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Annex A.

12

Project Environmental Impact Report

1. DETAILS OF THE PROJECT

Project Title:

Priority axis:

Specific Objective:

Locationfor the implementation of the project: (county/district, town)

Project Lead Partner:

2. PROJECT IMPACT ON THE ENVIRONMENT

Yes No Details
Biodiversity The project includes
operations with impact on the
Natura 2000 protected areas?

If yes, please specify if the


impact is positive or negative
and mention the surface within
the respective Natura 2000
protected area which could be
affected.
The project is focused on
implementing management
plans?

If yes, please specify the number


of management plans which
implementation is pursued by
the project. If the project
pursues to implement only a part
from a management plan, please
specify it.
The project includes
operations which have impact
on the air quality?

If yes, please specify if the


impact is positive or negative.

The project includes


Air
operations with impact on the
level of the greenhouse gas
emissions (CO2 and
equivalents)?

If yes, please specify if the


impact is positive or negative.

Cultural The project includes


heritage operations with impact on the
cultural heritage ?
The project includes
operations with impact on the
landscape ?
Landscape
If yes, please specify if the
impact is positive or negative.

The project includes


Energy operations with impact on the
efficiency reduction of the energy
consumption?
The project includes
operations which have as
Transport effect a transition from the
land to water transport ?
The project includes
operations that envisage the
transport infrastructure
development?
If yes, and if it is the case of a
new road construction, please
specify the land area on which
the transport infrastructure is
constructed.
The project includes
operations that envisage the
development of the river
transport infrastructure ?
The project includes
operations that envisage the
river banks reahabilitation?
Soil
If yes, please specify the length
of the rehabilitated banks.

The project includes


operations that envisage
reduction of the areas
affected by flooding ?
Protection If yes, please specify,
against approximately, the protected
flooding surface as a consequence of the
project implementation (in km2)
and the persons number that
benefit of the implementation of
the measures against flooding.

3. GENERAL ASPECTS

- The project is mainly focussed on the environment protection?

YES NO

- Generaly, the project impact on the environment is:

Positive Neutral Potential Negative ?

4. OTHER ASPECTS

In case you have other maters to specify concerning project impact on the
environment, please include them here.
Legal representative signature

[Name and surname]


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