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Signature over Printed Name
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Date
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Republic of the Philippines
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
Environmental Management Bureau
Visayas Avenue, Quezon City
November 2011
EIA DRR/CCA TECHNICAL GUIDELINES
Table of Contents
Acronyms & Abbreviations iii
Acknowledgement v
Memorandum Circular #005 vi
A. INTRODUCTION 1
1. Context/Rationale 1
2. Objectives of the Guidelines 2
3. Scope of the Guidelines 3
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ANNEXES
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Acknowledgement
The development and printing of this manual was made possible with the support and assistance of the
United Nations Development Programme (UNDP) and the National Economic and Development Authority
(NEDA), through the Millennium Development Goals Fund (MDGF-1656) Joint Programme on
Strengthening the Philippines Institutional Capacity to Adapt to Climate Change.
The formulation of the guidelines was made possible under the leadership, support and encouragement
of:
This is also to acknowledge the active participation of the various stakeholders especially during the
series of consultations. Recognition is also extended for the technical inputs provided by the following:
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A. INTRODUCTION
It is the policy of the State that optimum economic development shall be achieved without delay but shall
be pursued ensuring that the present generation meets its needs without compromising the needs of the
future generations. This is consistent with the principles of sustainable development. The Philippine
Environmental Impact Statement System (PEISS) established under Presidential Decree 1586 in 1978
provides a systems-oriented integrated approach in the analysis and management of environmental
concerns vis--vis the national development program. It requires a proponent to conduct an
Environmental Impact Assessment (EIA) and secure an Environmental Compliance Certificate (ECC)
prior to implementation of development projects classified as environmentally critical or those that are
proposed to be located in environmentally critical areas (ECAs).
As a planning and decision-making tool, the essential purpose of the EIA process is to improve decision
making and to ensure that project options under consideration are environmentally sound and
sustainable (World Bank, 1999). However, conventional EIA does not include natural hazards and
climate change projections as considerations either as factors in assessing the impact of the project on
the environment, or with respect to the impact of the environment on the project. Considering the
disastrous effects of natural hazards and the potential aggravating effects of climate change, it is
essential that the EIA cover natural hazards and related risks as well as the anticipated rise in the
frequency and intensity of climatological hazards associated with climate change.
1. Context/Rationale
The Philippines is one of the countries in the world that is prone to natural hazards. Deaths from natural
disasters in the 1990 decade and in 2000-2006 have increased compared with the 1980 decade levels. A
significant number of deaths are caused by typhoons. The National Disaster Coordinating Council
(NDCC) has estimated that during the period 1970-2002, an average of 500 deaths was recorded each
year due to typhoons and tropical cyclones. The high number of deaths in the 90s was mainly due to the
1990 earthquake that struck Luzon and the 1991 Mt. Pinatubo eruption wherein lives lost numbered about
2,000 and 6,200, respectively. The NDCC recorded a total number of 36,019 deaths caused by natural
disasters from 1980 to 2006. 1
In economic terms, the average cost of direct damage from natural disasters from 1970 to 2006 is
estimated at PhP15 billion at 2000 prices. Direct damage covers damage to agricultural crops, public
infrastructure and private homes. Damage was highest at about PhP70 billion in 1978 when 15 disasters
struck the country. Other major disasters with high direct damage were the Luzon earthquake in 1990
(about PhP66 billion), the Mt. Pinatubo eruption in 1991 (about PhP33 billion) and the droughts in 1984
and 1987. As a result, the declines in gross domestic product (GDP) were estimated at: a) 1.2 percent
due to the 1990 Luzon earthquake; b) 0.9 percent due to the Pinatubo eruption; and, c) 0.5 percent
average due to typhoons every year. 2
Compounding this vulnerability to natural hazards are the perceived effects of climate change. According
to the Fourth Assessment Report (Working Group 1) of the Inter-governmental Panel on Climate Change
(IPCC), the warming of the climate system is deemed unequivocal, as it is now evident from observations
of increases in global average air and ocean temperatures, widespread melting of snow and ice, and
rising global average sea level. 3
th
As global climate change escalates, the risk of floods, droughts and severe storms increases. In its 4
Assessment Report, the IPCC projects that rising global temperature will cause increasing
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NEDA-UNDP-EU, Guidelines on Mainstreaming Risk Reduction in Sub-national Development and land use/physical planning in the Philippines
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NEDA-UNDP-EU, Guidelines on Mainstreaming Risk Reduction in Sub-national Development and land use/physical planning in the Philippines
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Inter-governmental Panel on Climate Change (IPCC). Fourth Assessment Report: Climate Change 2007 (The Physical Science Basis)
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drought in mid-latitudes and semi-arid latitudes, increased water stress in many parts of the world,
increased damage from storms, and coastal flooding affecting millions more people each year.
The IPCC also concludes in the report of Working Group II that there are documented associations
between changes in temperature and observations of changes in physical and biological systems in the
aquatic, terrestrial and marine environments. These are environmental receptors that are typically
covered in EIAs. As such, it is imperative for the EIA to not only focus on possible environmental
degradation but to also ensure that the disaster- and climate-related consequences of potential projects
are carefully spelled out as part of the assessment process and taken into account in project design. For
instance, clearing mangroves to make way for prawn farming or tourism development may generate
substantial livelihood opportunities, but it also increases exposure to storm surges and tsunamis.
To ensure that natural hazard- and climate-related factors are incorporated in the EIA, the following need
to be observed:
Natural hazards, climate change and related risks should be considered as a fundamental first
step in broader project scoping and the findings should be used to determine if disaster and/or
climate change risks should be examined in further detail in other components of the project
appraisal process.
Systematic analysis of the potential disaster/climate risk-related consequences of a project via its
impact on the environment should be included as a central component of the assessment
process, especially in hazard-prone areas.
Measures to address identified environmental issues, including disaster risk reduction/climate
change adaptation (DRR/CCA) concerns should be formulated for incorporation in the final
design and implementation of the project.
The EIA DRR/CCA Technical Guidelines is intended to promote climate change adaptation and disaster
risk reduction at the project level, as well as to streamline EIA requirements under the PEISS as provided
for in DENR Memorandum Circular (MC) 2010-14. Specifically, the Guidelines aim to:
Provide enhanced standards for the preparation of EIA Reports that are customized for
specific industry types as required under the PEISS; and
Provide guidance for project proponents in integrating DRR and CCA concerns in the project
planning stage through the EIA Process to facilitate review and implementation of projects by
incorporating international best practices.
These Guidelines were formulated to provide EIA practitioners and stakeholders with:
an understanding of the implications of disaster and climate change risks in relation to the
preparation of an EIA Report;
direction on a project-specific basis on how disaster risks and climate change need to be
considered in an EIA;
sources of information for use in assessing disaster risks and climate change implications, and
guidance in incorporating DRR and CCA considerations into the EIA process.
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These Guidelines, including the annexes, shall be collectively known as the Environmental Impact
Assessment (EIA) Technical Guidelines for Incorporating Disaster Risk Reduction (DRR) and
Climate Change Adaptation (CCA) concerns in the Philippine EIS System (EIA DRR/CCA Technical
Guidelines).
This shall serve as the guidance document for the conduct of EIA and preparation of EIA Reports (i.e.,
EIS) required for ECC applications under the PEISS. The EIA is enhanced as a risk-based planning tool
to integrate DRR and CCA concerns in the project design and implementation. The Guidelines cover the
EIA requirement for both Environmentally Critical Projects (ECPs) and Non-ECPs located in
Environmentally Critical Areas (ECAs) as defined under Presidential Proclamation 2146 and the existing
implementing rules and regulations. Following are the components of the Guidelines:
General guidance document which provides the conceptual framework for Mainstreaming
DRR/CCA in EIA
Procedures on the use of the DRR/CCA-enhanced EIS Screening Forms
Procedures on the use of the DRR/CCA-enhanced Initial Environmental Examination (IEE)
Checklist Report Forms
The EIA is a comprehensive and systematic process under the PEISS designed to identify, analyze and
evaluate the environmental effects of proposed projects. As a process, it is intended to:
Projects covered by the PEISS are defined in the Revised Procedural Manual for DENR Administrative
Order (DAO) 2003-30. Heavy industries, resource extractive industries, infrastructure projects and golf
course projects are considered as ECPs that are covered under the PEISS. Also covered are projects
located in ECAs such as: areas declared by law as national parks, watershed reserves, wildlife preserves,
sanctuaries; areas set aside as aesthetic potential tourist spots; areas which are traditionally occupied by
cultural communities or tribes; areas frequently visited and/or hard-hit by natural calamities (geologic
hazards, floods, typhoons, volcanic activity, etc.); and, areas with critical slopes, among others. Details on
coverage and thresholds are contained in the RPM.
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The EIA process in the Philippines consists of seven (7) steps presented in brief below. Each step is
equally important in determining the overall environmental performance of the project:
1. Screening. This first step in the EIA process serves to determine whether a proposed project is
covered under the PEISS and, if covered, the level of assessment required.
2) Scoping. This step identifies the key issues and corresponding impact that should be the focus
of the EIA. This stage also defines the spatial boundary and time limit of the study.
3) Impact analysis. This step includes gathering of baseline information as well as identification
and prediction of the likely environmental and social impact of the proposed project and the
evaluation of its significance.
4) Mitigation. This step involves the formulation of recommended actions to reduce and avoid
the potential adverse environmental consequences of development activities.
5) Reporting. At this stage, the results of the EIA in the form of a report (i.e., EIA report) is
prepared for submission to the EMB.
6) Review of EIA/Project Appraisal. Here, the EMB examines the adequacy and appropriateness
of the EIA report. The EMB also ensures that information necessary for decision-making is
contained in the EIA report.
7) Project Implementation and Monitoring. At this stage, the project is commissioned. The
Project Monitoring and Evaluation (M&E) system is designed to ensure that the actual impact of
the project does not exceed the legal standards, and implementation of the mitigation
measures are consistent with those in the EIA report.
The DRR/CCA-enhanced EIA is a tool for ensuring that future developments (e.g., projects) are resilient
and that their environmental impact does not exacerbate natural hazards or climate changes effects on
human or natural systems. It should also be noted that the integration of DRR and CCA considerations
into the EIA process requires no change to the essential steps or sequence of the EIA process itself.
In the initial project definition and description, there is a need to determine if natural hazards and climate
change are likely to be potential considerations in the EIA process. Factors influencing this decision
include:
At this stage, the principles of precautionary approach should be applied in incorporating DRR/CCA into
the EIA process. The precautionary approach recognizes that the absence of full scientific certainty
should not be used as a reason to postpone decisions where there is a risk of serious or irreversible
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harm, and that precautionary measures should be taken even if some cause and effect relationships are
not fully established scientifically.
Project Screening
Screening of projects for coverage and EIA Requirement under the PEISS involves the consideration of
the project type (i.e., ECP) and thresholds, as well as its location in Environmentally Critical Areas
(ECAs).
Conceptually, projects would undergo additional screening by determining if their environmental impact
are highly likely to contribute to increased vulnerability to natural hazards and climate change. This
impact would be site-specific, typically reversible and, in most cases, risk reduction/mitigation measures
could easily be incorporated in the EMP/EMoP.
Under the EIA DRR/CCA Technical Guidelines, the screening process will be strengthened with the use
of hazard maps generated by mandated agencies (e.g., PHIVOLCS, MGB) and funded projects (e.g.,
READY Project). The screening process is further refined with the use of the climate change projections
generated by PAGASA.
Project Scoping
This stage of the process is critical as it defines the scope of the EIA to be required. EIA reports should, in
general, present detailed information concerning the nature, scope, setting (legal, financial, institutional)
and timing for the proposed project or activity. The level of information that may be required shall be
within what is relevant and available at the Feasibility Study Stage specific detailed engineering design
shall not be required. The project description to be submitted for purposes of scoping should contain
sufficient information to frame the scope of the EIA investigation so that time and resources are focused
on relevant issues.
It is important to note that scoping simply indicates whether or not there are concerns that need to be
addressed. It does not determine the extent of an effect, or whether an effect will actually occur. Public
concern raised at a meeting is sufficient at this stage to flag an issue as important enough to be included
in the scoping task. It is at this stage that scoping must also determine whether natural hazards and/or
climate change is/are relevant and should be included in the EIA whether in relation to potential
changes to the environment, or in consideration of the effects of the environment on the project.
Scoping must consider both natural hazards and climate change in relation to:
Project design criteria current project design criteria and code-related issues (i.e., regulatory
requirements such as safety, structural) must be reviewed and justified with respect to predicted
climatic changes and to the physical environment over the life span of the project. If
necessary, the project design criteria must be amended appropriately and/or modified design
factors must be applied to the project.
Ecological, socio-economic and physical factors possible changes and/or additions to
critical environmental receptors to be studied (e.g., health and safety, or pathways) due to
natural hazards and/or climate changes over the life- span of the project must be determined
and incorporated into the EIA process. This also includes possible physical environmental
factors that might affect the project.
Note that the integration of natural hazards and climate change into the EIA process should not
necessarily require modification of existing regulatory requirements, best practices or performance
standards, which would be outside of the scope of an EIA. In addition, it is important not to shift liability or
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introduce unreasonable costs into the EIA process. However, it is important to consider, for example, the
effects of natural hazards and the implications of the frequency and intensity of climatic extremes, and
their effects on both the project and its potentially modified impact on the environment.
Under the EIA DRR/CCA Technical Guidelines, scoping would ensure that description of the
project/activity includes the identification of environmental or social issues of concern as well as any
natural hazards and climate change vulnerabilities at the project level. One potential mode of integration
is the assessment of issues, especially with regards to the historical and projected occurrence of tropical
cyclones and other extreme climate events in the proposed project location that may affect project design,
construction, implementation or abandonment.
Examples of integration schemes for disaster and climate change risk are as follows (especially for
projects located in hazard-prone areas):
Energy impact of hydropower projects on natural water flow and flooding patterns.
Transport impact of road construction and associated infrastructure on drainage systems and
flooding patterns.
Urban development impact of development on the capacity of services and utilities to
prevent increased risk of flooding as could occur if, say, drainage systems are inadequate or
garbage collection services are limited, resulting in dumping of garbage in drainage systems or
waterways.
Mining implications for droughts and floods from impact of mining operations on level of
groundwater.
Agriculture impact on soil erosion and consequences in terms of levels of water retention,
downstream siltation and flooding; resilience of proposed projects in the event of rainfall
excesses or deficits.
Fisheries consequences of clearance of mangroves and other vegetation.
Forestry risk reduction benefits of forestry projects (e.g., in providing protection against
windstorms, landslides or tsunamis, and reducing the risk of flash flooding).
Impact Analysis
In general, the EIA process requires a detailed identification of significant impact. Determining whether an
impact is significant is a critical step in an EIA, and it is necessary to identify the criteria on which this
decision is based.
Traditional EIA typically views the environment in its current state, usually based on a seasonal analysis
of conditions (e.g., wet and dry seasons). The existing status of each environmental receptor is
characterized, and project activities are then analyzed vis--vis the existing environment to determine the
impact.
Incorporating natural hazards and climate change impact requires a paradigm shift from this perspective,
as the existing environment can no longer be viewed as a constant and separate from project effects. In
fact, a specific analysis of the potential changes associated with natural hazards and/or climate change
will be required before the impact of project activities can be isolated and assessed. The essence of the
EIA process does not change. Effects on the environment with and without the project are still
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determined, and the existing definitions of significance should be used to evaluate the impact of the
project after climate change considerations have been integrated.
The EIA, being ideally conducted at the project planning stage, has a lot of uncertainties, thus the need to
consider options and alternatives. The analysis of environmental impact shall consider range of
assumptions on production capacity, areas of development, process technologies, emissions, discharges
and other wastes. Under the DRR/CCA-enhanced guidelines, the PAGASA climate projections for 2020
and 2050 in the province where the project is to be located should be integrated into the project impact
analysis. Examination of the consequences of climate variability and changes, as well as the
effectiveness, costs and feasibility of adaptations that can reduce vulnerability at the project level shall
also be included in the impact analysis.
Ideally, the EIA shall consider the potential effects of the project (during construction, operation and, if
relevant, decommissioning) on the frequency, intensity and consequences of significant natural hazards
and the impact of these hazards, in turn, on the project. The assessment should take into account
relevant natural hazards and climate change concerns (e.g., how a rise in sea level might affect storm
surges, or how changes in precipitation might affect drought and flooding). In some cases, findings of
mathematical and computer-based hazard modeling exercises in the project area (for instance,
modeling of earthquake, flood or windstorm) should be used. Such exercises, if not available, should be
undertaken for large projects in high-risk areas.
On the other hand, the EIA process provides an excellent means to ensure that environmental effects on
the project are considered and factored into project decision-making. Possible adverse effects of the
environment (in terms of natural hazards and/or climate change) on the project may include:
Potential effects of the environment on the design criteria shall be the primary concern of the project.
Decisions on the project design criteria must be made in the context of the climate change projections
over the lifespan of the project. Detailed analysis may not necessarily be done during this assessment,
but the source of climate predictions and their specific magnitude must be described along with the
rationale for accepting the design criteria. Overall, any adverse impact of extreme climate events on the
project should be identified and the likelihood of their occurrence, specified.
These assessments will help to determine if these effects are significant. If potential effects are deemed
significant, appropriate management, mitigation and adaptation options must be identified. Furthermore,
if it has been determined that a project is highly affected by climate change, a project-level climate
change adaptation program should also be developed to address significant impact and define project
adaptation measures.
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For projects where the IEE Checklist Report Form would suffice, pre-identified
baseline data and impact analysis requirements as well as DRR/CCA options
are provided for particular project types to be filled-up/accomplished.
Detailed guidance on the use of the forms is provided in other sections of the EIA
DRR/CCA Technical Guidelines.
The impact mitigation section of the EIA report should consider the reduction or elimination of residual
impact remaining after standard measures (such as installation of pollution control devices and erosion
control techniques) have been applied. Note that standard mitigation through best management practices
is typically an integral part of the project design.
Measures associated with disaster risk reduction and climate change will normally fall within this category
and may include a range appropriate to the project and its setting. Mitigation, including any DRR/CCA
measures, should remain focused on reduction or elimination of significant impact of the project on the
environment, as well as the effects of the disaster and climate change risk projections on the project.
As a process, the EIA is primarily used to identify potentially significant impact and formulate measures to
reduce the impact to acceptable levels. The results of the process are documented in an environmental
impact statement (EIS). The EIS is prepared to convey the results of the various analyses conducted
during the EIA, as well as to incorporate the management, mitigation and adaptation measures necessary
to address natural hazard/climate change vulnerabilities and risks identified. The EIS should also be
used to ensure that the program for monitoring project implementation and impact includes the
assessment of effectiveness of these measures.
The nature, quality and quantity of data, impact assessment and management measures presented in the
EIS shall include those that will be most useful and critical in the integration of environmental, social,
climate and disaster risk reduction concerns during the preparation and finalization of the proponents
feasibility study and subsequent activities of the project, such as detailed engineering design,
construction, operation and decommissioning/ abandonment.
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For projects where the IEE Checklist Report Form would suffice, the duly
accomplished/completed form w i l l serve as the EIA Report for the proposed
project.
Detailed guidance on the use of the forms is provided in other sections of this
EIA DRR/CCA Technical Guidelines.
Review Process
Clarity. The EIS document is intended to communicate the results of the EIA to a wide range of
stakeholders, including regulators, evaluators from various disciplines and professions, decision
makers, affected communities, and the general public. It should therefore be written in a way
that is easily understood.
Balance. There are many ways by which balance can be gauged. An EIS document is
considered balanced if it is devoid of bias in the presentation and analysis of data. It is not
supposed to provide justifications for pre-conceived conclusions in favor of any interest group.
Moreover, the EIS document should demonstrate a balanced treatment of descriptive and
analytical discussion. Facts or data and their meaning or interpretation should be presented in
tandem; one without the other will not withstand scientific scrutiny.
Accuracy and Precision. These are universal criteria that need to be satisfied through
scientific inquiry or investigation. All analytical data presented in the EIS should satisfy the
prescribed levels of accuracy and precision as derived from established statistical tools and
methods. Furthermore, all the baseline characterization methods (e.g., sampling, survey,
testing procedures), as well as impact prediction tools and techniques (e.g., modeling
techniques, field tests, laboratory experiments) used in the EIA study will be scrutinized not only
for statistical, but also for scientific soundness.
Under the EIA DRR/CCA Technical Guidelines, the integration of DRR/CCA into the review process will
also ensure that:
All potentially significant environmental impact have been identified and analyzed, and both the
climate change projections and the hazard potential in the proposed project location were
considered. Furthermore, the review process shall ensure that appropriate impact mitigation
measures, as well as climate change adaptation and disaster risk reduction have been
formulated and analyzed based on agreements during the screening and scoping stages.
The project proponent has committed to implement and incorporate into the project design: a)
the appropriate and sufficient impact management and mitigation measures, and b) the
appropriate climate change adaptation and disaster risk reduction considerations.
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knowledge base for disaster risks and climate change in project-specific areas will normally improve
substantially over the life of a project. It should also be noted that disaster and/or climate change risks
are normally long-term risks, and hence may be difficult to assess in the short-term (i.e., project life).
Therefore, if a project is particularly sensitive to disaster risks and/or climate change over its predicted
life, monitoring should include periodic assessment of these aspects by reviewing new information and/or
monitoring specific hazard/climate elements. At the minimum, the evaluation should focus on
determining whether the mitigating and/or adaptation measures that were put in place were effective and
whether there were problems or excessive costs associated with them.
The compliance monitoring by the project proponent, validation by the Multi-Partite Monitoring Team
(MMT) (if required) and the evaluation by the EMB should focus on confirming whether mitigating
measures are performing as designed, or to identify changes needed to address the actual environmental
impact of the project. This will show whether the project had achieved its objectives or had caused
unintended adverse impact. In which case, it may be necessary to re-assess adaptation options, select
new mitigation and/or adaptation measures or modify the current set of measures.
For projects requiring an Environmental Impact Statement (EIS), DRR/CCA-enhanced EIS Screening
Forms have been developed as a guide for the scoping process. These screening forms are basically
checklists of the required scope of the EIA. The forms also provide guidance on how to incorporate
disaster and climate change risks, including the formulation of appropriate mitigation and adaptation
options at the project level.
The EIS Screening Forms have been customized for specific industry types to allow for a more precise
identification of the following:
The purpose of this document is to guide users (e.g., project proponent, EIA Consultant, EMB and other
stakeholders) in implementing a risk-based planning and management system for the proposed project, in
consideration of environmental management concerns as well as the climate change and disaster risks
concerns. This shall also serve as a guide for the formulation of an enhanced environmental management
plan which has integrated climate change adaptation and disaster risk reduction plan as an input to the
overall project design.
The EIS Screening Form was designed based on the prescribed outline contained in DENR
Memorandum Circular 2010-14 dated 29 June 2010. The form also includes the pre-identification of the
potential environmental impact specific to the industry type. The baseline data and the assessment
methodology requirement are likewise based on these considerations. The same form could be used for
completeness checking of EIAs being submitted as a requirement for ECC application. Columns have
been provided for such purpose.
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Available data on identified hazard areas and climate projections for specific provinces shall be included
in the assessment of project impact. Specifically, climate projections for rainfall, temperature, tropical
cyclones and extreme climate events for years 2020 and 2050 shall be used. Furthermore, a climate
change adaptation program shall be developed as part of the Environmental Management Plan (EMP).
Likewise, available data on areas prone to hazards or have historical incidence of disasters shall be used
to develop the Disaster Risk Management Plan at the project level. This Plan shall likewise be
incorporated in the EMP and considered in the project design.
General Information
This is where the basic information on the project to be screened are inputted. It also contains a
checklist of documentary requirements for the ECC application.
This provides technical guidance on the specific content requirement for each of the major sections
of the EIS for the specific project sector.
This contains a listing of pre-identified key environmental impacts for the specific project sector and
the corresponding environmental baseline data that needs to be established before the
implementation of the project. It also specifies required environmental assessment
methodology/approach for each identified key environmental impact. A corresponding management
and monitoring plan shall be formulated for each of the identified key environmental impact. The
checklist provides columns for checking the presence of these in the EIS that will be subjected to
screening.
This is a guide for identifying the type of risks that is critical for the specific project type (safety or
physical), the scope of assessment and the output/report type required for the type of risk. An
emergency response and monitoring plan should be formulated for the identified risks. The
checklist provides columns for checking the presence of these in the EIS that are subjected to
screening.
The EIS Screening Form also has provisions for affixing signatures of Reviewers, Preparers, Proponent
and EMB Representative who participated in the scoping activity.
Each of the EIS Screening Form was customized for specific project sectors but the following provides a
general guidance on what each of the sections of the EIS should contain.
The Screening Form starts with the Executive Summary. This section should be written clearly and
concisely as a stand-alone document summarizing the main findings of the study and how they were
arrived at. The summary should cover all main issues discussed in the Report and contain at least a brief
description of the project and the environment.
The summary should include a brief description of anticipated significant climate change impact affecting
the development, an account of the main mitigation and adaptation measures to be undertaken by the
proponent, and a description of any significant residual impact.
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A brief discussion of the method by which data were obtained should also be included.
1. The proponent/EIA consultant should indicate the precise location and boundaries of the proposed
project shown on a detailed (preferably topographic) map, a statement of the objectives of the
proposed project, its component and size, manpower and indicative project investment cost, including
all portions and phases of the project with corresponding timeframes needed for evaluation and
review of the environmental impact.
2. Under Project Rationale, the proponent should be able to state clearly the purpose or justification (in
reference to specific sustainable development agenda, e.g., regional development plan, provincial
development plan, local development plan) of the proposed project to allow for an evaluation of the
environmental effects vis--vis the proposed development.
3. Under Project Alternatives, a brief discussion on feasible alternatives including the reasons for the
selection of the preferred option should be provided. The discussion should include a comparison of
significant adverse environmental impact of the various options and the consideration of prevailing
and projected environmental issues. The no project option should also form part of this discussion.
A no project alternative is not equivalent to a status quo condition, as it must account for growth and
development in the foreseeable future if the proposed project were not approved based on current
plans and available infrastructure and community service.
4. The Project Component section should present a clear description of the project (text and maps, when
possible) of the projects basic lay-out, activities and support facilities likely to cause environmental
effects. This information will serve as a benchmark against which to measure environmental changes
and assess impact.
5. The Method/Technology option should identify the types and quantities of wastes which might be
produced, and the proposed disposal scheme/s.
An improvement under this section should include a description of the vulnerability to natural hazards
associated with climate change. Wastes include all residual process materials, effluents and
emissions. The types and quantities of waste matter or residual materials as well as the rate at which
these will be generated should be estimated. Further, the ways by which the project proposes to
treat these wastes and residuals should be indicated, along with the pathways by which they will
eventually be disposed of to the environment. If waste is to be recycled, the process should be
outlined in the report.
6. Project Size refers to a description of the magnitude of operation including any associated activities
required by or for the project using parameters specified in Annex 2-1b of the Revised Procedural
Manual for DAO 2003-30.
7. Development Plan, Description of Project Phases and Corresponding Timeframes refer to a detailed
description of the processes and activities, including timeframes associated with the different phases
(i.e., pre-construction, construction, operation, abandonment) of the proposed project.
8. In the Manpower section, the estimated number of people that will be employed in the various project
phases should be provided. The skill and qualification requirements should likewise be indicated.
9. The Indicative Project Investment Cost is a natural outgrowth of the proposed project expenditures
covering the entire project operation tasks and staffing processes. The cost estimate should be tied
up with the overall performance and realization of the proposed project covering the period from pre-
planning to pre-construction, construction, operation, and all way to the abandonment phase of the
entire engagement.
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EIA DRR/CCA TECHNICAL GUIDELINES
The current policy directive under DENR MC 2010-14 is to focus the EIA Report requirement to the most
essential information and on the environmental aspects that have scientific basis and are verifiable for
specific project types. As such, integrated analysis by environmental receptors (i.e., land, water, air and
people) shall be used in presenting the baseline information, impact assessment, impact management
and impact monitoring.
The discussions shall be based on the pre-identified project-specific environmental impact as reflected in
the various screening forms developed. The required baseline information has likewise been focused on
the relevant parameters in relation to the pre-identified key environmental impact.
The nature of the environmental impact shall be analyzed as to whether these are direct or indirect,
synergistic or cumulative, short-, medium- or long-term, permanent or temporary, positive or negative.
The impact should also be investigated and described with particular regard to identifying its effects on
biodiversity, soil, water, air, climate, coastal landscape, human health risk and the interactions among
them.
The expected relevance that the projected impact will have for people and the environment should be
considered in this section. The sources of standards and criteria, along with the rationale, assumptions
and value judgments used in assessing significance should be fully described. The significance of an
impact should be assessed, taking into consideration national and international quality standards, where
available.
Local land use plans, guidelines and policies shall serve as the main reference point of discussions. If
necessary, additional data shall be collected to support the assessment, taking into account natural and
human activities.
The analysis of impact should consider not only the current baseline scenario but also climate change
projections and disaster risks specifically for relevant parameters that have been pre-identified and
reflected in the EIS Screening Forms. The section should also include sufficient background in terms of
climate trends and climate change projections that may affect the project area. The level of detail in this
description should be sufficient to convey the general nature of the environmental and social resources
condition of the affected areas.
The proponent/preparer must be able to formulate an EMP that describes how the mitigation and other
environmental measures will be implemented. These measures should be set out to cover all phases of
the project from pre-construction, construction, operation through decommissioning phase, and should
outline mitigation and other measures that will be undertaken to ensure compliance with environmental
regulations and reduce or eliminate adverse impact. The cost of mitigation should be assessed and
included in the report.
The proponent/preparer must also be able to formulate appropriate risk reduction and adaptation
measures that would address significant disaster and climate change impact at the project level. These
measures must address adverse impact of the project on the environment as well as the impact of the
environment on the project.
The proponent/EIA consultant must be able to formulate an EMoP that would monitor the following
concerns: a) extent and severity of the actual environmental impact against the predicted impact; b)
performance of the environmental protection measures or compliance with pertinent rules and
regulations; c)trends in impact; and, d) overall effectiveness of the projects EMP.
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EIA DRR/CCA TECHNICAL GUIDELINES
The EMoP should identify specific parameters to be monitored based on impact assessment as well as
the necessary sampling and measurement plan, responsible entity/ies and environmental quality
performance management scheme.
A specific monitoring scheme should be developed for each of the pre-identified environmental impact for
specific project types as identified in the various EIS screening forms. The submission of such monitoring
plan/s shall be verified prior to official acceptance of the EIS for ECC applications.
As a guide for completeness checking prior to official acceptance of the EIS for ECC applications, blank
columns are provided on the right side of the list of key environmental impact, baseline data and
assessment method requirement. Page numbers where the baseline data, impact assessment, impact
management and monitoring plan requirements can be found within the EIS shall be indicated in the
screening form by the proponent/preparer along with the EIS submitted for procedural screening.
This component of the EIA Screening Form is required if the proposed project involves hazardous, toxic,
flammable, or explosive materials or chemicals, or if it involves the construction of structures such as
dams and bridges, which would endanger life, property, or the environment should they fail.
Appropriate and sufficient data shall be provided in the Project Description for
Scoping (PDS) to allow for determination whether an ERA is required
or not.
For these types of projects, the PDS should include the following:
During scoping, the type of risk shall be identified by putting a check mark () in the boxes provided in
the first column of the last page of the screening forms. The requirement for a Quantitative Risk
Assessment (QRA) shall be decided upon during the scoping based on the validation of the Level of
Coverage Computation done or based on technical discussions. A check mark () shall then be placed
in the box provided if a QRA would be required.
As a guide for completeness checking prior to official acceptance of the EIS for ECC applications,
blank columns are provided on the right side of the ERA requirement listing. Page numbers where
the specific risk assessment, emergency response plan and the monitoring plan requirements can be
found within the EIS shall be provided by the proponent/preparer along with the EIS submitted for
procedural screening.
In general, the proponent/EIA consultant assesses the impact on various environmental aspects as a
result of a proposed project. Once the impact have been examined, their significance should be
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EIA DRR/CCA TECHNICAL GUIDELINES
determined, i.e., whether they are acceptable, require mitigation, or considered unacceptable.
Corresponding measures will have to be provided to mitigate adverse impact or enhance positive impact
at all stages of project implementation from pre-construction/construction to operation all the way to the
abandonment/decommissioning stage. The IMP should ensure that all residual environmental impact are
appropriately and adequately managed. Methods that would be implemented may include technical,
social, and institutional measures to be made integral elements of the project.
The section should contain both a narrative summary of significant impact and a matrix (see Annex 2-17
of the Revised Procedural Manual for the format).
As regards to climate change, the assessment may consider the nature, extent and magnitude of
changes likely to be contributed by a proposed project to climate change. More importantly, the
assessment should examine the impact of climate change on the project. Also, the assessment should
scrutinize the potential aggravating effects of climate change on the projects environmental impact. For
example, climate change may aggravate the effect of the project on the extent or magnitude of flooding in
the area.
Assessment should be aided by various tools and techniques, the choice of which depends upon the
nature of the impact, data availability or lack of it, and the appropriate specifics of models employed
based on certain criteria established. All of these will have to be written down in a manner that is
comprehensible to the non-specialist. Tables, graphs and other devices should be used as appropriate.
Unnecessary technical or obscure language should be avoided. Technical terms, acronyms and initials
should be defined, either when first introduced into the text or in a glossary.
The SDP and IEC Framework shall be required for all ECPs. These may be required for EIS-Based ECC
applications for non ECPs at the discretion of the EMB-Regional Office (RO).
The SDP of the project shall be derived from and aligned with the LGU's existing SDP. The project's SDP
normally aims to prevent/mitigate the projects adverse impact and enhance the positive impact on
people's livelihood, health and environment. The SDP shall contain the following: a) livelihood or
community development programs/activities, b) responsible party and/or beneficiaries, c) partner
institutions (government, NGO, others), d) timeframe of implementation, and e) source of funds and
amount allocated per activity/component.
IEC is a critical component of the project to establish support, linkages, and participation of the
stakeholders by raising awareness about the proposed project and its impact on the environment,
including climate change, natural hazards and the associated risks and vulnerabilities. Public
consultations are needed to generate awareness, enable informed opinions/views, and solicit
suggestions/approaches from the community. It is important that misconceptions are clarified and
stakeholders are fully aware and well informed so as to eventually stimulate dynamic participation and
support in the implementation of adequate responses in the locality.
The IEC Framework shall include the following information: a) Target Sector Identified as needing Project
IEC, b) Major topic/s or concerns in relation to the project, c) IEC Scheme/Strategy/Methods, d)
Information medium, e) Indicative timelines and frequency, and f) Indicative cost.
This section describes the monitoring activities to be carried out to ensure that adverse environmental
impact will be minimized and the EMP is implemented. It describes how, when, where the environmental
15
EIA DRR/CCA TECHNICAL GUIDELINES
compliance monitoring activities will be undertaken; who will carry them out; and, who should receive the
monitoring report. It should also clearly describe the commitment of the proponent and identify the
implementation scheme and source of funds for such activities.
Section VII. Emergency Preparedness and Response Policy and Generic Guidelines
In general, the Emergency Preparedness and Response Policy and Generic Guidelines aim to prevent,
control and/or limit possible on-site and off-site negative impact arising from adverse events associated
with a particular project in a given area. Also, in anticipation of adverse impact of climate change, an
Emergency Response Plan should be designed to provide mitigation measures, if not prevent occurrence
of adverse impact, which could lead to accidents, and to reduce the magnitude of consequences in the
event that accidents may happen.
An Emergency Response Plan should have the following components, which should consider
vulnerabilities to disaster risk and climate change:
The essence of abandonment/decommissioning and rehabilitation should be to restore the stability of the
project site, improve the aesthetic quality, and render the land suitable for some other productive uses.
In addition, the Abandonment and Rehabilitation Policies and Procedures to be adopted by the proponent
should aim to achieve the following: a) reduce or eliminate adverse environmental effects once the project
ceases to operate; b) re-establish physical and biological conditions which meet regulatory requirements;
and, c) ensure that the decommissioned project does not pose an unacceptable risk to public health and
safety.
The Plan should indicate the institutional set-up with specific responsibilities that will ensure effective
implementation of the EMP.
The plan should specifically define an institutional structure that would: a) ensure the integration of all
environmental concerns in overall planning through coordination with affected stakeholders; b) ensure
observance of proper safeguards in the execution of all activities, including those in existence that have,
or are likely to have significant impact on the environment; and, c) enforce environmental standards,
regulations and policies relating to environment safety, public health, ecology and biodiversity.
For projects where an Initial Environmental Examination (IEE) Checklist Report Form is prescribed,
DRR/CCA-enhanced IEE Checklist Report Forms have been developed to serve as the EIA Report
submission for ECC application. Concerns on disaster and climate change risks have been integrated
into the Checklist Forms.
16
EIA DRR/CCA TECHNICAL GUIDELINES
The Checklist Forms have been customized for specific industry types where the following have been
pre-identified:
The purpose of the forms is to guide users (e.g., the project proponent, EMB and other stakeholders) in
implementing a risk-based planning and management system for the proposed project in consideration of
environmental management concerns, as well as climate change and disaster risks concerns. The
Checklist Forms also provide a pre-structured and enhanced environmental management plan which has
integrated climate change adaptation and disaster risk reduction considerations as an input to the overall
project design.
The IEE Checklist Report Form is a simplified form identifying all the activities of the proposed project and
sources of impact, including those arising from disaster risk and climate change. The assessment covers
all activities from construction to operation or decommissioning of the project, and considers these
alongside the characteristics of the project environment that could be affected, and determines where
there could be interactions among them.
The IEE Checklist Report Forms were designed based on the prescribed outline in DENR Memorandum
Circular 2010-14 dated 29 June 2010. The idea was to simplify and standardize EIA Reports such that
minimal technical expertise would be required in filling up the forms.
The IEE Checklist Report Forms contain a series of questions dealing with issues and concerns about the
proposed project and its environment. The checklist will also provide information on the proposed
projects environmental impact, both positive and negative. The information contained in the checklist will
serve as basis for the review and assessment of the EMB Regional Office to either approve or deny an
ECC application.
The IEE Checklist Report Forms shall suffice as EIA Report submission for the following projects located
in ECAs covered under the PEISS:
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EIA DRR/CCA TECHNICAL GUIDELINES
18
EIA DRR/CCA TECHNICAL GUIDELINES
19
EIA DRR/CCA TECHNICAL GUIDELINES
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EIA DRR/CCA TECHNICAL GUIDELINES
The Project Fact Sheet serves as the Executive Summary of the IEE Checklist Report Form. It provides
an overview of the project.
Project Description
The project proponent should furnish details that would give a brief but clear picture of the following:
Project Location and Area. Use maps showing general location, specific location, project
boundary and project site layout accompanied by specific geographical coordinates.
Project Component. Present, in tabular form, a clear description of the project components,
such as number of units or size, types of equipment/support facility/ies accompanied by specific
details, which are likely to cause environmental effects. The table should also include support
facilities and pollution control device/s.
Utilities Requirement. Provide an estimate and source of the power and water requirement.
Manpower Requirement. Provide an estimated labor requirement for both the construction and
operation phases.
Indicative Project Cost. Provide an estimated project cost in Philippine Pesos equivalent.
This Plan, prepared in matrix form, provides the checklist of environmental parameters for different
projects.
Possible Environmental/Social Impact. This section will serve to screen out no significant impact from
those with significant adverse impact by reviewing each relevant parameter according to the various
factors or operational stages.
Baseline Data Parameter. The proponent should enumerate significant data which describes the existing
environmental status of the identified study area. The project proponent must select an answer by
checking the appropriate box(es), as necessary.
In addition, the project proponent must also select/check appropriate measures designed to address the
potential disaster risks and climate change impact of the proposed project, as necessary. Note that these
disaster and climate change considerations have been integrated into the matrix. Mitigation measures,
where appropriate, were pre-identified as recommended measures to address environmental issues.
Potential environmental enhancement and adaptation measures are also included.
Cost of Mitigation. Mitigation is the stage when measures are identified to avoid, minimize or remedy
impact. These measures are implemented as part of the process of impact management along with any
necessary adjustments to respond to unforeseen impact. This would therefore require financial support to
realize such undertakings. Under this column, the Project Proponent must commit to allocate some
amount to cover expenditures in implementing these measures.
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EIA DRR/CCA TECHNICAL GUIDELINES
The essence of abandonment/decommissioning and rehabilitation is to restore the stability of the project
site, improve the aesthetic quality and render the land suitable for productive uses.
Based on the estimated project life/service, the Project Proponent shall provide a brief description of the
abandonment/decommissioning activities to be undertaken at the end of the project life/service.
This Plan should indicate an institutional set-up with specific responsibilities that will ensure effective
implementation of the EMP.
It should define an institutional structure that would: a) ensure the integration of all environmental
concerns in overall planning through coordination with affected stakeholders; b) ensure observance of
proper safeguards in the execution of all activities, including those in existence that have or are likely to
have significant impact on the environment; and, c)enforce environmental standards, regulations and
policies relating to environment safety, public health, ecology and biodiversity. A flowchart or diagram
may be used to show the interrelationship of the various elements or components of the Plan.
For the IEE Checklist Report Form, the organization chart with a brief description of the job
functions/responsibilities of key officer/s shall suffice as compliance. The appropriate space is provided
for this purpose.
5. Documentary Requirements
The IEE Checklist Report Form shall be submitted along with the following supporting documents:
Proof of compatibility with existing land use plan as contained in the zoning ordinance of the
LGU/s concerned
Proof of ownership or authority over the project site (e.g., OCT/TCT, lease agreement)
Vicinity/location map and photographs of the project site
Site development/layout plan
Organizational/Institutional Chart showing functions and responsibilities as well as the lines of
command and reporting of the Pollution Control Officer, and
Drawings/Plans of pollution control facilities/devices (e.g., wastewater treatment facility, air
pollution control devices) as may be applicable and appropriate.
Additional documentary requirements for specific industry types are listed/indicated in the respective
IEE Checklist Report Forms.
22
Annex 1 - A
ECC APPLICATION SCREENING FORM FOR AGRICULTURAL AND PLANTATION PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
Processing Fee: PhP _______ (Pay at EMB Cashier) Review Fund: Based on WFP (Pay to the duly
authorized 3rd Party Review Fund Manager)
O.R. #
Date
NOTED BY:
___________________________ _________________________
Screening Officer Section/Division Chief
1
Please refer to attached checklist of EIS Contents
1
ECC APPLICATION SCREENING FORM FOR AGRICULTURAL AND PLANTATION PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
2
ECC APPLICATION SCREENING FORM FOR AGRICULTURAL AND PLANTATION PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
3
ECC APPLICATION SCREENING FORM FOR AGRICULTURAL AND PLANTATION PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
4
ECC APPLICATION SCREENING FORM FOR AGRICULTURAL AND PLANTATION PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
5
ECC APPLICATION SCREENING FORM FOR AGRICULTURAL AND PLANTATION PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
template
6
ECC APPLICATION SCREENING FORM FOR AGRICULTURAL AND PLANTATION PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
9
ECC APPLICATION SCREENING FORM FOR AGRICULTURAL AND PLANTATION PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
10
ECC APPLICATION SCREENING FORM FOR AGRICULTURAL AND PLANTATION PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
3.1.2 Contribution in terms of Data on Greenhouse gasses (i.e., Discuss the projects
greenhouse gas emissions/ carbon dioxide, methane, nitrous contribution in terms of
sequestration oxide); Calculation of projected GHG greenhouse gas
emission/sequestration emissions/sequestration
3.2.2 Increase in ambient noise Characterization of ambient noise Use DENR standard
level level methods and procedures
for sampling and
sampling site map measurement.
Noise attenuation
modeling (applicable if
there is a source
capable of generating
11
ECC APPLICATION SCREENING FORM FOR AGRICULTURAL AND PLANTATION PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
4.4 Threat to delivery of basic Availability of public services in terms Discuss how the project
services /resource competition of: would affect the delivery
Water supply of basic services and
Power supply may result in resource
Communications/transportation competition in the area
Health resources (Government
4.5 Threat to public health and and Private) Discuss the project
safety Peace and order / crime implementations threat
Education facilities to public health vis--vis
12
ECC APPLICATION SCREENING FORM FOR AGRICULTURAL AND PLANTATION PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
13
ECC APPLICATION SCREENING FORM FOR AGRICULTURAL AND PLANTATION PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
Specific Instructions:
_________________________
EMERGENCY PLAN :
Specific Instructions:
_________________________
14
ECC APPLICATION SCREENING FORM FOR AGRICULTURAL AND PLANTATION PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
1. 1.
2. 2.
3. 3.
4. Project Proponent:
5.
6. Project Preparer/Consultant:
Resource Person
1.
15
Annex 1 - B
ECC APPLICATION SCREENING FORM FOR FOOD AND FOOD BY-PRODUCT AND BEVERAGES
MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
Date
Acceptable?
To be filled-up upon submission of EIS Screening Officers Remarks
Yes No
Environmental Impact Statement (EIS)1
Proof of Compatibility with the existing Land
Use Plan
Proof of Authority over the Project Site
Accountability Statements of Preparers &
Proponents (see Annexes 2-21 & 2-22 of
Revised Procedural Manual for DAO 2003-30)
Photographs or plates of the project site,
impact areas and affected areas and
communities
Duly Accomplished Project Environmental
Processing Fee: PhP _______ (Pay at EMB Cashier) Review Fund: Based on WFP (Pay to the duly
rd
authorized 3 Party Review Fund Manager)
O.R. #
Date
NOTED BY:
___________________________ _________________________
Screening Officer Section/Division Chief
_____________________________
1
Please refer to attached checklist of EIS Contents
1
ECC APPLICATION SCREENING FORM FOR FOOD AND FOOD BY-PRODUCT AND BEVERAGES
MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
Items to be
Specific Data Requirement Page # Acceptable? REMARKS
Described
I. Project Description
Items to be
Specific Data Requirement Page # Acceptable? REMARKS
Described
Discuss the alternatives (type and
location) considered and nominated
during the course of selecting the best
option for which the EIS is prepared;
Describe the bases upon which the
alternatives were rejected in favor of the
preferred option;
Describe the significant differences in
environmental impacts among the
alternatives considered.
Siting: Cite alternative project locations
including factors significant to the selection
such as perception of affected communities
with regards to project, ancestral domain
issues, land classification, etc. Discuss other
options on the siting of major components of
the project within the project area.
Items to be
Specific Data Requirement Page # Acceptable? REMARKS
Described
Identification of materials/product handling
facilities, infrastructure requirements
(transport road/rail/ship, energy, water
supply and storage, storm water drainage,
sewerage, telecommunications,
accommodation and other infrastructure)
Identification of Pollution Control devices
and corresponding facility being served or
connected.
Identification of waste management facilities
and devices to address solid waste
materials (domestic and hazardous and
chemicals) air emissions, solid waste
disposal, and wastewater
General layout of facilities
Footprint of proposed layout of project
facilities (if any)
Maps should be provided showing the
precise location of the project area, and in
particular, the location and boundaries of
project area, location and footprint of project
components, and location of all proposed
buffers.
When applicable contextualize using the
PAG-ASA 2020 and 2050 projected
rainfall/temperature data.
5) Process/ Processing/Manufacturing
Technology
Indicative process flow-sheets showing
material balances for the processing plant, and
the anticipated rates of inputs, along with
similar data on products, wastes and recycle
streams
Power & water supply system
4
ECC APPLICATION SCREENING FORM FOR FOOD AND FOOD BY-PRODUCT AND BEVERAGES
MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
Items to be
Specific Data Requirement Page # Acceptable? REMARKS
Described
temporary housing, transport of materials,
health and other services for the workforce)
Operation (projected period of start-
up/commissioning/full operation of various
project components) include discussion on
the operation of various components (as
identified above) in terms of material/product
handling, infrastructure requirements
(transportroad/rail/ship, energy, water
supply and storage, storm water drainage,
sewerage, telecommunications,
accommodation and other infrastructure),
waste management (character and
quantities of waste materials, air emissions,
Solid waste disposal, wastewater)
Abandonment
Final Rehabilitation/ Decommissioning Plan, to
include Land/soil restoration-The land use
suitability of the various land disturbance types
should also be described.
manpower requirements;
expertise/skills needed;
nature & estimated number of jobs
available for men, women, and indigenous
peoples (if sited in IP ancestral land);
preferred scheme for sourcing locally from
host and neighboring LGUs
9) Indicative Project Investment Cost (Philippine Peso)
Page # Acceptable?
General Contents Specific Content Requirement REMARKS
II. Key See attached checklist of contents
Environmental
Impacts and When applicable, include appropriate climate
Management/ change adaptation measures/options
Monitoring Plan (embedded in each sector).
5
ECC APPLICATION SCREENING FORM FOR FOOD AND FOOD BY-PRODUCT AND BEVERAGES
MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
Page # Acceptable?
General Contents Specific Content Requirement REMARKS
6
ECC APPLICATION SCREENING FORM FOR FOOD AND FOOD BY-PRODUCT AND BEVERAGES
MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
Page # Acceptable?
General Contents Specific Content Requirement REMARKS
7
ECC APPLICATION SCREENING FORM FOR FOOD AND FOOD BY-PRODUCT AND BEVERAGES MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
Analysis/estimation of water
availability taking into consideration
the PAG-ASA 2020 and 2050
climate projections
2.2 Oceanography
2.2.1 Change/disruption in Predicted tides; 24-hour tidal cycles;
circulation pattern Surface current system
2.2.2 Change in bathymetry Bathymetric map USLE / similar modeling
when applicable
2.3 Water Quality
2.3.1 Degradation of Physico-Chemical characterization Use DENR standard
groundwater quality of water : methods and procedures
3.1.1 Change in the local Monthly average rainfall and In the assessment,
climate, e.g., local temperature temperature of the area; consider the PAG-ASA
Climatological normals/extremes; climate change projections
Wind rose diagrams; Frequency of for 2020 and 2050.
Tropical cyclones
PM10
SOx
11
ECC APPLICATION SCREENING FORM FOR FOOD AND FOOD BY-PRODUCT AND BEVERAGES MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
3.2.2 Increase in ambient noise Characterization of ambient noise Use DENR standard
level level methods and procedures
for sampling and
sampling site map measurement.
If applicable, noise
attenuation modeling
(applicable if there is
source capable of
generating 200 dB or
more)
4. THE PEOPLE
4.1 Displacement of settler/s Demographic data of impact area:
- Number of households and Discuss how the project
Displacement / household size would affect existing
disturbance of properties - Land area, properties in the area in
- Population, terms of relocation and
Change/conflict in land - Population density /growth devaluation
ownership - Gender and age profile,
- Literacy rate, profile of educational
Change/conflict in right of attainment,
way
4.2 In-migration settlements map Discuss the in-migration
patterns as a result of
Proliferation of informal Census of population / property that project implementation
settlers will be displaced / disturbed
12
ECC APPLICATION SCREENING FORM FOR FOOD AND FOOD BY-PRODUCT AND BEVERAGES MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
Increased revenue of
LGUs
4.7 Traffic congestion Road network/ systems Traffic impact assessment
Existing transportation/traffic if applicable (including
situation capacity of road system in
terms of load/count)
14
ECC APPLICATION SCREENING FORM FOR FOOD AND FOOD BY-PRODUCT AND BEVERAGES MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
15
ECC APPLICATION SCREENING FORM FOR FOOD AND FOOD BY-PRODUCT AND BEVERAGES MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
1. 1.
2. 2.
3. 3.
4. Project Proponent:
5.
6. Project Preparer/Consultant:
Resource Person
1.
16
Annex 1 - C
ECC APPLICATION FORM FOR NON-FOOD MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
Date
Checklist of Documentary Requirements
Acceptable?
To be filled-up upon submission of EIS Screening Officers Remarks
Yes No
Environmental Impact Statement (EIS)1
Proof of Compatibility with the existing Land
Use Plan
Proof of Authority over the Project Site
Accountability Statements of Preparers &
Proponents (see Annexes 2-21 & 2-22 of
Revised Procedural Manual for DAO 2003-30)
Photographs or plates of the project site,
impact areas and affected areas and
Processing Fee: PhP _______ (Pay at EMB Cashier) Review Fund: Based on WFP (Pay to the duly
rd
authorized 3 Party Review Fund Manager)
O.R. #
Date
NOTED BY:
___________________________ _________________________
Screening Officer Section/Division Chief
_____________________________
1
Please refer to attached checklist of EIS Contents
1
ECC APPLICATION FORM FOR NON-FOOD MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
Page # Acceptable?
Contents REMARKS
2
ECC APPLICATION FORM FOR NON-FOOD MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
4
ECC APPLICATION FORM FOR NON-FOOD MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
manpower requirements;
expertise/skills needed;
nature & estimated number of jobs available
for men, women, and indigenous peoples (if
sited in IP ancestral land);
preferred scheme for sourcing locally from
host and neighboring LGUs
9) Indicative Project Investment Cost (Philippine Peso)
5
ECC APPLICATION FORM FOR NON-FOOD MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
6
ECC APPLICATION FORM FOR PROPOSED NON-FOOD MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
2.2 Oceanography
2.2.1 Change/disruption in Predicted tides; 24-hour tidal cycles;
8
ECC APPLICATION FORM FOR PROPOSED NON-FOOD MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
for completeness during procedural screening; page numbers should be provided
Baseline Data Parameter Required Assessment upon submission of the EIS
List of Key Impacts Baseline Impact Mgmt. Plan Monitoring Remarks
Requirements Methodology/Approach Conditions Analysis Plan
During scoping: Unless otherwise specified as agreed during scoping, all items listed are required. Write Page Page Page Page
specific instructions (if any) on the blanks/spaces provided.
circulation pattern Surface current system
2.2.2 Change in bathymetry Bathymetric map USLE / similar modeling
when applicable
2.3 Water Quality
2.3.1 Degradation of Physico-Chemical characterization of Use DENR standard
groundwater quality water : methods and procedures
pH for sampling and analysis.
BOD5
For project with
COD coastal/marine structures
DO and /or significant marine/
3.1.2 Contribution in terms of Data on Greenhouse gasses (i.e. Discuss the projects
greenhouse gas emissions carbon dioxide, methane, nitrous contribution in terms of
oxide); Calculation of projected GHG greenhouse gas
emission emissions (applicable for
power and landfill and
possible for mining and
dam)
3.2 Air Quality (and Noise)
3.2.1 Degradation of air quality Characterization of ambient air quality: Use DENR standard
TSP methods and procedures
PM10
for sampling and analysis.
10
ECC APPLICATION FORM FOR PROPOSED NON-FOOD MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
for completeness during procedural screening; page numbers should be provided
Baseline Data Parameter Required Assessment upon submission of the EIS
List of Key Impacts Baseline Impact Mgmt. Plan Monitoring Remarks
Requirements Methodology/Approach Conditions Analysis Plan
During scoping: Unless otherwise specified as agreed during scoping, all items listed are required. Write Page Page Page Page
specific instructions (if any) on the blanks/spaces provided.
measurement.
If applicable, noise
attenuation modeling
(applicable if there is a
source capable of
generating 200 dB or
more)
4. THE PEOPLE
4.1 Displacement of settler/s Demographic data of impact area:
11
ECC APPLICATION FORM FOR PROPOSED NON-FOOD MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
for completeness during procedural screening; page numbers should be provided
Baseline Data Parameter Required Assessment upon submission of the EIS
List of Key Impacts Baseline Impact Mgmt. Plan Monitoring Remarks
Requirements Methodology/Approach Conditions Analysis Plan
During scoping: Unless otherwise specified as agreed during scoping, all items listed are required. Write Page Page Page Page
specific instructions (if any) on the blanks/spaces provided.
Power supply result in resource
Communications competition in the area
/transportation
Health resources
4.5 Threat to public health and (Government and Private) Discuss the project
safety Peace and order / crime implementations threat to
Education facilities public health vis--vis the
Recreational facilities / sports baseline health conditions
facilities in the area
12
ECC APPLICATION FORM FOR PROPOSED NON-FOOD MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
for completeness during procedural screening; page numbers should be provided
Baseline Data Parameter Required Assessment upon submission of the EIS
List of Key Impacts Baseline Impact Mgmt. Plan Monitoring Remarks
Requirements Methodology/Approach Conditions Analysis Plan
During scoping: Unless otherwise specified as agreed during scoping, all items listed are required. Write Page Page Page Page
specific instructions (if any) on the blanks/spaces provided.
Increased revenue of
LGUs
13
ECC APPLICATION FORM FOR PROPOSED NON-FOOD MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
14
ECC APPLICATION FORM FOR PROPOSED NON-FOOD MANUFACTURING PLANTS PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
1. 1.
2. 2.
3. 3.
4. Project Proponent:
5.
6. Project Preparer/Consultant:
Resource Person
1.
15
Annex 1 - D
ECC APPLICATION SCREENING FORM FOR FORESTRY PROJECTS
(For Forestry Projects requiring EIS for ECC Application except Pulp and Paper Industry Projects)
Control No: __________
1st 2nd 3rd ___ th Screening
Date
Acceptable?
To be filled-up upon submission of EIS Screening Officers Remarks
Yes No
Environmental Impact Statement (EIS)1
Proof of Compatibility with the existing Land
Use Plan
Proof of Authority over the Project Site
Accountability Statements of Preparers &
Proponents (see Annexes 2-21 & 2-22 of
Revised Procedural Manual for DAO 2003-30)
Photographs or plates of the project site,
impact areas and affected areas and
communities
Duly Accomplished Project Environmental
Processing Fee: PhP _______ (Pay at EMB Cashier) Review Fund: Based on WFP (Pay to the duly
authorized 3rd Party Review Fund Manager)
O.R. #
Date
NOTED BY:
___________________________ _________________________
Screening Officer Section/Division Chief
1
Please refer to attached checklist of EIS Contents
1
ECC APPLICATION SCREENING FORM FOR FORESTRY PROJECTS
(For Forestry Projects requiring EIS for ECC Application except Pulp and Paper Industry Projects)
Control No: __________
1st 2nd 3rd ___ th Screening
Items to be REMARKS
Specific Data Requirement Page # Acceptable?
Described
2
ECC APPLICATION SCREENING FORM FOR FORESTRY PROJECTS
(For Forestry Projects requiring EIS for ECC Application except Pulp and Paper Industry Projects)
Control No: __________
1st 2nd 3rd ___ th Screening
Items to be REMARKS
Specific Data Requirement Page # Acceptable?
Described
3
ECC APPLICATION SCREENING FORM FOR FORESTRY PROJECTS
(For Forestry Projects requiring EIS for ECC Application except Pulp and Paper Industry Projects)
Control No: __________
1st 2nd 3rd ___ th Screening
Items to be REMARKS
Specific Data Requirement Page # Acceptable?
Described
4
ECC APPLICATION SCREENING FORM FOR FORESTRY PROJECTS
(For Forestry Projects requiring EIS for ECC Application except Pulp and Paper Industry Projects)
Control No: __________
1st 2nd 3rd ___ th Screening
Items to be REMARKS
Specific Data Requirement Page # Acceptable?
Described
5
ECC APPLICATION SCREENING FORM FOR FORESTRY PROJECTS
(For Forestry Projects requiring EIS for ECC Application except Pulp and Paper Industry Projects)
Control No: __________
1st 2nd 3rd ___ th Screening
V. Social SDP
Development Plan
(SDP) and IEC Community development or livelihood
Framework programs/activities, projected beneficiaries,
partner institutions, timeframe of
implementation as well as source and amount
allotted per activity/component (See Annex 2-
18 of RPM for DAO 2003-30)
IEC
6
ECC APPLICATION SCREENING FORM FOR FORESTRY PROJECTS
(For Forestry Projects requiring EIS for ECC Application except Pulp and Paper Industry Projects)
Control No: __________
1st 2nd 3rd ___ th Screening
7
ECC APPLICATION SCREENING FORM FOR FORESTRY PROJECTS
(For Forestry Projects requiring EIS for ECC Application except Pulp and Paper Industry Projects)
Control No: __________
st nd rd
1 2 3 ___ th Screening
8
ECC APPLICATION SCREENING FORM FOR FORESTRY PROJECTS
(For Forestry Projects requiring EIS for ECC Application except Pulp and Paper Industry Projects)
Control No: __________
st nd rd
1 2 3 ___ th Screening
9
ECC APPLICATION SCREENING FORM FOR FORESTRY PROJECTS
(For Forestry Projects requiring EIS for ECC Application except Pulp and Paper Industry Projects)
Control No: __________
st nd rd
1 2 3 ___ th Screening
Analysis/estimation of water
availability taking into consideration
the PAG-ASA 2020 and 2050 climate
projections
2.2 Oceanography
2.2.1 Change/disruption in Predicted tides; 24-hour tidal cycles;
circulation pattern Surface current system
2.2.2 Change in bathymetry Bathymetric map USLE / similar modeling
when applicable
2.3 Water Quality
2.3.1 Degradation of groundwater Physico-Chemical characterization of Use DENR standard
quality water : methods and procedures
for sampling and
pH analysis.
10
ECC APPLICATION SCREENING FORM FOR FORESTRY PROJECTS
(For Forestry Projects requiring EIS for ECC Application except Pulp and Paper Industry Projects)
Control No: __________
st nd rd
1 2 3 ___ th Screening
11
ECC APPLICATION SCREENING FORM FOR FORESTRY PROJECTS
(For Forestry Projects requiring EIS for ECC Application except Pulp and Paper Industry Projects)
Control No: __________
st nd rd
1 2 3 ___ th Screening
If applicable, noise
attenuation modeling
(applicable if there is
source capable of
generating 200 dB or
more)
4. THE PEOPLE
4.1 Displacement of settler/s Demographic data of impact area: Discuss how the project
- Number of households and would affect existing
household size properties in the area in
Displacement / disturbance of - Land area, terms of relocation and
properties - Population, devaluation
- Population density /growth
Change/conflict in land - Gender and age profile,
ownership - Literacy rate, profile of educational
attainment,
Change/conflict in right of way
Settlements map
12
ECC APPLICATION SCREENING FORM FOR FORESTRY PROJECTS
(For Forestry Projects requiring EIS for ECC Application except Pulp and Paper Industry Projects)
Control No: __________
st nd rd
1 2 3 ___ th Screening
13
ECC APPLICATION SCREENING FORM FOR FORESTRY PROJECTS
(For Forestry Projects requiring EIS for ECC Application except Pulp and Paper Industry Projects)
Control No: __________
st nd rd
1 2 3 ___ th Screening
14
ECC APPLICATION SCREENING FORM FOR FORESTRY PROJECTS
(For Forestry Projects requiring EIS for ECC Application except Pulp and Paper Industry Projects)
Control No: __________
st nd rd
1 2 3 ___ th Screening
15
ECC APPLICATION SCREENING FORM FOR FORESTRY PROJECTS
(For Forestry Projects requiring EIS for ECC Application except Pulp and Paper Industry Projects)
Control No: __________
st nd rd
1 2 3 ___ th Screening
1. 1.
2. 2.
3. 3.
4. Project Proponent:
5.
6. Project Preparer/Consultant:
Resource Person
1.
16
Annex 1 - E
ECC APPLICATION SCREENING FORM FOR HYDROPOWER/DAM PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
Date
Checklist of Documentary Requirements
Acceptable?
To be filled-up upon submission of EIS Screening Officers Remarks
Yes No
1
Environmental Impact Statement (EIS)
Proof of Compatibility with the existing Land
Use Plan
Proof of Authority over the Project Site
Accountability Statements of Preparers &
Proponents (see Annexes 2-21 & 2-22 of
Revised Procedural Manual for DAO 2003-30)
Photographs or plates of the project site,
impact areas and affected areas and
communities
Processing Fee: PhP _______ (Pay at EMB Cashier) Review Fund: Based on WFP (Pay to the duly
rd
authorized 3 Party Review Fund Manager)
O.R. #
Date
NOTED BY:
___________________________ _________________________
Screening Officer Section/Division Chief
1
Please refer to attached checklist of EIS Contents
1
ECC APPLICATION SCREENING FORM FOR HYDROPWER/DAM PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
Items to be
Specific Data Requirement Page # Acceptable? REMARKS
Described
2
ECC APPLICATION SCREENING FORM FOR HYDROPWER/DAM PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
Items to be
Specific Data Requirement Page # Acceptable? REMARKS
Described
3
ECC APPLICATION SCREENING FORM FOR HYDROPWER/DAM PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
Items to be
Specific Data Requirement Page # Acceptable? REMARKS
Described
4
ECC APPLICATION SCREENING FORM FOR HYDROPWER/DAM PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
Items to be
Specific Data Requirement Page # Acceptable? REMARKS
Described
area
manpower requirements;
expertise/skills needed;
nature & estimated number of jobs available
for men, women, and indigenous peoples (if
sited in IP ancestral land);
preferred scheme for sourcing locally from
host and neighboring LGUs
8) Indicative Project Investment Cost (Philippine Peso)
V. Social SDP
Development
Plan (SDP) and Community development or livelihood
IEC Framework programs/activities, projected beneficiaries,
partner institutions, timeframe of
implementation as well as source and amount
allotted per activity/component (See Annex 2-
18 of RPM for DAO 2003-30)
IEC
5
ECC APPLICATION SCREENING FORM FOR HYDROPWER/DAM PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
6
ECC APPLICATION SCREENING FORM FOR HYDROPOWER/DAM PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
7
ECC APPLICATION SCREENING FORM FOR HYDROPOWER/DAM PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
2. THE WATER
2.1 Hydrology/Hydrogeology
2.1.1 Change in drainage Drainage map; historical Flood simulation/
morphology / Inducement of flooding/drought occurrences, stream modeling should
8
ECC APPLICATION SCREENING FORM FOR HYDROPOWER/DAM PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
Assessment should
include potential
occurrence or
aggravation of flooding in
nearby areas.
2.1.2 Change in stream, lake Regional hydrogeological map
water depth
2.1.3 Depletion of water Identification of current / projected
resources/competition in water use water use in the area and adjacent
areas
Analysis/estimation of water
availability taking into consideration
the PAG-ASA 2020 and 2050 climate
projections
2.2 Oceanography
2.2.1 Change/disruption in Predicted tides; 24-hour tidal cycles;
circulation pattern Surface current system
2.2.2 Change in bathymetry Bathymetric map USLE / similar modeling
when applicable
2.3 Water Quality
2.3.1 Degradation of groundwater Physico-Chemical characterization of Use DENR standard
quality water : methods and procedures
9
ECC APPLICATION SCREENING FORM FOR HYDROPOWER/DAM PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
3.2.2 Increase in ambient noise Characterization of ambient noise Use DENR standard
level level methods and procedures
for sampling and
sampling site map measurement.
4. THE PEOPLE
4.1 Displacement of settler/s Demographic data of impact area: Discuss how the project
- Number of households and would affect existing
Displacement / disturbance household size properties in the area in
of properties - Land area, terms of relocation and
- Population, devaluation
Change/conflict in land - Population density /growth
ownership - Gender and age profile,
- Literacy rate, profile of educational
Change/conflict in right of attainment,
way
4.2 In-migration settlements map Discuss the in-migration
patterns as a result of
Proliferation of informal Census of population / property that project implementation
settlers will be displaced / disturbed
11
ECC APPLICATION SCREENING FORM FOR HYDROPOWER/DAM PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
13
ECC APPLICATION SCREENING FORM FOR HYDROPOWER/DAM PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
14
ECC APPLICATION SCREENING FORM FOR HYDROPOWER/DAM PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
1. 1.
2. 2.
3. 3.
4. Project Proponent:
5.
6. Project Preparer/Consultant:
Resource Person
1.
15
Annex 1 - F
ECC APPLICATION SCREENING FORM FOR NEW MINING PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
st nd rd
1 2 3 ___ th Screening
Date
Venue of Technical Scoping:_____________________________________________________________
Processing Fee: PhP _______ (Pay at EMB Cashier) Review Fund: Based on WFP (Pay to the duly
rd
authorized 3 Party Review Fund Manager)
O.R. #
Date
NOTED BY:
___________________________ _________________________
Screening Officer Section/Division Chief
_____________________________
1
Please refer to attached checklist of EIS Contents
1
ECC APPLICATION SCREENING FORM FOR NEW MINING PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
2
ECC APPLICATION SCREENING FORM FOR NEW MINING PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
3
ECC APPLICATION SCREENING FORM FOR NEW MINING PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
4
ECC APPLICATION SCREENING FORM FOR NEW MINING PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
5
ECC APPLICATION SCREENING FORM FOR NEW MINING PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
manpower requirements;
expertise/skills needed;
nature & estimated number of jobs
available for men, women, and indigenous
peoples (if sited in IP ancestral land);
preferred scheme for sourcing locally from
host and neighboring LGUs
9)Indicative Project Investment Cost (Philippine Peso)
REMARKS
General Contents Specific Content Requirement
Page # Acceptable?
V. Social SDP
Development
Plan (SDP) and Community development or livelihood
IEC Framework programs/activities, projected beneficiaries,
partner institutions, timeframe of
implementation as well as source and amount
allotted per activity/component (See Annex 2-
18 of RPM for DAO 2003-30)
IEC
6
ECC APPLICATION SCREENING FORM FOR NEW MINING PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
REMARKS
General Contents Specific Content Requirement
Page # Acceptable?
7
ECC APPLICATION SCREENING FORM FOR NEW MINING PROJECTS
(Requiring EIS for ECC Applications)
Control No: __________
1st 2nd 3rd ___ th Screening
1.3.2 Change in soil Laboratory results on soil sample Physical analysis (water
quality/fertility analysis for N, P, K, pH, organic holding capacity, texture
matter, micronutrients and trace aggregate stability of dam);
metals e. g. Pb, Hg, As, Cd, Cr secondary data: chemical
hexavalent, etc. analysis
2. THE WATER
2.1 Hydrology/Hydrogeology
2.1.1 Change in drainage Drainage map; historical Flood simulation/modeling,
morphology / Inducement of flooding/drought occurrences,
9
ECC APPLICATION SCREENING FORM FOR NEW MINING PROJECTS
(Requiring EIS for ECC Applications)
Control No: __________
1st 2nd 3rd ___ th Screening
Analysis/estimation of water
availability taking into consideration
the PAG-ASA 2020 and 2050
climate projections
2.2 Oceanography
2.2.1 Change/disruption in Predicted tides; 24-hour tidal cycles;
circulation pattern Surface current system
2.2.2 Change in bathymetry Bathymetric map USLE / similar modeling
when applicable
2.3 Water Quality
2.3.1 Degradation of Physico-Chemical characterization Use DENR standard
groundwater quality of water : methods and procedures
for sampling and analysis.
pH
Conduct chemical assay of
BOD5
ore and relate to Physico-
COD Chemical characterization
2.3.2 Degradation of surface
10
ECC APPLICATION SCREENING FORM FOR NEW MINING PROJECTS
(Requiring EIS for ECC Applications)
Control No: __________
1st 2nd 3rd ___ th Screening
coastal/marine water quality Oil and grease For project with coastal/
TSS marine structures and /or
Heavy Metals
significant marine / coastal
discharges, conduct
____________________
circulation / plume
fecal / total coliform modeling (include worst
Others: case scenario of failure of
_________________________ WWTF). For project with
significant heavy metals
discharges, conduct
sampling site map sediment transport
modeling.
2.4 Freshwater Ecology
2.4.1 Threat to existence Summary of endemicity / Include discussions on
and/or loss of important conservation status overall impact to
local species and habitat Abundance of ecologically and freshwater ecology.
economically important species
2.4.1 Threat to existence (fishes, benthos, planktons); Include discussions on
Presence of pollution indicator overall impact to freshwater
and/or loss of important
species ecology.
local species and habitat
sampling site map
Summary of endemicity/
conservation status
Abundance of ecologically and
economically important species
(fishes, benthos, planktons);
Presence of pollution indicator
species
11
ECC APPLICATION SCREENING FORM FOR NEW MINING PROJECTS
(Requiring EIS for ECC Applications)
Control No: __________
1st 2nd 3rd ___ th Screening
12
ECC APPLICATION SCREENING FORM FOR NEW MINING PROJECTS
(Requiring EIS for ECC Applications)
Control No: __________
1st 2nd 3rd ___ th Screening
If applicable, noise
attenuation modeling
(applicable if there is
source capable of
generating 200 dB or
more).
4. THE PEOPLE
4.1 Displacement of settler/s Demographic data of impact area:
13
ECC APPLICATION SCREENING FORM FOR NEW MINING PROJECTS
(Requiring EIS for ECC Applications)
Control No: __________
1st 2nd 3rd ___ th Screening
Increased revenue of
LGUs
14
ECC APPLICATION SCREENING FORM FOR NEW MINING PROJECTS
(Requiring EIS for ECC Applications)
Control No: __________
1st 2nd 3rd ___ th Screening
1. 1.
2. 2.
3. 3.
4. Project Proponent:
5.
6. Project Preparer/Consultant:
Resource Person
1.
16
Annex 1 - G
ECC APPLICATION SCREENING FORM FOR SANITARY LANDFILL PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
Date
Acceptable?
To be filled-up upon submission of EIS Screening Officers Remarks
Yes No
1
Environmental Impact Statement (EIS)
Proof of Compatibility with the existing Land
Use Plan
Proof of Authority over the Project Site
Accountability Statements of Preparers &
Proponents (see Annexes 2-21 & 2-22 of
Revised Procedural Manual for DAO 2003-30)
Photographs or plates of the project site,
impact areas and affected areas and
communities
Duly Accomplished Project Environmental
Monitoring & Audit Prioritization Scheme
Processing Fee: PhP _______ (Pay at EMB Cashier) Review Fund: Based on WFP (Pay to the duly
rd
authorized 3 Party Review Fund Manager)
O.R. #
Date
NOTED BY:
___________________________ _________________________
Screening Officer Section/Division Chief
_____________________________
1
Please refer to attached checklist of EIS Contents
1
ECC APPLICATION SCREENING FORM FOR SANITARY LANDFILL PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
,
Checklist of EIS Contents
I. Executive Summary (maximum of 5 pages)
Page # Acceptable?
Contents REMARKS
Items to be
Specific Data Requirement Page # Acceptable? REMARKS
Described
Items to be
Specific Data Requirement Page # Acceptable? REMARKS
Described
Items to be
Specific Data Requirement Page # Acceptable? REMARKS
Described
Items to be
Specific Data Requirement Page # Acceptable? REMARKS
Described
manpower requirements;
expertise/skills needed;
nature & estimated number of jobs available
for men, women, and indigenous peoples (if
sited in IP ancestral land);
preferred scheme for sourcing locally from
host and neighboring LGUs
9) Indicative Project Investment Cost (Philippine Peso)
V. Social SDP
Development
Plan (SDP) and Community development or livelihood
IEC Framework programs/activities, projected beneficiaries,
partner institutions, timeframe of
implementation as well as source and amount
allotted per activity/component (See Annex 2-
18 of RPM for DAO 2003-30)
5
ECC APPLICATION SCREENING FORM FOR SANITARY LANDFILL PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
,
General Contents Specific Content Requirement Page # Acceptable? REMARKS
IEC
6
ECC APPLICATION SCREENING FORM FOR SANITARY LANDFILL PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
7
ECC APPLICATION SCREENING FORM FOR SANITARY LANDFILL PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
2. THE WATER
2.1 Hydrology/Hydrogeology
2.1.1 Change in drainage Drainage map; historical Flood simulation/
morphology / Inducement of flooding/drought occurrences, stream modeling, consider
flooding/ Reduction in stream flow measurements/estimates; extreme weather
volumetric flow Delineation of watershed /sub- conditions and the PAG-
watersheds/ floodplain; and ASA 2020 and 2050
identification of aquifers, if any climate projections
8
ECC APPLICATION SCREENING FORM FOR SANITARY LANDFILL PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
13
ECC APPLICATION SCREENING FORM FOR SANITARY LANDFILL PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
During scoping: Check () required/applicable items; items with are automatically required; write specific instructions ( if Page Page Page Remarks
any) on the blanks/spaces provided.
Physical Risks - Identification of conditions, events and ERA REQUIREMENT
trigger which could be significant in
(Failure of Structure which bringing about identified physical risks Descriptive/Qualitative Risk
could endanger life, property - Description & assessment of the possible Assessment
and/or the environment)
accident scenarios
- Assessment of whether the project Specific Instructions :
location is projected to have extreme _____________________________
climate events for 2020 and/or 2050 that
could contribute to the triggering EMERGENCY PLAN :
identified scenarios
- Description of the hazards both Specific Instructions :
immediate (acute effects) and delayed ______________________________
(chronic effects) for man and the
environment posed by the failure of Refer to Annex 2-7e for the decision
structure, as applicable. criteria outline
14
ECC APPLICATION SCREENING FORM FOR SANITARY LANDFILL PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
1. 1.
2. 2.
3. 3.
4. Project Proponent:
5.
6. Project Preparer/Consultant:
Resource Person
1.
15
Annex 1 - H
ECC APPLICATION SCREENING FORM FOR THERMAL POWER PLANT PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
Date
Venue of Technical Scoping:_____________________________________________________________
Processing Fee: PhP _______ (Pay at EMB Cashier) Review Fund: Based on WFP (Pay to the duly
rd
authorized 3 Party Review Fund Manager)
O.R. #
Date
NOTED BY:
___________________________ _________________________
Screening Officer Section/Division Chief
_____________________________
1
Please refer to attached checklist of EIS Contents
1
ECC APPLICATION SCREENING FORM FOR THERMAL POWER PLANT PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
Page # Acceptable?
CONTENTS REMARKS
Items to be
Specific Data Requirement Page # Acceptable?
REMARKS
Described
II. I. Project Description
1)Project Location a) Map showing sitio, barangay, municipality,
and Area province, region boundaries, vicinity,
proposed buffers surrounding the area and
primary & secondary impact areas
b) Geographic coordinates (shape file data) of
project area (use PRS 92 datum - GPS
setting)
c) Rationale for selection primary & secondary
impact areas
d) Discussion on the accessibility of the project
site/area
2)Project Rationale Cite and focus on the need for the project
based on national and regional/local
economic development in terms of
contribution to sustainable development
agenda or current development thrusts.
Describe the justification for the Project
with particular reference to the economic
and social benefits, including employment
and associate economic development,
which the project may provide. The status
of the project should be discussed in a
regional and national context.
3)Project a) Cite criteria used in determining preliminary
Alternatives options for facility siting, development
design, process/technology selection,
resource utilization, including discussion of
the consequences of not proceeding with
the project:
Contextualize site selection in terms of
vulnerability/susceptibility to liquefaction,
ground shaking, ground rupture,
earthquake-induced landslides, volcanic
eruptions, rain-induced landslide, storm
surge, tsunami, and flooding as well as
extreme climatologic conditions (data
can be obtained from NDRRMC and
NAMRIA as well as other mandated
agencies)
2
ECC APPLICATION SCREENING FORM FOR THERMAL POWER PLANT PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
Items to be
Specific Data Requirement Page # Acceptable?
REMARKS
Described
Discuss the alternatives (type and
location) considered and nominated
during the course of selecting the best
option for which the EIS is prepared;
Describe the bases upon which the
alternatives were rejected in favor of the
preferred option;
Describe the significant differences in
environmental impacts among the
alternatives considered.
Siting: Cite alternative project locations
including factors significant to the selection,
such as perception of affected communities
with regards to project, ancestral domain
issues, land classification, etc. Discuss
other options on the siting of major
components of the project within the project
area.
3
ECC APPLICATION SCREENING FORM FOR THERMAL POWER PLANT PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
Items to be
Specific Data Requirement Page # Acceptable?
REMARKS
Described
Identification of pollution control devices
including other waste management and
corresponding facility being served or
connected
Identification of safety devices/ emergency
facilities to be used in the occurrence of
industrial accidents/emergencies (ie. fire,
explosion, accidental oil spillage etc.)
General layout of facilities
Footprint of proposed layout of project
facilities (if any)
Maps should be provided showing the
precise location of the project area, and in
particular, the location and boundaries of
project area, location and footprint of project
components, and location of all proposed
buffers.
When applicable, contextualize using the
PAG-ASA 2020 and 2050 projected
rainfall/temperature data.
5) Process/ Technology Description and Performance
Technology Specifications
4
ECC APPLICATION SCREENING FORM FOR THERMAL POWER PLANT PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
Items to be
Specific Data Requirement Page # Acceptable?
REMARKS
Described
identified above) in terms of raw materials
and fuel requirements, infrastructure
requirements (transportroad/rail/ship,
power, water supply and storage, storm
water drainage, sewerage,
telecommunications, accommodation and
other infrastructure), waste management
(characteristics and quantities of waste
materials: wastewater, air emissions, solid
wastes - toxic and hazardous, non toxic and
non hazardous)
Abandonment
Final Rehabilitation/ Decommissioning Plan,
to include land/soil restoration,
decontamination or remediation activities and
procedures & projected schedule. There
should also be discussions about strategies
and methods for final rehabilitation of the
environment disturbed by the project. The
land use suitability of the various land
disturbance types should likewise be
described.
manpower requirements;
expertise/skills needed;
nature & estimated number of jobs
available for men, women, and indigenous
peoples (if sited in IP ancestral land);
preferred scheme for sourcing locally from
host and neighboring LGUs
9)Indicative Project Investment Cost (Philippine Peso)
5
ECC APPLICATION SCREENING FORM FOR THERMAL POWER PLANT PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
V. Social SDP
Development Plan
(SDP) and IEC Community development or livelihood
Framework programs/activities, projected beneficiaries,
partner institutions, timeframe of
implementation as well as source and amount
allotted per activity/component (See Annex 2-
18 of RPM for DAO 2003-30)
IEC
6
ECC APPLICATION SCREENING FORM FOR THERMAL POWER PLANT PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
7
ECC APPLICATION SCREENING FORM FOR THERMAL POWER PLANT PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
1.2 Geology/Geomorphology
1.2.1 Change in surface Slope and Elevation/Topographic Map
landform/ topography/
terrain/slope
8
ECC APPLICATION SCREENING FORM FOR THERMAL POWER PLANT PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
1.3 Pedology
1.3.1 Soil erosion / Loss of Summary of Soil Investigation Report Include discussions on
topsoil/overburden on soil type and quality; Erodibility potential land
potential; Bank stability contamination due to
project operations. Relate
discussions to soil
characteristics.
1.4 Terrestrial Ecology
1.4.1 Vegetation removal and Flora and fauna species inventory or Quadrat sampling for
loss of habitat survey report; flora
Historical occurrences of pest
infestation, forest/grass fire and/or Use of mist nets, traps,
similar incidences transect walk for fauna
1.4.2 Threat to existence and/or Summary of endemicity / conservation
loss of important local status Include discussions on
species
overall impact to flora
1.4.3Threat to abundance, Summary of abundance, frequency
frequency and distribution and distribution and fauna
of important species Economic importance and uses of
significant flora and fauna Include impact
1.4.4 Hindrance to wildlife Sampling / survey map in relation to assessment on
access the project site vegetation (e.g.,
likelihood of destruction)
and specific management
measures (e.g.,
protection, balling,
transplanting,
replacement, etc.)
2. THE WATER
2.1 Hydrology/Hydrogeology
2.1.1 Change in drainage Drainage map; historical Discuss possible impacts
morphology / Inducement of flooding/drought occurrences, stream of the project on the
9
ECC APPLICATION SCREENING FORM FOR THERMAL POWER PLANT PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
Assessment should
include potential
occurrence or
aggravation of flooding in
nearby areas.
2.1.2 Change in stream, lake Regional hydrogeological map
water depth
10
ECC APPLICATION SCREENING FORM FOR THERMAL POWER PLANT PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
11
ECC APPLICATION SCREENING FORM FOR THERMAL POWER PLANT PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
3. THE AIR
3.1 Meteorology/Climatology
3.1.1 Change in the local Monthly average rainfall and In the assessment,
climate, e.g., local temperature temperature of the area; Climatological consider the PAG-ASA
normals/extremes; Wind rose climate change
projections for 2020 and
diagrams; Frequency of Tropical
2050.
cyclones
3.1.2 Contribution in terms of Data on Greenhouse gasses (i.e., Discuss the projects
greenhouse gas emissions carbon dioxide, nitrous oxide); contribution in terms of
Calculation of projected GHG emission greenhouse gas
emissions
others:
__________________________
(for sampling methods refer to Clean
Air Act)
If applicable, noise
attenuation modeling
(applicable if there is a
source capable of
generating 200 dB or
more).
4. THE PEOPLE
4.1 Displacement of settler/s Demographic data of impact area: Discuss how the project
would affect existing
Displacement / disturbance - Number of households and properties in the area in
of properties household size terms of relocation and
- Land area,
devaluation
Change/conflict in land - Population,
ownership - Population density /growth
- Gender and age profile,
Change/conflict in right of - Literacy rate, profile of educational
way attainment,
13
ECC APPLICATION SCREENING FORM FOR THERMAL POWER PLANT PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
14
ECC APPLICATION SCREENING FORM FOR THERMAL POWER PLANT PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
15
ECC APPLICATION SCREENING FORM FOR THERMAL POWER PLANT PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
16
ECC APPLICATION SCREENING FORM FOR THERMAL POWER PLANT PROJECTS
(Requiring EIS for ECC Application)
Control No: __________
1st 2nd 3rd ___ th Screening
1. 1.
2. 2.
3. 3.
4. Project Proponent:
5.
6. Project Preparer/Consultant:
Resource Person
1.
17
1
Annex 2 - A
for
This IEE Checklist Report Form shall be used for proposed BATCHING AND CRUSHING PLANT
PROJECTS required an IEE Report / IEE Checklist for ECC Application.
This IEE Checklist Report Form shall be submitted along with the following documents:
Read the questions carefully and write the required information on the spaces provided or
otherwise check () the appropriate boxes . Boxes with check marks are mandatory
requirements. Use additional sheets if necessary and indicate this in the appropriate space.
Misleading or erroneous answers are grounds for legal action and/or denial of ECC
issuance.
OK FOR PRINTING:
________________________________________
Signature over Printed Name
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Batching & Crushing Plant Projects 2
Proponent Name
Proponent Address
I. PROJECT DESCRIPTION
Please check project type and indicate size
Project Type Project Size
Project Size
Parameter
annual production
Batching & Crushing Plant
rate
See attached vicinity map/s and photographs of the project site and site development/layout plan.
Geographic coordinates of the project area (Preferably use PRS 92 datum; otherwise, specify datum used).
Perimeter/Boundary points (based Longitude Latitude
on OCT/TCT/etc.)
Initial Environmental Examination (IEE) Checklist Report Form for Batching & Crushing Plant Projects 3
6. Water source/supply
9. Drainage system
Power/Electricity KWh
(From Renewable Energy Sources)
Water m3/day
(Rainwater Collection System)
Water Source
____________________________________________________________________
(Sitio/Zone, Barangay, Municipality/City, Province, Region)
Initial Environmental Examination (IEE) Checklist Report Form for Batching & Crushing Plant Projects 5
Energy/Water Efficiency
Proposed Efficiency/Conservation
Estimated Savings
Utilities Measures
Power/Electricity KWh
3
Water m /day
I.4 MANPOWER
a. Construction Phase
Manpower Requirement Expertise/Skills Total
b. Operation Phase
Manpower Requirement Expertise/Skills Total
Residential
Commercial/ Institutional
Industrial
Agricultural/ Recreational
Protected Areas
Others, specify
______________
Residential
Commercial/ Institutional
Industrial
Agricultural/ Recreational
Protected Areas
Others, specify
______________
Disturbance to Existing vegetation in the area: Comply with conditions of Annual inspection of Cost integrated in the
wildlife due to DENR/LGU SLUP, Tree Cutting area replanted/ re- construction /operation
vegetation clearing Forestland Permit, ROW, PCA Permit vegetated cost
Marshland
Limit land clearing as much as
possible
Grassland Provide temporary fencing for
Mangrove vegetation that will be retained
Wetland Promote restoration of damaged or
Initial Environmental Examination (IEE) Checklist Report Form for Batching & Crushing Plant Projects 7
7
Possible Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Others, specify destroyed vegetation where possible
(e.g., tree planting)
____________
Change in surface Slope: Provide erosion control and slope Regular inspection of Slope/ Erosion Control
landform/ protection measures slope protection Cost: ___________
topography/ flat (0-3%) Designate a Spoils Storage Area, measures in erosion- Others, specify
terrain/slope prone areas
gently sloping to rolling (3- with topsoil set aside for later use _________________
18%) and allow maximum re-use of spoils Regular inspection for
Soil Erosion steep (>18%) Construct during dry season new eroded areas near
the site
Stabilize embankment with grasses
Others, specify
or other soil cover
_________________
Others, specify
____________
sandy-loam
Implement re-use and recycling of presence of mixed
waste materials garbage in the facility
Others, specify
Implement proper segregation, Weekly inspection of
____________________ waste accumulated
collection and disposal of domestic
wastes in designated areas Others, specify
Implement proper collection, _________________
labeling and storage of hazardous
waste
Provide receptacles / bins for solid
wastes
Coordinate with the municipal / city
Initial Environmental Examination (IEE) Checklist Report Form for Batching & Crushing Plant Projects 8
8
Possible Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
waste collectors
Engage third party company for
waste collection
Others, specify
________________
Impairment of Presence of visually significant Implement landscaping and other Regular inspection of Cost integrated in the
visual aesthetics landforms/ beautification measures landscaping and other construction/ operation
Devaluation of land landscape/structures? Provide adequate buffer beautification activities cost
values Compensate adjacent property Regular monitoring of
Yes owners buffer zones
No Others, specify
Regular monitoring for
________________ presence/absence of
complaints from adjacent
property owners
WATER
Increased siltation
Specify nearest/receiving Provide ring canals around fuelling Regular (ocular) inspection Cost integrated in the
water body: tanks/ motor pool/ maintenance of water body for: construction/ operation
due to project _____________________ areas cost
activities
Set up proper and adequate sanitary Turbidity and/or silted
Water quality Distance to nearest/receiving facilities condition
degradation water body:
Strictly require the contractor and its Floating wastes or debris
Others, specify workers to observe proper waste
_____________ 0 to less than 0.5 km disposal and proper sanitation
0.5 to 1 km Strictly observe proper waste
More than 1 km handling and disposal
Provide wastewater treatment
If nearest/receiving water body facility (e.g., septic tank, oil and
is fresh water, specify water separator, etc.)
classification: Set up silt trap/settling ponds to
AA minimize downstream siltation
A Others, specify
B ______________
C
D
Initial Environmental Examination (IEE) Checklist Report Form for Batching & Crushing Plant Projects 9
9
Possible Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
If nearest/receiving water body
is coastal or marine water,
specify classification:
SA
SB
SC
SD
Deepwell
Water district/LGU
Surface water
Others, specify
________________
Initial Environmental Examination (IEE) Checklist Report Form for Batching & Crushing Plant Projects 10
10
Possible Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Increased Is the project site located in an
area identified by MGB/
Use appropriate design for project Regular monitoring for Cost integrated in the
occurrence of facilities presence/absence of construction/ operation
PAG-ASA as flood prone?
flooding
Implement appropriate drainage
complaints cost
Yes system Regular coordination
No Limit the depth and area of
with concerned agencies
workspace Regular monitoring for
increased frequency of
Regularly remove debris and other flooding
materials that may obstruct water
flow Others, specify
__________________
Use appropriate technology (e.g.,
raised hand-pumps) to protect
drinking water from flood
contamination
Others, specify____________
AIR/NOISE
Air quality degradation Distance to nearest Properly operate and maintain all Regular monitoring for Cost integrated in the
community: emission sources (e.g., vehicles, presence/absence of construction/ operation
generator, etc.) complaints cost
0 to less than 0.5 km Install, when applicable, the
0.5 to 1 km appropriate air pollution control Regular (ocular) inspection
of:
More than 1 km
device/s
Strictly enforce good housekeeping Absence of white or
practices black smoke from
Control vehicle speed to lessen vehicles, generator,
etc.
suspension of road dust
Conduct water spraying to Presence of truck
suppress dust sources and cover during
minimize discomfort to nearby deliveries
residents
Quarterly monitoring of
Use covered vehicles to deliver ambient air for the following:
materials that may generate dust
Others, specify
TSP
__________________ PM10
NOx
Initial Environmental Examination (IEE) Checklist Report Form for Batching & Crushing Plant Projects 11
11
Possible Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
SOx
CO / CO2
Nuisance due to Distance to nearest Properly operate and maintain all Regular monitoring for Cost integrated in the
noise generation community: noise sources (e.g., vehicles, presence/absence of construction/ operation
generator, etc.) complaints cost
0 to less than 0.5 km Install, when applicable, the Regular monitoring of
0.5 to 1 km appropriate noise control device/s buffer zones
More than 1 km
(e.g., mufflers, silencer, sound Quarterly monitoring of
barriers, etc.) noise level
Implement appropriate operating
hours
Provide adequate buffer
(e.g., Perimeter planting of trees to
serve as sound buffer and greenbelt)
Others, specify
_________________
PEOPLE
Displacement of Size of population of host Provide relocation/disturbance Regular monitoring for Cost integrated in the
residents in the barangay: compensation packages presence/absence of construction/ operation
project site and Prioritize local residents for complaints cost
within its vicinity
1,000 persons employment Regular coordination
Displacement of
>1,000 and 5,000 Promptly pay local taxes and other with LGU
Indigenous Peoples
persons financial obligations Others, specify
Enhanced
>5,000 persons
Regular coordination with LGU ______________
employment and/or
livelihood
Conduct prior consultation and
Classification of host coordination to minimize disruption of
opportunities
barangay: daily domestic activities and to
Reduced
Urban
ensure respect for IP rights and
employment and/or cultural practices
livelihood Rural
Ensure participation of IPs in
opportunities
consultations and dialogues
Increased revenues Available services within/near
the host barangay: Provide appropriate traffic/warning
for LGU
Disruption/ Schools (e.g.
signs, lighting, etc.
13
III. ABANDONMENT / DECOMMISSIONING / REHABILITATION POLICIES AND GENERIC
GUIDELINES (if Applicable)
Provide description of the Abandonment activities, such as dismantling and waste disposal.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
14
Attach drawing/plan of waste water treatment facility (with dimensions and descriptions)
Initial Environmental Examination (IEE) Checklist Report Form for Batching & Crushing Plant Projects 15
15
Process flow
Initial Environmental Examination (IEE) Checklist Report Form for Batching & Crushing Plant Projects 16
16
Attach drawing/plan of pollution source and control installations (with dimensions and descriptions)
Initial Environmental Examination (IEE) Checklist Report Form for Batching & Crushing Plant Projects 17
17
SWORN STATEMENT OF ACCOUNTABILITY OF THE PROPONENT
This is to certify that all the information and commitments in this Initial Environmental
Examination (IEE) Checklist Report are accurate and complete to the best of my knowledge.
I hereby bind myself to answer any penalty that may be imposed arising from any
misrepresentation or failure to state material information in this IEE Checklist.
____________________________________
NAME OF PROPONENT HEAD
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
SUBSCRIBED AND SWORN TO before me this _____ day of ____________ 201__, affiant exhibiting
his/her Community Tax Certificate No. ___________________ issued at ______________________ on
__________________________.
Annex 2 - B
INITIAL ENVIRONMENTAL EXAMINATION (IEE) CHECKLIST REPORT FORM
for
This IEE Checklist Report shall be used for proposed FISHERY / AQUACULTURE PROJECTS
required an IEE Report or IEE Checklist Report for ECC Application.
This IEE Checklist Report shall be submitted along with the following documents:
Read the questions carefully and write the required information on the spaces provided or
otherwise check () the appropriate boxes . Boxes with check marks are mandatory
requirements. Use additional sheets if necessary and indicate this in the appropriate space.
Misleading or erroneous answers are grounds for legal actions and/or denial of ECC
issuance.
OK FOR PRINTING:
________________________________________
Signature over Printed Name
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Fishery/Aquaculture Projects 2
Name of the
Project
Proponent Name
Proponent
Address
I. PROJECT DESCRIPTION
Please check project type and indicate size
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
II.
See attached vicinity map/s and photographs of the project site and site development/layout plan.
Initial Environmental Examination (IEE) Checklist Report Form for Fishery/Aquaculture Projects 3
Geographic coordinates of the project area (Preferably use PRS 92 datum; otherwise, specify datum used).
Perimeter/Boundary points (based
Longitude Latitude
on OCT/TCT/etc)
2. Hatchery / Nursery
4. Storage facility
5. Postharvest facility
7. Others, specify
__________________
__________________
Power/Electricity KWh
3
Water (Total) m /day
Water m3/day
Water Source
____________________________________________________________________
(Sitio/Zone, Barangay, Municipality/City, Province, Region)
Initial Environmental Examination (IEE) Checklist Report Form for Fishery/Aquaculture Projects 5
Energy/Water Efficiency
Estimated Proposed Efficiency/Conservation Measures
Utilities Savings
Power/Electricity KWh
Water m3/day
I.4 MANPOWER
a. Construction Phase
Manpower Expertise/Skills Total
Requirement
b. Operation Phase
Manpower Expertise/Skills Total
Requirement
Disturbance to Existing vegetation in the area: Comply with conditions of Annual inspection of Cost integrated in the
wildlife due to DENR/LGU SLUP, Tree area replanted/ construction /operation
vegetation clearing Forestland Cutting Permit, ROW, PCA
Permit
re-vegetated cost
WATER
Current Water Use: Set up proper and Regular (ocular) inspection Cost integrated in the
of water body for:
Fishery
adequate sanitary facilities construction/ operation
Water quality
Strictly observe proper cost
degradation Tourist Zone / Park waste handling and Drainage/canal system
Others, specify Recreational disposal
____________ Industrial
Agricultural
Increased Is the project site located in an area Use appropriate design for Regular monitoring for Cost integrated in the
occurrence of identified by MGB/ PAG-ASA as project facilities presence/absence of construction/ operation
flooding flood prone?
Implement appropriate
complaints cost
drainage system Regular coordination
Yes Regularly remove debris
with concerned
No and other materials that
agencies
may obstruct water flow Regular monitoring for
increased frequency of
Use appropriate flooding
technology (e.g., raised
hand-pumps) to protect Others, specify
drinking water from flood _________________
contamination
Others, specify
__________________
Initial Environmental Examination (IEE) Checklist Report Form for Fishery/Aquaculture Projects 9
PEOPLE
Displacement of
Size of population of host barangay:
Provide Presence/Absence of Cost integrated in the
residents in the relocation/disturbance complaints construction/ operation
project site and compensation packages Regular coordination cost
within its vicinity 1,000 persons Prioritize local residents for with LGU
Displacement of >1,000 and 5,000 persons employment Others, specify
Indigenous Peoples >5,000 persons Promptly pay local taxes _________________
Enhanced and other financial
employment and/or obligations
livelihood Classification of host barangay: Regular coordination with
opportunities LGU
Reduced Urban Prior consultation and
employment and/or
livelihood
Rural coordination to minimize
disruption on daily
opportunities domestic activities & to
Increased revenues Available services within/near the host ensure respect for IP
for LGU barangay: rights and cultural practices
Disruption/ Ensure participation of IPs
Competition in Schools (e.g. elementary, high in consultations and
dialogues
delivery of public school, college)
services (e.g.,
Health facilities (e.g., clinics, Provide appropriate
education, peace traffic/warning signs,
hospitals, etc.)
and order, etc.) lighting, etc
Enhanced delivery of
Peace and order (e.g., police
Others, specify
outpost, Brgy. Tanod, etc.)
public services (e.g., _________________
education, peace Recreation and sports facilities
and order, etc.) Others, specify
Increase in traffic ___________________
volume and
worsening of traffic
flow
Depletion of local
fish populations by
stocking of wild
fry/fingerlings in
ponds
Initial Environmental Examination (IEE) Checklist Report Form for Fishery/Aquaculture Projects1010 10
Provide description of the Abandonment activities, such as dismantling and waste disposal.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
Initial Environmental Examination (IEE) Checklist Report Form for Fishery/Aquaculture Projects1111 11
Attach drawing/plan of pollution source and control installations (with dimensions and descriptions)
Initial Environmental Examination (IEE) Checklist Report Form for Fishery/Aquaculture Projects1212 12
This is to certify that all the information and commitments in this Initial Environmental
Examination (IEE) Checklist Report are accurate and complete to the best of my knowledge.
I hereby bind myself to answer any penalty that may be imposed arising from any
misrepresentation or failure to state material information in this IEE Checklist.
____________________________________
NAME OF PROPONENT HEAD
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
SUBSCRIBED AND SWORN TO before me this _____ day of ____________ 201__, affiant exhibiting
his/her Community Tax Certificate No. ___________________ issued at ______________________ on
__________________________.
Annex 2 - C
for
This IEE Checklist Report Form shall be used for proposed FOOD, FOOD BY-PRODUCT
AND BEVERAGES MANUFACTURING/PROCESSING PLANT PROJECTS required an IEE
Report / IEE Checklist for ECC Application.
This IEE Checklist Report Form shall be submitted along with the following documents:
Read the questions carefully and write the required information on the spaces provided or
otherwise check () the appropriate boxes . Boxes with check marks are mandatory
requirements. Use additional sheets if necessary and indicate this in the appropriate space.
Misleading or erroneous answers are grounds for legal action and/or denial of ECC issuance.
OK FOR PRINTING:
________________________________________
Signature over Printed Name
___________________________
Date
IEE Checklist Report Form for Food & Food By-product & Beverages Manufacturing/Processing Plant Projects2 2
Name of the
Project
Proponent Name
Proponent
Address
I. PROJECT DESCRIPTION
Please check project type and indicate size
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
IEE Checklist Report Form for Food & Food By-product & Beverages Manufacturing/Processing Plant Projects3 3
II.
See attached vicinity map/s and photographs of the project site and site development/layout plan.
Geographic coordinates of the project area (Preferably use PRS 92 datum; otherwise, specify datum used).
Perimeter/Boundary points (based Longitude Latitude
on OCT/TCT/etc)
Others, specify
__________________
2. Processing facility
Material preparation and
handling (e.g., screening,
sorting, conveyor belt, etc.)
Material size
reduction/agglomeration
Heating/Drying (direct
heat/energy application)
Processing (e.g., mixing,
blending, refining, milling,
pasteurization, etc.)
Distillation and fermentation
IEE Checklist Report Form for Food & Food By-product & Beverages Manufacturing/Processing Plant Projects4 4
Power/Electricity KWh
3
Water m /day
Water Source
____________________________________________________________________
(Sitio/Zone, Barangay, Municipality/City, Province, Region)
Energy/Water Efficiency
Power/Electricity KWh
Water m3/day
I.4 MANPOWER
a. Construction Phase
Manpower Expertise/Skills Total
Requirement
IEE Checklist Report Form for Food & Food By-product & Beverages Manufacturing/Processing Plant Projects6 6
b. Operation Phase
Manpower Expertise/Skills Total
Requirement
Residential
Commercial/ Institutional
Industrial
Agricultural/ Recreational
Protected Areas
Others, specify
___________________
Residential
Commercial/ Institutional
Industrial
Agricultural/ Recreational
Protected Areas
Others, specify
___________________
Disturbance to wildlife Existing vegetation in the area: Comply with conditions of Annual inspection of Cost integrated in
due to vegetation DENR/LGU SLUP, Tree Cutting area replanted/ the construction/
clearing Forestland Permit, ROW, PCA Permit re-vegetated operation cost
Marshland Limit land clearing as much as
Grassland
possible
Provide temporary fencing for
Mangrove vegetation that will be retained
Wetland Promote restoration of damaged
Others, specify or destroyed vegetation where
____________________ possible (e.g., tree planting)
IEE Checklist Report for Food & Food By-product & Beverages Manufacturing/Processing Plant Projects88 8
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Change in surface Slope: Provide erosion control and slope Regular inspection of Slope/ Erosion
landform/ topography/ protection measures slope protection Control Cost:
terrain/slope flat (0-3%) Designate a Spoils Storage Area, measures in erosion- ___________
gently sloping to rolling (3- with topsoil set aside for later use prone areas Others, specify
18%) and allow maximum re-use of Regular inspection for ____________
Soil Erosion steep (>18%) spoils new eroded areas
Construct during dry season near the site
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Others, specify
________________
Impairment of visual Presence of visually significant Implement landscaping and other Regular inspection of Cost integrated in
aesthetics landforms/landscape/structures? beautification measures landscaping and other the construction/
Devaluation of land Provide adequate buffer beautification activities operation cost
values Yes
Compensate adjacent property Regular monitoring of
No owners buffer zones
Others, specify
Regularly monitor
________________ presence/absence of
complaints from
adjacent property
owners
WATER
Increased siltation due Specify nearest/receiving water Set up proper and adequate Regular (ocular) Cost integrated in
to project activities body: sanitary facilities inspection of: the construction/
Water quality
____________________________ Strictly require the contractor and operation cost
degradation its workers to observe proper Drainage / canal
Distance to nearest/receiving water systems
Others, specify
waste disposal and proper
___________________
body: sanitation Water treatment
Strictly observe proper waste facility (i.e., grease
0 to less than 0.5 km handling and disposal trap, septic tank, etc.)
0.5 to 1 km Provision of wastewater treatment
More than 1 km facility (e.g., septic tank, oil and
water separator, etc.) Quarterly monitoring of the
Set up silt trap/stilling ponds to
following:
If nearest/receiving water body is minimize downstream siltation
fresh water, specify classification: Provision of three-chambered
pH
septic tank for domestic sewage TSS concentration
AA Provide ring canals around BOD
A fuelling tanks/ motorpool/ Total Coliform
maintenance areas
B Color
C
Others, specify
Oil and Grease
______________________
D
IEE Checklist Report for Food & Food By-product & Beverages Manufacturing/Processing Plant Projects1010 10
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
If nearest/receiving water body is
coastal or marine water, specify
classification:
SA
SB
SC
SD
Fishery
Tourist Zone / Park
Recreational
Industrial
Agricultural
Drinking/Domestic
Industrial
Agricultural
IEE Checklist Report for Food & Food By-product & Beverages Manufacturing/Processing Plant Projects1111 11
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Competition in water Size of population using receiving Implement rainwater harvesting Regular monitoring for Cost integrated in
use surface water: and similar measures as an presence/absence of the construction/
Depletion of water alternative source of water complaints operation cost
resources 1,000 persons Observe water conservation Regular coordination
>1,000 and 5,000 persons measures; with concerned
>5,000 persons Carefully select project site to
agencies
avoid disruption of traditional Regularly monitor
water uses occurrences of water
shortages
Available/nearest water source. Obtain Water Permit from NWRB
Improve efficiency of water
Others, specify
Deepwell supply and distribution system
____________
Increased occurrence Is the project site located in an Use appropriate design for project Regular monitoring for Cost integrated in
of flooding area identified by MGB/PAG-ASA facilities presence/absence of the construction/
as flood prone? Implement appropriate drainage
complaints operation cost
system Regular coordination
Yes Regularly remove debris and
with concerned
No other materials that may obstruct
agencies
water flow Regular monitoring for
increased frequency of
Use appropriate technology (e.g., flooding
raised hand-pumps) to protect
drinking water from flood Others, specify
contamination _________________
Others, specify
_____________________
IEE Checklist Report for Food & Food By-product & Beverages Manufacturing/Processing Plant Projects1212 12
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
AIR / NOISE
Air quality degradation Distance to nearest community: Properly operate and maintain all Regular monitoring for Cost integrated in
emission sources (e.g. vehicles, presence/absence of the construction/
0 to less than 0.5 km pumps, generator, etc) complaints operation cost
0.5 to 1 km Install when applicable, the
More than 1 km appropriate air pollution control Regular monitoring of
device/s the following:
Strictly enforce good TSP
housekeeping practices NOx
Control vehicle speed to lessen SOx
suspension of road dust
Conduct water spraying to Frequency
suppress dust sources and Annual
minimize discomfort to nearby
residents Semi-annual
Use covered vehicles to deliver Regular (ocular)
materials that may generate dust inspection of:
Other, specify Absence of white
___________________ or black smoke
from vehicles,
heavy equipment
and generator
Presence of truck
cover during
deliveries
Nuisance due to noise Distance to nearest community: Properly operate and maintain all Regular monitoring for Cost integrated in
generation noise sources (e.g. vehicles, presence/absence of the construction/
0 to less than 0.5 km pumps, generator, etc) complaints operation cost
0.5 to 1 km Install, when applicable, the Regular monitoring of
More than 1 km appropriate noise control device/s
(e.g., mufflers, silencer, sound
buffer zones
barriers, etc.)
Implement appropriate operating
hours
Provide adequate buffer and/or
IEE Checklist Report for Food & Food By-product & Beverages Manufacturing/Processing Plant Projects1313 13
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
planting of trees
Others, specify
______________________
PEOPLE
Displacement of Size of population of host Provide relocation/disturbance Regular monitoring for Cost integrated in
residents in the project barangay: compensation packages presence/absence of the construction/
site and within its Prioritize local residents for complaints operation cost
vicinity
1,000 persons employment Regular coordination
Displacement of
>1,000 and 5,000 persons Promptly pay local taxes and with LGU
Indigenous People other financial obligations Others, specify
Enhanced >5,000 persons
Regularly coordinate with LGU _________________
employment and/or
livelihood
Conduct prior consultation &
Classification of host barangay: coordination to minimize
opportunities
disruption on daily domestic
Reduced employment
Urban
activities and to ensure respect for
and/or livelihood IP rights and cultural practices
opportunities Rural
Ensure participation of IPs in
Increased revenues consultations and dialogues
for LGU
Available services within/near the Provide appropriate traffic/warning
Disruption/Competition
host barangay: signs, lighting, etc
in delivery of public
services (e.g.,
Others, specify
education, peace and Schools (e.g., elementary, high ________________
order, etc.) school, college)
Enhanced delivery of Health facilities (e.g., clinics,
public services (e.g., hospitals, etc.)
education, peace and Peace and order (e.g., police
order, etc.) outpost, Brgy. Tanod, etc.)
Increase in traffic Recreation and sports facilities
volume and worsening
of traffic flow Others, specify
_____________________
IEE Checklist Report for Food & Food By-product & Beverages Manufacturing/Processing Plant Projects1414 14
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Impacts on community Source of risks Regularly coordinate with LGU Regular monitoring for Cost integrated in
health and safety Observe proper housekeeping presence/absence of the construction/
Flammable substances
Strictly comply with fire, safety
complaints operation cost
Others and similar regulatory Regular monitoring of
Safety Risks _________________________ buffer zones
requirements
Fire
Others, specify Regular coordination
___________________________ with LGU
Regular submission of
reports to concerned
agency
Others, specify
_________________
IEE Checklist Report Form for Food & Food By-product & Beverages Manufacturing/Processing Plant Projects1515 15
Provide description of the Abandonment activities, such as dismantling and waste disposal.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
IEE Checklist Report Form for Food & Food By-product & Beverages Manufacturing/Processing Plant Projects1616 16
Attach drawing/plan of waste water treatment facility (with dimensions and descriptions)
IEE Checklist Report Form for Food & Food By-product & Beverages Manufacturing/Processing Plant Projects1717 17
Process Flow
IEE Checklist Report Form for Food & Food By-product & Beverages Manufacturing/Processing Plant Projects1818 18
Attach drawing/plan of pollution source and control installations (with dimensions and descriptions)
IEE Checklist Report Form for Food & Food By-product & Beverages Manufacturing/Processing Plant Projects1919 19
This is to certify that all the information and commitments in this Initial Environmental
Examination (IEE) Checklist Report are accurate and complete to the best of my knowledge.
I hereby bind myself to answer any penalty that may be imposed arising from any
misrepresentation or failure to state material information in this IEE Checklist.
____________________________________
NAME OF PROPONENT HEAD
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
SUBSCRIBED AND SWORN TO before me this _____ day of ____________ 201__, affiant exhibiting
his/her Community Tax Certificate No. ___________________ issued at ______________________ on
__________________________.
for
This IEE Checklist Report Form shall be used for proposed NON-FOOD (Textile, Rubber,
Chemical) MANUFACTURING PLANT PROJECTS required an IEE Report / IEE Checklist for
ECC Application.
This IEE Checklist Report Form shall be submitted along with the following documents:
Read the questions carefully and write the required information on the spaces provided or
otherwise check () the appropriate boxes . Boxes with check marks are mandatory
requirements. Use additional sheets if necessary and indicate this in the appropriate space.
Misleading or erroneous answers are grounds for legal action and/or denial of ECC
issuance.
OK FOR PRINTING:
________________________________________
Signature over Printed Name
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Non-Food Manufacturing Plant Projects 2
Proponent Name
Proponent Address
I. PROJECT DESCRIPTION
Please check project type and indicate size
quantity of toxic
Manufacturing, processing and/or use of substances included in the chemicals to be used
Priority Chemical List
per month
Manufacture of agri-chemicals and other industrial chemicals not in
annual production rate
the PCL
Pharmaceutical industries and manufacture of soap and detergents,
annual production rate
health and beauty products, and other consumer products.
Surface coating industries (paints, pigments, varnishes, lacquers, anti-
annual production rate
capacity fouling coating, printing inks)
Textile, Wood, Rubber Industries
Textile, Wood, Rubber Industries annual production rate
Daily processing rate of
Leather and related industries
raw hides
Mineral Ore Processing
Metallic Mineral or Ore Processing (e.g., copper, lead, nickel, cobalt,
Annual processing rate
zinc, silver, magnesium, and manganese, gold, placer with metal
(inputs)
content) with Physical or Mechanical Processing
See attached vicinity map/s and photographs of the project site and site development/layout plan.
Geographic coordinates of the project area (Preferably use PRS 92 datum; otherwise, specify datum used).
Perimeter/Boundary points (based Longitude Latitude
on OCT/TCT/etc.)
2. Processing facility
Material preparation and handling
(e.g., screening, sorting, conveyor
belt, etc.)
Material size
reduction/agglomeration
Heating/Drying (direct heat/energy
application)
Processing (e.g., mixing, blending,
refining, milling, etc.)
Finishing (e.g., sorting, filling,
packaging, etc.)
Others, specify
________________
Power/Electricity KWh
(From Renewable Energy Sources)
Water m3/day
(Rainwater Collection System)
Water Source
____________________________________________________________________
(Sitio/Zone, Barangay, Municipality/City, Province, Region)
Initial Environmental Examination (IEE) Checklist Report Form for Non-Food Manufacturing Plant Projects 5
Energy/Water Efficiency
Proposed Efficiency/Conservation
Utilities Estimated Savings
Measures
Power/Electricity KWh
3
Water m /day
I.4 MANPOWER
a. Construction Phase
Manpower Requirement Expertise/Skills Total
b. Operation Phase
Manpower Requirement Expertise/Skills Total
Disturbance to Existing vegetation in the area: Comply with conditions of Annual inspection of Cost integrated in the
wildlife due to Forestland DENR/LGU SLUP, Tree Cutting
Permit, ROW, PCA Permit
area replanted/
re-vegetated
construction /operation
cost
vegetation clearing
Marshland
Limit land clearing as much as
Grassland possible
Mangrove Provide temporary fencing for
Wetland vegetation that will be retained
Others, specify Promote restoration of damaged or
_______________ destroyed vegetation where possible
(e.g., tree planting)
Initial Environmental Examination (IEE) Checklist Report Form for Non-Food Manufacturing Plant Projects 7
Possible Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Implementation Monitoring
Impacts
Change in surface Slope: Provide erosion control and slope Regular inspection of Slope/ Erosion Control
landform/ protection measures slope protection Cost: ___________
topography/ flat (0-3%) Designate a Spoils Storage Area, measures in erosion- Others, specify
terrain/slope prone areas
gently sloping to rolling (3- with topsoil set aside for later use __________________
18%) and allow maximum re-use of spoils Regular inspection for
Soil Erosion steep (>18%) Construct during dry season new eroded areas near
the site
Stabilize embankment with grasses
Others, specify
or other soil cover
_________________
Others, specify
____________
Possible Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Implementation Monitoring
Impacts
Impairment of Presence of visually significant Implement landscaping and other Regular inspection of Cost integrated in the
visual landforms/landscape/structure beautification measures landscaping and other construction/ operation
aesthetics s?
Provide adequate buffer beautification activities cost
Devaluation of Compensate adjacent property Regular monitoring of
land values Yes owners buffer zones
No Others, specify
Regular monitoring for
presence/absence of
________________
complaints from adjacent
property owners
WATER
AA
handling and disposal Total Coliform
Set up silt trap/stilling ponds to Color
A
minimize downstream siltation
Oil and Grease
B Others, specify Trace Metals (Pb,
C _________________ Cd, Hg, Cr6, As)
D
Initial Environmental Examination (IEE) Checklist Report Form for Non-Food Manufacturing Plant Projects 9
Possible Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Implementation Monitoring
Impacts
If nearest/receiving water body
is coastal or marine water,
specify classification:
SA
SB
SC
SD
Competition in Size of population using Implement rainwater harvesting and Regular monitoring for Cost integrated in the
water use receiving surface water: similar measures as an alternative presence/absence of construction/ operation
Depletion of water source of water complaints cost
resources 1,000 persons Observe water conservation Regular coordination
>1,000 and 5,000 measures with concerned agencies
persons Carefully select project site to avoid Regular monitoring for
>5,000 persons disruption of traditional water uses occurrences of water
shortages
Obtain Water Permit from NWRB
Initial Environmental Examination (IEE) Checklist Report Form for Non-Food Manufacturing Plant Projects 10
Possible Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Implementation Monitoring
Impacts
Available/nearest water
source.
Improve efficiency of water supply Others, specify
and distribution system _____________
Deepwell Others, specify
Water district/LGU ____________________
Surface water
Others, specify
________________
Increased Is the project site located in an Use appropriate design for project Regular monitoring for Cost integrated in the
occurrence of area identified by MGB/PAG- facilities presence/absence of construction/ operation
flooding ASA as flood prone?
Implement appropriate drainage
complaints cost
system Regular coordination
Yes Regularly remove debris and other
with concerned agencies
No materials that may obstruct water Regular monitoring for
flow increased frequency of
flooding
Use appropriate technology (e.g.,
raised hand-pumps) to protect Others, specify
drinking water from flood ________________
contamination
Others, specify
____________________
AIR / NOISE
Air quality degradation Distance to nearest Properly operate and maintain all Regular monitoring for Cost integrated in the
community: emission sources (e.g. vehicles, presence/absence of construction/ operation
boiler, generator, etc) complaints cost
0 to less than 0.5 km Install, when applicable, the
0.5 to 1 km appropriate air pollution control
More than 1 km
device/s
Strictly enforce good housekeeping
practices
Control vehicle speed to lessen
suspension of road dust
Initial Environmental Examination (IEE) Checklist Report Form for Non-Food Manufacturing Plant Projects 11
Possible Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Implementation Monitoring
Impacts
Quarterly monitoring of
ambient air for the following:
TSP
PM10
NOx
SOx
CO / CO2
Nuisance due to Distance to nearest Properly operate and maintain all Regular monitoring for Cost integrated in the
noise generation community: emission sources (e.g. vehicles, presence/absence of construction/ operation
boiler, generator, etc) complaints cost
0 to less than 0.5 km Install, when applicable, the
0.5 to 1 km appropriate air pollution control
More than 1 km
device/s
Strictly enforce good housekeeping
practices
Control vehicle speed to lessen
suspension of road dust
Conduct water spraying to suppress
dust sources and minimize
discomfort to nearby residents
Use covered vehicles to deliver
materials that may generate dust
Others, specify
____________________
Initial Environmental Examination (IEE) Checklist Report Form for Non-Food Manufacturing Plant Projects 12
Possible Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Implementation Monitoring
Impacts
PEOPLE
Displacement of Size of population of host Provide relocation/disturbance Regular monitoring for Cost integrated in the
residents in the barangay: compensation packages presence/absence of construction/ operation
project site and Prioritize local residents for complaints cost
within its vicinity 1,000 persons employment Regular coordination
Displacement of >1,000 and Promptly pay local taxes and other with LGU
Indigenous Peoples 5,000persons financial obligations Others, specify
Enhanced >5,000person Regular coordination with LGU _____________
employment and/or
livelihood
Conduct prior consultation and
coordination to minimize disruption
opportunities Classification of host of daily domestic activities and to
Reduced barangay: ensure respect for IP rights and
employment and/or cultural practices
livelihood
opportunities
Urban Ensure participation of IPs in
Possible Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Implementation Monitoring
Impacts
Impacts on Regularly coordinate with LGU Regular monitoring for Cost integrated in the
community health Provide appropriate warning signs, presence/absence of
complaints
construction/ operation
cost
and safety lighting and barricades, whenever
Others, specify practicable Regular coordination
_____________ Observe proper housekeeping with LGU
Provide on-site medical services for
Regular submission of
any emergency. reports to concerned
agency
Participate in public awareness
Others, specify
programs on health and safety
__________________
Implement appropriate safety
programs for both community and
workers
Strictly comply with fire, safety and
similar regulatory requirements
Strictly comply with requirements of
RA 6969
Others, specify
__________________________
Initial Environmental Examination (IEE) Checklist Report Form for Non-Food Manufacturing Plant Projects 14
Provide description of the Abandonment activities, such as, dismantling and waste disposal.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Organization Chart:
Initial Environmental Examination (IEE) Checklist Report Form for Non-Food Manufacturing Plant Projects 15
Process Flow
Initial Environmental Examination (IEE) Checklist Report Form for Non-Food Manufacturing Plant Projects 16
Attach drawing/plan of waste water treatment facility (with dimensions and descriptions)
Initial Environmental Examination (IEE) Checklist Report Form for Non-Food Manufacturing Plant Projects 17
Attach drawing/plan of pollution source and control installations (with dimensions and descriptions)
Initial Environmental Examination (IEE) Checklist Report Form for Non-Food Manufacturing Plant Projects 18
This is to certify that all the information and commitments in this Initial Environmental Examination
(IEE) Checklist Report are accurate and complete to the best of my knowledge.
I hereby bind myself to answer any penalty that may be imposed arising from any
misrepresentation or failure to state material information in this IEE Checklist.
____________________________________
NAME OF PROPONENT HEAD
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
SUBSCRIBED AND SWORN TO before me this _____ day of ____________ 201__, affiant exhibiting
his/her Community Tax Certificate No. ___________________ issued at ______________________ on
__________________________.
Annex 2 - E
for
This IEE Checklist Report Form shall be used for proposed SUBDIVISIONS AND HOUSING
PROJECTS required an IEE Report / IEE Checklist for ECC Application.
This IEE Checklist Report Form shall be submitted along with the following documents:
Read the questions carefully and write the required information on the spaces provided or
otherwise check () the appropriate boxes . Boxes with check marks are mandatory
requirements. Use additional sheets if necessary and indicate this in the appropriate space.
Misleading or erroneous answers are grounds for legal action and/or denial of ECC
issuance.
OK FOR PRINTING:
________________________________________
Signature over Printed Name
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Subdivision & Housing Projects 2
Proponent Name
Proponent Address
I. PROJECT DESCRIPTION
Please Check Project Type (indicate total land area below)
Total land area, including all common, open and other areas : ___________________ Hectares
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
See attached vicinity map/s and photographs of the project site and site development/layout plan.
Initial Environmental Examination (IEE) Checklist Report Form for Subdivision & Housing Projects 3
Geographic coordinates of the project area (Preferably use PRS 92 datum; otherwise, specify datum used).
Perimeter/Boundary points (based Longitude Latitude
on OCT/TCT/etc.)
Power/Electricity KWh
(From Renewable Energy Sources)
Water Source
____________________________________________________________________
(Sitio/Zone, Barangay, Municipality/City, Province, Region)
Initial Environmental Examination (IEE) Checklist Report Form for Subdivision & Housing Projects 5
Energy/Water Efficiency
Proposed Efficiency/Conservation
Utilities Estimated Savings
Measures
Power/Electricity KWh
3
Water m /day
I.4 MANPOWER
a. Construction Phase
Manpower Requirement Expertise/Skills Total
b. Operation Phase
Manpower Requirement Expertise/Skills Total
Residential
Commercial/ Institutional
Industrial
Agricultural/ Recreational
Protected Areas
Others, specify
______________
Residential
Commercial/ Institutional
Industrial
Agricultural/ Recreational
Protected Areas
Others, specify
______________
Disturbance to Existing vegetation in the area: Comply with conditions of Annual inspection of Cost integrated in the
wildlife due to DENR/LGU SLUP, Tree Cutting area replanted/ construction/operation
vegetation clearing Forestland Permit, ROW, PCA Permit re-vegetated cost
Marshland
Limit land clearing as much as
possible
Grassland Provide temporary fencing for
Initial Environmental Examination (IEE) Checklist Report Form for Subdivision & Housing Projects 7
Soil Erosion steep (>18%) Construct during dry season new eroded areas near
the site
Stabilize embankment with grasses Others, specify
or other soil cover ______________
Others, specify
____________
Is the project site located in an
area identified by MGB/ Comply with DENR Administrative
Order No. 2003-30 and DENR
PAG-ASA/ PHIVOLCS as Administrative Order No. 2000-28,
hazard prone? Implementing Guidelines on
Engineering Geological and Geo-
Yes hazard Assessment (EGGA).
No
Soil/Land Existing soil type in the area: Implement the Ecological Solid Daily inspection of Cost integrated in the
contamination due Waste Management Plan (ESWMP) waste/recycling bins for construction/operation
to improper solid sandy Set up temporary fence around the segregation cost
waste disposal
clay construction area Daily inspection for
Impairment of Presence of visually significant Implement landscaping and other Regular inspection of Cost integrated in the
visual landforms/landscape/structure beautification measures landscaping and other construction/operation
aesthetics s? Provide adequate buffer beautification activities cost
Devaluation of Compensate adjacent property Regular monitoring of
land values Yes owners buffer zones
No Others, specify
Regular monitoring for
________________ presence/absence of
complaints from adjacent
property owners
WATER
Increased siltation Specify nearest water body: Set up proper and adequate sanitary Regular (ocular) inspection Cost integrated in the
due to project facilities of: construction/operation
____________________
activities Strictly require the contractor and its cost
Water quality Distance to nearest water workers to observe proper waste Drainage / canal
degradation body: disposal and proper sanitation systems
Others, specify Strictly observe proper waste Water treatment facility
____________ 0 to less than 0.5 km handling and disposal (i.e., grease trap, septic
0.5 to 1 km Provide wastewater treatment tank, etc.)
facility (e.g., oil and water separator,
More than 1 km etc.)
Quarterly monitoring of the
Set up silt trap/stilling ponds to following:
If nearest water body is fresh minimize downstream siltation
water, specify classification: Provide three-chambered septic pH
tank for domestic sewage
TSS concentration
AA Others, specify
BOD
A
___________
Initial Environmental Examination (IEE) Checklist Report Form for Subdivision & Housing Projects 9
SA
SB
SC
SD
Drinking/Domestic
Industrial
Agricultural
Initial Environmental Examination (IEE) Checklist Report Form for Subdivision & Housing Projects 10
Increased Is the project site located in an Use appropriate design for project Regular monitoring for Cost integrated in the
occurrence of area identified by MGB/ facilities presence/absence of construction/operation
flooding PAG-ASA as flood prone? Implement appropriate drainage
complaints cost
system Regular coordination
Yes Regularly remove debris and other
with concerned agencies
No materials that may obstruct water Regular monitoring for
flow increased frequency of
flooding
Use appropriate technology (e.g.,
raised hand-pumps) to protect Others, specify
drinking water from flood _________________
contamination
Others, specify
_________________________
AIR / NOISE
Air quality degradation Distance to nearest
community:
Properly operate and maintain all Regular monitoring for Cost integrated in the
emission sources (e.g. vehicles, presence/absence of construction/operation
0 to less than 0.5 km generator, etc) complaints cost
0.5 to 1 km Strictly enforce good housekeeping
More than 1 km practices
Initial Environmental Examination (IEE) Checklist Report Form for Subdivision & Housing Projects 11
Nuisance due to Distance to nearest Properly operate and maintain all Regular monitoring for Cost integrated in the
noise generation community: noise sources (e.g., vehicles, presence/absence of construction/operation
generator, etc.) complaints cost
0 to less than 0.5 km Install, when applicable, the Regular monitoring of
0.5 to 1 km appropriate noise control device/s buffer zones
More than 1 km
(e.g., mufflers, silencer, sound
barriers, etc.)
Implement appropriate operating
hours
Provide adequate buffer and/or
planting of trees
Others, specify
_____________________
PEOPLE
Displacement of Size of population of host Provide relocation/disturbance Regular monitoring for Cost integrated in the
residents in the barangay: compensation packages presence/absence of construction/operation
project site and Prioritize local residents for complaints cost
within its vicinity
1,000 persons employment Regular coordination
Displacement of
>1,000 and Promptly pay local taxes and other with LGU
Indigenous Peoples
5,000persons financial obligations Others, specify
Enhanced
>5,000person
Regularly coordinate with LGU _________________
employment and/or
Initial Environmental Examination (IEE) Checklist Report Form for Subdivision & Housing Projects 12
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
Initial Environmental Examination (IEE) Checklist Report Form for Subdivision & Housing Projects334 14
This is to certify that all the information and commitments in this Initial Environmental
Examination (IEE) Checklist Report are accurate and complete to the best of my knowledge.
I hereby bind myself to answer any penalty that may be imposed arising from any
misrepresentation or failure to state material information in this IEE Checklist.
____________________________________
NAME OF PROPONENT HEAD
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
SUBSCRIBED AND SWORN TO before me this _____ day of ____________ 201__, affiant exhibiting
his/her Community Tax Certificate No. ___________________ issued at ______________________ on
__________________________.
Annex 2 - F
for
BUILDING PROJECTS
This IEE Checklist Report Form shall be used for proposed BUILDING PROJECTS
(Commercial, Institutional, Land Transport Terminal, Motels, Hotels,
Condominiums/Apartelles, and Non-Hazardous/non-Toxic Materials Storage Facilities)
required an IEE Report / IEE Checklist for ECC Application.
This IEE Checklist Report Form shall be submitted along with the following documents:
Read the questions carefully and write the required information on the spaces provided or
otherwise check () the appropriate boxes . Boxes with check marks are mandatory
requirements. Use additional sheets if necessary and indicate this in the appropriate space.
Misleading or erroneous answers are grounds for legal action and/or denial of ECC
issuance.
OK FOR PRINTING:
________________________________________
Signature over Printed Name
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Building Projects 2
Name of the
Project
Proponent Name
Proponent
Address
I. PROJECT DESCRIPTION
Please Check Project Type (indicate total gross floor area below)
Commercial [Business centers with residential units (mixed use), malls, supermarkets, public
markets]
Fast food/Restaurant Projects
Commercial Establishments (i.e., Showrooms)
Commercial [office spaces only]
Institutional and other related facilities: religious, government, and educational
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Initial Environmental Examination (IEE) Checklist Report Form for Building Projects 3
See attached vicinity map/s and photographs of the project site and site development/layout plan.
Geographic coordinates of the project area (Preferably use PRS 92 datum; otherwise, specify datum used).
Perimeter/Boundary points (based Longitude Latitude
on OCT/TCT/etc)
3. Institutional component
offices, classroom and other
similar facilities
laboratory, hospital rooms and
other medical facilities
Others (please specify)
4. Storage/Warehouse component
5. Amenities (e.g. swimming pools,
gym, etc.)
6. Open/Common Spaces (e.g.
reception area, garden parks,
etc.)
7. Parking area
8. Terminal/Passenger Area
9. Waste water management
facility
10. Solid waste management
facilities
Initial Environmental Examination (IEE) Checklist Report Form for Building Projects 4
____________________
Statutory Requirements
Calculations/Computations
(number of parking lots)
Power/Electricity KWh
(From Renewable Energy Sources)
Water Source
____________________________________________________________________
(Sitio/Zone, Barangay, Municipality/City, Province, Region)
Energy/Water Efficiency
Proposed Efficiency/Conservation
Utilities Estimated Savings
Measures
Power/Electricity KWh
Water m3/day
I.4 MANPOWER
a. Construction Phase
Manpower
Expertise/Skills Total
Requirement
Initial Environmental Examination (IEE) Checklist Report Form for Building Projects 6
b. Operation Phase
Manpower
Expertise/Skills Total
Requirement
Disturbance to Existing vegetation in the area: Comply with conditions of Annual inspection of Cost integrated in the
wildlife due to DENR/LGU SLUP, Tree Cutting area replanted/ re- construction /operation
vegetation clearing Forestland Permit, ROW, PCA Permit vegetated cost
Marshland
Limit land clearing as much as
possible
Grassland Provide temporary fencing for
Mangrove vegetation that will be retained
Wetland Promote restoration of damaged or
Others, specify
destroyed vegetation where possible
(e.g., tree planting)
____________
8
Initial Environmental Examination (IEE) Checklist Report Form for Building Projects
Soil Erosion steep (>18%) Construct during dry season new eroded areas near
the site
Stabilize embankment with grasses
Others, specify
or other soil cover
______________
Others, specify____________
Impairment of Presence of visually significant Implement landscaping and other Regular inspection of Cost integrated in the
visual aesthetics landforms/landscape/structure beautification measures landscaping and other construction/operation
Devaluation of land
s?
Provide adequate buffer beautification activities cost
values Compensate adjacent property Regular monitoring of
Yes owners buffer zones
No Others, specify
Regular monitoring for
presence/absence of
________________
complaints from adjacent
property owners
WATER
Increased siltation
Specify nearest/receiving
Set up proper and adequate sanitary
Regular (ocular) inspection Cost integrated in the
water body: of water body for: construction/operation
due to project facilities
____________________ cost
activities Strictly require the contractor and its
Drainage/canal systems
Water quality Distance to nearest/receiving workers to observe proper waste
degradation water body:
disposal and proper sanitation Water treatment facility
Others, specify Strictly observe proper waste (i.e., grease trap, septic
tank, etc.
handling and disposal
____________ 0 to less than 0.5 km
0.5 to 1 km
Provide wastewater treatment Quarterly monitoring of the
facility (e.g., oil and water separator,
More than 1 km etc.)
following:
Deepwell
Others, specify
_________________
Water district/LGU
Surface water
Others, specify
_____________
Increased Is the project site located in an Use appropriate design for project Regular monitoring for Cost integrated in the
occurrence of area identified by MGB/ facilities presence/absence of construction/operation
flooding PAG-ASA as flood prone?
Implement appropriate drainage
complaints cost
system Regular coordination
Yes Regularly remove debris and other
with concerned agencies
No materials that may obstruct water Regular monitoring for
flow increased frequency of
flooding
Use appropriate technology (e.g.,
raised hand-pumps) to protect Others, specify
drinking water from flood _________________
contamination
Others, specify
_____________________
AIR / NOISE
Air quality degradation Distance to nearest Properly operate and maintain all Regular monitoring for Cost integrated in the
community: emission sources (e.g. vehicles, presence/absence of construction/operation
generator, etc) complaints cost
0 to less than 0.5 km Strictly enforce good housekeeping
0.5 to 1 km practices
Regular (ocular) inspection
More than 1 km Control vehicle speed to lessen of:
suspension of road dust
12
Initial Environmental Examination (IEE) Checklist Report Form for Building Projects
Nuisance due to Distance to nearest Properly operate and maintain all Regular monitoring for Cost integrated in the
noise generation community: noise sources (e.g., vehicles, presence/absence of construction/ operation
generator, etc.) complaints cost
0 to less than 0.5 km Install, when applicable, the Regular monitoring of
0.5 to 1 km appropriate noise control device/s buffer zones
More than 1 km
(e.g., mufflers, silencer, sound
barriers, etc.)
Provide adequate buffer and
planting of trees
Others, specify
_________________
PEOPLE
Displacement of Size of population of host Provide relocation/disturbance Regular monitoring for Cost integrated in the
residents in the barangay: compensation packages presence/absence of construction/operation
project site and
1,000 persons
Prioritize local residents for complaints cost
within its vicinity employment Regular coordination
Displacement of >1,000 and 5,000 Promptly pay local taxes and other with LGU
Indigenous Peoples persons financial obligations Others, specify
Enhanced >5,000 persons ______________
employment and/or Regularly coordinate with LGU
livelihood
opportunities Classification of host Conduct prior consultation and
coordination to minimize disruption
Reduced barangay:
of daily domestic activities and to
employment and/or Urban ensure respect for IP rights and
livelihood
opportunities
Rural cultural practices
13
Initial Environmental Examination (IEE) Checklist Report Form for Building Projects
Provide description of the Abandonment activities, such as dismantling and waste disposal.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
Initial Environmental Examination (IEE) Checklist Report Form for Building Projects 15
Attach drawing/plan of waste water treatment facility (with dimensions and descriptions)
Initial Environmental Examination (IEE) Checklist Report Form for Building Projects 16
Attach drawing/plan of air pollution source and control installations (with dimensions and
descriptions)
Initial Environmental Examination (IEE) Checklist Report Form for Building Projects 17
This is to certify that all the information and commitments in this Initial Environmental
Examination (IEE) Checklist Report are accurate and complete to the best of my knowledge.
I hereby bind myself to answer any penalty that may be imposed arising from any
misrepresentation or failure to state material information in this IEE Checklist.
____________________________________
NAME OF PROPONENT HEAD
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
SUBSCRIBED AND SWORN TO before me this _____ day of ____________ 201__, affiant exhibiting
his/her Community Tax Certificate No. ___________________ issued at ______________________ on
__________________________.
for
This IEE Checklist Report Form shall be used for proposed CEMETERY, FUNERAL
PARLORS, CREMATORIUM, AND COLUMBARIUM PROJECTS required an IEE Report /
IEE Checklist for ECC Application.
This IEE Checklist Report Form shall be submitted along with the following documents:
Read the questions carefully and write the required information on the spaces provided or
otherwise check () the appropriate boxes . Boxes with check marks are mandatory
requirements. Use additional sheets if necessary and indicate this in the appropriate space.
Misleading or erroneous answers are grounds for legal action and/or denial of ECC issuance.
OK FOR PRINTING:
________________________________________
Signature over Printed Name
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Cemetery & Other Funeral Facilities Projects 2
Name of the
Project
Proponent Name
Proponent
Address
I. PROJECT DESCRIPTION
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
II.
See attached vicinity map/s and photographs of the project site and site development/layout plan.
Initial Environmental Examination (IEE) Checklist Report Form for Cemetery & Other Funeral Facilities Projects 3
Geographic coordinates of the project area (Preferably use PRS 92 datum; otherwise, specify datum used).
Perimeter/Boundary points (based
Longitude Latitude
on OCT/TCT/etc)
____________________
Power/Electricity KWh
(From Renewable Energy Sources)
Water m3/day
Water Source
____________________________________________________________________
(Sitio/Zone, Barangay, Municipality/City, Province, Region)
Energy/Water Efficiency
Estimated
Utilities Proposed Efficiency/Conservation Measures
Savings
Power/Electricity KWh
Water m3/day
Initial Environmental Examination (IEE) Checklist Report Form for Cemetery & Other Funeral Facilities Projects 5
I.4 MANPOWER
a. Construction Phase
Manpower Expertise/Skills Total
Requirement
b. Operation Phase
Manpower Expertise/Skills Total
Requirement
Residential
Commercial/ Institutional
Industrial
Agricultural/ Recreational
Protected Areas
Others, specify
______________
Residential
Commercial/ Institutional
Industrial
Agricultural/ Recreational
Protected Areas
Others, specify
______________
Disturbance to Existing vegetation in the area: Comply with conditions of Annual inspection of Cost integrated in the
wildlife due to DENR/LGU SLUP, Tree Cutting area replanted/ re- construction /operation
vegetation clearing Forestland Permit, ROW, PCA Permit vegetated cost
Marshland
Limit land clearing as much as
possible
Grassland
Provide temporary fencing for
Mangrove vegetation that will be retained
Wetland Promote restoration of damaged or
7
Initial Environmental Examination (IEE) Checklist Report Form for Cemetery & Other Funeral Facilities Projects
Change in surface Slope: Provide erosion control and slope Regular inspection of Slope/ Erosion Control
landform/ flat (0-3%) protection measures slope protection Cost: ___________
sandy-loam
Implement re-use and recycling of presence of mixed
waste materials garbage in the facility
Others, specify
Implement proper segregation, Weekly inspection of
____________________ waste accumulated
collection and disposal of domestic
wastes in designated areas Others, specify
Implement proper collection, _________________
labeling and storage of hazardous
waste
Provide receptacles / bins for solid
8
Initial Environmental Examination (IEE) Checklist Report Form for Cemetery & Other Funeral Facilities Projects
Impairment of Presence of visually significant Implement landscaping and other Regular inspection of Cost integrated in the
visual aesthetics landforms/ beautification measures landscaping and other construction/operation
Devaluation of land landscape/structures? Provide adequate buffer beautification activities cost
values Compensate adjacent property Regular monitoring of
Yes owners buffer zones
No Others, specify
Regular monitoring for
presence/absence of
________________
complaints from adjacent
property owners
WATER
Specify nearest water body: Regular (ocular) inspection Cost integrated in the
Increased siltation ___________________
Set up proper and adequate sanitary of water body for: construction/operation
due to project facilities cost
activities
Distance to nearest water Strictly require the contractor and its Drainage/canal systems
Water quality body: workers to observe proper waste
Water treatment facility
degradation disposal and proper sanitation
Others, specify
0 to less than 0.5 km Strictly observe proper waste
(i.e., grease trap, septic
tank, etc.
____________ 0.5 to 1 km handling and disposal
More than 1 km Provide wastewater treatment
facility (e.g., septic tank, oil and Regular (ocular) inspection
water separator, etc.) of water body for:
If nearest water body is fresh Set up silt trap/settling ponds to
water, specify classification: minimize downstream siltation Turbidity and/or silted
AA Others, specify ______________ condition
A Provide three-chambered septic Floating wastes or debris
B tank for domestic sewage
9
Initial Environmental Examination (IEE) Checklist Report Form for Cemetery & Other Funeral Facilities Projects
SA
SB
SC
SD
Water district/LGU
Surface water
Others, specify
_____________
Increased Is the project site located in an Use appropriate design for project Regular monitoring for Cost integrated in the
occurrence of area identified by MGB/ facilities presence/absence of construction/operation
flooding PAG-ASA as flood prone?
Implement appropriate drainage
complaints cost
system Regular coordination
Yes Regularly remove debris and other
with concerned agencies
No materials that may obstruct water Regular monitoring for
flow increased frequency of
flooding
Others, specify__________
Others, specify
_________________
AIR / NOISE
Air quality degradation Distance to nearest Properly operate and maintain all Regular monitoring for Cost integrated in the
community: emission sources (e.g., generator, presence/absence of construction/operation
crematorium, etc) complaints cost
0 to less than 0.5 km Installappropriate air pollution
0.5 to 1 km control device/s for the
Regular (ocular) inspection
More than 1 km _______________
of:
Strictly enforce good housekeeping
Absence of white or
practices
black smoke from
Others, specify vehicles, generator,
___________________ etc.
11
Initial Environmental Examination (IEE) Checklist Report Form for Cemetery & Other Funeral Facilities Projects
PEOPLE
Impacts on Regularly coordinate with LGU Regular monitoring for Cost integrated in the
community health Provide appropriate warning signs, presence/absence of
complaints
construction/operation
cost
and safety lighting and barricades, whenever
Others, specify practicable Regular coordination
_______________ Observe proper housekeeping with LGU
Provide on-site medical services for Regular submission of
reports to concerned
any emergency.
agency
Participate in public awareness
Others, specify
programs on health and safety
________________
Others, specify
_________________
Initial Environmental Examination (IEE) Checklist Report Form for Cemetery & Other Funeral Facilities Projects 13
Provide description of the Abandonment activities, such as, dismantling and waste disposal.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
Initial Environmental Examination (IEE) Checklist Report Form for Cemetery & Other Funeral Facilities Projects 14
Attach drawing/plan of air pollution source and control installations (with dimensions and
descriptions)
Initial Environmental Examination (IEE) Checklist Report Form for Cemetery & Other Funeral Facilities Projects 15
This is to certify that all the information and commitments in this Initial Environmental
Examination (IEE) Checklist Report are accurate and complete to the best of my knowledge.
I hereby bind myself to answer any penalty that may be imposed arising from any
misrepresentation or failure to state material information in this IEE Checklist.
____________________________________
NAME OF PROPONENT HEAD
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
SUBSCRIBED AND SWORN TO before me this _____ day of ____________ 201__, affiant exhibiting
his/her Community Tax Certificate No. ___________________ issued at ______________________ on
__________________________.
Annex 2 - H
for
LIVESTOCK/POULTRY PROJECTS
This IEE Checklist Report Form shall be used for proposed LIVESTOCK/POULTRY PROJECTS
required an IEE Report / IEE Checklist for ECC Application.
This IEE Checklist Report Form shall be submitted along with the following documents:
Read the questions carefully and write the required information on the spaces provided or
otherwise check () the appropriate boxes . Boxes with check marks are mandatory
requirements. Use additional sheets if necessary and indicate this in the appropriate space.
Misleading or erroneous answers are grounds for legal action and/or denial of ECC
issuance.
OK FOR PRINTING:
________________________________________
Signature over Printed Name
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Livestock/Poultry Projects 2
Proponent Name
Proponent Address
I. PROJECT DESCRIPTION
Please check project type and indicate size
See attached vicinity map/s and photographs of the project site and site development/layout plan.
Initial Environmental Examination (IEE) Checklist Report Form for Livestock/Poultry Projects 3
Geographic coordinates of the project area (Preferably use PRS 92 datum; otherwise, specify datum used).
Perimeter/Boundary points (based Longitude Latitude
on OCT/TCT/etc.)
1. Gestating/Nursery Compartment
/ Hatchery
2. Support Facilities (e.g. feeders,
generators, admin building,
workers quarter, etc.)
3. Storage facility
Power/Electricity KWh
(From Renewable Energy Sources)
3
Water (Total) m /day
(Fill-up table below if water is not
obtained from the local water utility)
3
Water m /day
(Rainwater Collection System)
Water Source
____________________________________________________________________
(Sitio/Zone, Barangay, Municipality/City, Province, Region)
Initial Environmental Examination (IEE) Checklist Report Form for Livestock/Poultry Projects 5
Energy/Water Efficiency
Proposed Efficiency/Conservation
Estimated Savings
Utilities Measures
Power/Electricity KWh
3
Water m /day
I.4 MANPOWER
a. Construction Phase
Manpower Requirement Expertise/Skills Total
b. Operation Phase
Manpower Requirement Expertise/Skills Total
Disturbance to wildlife Existing vegetation in the area: Comply with conditions of Annual inspection of Cost integrated in
due to vegetation
clearing
Forestland
DENR/LGU SLUP, Tree Cutting
Permit, ROW, PCA Permit
area replanted/
re-vegetated
the construction/
operation cost
Marshland Limit land clearing as much as
Grassland possible
Mangrove Provide temporary fencing for
Wetland
vegetation that will be retained
Promote restoration of damaged or
Others, specify destroyed vegetation where
__________________ possible (e.g., tree planting)
Initial Environmental Examination (IEE) Checklist Report Form for Livestock/Poultry Projects 7
18%) with topsoil set aside for later use prone areas Others, specify
and allow maximum re-use of Regular inspection for _________________
Soil Erosion steep (>18%) spoils new eroded areas near
Construct during dry season the site
Stabilize embankment with Others, specify
grasses or other soil cover _________________
Others, specify
_______________________
Impairment of Presence of visually significant Implement landscaping and other Regular inspection of Cost integrated in
visual aesthetics landforms/landscape/structures? beautification measures landscaping and other the construction/
Devaluation of Yes Provide adequate buffer beautification activities operation cost
land values No Compensate adjacent property Regular monitoring of
owners buffer zones
Others, specify
Regular monitoring for
presence/absence of
________________
complaints from
adjacent property
owners
WATER
Increased siltation due Specify nearest/receiving water Set-up proper and adequate Regular (ocular) inspection Cost integrated in the
to project activities body: sanitary facilities of: construction/
Water quality _________________________ Strictly require the contractor and operation cost
degradation its workers to observe proper Drainage / canal
Distance to nearest/receiving systems
Others, specify
waste disposal and proper
_______________
water body: sanitation Water treatment facility
0 to less than 0.5 km Strictly observe proper waste (i.e., grease trap, septic
0.5 to 1 km
handling and disposal tank, etc.)
Surface water
Others, specify
_________________________
Others, specify
________________
Increased occurrence Is the project site located in an Use appropriate design for project Regular monitoring for Cost integrated in the
of flooding area identified by MGB/PAG- facilities presence/absence of construction/
ASA as flood prone? Implement appropriate drainage
complaints operation cost
Yes system Regular coordination
No Use appropriate technology (e.g.,
with concerned
agencies
raised hand-pumps) to protect
drinking water from flood Regular monitoring for
contamination increased frequency of
flooding
Others,
specify___________________ Others, specify
____________________
AIR / NOISE
Air quality degradation Distance to nearest community: Properly operate and maintain all Regular monitoring for Cost integrated in the
emission sources (e.g. vehicles, presence/absence of construction/
0 to less than 0.5 km generator, etc) complaints operation cost
0.5 to 1 km Strictly enforce good
Regular (ocular) inspection
More than 1 km housekeeping practices
of:
Initial Environmental Examination (IEE) Checklist Report Form for Livestock/Poultry Projects 11
Nuisance due to noise Distance to nearest community: Regular clean-up of animal houses Regular monitoring for Cost integrated in the
generation 0 to less than 0.5 km Use environment-friendly
presence/absence of construction/
complaints operation cost
0.5 to 1 km deodorizer or odor masking
More than 1 km
substances
Use sprays with natural / microbial
disinfectants
Is the wind direction blowing Provide adequate buffer and/or
towards the nearest community planting of trees
most of the year? Others, specify
Yes ____________________
No
PEOPLE
Displacement of Size of population of host Provide relocation/disturbance Regular monitoring for Cost integrated in the
residents in the project barangay: compensation packages presence/absence of construction/
site and within its
1,000 persons Prioritize local residents for complaints operation cost
vicinity Regular coordination
>1,000 and 5,000
employment
Displacement of persons Promptly pay local taxes and other with LGU
Indigenous Peoples
financial obligations Others, specify
Enhanced
>5,000 persons
Regular coordination with LGU _________________
employment and/or
livelihood
Conduct prior consultation and
Classification of host barangay: coordination to minimize disruption
opportunities
Reduced employment Urban
of daily domestic activities and to
ensure respect for IP rights and
and/or livelihood Rural cultural practices
Initial Environmental Examination (IEE) Checklist Report Form for Livestock/Poultry Projects 12
Impacts on community Regularly coordinate with LGU Regular monitoring for Cost integrated in the
health and safety Provide appropriate warning signs, presence/absence of construction/
Others, specify lighting and barricades, whenever complaints operation cost
_______________ practicable Regular coordination
Observe proper housekeeping with LGU
Provide on-site medical services Regular submission of
for any emergency. reports to concerned
agency
Participate in public awareness
Others, specify
programs on health and safety
________________
Regularly spray disinfectant,
pesticides and other similar
substances when applicable
Strictly comply with fire, safety and
similar regulatory requirements
Others, specify
__________________________
Initial Environmental Examination (IEE) Checklist Report Form for Livestock/Poultry Projects 13
Provide description of the Abandonment activities, such as dismantling and waste disposal.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
Initial Environmental Examination (IEE) Checklist Report Form for Livestock/Poultry Projects 14
Attach drawing/plan of waste water treatment facility (with dimensions and descriptions)
Initial Environmental Examination (IEE) Checklist Report Form for Livestock/Poultry Projects 16
This is to certify that all the information and commitments in this Initial Environmental
Examination (IEE) Checklist Report are accurate and complete to the best of my knowledge.
I hereby bind myself to answer any penalty that may be imposed arising from any
misrepresentation or failure to state material information in this IEE Checklist.
____________________________________
NAME OF PROPONENT HEAD
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
SUBSCRIBED AND SWORN TO before me this _____ day of ____________ 201__, affiant exhibiting
his/her Community Tax Certificate No. ___________________ issued at ______________________ on
__________________________.
Annex 2 - I
for
This IEE Checklist Report Form shall be used for proposed RESORTS AND OTHER TOURISM /
LEISURE PROJECTS required an IEE Report / IEE Checklist for ECC Application.
This IEE Checklist Report Form shall be submitted along with the following documents:
Read the questions carefully and write the required information on the spaces provided or
otherwise check () the appropriate boxes . Boxes with check marks are mandatory
requirements. Use additional sheets if necessary and indicate this in the appropriate space.
Misleading or erroneous answers are grounds for legal action and/or denial of ECC
issuance.
OK FOR PRINTING:
________________________________________
Signature over Printed Name
___________________________
Date
2
Initial Environmental Examination (IEE) Checklist Report Form for Resorts & Other Tourism/Leisure Projects
Proponent Name
Proponent Address
I. PROJECT DESCRIPTION
See attached vicinity map/s and photographs of the project site and site development/layout plan.
Geographic coordinates of the project area (Preferably use PRS 92 datum; otherwise, specify datum used).
Perimeter/Boundary points (based Longitude Latitude
on OCT/TCT/etc.)
3
Initial Environmental Examination (IEE) Checklist Report Form for Resorts & Other Tourism/Leisure Projects
2. Villas
3. Public washrooms/toilets
4. Swimming pools
5. Function/Convention Hall
6. Lobby/Reception Area
7. Restaurant
8. Parking area
13. Garden/Landscaping
Power/Electricity KWh
(From Renewable Energy Sources)
Water Source
____________________________________________________________________
(Sitio/Zone, Barangay, Municipality/City, Province, Region)
5
Initial Environmental Examination (IEE) Checklist Report Form for Resorts & Other Tourism/Leisure Projects
Energy/Water Efficiency
Proposed Efficiency/Conservation
Estimated Savings
Utilities Measures
Power/Electricity KWh
3
Water m /day
I.4 MANPOWER
a. Construction Phase
Manpower Requirement Expertise/Skills Total
b. Operation Phase
Manpower Requirement Expertise/Skills Total
Disturbance to Existing vegetation in the area: Comply with conditions of Annual inspection of area Cost integrated in
wildlife due to DENR/LGU SLUP, Tree Cutting replanted/ the construction
vegetation clearing Forestland Permit, ROW, PCA Permit re-vegetated /operation cost
Marshland
Limit land clearing as much as
possible
Grassland Provide temporary fencing for
Mangrove vegetation that will be retained
Wetland Promote restoration of damaged or
Others, specify
destroyed vegetation where possible
(e.g., tree planting)
____________________
7
Initial Environmental Examination (IEE) Checklist Report Form for Resorts & Other Tourism/Leisure Projects
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Change in surface Slope: Provide erosion control and slope Regular inspection of slope Slope/ Erosion
landform/ flat (0-3%) protection measures protection measures in Control Cost:
topography/ gently sloping to rolling (3- Designate a Spoils Storage Area, erosion-prone areas ___________
terrain/slope 18%) with topsoil set aside for later use Regular inspection for new Others, specify
Soil Erosion steep (>18%) and allow maximum re-use of spoils eroded areas near the site ________________
Construct during dry season Others, specify __
Stabilize embankment with grasses _________________
or other soil cover
Others, specify
__________________________
sandy-loam
Implement re-use and recycling of presence of mixed garbage
waste materials in the facility
Others, specify
Implement proper segregation, Weekly inspection of waste
____________________ accumulated
collection and disposal of domestic
wastes in designated areas Others, specify
Implement proper collection and ___________________
processing of animal waste into
organic fertilizer
Implement proper collection,
labeling and storage of hazardous
waste
Provide receptacles / bins for solid
wastes
8
Initial Environmental Examination (IEE) Checklist Report Form for Resorts & Other Tourism/Leisure Projects
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Coordinate with the municipal / city
waste collectors
Engage third party company for
waste collection
Others, specify
__________________________
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
If nearest/receiving water body
is coastal or marine water,
specify classification:
SA
SB
SC
SD
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Competition in Size of population using
receiving surface water:
Implement rainwater harvesting and Regular monitoring for Cost integrated in
water use similar measures as an alternative presence/absence of the construction/
Depletion of water 1,000 persons source of water complaints operation cost
resources >1,000 and 5,000 Observe water conservation Regular coordination with
persons measures concerned agencies
>5,000 persons Carefully select project site to avoid Regular monitoring for
disruption of traditional water uses occurrences of water
Available/nearest water Obtain Water Permit from NWRB
shortages
source.
Improve efficiency of water supply Others, specify
Deepwell and distribution system
___________________
Water district/LGU Use drought resistant species which
Surface water require less water input and hence
Others, specify
have less impact on water tables
________________ Others, specify
______________________
Increased Is the project site located in an Use appropriate design for project Regular monitoring for Cost integrated in
occurrence of area identified by MGB/ facilities presence/absence of the construction/
flooding PAG-ASA as flood prone? Implement appropriate drainage
complaints operation cost
system Regular coordination with
Yes Regularly remove debris and other
concerned agencies
No materials that may obstruct water Regular monitoring for
flow increased frequency of
flooding
Use appropriate technology (e.g.,
raised hand-pumps) to protect Others, specify
drinking water from flood ___________________
contamination
Others, specify
__________________________
AIR / NOISE
Air quality degradation Distance to nearest
community:
Properly operate and maintain all Regular monitoring for Cost integrated in
emission sources (e.g. vehicles, presence/absence of the construction/
0 to less than 0.5 km generator, etc) complaints operation cost
0.5 to 1 km Install, when applicable, the
Regular (ocular) inspection of:
11
Initial Environmental Examination (IEE) Checklist Report Form for Resorts & Other Tourism/Leisure Projects
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
More than 1 km appropriate air pollution control
device/s
Absence of white or
black smoke from
Strictly enforce good housekeeping vehicles, generator, etc.
practices Presence of truck cover
Control vehicle speed to lessen during deliveries
suspension of road dust
Conduct water spraying to
suppress dust sources and
minimize discomfort to nearby
residents
Use covered vehicles to deliver
materials that may generate dus
Others, specify
___________________
Nuisance due to Distance to nearest Regularly clean up animal houses Regular monitoring for Cost integrated in
community:
generation of
obnoxious/
Use environment-friendly deodorizer
presence/absence of
complaints
the construction/
operation cost
or odor masking substances
unpleasant odor 0 to less than 0.5 km
Use sprays with natural / microbial
0.5 to 1 km disinfectants
More than 1 km Provide adequate buffer and/or
planting of trees
Others, specify ___________
Nuisance due to Distance to nearest
community:
Properly operate and maintain all Regular monitoring for Cost integrated in
noise generation noise sources (e.g., vehicles, presence/absence of the construction/
0 to less than 0.5 km generator, etc.) complaints operation cost
0.5 to 1 km Install when applicable, the Regular monitoring of buffer
More than 1 km appropriate noise control device/s zones
(e.g., mufflers, silencer, sound Quarterly monitoring of
Is the wind direction blowing barriers, etc.) noise level
towards the nearest Implement appropriate operating
community most of the year? hours
Provide adequate buffer
Yes (e.g., Perimeter planting of trees to
serve as sound buffer and greenbelt)
No
12
Initial Environmental Examination (IEE) Checklist Report Form for Resorts & Other Tourism/Leisure Projects
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Others, specify
_____________________
PEOPLE
Displacement of Size of population of host Provide relocation/disturbance Regular monitoring for Cost integrated in
residents in the barangay: compensation packages presence/absence of the construction/
project site and 1,000 persons Prioritize local residents for complaints operation cost
within its vicinity
>1,000 and employment Regular coordination with
Displacement of 5,000persons Promptly pay local taxes and other LGU
Indigenous Peoples
>5,000person financial obligations Others, specify
Enhanced Regular coordination with LGU _____________________
employment and/or
livelihood
Classification of host
barangay:
Conduct prior consultation and
coordination to minimize disruption
opportunities
Urban of daily domestic activities and to
Reduced
Rural ensure respect for IP rights and
employment and/or cultural practices
livelihood
opportunities
Available services within/near Ensure participation of IPs in
the host barangay: consultations and dialogues
Increased revenues
Schools (e.g., Provide appropriate traffic/warning
for LGU
elementary, high signs, lighting, etc
Disruption/ school, college) Others, specify
Competition in
delivery of public
Health facilities (e.g., ____________________________
clinics, hospitals, etc.)
services (e.g.,
education, peace Peace and order (e.g.,
and order, etc.) police outpost, Brgy.
Enhanced delivery
Tanod, etc.)
of public services Recreation and sports
(e.g., education, facilities
peace and order, Others, specify
etc.) ________________
Increase in traffic
volume and
worsening of traffic
flow
13
Initial Environmental Examination (IEE) Checklist Report Form for Resorts & Other Tourism/Leisure Projects
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Impacts on Regularly coordinate with LGU Regular monitoring for Cost integrated in
community health
and safety
Provide appropriate warning signs, presence/absence of
complaints
the construction/
operation cost
lighting and barricades, whenever
Others, specify practicable Regular coordination with
____________ Observe proper housekeeping LGU
Provide on-site medical services for
Regular submission of
reports to concerned agency
any emergency.
Participate in public awareness Others, specify
_____________
programs on health and safety
Implement appropriate safety
programs for both community and
workers
Strictly comply with fire, safety and
similar regulatory requirements
Provide description of the Abandonment activities, such as dismantling and waste disposal.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
Initial Environmental Examination (IEE) Checklist Report Form for Resorts & Other Tourism/Leisure Projects 15
Attach drawing/plan of waste water treatment facility (with dimensions and descriptions)
Initial Environmental Examination (IEE) Checklist Report Form for Resorts & Other Tourism/Leisure Projects 16
This is to certify that all the information and commitments in this Initial Environmental
Examination (IEE) Checklist Report are accurate and complete to the best of my knowledge.
I hereby bind myself to answer any penalty that may be imposed arising from any
misrepresentation or failure to state material information in this IEE Checklist.
____________________________________
NAME OF PROPONENT HEAD
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
SUBSCRIBED AND SWORN TO before me this _____ day of ____________ 201__, affiant exhibiting
his/her Community Tax Certificate No. ___________________ issued at ______________________ on
__________________________.
Annex 2 - J
for
This IEE Checklist Report Form shall be used for proposed ROAD AND BRIDGE PROJECTS
required an IEE Report / IEE Checklist for ECC Application.
This IEE Checklist Report Form shall be submitted along with the following documents:
Read the questions carefully and write the required information on the spaces provided or
otherwise check () the appropriate boxes . Boxes with check marks are mandatory
requirements. Use additional sheets if necessary and indicate this in the appropriate space.
Misleading or erroneous answers are grounds for legal action and/or denial of ECC
issuance.
OK FOR PRINTING:
________________________________________
Signature over Printed Name
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Road and Bridge Projects 2
Proponent Name
Proponent Address
I. PROJECT DESCRIPTION
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
See attached vicinity map/s and photographs of the project site and site development/layout plan.
Initial Environmental Examination (IEE) Checklist Report Form for Road and Bridge Projects 3
Geographic coordinates of the project area (Preferably use PRS 92 datum; otherwise, specify datum used).
Perimeter/Boundary points (based Longitude Latitude
on OCT/TCT/etc.)
1. Road
2. Intersections
3. Bridge/s
4. Access roads/Ramp
5. Drainage facilities
(i.e. Reinforced Concrete Box
Culverts (RCBC);Reinforced
Concrete Pipe Culverts (RCPC),
others)
6. Associated facilities (i.e.
Guardrails, Traffic signs, etc.)
8. Others, specify
_______________________
_____________________
Power/Electricity KWh
(From Renewable Energy Sources)
Water Source
____________________________________________________________________
(Sitio/Zone, Barangay, Municipality/City, Province, Region)
Initial Environmental Examination (IEE) Checklist Report Form for Road and Bridge Projects 5
Energy/Water Efficiency
Proposed Efficiency/Conservation
Estimated Savings
Utilities Measures
Power/Electricity KWh
3
Water m /day
I.3 MANPOWER
a. Construction Phase
Manpower Requirement Expertise/Skills Total
b. Operation Phase
Manpower Requirement Expertise/Skills Total
Disturbance to Existing vegetation in the area: Comply with conditions of Annual inspection of Cost integrated in the
wildlife due to Forestland DENR/LGU SLUP, Tree Cutting
Permit, ROW, PCA Permit
area replanted/
re-vegetated
construction /operation
cost
vegetation clearing
Marshland
Limit land clearing as much as
Grassland possible
Mangrove Provide temporary fencing for
Wetland vegetation that will be retained
Others, specify
Promote restoration of damaged or
____________ destroyed vegetation where
possible (e.g., tree planting)
Initial Environmental Examination (IEE) Checklist Report Form for Road and Bridge Projects 7
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Change in surface Slope: Provide erosion control and slope Regular inspection of Slope/ Erosion Control
landform/ flat (0-3%) protection measures slope protection Cost: ___________
topography/
terrain/slope gently sloping to rolling (3- Designate a Spoils Storage Area, measures in erosion-
prone areas
Others, specify
18%) with topsoil set aside for later use __________________
Soil Erosion
steep (>18%)
and allow maximum re-use of spoils Regular inspection for
Construct during dry season new eroded areas near
the site
Stabilize embankment with grasses
Others, specify
or other soil cover
_________________
Others, specify
____________
Is the project site located in an
area identified by MGB/ Comply with the DENR
Administrative Order No. 2003-30
PAG-ASA/ PHIVOLCS as
and DENR Administrative Order No.
hazard prone? 2000-28, Implementing Guidelines
on Engineering Geological and
Yes Geo-hazard Assessment (EGGA).
No
Soil/Land Existing soil type in the area: Implement Ecological Solid Waste Daily inspection of Cost integrated in the
contamination due Management Plan (ESWMP) waste/recycling bins for construction /operation
to improper solid sandy Set up temporary fence around the segregation cost
waste disposal
clay construction area Daily inspection for
sandy-loam
Implement re-use and recycling of presence of mixed
waste materials garbage in the facility
Others, specify
Implement proper segregation, Weekly inspection of
____________________ waste accumulated
collection and disposal of domestic
wastes in designated areas Others, specify
Implement proper collection, _________________
labeling and storage of hazardous
waste
Provide receptacles / bins for solid
wastes
Coordinate with the municipal / city
waste collectors
Engage third party company for
waste collection
Initial Environmental Examination (IEE) Checklist Report Form for Road and Bridge Projects 8
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Others, specify
________________
Encroachment into Is the project area near Obtain appropriate Regular coordination Cost integrated in the
protected areas or protected areas or ecologically- permits/clearances from concerned with concerned agencies construction/ operation
ecologically- sensitive areas? agencies cost
sensitive areas Provide adequate buffer
Yes Others, specify
No ________________
Impairment of Presence of visually significant Implement landscaping and other Regular inspection of Cost integrated in the
visual aesthetics landforms/landscape/structures? beautification measures landscaping and other construction/ operation
Devaluation of Provide adequate buffer beautification activities cost
land values Yes
Compensate adjacent property Regular monitoring of
No owners buffer zones
Others, specify
Regular monitoring for
________________ presence/absence of
complaints from
adjacent property
owners
WATER
Specify nearest water body: Set up proper and adequate Regular (ocular) inspection Cost integrated in the
Increased siltation __________________________ sanitary facilities of: construction/ operation
due to project
Strictly require the contractor and its Drainage / canal cost
activities Distance to nearest water body: systems
workers to observe proper waste
Water quality 0 to less than 0.5 km disposal and proper sanitation Sanitation facilities
degradation 0.5 to 1 km Strictly observe proper waste
Others, specify More than 1 km handling and disposal Regular (ocular) inspection
of water body for:
_______________
Set up silt trap(Gabions,
If nearest water body is fresh Fascines)/settling ponds to Turbidity and/or silted
water, specify classification: minimize downstream siltation condition
AA Others, specify Floating wastes or
debris
A ___________
B
C
Initial Environmental Examination (IEE) Checklist Report Form for Road and Bridge Projects 9
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
D
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Available/nearest water source. Others, specify
________________
Deepwell
Water district/LGU
Surface water
Others, specify
________________
Increased Is the project site located in an Use appropriate design for project Regular monitoring for Cost integrated in the
occurrence of area identified by MGB/ facilities presence/absence of construction/ operation
flooding PAG-ASA as flood prone? Implement appropriate drainage complaints cost
system Regular coordination
Yes Regularly remove debris and other
with concerned agencies
No materials that may obstruct water Regular monitoring for
flow increased frequency of
flooding
Others, specify
___________________ Others, specify
____________________
AIR / NOISE
Air quality degradation Distance to nearest community: Properly operate and maintain all Regular monitoring for Cost integrated in the
emission sources (e.g. vehicles, presence/absence of construction/ operation
0 to less than 0.5 km generator, etc) complaints cost
0.5 to 1 km Install, when applicable, the
Regular (ocular) inspection
More than 1 km appropriate air pollution control
device/s
of:
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
materials that may generate dust
Others, specify
___________________
Nuisance due to Distance to nearest community: Properly operate and maintain all Regular monitoring for Cost integrated in the
noise generation noise sources (e.g., vehicles, presence/absence of construction/ operation
0 to less than 0.5 km generator, etc.) complaints cost
0.5 to 1 km Install, when applicable, the Regular monitoring of
More than 1 km appropriate noise control device/s
(e.g., mufflers, silencer, sound
buffer zones
barriers, etc.)
Implement appropriate operating
hours
Provide adequate buffer and/or
planting of trees
Others, specify
_____________________
PEOPLE
Displacement of Size of population of host Provide relocation/disturbance Regular monitoring for Cost integrated in the
residents in the barangay: compensation packages presence/absence of construction/ operation
project site and 1,000 persons Prioritize local residents for complaints cost
within its vicinity
>1,000 and employment Regular coordination
Displacement of 5,000persons Promptly pay local taxes and other with LGU
Indigenous
>5,000 persons
financial obligations Others, specify
Peoples
Regularly coordinate with LGU _________________
Enhanced
Classification of host barangay: Conduct prior consultation and
employment and/or Urban coordination to minimize disruption
of daily domestic activities and to
livelihood Rural ensure respect for IP rights and
opportunities
cultural practices
Reduced Available services within/near
the host barangay: Ensure participation of IPs in
employment and/or
consultations and dialogues
livelihood Schools (e.g.,
opportunities elementary, high school, Provide appropriate traffic/warning
Increased college) signs, lighting, etc.
Initial Environmental Examination (IEE) Checklist Report Form for Road and Bridge Projects 12
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
revenues for LGU Health facilities (e.g., Others, specify
Disruption/ clinics, hospitals, etc.) _________________
Competition in
delivery of public
Peace and order (e.g.,
police outpost, Brgy.
services (e.g., Tanod, etc.)
education, peace
and order, etc.) Recreation and sports
facilities
Enhanced delivery
of public services Others, specify
(e.g., education, ___________________
peace and order,
etc.)
Increase in traffic
volume and
worsening of traffic
flow
Impacts on Regularly coordinate with LGU Regular monitoring for Cost integrated in the
community health Provide appropriate warning signs, presence/absence of
complaints
construction/ operation
cost
and safety lighting and barricades, whenever
Others, specify practicable
_______________ Observe proper housekeeping Regular coordination
with LGU
Provide on-site medical services for
Regular submission of
any emergency.
reports to concerned
Participate in public awareness agency
programs on health and safety
Others, specify
Implement appropriate safety ________________
programs for both community and
workers
Others, specify
_____________________
Initial Environmental Examination (IEE) Checklist Report Form for Road and Bridge Projects 13
Provide description of the Abandonment activities, such as dismantling and waste disposal.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
Initial Environmental Examination (IEE) Checklist Report Form for Road and Bridge Projects 14
This is to certify that all the information and commitments in this Initial Environmental
Examination (IEE) Checklist Report are accurate and complete to the best of my knowledge.
I hereby bind myself to answer any penalty that may be imposed arising from any
misrepresentation or failure to state material information in this IEE Checklist.
____________________________________
NAME OF PROPONENT HEAD
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
SUBSCRIBED AND SWORN TO before me this _____ day of ____________ 201__, affiant exhibiting
his/her Community Tax Certificate No. ___________________ issued at ______________________ on
__________________________.
Annex 2 - K
for
This IEE Checklist Report Form shall be used for proposed WATER SUPPLY PROJECTS
required an IEE Report / IEE Checklist for ECC Application.
This IEE Checklist Report Form shall be submitted along with the following documents:
Read the questions carefully and write the required information on the spaces provided or
otherwise check () the appropriate boxes . Boxes with check marks are mandatory
requirements. Use additional sheets if necessary and indicate this in the appropriate space.
Misleading or erroneous answers are grounds for legal action and/or denial of ECC
issuance.
OK FOR PRINTING:
________________________________________
Signature over Printed Name
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Water Supply Projects 2
2
Proponent Name
Proponent Address
I. PROJECT DESCRIPTION
Please check project type and indicate size
Actual Project
Project Type Project Size Parameter
Size
# of wells and other systems
Water Supply Systems (Complete System)
(e.g., infiltration gallery, etc.)
Water Supply System (Distribution Only) Level
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
See attached vicinity map/s and photographs of the project site and site development/layout plan.
Initial Environmental Examination (IEE) Checklist Report Form for Water Supply Projects 3
3
Geographic coordinates of the project area (Preferably use PRS 92 datum; otherwise, specify datum used).
Perimeter/Boundary points (based Longitude Latitude
on OCT/TCT/etc.)
Power/Electricity KWh
(From Renewable Energy Sources)
Water m3/day
(Rainwater Collection System)
Water Source
____________________________________________________________________
(Sitio/Zone, Barangay, Municipality/City, Province, Region)
Initial Environmental Examination (IEE) Checklist Report Form for Water Supply Projects 5
5
Energy/Water Efficiency
Proposed Efficiency/Conservation
Estimated Savings
Utilities Measures
Power/Electricity KWh
3
Water m /day
I.4 MANPOWER
a. Construction Phase
Manpower Requirement Expertise/Skills Total
b. Operation Phase
Manpower Requirement Expertise/Skills Total
Disturbance to Existing vegetation in the area: Comply with conditions of Annual inspection of Cost integrated in the
wildlife due to DENR/LGU SLUP, Tree Cutting area replanted/ construction/operation
vegetation clearing Forestland Permit, ROW, PCA Permit re-vegetated cost
Marshland
Limit land clearing as much as
possible
Grassland Provide temporary fencing for
Mangrove vegetation that will be retained
Wetland Promote restoration of damaged or
Others, specify
destroyed vegetation where possible
(e.g., tree planting)
__________________
Initial Environmental Examination (IEE) Checklist Report Form for Water Supply Projects 7
Possible Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Implementation Monitoring
Impacts
Change in surface Slope: Provide erosion control and slope Regular inspection of Slope/ Erosion Control
landform/ protection measures slope protection Cost: ___________
topography/
terrain/slope
flat (0-3%) Designate a Spoils Storage Area, measures in erosion-
prone areas
Others, specify
gently sloping to rolling (3- with topsoil set aside for later use _______________
18%) and allow maximum re-use of spoils Regular inspection for
Soil Erosion steep (>18%) Construct during dry season new eroded areas near
the site
Stabilize embankment with grasses
Others, specify
or other soil cover
______________
Others, specify
____________
Is the project site located in an
area identified by MGB/PAG- Comply with the DENR
Administrative Order No. 2003-30
ASA/ PHIVOLCS as hazard
and DENR Administrative Order No.
prone? 2000-28, Implementing Guidelines
on Engineering Geological and Geo-
Yes hazard Assessment (EGGA).
No
Soil/Land Existing soil type in the area: Implement the Ecological Solid Daily inspection of Cost integrated in the
contamination due Waste Management Plan (ESWMP) waste/recycling bins for construction/operation
to improper solid sandy Set up temporary fence around the segregation cost
waste disposal
clay construction area Daily inspection for
sandy-loam
Implement re-use and recycling of presence of mixed
waste materials garbage in the facility
Others, specify
Implement proper segregation, Weekly inspection of
____________________ waste accumulated
collection and disposal of domestic
wastes in designated areas Others, specify
_______________
Implement proper collection,
labeling and storage of hazardous
waste
Provide receptacles / bins for solid
wastes
Coordinate with the municipal / city
waste collectors
Initial Environmental Examination (IEE) Checklist Report Form for Water Supply Projects 8
Possible Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Implementation Monitoring
Impacts
Engage third party company for
waste collection
Others, specify
________________
Impairment of Presence of visually significant Implement landscaping and other Regular inspection of Cost integrated in the
visual landforms/landscape/structure beautification measures landscaping and other construction/operation
aesthetics s? Provide adequate buffer beautification activities cost
Devaluation of Compensate adjacent property Regular monitoring of
land values Yes owners buffer zones
No Others, specify
Regular monitoring for
________________ presence/absence of
complaints from adjacent
property owners
WATER
Increased siltation
Specify nearest/receiving
Set up proper and adequate sanitary
Regular (ocular) inspection Cost integrated in the
water body: of: construction/operation
due to project facilities
________________________ cost
activities Strictly require the contractor and its
Drainage / canal
Water quality Distance to nearest/receiving workers to observe proper waste
systems
degradation disposal and proper sanitation
Others, specify
water body:
Strictly observe proper waste Water treatment facility
handling and disposal (i.e., grease trap, septic
_____________ 0 to less than 0.5 km tank, etc.)
0.5 to 1 km
Provide wastewater treatment
facility
More than 1 km Set up silt trap/stilling ponds to Quarterly monitoring of the
minimize downstream siltation following:
If nearest/receiving water body Provide ring canals around fuelling
is fresh water, specify
tanks/ motorpool/ maintenance pH
classification:
areas TSS concentration
Others, specify BOD
______________
AA Total Coliform
A Color
B Oil and Grease
Initial Environmental Examination (IEE) Checklist Report Form for Water Supply Projects 9
Possible Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Implementation Monitoring
Impacts
C
D
SA
SB
SC
SD
Fishery
Tourist Zone / Park
Recreational
Industrial
Agricultural
Drinking/Domestic
Industrial
Agricultural
Initial Environmental Examination (IEE) Checklist Report Form for Water Supply Projects 10
Possible Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Implementation Monitoring
Impacts
Competition in Size of population using Implement rainwater harvesting and Regular monitoring for
presence/absence of
Cost integrated in the
water use receiving surface water: similar measures as an alternative construction/operation
complaints
Depletion of water source of water
cost
resources 1,000 persons Observe water conservation Regular coordination
with concerned agencies
>1,000 and 5,000 measures;
persons Careful selection of project site to Regular monitoring for
occurrences of water
>5,000 persons avoid disruption of traditional water
uses shortages
Obtain Water Permit from NWRB Others, specify
________________
Available/nearest water Improve efficiency of water supply
source. and distribution system
Implement community ponds and
Deepwell similar measures as alternative
Water district/LGU water source for non-domestic uses
Surface water Increase, when practical, storage
capacities of water supply structures
Others, specify for resilience to greater climate
________________ variations and extremes
Others, specify
_______________________
Increased Is the project site located in an Use appropriate design for project Regular monitoring for Cost integrated in the
occurrence of area identified by MGB/PAG- facilities presence/absence of construction/operation
flooding ASA as flood prone? Implement appropriate drainage
complaints cost
system Regular coordination
Yes Regularly remove debris and other
with concerned agencies
No materials that may obstruct water Regular monitoring for
flow increased frequency of
flooding
Use appropriate technology (e.g.,
raised hand-pumps) to protect Others, specify
drinking water from flood __________________
contamination
Others, specify
________________________
Initial Environmental Examination (IEE) Checklist Report Form for Water Supply Projects 11
Possible Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Implementation Monitoring
Impacts
AIR / NOISE
Air quality degradation Distance to nearest Properly operate and maintain all Regular monitoring for Cost integrated in the
community: emission sources (e.g. vehicles, presence/absence of construction/operation
pumps, generator, etc) complaints cost
0 to less than 0.5 km Install, when applicable, the
Regular (ocular) inspection
0.5 to 1 km appropriate air pollution control
of:
More than 1 km
device/s
Strictly enforce good housekeeping Absence of white or
practices black smoke from
Control vehicle speed to lessen
vehicles, generator,
etc.
suspension of road dust
Conduct water spraying to
Presence of truck
cover during
suppress dust sources and
deliveries
minimize discomfort to nearby
residents
Use covered vehicles to deliver
materials that may generate dust
Others, specify
_________________
Nuisance due to Distance to nearest Properly operate and maintain all Regular monitoring for Cost integrated in the
noise generation community: noise sources (e.g., vehicles, presence/absence of construction/operation
pumps, generator, etc.) complaints cost
0 to less than 0.5 km Install, when applicable, the Regular monitoring of
0.5 to 1 km appropriate noise control device/s buffer zones
More than 1 km
(e.g., mufflers, silencer, sound
barriers, etc.)
Implement appropriate operating
hours
Provide adequate buffer and/or
planting trees
Others, specify
_________________
Initial Environmental Examination (IEE) Checklist Report Form for Water Supply Projects 12
PEOPLE
Provide description of the Abandonment activities, such as dismantling and waste disposal.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
Initial Environmental Examination (IEE) Checklist Report Form for Water Supply Projects 15
Attach drawing/plan of air pollution source and control installations (with dimensions and
descriptions)
Initial Environmental Examination (IEE) Checklist Report Form for Water Supply Projects 16
Process flow
Initial Environmental Examination (IEE) Checklist Report Form for Water Supply Projects 17
Attach drawing/plan of waste water treatment facility (with dimensions and descriptions)
Initial Environmental Examination (IEE) Checklist Report Form for Water Supply Projects 18
This is to certify that all the information and commitments in this Initial Environmental
Examination (IEE) Checklist Report are accurate and complete to the best of my knowledge.
I hereby bind myself to answer any penalty that may be imposed arising from any
misrepresentation or failure to state material information in this IEE Checklist.
____________________________________
NAME OF PROPONENT HEAD
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
SUBSCRIBED AND SWORN TO before me this _____ day of ____________ 201__, affiant exhibiting
his/her Community Tax Certificate No. ___________________ issued at ______________________ on
__________________________.
Annex 2 - L
for
This IEE Checklist Report Form shall be used for proposed IRRIGATION / FLOOD CONTROL/
MINOR DAM PROJECTS required an IEE Report / IEE Checklist for ECC Application.
This IEE Checklist Report Form shall be submitted along with the following documents:
Read the questions carefully and write the required information on the spaces provided or
otherwise check () the appropriate boxes . Boxes with check marks are mandatory
requirements. Use additional sheets if necessary and indicate this in the appropriate space.
Misleading or erroneous answers are grounds for legal action and/or denial of ECC
issuance.
OK FOR PRINTING:
________________________________________
Signature over Printed Name
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Irrigation / Flood Control / Minor Dam Projects 2
Proponent Name
Proponent Address
I. PROJECT DESCRIPTION
Please check project type and indicate size
Actual
Project Type Project Size Project Size Parameter
reservoir flooded area
Impounding System or Flood Control Project (hectare) or water storage
capacity (m3)
Irrigation System (Distribution System Only) service area (hectare)
reservoir flooded area
Minor Dam (hectare) or water storage
capacity (m3)
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
See attached vicinity map/s and photographs of the project site and site development/layout plan.
Initial Environmental Examination (IEE) Checklist Report Form for Irrigation / Flood Control / Minor Dam Projects 3
Geographic coordinates of the project area (Preferably use PRS 92 datum; otherwise, specify datum used).
Perimeter/Boundary points (based Longitude Latitude
on OCT/TCT/etc.)
3. Impounding System
5. Drainage canals
8. Others, specify:
_____________________
_____________________
Power/Electricity KWh
(From Renewable Energy Sources)
3
Water (Total) m /day
(Fill-up table below if water is not
obtained from the local water utility)
3
Water m /day
(Rainwater Collection System)
Water Source
____________________________________________________________________
(Sitio/Zone, Barangay, Municipality/City, Province, Region)
Initial Environmental Examination (IEE) Checklist Report Form for Irrigation / Flood Control / Minor Dam Projects 5
Energy/Water Efficiency
Proposed Efficiency/Conservation
Estimated Savings
Utilities Measures
Power/Electricity KWh
3
Water m /day
I.4 MANPOWER
a. Construction Phase
Manpower Requirement Expertise/Skills Total
b. Operation Phase
Manpower Requirement Expertise/Skills Total
Disturbance to Existing vegetation in the area: Comply with conditions of Annual inspection of Cost integrated in the
wildlife due to Forestland DENR/LGU SLUP, Tree Cutting
Permit, ROW, PCA Permit
area replanted/
re-vegetated
construction/operation
cost
vegetation clearing
Marshland
Limit land clearing as much as
Grassland possible
Mangrove Provide temporary fencing for
Wetland vegetation that will be retained
Others, specify
Promote restoration of damaged or
___________________ destroyed vegetation where possible
(e.g., tree planting)
Initial Environmental Examination (IEE) Checklist Report Form for Irrigation / Flood Control / Minor Dam Projects 7
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Change in surface Slope: Provide erosion control and slope Regular inspection of Slope/ Erosion Control
landform/ protection measures slope protection Cost: ___________
topography/
terrain/slope
flat (0-3%) Designate a Spoils Storage Area, measures in erosion-
prone areas
Others, specify
gently sloping to rolling (3- with topsoil set aside for later use ______________
18%) and allow maximum re-use of spoils Regular inspection for
Soil Erosion steep (>18%) Construct during dry season new eroded areas near
the site
Stabilize embankment with grasses
Others, specify
or other soil cover
_____________
Others, specify
_________________________
sandy-loam
Implement re-use and recycling of presence of mixed
waste materials garbage in the facility
Others, specify
Implement proper segregation, Weekly inspection of
____________________ waste accumulated
collection and disposal of domestic
wastes in designated areas Others, specify
Implement proper collection, _____________
labeling and storage of hazardous
waste
Provide receptacles / bins for solid
wastes
Coordinate with the municipal / city
waste collectors
Engage third party company for
Initial Environmental Examination (IEE) Checklist Report Form for Irrigation / Flood Control / Minor Dam Projects 8
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
waste collection
Others, specify
________________
WATER
Increased siltation Specify nearest water body: Regular (ocular) inspection Cost integrated in the
due to project ________________________ of: construction/operation
activities cost
Water quality Drainage/canal systems
degradation Distance to nearest water
Water treatment facility
Others, specify
body: (i.e., grease trap, septic
_______________ 0 to less than 0.5 km tank, etc.
0.5 to 1 km
More than 1 km Set up proper and adequate sanitary
Regular (ocular) inspection
facilities
of water body for:
Strictly require the contractor and its
If nearest water body is fresh workers to observe proper waste
water, specify classification: disposal and proper sanitation Turbidity and/or silted
condition
Strictly observe proper waste
AA
handling and disposal Floating wastes or debris
A
Provide wastewater treatment
B facility (e.g., septic tank, oil and
C water separator, etc.)
D Set up silt trap/settling ponds to
minimize downstream siltation
Others, specify
If nearest water body is ______________
coastal or marine water,
specify classification:
SA
SB
SC
SD
Current Water Use:
Fishery
Initial Environmental Examination (IEE) Checklist Report Form for Irrigation / Flood Control / Minor Dam Projects 9
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Tourist Zone / Park
Recreational
Industrial
Agricultural
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
require less water input and hence
have less impact on water tables
Modify irrigation techniques,
including amount, timing or
technology
Improve water management to
prevent water logging, erosion and
leaching
Modify crop calendars and/or
implement seasonal climate
forecasting (e.g., timing or location
of cropping activities)
Others, specify
_____________________
Increased Is the project site located in an Use appropriate design for project Regular monitoring for Cost integrated in the
occurrence of area identified by MGB/ facilities presence/absence of construction/operation
flooding PAG-ASA as flood prone? Implement appropriate drainage
complaints cost
system Regular coordination
Yes Regularly remove debris and other
with concerned agencies
No materials that may obstruct water Regular monitor of
flow increased frequency of
flooding
Use appropriate technology (e.g.,
raised hand-pumps) to protect Others, specify
drinking water from flood _________________
contamination
Others, specify
_______________________
Initial Environmental Examination (IEE) Checklist Report Form for Irrigation / Flood Control / Minor Dam Projects 11
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
AIR / NOISE
Air quality degradation Distance to nearest Properly operate and maintain all Regular monitoring for Cost integrated in the
community: emission sources (e.g., vehicles, presence/absence of construction/operation
pumps, generator, etc.) complaints cost
0 to less than 0.5 km Install, when applicable, the Regular (ocular) inspection
0.5 to 1 km appropriate air pollution control of:
More than 1 km
device/s
Strictly enforce good housekeeping Absence of white or
practices black smoke from
vehicles, generator,
Control vehicle speed to lessen etc.
suspension of road dust
Conduct water spraying to suppress
Presence of truck
cover during
dust sources and minimize deliveries
discomfort to nearby residents
Use covered vehicles to deliver
materials that may generate dust
Others, specify
__________________
Nuisance due to Distance to nearest Properly operate and maintain all Regular monitoring for Cost integrated in the
noise generation community: noise sources (e.g., vehicles, presence/absence of construction/operation
pumps, generator, etc.) complaints cost
0 to less than 0.5 km Install, when applicable, the Regular monitoring of
0.5 to 1 km appropriate noise control device/s buffer zones
More than 1 km
(e.g., mufflers, silencer, sound Quarterly monitoring of
barriers, etc.) noise level
Implement appropriate operating
hours
Provide adequate buffer and/or
planting of trees
Others, specify
_____________________
Initial Environmental Examination (IEE) Checklist Report Form for Irrigation / Flood Control / Minor Dam Projects 12
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
PEOPLE
Displacement of Size of population of host Provide relocation/disturbance Regular monitoring for Cost integrated in the
residents in the barangay: compensation packages presence/absence of construction/operation
project site and
1,000 persons Prioritize local residents for complaints cost
within its vicinity employment Regular coordination
Displacement of >1,000 and 5,000
Promptly pay local taxes and other with LGU
persons
Indigenous Peoples financial obligations Others, specify
Enhanced >5,000 persons
Regular coordination with LGU ___________________
employment and/or
livelihood Classification of host Conduct prior consultation and
barangay: coordination to minimize disruption
opportunities
of daily domestic activities and to
Reduced Urban ensure respect for IP rights and
employment and/or Rural cultural practices
livelihood
opportunities
Ensure participation of IPs in
Available services within/near consultations and dialogues
Increased revenues the host barangay:
Provide appropriate traffic/warning
for LGU Schools (e.g., signs, lighting, etc
Disruption/Competit elementary, high
Others, specify
ion in delivery of school, college)
__________________________
public services
(e.g., education,
Health facilities (e.g.,
clinics, hospitals, etc.)
peace and order,
etc.) Peace and order (e.g.,
police outpost, Brgy.
Enhanced delivery Tanod, etc.)
of public services
(e.g., education, Recreation and sports
peace and order, facilities
etc.) Others, specify
Increase in traffic ________________
volume and
worsening of traffic
flow
Impacts on Regularly coordinate with LGU Regular monitoring for Cost integrated in the
community health Provide appropriate warning signs, presence/absence of
complaints
construction/ operation
cost
and safety lighting and barricades, whenever
practicable
Initial Environmental Examination (IEE) Checklist Report Form for Irrigation / Flood Control / Minor Dam Projects 13
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Others, specify Observe proper housekeeping Regular coordination
______________ Provide on-site medical services for with LGU
any emergency. Regular submission of
Participate in public awareness
reports to concerned
agency
programs on health and safety
Implement appropriate safety Others, specify
_____________
programs for both community and
workers
Others, specify
_____________________
Initial Environmental Examination (IEE) Checklist Report Form for Irrigation / Flood Control / Minor Dam Projects 14
Provide description of the Abandonment activities, such as dismantling and waste disposal.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
Initial Environmental Examination (IEE) Checklist Report Form for Irrigation / Flood Control / Minor Dam Projects 15
This is to certify that all the information and commitments in this Initial Environmental
Examination (IEE) Checklist Report are accurate and complete to the best of my knowledge.
I hereby bind myself to answer any penalty that may be imposed arising from any
misrepresentation or failure to state material information in this IEE Checklist.
____________________________________
NAME OF PROPONENT HEAD
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
SUBSCRIBED AND SWORN TO before me this _____ day of ____________ 201__, affiant exhibiting
his/her Community Tax Certificate No. ___________________ issued at ______________________ on
__________________________.
Annex 2 - M
for
This IEE Checklist Report Form shall be used for proposed WASTE MANAGEMENT PROJECTS
required an IEE Report / IEE Checklist for ECC Application.
This IEE Checklist Report Form shall be submitted along with the following documents:
Read the questions carefully and write the required information on the spaces provided or
otherwise check () the appropriate boxes . Boxes with check marks are mandatory
requirements. Use additional sheets if necessary and indicate this in the appropriate space.
Misleading or erroneous answers are grounds for legal action and/or denial of ECC
issuance.
OK FOR PRINTING:
________________________________________
Signature over Printed Name
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Waste Management Projects 2
Proponent Name
Proponent Address
I. PROJECT DESCRIPTION
Please check project type and indicate size
Project Type
Actual Project
Project Size Parameter
Size (MT)
Compost/Fertilizer making Daily production rate
Quantity of waste to be
Domestic waste water treatment facility
treated annually
Materials recovery facility Kind of activity
Receiving facilities, paper, plastic and other material Quantity of waste to be
recycling treated annually
Sanitary landfill for domestic waste only Daily waste input
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
See attached vicinity map/s and photographs of the project site and site development/layout plan.
Initial Environmental Examination (IEE) Checklist Report Form for Waste Management Projects 3
Geographic coordinates of the project area (Preferably use PRS 92 datum; otherwise, specify datum used).
Perimeter/Boundary points (based Longitude Latitude
on OCT/TCT/etc.)
3. Support Facilities
Road/access system
Drainage system
Landfill Gas Collection/
Recovery Facility
Gas venting/temporary flare
Leachate collection and
treatment facility
Electrical / Genset Room
Building for Composting Plant
Pump Room
Fuel storage and dispensing
facility
Power Supply System
Water Supply System
Initial Environmental Examination (IEE) Checklist Report Form for Waste Management Projects 4
4. Admin support
Administration Building
Guard House
Engineering Office
Clinic
Mess Hall/Canteen
Personal Quarters
Motor Pool
Stalls/Storage
Trucks Wait Area/ Parking
Public Toilet
Laboratory
Others, specify
_____________________
Power/Electricity KWh
(From Renewable Energy Sources)
Water Source
____________________________________________________________________
(Sitio/Zone, Barangay, Municipality/City, Province, Region)
Energy/Water Efficiency
Proposed Efficiency/Conservation
Estimated Savings
Utilities Measures
Power/Electricity KWh
Water m3/day
I.4 MANPOWER
a. Construction Phase
Manpower Requirement Expertise/Skills Total
Initial Environmental Examination (IEE) Checklist Report Form for Waste Management Projects 6
b. Operation Phase
Manpower Requirement Expertise/Skills Total
Disturbance to Existing vegetation in the area: Comply with conditions of Annual inspection of Cost integrated in the
wildlife due to DENR/LGU SLUP, Tree Cutting area replanted/ construction /
vegetation clearing Forestland Permit, ROW, PCA Permit re-vegetated operation cost
Limit land clearing as much as
Marshland possible
Grassland Provide temporary fencing for
Mangrove vegetation that will be retained
Wetland Promote restoration of damaged or
Others, specify
destroyed vegetation where
possible (e.g., tree planting)
___________________
Initial Environmental Examination (IEE) Checklist Report Form for Waste Management Projects 8
WATER
Increased siltation Specify nearest water body: Set up proper and adequate
Regular (ocular) inspection
Cost integrated in the
due to project ________________________ of:
sanitary facilities construction/
activities
Water quality Distance to nearest water body: Strictly require the contractor and its Drainage / canal
operation cost
workers to observe proper waste systems
degradation
disposal and proper sanitation
Others, specify 0 to less than 0.5 km
Strictly observe proper waste
Water treatment
_____________ 0.5 to 1 km handling and disposal
facility (i.e., grease
trap, septic tank, etc.)
More than 1 km
Initial Environmental Examination (IEE) Checklist Report Form for Waste Management Projects 10
AIR / NOISE
Air quality degradation Distance to nearest community: Properly operate and maintain all Regular monitoring for Cost integrated in the
0 to less than 0.5 km emission sources (e.g. vehicles, presence/ absence of construction/
complaints operation cost
0.5 to 1 km
boiler, generator, etc)
More than 1 km
Install, when applicable, the Regular (ocular) inspection
appropriate air pollution control of:
device/s
Install methane recovery facility Absence of white or
black smoke from
Install biogas and composting vehicles, generator,
facility etc.
Strictly enforce good housekeeping Presence of truck
practices cover during deliveries
Control vehicle speed to lessen Quarterly monitoring of
suspension of road dust ambient air for the
Conduct water spraying to suppress following:
dust sources and minimize
discomfort to nearby residents
TSP
Nuisance due to Distance to nearest community: Properly operate and maintain all Regular monitoring for Cost integrated in the
noise generation 0 to less than 0.5 km noise sources (e.g., vehicles, boiler, presence/absence of construction/
complaints operation cost
0.5 to 1 km
generator, etc.)
More than 1 km
Install, when applicable, the Regular monitoring of
appropriate noise control device/s buffer zones
(e.g., mufflers, silencer, sound
barriers, etc.)
Implement appropriate operating
hours
Provide adequate buffer and plating
of trees
Others, specify
________________________
PEOPLE
Displacement of Size of population of host Provide relocation/disturbance Regular monitoring for Cost integrated in the
residents in the barangay: compensation packages presence/absence of construction/
project site and 1,000 persons Prioritize local residents for complaints operation cost
within its vicinity
>1,000 and 5,000 employment Regular coordination
Displacement of
Indigenous Peoples
persons Promptly pay local taxes and other with LGU
Provide description of the Abandonment activities, such as final sealing of the filled landfill, subsidence
process and the monitoring and inspection activity.
Include in the plan a discussion on how to improve coordination within and among affected stakeholders
who are organizing and providing scientific, technical and managerial personnel on climate change.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
Initial Environmental Examination (IEE) Checklist Report Form for Waste Management Projects 15
This is to certify that all the information and commitments in this Initial Environmental
Examination (IEE) Checklist Report are accurate and complete to the best of my knowledge.
I hereby bind myself to answer any penalty that may be imposed arising from any
misrepresentation or failure to state material information in this IEE Checklist.
____________________________________
NAME OF PROPONENT HEAD
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
SUBSCRIBED AND SWORN TO before me this _____ day of ____________ 201__, affiant exhibiting
his/her Community Tax Certificate No. ___________________ issued at ______________________ on
__________________________.
Annex 2 - N
This Generic IEE Checklist Report Form shall be used as the interim pro-forma EIA Report
requirement for projects required an IEE Report / IEE Checklist for ECC Application and where a
customized IEE Checklist Report Form has not yet been developed.
This IEE Checklist Report Form shall be submitted along with the following documents:
Read the questions carefully and write the required information on the spaces provided or otherwise
check () the appropriate boxes . Boxes with check marks are mandatory requirements. Use
additional sheets if necessary and indicate this in the appropriate space.
Misleading or erroneous answers are grounds for legal action and/or denial of ECC issuance.
OK FOR PRINTING:
________________________________________
Signature over Printed Name
___________________________
Date
Generic Initial Environmental Examination (IEE) Checklist Report Form 2
Proponent Name
Proponent Address
I. PROJECT DESCRIPTION
1
See attached vicinity map/s and photographs of the project site and site development/layout plan.
Geographic coordinates of the project area (Preferably use PRS 92 datum; otherwise, specify datum used).
Perimeter/Boundary points (based
Longitude Latitude
on OCT/TCT/etc.)
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Generic Initial Environmental Examination (IEE) Checklist Report Form 3
2. Processing facility
Material preparation and
handling (e.g., screening,
sorting, conveyor belt, etc.)
Material size
reduction/agglomeration
Heating/Drying (direct
heat/energy application)
Processing (e.g., mixing,
blending, refining, milling, etc.)
Finishing (e.g., sorting, filling,
packaging, etc.)
Others, specify
________________
Power/Electricity KWh
(From Renewable Energy Sources)
Water Source
ground water well spring others: ____________________________
____________________________________________________________________
(Sitio/Zone, Barangay, Municipality/City, Province, Region)
Energy/Water Efficiency
Proposed Efficiency/Conservation
Estimated Savings
Utilities Measures
Power/Electricity KWh
Water m3/day
Generic Initial Environmental Examination (IEE) Checklist Report Form 5
I.4 MANPOWER
a. Construction Phase
Manpower Requirement Expertise/Skills Total
b. Operation Phase
Manpower Requirement Expertise/Skills Total
Disturbance to wildlife Existing vegetation in the area: Comply with conditions of Annual inspection of Cost integrated
due to vegetation Forestland DENR/LGU SLUP, Tree Cutting area replanted/ in the
clearing Marshland
Permit, ROW, PCA Permit re-vegetated construction/
Grassland
Limit land clearing as much as operation cost
possible
Mangrove Provide temporary fencing for
Wetland vegetation that will be retained
Others, specify Promote restoration of damaged or
____________________ destroyed vegetation where
possible (e.g., tree planting)
7
Generic Initial Environmental Examination (IEE) Checklist Report Form
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Change in surface Slope: Provide erosion control and slope Regular inspection of Slope/ Erosion
landform/ topography/ flat (0-3%) protection measures slope protection Control Cost:
terrain/slope gently sloping to rolling (3-18%) Designate a Spoils Storage Area, measures in erosion- __________
steep (>18%) with topsoil set aside for later use prone areas Others, specify
Soil Erosion and allow maximum re-use of spoils Regular inspection ____________
Construct during dry season for new eroded areas
near the site
Stabilize embankment with grasses
Others, specify
or other soil cover
_________________
Others, specify
___________________________
sandy-loam
construction area Daily inspection for operation cost
Others, specify
Implement re-use and recycling of presence of mixed
waste materials garbage in the facility
_________________________
Implement proper segregation, Weekly inspection of
collection and disposal of domestic waste accumulated
wastes in designated areas Others, specify
Provide receptacles / bins for solid _________________
wastes
Coordinate with the municipal / city
waste collectors
Engage third party company for
waste collection
Others, specify
___________________________
8
Generic Initial Environmental Examination (IEE) Checklist Report Form
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Impairment of visual Presence of visually significant
landforms/landscape/structures?
Implement landscaping and other Regular inspection of Cost integrated
aesthetics beautification measures landscaping and in the
Devaluation of land Yes Provide adequate buffer other beautification construction/
values No Compensate adjacent property
activities operation cost
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
SD
Current Water Use:
Fishery
Tourist Zone / Park
Recreational
Industrial
Agricultural
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Increased occurrence of Is the project site located in an area
identified by MGB/PAG-ASA as
Use appropriate design for project Regular monitoring Cost integrated
flooding facilities for presence/absence in the
flood prone?
Implement appropriate drainage
of complaints construction/
Yes system Regular coordination operation cost
No Regularly remove debris and other
with concerned
agencies
materials that may obstruct water
flow Regular monitoring
for increased
Use appropriate technology (e.g., frequency of flooding
raised hand-pumps) to protect
drinking water from flood Others, specify
contamination
__________________
Others, specify
_____________________
AIR / NOISE
Air quality degradation Distance to nearest community: Properly operate and maintain all Regular monitoring Cost integrated
0 to less than 0.5 km emission sources (e.g., vehicles, for presence/absence in the
0.5 to 1 km pumps, generator, etc.) of complaints construction/
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
Presence of truck
cover during
deliveries
Nuisance due to noise Distance to nearest community: Properly operate and maintain all Regularly monitor Cost integrated
generation noise sources (e.g. vehicles, presence/absence of in the
0 to less than 0.5 km pumps, generator, etc) complaints construction/
0.5 to 1 km Install when applicable, the Regular monitoring of operation cost
barriers, etc.)
Implement appropriate operating
hours
Provide adequate buffer and/or
planting of trees
Others, specify
______________________
PEOPLE
Displacement of Size of population of host barangay: Provide relocation/disturbance Regular monitoring Cost integrated
for presence/absence
residents in the project 1,000 persons compensation packages
of complaints
in the
site and within its
>1,000 and 5,000persons
Prioritize local residents for construction/
vicinity employment Regular coordination operation cost
Displacement of
>5,000person
Promptly pay local taxes and other
with LGU
Indigenous People
Classification of host barangay:
financial obligations Others, specify
Regular coordination with LGU
_________________
Enhanced employment
Urban
and/or livelihood
Rural
Prior consultation & coordination to
opportunities minimize disruption on daily
Reduced employment
Available services within/near the
domestic activities & respect for IP
and/or livelihood rights and cultural practices
host barangay:
opportunities
Ensure participation of IPs in
Increased revenues for
Schools (e.g. elementary, high
school, college)
consultations and dialogues
LGU
Provide appropriate traffic/warning
Disruption/Competition
Health facilities (e.g., clinics,
hospitals, etc.)
signs, lighting, etc
in delivery of public
Peace and order (e.g., police
Others, specify
services (e.g., ________________
education, peace and outpost, Brgy. Tanod, etc.)
12
Generic Initial Environmental Examination (IEE) Checklist Report Form
Possible
Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
order, etc.) Recreation and sports facilities
Enhanced delivery of Others, specify
public services (e.g., _____________________
education, peace and
order, etc.)
Increase in traffic
volume and worsening
of traffic flow
Impacts on community Source of risks Regularly coordinate with LGU Regular monitoring Cost integrated
health and safety Explosives Provide appropriate warning signs, for presence/absence in the
Flammable substances lighting and barricades, whenever of complaints construction/
Safety Risks
Toxic substances
practicable Regular monitoring of operation cost
Fire buffer zones
Others, specify
Observe proper housekeeping
Explosion _________________________ Provide on-site medical services for Regular coordination
Release of toxic any emergency. with LGU
materials Participate in public awareness
Regular submission
programs on health and safety of reports to
concerned agency
Implement appropriate safety
Others, specify
programs for both community and
workers _________________
Strictly comply with fire, safety and
similar regulatory requirements
Strictly comply with requirements of
RA 6969
Others, specify
___________________________
Generic Initial Environmental Examination (IEE) Checklist Report Form13 13
Provide description of the Abandonment activities, such as, dismantling and waste disposal.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
Generic Initial Environmental Examination (IEE) Checklist Report Form14 14
Attach drawing/plan of waste water treatment facility (with dimensions and descriptions)
Generic Initial Environmental Examination (IEE) Checklist Report Form15 15
Attach drawing/plan of air pollution source and control installations (with dimensions and
descriptions)
Generic Initial Environmental Examination (IEE) Checklist Report Form16 16
This is to certify that all the information and commitments in this Initial Environmental
Examination (IEE) Checklist Report are accurate and complete to the best of my knowledge.
I hereby bind myself to answer any penalty that may be imposed arising from any
misrepresentation or failure to state material information in this IEE Checklist.
____________________________________
NAME OF PROPONENT HEAD
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
SUBSCRIBED AND SWORN TO before me this _____ day of ____________ 201__, affiant exhibiting
his/her Community Tax Certificate No. ___________________ issued at ______________________ on
__________________________.