APPENDIX I (See paragraph - 6) FORM 1 - Seiaacg.org

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):S. No.Information/checklistconfirmation2.1 Land especially undeveloped oragricultural land (ha)2.2 Water (expected source &competing users) unit: KLDYes/NoYesYesDetails thereof (with approximate quantities /rates,wherever possible) with source of information dataLand Undeveloped.The area consists of essentially flat land. At the endof the life of the mine it is proposed that area to bewater filled and used for Agriculture as well as thiswater reservoir will be surrounded by treeplantations which will help in recharging the groundwater and can also be used for irrigation purpose.About 5 KLPD of water will be required for miningoperations including drinking, dust suppression alonghaul road/faces, cleaning, washing as well asplantation.Soil preperation for bricks & Dust Supression: 3 KLPDPlantation: 1 KLPDDrinking/Domestic: 1 KLPD2.3 Minerals (MT) No No minerals will be used2.4 Construction material – stone, No NAaggregates, sand / soil (expectedsource – MT)2.5 Forests and timber (source – MT) No NA2.6 Energy including electricity andfuels (source, competing users)Unit: fuel (MT), energy (MW)2.7 Any other natural resources (useappropriate standard units)Yes Electrical Motor would be used for miningoperations.Electrical pump for dewatering from pit and dustsuppression.No NA3. Use, storage, transport, handling or production of substances or materials, which could beharmful to human health or the environment or raise concerns about actual or perceived risksto human health.S. No. Information/Checklist confirmation3.1 Use of substances or materials,which are hazardous (as per MSIHCrules) to human health or theenvironment (flora, fauna, andwater supplies)3.2 Changes in occurrence of disease oraffect disease vectors (e.g. insect orwater borne diseases)Yes/NoNoNoDetails thereof (with approximate quantities/rates,wherever possible) with source of information dataNANo effect envisaged

3.3 Affect the welfare of people e.g. bychanging living conditions?3.4 Vulnerable groups of people whocould be affected by the project e.g.hospital patients, children, theelderly etc.,YesNoStandard of living of population surrounding theproposed project area is likely to be improvedNo effect envisaged3.5 Any other causes Nil Nil4. Production of solid wastes during construction or operation or decommissioning (MT/month)S. No. Information/Checklist confirmation Yes/NoDetails thereof (with approximate quantities/rates,wherever possible) with source of information data4.1 Soil, overburden or mine wastes No It has already been mentioned that the bricks (minormineral) is made by soil. There is no material whichcan be called as waste rock.4.2 Municipal wasteNo Nil(domestic and/or commercialwastes)4.3 Hazardous wastesNo Nil(As per Hazardous WasteManagement Rules)4.4 Other industrial process wastes No NA4.5 Surplus product No NA4.6 Sewage sludge or other sludge from No NAeffluent treatment4.7 Construction or demolition wastes No NA4.8 Redundant machinery or No Nilequipment4.9 Contaminated soils or other No Nilmaterials4.10 Agricultural wastes No NA4.11 Other solid wastes No Nil

5. Release of pollutants or any hazardous, toxic or noxious substances to air (Kg/hr)S. No. Information/ChecklistconfirmationYes/NoDetails thereof (with approximate quantities/rates,wherever possible) with source of information data5.1 Emissions from combustion of fossilfuels from stationary or mobilesources5.2 Emissions from productionprocesses5.3 Emissions from materials handlingincluding storage or transport5.4 Emissions from constructionactivities including plant andequipment5.5 Dust or odors from handling ofmaterials including constructionmaterials, sewage and waste5.6 Emissions from incineration ofwaste5.7 Emissions from burning of waste inopen air (e.g. slash materials,construction debris)YesYesYesNoYes5.8 Emission from any other sources No NilNoNoThe emission of SOx and NOx may be due to use ofdiesel operated Dumper/Truck etc. The bettermaintenance of equipment will help to reduce suchemissions and maintain below permissible limit.Dust will be suppressed by water sprinkler & wetdrillingThe emission of SOx and NOx may be due to use ofdiesel operated Dumper/Truck etc. The bettermaintenance of equipment will help to reduce suchemissions and maintain below permissible limit. Thefugitive emission on haul road will be suppressed bywater spray.NilDust will be generated during transportation. Dustsuppression will be done by sprinkling of water.Not applicableNot applicable6. Generation of Noise and Vibration, and Emissions of Light and Heat:S. No. Information/Checklistconfirmation6.1 From operation of equipmente.g. engines, ventilation plant,crushersYes/No6.2 From industrial or similar processes No Not applicableYes6.3 From construction or demolition No NADetails thereof (with approximate quantities/rates,wherever possible) with source of information datawith source of information dataThere is likely hood of some increase in noise due tooperation of machinery like Trucks, Tractorsgenerates high noise level at source ranges from 20-25 decibels. However persons working just close tomachines will be provided with ear plugs/ear muffsfor further protection.Vibrations due to transportation are normal there isno need of vibrations control technique.

6.4 From blasting or piling No Not applicable6.5 From construction or operationaltrafficYes During vehicular movement, the noise is likely to bein the range of 20-25 DBA which is intermittent/slowprocess.6.6 From lighting or cooling systems No Not applicable6.7 From any other sources No Not applicable7. Risks of contamination of land or water from releases of pollutants into the ground or intosewers, surface waters, groundwater, coastal waters or the sea:S. No. Information/Checklistconfirmation7.1 From handling, storage, use orspillage of hazardous materials7.2 From discharge of sewage or othereffluents to water or the land(expected mode and place ofdischarge)Yes/NoNoNoDetails thereof (with approximate quantities/rates,wherever possible) with source of information dataNot applicableNot applicable7.3 By deposition of pollutants emittedto air into the land or into water7.4 From any other sources No Not applicableNoDust will be generated during transportation andmanufacturing process. Dust suppression will bedone by sprinkling of water.The emission of SOx and NOx may be due to use ofdiesel operated Dumper/Truck etc. The bettermaintenance of equipment will help to reduce suchemissions and maintain below permissible limit. Thefugitive emission on haul road will be suppressed bywater spray.Impact referred above is localized, transitory andintermittent in nature and hence their effect onenvironment is insignificant.7.5 Is there a risk of long term build upof pollutants in the environmentfrom these sources?NoImpact of air quality is localized, transitory andintermittent in nature and hence their effect onenvironment is insignificant.No likely impact on surface water is envisaged.

8. Risk of accidents during construction or operation of the Project, which could affect humanhealth or the environmentS. No. Information / Checklistconfirmation8.1 From explosions, spillages, firesetc from storage, handling, use orproduction of hazardoussubstancesYes /No8.2 From any other causes No Not applicable8.3 Could the project be affected by No Not applicablenatural disasters causingenvironmental damage (e.g floods,earthquakes, landslides,cloudburst etc)?NoDetails thereof (with approximate quantities/ rates, wherever possible) with source ofinformation dataNot applicable

9. Factors which should be considered (such as consequential development) which could lead toenvironmental effects or the potential for cumulative impacts with other existing or plannedactivities in the localityS. No. Information/Checklistconfirmation9.1 Lead to development of supportingutilities, ancillary development ordevelopment stimulated by theproject which could have impact onthe environment e.g.:• Supporting infrastructure (roads,power supply, waste or waste watertreatment, etc.)• Housing development• Extractive industries• Supply industries• Other9.2 Lead to after-use of the site, whichcould have an impact on theenvironment9.3 Set a precedent for laterdevelopments9.4 Have cumulative effects due toproximity to other existing orplanned projects with similareffectsYes/NoNoYesYesYesDetails thereof (with approximate quantities / rates,wherever possible) with source of information dataNot envisagedAt the end of the life of the mine it is proposed thatarea to be water filled and used for Agriculture aswell as this water reservoir will be surrounded bytree plantations which will help in recharging theground water and can also be used for irrigationpurpose.A better after use scenario which is likely to increaseaesthetic beauty of area in addition to benefit ofbetter water regime & greenery would set aprecedence for subsequent entrepreneurs whoventure such projectsA better planned and executed project will yield abetter result individually; which in turn will givebetter cumulative effect also.

III. Environmental SensitivityS.No.Areas Name /Identity1 Areas protected under international NILconventions, national or locallegislation for their ecological,landscape, cultural or other relatedvalue2 Areas which are important or NILsensitive for ecological reasons -Wetlands, watercourses or otherwater bodies, coastal zone,biospheres, mountains, forests3 Areas used by protected, important NILor sensitive species of flora or faunafor breeding, nesting, foraging,resting, over wintering, migrationAerial distance (within 15 km.) Proposed projectlocation boundaryN.A.None within the radius of 10 Km.Not applicablep4 Inland, coastal, marine or No Nilunderground waters5 State, National boundaries NIL Not applicable6 Routes or facilities used by the public NIL Not applicablefor access to recreation or othertourist, pilgrim areas7 Defense installations NIL Not applicable8 Densely populated or built-up area Yes Tehsil – Pratappur is at a distance of about 25 km(approx).9 Areas occupied by sensitive manmadeHospitals Not Within the radius of 8 Km.land uses (hospitals, schools, / Schoolsplaces of worship, communityfacilities)10 Areas containing important, high NIL Not applicablequality or scarce resources(ground water resources, surfaceresources, forestry, agriculture,fisheries, tourism, minerals)11 Areas already subjected to pollution No Nilor environmental damage. (thosewhere existing legal environmentalstandards are exceeded)12 Areas susceptible to natural hazard No Nilwhich could cause the project topresent environmental problems(earthquakes, subsidence, landslides,erosion, flooding or extreme oradverse climatic conditions)

"I hereby given undertaking that the data and information given in the application andenclosures are true to the best of my knowledge and belief and I am aware that if any part of thedata and information submitted is found to be false or misleading at any stage, the project willbe rejected and clearance give, if any to the project will be revoked at our risk and cost."Date: 20/11/2012Signature of the applicantPlace: Rewati, PratappurSmt. Santoshi GuptaVillage: Rewati, Post: Rewati Teh.- PratappurDist: Surajpur (C.G.) Pin- 497223Mobile No. 09009158666 Proposed Terms of Reference for EIA studiesBASELINE DATA COLLECTION:AMBIENT AIR QUALITYBASELINE DATA WILL BE COLLECTED FROM THE PROPOSED SITE.A STUDY AREA OF 10 KM RADIUS HAS BEEN CHOSEN.5 NOS. OF SAMPLING STATIONS HAVE BEEN CHOSEN BASED ON PREDOMINANT WIND DIRECTION,UPWIND DIRECTION, CROSS WIND DIRECTION, RURAL AREA REPRESENTATION AND URBAN AREAREPRESENTATIONPARAMETERS MONITORED ARE RPM, SPM, SO2, NOXFREQUENCY OF MONITORING 2 DAYS A WEEK FOR 3 MONTHS AFTER MONSOON SEASON I.E SEPT.TO NOV. …WATER QUALITYGROUND WATER QUALITY WILL BE MONITORED AT 5 LOCATIONS WITHIN THE STUDY AREAGROUND WATER QUALITY WILL BE MONITORED FOR PARAMETERS AS PER IS: 10500SURFACE WATER QUALITY WILL BE MONITORED AT ONE LOCATION AND ANALYZED FOR VARIOUSPARAMETERS.NOISE LEVELSNOISE LEVELS WILL BE MONITORED (DAY TIME & NIGHT TIME) AT 10 LOCATIONS WITH IN THE STUDYAREA.MICRO METEOROLOGICAL DATAWIND DIRECTION, WIND SPEED, TEMPERATURE, RELATIVE HUMIDITY AND RAINFALL, CLOUD COVER

WILL BE MONITORED ON HOURLY BASIS FOR ONE SEASON.SOCIO-ECONOMIC DETAILSSOCIO ECONOMIC DETAILS OF PEOPLE IN THE STUDY AREA WILL BE COLLECTED.FLORA & FAUNALIST OF FLORA & FAUNA IN THE STUDY AREA WILL BE COLLECTED.PREDICTION OF IMPACTSPREDICTION OF GLC’S OR SPM, SO2 & NOX, USING AIR QUALITY MODELFINDING OUT THE NET RESULTANT GLC’S BY SUPERIMPOSING PREDICTED INCREMENTAL RISE INCONCENTRATIONS OVER THE BASELINE CONCENTRATIONS AND COMPARING THEM WITH NATIONALAMBIENT AIR QUALITY STANDARDS.PREDICTION OF IMPACTS ON WATER ENVIRONMENT, LAND ENVIRONMENT, NOISE ENVIRONMENT,FLORA & FAUNA, SOCIO-ECONOMIC ENVIRONMENTENVIRONMENTAL IMPACT STATEMENTPREPARATION ENVIRONMENT IMPACT STATEMENT COMPRISING OF AIR ENVIRONMENT, WATERENVIRONMENT, LAND ENVIRONMENT, NOISE ENVIRONMENT, FLORA & FAUNA, SOCIO ECONOMICENVIRONMENT.ENVIRONMENTAL MANAGEMENT PLANAIR EMISSION MANAGEMENT INCLUDING THE CONTROL OF SECONDARY FUGITIVEEMISSIONS.EFFLUENT TREATMENT & DISPOSAL.SOLID WASTE GENERATION, STORAGE & DISPOSALGREENBELT DEVELOPMENT PLANRAIN WATER HARVESTINGPOST PROJECT ENVIRONMENTAL MONITORINGYour’s Faithfully,Smt. Santoshi Gupta(Authorised Signatory)

FORM XIX(See Rule 48(1))Scheme of Environmental ManagementIk;kZoj.kh; izca/ku dh ;kstuk1. Name and Address of quarry lease holder.[knku iV~Vk /kkjd dk uke ,oa irka. NameukeSMT. SANTOSHI GUPTAb. Address of leaseiV~Vs dk irkVILL-REVTI, PO-REVTI, TEH-PRATAPPUR, DISTT-SURAJPURCHHATTISGARH – 497223c. Contact NumberlaidZ lw=9009839023d. E-mail(if available)bZ&esy ¼;fn gks rks½N/A2. Particulars of the area.{ks= dk C;kSjka. Date of execution of agreementvuqca/k ykxw gksus dh frfFkb. Periodvof/kN/A10 YEARSC:\Users\lenovo\Desktop\Khagesh 11-06-13\Ambey Mahila Swasahayta Samooh Rewati tehsil & Dist Surajpur\Environment Scheme for mines having lease area less than5 ha.doc Page 1 of 8

c. Extent of area.{ks= dh lhek,ad. Mineral[kfute. Khasra Nos.[kljk dzekadf. Panchayat and tehsiliapk;r ,oa rglhyg. Districtftyk1.33 HECTAREBRICKS MANUFACTURING332REVTI TEHSIL PRATAPPURSURAJPUR3. Particulars of the machines to be usediz;qDr dh tkus okyh e'khuksa dk C;kSjkSr. NoMachineDetailsNumbervuqdzekade'khufooj.kla[;ka. Drill machinefMªy e'khub. Loading machineHkjkbZ e'khuc. Dumper/Tipper/Trucks etcMEij@fVij@Vªd vkfnN/AN/A(TRUCK)1 No.d. Any other machineriesproposed to be usedLABOURS 50vU; dksbZ e'khu tksmi;ksx gsrq izLrkfor gksC:\Users\lenovo\Desktop\Khagesh 11-06-13\Ambey Mahila Swasahayta Samooh Rewati tehsil & Dist Surajpur\Environment Scheme for mines having lease area less than5 ha.doc Page 2 of 8

4. The plan of the area showing number of pits already, showing allareas within 500 meters of the lease boundary with details thereof.iV~Vs dh lhekvksa ls 500 ehVj ds {ks= esa fo|eku x

csap dh ÅapkbZe. Bench widthcsap dh pkSM+kbZf. slope

ifjogu izfdz;k dk laf{kIr o.kZum. Brief description of Crushing/Cuttingpolishing or any other processingproposed to be carried out in the leasearea its likely env impact andmitigation measuresN/A[knku {ks= esa izLrkfor rksM+kbZ@dVkbZ ;kIk;kZoj.k dks izHkkfor djus okyh vU;izfdz;k dk o.kZu6. Scheme for plantation of trees.o`{kkjksi.k gsrq ;kstukSr. novuqdzekada. Number of existing trees in thelease areaNILyht {ks= esa fo|eku o`{kksa dh la[;kb. Number of trees likely to beuprootedNILdkVs tkus okys laHkkfor o`{kksa dh la[;kc. Trees to be grown year wise(location should be shown on themap)500 TREESo"kZokj o`{kkjksi.k ¼LFky uD'ks esa n'kkZ;s½7. Scheme for progressive reclamation and rehabilitation of the landdisturbed.fcx

a. Depth of the top soilÅijh e`nk dh xgjkbZb. Expected quantity of top soil(year wise beakup)1.5 MTR.40000 Cum.Åijh e`nk dh vuqekfur ek=k ¼o"kZokj½c. Details of place for stacking the top soilLEASE AREA(should be shown on the map)Åijh e`nk ds

Hkwfe dk iqu% Hkjko ,oa leryhdj.k ¼o"kZokj½k. Rehabilitation of dump

g. Measures taken for minimizing Silting andcontamination of waterN/AfeV~Vh ds teko ,oa ty dks lanwf"kr gksus ls cpkusds mik;h. Requirement of water for mining/beneficiation(crushing/cutting polishing etc)7 KLPD[kuu@rksM+kbZ@dVkbZ vkfn esa ty dh vko';drki. Source of waterty L=ksrj. Waste water likely to be discharged into waterbody, streams, nalla, river etcTUBEWELLN/Aunh] ukyk] rkykc vkfn esa nwf"kr ty fudklh9. Any other matter which the lessee desires to state.vU; lqlaxr tkudkjh tks iV~Vk/kkjd mfpr le>s %&Place :LFkyDate :fnukadSignaturegLrk{kjName in Fulliwjk ukeC:\Users\lenovo\Desktop\Khagesh 11-06-13\Ambey Mahila Swasahayta Samooh Rewati tehsil & Dist Surajpur\Environment Scheme for mines having lease area less than5 ha.doc Page 8 of 8

Sai Bricks Industries +91-9009158666Prop:- Smt. Santoshi GuptaVill- Rewati Post: Rewati Teh.- PratappurDist: Surajpur (C.G.)To,The Member Secretary,SLEIAA (State Level Environment Impact Assessment Authority),Ministry of Environment and Forests,Commercial Complex,Kabir Nagar, Raipur (C.G.)Sub.- Application for Environment Clearance for Bricks Industries (Minor Mineral) Covering Over an Areaof 3.28 Acre at village- Rewati Post- Rewati Tah. Surajpur Dist.- Surajpur (C.G.).Respected Sir,This has reference to the aforesaid subject and office memorandum government of India,Ministry of Environment and forest, We are Hereby submitting the form- 1 as per the notification beforeministry of Environment and forest for the Environment Clearance for Bricks Industries (Minor Mineral)covering over an area of Khasra no.- 332 area, 3.28 Acre at village- Rewati Post- Rewati Tah. PratappurDist.- Surajpur (C.G.) . Along with Form No.- 1, We are submitting the pre- feasibility report and othertechnical detail of the project.Requesting you to kindly consider our case for the further progress of the abovementioned project.Thanking You,Yours Faithfully,Enclosed; as aboveForm no.- 1, Google map,Form B1, Form P II,Project ReportCopy of the Application Produced to Mining Office.Santoshi Gupta(Proprietor)