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/46325/2020   (ii). Name of Project for which Forest Land is required : “Construction of Approach Road for Proposed Hindustan Petroleum Retail Outlet on Patta No 228 Beechwal Sri Ganga Nagar Road NH-15(New NH-62, RHS)AT Bikaner WML (Between RSRTC Bus Stand & Kanasar By P   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : “Construction of Approach Road for Proposed Hindustan Petroleum Retail Outlet on Patta No 228 Beechwal Sri Ganga Nagar Road NH-15(New NH-62, RHS) Kms 8-9 , AT Bikaner WML (Between RSRTC Bus Stand & Kanasar By Pass Tiraha)Tehsil & District Bikaner, Rajasthan.”   (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.): 0.0457   (ix). Non-forest land required for this project(in ha.): 0.0715   (x). Total period for which the forest land is proposed to be diverted(in years): 20
A-2. Details of User Agency
  (i). Name : HINDUSTAN PETROLEUM CORPORATION LIMITED-JODHPUR   (ii). Address1 : HPCL ,BHAGAT KI KOTHI ,JODHPUR   (iii). Address2 : NIL   (iv). State : Rajasthan   (v). District : Jodhpur   (vi). Pin : 342005   (vii). Landmark : BHAGAT KI KOTHI   (viii). Email address : beechwalhpcl@gmail.com   (ix). Landline Telephone No. : 291-5131301   (x). Fax No. : 291-2747183   (xi). Mobile No. : 9610092999   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Central PSU
A-3. Details of Person Making Application
  (i). First Name: KRISHAN   (ii). Middle Name: NIL   (iii). Last Name: LAL   (iv). Gender: Male   (v). Designation: DyGeneralManager   (vi). Address 1: HPCL,BHAGAT KI KOTHI,JODHPUR   (vii). Address 2: NIL   (viii). State: Rajasthan   (ix). District: Jodhpur   (x). Tehsil: Jodhpur   (xi). Pin: 342005   (xii). Landmark: NIL   (xiii). Email Address: beechwalhpcl@gmail.com   (xiv). Landline Telephone No.: 291-5131301   (xv). Fax No.: 2912747183   (xvi). Mobile No.: 9610092999   (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/15449/2015F.1(101)FOREST/20150.10990.109917 Dec 201503 Mar 2016
Total 0.1099 0.1099
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.Bikaner Territorial0.04570.0715
Total0.04570.0715
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Bikaner0.04570.0715
Total0.04570.0715
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Beechwal0.04570.0715
Total 0.0457 0.0715
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Approach Road0.04570
2Retail Out let00.0715
Total 0.0457 0.0715
C. Maps of forest land proposed to be diverted
Division 1. : Bikaner Territorial
  (i). Area of forest land proposed to be diverted(in ha.) : 0.0457   (ii). Nature of the Project: Linear   (b). No. of Segments : One
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).
1.0.0457    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 RoW is declared as Protected Forest La
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 8   (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
2POWER OF ATORRNEY
3PWD NOC
4LAND DOCUMENTS
5PLOT SITE PLAN (Patta)
6CERTIFICATE FOR MINIMUM USE OF FOREST LAND CHECK LIST SERIAL NUMBER-11
7JUSTIFICATION FOR LOCATING THE PROJECT IN FOREST AREA
8UNDERTAKING FOR PAYMENT OF COST OF COMPENSATORY AFFORESTATION CHECK LIST SERIAL NUMBER-12
9UNDERTAKING FOR PAYMENT OF NET PRESENT VALUE OF FOREST AFFORESTATION CHECK LIST SERIAL NUMBER-13
10UNDERTAKING FOR CONSERVATION OF FLORA-FAUNA AND WILDLIFE ANIMALS DURING ROAD CONSTRUCTION
11UNDERTAKING FOR FRA CERTIFICATE
12UNDERTAKING FOR MUCK DISPOSAL DURING CONSTRUCTION OF ROAD
13UNDERTAKING FOR NO CHANGES IN STATUTORY POSITION OF DIVERTED FOREST LAND
14UNDERTAKING FOR USE OF ANY MATERIAL FROM SURROUNDED FOREST LAND DURING CONSTRUCT ROAD
15UNDERTAKING FOR WASTE MANAGEMENT DURING CONSTRUCTION ACTIVITY
16STATEMENT SHOWING DETAILS OF FOREST AREA PROPOSED FOR DIVERSION CHECK LIST SERIAL NUMBER-07
17STATEMENT SHOWING DETAILS OF NON FOREST AREA INVOLVED IN THE PROPOSAL CHECK LIST SERIAL NUMBER-08
18BAR CHART
19APPROVED LAYOUT PLAN
20EDS REPLY LETTER -25-06-2020
21PROJECT RE REPORT
22Details of Permanent Employment to be Generated
23EDS REPLY LETTER -25-06-2020
24PROJECT RE REPORT
25Details of Permanent Employment to be Generated
26Georeferenced SOI full Toposheet Map 50000 Scale
27Geo referenced Digital map With Coordinates
28Geo referenced Google imagery map With Coordinates
29EDS HP retailout let Beechwal Pillar Marking report-3-09-2020