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/46675/2020   (ii). Name of Project for which Forest Land is required : Construction of Approach Road for Proposed Bio-Diesel Plant, on NH-62(Old-NH-15) Chainage No 209+621 to 209 +671(RHS)AT Chak 7 BLW,SQ No-55,Killa No 21-25 At Village- Kenchiya,Tehsil-Pilibanga , Dist   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Construction of Approach Road for Proposed Bio-Diesel Plant, on NH-62(Old-NH-15) Chainage No 209+621 to 209 +671(RHS)AT Chak 7 BLW,SQ No-55,Killa No 21-25 At Village- Kenchiya,Tehsil-Pilibanga , District Hanumnagarh (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) : 687   (viii). Area of forest land proposed for diversion(in ha.): 0.2239   (ix). Non-forest land required for this project(in ha.): 1.0561   (x). Total period for which the forest land is proposed to be diverted(in years): 20
A-2. Details of User Agency
  (i). Name : M/S JUGGLER HAWK INDUSTRIES PVT. LTD.   (ii). Address1 : 40/40 IIIrd BLOCK,NEW DHAN MANDI , SHRI GANGANAGAR,RAJASTHAN   (iii). Address2 : NIL   (iv). State : Rajasthan   (v). District : Sri Ganganagar   (vi). Pin : 335001   (vii). Landmark : DHAN MANDI   (viii). Email address : sushilgoyal955@gmail.com   (ix). Landline Telephone No. : 154-2483437   (x). Fax No. : 154-   (xi). Mobile No. : 9414964955   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Private
A-3. Details of Person Making Application
  (i). First Name: SUSHIL   (ii). Middle Name: KUMAR   (iii). Last Name: GOYAL   (iv). Gender: Male   (v). Designation: GENERALMANAGER   (vi). Address 1: 40/40 3rd BLOCK, NEW DHAN MANDI ,SHRI GANGANAGAR,RAJASTHAN   (vii). Address 2: NIL   (viii). State: Rajasthan   (ix). District: Sri Ganganagar   (x). Tehsil: Ganganagar   (xi). Pin: 335001   (xii). Landmark: DHAN MANDI   (xiii). Email Address: sushilgoyal955@gmail.com   (xiv). Landline Telephone No.: 154-2483437   (xv). Fax No.: NIL   (xvi). Mobile No.: 9414964955   (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.Hanumangarh Territorial0.22391.0561
Total0.22391.0561
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Hanumangarh0.22391.0561
Total0.22391.0561
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Chak -7 BLW (Kenchiya)0.22391.0561
Total 0.2239 1.0561
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Construction of Approach Road Deceleration Lane LH0.10270
2Front Side Service Road0.00810
3Construction of Proposed Bio-Diesel Plant01.0561
4Construction of Approach Road Acceleration Lane RH0.11310
Total 0.2239 1.0561
C. Maps of forest land proposed to be diverted
Division 1. : Hanumangarh Territorial
  (i). Area of forest land proposed to be diverted(in ha.) : 0.2239   (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).
1.0.1027    View File
2.0.1131    View File
3.0.0081    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: Along the Existing road
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 25   (iii). Temporary Employment(Number of person-days): 3500
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
1Authorisation letter
2COMPANY REGISTRATION JUGGLER_INDUSTRIES_CERTIFICATE OF INCORPORATION
3GRAM PANCHAYAT NOC
4JAMABANDI
5khasra Map
6LAND CONSVERSION DOCUMENT
7PROJECT COST
8PROJECT REPORT
9BAR CHART
10CERTIFICATE FOR MINIMUM USE OF FOREST LAND
11JUSTIFICATION FOR EMPLOYMENT
12JUSTIFICATION FOR LOCATING THE PROJECT IN FOREST AREA
13STATEMENT SHOWING DETAILS OF FORESTAREA PROPOSED FOR DIVERSION-final
14UNDERTAKING FOR CONSERVATION OF FLORA-FAUNA AND WILDLIFE ANIMALS DURING ROAD CONSTRUCTION
15UNDERTAKING FOR FRA CERTIFICATE
16UNDERTAKING FOR MUCK DISPOSAL DURING CONSTRUCTION OF ROAD
17UNDERTAKING FOR MUCK DISPOSAL DURING CONSTRUCTION OF ROAD
18UNDERTAKING FOR NO CHANGES IN STATUTORY POSITION OF DIVERTED
19UNDERTAKING FOR PAYMENT OF ANY OTHER COST & CONDITION
20UNDERTAKING FOR PAYMENT OF COST OF COMPENSATORY AFFORESTATION
21UNDERTAKING FOR PAYMENT OF NET PRESENT VALUE OF FOREST AREA
22UNDERTAKING FOR USE OF ANY MATERIAL FROM SURROUNDED FOREST LAND DURING CONSTRUCTION ROAD
23UNDERTAKING FOR WASTE MANAGEMENT DURING CONSTRUCTION ACTIVITY
24Full Toposheet Map 50000 scale H43N14
25Geo Referenced Digital map with Coordinates
26Geo Referenced Google Imagery map with Coordinates
27MORTH PERMISSION
28APPROVED LAYOUT PLAN NHAI
29EDS Juggler Hawk Industries -17-09-2020