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/Others/120617/2021   (ii). Name of Project for which Forest Land is required : City Gas Distribution Pipeline Project of 9 KM in Bulandshahr District   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : The project involves underground laying of natural gas pipeline in ROW of existing roads from CH 58 to CH 67 City gas Distribution Project of 9 KM in Bulandshahr District authorized by PNGRB and as per notification reference number F.NO. 11-09/98/FC Dated 07.11.2014 issued by MoEF&CC (Forest Conser   (iv). State : Uttar Pradesh   (v). Category of the Proposal : Others   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 840   (viii). Area of forest land proposed for diversion(in ha.): 0.45   (ix). Non-forest land required for this project(in ha.): 0   (x). Total period for which the forest land is proposed to be diverted(in years): 50
A-2. Details of User Agency
  (i). Name : INDIANOIL ADANI GAS PVT LTD   (ii). Address1 : 2nd Floor SK & Company,Shikarpur Bypass Road,Bulandshahr   (iii). Address2 : NIL   (iv). State : Uttar Pradesh   (v). District : Bulandshahr   (vi). Pin : 203001   (vii). Landmark : Near Kali nadi   (viii). Email address : abhisar.agarwal@ioagpl.com   (ix). Landline Telephone No. : 11-26944203   (x). Fax No. : 11-   (xi). Mobile No. : 8929766295   (xii). Website (if any) : www.ioagpl.com   (xiii). Legal status of User Agency : Private
A-3. Details of Person Making Application
  (i). First Name: Tushar   (ii). Middle Name: NIL   (iii). Last Name: Agrawal   (iv). Gender: Male   (v). Designation: Deputy Manager   (vi). Address 1: 2nd Floor, SK Company, Shikarpur Bypass road Bulandshahr   (vii). Address 2: NIL   (viii). State: Uttar Pradesh   (ix). District: Bulandshahr   (x). Tehsil: Bulandshahr   (xi). Pin: 203001   (xii). Landmark: Near kali nadi   (xiii). Email Address: tushar.agrawal@ioagpl.com   (xiv). Landline Telephone No.: 11-26944203   (xv). Fax No.: NIL   (xvi). Mobile No.: 9999180968   (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.Social Forestry Division Bulandshahar0.450
Total0.450
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Bulandshahr0.450
Total0.450
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Adhauli0.0480
2Chanderu0.1260
3Bilsuri0.1260
4Lalpur0.0780
5Junedpur0.0640
6Sukhlalpur0.0080
Total 0.45 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1City Gas Distribution Pipeline Project0.450
Total 0.45 0
C. Maps of forest land proposed to be diverted
Division 1. : Social Forestry Division Bulandshahar
  (i). Area of forest land proposed to be diverted(in ha.) : 0.45   (ii). Nature of the Project: Linear   (b). No. of Segments : Twelve
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).
1.0.046    View File
2.0.07    View File
3.0.0006    View File
4.0.054    View File
5.0.0015    View File
6.0.051    View File
7.0.0135    View File
8.0.07    View File
9.0.0175    View File
10.0.014    View File
11.0.0659    View File
12.0.046    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: No other feasible land to connect Sikandrabad.
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 175   (iii). Temporary Employment(Number of person-days): 21000
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? : No
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
1Letter of Authorization from PNGRB
2Area Calculation Sheet
3Brief Summary of Project
4NHAI Permission
5Justification for locating the project in Forest Area
6Certificate for Minimum use of Forest Land
7Undertaking for Payment of use of Compensatory Afforestation
8Undertaking for Payment of Net Present Value of Forest area
9Undertaking for Payment of Additional Net Present Value of Forest area
10Typical Trench Cross-section
11Gross Capital Investment Detail
12Letter Received from Ministry of Forest for giving general permission to CNG/PNG Gas Pipeline
13Clarification regarding guidelines for diversion of forest land for non-forest purpose as per the general approval , under Section-2 of the Forest (Conservation) Act, 1980, for laying of underground CNG/PNG and Slurry pipelines-reg.
14Muck Disposal Certificate
15Gazette of India for Protected Forest along highways in Bulandshahr District
16Undertaking for work not started
17Uttar Pradesh Govt Forest Conditions
18Acknowledgement slip