Department of Environment and Natural Resources Environmental Management Bureau Reference No: (40 be filed up by DENR only) GENERAL INFORMATION SHEET ‘Name of the Establishment/Faciliy PHILIPPINE PORTS AUTHORITY-TMO CULION Establishment/Facility Address (NOT the company of head olfice) Street # & Street Name: Port Area Barangay: Balala City/Municipality: Culion Province: Palawan, Name of Owne/Comgeny PHILIPPINE PORTS AUTHORITY Street # & Street Name: Address (Wfadatess is notthe same as | Barangay: City/Municipality: previous adaess) Province: Phone Number 04g — 434-4881 Fax Number 0484345626 e-mail address tmoculion@gmail.com Philippine Standard Industry Classification Code No. GOCC. ‘Type of Business! Industry Classification Philippine Standard Industry Descriptor: _GOCC Responsible Officer/s: CEO/President. ELIZALDE M.ULSON Tel #: 0484345626 Fax #: 0484345626 e-mail address: pmopalawan@gmail.com Plant Manager: Tel Fax # e-mail address: Pollution Control Officer Name. JAKE VINCENT P, QUIRIT Tel 09175765563 Fax # e-mail address: jupquirit69@gmail,com Legal Classification single proprietorship 1D partnership 1 private domestic corporation 1D government corporation 1 Malti-national o We hereby certify that the above information are true and correct. ELIZALDE M. ULSON Name/Signature of Port Manager Name/Signature of PCO COA NO. 2018-R4B-02161Name of Plant: PHILIPPINE PORTS ALITHORITY = 7MO CULO! ry To MARCH 2021 Reference No: Department of Environment and Natural Resources Environmental Management Bureau QUARTERLY SELF-MONITORING REPORT MODULE 1:_ GENERAL INFORMATION, Name of the Plant PHILIPPINE PORTS AUTHORITY ~TMO CULION Please provide the necessary revised, corrected or updated information not contained in your General Information Sheet DENR Permits/Licenses/Clearances Fnvionmenal Permits Date oftsue | Expty Date WEN. [For Compliance PD. 98 PON BOC pp ases noc? Boca DENR DENT _| For Compliance (CO Regiary | For Compliance A 969 = Grane No Permit Temper ACN, Ra gras PON, | For Compliance Operation Operating howrsiday [Operating daye/veck io shifday ‘Average 10h 7 days L Maximum his Taye L Operation/Production/Capacity: “Average Daily Production Output 7 Total Output this Quarter_| 6337 “Total Water Consumption this Quarter (cubic 252 meters) Total Electric Consumption this Quarter | 4414 (KwH) Please ue adtonal sheds W necesary Module 1: General information Page |iName of Plant: PHILIPPINE PORTS AUTHORITY — TMO CULION (JANUARY TO MARCH 2021) _| Reference No: MODULE 2: RA 6969 A. CCO Report (please accomplish this section for each chemical/substance) ‘Common Name/IUPAC/CAS Index Name. CAS No ‘Trade Name: For importers only: Qvantity | TP Dateof | Quantity. | poo entry | Country of | Country of Requested | mm | Anivat | Receted’ | POROFERY | “Grin” | Manufacture “Total Quantity Requested Total Quantity Received annual) (annual) attach copy/s of Bil of Lading For distributors (importers/non-importers) ‘Name of Client License No. Quantity Date of Distribution ‘Total Quantity Distributed For non-importer users: Name of Distributor Quantity Date of Purchase Total Quantity Purchased from Distributor For producers “Average Daily ‘Total Output this Quarter Module 28: RA 6969 (Hazardous Wastes Generator) Page |iName of Plant PHILIPPINE PORTS AUTHORITY ~TMO CULION JANUARY TO MARCH 2023) _| Reference No: Production Output ‘Quantity of Stock Quantity of Stock Inventory (Start of Inventory (End of Quarter) Quarter) Name of Buyer Quantity Date of Purchase ‘Total Quantity Sold Used in Production (please fill up only if chemical/substance is not main product) “Average Daily Production Output Total Output this Quarter “Average Quantity Used Total Quantity Used this, per month Quarter Describe any changes in Production/Process/Operations: ‘Stock Inventory/Waste Chemical Generated: “Average Quantity of Total Quantity of Waste ‘Waste Chemical Chemical Generated this Generated per month Quarter Quantity of Stock Quantity of Stock, Inventory (Start of Inventory (End of Quarter) Quarter) Other Information: Manner of handling | © storage on-site 1 Treatment on-site ezardous wastes Di storage off-site 1 Treatment off-site ‘Changes in Safety 1 Yes (please atach copy of revised pan) Management System — |G) No Chemical Substitute | Yes (lease aach copy fot submitednclaed in previous reports or ha ben ese) Plan ONo B. Hazardous Wastes Generator HW Generation: Module 28: RA 6969 (Hazardous Wastes Generator) Page |2Name of Plant: PHILIPPINE PORTS AUTHORITY ~ TMO CULION JANUARY TO MARCH 2023) __| Reference No: ‘Remaining HW fom uw hss nw Hw ee HW Generated No mer Nature | Cataloguing | Quanity [Unie | Quanity [Unit D407 | Busted Solid | Toxic a4 pes Fluorescent Lamp 1102_| Used Oil Liquid [Flammable [5 Titers D406 | Batteries (Lead | Solid | Toxic Compound 1101 | Used industrial | Liquid | Flammable | 10 Titers oil ‘Waste Storage, Treatment and Disposal: (Pease fi-up oe table per HW) HW Deals Qyy of HW Treated ‘TSD Location HWNo,: D407 Busted Fluoresecent Lamp —__ Unit: Storage ‘Admin Bldg Method: fn 1D Name: ransporter 2 Date: 1D Name: “Treater Date: 1D Name: Disposal Date: Date: HW No,: 1102 used Vegetable oil HW Details Qty of HW Treated: Unit: “TSD Location Name: Temporary stored at Hazardous waste storage facility at the back of PPA Storage Admin Bldg Method: Stored in Drum 7 1D Name: ransporter 7 Date: 1D Name: ‘Treater Method: Date: Disposal iD Name: Module 28: RA 6969 (Hazardous Wastes Generator) Page |3Name of Plant: PHILIPPINE PORTS AUTHORITY ~ TMO CULION JANUARY TO MARCH 2023) __| Reference No: Date: Date: HW Deals Quy of HW Treated: ‘TSD Location: HWNo,: 01 used Industil oi —__ Unit: Storage Admin Bldg Name: Temporary stored at Hi ‘waste storage facili kof PPA. Method: Stored in Drum. 1D: ‘Name: ‘Transporter Date: 1D: Nam Method: Date: ‘Treater 1D: Name: Disposal Date: Date: HW No; HW Details Quy of HW Treated: TSD Location: Unit: Name: Storage e ‘Method: 1D: Nam ‘Transporter Date: ID: ‘Name: Methox Date: ‘Treater ID: ‘Nam Disposal . Date: Date: On-Site Self Inspection of Storage Area: Date Conducted Premises/Area Inspected | Findings & Observations Corrective Action Taken (ifany) PPA Hazardous Waste | No problem observed. saai2ae) Storage Facility Module 28: RA 6969 (Hazardous Wastes Generator) Page [4Name of Plant: PHILIPPINE PORTS AUTHORITY ~ TMO CULION JANUARY TO MARCH 2023) __| C. Hazardous Wastes Treater/Recycler HW Stored and/or Untreated as of End of Quarter: Reference No: Type of wanes | pacar | Tsar Strage | Time Tale HW Number vermtDae | Vaidunit | Quantiy | Comat’ | tor Geomune | Tron | Polls names | for HW Treated and/or Recycled as of End of Quarter: Tipe Type ot ‘Transport a Quantity of ‘typeof umier| Weses | paeot | Tamer | | | reamentor | uty of Wet | Namie | rs, | ae | Romine | cumiy | Tan | React ce’ | eed Residual Wastes Generated from the Treatment and/or Recycling Operation: Process by Type of owes | BW Number | Westcis | tansy | comets Generated fof contines Disposal Option ‘Time Table for Disposal Module 2C: RA 6969 (Hazardous Wastes Treater/Recycler)Name of Plant: PHILIPPINE PORTS AUTHORITY ~TMO CULION JANUARY TO MARCH 2023) _| Reference No: MODULE 3: P.D. 984 (Water Pollution) ‘Water Pollution Data Domestic wastewater | Less than 3,00 cubic Process wastewater (cubic meters/day) meters (cubic meters/day) Cooling water Others: _watering plants (cubic meters/day) (cubic meters/day) Less than 1 cubic meter ‘Wash water, equipment (ov iday) ‘Wash water, floor (cubic meters/day) Less than 1 cubic meter Record of Cost of Treatment (Separate entries for separate facilities) Month 1 Month 2 ‘Month 3 Person employed, (# oF employees) Person employed, (cost) ‘Cost of Chemicals used by WIP, Utility Costs of WTP (electricity & water) “Administrative and Overhead Costs Cost of operating in- house laboratory New/Additional Investments in WTP. (Description) Cost of New/Aad Invesiments WTP Discharge Location ue Location of the Outlet Name of Receiving Water Body 1 ‘Near Stair Landing Galion Bay 2 At Back-up Area Galion Bay 3 4 5 Module 3: .D. 984 (Water Pollution) Page |iName of Plant: PHILIPPINE PORTS AUTHORITY — TMO CULION (JANUARY TO MARCH 2023) Reference No: Detailed Report of Wastewater Characteristics for Conventional Pollutants Outlet No, Effluent oie ar Bop TSS Temp rise | —twaney pate | FlowRate | a Color pH Grease ‘oridayy. | (81) | (m@lLy Gop | ¢O = Please fillup/accomplish separate fornvs for other outlevs- Detailed Report of Wastewater Characteristics for Other Pollutants Module 3: .D. 984 (Water Pollution) Page |2Name of Plant: Reference No: Outlet No. Effluent | 5 am | es = pare | etiat, | tamer won | tomes ‘rome (oridey)_| “ra = a | See | Sr r= = ‘Please il-up/accomplish separate forms for other outlets Please use additional shee if necessary. Module 3: .D. 984 (Water Pollution) PagesName of Plant: PHILIPPINE PORTS AUTHORITY ~TMO CULION JANUARY TO MARCH 2023) _| Reference No: MODULE 4: R.A. 8749 (Air Pollution) Summary of APSE/APCF Process Equipment Location # of his of operations 1. Lunit 45KVA Genset Genset House atthe back of TMO Office | 31.27 hours 2. 3 4 Coummen Locaon ee a; 2 3. 4 5. 6 Pollution Control Facility Location # of hrs of operations 1. 2 3 4 Cost of Treatment Month 1 Month 2 Month 3 ‘Cost of Person employed, (salary) ‘Total Consumption oF Water (cubic meters) Total Cost of chemicals used (e.g. activated carbon, KMnO.) ‘Total Consumption oF Electricity (KwH) “Administrative and ‘Overhead Costs ‘Cost of operating in- house laboratory, if an Improvement or ‘modification, if any. (Description) ‘Cost of improvement of modification Module 4: RA 8749 (Air Pollution) Page |iName of Plant: PHILIPPINE PORTS AUTHORITY — TMO CULION (JANUARY TO MARCH 2021) _| Reference No: Detailed Report of Air Emission Characteristics ‘Description/Location ‘of PCE Flow Rate | CO No. | Particulates | —Gaey— | tase | temo | oe DATE | (Neméay) | (mgiNem) | (mgyNem) | (mg/m) (ong/Nem) | (mg/cm) | tmg/'Nem) | (mg/Nem) Please fil-up/accomplish separate forms or other PCPs. Please use additional sheetisif necessary. Module 4: RA 8749 (Air Pollution) Page |2Name of Plant: PHILIPPINE PORTS AUTHORITY ~ TMO CULION (JANUARY TO MARCH 2021) _| Reference No: MODULE 5: P.D. 1586 Ambient Air Quality Monitoring (if required as part of ECC conditions) DDescripton/Location of Monitoring Station pare | Nese | co] no, | parictaes | as | eam | amr | ar any | Co1eNem) | (mg/cm) | (mg/Nem) (cog/Nem) | (mg/cm) ¢ong/Nicm) | (mg/Nem) (Please accomplish one table per monitoring station.) Ambient Water Quality Monitoring (if required as part of ECC conditions) Description/Lacation of Sampling Staton pare | m9 | wane | ene | ame | Tame | ema | rma | tamer Se | Se | a | ey | ee | Ser | ea | Ser ‘Please accomplish one fable per sampling sation.) Module 5: P.D. 1586 (EIS System) Page |1Name of Plant: PHILIPPINE PORTS AUTHORITY ~ TMO CULION (JANUARY TO MARCH 2021) _| Reference No: Other ECC Conditions ‘Status of Compliance ECC Conditions Actions Taken Yes No. 1 2. 3. 4. 5. 6. Please use additional sheets if necessary. Environmental Management Plan/Program Status of Enhancement/Mitigation Measures Implementation Actions Taken Yes No 1 2 3. 4 5. 6. Please use additional sheets if necessary. Solid Waste Characterization/Information: Average Quantity of | 56.77 kilos Total Quantity of Solid | 170-32 kilos Solid Wastes Generated ‘Wastes Generated this ‘per month Quarter Average Quantity of | 46.44 kilos Total Quantity of Solid | 139.32 kilos Solid Wastes Collected ‘Wastes Collected this per month Quarter Entity in charge of collecting solid wastes LGU Gulion Brief Description of Solid Waste Management Plan (e.g., waste reduction, segregation, recycling) ‘Waste segregation, waste reduction, recycling, Module 5: P.D. 1586 (EIS System) Page |2Name of Plant: PHILIPPINE PORTS AUTHORITY — TMO CULION (JANUARY TO MARCH 2021) _| Reference No: MODULE 6: OTHERS Accidents & Emergency Records Findings and Date AveatLocation | Findings and] actions Taken Remarks Personnel/Staff Training Fof Personnel Date Conducted Course/Training Description Aaa July 2-5, 2019 Basic Training For New 1 Pollution Control Officer Thereby certify that the above information are true and correct. Done this___March 5, 2021 in PI Name/Signature of PCO ELIZALDE M. ULSON ‘Name/Signature of Port Manager SUBSCRIBED AND SWORN before me, a Notary Public, this day of _ affiants exhibiting to me their Community Tax Receipts: Name CTR No. Issued at Issued on ELIZALDE M, ULSON n1a19172 PPC January 2, 2020 JAKE VINCENT P, QUIRIT 27770804 Culion, Palawan. January 4.2021 Module 5: P.D. 1586 (EIS System) Page |3