Fnvironmental: FORM-7 Application Clearance Ofthc Earlier
Fnvironmental: FORM-7 Application Clearance Ofthc Earlier
Pin code
e-mail
Tcl No.
Fax No.
of the Proj€ct/Activityll]r Schedute of EIA Notilicatior
Project / Acrivil)
[l(axi) / l(a)(ii) / l(b) / l(c) / t(d) / | (e) t 2(a) t 2(b) / 3(a) / 3(b\ / 4(a\ /
a(b)(i)/ a(b) (ii) / a(c) / 4(d) / 4(e) / 4(t) / 5(a:) t 5(b) / 5(c) / 5(d) / 5(e) / 5(0 /
5(s) / 5(h) / 5(i) / 5(1) / 6(ay 6(b)t 7 (a) t 7 (6)t 7 (c:) t 7 (d) t 1 (da) t 7 (e) / j (f)
/ 7 (f\ / 1 (h\ / 7 (i\ / 8 h\ / 8 (b\l
IfB or 82
Reason for application al Central Level / Stare level (in case ofB: proiects
lfOlhers
Please SDeci
Page 14 of 17
Details of Etrvironmental Clearance
Date of issue of Environmental Cleamnce
MoEf-&CC / SEIAA File No.
Upload EC lener {PDl-
Detoils of Cons€nt to Establishment
Whether Consent to tstabli:hmenl oblained { YesNo}?
I
hereby give undertaking that the data and inlormation given in the application and
ofmy knowlcdge and beliefand I am aware that ifany part of
enclosures are true to be best
the data and information found to be false or misleading at any stage,the project will be
rejectcd and cleamnce given,ifany to the project will be revoked at oul risk and cost. In
addition to above,l hereby give undertaking that no activity / construction / expansion has
since been talen
Nane
Designation
Company
Address
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