Preliminary Data Capture Form — Greenfield Projects

Bucephalus Ecovestments · Preliminary Data Capture — Greenfield Projects

Preliminary Data
Capture Form

Industrial Infrastructure Development · Site & Process Profile

🔒 Internal Document — Intended Purpose Only

Form No.

Date

ModeClient Self Submission

Empowering Industrial Growth Through Expertise and Precision

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Client Instructions: Please fill all sections to the best of available information.

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Confidentiality: This document is for internal use only and is not to be duplicated, circulated, or used for purposes other than those for which it was issued.

00 Project & Client Identification 🏷

Project Name / Company Name

MoU With Guidance Bureau

Yes No

Primary Contact Person

Designation

Phone

01 Land Details 🌍

Site Address

Village Name (optional)

Taluk Name (optional)

District Name

GPS Location (Google Maps Link)

Land Type

Leased Owned

Land Use Classification

Total Land / Project Area (Sqm)

02Project Value💰

Proposed Gross Fixed Assets — Land & Building (₹ Lakhs) ) If Leased Rental value over 20 years where applicable.

Proposed GFA — Plant & Machinery + Other Fixed Assets (₹ Lakhs)

03Power Requirements⚡

Temporary LT Power (kVA · construction & allied)

Permanent HT Power (kVA · operations)

Permanent Power Voltage

04Factory — Load, Manpower & Hazards🏭

Connected Load & Equipment

Total Load — Machinery + Amenities + Stand-by (HP)

Compressor Capacity / Count (Nos · if any)

Manpower (Construction Phase)

Total Employees (Construction)

Contractual Employees (Construction)

Inter-State Migrant Employees (Construction)

Manpower (Operations Phase)

Total Employees During Operation

Contractual Employees (If Any)

Inter-State Migrant Employees (Operations)

Hazardous Storage & Statutory Triggers

Storage of Hazardous Chemicals (MSIHC Rules)

Yes No

Name of Chemicals & Quantity

Storage / Transport of Petroleum Class B Products

Yes No

Product Name & Quantity

Storage of Explosives in the process as per Explosives Rules, 2008

Yes No

Storage Quantity (Kgs)

Storages of compressed gases other than non- flammable, non-toxic gases under rule 46(a) of SMPV(U) Rules, if any

Yes No

Gas Name & Storage Quantity

05Manufacturing Process & Statutory Profile⚗

Manufacturing Process / Activity Description

List of Raw Materials (with quantity)

List of Products Manufactured

EIA Category Applicability As per EIA Notification 2006 (and subsequent amendments).

Hazardous Process — Section 2(cb), Factories Act 1948

Dangerous Process — Rule 95, TN Factories Rules 1950

Total Water Requirement (Litres/Day)

Approved Water Source

07Supporting Documents Checklist📎

Tick the documents you can share alongside this form. Files are not uploaded here — our team will request them via email after your submission.

Manufacturing Process Flow Chart

Detailed process flow diagram with description of each stage.

Tentative Site Layout

Plant layout drawing showing machinery placement, utilities and circulation.

Other Remarks / Information