P1: Debris Disposal Site Identification

P1: Identification of Debris Disposal Site

S No.	Project Details			Information
	Site Details
	Latitude		Alt. submit kml	Longitude
	Name of the Village			Block / Tehsil
	Depth of the site (m)			District
	Distance from Alignment (Km)			Side (LHS/RHS)
	Area of site (m²)			Current land use
	Ownership of the land (Owned / Leased)			Survey No.
	Photographs of the Site (Attach separately)			Note: Photograph must have date & time
	If leased, name, address and contact details of owner
	Distance from settlement (m)
	Distance from surface water body (m)
	Distance from Ecologically Sensitive Areas (m)
	Width of access road (m)
	No of trees with girth > 0.3m
	No of trees to be cut
	Is top soil conservation required (Yes/ No)
Notes (if any):
Submission Details		Submitted by: (Contractor)			Approved by: (AE/IE)
Signature
Date:
Name
Designation