soil (expected source MT) Details of water consumption during construction and operation phases are elaborated in Annexure 4. Construction materials such as stone, cement, sand, bricks, marble, paints, tiles, electric ware, sanitary ware, glass will be used. All the above materials will be purchased from the local market and from nearest approved quarries, as and when required. It will be stored temporarily at the site. Approximate quantity are as follows: Material Quantity 1. Steel (t) 582 2. Cement (bags) 137020 3. Stone Aggregate (m 3 ) 19960 4. Sand (m 3 ) 57060 5. Bricks (m 3 ) 495 6. Glass (m 2 ) 3520 7. Fly Ash Based Products (m 3 ) 1320 2.5 Forests & Timber (sources MT) Wood will be required in small quantity for doors, windows, furniture etc. for the proposed project. 2.6 Energy including electricity & fuels (sources/competing users) Units: Fuel (MT) & Energy (MW) Construction Phase: Requirement 21.0 KVA Source Torrent Power Operation Phase: Requirement 642.0 KVA Source Torrent Power

2.7 Any other natural resources (appropriate standard units) t Applicable 3. Use, storage, transport, handling or production of substances or materials, which would be harmful to human health or the environment or raise certain about actual or perceived risks to human health. Information/Checklist 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 diseases) 3.3 Affect the welfare of 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. yes/ 3.5 Any other causes ne Details thereof(with approximate quantities/rate, wherever possible) with t Applicable t Applicable During construction phase 100 workers will be employed temporarily from nearby areas. During the operational phase, there will be around 1065 s. people. such groups of people will be affected by the proposed project. 4. Production of solid wastes during construction or operation or decommissioning (MT/Month) Information / Checklist yes/ 4.1 Spoil, overburden or mine wastes t Applicable 4.2 Municipal waste (domestic and or commercial wastes) Details thereof(with approximate quantities/rate, wherever possible) with The municipal solid wastes generated during operation phase will consist of: Organic waste: Waste vegetables and foods Inorganic waste: Papers, cartons, Thermocol, plastics, polythene bags, Glass,

4.3 Hazardous wastes (as per Hazardous Waste Management Rules) etc. 4.4 Other industrial process wastes t Applicable 4.5 Surplus product t Applicable 4.6 Sewage sludge or other sludge from effluent treatment Solid waste storage location will be incorporated in the design itself. Adequate number of collection bins, separately for biodegradable and nonbiodegradable waste will be provided as per Municipal Solid Waste (Management and Handling) Rule, 2000. Waste from such bins will be collected separately on daily basis. The quantity of solid wastes generated will be approximately 615 kg/day. Please refer Annexure 5 for more details. There will be no generation of any type of Hazardous waste. t Applicable 4.7 Construction or demolition wastes The Small quantity of construction waste free from any hazardous content will be generated and used for filling in a low-lying area. 4.8 Redundant machinery or t Applicable equipment 4.9 Contaminated soils or other t Applicable materials 4.10 Agricultural wastes t Applicable The construction waste will consist of construction debris along with cement bags, Unusable steel scrap (small cut-pieces of steel), insulating and packaging materials etc. Cement bags, waste paper and cardboard packing material will be sold off to recyclers. Unusable steel scrap (small cutpieces of steel) will also be collected at site and sold to recyclers.

4.11 Other solid wastes t Applicable 5. Release of pollutants or any hazardous, toxic or noxious substances to air (Kg/hr) Information / Checklist 5.1 Emissions from combustion of fossil fuels from stationary or mobile sources 5.2 Emissions 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 odours from handling of materials including construction materials, sewage and waste / Details thereof (with approximate quantities/rate, wherever possible) with t Applicable t Applicable High levels of Suspended Particulate Matters (SPM) may be noted due to various construction activities & handling and storage of construction materials. However, continuous water sprinkling will be done and temporary wind shield barriers will be provided by the use of bamboos and GI sheets to prevent the emissions. Temporary emission of a very moderate level of particulate matter is anticipated due to vehicular movement during the construction phase. However, the entire area will be sprinkled with water and rising of greenbelt will be commenced simultaneously with the project to minimize emission levels. At the time of transportation & construction, dust will be generated. Manually Water sprinkling will be carried out to minimize dust suppression. Construction Phase: Dust will be generated during construction activity. Water sprinkling will be carried out to minimize dust suppression. On site sanitation facilities (septic tank and soak pit) will be provided during the construction phase. Temporary Solid waste storage will be provided at site and recyclable material will be sold to recyclers. Operation Phase:

5.6 Emissions from incineration of waste 5.7 Emissions from burning of waste in open air (e.g. slash materials, construction debris) During the operational phase, sewage will be disposed off in to AMC under drainage line. t Applicable 5.8 Emissions from any other sources t Applicable open burning will be carried out within the premises. 6. Generation of ise and Vibration, and Emissions of Light and Heat Information / Checklist 6.1 From operation of equipment e.g. engines, ventilation plant, crushers / Details thereof (with approximate quantities/rates, wherever possible) with During construction, the machinery used for construction will be of high standard of reputed make and will adhere to International standards. These standards itself take care of noise pollution control/ vibration control and air emission control. Hence, insignificant impacts due to construction machinery are envisaged. There won t be any major source of noise generation during the operation phase. 6.2 From industrial or similar t Applicable processes 6.3 From construction or demolition Minor noise will be generated during the construction work which will be temporary and the immediate vicinity of the project site. 6.4 From blasting or piling t Applicable 6.5 From construction or operational traffic ise will be generated due to construction as well as operational traffic; however the quantum would be very marginal and may happen for short period only. 6.6 From lighting or cooling systems There will be minor chances of noise

6.7 From any other sources t Applicable generation from such types of equipment. However, necessary care will be taken at the time of equipment selection. 7. Risk of contamination of land or water from releases of pollutants into the ground or into sewers, surface waters, groundwater, coastal waters or the sea: Information / Checklist 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 / Details thereof(with approximate quantities/rate, wherever possible) with t Applicable t applicable due to the fact that the wastewater to be generated from proposed project will be discharged in to the under drainage line of Ahmedabad Municipal Corporation (AMC). t Applicable 7.4 From any other sources t Applicable 7.5 Is there a risk of long term buildup of pollutants in the environment from these sources? t Applicable 8. Risk of accidents during construction or operation of the Project, which could affect human health or the environment Information / Checklist 8.1 Form explosions, spillages, handling, use or production of hazardous substances / Details thereof (with approximate quantities/rate, wherever possible) with t Applicable 8.2 From any other causes During the Construction phase possibility of accidents may be fall from height, scaffolds, temporary stairs, cutting and welding, electrical fitting etc During the Operation phase possibility of accidents may be electrical fire. Please refer Annexure 8 for more details.

8.3 Could the project be affected by natural disasters causing environmental damage (e.g. floods, earthquakes, landslides, cloudburst etc)? Project area is categorized in the seismic zone III, which is classified as having a moderate seismic intensity. The structure Design is as per Codes to negate the threat of environmental and other damages by natural disasters. 9. Factors which should be considered (such as consequential development) which could lead to environmental effected or the potential for cumulative impacts with other existing or planned activities in the locality. Information / Checklist 9.1 Lead to development of supporting. Facilities, 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 projects with similar effects / Details thereof (with approximate quantities/rates, wherever possible) with Supporting infrastructure will be developed like road, water supply network, power etc. Increase in demand for housing Increase in demand in industrial facilities Increase in demand in supply industries Increase in demand for commercial and recreational facilities Negligible increase in traffic and there will be positive impact on socio- economic environment. The project will lead to development of residential flats. t Applicable (III) Environmental Sensitivity

Areas 1. 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 reasons wetlands, water courses or other water bodies, coastal zone, biospheres, mountains, forests 3. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration 4. Inland, coastal, marine or underground waters Name/ Identity ne River ne ne Arial distance (within 15 km) from proposed project location boundary t Applicable Sabarmati River @ 7.5 km, West t Applicable t Applicable 5. State, National boundaries ne state or national boundary falls within 15 km from the project site. 6. Routes or facilities used by the public for access to recreation or other tourist, pilgrim areas ne t Applicable 7. Defense installations ne t Applicable 8. Densely populated or built-up area Ahmedabad City 9. Areas occupied by sensitive manmade land uses (hospitals, schools, places of worship, community facilities) 10. Areas containing important, high quality or scarce resources (ground water resources, surface resources, forestry, agriculture, fisheries, The site is situated within the limits of Ahmedabad Municipal Corporation. Hospitals, schools, institutes, places of worship, community places etc. are present. It may be noted that the proposed project consists of residential flats. Therefore, it would not have any adverse impact on such places. t Applicable

tourism, minerals) Areas 11. Areas already subjected to pollution or environmental damage. (those where existing legal environmental standards are exceeded) 12. Areas susceptible to natural hazard which could cause the project to present environmental problems (earthquakes, subsidence, landslides, erosion, flooding or extreme or adverse climatic conditions) Name/ Identity Arial distance (within 15 km) from proposed project location boundary t Applicable As per earthquake sensitivity index, the proposed project site is situated in Zone III having moderate damage risk (MSK VII) and considering the same proposed project will be designed. There is no other threat for the natural hazard. I hereby given undertaking that the data and information given in the application and enclosures are true to the best of my knowledge 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 resolved at our risks and cost. Date: 17/07/2017 Place: Nikol, Ahmedabad Signature of the applicant (Partner) Name:Vijaybhai C. Kothiya Address:26, Sadguru Vatika, Opp. Sargam Vatika, Mahatma Gandhi Road, New Nikol, Ahmedabad.