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/45878/2020   (ii). Name of Project for which Forest Land is required : Construction of Approach Road for Proposed Indian Oil Corporation Ltd. Retail Outlet on Jaisalmer to Barmer/Sanchor Road (NH-68) between KM Stone No. 120-121 (Chainage: 120.657 - 120.692) RHS in Khasra No. 13, At Village - Jasotaniyon ki Dhani, Tehsil - Barmer, District - Barmer, Raj   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Construction of Approach Road for Proposed Indian Oil Corporation Ltd. Retail Outlet on Jaisalmer to Barmer/Sanchor Road (NH-68) between KM Stone No. 120-121 (Chainage: 120.657 - 120.692) RHS in Khasra No. 13, At Village - Jasotaniyon ki Dhani, Tehsil - Barmer, District - Barmer, Raj   (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) : 45   (viii). Area of forest land proposed for diversion(in ha.): 0.1885   (ix). Non-forest land required for this project(in ha.): 0.1575   (x). Total period for which the forest land is proposed to be diverted(in years): 19.90
A-2. Details of User Agency
  (i). Name : Indian Oil Corporation Limited   (ii). Address1 : Marketing Division, jodhpur divisional office   (iii). Address2 : sector-12, chopasni housing board   (iv). State : Rajasthan   (v). District : Jodhpur   (vi). Pin : 342008   (vii). Landmark : NIL   (viii). Email address : iocljodhpuroffice@gmail.com   (ix). Landline Telephone No. : 291-2711760   (x). Fax No. : 291-   (xi). Mobile No. : 9024894212   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Central PSU
A-3. Details of Person Making Application
  (i). First Name: Shailendra   (ii). Middle Name: NIL   (iii). Last Name: Shrivastava   (iv). Gender: Male   (v). Designation: Manager   (vi). Address 1: Jodhpur divisional office   (vii). Address 2: Chopasni Housing Board   (viii). State: Rajasthan   (ix). District: Jodhpur   (x). Tehsil: NIL   (xi). Pin: 342008   (xii). Landmark: NIL   (xiii). Email Address: iocljodhpuroffice@gmail.com   (xiv). Landline Telephone No.: 291-2711760   (xv). Fax No.: NIL   (xvi). Mobile No.: 9024894212   (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/34460/20181(15)Forest/20190.1650.16527 May 201904 Nov 2019
Total 0.165 0.165
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 Territorial0.18850.1575
Total0.18850.1575
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Barmer0.18850.1575
Total0.18850.1575
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Jasotaniyon Ki Dhani0.18850.1575
Total 0.1885 0.1575
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Construction of Approach Road LHS0.0730
2Construction of Approach Road RHS0.10570
3Front Side Service Road0.00980
4Construction of Retail Outlet00.1575
Total 0.1885 0.1575
C. Maps of forest land proposed to be diverted
Division 1. : Barmer Territorial
  (i). Area of forest land proposed to be diverted(in ha.) : 0.1885   (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).
1.0.073    View File
2.0.1057    View File
3.0.0098    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 Road side RoW is declared as PF.
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): 250
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
1LOI Letter.
2Land Conversion Letter.
3NHAI NOC.
4Khasra map and Jamabandi.
5Approved Layout Plan.
6Project Report.
7Layout Plan with Area Calculation.
8Area Calculation Sheet.
9CERTIFICATE FOR MINIMUM USE OF FOREST LAND.
10Details of Permanent Employment to be generated.
11UNDERTAKING FOR CONSERVATION OF FLORA FAUNA DURING.
12UNDERTAKING FOR FRA CERTIFICATE.
13UNDERTAKING FOR HIGH TENSION LINE.
14UNDERTAKING FOR LP GAS GODOWN.
15UNDERTAKING FOR NO CHANGES IN STATUTORY POSITION OF DIVERTED FOREST LAND.
16UNDERTAKING FOR NO OTHER FEASIBLE ALTERNATIVE MINIMUM FOREST LAND.
17UNDERTAKING FOR PAYMENT OF ANY OTHER COST and CONDITION.
18UNDERTAKING FOR PAYMENT OF COST OF COMPENSATORY AFFORESTATION.
19UNDERTAKING FOR PAYMENT OF NET PRESENT VALUE OF FOREST AREA.
20UNDERTAKING FOR SUBMISSION OF POLLUTION CONTROL BOARD NOC.
21Undertaking for Use of Any Material From Forest Land During Construction.
22UNDERTAKING FOR USE OF FOREST LAND.
23Undertaking for Waste Management.
24Bar Chart Status.
25Geo Referenced Digital map with Coordinates.
26Geo Referenced Full Toposheet Map 50000 scale 40N8.
27Geo Referenced SOI Toposheet Map 50000 Scale.
28Existing Retail Outlet Certificate.
29EDS Reply Letter Dated 18_06_2021.
30Land Sahmti Patra.