FORM - A
Form for seeking prior approval of Central Government under section 2 of the Forest(Conservation) Act,1980 for Diversion of fresh forest area
PART - I
(To be filled up by User Agency)
A. General Details
A-1. Project Details
  (i). Proposal No. : FP/RJ/ROAD/38474/2019   (ii). Name of Project for which Forest Land is required : Construction of Approach Road for Proposed Hindustan petroleum Retail Outlet on Ganganagar -Bikaner NH-15(R.H.SIDE) ,Between Chainage ms stone 89/760 to 89/841.40,Lunkaransar-Malkisar at Village- Chak -2 BHM, Tehsil-Lunkaransar, District Bikaner   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Construction of Approach Road forProposed Hindustan petroleum Retail Outlet,on Ganganagar -Bikaner NH-15(R.H.S.) ,Between Chainage from ms stone 89/760 to 89/841.40,Lunkaransar-Malkisar at Village- Chak -2 BHM, Tehsil-Lunkaransar, District Bikaner   (iv). State : Rajasthan   (v). Category of the Proposal : Road   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 55   (viii). Area of forest land proposed for diversion(in ha.): 0.1276   (ix). Non-forest land required for this project(in ha.): 0.3639   (x). Total period for which the forest land is proposed to be diverted(in years): 19.99
A-2. Details of User Agency
  (i). Name : Hindustan Petroleum Corporation Limited   (ii). Address1 : JODHPUR RETAIL REGION, BHAGAT KI KOTHI,JODHPUR   (iii). Address2 : NIL   (iv). State : Rajasthan   (v). District : Jodhpur   (vi). Pin : 342005   (vii). Landmark : BHAGAT KI KOTHI   (viii). Email address : pariharsunny84@gmail.com   (ix). Landline Telephone No. : 291-5131301   (x). Fax No. : 291-2747183   (xi). Mobile No. : 9413011935   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Central PSU
A-3. Details of Person Making Application
  (i). First Name: SHALABH   (ii). Middle Name: RAJ   (iii). Last Name: GUPTA   (iv). Gender: Male   (v). Designation: CHIEFREGIONALMANAGER   (vi). Address 1: JODHPUR RETAIL REGION,BHAGAT KI KOTHI , JODHPUR   (vii). Address 2: NIL   (viii). State: Rajasthan   (ix). District: Jodhpur   (x). Tehsil: NIL   (xi). Pin: 342005   (xii). Landmark: BHAGAT KI KOTHI   (xiii). Email Address: pariharsunny84@gmail.com   (xiv). Landline Telephone No.: 291-5131301   (xv). Fax No.: NIL   (xvi). Mobile No.: 9413011935   (xvii). Copy of documents in support of the competence/authority of the person making this application to make application on behalf of the User Agency:
B. Details of land required for the Project
B-1. Details of proposal seeking prior approval of Central Government under the Act for diversion of forest land for the Project already submitted in the past
Proposal Submitted in Past
S.no Proposal Status. Proposal No. Moef File No. Area Proposed for Diversion(Ha.) Area Diverted(Ha.) Date of In-Principle Approval Date of Final Approval
1ApprovedFP/RJ/ROAD/29398/2017F.1(76)Forest/20170.05930.059301 Jan 201807 Feb 2018
2ApprovedFP/RJ/ROAD/25888/2017F.1(46)Forest/20170.14210.142109 Aug 201805 Mar 2019
Total 0.2014 0.2014
B-2. Details of forest land proposed to be diverted
B-2.1 Details of Divisions involved
Details of Divisions involved
S.no Division Name Forest Land(ha.) Non-Forest Land(ha.)
1.Bikaner Territorial0.12760.3639
Total0.12760.3639
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Bikaner0.12760.3639
Total0.12760.3639
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
12BHM0.12760.3639
Total 0.1276 0.3639
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1PROPOSED DECELERATION LANE (LHS)0.05310.0298
2PROPOSED ACCELERATION LANE (RHS)0.07450.0206
3HPCL RETAIL OUTLET PLOT AREA00.3135
Total 0.1276 0.3639
C. Maps of forest land proposed to be diverted
Division 1. : Bikaner Territorial
  (i). Area of forest land proposed to be diverted(in ha.) : 0.1276   (ii). Nature of the Project: Linear   (b). No. of Segments : Two
Segment wise details
Segments Segment Area(in ha.) Kml File of Segments
(To view KML file on google the same may be downloaded and then open if in google earth install in your computer).
1.0.0531    View File
2.0.0745    View File
  (iii). Copy of Survey of India Toposheet indicating boundary of forest land proposed to be diverted:   (iv). Scanned copy of the Geo-referenced map of the forest land proposed to be diverted prepared by using GPS or Total Station:
D. Justification for locating the Project in forest land and details of alternatives examined:
  (i). Copy of note containing justification for locating the Project in forest land:   (ii). Whether a copy of map indicating location of alternative examine is required to be provided: No   (a). Reason for not providing such map: Entire NH-15 Road Side Row is Declared as P.F.
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 5   (iii). Temporary Employment(Number of person-days): 350
F. Displacement of People due to the Project, if any
  (i). Whether Project involves displacement?: No
G. Details of Cost-Benefit analysis for the Project
  (i). Whether the Project requires Cost-Benefit analysis?: No
H. Status of Environmental Clearance
  (i). Whether the Project requires Clearance under the Environment (Protection) Act 1986 ? : No
I. Status of Wildelife Clearance
  (i). Whether the Project or a part thereof is located in any Protected Area or their Eco sensitive zone? : No
J. Applicability of special provisions governing Scheduled Areas
  (i).Whether the Project or a part thereof is located in a Scheduled Area? : No
K. Status of settlement of rights under the Forest Rights Act,2006 on the forest land proposed to be diverted
  (i). Whether the process for settlement of Rights under the Forest Rights Acts 2006 on the forest land proposed to be diverted has been completed? : Yes   (a). Copy of documentry evidence in support of settlement of rights under the Forest Rights Act,2006 on the forest land proposed to be diverted:
L. Details of land identified for Compensatory Afforestation
  (i). Whether non-forest or Revenue forest land is required to be provided by User Agency?: Not Applicable   (ii). Whether the area of non-forest land or Revenue forest land required to be provided by User Agency for raising Compensatory Afforestation is less than area of forest land proposed to be diverted ?: Not Applicable   (iii) . Reason for not providing Non-Forest Land: Not Applicable
Additional information Details
Documents
S.No Documents
Remarks
1AUTHORIZATION LETTER
2LOI LETTER
3APPROVED LAY OUT PLAN
4MORTH PERMISSION RELETED LETTER
5JAMABANDI AND KHASRA MAP.pdf
6GRAMPANCHYAT NOC.pdf
7JUSTIFICATION FOR LOCATING THE PROJECT IN FOREST AREA.pdf
8LAND CONVERSION DOCUMENTST.pdf
9UNDERTAKING FOR CONSERVATION OF FLORA-FAUNA AND WILDLIFE ANIMALS DURING ROAD CONSTRUCTION.pdf
10UNDERTAKING FOR FRA CERTIFICATE.pdf
11UNDERTAKING FOR MUCK DISPOSAL DURING CONSTRUCTION OF ROAD.pdf
12UNDERTAKING FOR NO CHANGE’S IN STATUTORY POSITION OF DIVERTED FOREST LAND.pdf
13UNDERTAKING FOR USE OF ANY MATERIAL FROM SURROUNDED FOREST LAND DURING CONSTRUCT ROAD.pdf
14UNDERTAKING FOR WASTE MANAGEMENT DURING CONSTRUCTION ACTIVITY.pdf
15Eds Reply letter by Hindustan Petroleum Retail outlet on Ganganagar- Bikaner .pdf
16EDS REPLY Hindustan Petroleum Retail outlet -22-08-2019
17BAR CHART.pdf
18AREA CALCULATION SHEET WITH LAYOUT
19CERTIFICATE FOR MINIMUM USE OF FOREST LAND
20UNDERTAKING FOR PAYMENT OF COST OF COMPENSATORY AFFORESTATION
21UNDERTAKING FOR PAYMENT OF NET PRESENT VALUE OF FOREST AREA
22LAND CONVERSION DOCUMENTS
23MAP SHOWING FOR GEO-REFERENCED SURVEY OF INDIA TOPOSHEET WITH FOREST LAND AND PROPOSED APPROACH ROAD ALIGNMENT OF HPCL OUT LET SCALE 1: 50.000
24DIGITAL MAP SHOWING FOR REQUIRED FOREST T LAND COORDINATE AND PROPOSED APPROACH ROAD ALIGNMENT OF HPCL OUT LET
25GOOGLE MAP SHOWING FOR FOREST T LAND COORDINATE AND PROPOSED APPROACH ROAD ALIGNMENT OF HPCL OUT LET
26EDS REPLY-20-07-2021
27CERTIFICATE TOWARD MUCK DISPOSAL MANAGMENT PLAN
28FIRE NOC
29FRA CERTIFICATE BY DISTRICT COLLECTOR
30GRAM PANCHAYAT NOC
31RAJASTHAN STATE POLLUTION CONTROL BOARD NOC
32REVISED STATMENT OF AREA IN INVOLEMENT FOREST AND NON FOREST