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/148689/2021   (ii). Name of Project for which Forest Land is required : Construction of Approach Road for Proposed Indian Oil Corporation Ltd. Retail Outlet on Bikaner-Sri Ganganagar Road (NH-62) between KM Stone No. 189 - 190 (Chainage: 189.692 to 189.727) RHS in Kila No 9 & 10 Murbba No 11, at Village - 17 STB, Tehsil-Suratgarh, District - Sri Ganganagar, 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 Bikaner-Sri Ganganagar Road (NH-62) between KM Stone No. 189 - 190 (Chainage: 189.692 to 189.727) RHS in Kila No 9 & 10 Murbba No 11, at Village - 17 STB, Tehsil-Suratgarh, District - Sri Ganganagar, Raj.   (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.): 0.1817   (ix). Non-forest land required for this project(in ha.): 0.1225   (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 : ioclladekhan@gmail.com   (ix). Landline Telephone No. : 291-2711760   (x). Fax No. : 291-2710422   (xi). Mobile No. : 9828016413   (xii). Website (if any) : www.iocl.com   (xiii). Legal status of User Agency : Central PSU
A-3. Details of Person Making Application
  (i). First Name: Vinay   (ii). Middle Name: NIL   (iii). Last Name: Agarwal   (iv). Gender: Male   (v). Designation: Sr. Manager (Retail Sales)   (vi). Address 1: Marketing Division, Jodhpur Divisional Office,   (vii). Address 2: Sector-12, Chopasni Housing Board   (viii). State: Rajasthan   (ix). District: Jodhpur   (x). Tehsil: NIL   (xi). Pin: 342008   (xii). Landmark: NIL   (xiii). Email Address: iocl.anupgarh@gmail.com   (xiv). Landline Telephone No.: 291-2711760   (xv). Fax No.: 2912710422   (xvi). Mobile No.: 9414040239   (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/17391/2016F.1(38)Forest/20160.1050510.10505124 Oct 201629 Dec 2016
Total 0.105051 0.105051
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.Sriganganagar Territorial0.18170.1225
Total0.18170.1225
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Sri Ganganagar0.18170.1225
Total0.18170.1225
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
117 STB0.18170.1225
Total 0.1817 0.1225
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Left Hand Side (Deceleration Lane)0.07350
2Right Hand Side (Acceleration Lane)0.09870
3Front Side Service Road0.00950
4Retail Outlet Area00.1225
Total 0.1817 0.1225
C. Maps of forest land proposed to be diverted
Division 1. : Sriganganagar Territorial
  (i). Area of forest land proposed to be diverted(in ha.) : 0.1817   (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).
1.0.0735    View File
2.0.0987    View File
3.0.0095    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
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): 175
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
1CERTIFICATE FOR MINIMUM USE OF FOREST LAND.
2Details of Permanent Employment to be generated.
3UNDERTAKING FOR CHANGES IN STATUTORY POSITION OF DIVERTED FOREST LAND.
4UNDERTAKING FOR CONVERSION OF FLORA FAUNA DURING CONSTRUCTION OF FOREST AREA.
5UNDERTAKING FOR EXISTING RETAIL OUTLET.
6UNDERTAKING FOR HIGH TENSION LINE.
7UNDERTAKING FOR LP GAS GODOWN.
8UNDERTAKING FOR NO OTHER FEASIBLE ALTERNATIVE & DIVERSION OF MINIMUM FOREST LAND.
9UNDERTAKING FOR PAYMENT OF ANY OTHER COST & CONDITION.
10UNDERTAKING FOR PAYMENT OF COST OF COMPENSATORY AFFORESTATION.
11UNDERTAKING FOR PAYMENT OF NET PRESENT VALUE OF FOREST AREA.
12UNDERTAKING FOR SUBMISSION OF POLLUTION CONTROL BOARD NoC.
13UNDERTAKING FOR USE OF ANY MATERIAL FROM SURROUNDED FOREST LAND DURING CONSTRUCTION OF APPROACH ROAD.
14UNDERTAKING FOR USE OF FOREST LAND.
15UNDERTAKING FOR WASTE MANAGMENT DURING CONSTRUCTION ACTIVITY.
16Area Calculation Sheet.
17Khasra Map and Jamabandi.
18Land Conversion Letter.
19LOI Letter.
20Morth NOC.
21PROJECT REPORT.
22PWD NH Division NOC.
23Bar Chart Status.
24Georeferenced Digital Map.
25Georeferenced Full Toposheet Map 44G15.
26Georeferenced Toposheet Map 50000 scale.
27Approved Layout Plan.
28Layout Plan with Area Calculation.