APENDIX 1

See Paragraph - 6)

FORM 1
(1) Basic lnformation

Sr. No. Item Details

1 Name of the Projects Bolegaon Sandbelt
Auction for Revenue Year
2015-16
2 S.No. in the Schedule Adjasent gut no.320, 321 in
Manira river bed
3 Proposed Capacity / area / length/ tonnage to be Removal of sand 10601 brass of
handled / command area / lease area/ number of quantity per annum Area = 3.00
wells to be drilled HR, 300 M. lenqth
4 NeW Expansion / Modernization No
5 Existinq Capacity / Area etc. 10601 Brass/3.00 H.R.
6 Catagory of Project i.e. 'A' or 'B' B
7 Does it attract the general condition' if yes please Nit
specify
8 Does it attract the specific condition' if yes please Nit
specify
o Location Villaqe - Boleoaon
Plot /Survey / Khasra No. Adjasent gut no.320,321 in
l\4an jra river bed
Village Boleqaon
Tahsil Biloli
District Nanded
State Maharastra
10 Nearest railway station/ airport along with distance Rly station-Dharmabad 35 kms
in kms.
'11 Nearest Town, City, District Headquarters along Tahsil Biloli - 13 Kms
with distance in Kms. Dist. Nanded - 83 Kms
12 Village Panchayat, Zilla Parishd, Municipal
Corporation, Local Body (Complete postal address Village Panchayat = Bolegaon,
with telephone nos. to be given) Z.P.Nanded
Name of the applicant Collector Nanded
14 Registered Address Collector Office Nanded
15 Address for correspondencei Collector OfficeNanded,
Vazirabad, Nanded .431 601
Name Collector Nanded
Designation (Owner/Partner/ CEO) Collector Nanded
Address Collector OfficeNanded,
Vazirabad, Nanded .431 601
Pin Code 431 601
E-mail Collectornandedl (Aqmail.com
Telephone No. 02462-235077
Fax No. 02462-238500
to Details of Alternatlve Sites examtned, any. if Nit
Location of these sites should be shown on a topo
sheet
lnterlinked Projects Nil
18 Whether separate application of interlinked project No
has been submitted.

39
 19 lf yes, date of submission Nit
20 if no, reason Nit
21 Whether the proposal involves approval / clearance No
under : if yes, details of the same and their status to
be given.
a) The Forest (Conservation) Act 1980?
b) The Wildlife (Protection) Acl, 1972 ?
c) The C.R.Z. Notification, 1991 ?
22 Whether there is any Government Order / Policy ar€"r, ff6qd q rf, fusrEr ffiq
relevant / relating to the site ?
6.ritqB fi / ostz / q.,F.3oo,/rr, Edi6
12 ffr{, 2013

Forest land involved (hectares) Nil

24 Whether there is any litigation pending against the No
project and / or land in which the project is propose to
be set up ?
a) Name cf the Court.
b) Case No.
c) Order/ direction of the Court, if any and its
relevance wich the proposed project
(il)
Construction, operation or decommissioning of the Project involving actions, which will cause
in the Pto land in water etc.
Sr. No. lnformation / Cheeklist Confirmation Yes/ No. Details thereof (will
approximate
quantities / rates
wherever possible)
with source of
information data.
I Permanent or temporary change in land use Excavation of Sand
land co
2 Clearance of existing land, vegetation and River bed
buildinq ?
Creation of new land uses? No
4 Pre-construction investigations e.g. bore No
houses. soil testinq?
Construction works ? temperary approach road from
existing village road to sand
site will be constructed by
sand auction holder, whenever
it's found necessary

o Demolition works? No
7 Temporary sites used for construction works No
or housinq of constuction workers?
8 Above ground buildings sturctures or earth No
works including linear structures cut and fill
or excavations.
9 Undergroud works including mining or No
runnelinq?
10 Reclamation works? No
11 Dredqinq? No
12 Offshore structures? No
13 Production and manufacturing processes No
14 Facilities for storaqe of goods or materials No
15 Facilities for treatment or disposal of solid No
waste or liquid etfluents?
to Facilities for long term housing of operational No
workers?
17 New road. rail or sea traffic during No
consturction or oPeration?
 2

18 New road. rail air waterborne or other No

transport infratructure including new or
altered routes and statrons. ports airports
etc?
19 Closure or diversion of existing transport No
routes or infrastucture leading to changes
in traffic movements?
20 New or diverted transmission lines or No
nipelines ?
21 lmpoundment damming, culverting No
realignment or other changes to the
hvdroloqy of watercourses aquifers?
22 Stream crossinqs? No
)2. Abstaction or transfers of water form No
qround or surface waters?
24 Changes in water bodies or the land No
surface afectinq drainaqe or run-off?
Transport of personnel or materials for No
construction, operation or
decommissionino?
26 Long-term dismantling or No
decommissioninq or restoration works?
27 Ongoing activity during decommissioning No
which could have an impact on the
environment?
28 lnflux of people to an area in either No
temporarilv or permanently ?
29 lntroduction of alien species ? No
30 Loss of native species or genetic diversity No
?
31 Any other actions ? No
2. Use of Natural resources for construction or opration of the as land, water, materials or
)ecially any resources which are non-renewable or in short supply) :-
Sr. No. lnformation/Checklist Yes/No Details thereof approximate
confirmation quantities /rates wherever
possible with of infomation data
1 Land respecially undeveloped or No
aoricultural land (ha)
2 Water (expected source & No
competinq users) unit : KLD
3 Minerals (MT) No
4 Consturction material - stone. No
aggregates, and / soil (expected
source - MT)
5 Forests and timber (Source - MT) No
6 Energy inluding electricity and fuels No
source, competing users) Unit :

Fuel (MT), enerqv (MW)

7 Any other natural resources (use No
approprite standart units)
3. Use, storage, transport, handling or production of substances or materials, which could be harmful to
human health or the envionment or raise concerns about actual or perceived risks to human
Sr. No. lnformation/Checklist confirmation Yes/No Details thereof approximate
quantities / rates, wherevea
possible with source of
information data
1 Use of substances or materials, which No
are lazardous (as per MSIHC rules) to
human health or the encironment (flora,
fauna and water supplies)

2
 J
2 Changes in occurrence of disease or No
affect diseasevectors (e.9. insect or
water borne diseases)
J Affect the welfare of people e.g. by No
changing livinq conditions ?
4 Vulnerable groups of people who could No
be affected by the project e.g. hospital
patients, ch jldren the etc.
5 Any other causes. No

4. Production of solid wastes during construction or operation or / onth

Sr. No. lnformation/Checklist Yes/No Details thereof with approximate
confirmation quantities / rates, wherever
possible with source of
information data
1 Spoil, overburden or mine wastes No
2 Municipal waste (domestic and or No
commercial wastes)
3 Hazardous wastes (as per No
Hazardous waste Management
Rules)
4 Other industrial process wastes No
5 Surplus product No
6 Sewage sludge or other sludge No
from eftluent reatment
7 Construction or demolition wastes No
8 Redundant machinerv or eouiDment No
9 Contaminated soils or other No
materials
10 Aqricultural wastes No
11 Other solid wastes No

5. Release of or any hazardous, toxic or noxious substances to air nq/nr

Sr. No. lnformation/Checklist Yes/No Details thereof approximate
confirmation quantities / rates, wherever
possible with source of
information data
1 Emissions from combustion of fossil No
fuels from stationary or mobile
sources
2 Emissions from production No
processes
3 Emissions from materials handling No
includino storaqe or transport
4 Emissions from construction No
activitties including plant and
equipment
Dust or odours from handling of No
materials including consturction
materials. sewaqe and waste
6 Emissions from incineration of No
waste
7 Emissions from burning of waste in No
open air (e.9. slash materials,
construction debris)
I Emissions from any other sources No

3
 4

6. Generation of Noise and Vidration and Emissions of Light and Heat.

Sr. No. lnformation/Checklist Details thereof (with

confirmation
Yes/No
approximate quantities /rates,
wherever possible) with source
of information data
1 From operation of equipment e.g.
No
enqines vantilation olant. crushers
2 From industrial or similar orocesses No
3 From construction or deolition No
4 From blastinq or pillinq No
5 From construction or operational
No
traffic
6 From liqhtinq or coolinq systems No
7 From anv other sources No

7. Risks of contamination of land or water from releases of pollutants into the ground or into sewers, surface
coastal waters or the sea:
Sr. No. lnformation/Checklist Yes/No Details thereof (with
confirmation approximate quantities /rates,
whirever possibte) with sourcl
of information data
1 From handling, storage, use or
No
spillaqe of hazardous materials
2 From discharge of sewage or other
effluents to water ro the land
No
(expected mode and place of
discharqe)
By deposition of pollutants emitted
No
to air into the land or into water
4 From any other sources No
5 ls there a nsk of long term build up
of pollutants in the environment No
from these sources?

8. Risk of accidents during construction or operation of the Project, which could affect human helath or the
environment.

Sr. No. lnformation/Checklist Yes/No Details thereof (with

confirmation approximate quantities /rates,
wherever possible) with source
of information data
1 From explosions, spillages, fires
etc, fom storage handling use or
No
production of hazardous
substances
2 From any other causes No
J Could the project be affected by
natural disasters causing
environmental damage (e.9. floods No
earthquakcs, landslides, cloudburst
etc) ?

9. Factors which should be considered (such as consequential development) which could lead to
environmental effects or the potential for cumulative impacts with other existing or planned activities in
the locality.

4
 5

Sr. No. lnformation/Checklist Yes/No Details thereof (with approximate

confirmation quantities /rates, wherever
possible) with source of
information data
1 Lead to development of supporting
liues ancillary development or
development stimulated by the
project which could habe impact on
the enviroment e.g. Supporting
infrastructure (roads, power supply,
No
waste or waste water treatment,
etc. )
. Housing development
. extractiveindustries
. suPPlY industries
.other
2 Lead to after-use of the site, which
could havean impact on the No
environment
3 Set a precedent for later
No
developments
4 Have cumulative effects due to
proximity to other existing or No
planned projects with similar
effects.
Environmental Sensitivity.
Sr. No. Areas Name / ldentity Aerial distance (within Km)
Proposed proiect local boundary.
1 Areas protected uder international
conventions, national or local
legislation for their ecological Nil
landscape, cultural or other related
value
2 Areas which are important or
sensitive for ecological reasons-
Wetlands, watercourses or other Nir
water bodies, coastal zone,
biospheres, mountains, forests
3 Areas used by protected, important
or sensitive species of flora or fauna Nit
for breeding, nesting, foraging.
restinq, over wintering, migratior
4 lnland, coastal, marine or Nil
underqround waters
5 State, National boundaries. Nil
6 Routes or facilities used bY the
public for access to recreation or Nit
other tourist, pilqrim areas
7 Defence installations Nil
I Densetv oopulation or built-up area Nit
o Areas occupied by sensitive man-
made land uses (hospitals, schools, NiI
place of
worship, community,
facilities)
10 Areas containing important, high
quality or scarce sources
(ground water resources, surface Nir
resources prestry agriculture,
fisheries, tourism, minerals)

5
 11 Areas already subjected to pollution
or environment damage (those Nit
where existing legal environmental
standards are exceeded)
12 Areas susceptible to natural hazard
which could cause the project to
present encironmental problems
(earthquakes, subsidence, Nit
landslides, erosion fooding or
extreme or adverse clamatic
conditions)

(lV) Proposed Terms of Referance for EIA studies-

It is requested that EIA may be condoned in view of -

1. The sandbelt auction period (removal of sand from river bed) is for revenue vear 20{5-2016 (1.10.20f 5
to 30.9.2016 ) only.
2. Proposed each & every sandbelts were surveyed by Geologist from Ground Water Survey &
Development Agency,Govt. Of Maharashtra, district office Aurangabad (GSDA) and recommended
(feasible) sandbelts will put to auction.(Feasible Report)
3. Removal of sand from the river bed is maxuimum upto the depth of 1.00 M. (0.40 to 1.00 M) as
recommended by GSDA. in their survey report Annexure-
4. The process of removal of sand is manualy by Tikas, spade and machinary with use of suction Pump
5. The area for removal of sand is much below 5.00 H.
6. The removal of sand is seasonal.
7. There will not be any major dust pollution.
8. There will not be any major air pollution
9. There will not be any major noise pollution.
10. There will not be release of any hazardous material.
11. There will not be any harm to flora & fauna.

Hereby given undertaking that the data and inforrmation given in the application and enclousures
are true to the best of my knowledge and belief and I am aware that any part of the data and information
submitted is found to be false or misleading any stage, the project will be rejected and clearance give, if any
to the project will at our risk and cost.

Date :-1V 8t2015

Place :- Nanded
( D.N.Sffi?stri)
District Mining Officer,
Office of the Collector Nanded
DistidMining Otror
Coltector Office, Nanded.
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