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/Approach/154227/2022
(ii). Name of Project for which Forest Land is required :
“Construction of Approach Access for Proposed Hindustan Petroleum Corporation Retail Outlet on Shiv-Nimbla Road NH-68 (Old NH-15) LHS on Chainage 114+570.00 to 114+605.00 on Khasra No 822/506 At Village-Nimbla, Tehsil -Shiv & District – Barmer(Rajasthan)”
(iii). Short narrative of the proposal and Project/scheme for which the forest land is required :
“Construction of Approach Access for Proposed Hindustan Petroleum Corporation Retail Outlet on Shiv-Nimbla Road NH-68 (Old NH-15) LHS on Chainage 114+570.00 to 114+605.00 on Khasra No 822/506 At Village-Nimbla, Tehsil -Shiv & District – Barmer (Rajasthan)”
(iv). State :
Rajasthan
(v). Category of the Proposal :
Approach Access
(vi). Shape of forest land proposed to be diverted :
Linear
(vii). Estimated cost of the Project(Rupees in lacs) :
45
(viii). Area of forest land proposed for diversion(in ha.):
0.1801
(ix). Non-forest land required for this project(in ha.):
0.1639
(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 :
495/1, 2nd Floor, RPG Tower, University Road, Mangal Pandey Road, Meerut
(iii). Address2 :
NIL
(iv). State :
Uttar Pradesh
(v). District :
Bareilly
(vi). Pin :
250004
(vii). Landmark :
NIL
(viii). Email address :
nitins@hpcl.in
(ix). Landline Telephone No. :
0--
(x). Fax No. :
0-
(xi). Mobile No. :
9999578812
(xii). Website (if any) :
NIL
(xiii). Legal status of User Agency :
Central PSU
A-3.
Details of Person Making Application
(i). First Name:
Praveen
(ii). Middle Name:
NIL
(iii). Last Name:
Kumar
(iv). Gender:
Male
(v). Designation:
Sr Regional Manager Retail
(vi). Address 1:
HINDUSTAN PETROLEUM CORPORATION LIMITED, JODHPUR RETAIL REGION, BHAGAT KI KOTHI DIESEL SHED ROAD , JODHPUR
(vii). Address 2:
NIL
(viii). State:
Rajasthan
(ix). District:
Jodhpur
(x). Tehsil:
NIL
(xi). Pin:
342005
(xii). Landmark:
NIL
(xiii). Email Address:
vklic2018@gmail.com
(xiv). Landline Telephone No.:
0-
(xv). Fax No.:
NIL
(xvi). Mobile No.:
9910175615
(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
1
Approved
FP/RJ/ROAD/119308/2021
1(81)forest/2021
0.1718
0.1718
10 Nov 2021
18 Feb 2022
2
Approved
FP/RJ/ROAD/44368/2020
1(65)forest/2021
0.3127
0.3127
08 Oct 2021
11 Mar 2022
Total
0.4845
0.4845
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.
Barmer Territorial
0.1801
0.1639
Total
0.1801
0.1639
B-2.2
Details of Districts involved
District wise breakup
S.no
District Name
Forest Land(ha.)
Non-Forest Land(ha.)
1.
Barmer
0.1801
0.1639
Total
0.1801
0.1639
B-2.3
Village wise breakup
Villages wise breakup
S.no
Village
Forest Land(ha.)
Non-Forest Land(ha.)
1
Nimbla
0.1801
0.1639
Total
0.1801
0.1639
B-2.4
Component wise breakup
Component wise breakup
S.no
Component
Forest Land(ha.)
Non-Forest Land(ha.)
1
Deceleration Lane
0.0589
0.0207
2
Acceleration Lane
0.0837
0.0207
3
Front Side Service Road
0.0375
0
4
HPCL Retail Outlet Area
0
0.1225
Total
0.1801
0.1639
C.
Maps of forest land proposed to be diverted
Division 1. : Barmer Territorial
(i). Area of forest land proposed to be diverted(in ha.) :
0.1801
(ii). Nature of the Project:
Linear
(b). No. of Segments :
Three
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.
0.0589
View File
2.
0.0837
View File
3.
0.0375
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:
NH-68(Old NH-15) side land is declared as protecte
E.
Employment likely to be generated
(i). Whether the Project is likely to generate employment ?:
Yes
(ii). Permanent/Regular Employment(Number of persons):
9
(iii). Temporary Employment(Number of person-days):
150
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
1
LOI Letter
2
Authorization Letter
3
Morth Permission
4
Approved layout plan
5
Area Calculation Sheet
6
BAR CHART
7
CERTIFICATE FOR MINIMUM USE OF FOREST LAND
8
CERTIFICATE TOWARD MUCK DISPOSAL AND MANAGMENT PLAN
9
checkilst
10
Details of Permanent Employment to be Generated
11
Gram Panchayat Noc
12
JAMABANDI COPY
13
Khasra Map Patwri
14
JUSTIFICATION FOR LOCATING THE PROJECT IN FOREST AREA
15
Land Conversion order
16
PROJECT RE REPORT
17
STATEMENT SHOWING DETAILS OF FOREST AREA PROPOSED FOR DIVERSION
18
STATEMENT SHOWING DETAILS OF NON-FOREST AREA INVOLVED IN PROPOSAL
19
UNDERTAKING FOR CONSERVATION OF FLORA-FAUNA AND WILDLIFE ANIMALS DURING APPROACH ACCESS CONSTRUCTION
20
UNDERTAKING FOR FRA CERTIFICATE
21
UNDERTAKING FOR HIGH TENSION LINE
22
UNDERTAKING FOR LP GAS GODOWN
23
UNDERTAKING FOR MUCK DISPOSAL DURING CONSTRUCTION OF APPROACH ACCESS
24
UNDERTAKING FOR NO CHANGE’S IN STATUTORY POSITION OF DIVERTED FOREST LAND
25
UNDERTAKING FOR PAYMENT OF ANY OTHER COST AND CONDITION
26
UNDERTAKING FOR PAYMENT OF COST OF COMPENSATORY AFFORESTATION
27
UNDERTAKING FOR PAYMENT OF NET PRESENT VALUE OF FOREST AREA
28
UNDERTAKING FOR SITE SELECTION and DISTANCE BETWEEN RETAIL OUTLET ON EITHER SIDE
29
UNDERTAKING FOR USE OF ANY MATERIAL FROM SURROUNDED FOREST
30
UNDERTAKING FOR WASTE MANAGEMENT DURING CONSTRUCTION ACTIVITY
31
Map Showing Geo-Referenced for Survey of India Toposheet With Proposed Retail Outlet Full Toposheet No 40 N/8 Scale 1: 50000
32
Geo-Referenced DGPMS Required Land Coordinates with proposed Retail Outlet
33
Geo-Referenced Google Imagery Map with proposed Retail Outlet
34
Khasra Super Imposed for Retail out let
35
EDS Reply-22-04-2022
36
LEASE HPCL VINOD KUMARI
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