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/UP/MIN/47074/2020   (ii). Name of Project for which Forest Land is required : The Mining Lease for Mines at village Kota and Padrach in Tehsil – Obra of Distt. Sonbhadra for Dalla Cement Works, Unit of UltraTech Cement Limited   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Proposed Diversion of Forest Land (331.475 ha) of Kajrahat (Dalla) Mining Lease at Village Kota and Padrach in Tehsil – Obra, District-Sonbhadra for Dalla Cement Works (UNIT OF ULTRATECH CEMENT LIMITED)   (iv). State : Uttar Pradesh   (v). Category of the Proposal : Mining   (vi). Shape of forest land proposed to be diverted : Non Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 150000   (viii). Area of forest land proposed for diversion(in ha.): 331.475   (ix). Non-forest land required for this project(in ha.): 309.316   (x). Total period for which the forest land is proposed to be diverted(in years): 10
A-2. Details of User Agency
  (i). Name : ULTRATECH CEMENT LIMITED - UNIT DALLA CEMENT WORKS   (ii). Address1 : UltraTech Cement Limited Dalla Cement Works   (iii). Address2 : SH 5 Post Dalla Distt. Sonbhadra   (iv). State : Uttar Pradesh   (v). District : Sonbhadra   (vi). Pin : 231207   (vii). Landmark : Near Dalla Cement Works   (viii). Email address : dallasuper@adityabirla.com   (ix). Landline Telephone No. : 5445-265778   (x). Fax No. : 5445-265802   (xi). Mobile No. : 9819300300   (xii). Website (if any) : www.ultratechcement.com   (xiii). Legal status of User Agency : Private
A-3. Details of Person Making Application
  (i). First Name: Rajendra   (ii). Middle Name: NIL   (iii). Last Name: Kabra   (iv). Gender: Male   (v). Designation: COO   (vi). Address 1: UltraTech Cement Limited unit dalla cement works   (vii). Address 2: SH 5 POST DALLA distt Sonbhadra   (viii). State: Uttar Pradesh   (ix). District: Sonbhadra   (x). Tehsil: Robertsganj   (xi). Pin: 231207   (xii). Landmark: NIL   (xiii). Email Address: dallasuper@adityabirla.com   (xiv). Landline Telephone No.: 5445-265778   (xv). Fax No.: 05445265801   (xvi). Mobile No.: 8007442255   (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
List of 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
NIL
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.Forest Division Obra331.475309.316
Total331.475309.316
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Sonbhadra331.475309.316
Total331.475309.316
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Padrach56.0988.928
2Kota275.377300.388
Total 331.475 309.316
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Mined out Area in the Lease211.51173.394
2Area under Utility services1.8917.777
3Area undisturbed/virgin118.073228.145
Total 331.475 309.316
C. Maps of forest land proposed to be diverted
Division 1. : Forest Division Obra
  (i). Area of forest land proposed to be diverted(in ha.) : 331.475   (ii). Nature of the Project: Non Linear   (a). No. of patches : One
Patch wise details
Patch No. Area of Patch(in ha.) Kml File of PatchesTo view KML file on google the same may be downloaded and then open if in google earth install in your computer.
1.331.475    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:
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 500   (iii). Temporary Employment(Number of person-days): 2000
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?: Yes   (a). Copy of Cost-Benefit analysis:
H. Status of Environmental Clearance
  (i). Whether the Project requires Clearance under the Environment (Protection) Act 1986 ? : Yes   (a). Status of the Environmental Clearance to the Project: EC obtained   (b). Environmental Clearance File No.: J-11011/560/2007-IA.II(I)   (c). Copy of Environmental Clearance to the Project:   (d). Date of grant of Environmental Clearance to the Project: 2008-29-09
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?: Yes   (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 ?: No   (iii). No. of districts involved for raising Compensatory Afforestation: 2   (iv). No. of patches: Three
District 1. : Chitrakoot
  (a). Village: KUSUMI, CHUREH KESARUVA   (b). Area(in ha.): 72.194   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 117 to 119, 126, 128, 132 in Kusumi, 1689 to 1698 in chureh   (e). Present owner: User Agency   (f). Copy of Ownership proof:
District 2. : Mirzapur
  (a). Village: PAUDI RAMPUR, BADAUHA, PARASIA MUDHPELI   (b). Area(in ha.): 60.541   (c). Copy of KML file of the patch:     View File   (d). Khasra details: PAUDI RAMPUR 474 Kha, BADAUHA 651, 561 Da, PARASIA MUDHPELI 4 chha, 686 Gha   (e). Present owner: User Agency   (f). Copy of Ownership proof:
District 3. : Mirzapur
  (a). Village: MANIKPUR, URUWA, RAIKARA, CHAK GAMBHIRA, SINDHORA   (b). Area(in ha.): 203.812   (c). Copy of KML file of the patch:     View File   (d). Khasra details: MANIKPUR 3 Chha, URUWA 78 Ya, RAIKARA 108 Tha, CHAK GAMBHIRA 114 Mi, SINDHORA 1007   (e). Present owner: User Agency   (f). Copy of Ownership proof:
  (v). Scanned copy of the map of the land identified for creation of Compensatory Afforestation prepared by using GPS ot Total Station:   (vi). Copy of Survey of India Toposheet in 1:50,000 scale indicating location of the land identified for creation of Compensatory Afforestation:
M. Mining Details
M-1. Details of Mineral Concessions
  (i). Whether the forest land is aquired under Coal Bearing Areas Act: No   (a). Reference number of Letter of Intent for grant of mining lease.(approval letter of the State Mines and Geology Department): 3704(1)/86-2007- 404/07   (b). Date of issue of the Letter of Intent(LOI) for grant of mining lease: 12 Dec 2007   (c). Copy the Letter of Intent(LOI):   (d). Total area of the mining lease(in ha.): 751   (e). Area of forest land located in the mining lease(in ha.): 331.475
M-2. Details of Mining Plan
  (i). Date of approval of mining plan: 31 Oct 2025   (ii). Approval authority: INDIAN BUREAU OF MINES, MINISTRY OF MINES, GOVT. OF INDIA   (iii). Copy of approval of mining plan:   (iv). Copy of approved mining plan:   (v). Nature of mining (underground/opencast): Opencast   (vi). Copy of the detailed land use plan in 1:4,000 scale prepared by using GPS or Total Station :   (vii). Copy of map of the outer boundary of mining lease area:     View file
M-3. Details of prospecting undertaken to assess mineral reserves
  (i). Whether detailed prospecting to assess mineral reserve in the lease has been undertaken: No
M-4. Details of extension (if any) of original prospecting licence issued in the past
  (i). Whether detailed prospecting to assess mineral reserve in the lease has been undertaken: No
M-5. Brief details of prospecting activities undertaken in the mining lease :
  (i). Detail of prospecting activity under taken in the mining lease: Prospecting activities have been undertaken by the User Agency to assess mineral reserve in the mine lease area
M-5.1 Details of bore holes drilled for prospecting :
Bore holes drilled for prospecting
S.no No. of Bore holes (in forest land) Diameters(in inch.) forest land No. of Bore holes (in non-forest land) Diameters(in inch.) non-forest land
1001041.875
M-5.2 Estimated Reserve along with accuracy and confidence level
Estimated Reserve along with accuracy and confidence level
Minerals Estimated Reserve
(million tones)
% accuracy (+ -) % confidence level Estimated Reserve
(million tones)
% accuracy (+ -) % confidence level
Limestone and Other Calcareous Materials217.510030.639595
M-6. Details of approval under the Forest (Consevation) Act,1980 obtained for undertaking prospecting activities in the forest land located in the mining lease
  (i).Whether approval under the Forest (Conservation) Act, 1980 for undertaking prospecting activities in the forest land located in the mining lease have been obtained No
Details of approval under the Forest(Consevation) Act,1980
S.no MoEF File No Date of approval Area of forest land diverted(in ha.) From Date To Date
NIL
M-7. Mineral wise details
  (i). No. of minerals: One
Mineral wise details
Minerals Estimated reserve in
non forest land(million tons.)
Estimated reserve
in forest land(million tons.)
Estimated annual
extraction(million tons.)
Estimated life
of mine(Yrs.)
Total estimated extraction during
mining lease period(million tons.)
Estimated mineral reserve
at the end of mining lease(million tons.)
Limestone and Other Calcareous Materials30.63217.5121240.59247.64
M-7.1 Proposed use of the minerals proposed to be raised from the mining lease
  (i). Proposed use of the minerals proposed to be raised from the mining lease: Captive   (a).Copy note containing details of the linked end-use Project:   (ii).Copy note containing details of the plan for the transportation of the minerals proposed to be raised from the mining lease:
Additional information Details
Documents
S.No Documents
Remarks
11 Approval of mining plan
22 Detailed note of the project
33 Justification For Locating The Project
44 SOI Map of Proposed Forest Land
55 DGPS Map of Proposed Forest Land
66 Land Use Map of Lease Area
77 Forest Gazette Notification
88 LOI of Mining Lease
99 Joint Survey Mines
1010 EC of the Mines
1111 NOC from DFO WL
1212 Whether the project is located in any protected area
1313 Kaimoor ESZ Gazette
1414 Joint Survey report ESZ
1515 Statement showing component wise area
1616 Statement showing forest land
1717 Statement showing non-forest area
1818 Cost Benifit Analysis
1919 FRA
2020 Muck Management Plan
2121 Mank Sarth
2222 Cert of undertaking for end use of product
2323 Cert of undertaking for extraction of material from forest land
2424 Cert of undertaking for NPV
2525 Cert of undertaking for plan for transportation of the mineral
2626 Certificate for minimum use of forest land
2727 Certificate of Lease Period
2828 Cert of undertaking for muck management
2929 Cert of undertaking FCA 1980
3030 Cert of undertaking for CA
3131 Undertaking for forest land
3232 Undertaking for no work
3333 Undertaking for payment of any other costs
3434 Undertaking for stone pillars
3535 Undertaking for Wildlife Mitigation plan
3636 CA Suitability and VIP letter by DFO Mirzapur
3737 VIP letter for CA land at Mirzapur District
3838 Cabinet Order for CA land at Mirzapur
3939 Land Document CA land Mirzapur
4040 VIP Letter Chureh Kesrua Chitrakoot
4141 VIP Letter Kusumi Chitrakoot
4242 CA Suitability Report Chureh Kesrua Chitrakoot
4343 CA Suitability Report Kusumi Chitrakoot
4444 Land Documents for CA Land Chitrakoot
4545 Khasra Maps of CA Land Chitrakoot
4646 Cost Estimation for CA land at Chureh Kesrua Chitrakoot
4747 Cost Estimation CA land Kusumi Chitrakoot
4848 Cost Estimation for CA land Mirzapur District
4949 CA Suitability and VIP by DFO Kaimoor
5050 Undertaking to Pay Lease Rent
5151 Undertaking for CAT Plan
5252 Details of CA Land
5353 Details of CA land and Site Suitability Certificate
5454 Forest and Non Forest Land Schedule
5555 Part 1
5656 Encumbrance Free Certificate of CA land Mirzapur District
5757 Khasra Map of Project
5858 Checklist of DFO
5959 Tree Enumeration List
6060 EDS Reply 10 March 2026 EMPTY
6161 HINDI PART 1
62Checklist as per FCA