DRR-CCA EIA Technical Guidelines

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Signature over Printed Name
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Republic of the Philippines

DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
Environmental Management Bureau
Visayas Avenue, Quezon City
Environmental Impact Assessment (EIA)

Technical Guidelines Incorporating
Disaster Risk Reduction (DRR) and
Climate Change Adaptation (CCA) Concerns
Under the
Philippine Environmental Impact Statement (EIS)
System
(EIA DRR/CCA Technical Guidelines)
November 2011
EIA DRR/CCA TECHNICAL GUIDELINES
Table of Contents
Acronyms & Abbreviations
iii
v
vi
Acknowledgement
Memorandum Circular #005
A. INTRODUCTION
1
1
2
3
1. Context/Rationale
2. Objectives of the Guidelines
3. Scope of the Guidelines
B. GENERAL GUIDELINES FOR MAINSTREAMING DRR/CCA IN EIA
1.
2.
Overview of the Philippine EIS System

Mainstreaming DRR/CCA in the EIA Process
Basic Project Considerations
Project Screening
Project Scoping
Impact Analysis
Impact Mitigation Planning
Preparation of the Environment Impact Statement (EIS)
Review Process
Project Monitoring and Evaluation
C. PROCEDURES IN USING THE DRR/CCA-ENHANCED SCREENING

FORMS
1. Purpose of the EIS Screening Forms
2. Use of the EIS Screening Form
3. The EIS Screening Forms
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3
4
4
5
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6
8
8
9
9
10
The Executive Summary

Section I. Project Description
10
10
11
11
12
Section II. Key Environmental Impact and Management/Monitoring Plan
13
Section III. Environmental/Ecological Risks Assessment
14
Section IV. Impact Management Plan (IMP)

Section V. Social Development Plan (SDP) and IEC Framework
14
15
Section VI. Environmental Compliance Monitoring
15
Section VII. Emergency Preparedness and Response Policy and

Generic Guidelines
16
Section VIII. Abandonment/Decommissioning/Rehabilitation Policy
16
Section IX. Institutional Plan for EMP Implementation
16
D. PROCEDURES IN USING THE DRR/CCA-ENHANCED IEE CHECKLIST

REPORT
1. Purpose of the IEE Checklist Report Forms
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16
2. Use of the IEE Checklist Report Forms

3. Coverage and Scope
4. The IEE Checklist Report Forms
Executive Summary (Project Fact Sheet)
Project Description
Environmental Impact and Management Plan
Abandonment/Decommissioning/Rehabilitation Policies and Generic
Guidelines
Institutional Plan for EMP Implementation
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17
20
21
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5. Documentary Requirements
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ANNEXES
Annex 1: EIS Screening Forms
1-A: Agricultural Plantation Projects
1-B: Food & Food By-Product and Beverages Manufacturing Plants Projects
1-C: Non-Food Manufacturing Plants Projects
1-D: Forestry Projects
1-E: Hydropower/Dam Projects
1-F: New Mining Projects
1-G: Sanitary Landfill Projects
1-H: Thermal Power Plant Projects
Annex 2: IEE Checklist Reports Forms
2A: Batching and Crushing Plant Projects
2B: Fishery/Aquaculture Projects
2C: Food & Food By-Product and Beverages Manufacturing Plant Projects
2D: Non-Food (Textile, Rubber, Chemical) Manufacturing Plant Projects
2E: Subdivision and Housing Projects
2F: Building Projects
2G: Cemetery and Other Funeral Facilities Projects
2H: Livestock/Poultry Projects
2I: Resorts & Other Tourism/Leisure Projects
2J: Road/Bridge Projects
2K: Water Supply Projects
2L: Irrigation/Flood Control/Minor Dam Projects
2M: Waste Management Projects
2N: Generic
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Acronyms & Abbreviations

CARP
CADC/CADT
CCA
CNC
COC
DAO
DENR
DRA
DO
DRR
ECA
ECC
EIA
EIARC
EIS
EGF
EMF
EMB
EMB-RO
EMoP
EMP
EPRMP
EU
IFMA/CBFMA
GDP
IEC
IEE
IP
IPCC
LGU
M&E
MC
MDGF
MGB
MMT
MPSA
MSDS
MT
NAMRIA
NDCC
NDRRMC
NEDA
NGO
NOx
OCT
PAGASA
PDS
PEISS
PHIVOLCS
PCL
PEPRMP
RPM
Comprehensive Agrarian Reform Program

Certificate of Ancestral Domain Claim/Certificate of Ancestral Domain Title
Climate Change Adaptation
Certificate of Non-Coverage
Coal Operating Contract
DENR Administrative Order
Department of Environment and Natural Resources
Disaster Risk Assessment
Dissolved Oxygen
Disaster Risk Reduction
Environmentally Critical Area
Environmental Compliance Certificate
Environmental Impact Assessment
Environmental Impact Assessment Review Committee
Environmental Impact Statement
Environmental Guarantee Fund
Environmental Monitoring Fund
Environmental Management Bureau
Environmental Management Bureau-Regional Office
Environmental Monitoring Plan
Environmental Management Plan
Environmental Performance Report and Management Plan
European Union
Integrated Forest Management Agreement/Community Based Forest Management
Agreement
Gross Domestic Product
Information, Education, and Communication
Initial Environmental Examination
Indigenous Peoples
Inter-governmental Panel on Climate Change
Local Government Unit
Monitoring & Evaluation
Memorandum Circular
Millennium Development Goal Achievement Fund
Mines and Geo-Sciences Bureau
Multi-Partite Monitoring Team
Mineral Production Sharing Agreement
Material Safety Data Sheet
Metric Ton
National Mapping and Resource Information Authority
National Disaster Coordinating Council
National Disaster Risk Reduction Management Council
National Economic and Development Authority
Non-Government Organization
Nitrogen Oxides
Original Certificate of Title
Philippine Atmospheric, Geophysical and Astronomical Services Administration
Project Description for Scoping
Philippine Environmental Impact Statement System
Philippine Institute of Volcanology and Seismology
Priority Chemical List
Programmatic Environmental Performance Report and Management Plan
Revised Procedural Manual
iii
QRA
ROW
SDP
SOx
TCT
TSP
TSS
UNDP
USLE
WFP
WWTF
Quantitative Risk Assessment

Right of Way
Social Development Plan
Sulfur Oxides
Transfer Certificate of Title
Total Suspended Particulate
Total Suspended Solids
United Nations Development Programme
Universal Soil Loss Equation
Work and Financial Plan
Waste Water Treatment Facility
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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:
Director Juan Miguel Cuna
Assistant Director Jonas Leones
Assistant Director Gilbert Gonzales
Engr. Cesar Siador
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:
Engr. Pura Vita G. Pedrosa
Engr. Esperanza A. Sajul
Engr. Elsie P. Cezar
Engr. Marivic Yao
Engr. Regina Eugenio
For. Verna Vidal
Mr. Jess Adawe
Mr. Allan Alcantara
Engr. Jayr Liles
Dr. Jacob S. Tio
Dr. Renato Lapitan
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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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2
3
NEDA-UNDP-EU, Guidelines on Mainstreaming Risk Reduction in Sub-national Development and land use/physical planning in the Philippines
NEDA-UNDP-EU, Guidelines on Mainstreaming Risk Reduction in Sub-national Development and land use/physical planning in the Philippines
Inter-governmental Panel on Climate Change (IPCC). Fourth Assessment Report: Climate Change 2007 (The Physical Science Basis)
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.
1. Objectives of the Guidelines

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.
Note for Users:

The EIA Technical Guidelines on DRR/CCA is intended t o guide proponents and
preparers in mainstreaming DRR/CCA at the project level. The DRR/CCA activities
in the PEISS are not intended to replace the responsibilities of government agencies
in the conduct of natural hazard assessment, disaster risk assessment (DRA),
sectoral impact assessment, vulnerability assessment and other similar studies at the
national and sub-national levels.
2. Scope of the Guidelines

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
B. GENERAL GUIDANCE FOR MAINSTREAMING DRR/CCA IN EIA

1. Overview of the Philippine EIS System (PEISS)
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:
involve the public in an open, transparent and participatory manner
allow for the effective integration of environmental considerations and public concerns into the
decision-making process
provide a powerful tool to help decision-makers achieve the goal of sustainable development
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.
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)
2.
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.
Mainstreaming DRR/CCA in the EIA Process
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.
Basic Project Considerations
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:
the nature of the project and its setting
the life of the project
natural hazard and climate-related parameters likely to influence the critical environmental
receptors and the project
anticipated changes in these parameters over the life of the project, and
applicable regulatory requirements, guidelines and expectations.
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
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 lifespan of the project must be determined
and incorporated into the EIA process. This also includes possible physical environmental
factors that might affect the project.
Environmental impact possible environmental impact (including cumulative effects, if
appropriate) must be identified based on effects associated with natural hazards and/or climate
changes being considered for the life-span of 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).
For projects that require an EIS, DRR/CCA-enhanced EIS Screening

Forms are provided in Annex 1.
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
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:
destruction of the project or components of the project
negative impact to the operation and productivity of the project
increase in cost of project development
revisions of project design
increase in maintenance frequency and costs, and
requirement for future project modifications
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.
For projects that require an EIS, t h e DRR/CCA-enhanced EIS Screening

Forms provide a list of projected impact and corresponding baseline data
requirement as well as prescribed assessment methodology and approach in
consideration of the disaster and climate change vulnerability parameters
relevant for specific types of projects. These pre-identified requirements shall
be included as part of impact analysis of the EIA.
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.
Impact Mitigation Planning

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.
Note for Users:
The mainstreaming o f DRR/CCA in the PEISS is focused at the project level. As
such, the assessment process should be limited to the impact of a project on
natural hazards as well as effects of natural and climate hazards on the project.
Likewise, risk reduction and adaptation measures should be appropriate for project level
implementation.
Preparation of the Environmental Impact Statement (EIS)

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.
For projects that require an EIS, t h e DRR/CCA-enhanced EIS Screening

Forms will serve as the checklist f o r information and analysis requirements
identified during the scoping stage.
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
The PEISS review process is premised on the following criteria:
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.
Project Monitoring and Evaluation

In the context of the PEISS, monitoring and evaluation (M&E) is undertaken after the issuance of the
Environmental Compliance Certificate (ECC) to determine whether predictions made in the EIA report
were accurate. Furthermore, if disaster and climate change risks have been identified as potential
concerns, the M&E should take this into consideration. Monitoring should focus on areas where
potentially significant impact could occur, or where mitigating measures have been proposed. The
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.
C. PROCEDURES IN USING THE DRR/CCA-ENHANCED SCREENING FORMS

1. Purpose of the EIS Screening Forms
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:
assessment needs in terms of specific impact of each industry type
the critical climate and disaster risk parameters that need to be incorporated in the EIA
disaster risk reduction measures and/or climate change adaptation options that should be
considered/studied and incorporated in the project design
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.
2. Use of the EIS Screening Forms

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.
10
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.
3. The EIS Screening Forms

The EIS Screening Form is composed of four (4) major parts:
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.
Checklist of EIS Contents
This provides technical guidance on the specific content requirement for each of the major sections
of the EIS for the specific project sector.
Checklist of Key Environmental Impact
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.
Environmental Risk Assessment Requirement Checklist
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 Executive Summary
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.
11
A brief discussion of the method by which data were obtained should also be included.
Section I. Project Description
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 preplanning to pre-construction, construction, operation, and all way to the abandonment phase of the
entire engagement.
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Section II. Key Environmental Impact and Management / Monitoring Plan

Key Environmental Impact
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.
Environmental Monitoring Plan (EMoP)
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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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.
Section III. Environmental / Ecological Risks Assessment
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.
The preparer/proponent shall undertake initial screening (for ERA coverage)
which will be validated during the scoping process. The scoping process
is deemed complete only when it includes the determination of ERA
requirement.
For these types of projects, the PDS should include the following:
-
Projected inventory of hazardous materials

Material Safety Data Sheet of the hazardous materials
Level of Coverage Computation based on Annex 2-7e of the Revised Procedural
Manual for DAO 2003-30 (for projects involving hazardous, toxic, flammable, or
explosive materials or chemicals and other unclassified hazardous materials)
Maximum impounding/storage capacity (for projects involving the construction of
structures such as dams and bridges, which would endanger life, property, or the
environment should they fail.
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.
Section IV. Impact Management Plan (IMP)
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
14
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.
Section V. Social Development Plan (SDP) and IEC Framework
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).
Social Development Plan (SDP)
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.
Information, Education and Communication (IEC) Framework
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.
Section VI. Environmental Compliance Monitoring
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
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:
Safety Management Policy
Emergency Response Organization
Evacuation and Rescue Plan
Fire/Toxic Gas Explosion Accident Prevention and Control
Section VIII. Abandonment / Decommissioning / Rehabilitation Policy
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.
Section IX. Institutional Plan for EMP Implementation
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.
D. PROCEDURES IN USING THE DRR/CCA-ENHANCED IEE CHECKLIST

REPORT FORMS
1.
Purpose of the IEE Checklist Report Forms
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
The Checklist Forms have been customized for specific industry types where the following have been
pre-identified:
specific impact expected of specific industry types
disaster risk reduction measures and/or climate change adaptation options that
considered/studied and incorporated in the project design
should be
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.
2. Use of the IEE Checklist Report Forms

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.
Project proponents are strongly discouraged from engaging the services of

consultants/facilitators to accomplish/fill-up the IEE Checklist Report Form.
The Report Forms have been designed to be user-friendly.
Furthermore, EMB Regional Offices are required to complete the processing of
an ECC application using the IEE Checklist Report within twenty (20) working
days upon receipt of completed/duly-accomplished forms.
3. Coverage and Scope

The IEE Checklist Report Forms shall suffice as EIA Report submission for the following projects located
in ECAs covered under the PEISS:
17
Type of Project
Project/Industry
Batching and Crushing

Plant
Fishery/Aquaculture
Food & Food By-product

and Beverages
Manufacturing Plants
Regardless of size and capacity

(those that are mobile or to be
operated for less than 1 year may be
issued CNC)
---For projects using fresh or brackish

water
For projects located in coastal or
marine area (off-shore)
Animal products processing
(fish/meat processing, canning,
slaughterhouses, etc.)
Coconut processing plants
(including production of coconutbased products)
Distillation and Fermentation Plants
( e.g. bio-ethanol project)
Fruit and vegetable processing
Other types of food (and other food byproducts, additives, etc.) processing
industries
Processing of dairy products
Sugar Mills
Non-Food (Textile,
Rubber, Chemical)
Manufacturing Plants
Criteria/Limit
(Threshold)
Glass-based products
Metal-based products (including
semi-conductor / electronic
industries)
Paper and plastic-based products
Manufacturing, processing and/or use
of substances included in the Priority
Chemical List (PCL)
Manufacture of agri-chemicals and
other industrial chemicals not in the
PCL
Pharmaceutical industries and
manufacture of soap and
detergents, health and beauty
products, and other consumer
products.
Surface coating industries (paints,
pigments, varnishes, lacquers, anticapacity fouling coating, printing
inks)
Textile, Wood, Rubber Industries
Leather and related industries
Metallic Mineral or Ore Processing
(e.g., copper, lead, nickel, cobalt, zinc,
silver, magnesium, and manganese,
gold, placer with metal content) with
Physical or Mechanical Processing
18
1 hectare but < 25 hectares

125 MT but < 2,500 MT
(Annual production/rated capacity)
< 25,000 MT
(Monthly rated/production rate)
< 50,000 MT
< 125 MT
< 50,000 MT
(Annual rated/production rate of
finished product)
< 10,000 L (liquid)
or
< 100 MT (solid)
(Monthly production rate)
< 50,000 MT
(Annual rated/production rate)
30,000 MT
15,000 MT
15,000 MT
>0.001 MT but < 1.0 MT
(quantity of toxic chemicals to be
used per month)
> 200 MT but < 30,000 MT
> 200 MT but < 50,000 MT

> 200 MT but < 30,000 MT

<50,000 MT
250 MT
(Annual rated/production rate of raw
hides)
>200 MT but <70,000 MT

(Annual processing (inputs))
Type of Project
Subdivision and Housing
Building
Cemetery & other

Funeral Facilities
Project/Industry
Subdivision and housing
projects, resettlement projects,
economic and socialized housing
project, open market housing and
other similar (horizontal) land
development projects
Low-cost subdivision/housing
and resettlement area projects
(including amenities)
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
Institutional and other related
facilities: medical facilities
Institutional and other structures
with laboratory facilities
Motels, Hotels, Condominiums /
Apartelles (residential) with
commercial space 10% or less of
the total floor area
Storage facilities, non-toxic/nonhazardous materials, substances or
products
Storage facilities, toxic/hazardous
materials, substances or products
Land transport terminal (for buses,
jeepneys and other modes of
transportation) with service facilities
Cemetery, memorial park and
similar projects
Columbarium and similar projects
Livestock /Poultry
Pigs / Goats
Poultry / Birds
Resorts and other

Tourism/Leisure Projects
Roads and Bridges
---Bridges and viaducts, new

construction
Bridges and viaducts, rehabilitation
and/or improvement
Roads, new construction
(including RO-RO facilities)
Roads, widening, rehabilitation
and/or improvement
Elevated roads, flyover/cloverleaf/
Interchanges
19
Criteria/Limit
(Threshold)
> 10 hectares
(total land area, including all common,
open and other areas)
(Per Memorandum dated 31 May 2012, implementation of
this was deferred. Hence, threshold is >1 hectares)
1 hectare but <2.5 hectares

(total/gross floor area including
parking and other areas)
1 hectare (total/gross floor area
including parking and other areas)
Primary and Secondary hospitals or
Medical Facilities
Regardless of size or area
1 hectare (total/gross floor area
including parking and other areas)
1 hectare
0.1 MT but < 1,000 MT
(total storage capacity)
(total land area)
> 5 hectares
(total land area)
1 hectare
100 heads but < 5,000 heads
(Stock Population)
10,000 heads but < 100,000
heads (Stock Population)
>0.1 hectare but <25 hectares
(total area to be developed)
80 m but < 10.0 km ( length)
50% increase in capacity
(or in terms of length/width)
2 km but < 20.0 km, (length
with no critical slope)
OR
2 km but < 10.0 km
(length with critical slope)
50% increase in capacity
(or in terms of length/width)
Regardless of length and width
Type of Project
Project/Industry
Tunnels and sub-grade roads and
railways
----
Water Supply
Irrigation/Flood
Control/Minor Dam
Water Supply Systems (Complete

System)
Water Supply System (Distribution
Only)
Impounding System or Flood
Control Project
Irrigation System (Distribution

System Only)
Waste Management
Compost/Fertilizer making
Domestic waste water treatment
facility
Materials recovery facility
Receiving facilities, paper, plastic

and other material recycling
Sanitary Landfill
Sanitary landfill for domestic waste

only
Criteria/Limit
(Threshold)
< 1.0 km ( length)
All underpass projects
(Pedestrian passages)
6 wells and other systems (e.g.,
infiltration gallery, etc.)
Level III with household
connection and water treatment
< 25 hectares
OR
3
impounded water 20 million m

(reservoir flooded area or water
storage capacity)
300 hectares but < 1,000 hectares
(service area)
3,750 MT
(Annual rated/ production rate)
< 5,000 cubic meter (Quantity of
waste to be treated annually)
With composting facilities of 3,750
MT or more annual
rated/production rate
< 300,000 MT
OR
involving the use of chemicals
(Quantity of waste to be treated
annually)
Category 1: Net Residual Waste
Generated or Net Residual
Disposable Waste < 3,750 MT
annual rated capacity
Category 2: Net Residual Waste
Generated or Net Residual
Disposable Waste > 3,750 but <
22,500 MT annual rated capacity
4. The IEE Checklist Report Forms

The IEE Checklist is composed of the following major parts:
Project Description
o Project Location and Area
o Project Components
o Utilities Requirement
o Manpower Requirement
o Indicative Project Cost
o Possible Environmental/Social Impact
o Baseline Data Parameter
o Monitoring Parameters/Implementation
o Cost of Mitigation
20
Abandonment/Decommissioning/Rehabilitation Policies and Generic 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.
Monitoring Parameters/Implementation. This column describes the parameters that should be
monitored to ensure that adverse environmental impact are addressed. Also, as appropriate, climate
change monitoring parameters have been 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.
21
Abandonment/Decommissioning/Rehabilitation Policies and Generic 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
Date Submitted for Screening: _______________________________________________________________

Form of Submission: ___ Hard ___ Digital
Project Title: _____________________________________________________________________________
Project Location: _________________________________________________________________________
Project Proponent: ________________________________________________________________________
Address: ________________________________________________________________________________
Contact No:
Fax No:______________Contact Person:___________________________
EIS Consultant: ___________________________________________________________________________
Address: ________________________________________________________________________________
Contact No:
Fax No:
Contact Person:__________________________
Project Classification & Type: _______________________________________________________________
Project Classification Code (Refer to RPM for DAO 2003-30): ______________________________________
Project Size based on Classification: __________________________________________________________
Date of Technical Scoping:______________________________________________________________

Venue of Technical Scoping:_____________________________________________________________
Checklist of Documentary Requirements
To be filled-up upon submission of EIS
Acceptable?
Yes
No
Screening Officers Remarks
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
Monitoring & Audit Prioritization Scheme
(PEMAPS) Questionnaire (see Annex 2-7d of
ACTION TAKEN: (Please check to indicate corresponding action taken)
Document accepted; please submit
__ copies
EIARC Needed? ( ) Yes ( ) No Expertise Needed:
Processing Fee: PhP _______ (Pay at EMB Cashier) Review Fund: Based on WFP (Pay to the duly
authorized 3rd Party Review Fund Manager)
Document not accepted
O.R. #
Date
NOTED BY:
___________________________
Screening Officer
_________________________
Section/Division Chief
EMB Regional Office

Screening Office
Date:
Please refer to attached checklist of EIS Contents


I. Executive Summary (maximum of 5 pages)
Contents
Page #
Acceptable?
Page #
Acceptable?
REMARKS
Project Fact Sheet PD Summary (1 page)

Process Documentation of the conduct of EIA (1 page) (EIA Team, EIA
Study Schedule & Area, EIA Methodology, Public Participation)
Summary of Baseline Characterization, Key Environmental Impacts and
Management & Monitoring Plan, and EMF Commitments (if applicable)
Items to be Described
Specific Data Requirement
II. I. Project Description

1) Project Location and
Area
2) Project Rationale
3) Project Alternatives
a) Map showing sitio, barangay, municipality,

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 of primary & secondary
impact areas
d) Discussion on the accessibility of the project
site/area
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.
a) Cite criteria used in determining preliminary
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
REMARKS


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.
Technology Selection/Operation Processes:
Discuss the projects advantage over
alternative technologies, operation processes
and engineering design.
Discuss alternative measures for the
prevention of the occurrence of major impacts
(e.g., air and water pollution, possible
groundwater and land contamination.
4) Project Components
Resources:
Discuss
the
alternatives
considered in the course of selecting the
power/water requirements as well as raw
materials, and how the decisions were made in
favor of the preferred resource. Discuss the
sustainability of the raw materials/inputs (e.g.,
fertilizers, planting stocks, pesticides, etc.) to
be tapped and transportation plan of raw
materials.
b) Cite reasons for selecting the preferred options
delineated in terms of technical, commercial,
social and natural environmental aspects.
c) After determining the preliminary options,
please provide a summary of the comparative
environmental impacts of each alternative.
Identification of major components (including
technical
details,
such
as
area
planted/cultivated, specifications, capacity,
number, etc.)
Specify the operations and process
Identification of other Support Facilities (e.g.
energy/power source, water supply system,
etc.)
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)
3
Page #
Acceptable?
REMARKS

5) Process/ Technology

Identification of pollution control devices
including other waste management and
corresponding facility
being served or
connected
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 PAGASA
2020
and
2050
projected
rainfall/temperature data.
Method / Technology for:
Planting / Harvesting - fertilizers and pesticides
to be used and corresponding amount for
applications. Discuss the handling/storage
procedures for fertilizers and pesticides
Processing/Post
harvest
technology
Indicative process flow-sheets showing
material balances for the processing plant (if
any), and the anticipated rates of inputs, along
with similar data on products, wastes and
recycle streams
Power & water supply system
Waste Management Systems (wastewater
treatment facility, dust collector, etc.)
When applicable, consider the PAG-ASA 2020
and 2050 projected rainfall data.
6) Project Size
Estimated yield per hectare and, If with

processing, indicate annual production rate
Total Project Area in square meters or hectares
7) Development Plan,
Description of Project
Phases and
Corresponding
Timeframes
Phases to be described in terms of identifying

specific activities (with special attention on those
with significant environmental impacts as well as
climate change adaptation options relevant to the
project and project activities) and corresponding
projected implementation timeframes:
Pre-construction (e.g., planning, securing
permits/ clearances, etc.)
Construction (e.g., land/site clearing, fencing,
transport of materials, etc.)
Operation (projected period of startup/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
(transport
4
Page #
Acceptable?
REMARKS

Page #
Acceptable?
REMARKS
Page #
Acceptable?
REMARKS

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
Decommissioning plan to include land
restoration, procedures, and proposed
schedule.
8) Manpower
Tabulate the following per project phase:
manpower requirements;
expertise/skills needed;
nature and 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)
General Contents
Specific Content Requirement
II. Key Environmental

Impacts and
Management/
Monitoring Plan
See attached checklist of contents
III. Environmental Risk

Assessment
IV. Impact
Management Plan
Limit to most significant impacts per project

phase and per environmental component arising
from key environmental aspects (See Annex 217 of RPM for DAO 2003-30)
SDP
V. Social Development
Plan (SDP) and IEC
Framework
VI. Environmental
Compliance Monitoring
When applicable, include appropriate climate

change adaptation measures/options (embedded
in each sector).
Community
development
or
livelihood
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
Target sector, key messages,
scheme/strategy/methods, Information medium,
timelines and frequency, cost (See Annex 2-19
of RPM for DAO 2003-30)
Environmental Monitoring Plan ( Self Monitoring)
Use Annex 2-20 of RPM for DAO 2003-30 as
5

General Contents

template
Multi-Sectoral Monitoring Framework / (if

applicable)
Tabulate the list of stakeholder-members of the
MMT, basis for selection, proposed role, and
scope of MMT responsibilities and activities, etc.
(See Annex 3-4 of the RPM for DAO 2003-30).
Environmental Monitoring Fund Commitments (if
applicable)
VII. Emergency
Preparedness and
Response Policy and
Generic Guidelines
Present a proposed amount of EMF (based on a

draft AWFP in Annex 3-4 and consistent with
guidelines in Annex 3-5 of RPM for DAO 200330)
The safety policy and generic guidelines should
be consistent with the regulatory requirements.
Emergency Preparedness should also consider
natural hazards to the infrastructures and
facilities.
VIII. Abandonment/
Decommissioning/
Rehabilitation Policy
Statement on proponents policies and generic

procedures for Decommissioning/Abandonment.
IX. Institutional Plan for

EMP Implementation
Discuss the organizational scheme of the

proponent including line of command and
reporting procedures as well as manpower
complement and relationships with other
operating departments.
Page #
Acceptable?
REMARKS


Key Environmental Impacts and Management/Monitoring Plan
List of Key Impacts
Baseline Data Parameter

Requirements
Required Assessment
Methodology/Approach
During scoping: Unless otherwise specified as agreed during scoping, all items listed are required. Write
specific instructions (if any) on the blanks/spaces provided.
1. THE LAND
1.1 Land Use and Classification
1.1.1 Change/Inconsistency in land
use
1.1.2 Encroachment in
Environmentally Critical
Areas (ECAs)
1.1.3 Possible tenurial / land issue
Description & Map showing the

project area in relation to existing land
use.
Identify ECA where the project is
located or near the project area.
Identify areas vulnerable/susceptible
to natural hazards where the project
is located or near the project area
(include map/s).
Identify areas under CARP or with
CADC / CADT where the project is
Assessment of the
compatibility of the
proposed project in
relation to land use
and/or the coastal
resource management
plan of the LGU, if any
Specify other conflicting tenurial / land

issues (e.g., IFMA/CBFMA within
COC and within MPSA, etc.)
1.2 Geology/Geomorphology
1.2.1 Change in surface landform/
topography/ terrain/slope
1.2.2 Change in sub-surface/
underground geomorphology
1.2.3 Inducement of subsidence,
liquefaction, landslides, mud /
debris flow, etc.
1.3 Pedology
1.3.1 Soil erosion / Loss of topsoil/
overburden
Slope and Elevation/Topographic

Map
Regional/General Geological Map
Geological Maps as needed; Hazard
Maps (NAMRIA, NDRRMC, MGB,
PHIVOLCS, PAG-ASA)
Include discussions on
impacts/effects of natural
hazard on the project.
Summary of Soil Investigation Report

on soil type and quality; Erodibility
potential; Bank stability
USLE / similar modeling

when applicable.
If applicable, provide
discussions on possible
soil contaminations due
to project operation
7
for completeness during procedural screening; page numbers should be provided

upon submission of the EIS
Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt.
Plan
Page
Monitoring
Plan
Page
Remarks

List of Key Impacts

Requirements
Required Assessment
1.3.2 Change in soil quality/fertility
1.4 Terrestrial Ecology

1.4.1 Vegetation removal and loss
of habitat
1.4.2 Threat to existence and/or

loss of important local species
1.4.3Threat to abundance,
frequency and distribution of
important species
1.4.4 Hindrance to wildlife access
2. THE WATER
2.1. Hydrology/Hydrogeology
2.1.1
Change
in
drainage
morphology/Inducement
of
flooding/ Reduction in stream
volumetric flow
Laboratory results on soil sample

analysis for N, P, K, pH, organic
matter, micronutrients
Physical analysis (water

holding capacity;
secondary data:
chemical analysis
Flora and fauna species inventory

or survey report
Historical occurrences
of pest
infestation, forest/grass fire and/or
similar incidences
Summary of endemicity/ conservation
status
Summary of abundance, frequency
and distribution
Economic importance and uses of
significant flora and fauna
Sampling / survey map in relation to
the project site
Quadrat sampling for

flora
Drainage map; historical

flooding/drought occurrences, stream
flow measurements/estimates;
Delineation of watershed /subwatersheds/ floodplain; and
identification of aquifers, if any
Discuss possible
impacts of the project on
the occurrence of
flooding and vice versa.
Consider extreme
weather conditions and
the PAG-ASA 2020 and
2050 climate projections.
Assessment should
include potential
occurrence or
Use of mist nets, traps,

transect walk for fauna
overall impact to flora
and fauna
Include impact
assessment on
vegetation (e.g.,
likelihood of destruction)
and specific
management measures
(e.g., protection, balling,
transplanting,
replacement, etc.)

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt.
Plan
Page
Monitoring
Plan
Page
Remarks


Requirements
List of Key Impacts
Required Assessment
aggravation of flooding
in nearby areas.
2.1.2 Change in stream, lake water
depth
2.1.3 Depletion of water resources /
competition in water use
Regional hydrogeological map

Identification of current / projected
water use in the area and adjacent
areas
Spring and well inventory and location
map; depth of water table
Analysis/estimation of water
availability taking into consideration
the PAG-ASA 2020 and 2050 climate
projections
2.2 Oceanography
2.2.1
Change/disruption
circulation pattern
2.2.2 Change in bathymetry
in
2.3 Water Quality

2.3.1 Degradation of groundwater
quality
2.3.2 Degradation of surface water

quality
Predicted tides; 24-hour tidal cycles;

Surface current system
Bathymetric map
Physico-Chemical characterization of
water :
pH
BOD5
DO
Oil and grease
TSS
For project with

significant water
requirement, conduct
water balance / budget
analysis.
If applicable, provide
Aquifer (Groundwater)
vulnerability Assessment
(ie. discussions on
groundwater
contamination due to
project operation) or
groundwater
contamination modeling

when applicable
Use DENR standard
methods and procedures
for sampling and
analysis.

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt.
Plan
Page
Monitoring
Plan
Page
Remarks

List of Key Impacts

Requirements
Required Assessment
2.3.3 Degradation of coastal/

marine water quality
pesticide analysis
others:
__________________________
sampling site map
2.4
Freshwater Ecology

and habitat
2.4.2 Threat to abundance,

species
2.5 Marine Ecology
loss of important local species and
habitat
frequency and distribution
Summary of endemicity/
conservation status
Abundance of ecologically and
economically important species
(fishes, benthos, planktons);
Presence of pollution indicator
species
overall impact to
freshwater ecology
sampling site map
Abundance/densities/distribution of
ecologically
and
economically
important species (mangroves,
fishes, benthos, planktons, coral
reefs, algae, seaweeds, sea
grasses);
species;
Historical occurrences of red tide,
fish kill or any related event
Marine resource map
Quadrat, transect, line

intercept, spot dive,
manta tow, marine
resource
characterization
(e.g., municipal and
commercial fisheries
data)
overall impact to marine
ecology
sampling site map
10

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt.
Plan
Page
Monitoring
Plan
Page
Remarks

List of Key Impacts

Requirements
Required Assessment
3. THE AIR
3.1 Meteorology/Climatology
3.1.1 Change in the local climate,
e.g., local temperature
3.1.2 Contribution in terms of

greenhouse gas emissions/
sequestration
3.2 Air Quality (and Noise)

3.2.1 Degradation of air quality
Monthly average rainfall and

temperature of the area;
Climatological normals/extremes;
Wind rose diagrams; Frequency of
Tropical cyclones
In the assessment,
consider the PAG-ASA
climate change
projections for 2020 and
2050.
Data on Greenhouse gasses (i.e.,

carbon dioxide, methane, nitrous
oxide); Calculation of projected GHG
emission/sequestration
Discuss the projects

contribution in terms of
greenhouse gas
emissions/sequestration
Characterization of ambient air

quality:
TSP
PM10
SOx
NOx
others:
__________________________
Use DENR standard

for sampling and
analysis.
(for sampling methods refer to Clean

Air Act)
sampling site map
3.2.2 Increase in ambient noise
level
Characterization of ambient noise

level
sampling site map
Use DENR standard

for sampling and
measurement.
Noise attenuation
modeling (applicable if
there is a source
capable of generating
11

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt.
Plan
Page
Monitoring
Plan
Page
Remarks

List of Key Impacts

Requirements
Required Assessment
200 dB or more) or with

presence of residential
area in the project
vicinity
4. THE PEOPLE
4.1 Displacement of settler/s
Displacement / disturbance of
properties
Change/conflict in land
ownership
Change/conflict in right of way
4.2 In-migration
Proliferation of informal
settlers
4.3
Cultural/Lifestyle
change
(especially on Indigenous Peoples,
if any)
4.4 Threat to delivery of basic

services /resource competition
4.5 Threat to public health and

safety
Demographic data of impact area:

- Number
of
households
and
household size
- Land area,
- Population,
- Population density /growth
- Gender and age profile,
- Literacy rate, profile of educational
attainment,
Discuss how the project

would affect existing
properties in the area in
terms of relocation and
devaluation
Settlements map
Discuss the in-migration

patterns as a result of
project implementation
Census of population / property that

will be displaced / disturbed
Housing
ownership
profile
/
availability of housing/ number of
informal settlers
Demographic data on Indigenous
Peoples (if any) and existing
Culture/Lifestyle
that
may
be
significantly affected
Availability of public services in terms
of:
Water supply
Power supply
Communications/transportation
Health resources (Government
and Private)
Peace and order / crime
Education facilities
Discuss the impacts on

IPs and Culture/Lifestyle

would affect the delivery
of basic services and
may result in resource
competition in the area
Discuss the project
implementations threat
to public health vis--vis
12

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt.
Plan
Page
Monitoring
Plan
Page
Remarks

List of Key Impacts

Requirements
Required Assessment
Recreational facilities / sports

facilities
4.6 Generation of Local Benefits

from the project
Enhancement of
employment and livelihood
opportunities
Increased business
opportunities and associated
economic activities
Increased revenue of LGUs
4.7 Traffic congestion
the baseline health

conditions in the area
Statistical data / information related to

public services:
Literacy rate, profile of
educational attainment
Morbidity and mortality rates
(infants and adults - 5-year
trend)
Common diseases in the
area
including
endemic
diseases
Environmental Health and
Sanitation Profile
Crime rate
Food security
Socioeconomic data:
Main sources of Income
Employment rate/ profile
Sources of livelihood
Poverty Incidence
Commercial establishments
and activities
Banking
and
financial
institutions
Analysis of diseases that

may be affected by
climate change.
Road network/ systems

Existing transportation/traffic situation
Traffic impact
assessment if applicable
(including capacity of
road system in terms of
load/count)
13

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt.
Plan
Page
Monitoring
Plan
Page
Remarks

III.
Environmental Risk Assessment
Type of Risks
Scope of Assessment
Report/Output Required
During scoping: Check () required/applicable items; items with are automatically required; write specific instructions ( if
any) on the blanks/spaces provided.
Safety Risks
Release of toxic
substances
- Identification of conditions, events and

circumstances which could be significant in
bringing about identified safety risks
- Description & assessment of the possible
accident scenarios
- Assessment of whether the project location is
projected to have extreme climate events for
2020 and/or 2050 that could contribute to the
triggering identified scenarios
- Description of the hazards, both immediate
(acute effects) and delayed (chronic effects)
for man and the environment posed by the
release of toxic substance, as applicable
ERA REQUIREMENT
Quantitative Risk
Assessment(QRA)
Specific Instructions:
_________________________
Descriptive/Qualitative Risk
Assessment
_________________________
EMERGENCY PLAN :
_________________________
Refer to Annex 2-7e for the decision
criteria outline
14
for completeness during procedural screening; page numbers should

be provided upon submission of the EIS
Monitoring
ERA
ERP
Plan
Remarks
Page
Page
Page

Noted By:
Signature
Signature
Review Committee Members
EMB Representatives
1.
1.
2.
2.
3.
3.
4.
Project Proponent:
5.
6.
Project Preparer/Consultant:
Resource Person
1.
15
Annex 1 - B

Project Title: _____________________________________________________________________________
Address: ________________________________________________________________________________
Contact No:
Fax No:______________Contact Person:__________________________
EIS Consultant: ___________________________________________________________________________
Address: ________________________________________________________________________________
Contact No:
Fax No:
Contact Person:__________________________
Project Classification Code (Refer to RPM for DAO 2003-30): ______________________________________
Project Size based on Classification: __________________________________________________________

Acceptable?
Yes
No

Use Plan
communities
__ copies
rd
authorized 3 Party Review Fund Manager)
O.R. #
Date
NOTED BY:
___________________________
Screening Officer
_________________________
EMB Regional Office

Screening Office
Date:
_____________________________
1
OKAY FOR PRINTING: _____________________________________________ ________________________________

Date
ECC APPLICATION SCREENING FORM FOR FOOD AND FOOD BY-PRODUCT AND BEVERAGES
MANUFACTURING PLANTS PROJECTS
st
nd
rd
1 2 3 ___ th Screening
st
nd
rd

I.
Executive Summary (maximum of 5 pages)

Contents
Page #
Acceptable?
REMARKS
Page #
Acceptable?
REMARKS

Management & Monitoring Plan; and EMF Commitments (if applicable)
Items to be
Described
I. Project Description
1) Project Location
and Area
3) Project
Alternatives

province,
region boundaries,
vicinity,
proposed buffers surrounding the area and
primary & secondary impact areas
project area (use PRS 92 datum - GPS
setting)
c) Rationale for selection of primary &
site/area
economic development in terms of
Discuss the justification for the Project with
associate economic development, which
the project may provide. The status of the
project should be discussed in a regional
and national context.
options for facility siting, development
design,
process/technology
selection,
resource utilization including discussion of
the consequences of not proceeding with the
project:
ground
shaking,
ground
rupture,
as well as mandated agencies)
2
st
nd
rd
Items to be
Described
Page #
Discuss the alternatives (type and

location)
considered and nominated
during the course of selecting the best
option for which the EIS is prepared;
preferred option;
environmental impacts among the
including factors significant to the selection
alternative
technologies,
operation
processes and engineering design
Discuss alternative measures to prevent
occurrence of major impacts
Resources:
Discuss
the
alternatives
materials, and how the decisions were made
in favor of the preferred resource. Discuss
the sustainability of the raw materials/inputs
(e.g., fertilizers, planting stocks, pesticides,
meat, crops, packaging materials etc.) to be
tapped and transportation plan of raw
materials.
b) Reasons for selecting the preferred options
social and natural environmental aspects
environmental impacts of each alternative
4) Project
Components

technical
details,
such
as
area
planted/cultivated and types of crops,
processing/manufacturing facilities, capacity,
number, etc.)
etc.)
3
Acceptable?
REMARKS
st
nd
rd
Items to be
Described
5) Process/
Technology
Page #

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
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
Processing/Manufacturing
material balances for the processing plant, and
the anticipated rates of inputs, along with
similar data on products, wastes and recycle
streams
6) Project Size
Waste Management System (wastewater

treatment facility, solid waste management
system, dust collector etc.)
When applicable, consider the PAG-ASA 2020
and 2050 projected rainfall data.
Daily/Monthly/Annual Production rate
Total Project Area in square meters or
hectares
7) Development
Plan, Description
of Project Phases
and
Corresponding
Timeframes

specific activities (with special attention on
those with significant environmental impacts
as well as climate change adaptation options
relevant to the project and project activities)
and corresponding projected implementation
timeframes:
Pre-construction (e.g., planning, acquisition
of rights to use land, etc.)
Construction (e.g. land/site clearing,
4
Acceptable?
REMARKS
st
nd
rd
Items to be
Described
Page #
Acceptable?
Page #
Acceptable?
REMARKS
temporary housing, transport of materials,

health and other services for the workforce)
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
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.
The proposed decommissioning plan should
be in terms of the following:
8) Manpower
Procedures for the decommissioning of the

project components;
Transport/disposal of equipment and other
materials used in the plants operation;
Alternatives for the future use of
abandoned area;
Consistency with long-term zoning and land
use development plan of the municipality;
Rehabilitation plans, if any
nature & estimated number of jobs
General Contents
II. Key
Environmental
Impacts and
Management/
Monitoring Plan

change
adaptation
measures/options
(embedded in each sector).
REMARKS
st
nd
rd
General Contents
III. Environmental
Risk Assessment
IV. Impact
Management Plan

phase and per environmental component
arising from key environmental aspects (See
Annex 2-17 of RPM for DAO 2003-30)
V. Social
Development Plan
(SDP) and IEC
Framework
SDP (if applicable)

Community
development
or
livelihood
programs/activities, projected beneficiaries,
partner
institutions,
timeframe
of
implementation as well as source and amount
allotted per activity/component (See Annex 218 of RPM for DAO 2003-30)
IEC (if applicable)
scheme/strategy/methods, Information
medium, timelines and frequency, cost (See
VI. Environmental
Compliance
Monitoring
Self-Monitoring Plan
template
applicable)
Tabulate the list of stakeholder-members of
the MMT, basis of selection, proposed role,
and scope of MMT responsibilities and
activities, etc. (See Annex 3-4 of the RPM for
DAO 2003-30).
Environmental Guarantee and Monitoring
Fund Commitments (if applicable)
Present a proposed amount of EMF
(based on a draft AWFP in Annex 3-4 and
consistent with guidelines in Annex 3-5 of
RPM for DAO 2003-30); and
Present a proposed amount of EGF and
the basis for the estimate following the
guidelines in Annex 3-6 of RPM for DAO
2003-30
Page #
Acceptable?
REMARKS
st
nd
rd
General Contents
VII. Emergency
Preparedness and
Response Policy
and Generic
Guidelines
The safety policy and generic guidelines

should be consistent with the regulatory
requirements.
Emergency Preparedness
should also consider natural hazards to the
infrastructures and facilities.
VIII. Abandonment/
Decommissioning/

procedures
for
Decommissioning/Abandonment.
IX. Institutional Plan

for EMP
Implementation

Page #
Acceptable?
REMARKS
ECC APPLICATION SCREENING FORM FOR FOOD AND FOOD BY-PRODUCT AND BEVERAGES MANUFACTURING PLANTS PROJECTS
st
nd
rd

List of Key Impacts

Requirements
Required Assessment
1. 1.
THE LAND
1.1.1 Change/Inconsistency in Description & Map showing the
land use
project area in relation to existing
land use.
Areas (ECAs)
(include map/s).
1.1.3 Possible tenurial / land Identify areas under CARP or with
issue
Specify other conflicting tenurial /
land issues (e.g., IFMA/CBFMA
within COC and within MPSA, etc.)
1.2.1 Change in surface
landform/ topography/
Map
terrain/slope
1.2.2Change in sub-surface/ Regional/General Geological Map
underground
geomorphology
1.2.3
Inducement
of Geological Maps as needed; Hazard
subsidence, liquefaction, maps (NAMRIA, NDRRMC, MGB,
landslides, mud / debris PHIVOLCS, PAG-ASA)
flow, etc.
1.3 Pedology
1.3.1 Soil erosion / Loss of
Summary of Soil Investigation
topsoil/overburden
Report on soil type and quality;
Erodibility potential; Bank stability
Assessment of the
proposed project in relation
to land use and/or the
coastal resource
management plan of the
LGU, if any

when applicable
8

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt. Plan
Page
Monitoring
Plan
Page
Remarks
st
nd
rd
List of Key Impacts

Requirements
Required Assessment
1.3.2 Change in soil quality/

fertility

1.4.1 Vegetation removal and
loss of habitat

loss of important local
species
of important species
1.4.4 Hindrance to wildlife
access
2. THE WATER
2.1 Hydrology/Hydrogeology
2.1.1 Change in drainage
morphology / Inducement of
volumetric flow
2.1.2 Change in stream, lake

water depth
2.1.3 Depletion of water
resources / competition in water
use


holding capacity;
secondary data: chemical
analysis

or survey report;
of pest
similar incidences
Summary of endemicity /
conservation status
Quadrat sampling for flora;

Summary
of
abundance,
the project site

flooding/drought occurrences,
stream flow
measurements/estimates;
Discuss possible impacts

of the project on the
occurrence of flooding and
vice versa. Consider
extreme weather conditions
and the PAG-ASA 2020
and 2050 climate
projections

areas
For project with significant

water requirement, conduct
analysis
9

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt. Plan
Page
Monitoring
Plan
Page
Remarks
st
nd
rd

Requirements
List of Key Impacts
Required Assessment
Spring and well inventory and

location map; depth of water table
the PAG-ASA 2020 and 2050
climate projections
2.2 Oceanography
2.2.1
Change/disruption
circulation pattern
2.3 Water Quality
2.3.1
Degradation
groundwater quality
in
of
2.3.2 Degradation of surface

water quality
2.3.3 Degradation of coastal/

Bathymetric map
Physico-Chemical characterization
of water :
pH
BOD5
DO
Oil and grease
TSS
fecal / total coliform
pesticide analysis

when applicable
Use DENR standard
for sampling and analysis.
For project with
coastal/marine structures
and /or significant marine /
coastal discharges,
conduct circulation / plume
modeling (include worst
case scenario of failure of
WWTF)
others:
_________________________
sampling site map

2.4 Freshwater Ecology
2.4.1 Threat to existence
and/or loss of important
local species and habitat
conservation status
10

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt. Plan
Page
Monitoring
Plan
Page
Remarks
st
nd
rd

Requirements
List of Key Impacts
Required Assessment

species

species;
sampling site map
2.5 Marine Ecology

3.5.1
Threat to existence
and/or loss of important local
species and habitat
Abundance/densities/distribution
of ecologically and economically
grasses);
species;
Historical occurrences of red-tide,
Marine resource map

manta tow, marine
resource characterization
data)
sampling site map

3. THE AIR
3.1.1 Change in the local
climate, e.g., local temperature


Tropical cyclones
In the assessment,
climate change projections
for 2020 and 2050.
characterization of ambient air

quality:
Use DENR standard

TSP
PM10
SOx
11

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt. Plan
Page
Monitoring
Plan
Page
Remarks
st
nd
rd

Requirements
List of Key Impacts
Required Assessment
NOx
others:
_________________________

Air Act)
sampling site map
level

level
sampling site map
Use DENR standard

for sampling and
measurement.
If applicable, noise
attenuation modeling
(applicable if there is
source capable of
generating 200 dB or
more)
4. THE PEOPLE
Displacement /
disturbance of properties
Change/conflict
ownership
in
land
Change/conflict in right of
way
4.2 In-migration
settlers

- Number of households and
household size
- Land area,
- Population,
attainment,
settlements map

devaluation

12

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt. Plan
Page
Monitoring
Plan
Page
Remarks
st
nd
rd
List of Key Impacts

Requirements
Required Assessment
4.3 Cultural/Lifestyle change

(especially
on
Indigenous
Peoples, if any)

safety
Housing
ownership
profile
/
informal settlers
Culture/Lifestyle that may be
Availability of public services in
terms of:
Water supply
Power supply
Communications
/transportation
Health
resources
(Government and Private)
Recreational facilities /
sports facilities
Statistical data / information related
to public services:
Morbidity and mortality
rates (infants and adults 5-year trend)
area including endemic
diseases;
Sanitation Profile;
Crime rate
Food security
Discuss the impacts on IPs

and Culture/Lifestyle

would affect the delivery of
basic services and may
result in resource
Discuss the project
implementations threat to
public health vis--vis the
baseline health conditions
in the area
may be affected by climate
change.
13

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt. Plan
Page
Monitoring
Plan
Page
Remarks
st
nd
rd
List of Key Impacts

Requirements
Required Assessment
4.6
Generation
of
Local
Benefits from the project
Enhancement of
employment and
livelihood opportunities
Increased business
opportunities and
associated economic
activities
Increased revenue of
LGUs
Socioeconomic data:
and activities
Banking
and
financial
institutions

Existing transportation/traffic
situation
Traffic impact assessment

if applicable (including
capacity of road system in
terms of load/count)
14

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt. Plan
Page
Monitoring
Plan
Page
Remarks
st
nd
rd
III.

Type of Risks
Scope of Assessment
During scoping: Check () required/applicable items; items with are automatically required; write specific instructions ( if any)
on the blanks/spaces provided.
Safety Risks
ERA REQUIREMENT
circumstances which could be
Quantitative Risk Assessment(QRA)
Release of toxic
significant in bringing about identified
substances (e.g.
safety risks
ammonia from cold
Specific Instructions :
- Description & assessment of the
storage facility)
_____________________________
possible accident scenarios
- Assessment of whether the project
location is projected to have extreme
climate events for 2020 and/or 2050
Assessment
that could contribute to the triggering
identified scenarios
- Description of the hazards, both
____________________________
immediate (acute effects) and delayed
(chronic effects) for man and the
EMERGENCY PLAN :
environment posed by the release of
toxic substance, as applicable
__________________________
criteria outline
15
for completeness during procedural screening; page numbers

should be provided upon submission of the EIS
Monitoring
ERA
ERP
Plan
Remarks
Page
Page
Page
st
nd
rd
Noted By:
Signature
Signature
EMB Representatives
1.
1.
2.
2.
3.
3.
4.
Project Proponent:
5.
6.
Resource Person
1.
16
Annex 1 - C
ECC APPLICATION FORM FOR NON-FOOD MANUFACTURING PLANTS PROJECTS

Project Title: _____________________________________________________________________________
Address: ________________________________________________________________________________
Contact No:
EIS Consultant: ___________________________________________________________________________
Address: ________________________________________________________________________________
Contact No:
Fax No:
Contact Person:__________________________
Project Classification Code (Refer to RPM for DAO 2003-30): _____________________________________
Project Size based on Classification: _________________________________________________________

Acceptable?
Yes
No

Use Plan
communities
__ copies
rd
O.R. #
Date
NOTED BY:
___________________________
Screening Officer
_________________________
EMB Regional Office

Screening Office
Date:
_____________________________
1

Date

st
nd
rd

st
nd
rd

Contents
Page #
Acceptable?
Page #
Acceptable?
REMARKS

Summary of Baseline Characterization, Key Environmental Impacts
and Management & Monitoring Plan; and EMF Commitments (if
applicable)
Items to be
Described

1) Project Location
and Area
3) Project
Alternatives

province,
region
boundaries,
vicinity,
setting)
site/area
Describe the justification for the Project with
associated economic development, which
process/technology
selection,
resource
project:
ground
shaking,
ground
rupture,
2
REMARKS

st
nd
rd
Items to be
Described
Page #

as well as mandated agencies)
location)
preferred option;
including factors significant to the selection
and engineering design
Resources:
Discuss
the
alternatives
in favor of the preferred resource. Discuss
the sustainability of the raw materials/inputs
to be tapped and transportation plan of raw
materials.
environmental impacts of each alternative
4) Project
Components

technical
details,
such
as
area
planted/cultivated, specifications, capacity,
number, etc.)
Identification of other Support Facilities (e.g.,
etc.)
facilities,
infrastructure
requirements
sewerage,
telecommunications,
3
Acceptable?
REMARKS

st
nd
rd
Items to be
Described
5) Process/
Technology
6) Project Size
7) Development
Plan, Description
of Project Phases
and
Corresponding
Timeframes
Page #

Identification of Pollution Control devices and
corresponding facility being served or
connected.
and devices to address solid waste materials
(domestic and hazardous and chemicals) air
emissions, solid waste disposal, and
wastewater
facilities (if any)
buffers.
When applicable, contextualize using the
streams
Waste Management Systems (e.g., wastewater
treatment facility, baghouse filter, desulfurizer,
other pollution control devices
Daily/Monthly/Annual production rate (refer to
Annex 2-1b)
those with significant environmental impacts as
well as climate change adaptation options
timeframes:
Construction (e.g., land/site clearing,
handling,
infrastructure
requirements
(transportroad/rail/ship,
energy,
water
sewerage,
telecommunications,
4
Acceptable?
REMARKS

st
nd
rd
Items to be
Described
Page #
Acceptable?
Page #
Acceptable?
REMARKS

waste management (character and quantities
of waste materials, air emissions, Solid
waste disposal, wastewater)
Abandonment
Final
Rehabilitation/
Decommissioning Plan, to include land/soil
restoration, procedures, and projected
schedule. The land use suitability of the
various land disturbance types should also
be described.
The proposed decommissioning plan should be
in terms of the following:
project components;
Alternatives for the future use of abandoned
area;
8) Manpower
nature & estimated number of jobs available
for men, women, and indigenous peoples (if
sited in IP ancestral land);
General Contents
II. Key
Environmental
Impacts and
Management/
Monitoring Plan
III. Environmental
Risk Assessment
IV. Impact
Management Plan

V. Social
Development Plan
(SDP) and IEC
SDP (if applicable)

change
adaptation
measures/options
Community
development
or
livelihood
5
REMARKS

st
nd
rd
General Contents
Framework
Page #

partner
institutions,
timeframe
of
IEC (if applicable)
VI. Environmental
Compliance
Monitoring
Environmental
Monitoring)
Monitoring
Plan
Self

template
applicable)
MMT, basis of selection, proposed role, and
scope of MMT responsibilities and activities,
etc. (See Annex 3-4 of the RPM for DAO 200330).
Environmental Guarantee and Monitoring Fund
Commitments (if applicable)
VII. Emergency
Preparedness and
Response Policy
and Generic
Guidelines

2003-30
facilities.
VIII. Abandonment/
Decommissioning/

procedures for Decommissioning/
Abandonment.

for EMP
Implementation

Acceptable?
REMARKS
ECC APPLICATION FORM FOR PROPOSED NON-FOOD MANUFACTURING PLANTS PROJECTS

st
nd
rd

List of Key Impacts

Requirements
Required Assessment
1. THE LAND
1.1.1 Change/Inconsistency in
land use
Environmentally Critical Areas
(ECAs)
1.1.3 Possible tenurial / land

issue
Description & Map showing the project

area in relation to existing land use.
Identify areas vulnerable/susceptible to

natural hazards where the project is
located or near the project area
(include map/s).
CADC/ CADT where the project is
Assessment of the
proposed project in
relation to land use and/or
the coastal resource
LGU, if any.

issues (e.g., IFMA/CBFMA within COC
and within MPSA, etc.)
terrain/slope
1.2.2Change in sub-surface/
underground
geomorphology
liquefaction,
landslides,
mud / debris flow, etc.
1.3 Pedology
topsoil/overburden
1.4
Slope and Elevation/Topographic Map

maps (NAMRIA, NDRRMC, MGB,
PHIVOLCS, PAG-ASA)


when applicable
Terrestrial Ecology
7

Baseline
Impact
Mgmt. Plan
Monitoring
Remarks
Conditions
Analysis
Plan
Page
Page
Page
Page

st
nd
rd
Requirements
List of Key Impacts
Required Assessment

loss of habitat

species
access
2. THE WATER
morphology /
Inducement of
volumetric flow

water depth
2.1.3
Depletion
of
water
use
2.2 Oceanography
2.2.1
Change/disruption
in
Flora and fauna species inventory or

survey report;
of pest
similar incidences
Summary of endemicity / conservation
status

flora


and distribution
the project site


occurrence of flooding
and vice versa. Consider
extreme weather
conditions and the PAGASA 2020 and 2050
climate projections

areas
Analysis/estimation of water availability
taking into consideration the PAG-ASA
2020 and 2050 climate projections

water requirement,
conduct water balance /
budget analysis

8

Baseline
Impact
Mgmt. Plan
Monitoring
Remarks
Conditions
Analysis
Plan
Page
Page
Page
Page

st
nd
rd
Requirements
List of Key Impacts
Required Assessment
circulation pattern

Bathymetric map
2.3 Water Quality

2.3.1 Degradation of
groundwater quality
water :

water quality
coastal/marine water quality
pH
BOD5
COD
DO
Oil and grease
TSS
Heavy Metals :_______________
others:
__________________________
sampling site map

and habitat

species

when applicable
Use DENR standard
For project with
and /or significant marine/
coastal discharges,
conduct circulation /
plume modeling (include
worst case scenario of
failure of WWTF)
heavy metals discharges,
conduct sediment
transport modeling
conservation status
economically important
species
(fishes, benthos, planktons)
species
sampling site map
2.5 Marine Ecology

and habitat
ecologically
and
economically
important
species
(mangroves,
reefs,
algae,
seaweeds,
sea
grasses);

manta tow, marine
resource
9
characterization (e.g.,
municipal and

Baseline
Impact
Mgmt. Plan
Monitoring
Remarks
Conditions
Analysis
Plan
Page
Page
Page
Page

st
nd
rd
Requirements
List of Key Impacts
Required Assessment

and habitat
3. THE AIR

greenhouse gas emissions


temperature of the area; Climatological
normals/extremes; Wind rose
diagrams; Frequency of Tropical
cyclones
In the assessment,
climate change
2050.
Data on Greenhouse gasses (i.e.

emission

greenhouse gas
emissions (applicable for
power and landfill and
possible for mining and
dam)
Characterization of ambient air quality:
Use DENR standard

TSP
PM10
SOx
NOx
Trace Metals:
____________________
others:
__________________________
Air Act)

level
sampling site map

Characterization of ambient noise level
sampling site map
If applicable air
dispersion modeling
(include worst case
scenario of failure of
APCD)
Heavy metals (baseline
and modeling) apply to
selected chemical
industries
Use DENR standard
for sampling and
10

Baseline
Impact
Mgmt. Plan
Monitoring
Remarks
Conditions
Analysis
Plan
Page
Page
Page
Page

st
nd
rd
Requirements
List of Key Impacts
Required Assessment
measurement.
(applicable if there is a
source capable of
more)
4. THE PEOPLE
Displacement / disturbance
of properties
Change/conflict
ownership
in
land
way
4.2 In-migration
Proliferation
settlers
of
- Number
of
households
and
household size
- Land area,
- Population,
attainment,

devaluation
Settlements map

informal

(especially on Indigenous
Peoples, if any)

Housing ownership profile / availability
of housing/ number of informal settlers
Culture/Lifestyle
that
may
be
of:
Water supply


of basic services and may
11

Baseline
Impact
Mgmt. Plan
Monitoring
Remarks
Conditions
Analysis
Plan
Page
Page
Page
Page

st
nd
rd
List of Key Impacts

Requirements
Required Assessment

safety
Power supply
Communications
/transportation
Health resources
facilities
public services:
result in resource
Discuss the project

in the area
may be affected by
climate change.

trend)
Common diseases in the area
including endemic diseases;
Sanitation Profile;
Crime rate
Food security
from the project
Enhancement of
opportunities
Increased business
opportunities and
associated economic
activities
Socioeconomic data:
and activities
Banking
and
financial
institutions
12

Baseline
Impact
Mgmt. Plan
Monitoring
Remarks
Conditions
Analysis
Plan
Page
Page
Page
Page

st
nd
rd
List of Key Impacts

Requirements
Required Assessment
LGUs

Traffic impact
load/count)
13

Baseline
Impact
Mgmt. Plan
Monitoring
Remarks
Conditions
Analysis
Plan
Page
Page
Page
Page

st
nd
rd
III. Environmental Risk Assessment

Type of Risks
Scope of Assessment
Safety Risks
ERA REQUIREMENT
Quantitative Risk
Fire
Explosion
Assessment(QRA)
accident scenarios
Release of toxic
substances
- Assessment of whether the project location
is projected to have extreme climate
__________________________
events for 2020 and/or 2050 that could
contribute to the triggering identified
scenarios
Assessment
(acute effects) and delayed (chronic
effects) for man and the environment
posed by the release of toxic substance,
as applicable
____________________________
Physical Risks
trigger which could be significant in
EMERGENCY PLAN :
(Failure of Structure which
bringing about identified physical risks
could endanger life, property
and/or the environment)
accident scenarios
- Assessment of whether the project location ____________________________
is projected to have extreme climate
events for 2020 and/or 2050 that could
Refer to Annex 2-7e for the
contribute to the triggering identified
decision criteria outline
scenarios
- Description of the hazards both immediate
(acute effects) and delayed (chronic
effects) for man and the environment
posed by the failure of structure, as
applicable
14

Monitoring
ERA
ERP
Remarks
Plan
Page
Page
Page

st
nd
rd
Noted By:
Signature
Signature
EMB Representatives
1.
1.
2.
2.
3.
3.
4.
Project Proponent:
5.
6.
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)

Project Title: _____________________________________________________________________________
Address: ________________________________________________________________________________
Contact No:
EIS Consultant: ___________________________________________________________________________
Address: ________________________________________________________________________________
Contact No:
Fax No:
Contact Person:__________________________

Acceptable?
Yes
No

Use Plan
communities
__ copies
authorized 3rd Party Review Fund Manager)
O.R. #
Date
NOTED BY:
___________________________
Screening Officer
_________________________
EMB Regional Office

Screening Office
Date:

Date



Contents
Page #
Acceptable?
Page #
Acceptable?
REMARKS

Management & Monitoring Plan, and EMF Commitments (if applicable)
Items to be
Described

1) Project Location
and Area

province,
region
boundaries,
vicinity,
setting)
site/area
Describe the justification for the project with
associate economic development which the
project may provide. The status of the
REMARKS

Items to be
Described
3) Project
Alternatives
Page #

process/technology
selection,
resource
project:
ground
shaking,
ground
rupture,
as well as other mandated agencies).
location)
option for which the EIS is prepared.
preferred option.
environmental
impacts
among
the
the project within the project area. Discuss
alternative location of access roads in case
the preferred locations of the various
components are found environmentally not
feasible.
Resources:
Discuss
the
alternatives
in favor of the preferred resource. Discuss the
sustainability of the raw materials/inputs to be
materials.
b) Cite reasons for selecting the preferred
options delineated in terms of technical,
commercial, social and natural environmental
aspects.
Acceptable?
REMARKS

Items to be
Described
4) Project
Components
5) Process/
Technology
Page #

Identification of major components including
technical details specifications, capacity,
number
(e.g.,
area
planted/cultivated,
nursery, etc.) as well as processing facility, if
any (e.g., sawmill, veneer, plywood, etc.)
etc.)
facilities,
infrastructure
requirements
sewerage,
telecommunications,
connected.
wastewater
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.
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
When applicable, consider the PAG-ASA
2020 and 2050 projected rainfall data.
6) Project Size
Volume of trees to be cut and, if with

processing, indicate annual production rate.
7) Development
Plan, Description
of Project Phases
and
Corresponding
Timeframes

relevant to the project and project activities) and
4
Acceptable?
REMARKS

Items to be
Described

corresponding
timeframes:
projected
Page #
implementation

handling,
infrastructure
requirements
energy,
water
sewerage,
telecommunications,
waste management (character and quantities
of waste materials, air emissions, solid waste
disposal, wastewater)
Abandonment
Final
Rehabilitation/
Decommissioning Plan, to include land/soil
restoration and procedures and projected
schedule. The land use suitability of the
various land disturbance types should also be
described.
Include also the proposed decommissioning
plan in terms of the following:
project components;
area;
8) Manpower
nature and estimated number of jobs
Acceptable?
REMARKS

General Contents
REMARKS
Page #
II. Key
Environmental
Impacts and
Management/
Monitoring Plan
III. Environmental
Risk Assessment
IV. Impact
Management Plan

V. Social
Development Plan
(SDP) and IEC
Framework
SDP

change
adaptation
measures/options
Community
development
or
livelihood
partner
institutions,
timeframe
of
IEC
scheme/strategy/methods, Information medium,
timelines and frequency, cost (See Annex 2-19
of RPM for DAO 2003-30)
VI. Environmental
Compliance
Monitoring
template
applicable)
MMT, basis for selection, proposed role, and
Present a proposed amount of EMF (based
on a draft AWFP in Annex 3-4 and
6
Acceptable?

General Contents
REMARKS
Page #
VII. Emergency
Preparedness and
Response Policy
and Generic
Guidelines

2003-30
facilities.
VIII. Abandonment/
Decommissioning/

procedures
for
Rehabilitation/
Decommissioning/Abandonment
to
be
submitted as post-ECC, within a timeframe
specified in the ECC.

for EMP
Implementation

Acceptable?

st
nd
rd

List of Key Impacts

Requirements
Required Assessment
1. THE LAND
1.1.1 Change/Inconsistency in land
use
Areas (ECAs)
1.1.3 Possible tenurial / land issue
1.2.1 Change in surface landform/
topography/ terrain/slope
debris flow, etc.
1.3 Pedology
topsoil/overburden
Description & Map showing the

use.
(include map/s).
Assessment of the
proposed project in
and/or the coastal
resource management

Map
Maps (NAMRIA, NDRRMC, MGB,
PHIVOLCS, PAG-ASA)

potential; Bank stability;

when applicable
holding capacity

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt.
Plan
Page
Monitoring
Plan
Page
Remarks

st
nd
rd
List of Key Impacts

Requirements
Required Assessment

1.4.1 Vegetation removal and loss
of habitat

important species
2. THE WATER
2.1. Hydrology/Hydrogeology
2.1.1
Change
in
drainage
morphology/Inducement
of
volumetric flow
2.1.2 Change in stream, lake water

depth
2.1.3 Depletion of water resources /
competition in water use

or survey report
of pest
similar incidences
Summary
of
endemicity
/
conservation status
and distribution
the project site

flora


extreme weather
climate projections

and fauna
Include impact
assessment on
vegetation (e.g.,
and specific
management measures
transplanting,
replacement, etc.)

areas
9

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt.
Plan
Page
Monitoring
Plan
Page
Remarks

st
nd
rd

Requirements
List of Key Impacts
Required Assessment

projections
2.2 Oceanography
2.2.1
Change/disruption
circulation pattern
in
2.3 Water Quality

quality

quality
2.3.3Degradation of coastal/marine
water quality

Bathymetric map
water :
pH
DO
Oil and grease
TSS
others:
__________________________
sampling site map
2.4

when applicable
Use DENR standard
for sampling and
analysis.
For projects with
and /or significant
marine / coastal
discharges, conduct
circulation / plume
case scenario of failure
of WWTF)
Freshwater Ecology

and habitat
Summary
of
endemicity
/
conservation status
species
overall impact to
freshwater ecology
10

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt.
Plan
Page
Monitoring
Plan
Page
Remarks

st
nd
rd

Requirements
List of Key Impacts
Required Assessment
sampling site map

2.5 Marine Ecology (if applicable)
habitat
ecologically
and
economically
grasses);
species;
Historical occurrences of red tide,
Marine resource map

manta tow, marine
resource
characterization
data)
ecology
sampling site map

3. THE AIR

greenhouse gas emissions/
sequestration
3.2.1 Degradation of air quality, if
with processing

Tropical cyclones
emission/sequestration
In the assessment,
climate change
2050.
greenhouse gas
emissions/sequestration
Characterization of ambient air

quality:
Use DENR standard

for sampling and
analysis.
TSP
SOx
NOx
11

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt.
Plan
Page
Monitoring
Plan
Page
Remarks

st
nd
rd
List of Key Impacts

Requirements
Required Assessment
(for sampling methods, refer to Clean

Air Act)
sampling site map
level

level
sampling site map
Use DENR standard

for sampling and
measurement.
source capable of
more)
4. THE PEOPLE
Displacement / disturbance of
properties
ownership

- Number
of
households
and
household size
- Land area,
- Population,
attainment,

devaluation
Change/conflict in right of way

Settlements map
Housing
ownership
profile
/
informal settlers
12

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt.
Plan
Page
Monitoring
Plan
Page
Remarks

st
nd
rd
List of Key Impacts

Requirements
Required Assessment
4.2 In-migration
Settlers
4.3
Cultural/Lifestyle
change
if any)

safety

Culture/Lifestyle
that
may
be
of:
Water supply
Power supply
Communications/transportation
and Private)
facilities


public services:
trend)
area
including
endemic
diseases
Sanitation Profile
Crime rate
Food security

may be affected by
climate change.

Discuss the project
the baseline health
13

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt.
Plan
Page
Monitoring
Plan
Page
Remarks

st
nd
rd
List of Key Impacts

Requirements
Required Assessment

from the project
Enhancement
of
opportunities
Increased
business
opportunities and associated
economic activities
Socioeconomic data:
and activities
Banking
and
financial
institutions

Traffic impact
load/count)
14

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt.
Plan
Page
Monitoring
Plan
Page
Remarks

st
nd
rd
III.

for completeness during procedural screening; page numbers should
be provided upon submission of the EIS
Type of Risks
Scope of Assessment
Safety Risks
Fire
Release of toxic
substances
Physical Risks

accident scenarios
release of toxic substance, as applicable
- Identification of conditions, events and trigger
which could be significant in bringing about
identified physical risks
accident scenarios
failure of structure, as applicable
ERA REQUIREMENT
Quantitative Risk
Assessment(QRA)
_________________________
Assessment
_________________________
EMERGENCY PLAN :
_________________________
criteria outline
15
ERA
Page
Monitoring
Plan
ERP
Page
Page
Remarks

st
nd
rd
Noted By:
Signature
Signature
EMB Representatives
1.
1.
2.
2.
3.
3.
4.
Project Proponent:
5.
6.
Resource Person
1.
16
Annex 1 - E
ECC APPLICATION SCREENING FORM FOR HYDROPOWER/DAM PROJECTS

Project Title: _____________________________________________________________________________
Address: ________________________________________________________________________________
Contact No:
EIS Consultant: ___________________________________________________________________________
Address: ________________________________________________________________________________
Contact No:
Fax No:
Contact Person:__________________________

Acceptable?
Yes
No
Environmental Impact Statement (EIS)

Use Plan
communities
__ copies
rd
O.R. #
Date
NOTED BY:
___________________________
Screening Officer
_________________________
EMB Regional Office

Screening Office
Date:

Date

ECC APPLICATION SCREENING FORM FOR HYDROPWER/DAM PROJECTS


Contents
Page #
Acceptable?
REMARKS
Page #
Acceptable?
REMARKS

and Management & Monitoring Plan; EGF and EMF Commitments
Items to be
Described
III.
1) Project Location
and Area
3) Project
Alternatives

province,
region
boundaries,
vicinity,
setting)
site/area
associate economic development, which the
project may provide. The status of the
process/technology
selection,
resource
project:
ground
shaking,
ground
rupture,
2

Items to be
Described
Page #

as well as other mandated agencies)
location)
preferred option;
feasible.
occurrence of major impacts.
Resources:
Discuss
the
alternatives
considered for power generation and how the
decisions were made. Discussion should also
be in the context of climate change (e.g. use
of renewable energy).
4) Project
Components

technical details such as specifications,
capacity, number, etc. (e.g. penstock,
spillway, freeboard, etc.)
Specify the operations and processes
Identification of other Support Facilities (i.e.
emergency power, process control, early
3
Acceptable?
REMARKS

Items to be
Described
5) Process/
Technology
Page #
warning/alarm system, etc.)

Identification of infrastructure requirements
energy,
storm
water
drainage,
sewerage,
telecommunications, accommodation and
other
infrastructure),Identification
of
materials/product
handling
facilities,
infrastructure requirements (transport
other infrastructure)
connected.
wastewater
facilities (if any)
buffers.
Technology Description and Performance
Specifications
Indicative process flow-sheets
efficiency of power generation
including
Discuss the impacts of the PAG-ASA 2020 and

2050 projected rainfall pattern on the project
and performance/efficiency of the facility.
6) Project Size
Total volume of water to be impounded &

power rated capacity to be generated (if
hydropower)
Capacity and type of Dam structure
including area to be inundated and/or service
4
Acceptable?
REMARKS

Items to be
Described
Page #
Acceptable?
REMARKS
Page #
Acceptable?
REMARKS
area
7) Manpower
General Contents
II. Key
Environmental
Impacts and
Management/

change
adaptation
measures/options
Monitoring Plan
III.Environmental
Risk Assessment
IV. Impact
Management
Plan

V. Social
Development
Plan (SDP) and
IEC Framework
SDP
Community development or livelihood
partner institutions, timeframe of
IEC
VI. Environmental
Compliance
Use Annex 2-20 of RPM for DAO 2003-30
as template

General Contents
Monitoring
Page #
Multi-Sectoral Monitoring Framework

VII. Emergency
Preparedness and
Response Policy
and Generic
Guidelines

2003-30
facilities.
VIII. Abandonment
/Decommissioning
/Rehabilitation Policy

procedures
for
Rehabilitation/
to
be

for EMP
Implementation

Acceptable?
REMARKS


List of Key Impacts

Requirements
Required Assessment
1. THE LAND
land use
use.
Areas (ECAs)
(include map/s).
1.1.3 Possible tenurial / land issue Identify areas under CARP or with
CADC / CADT/ CALC/ CALT where
the project is located or near the
project area.
Assessment of the
proposed project in
and/or the coastal
resource management

1.2
Geology/Geomorphology
terrain/slope
1.2.2Change
in
sub-surface/
liquefaction, landslides, mud/
debris flow, etc.

Map
Geological Cross-Sections; Sequence
Stratigraphic Column of Rock Units;
Geomorphological Map: G Factor
Contour Maps; Seismicity Map;
Differential Settling Map; Results of
Geochemical Analyses of Rock
Samples (applicable areas); Hazard
PHIVOLCS, PAG-ASA)

Baseline
Impact
Mgmt.
Monitoring
Conditions
Analysis
Plan
Plan
Remarks
Page
Page
Page
Page

List of Key Impacts

Requirements
Required Assessment
1.3
Pedology
topsoil/overburden
1.4
Terrestrial Ecology
loss of habitat

species
important species
2. THE WATER
2.1.1
Change
in
drainage
morphology /
Inducement of


when applicable

or survey report;
of pest
similar incidences
conservation status

flora

and distribution
the project site
and fauna

Flood simulation/
modeling should

holding capacity, texture
aggregate stability of
dam); secondary data:
chemical analysis

Impact inundation on
terrestrial ecology
Include impact
assessment on
vegetation (e.g.,
and specific
management measures
transplanting,
replacement etc.)

Baseline
Impact
Mgmt.
Monitoring
Conditions
Analysis
Plan
Plan
Remarks
Page
Page
Page
Page


Requirements
List of Key Impacts
Required Assessment
flooding/ Reduction
volumetric flow
in
stream
consider extreme
weather conditions and
the PAG-ASA 2020 and
2050 climate projections
Assessment should
include potential
occurrence or
aggravation of flooding in
nearby areas.

water depth
2.1.3
Depletion
of
water
resources/competition in water use

areas
projections
2.2 Oceanography
2.2.1
Change/disruption
circulation pattern
in
2.3 Water Quality

quality
quality
2.3.3 Degradation
of
coastal/

Bathymetric map
water :
pH
BOD5

when applicable
Use DENR standard
for sampling and
analysis.
Oil and grease

TSS
9

Baseline
Impact
Mgmt.
Monitoring
Conditions
Analysis
Plan
Plan
Remarks
Page
Page
Page
Page

List of Key Impacts

Requirements
Required Assessment
sampling site map

species and habitat
conservation status
species
overall impact to
freshwater ecology
sampling site map

2.5 Marine Ecology (if applicable)
habitat
2.5.2
Threat to abundance,
ecologically
and
economically
grasses);
species;
Marine resource map
sampling site map
3. THE AIR

greenhouse
gas
emissions/

Tropical cyclones
carbon dioxide, methane); Calculation

manta tow, marine
resource
municipal and
data)
Impact on inundation
on marine ecology.
overall impact to
marine ecology
In the assessment,
climate change
2050.
10

Baseline
Impact
Mgmt.
Monitoring
Conditions
Analysis
Plan
Plan
Remarks
Page
Page
Page
Page


Requirements
List of Key Impacts
Required Assessment
sequestration
of projected GHG emission
greenhouse gas
emissions

3.2.1 Degradation of air quality, if
with processing
characterization of ambient air quality:
Use DENR standard

for sampling and
analysis.
TSP
(for sampling methods, refer to Clean

Air Act)
sampling site map
level

level
sampling site map
4. THE PEOPLE
of properties
Change/conflict
ownership
in
land
way
4.2 In-migration
settlers
For construction phase

only
Use DENR standard
for sampling and
measurement.

- Number
of
households
and
household size
- Land area,
- Population,
attainment,

devaluation
settlements map


Housing ownership profile /
informal settlers
11

Baseline
Impact
Mgmt.
Monitoring
Conditions
Analysis
Plan
Plan
Remarks
Page
Page
Page
Page

List of Key Impacts

Requirements
Required Assessment
4.3
Cultural/Lifestyle
change
if any)

safety

from the project
Enhancement of
opportunities

Culture/Lifestyle
that
may
be
of:
Water supply
Power supply
Communications/
transportation
Health
resources
Recreational
facilities
/
sports facilities


public services:
trend)
area
including
endemic
diseases
Sanitation Profile
Crime rate
Food security
Socioeconomic data:
Poverty incidence

may be affected by
climate change.

Discuss the project

the baseline health
12

Baseline
Impact
Mgmt.
Monitoring
Conditions
Analysis
Plan
Plan
Remarks
Page
Page
Page
Page

List of Key Impacts

Requirements
Required Assessment
Increased business
opportunities and
associated economic
activities
and activities
Banking
and
financial
institutions
Traffic impact
assessment, if applicable
load/count)
13

Baseline
Impact
Mgmt.
Monitoring
Conditions
Analysis
Plan
Plan
Remarks
Page
Page
Page
Page

III.

Type of Risks
Scope of Assessment
ERA
Safety Risks
Fire
Release of toxic
substances
Physical Risks

circumstances which could be significant in bringing
about identified safety risks
- Description & assessment of the possible accident
scenarios
projected to have extreme climate events for 2020
and/or 2050 that could contribute to the triggering
- Description of the hazards, both immediate (acute
effects) and delayed (chronic effects) for man and
the environment posed by the release of toxic
substance, as applicable
scenarios
- Description of the hazards both immediate (acute
the environment posed by the failure of structure, as
applicable
ERA REQUIREMENT
Quantitative Risk
Assessment(QRA)
__________________________
Assessment
____________________________
EMERGENCY PLAN :
_____________________________
Refer to annex 2-7e for the
14
Page
Monitoring
Plan
ERP
Page
Page
Remarks

Noted By:
Signature
Signature
EMB Representatives
1.
1.
2.
2.
3.
3.
4.
Project Proponent:
5.
6.
Resource Person
1.
15
Annex 1 - F

Project Title: _____________________________________________________________________________
Address: ________________________________________________________________________________
Contact No:
EIS Consultant: ___________________________________________________________________________
Address: ________________________________________________________________________________
Contact No:
Fax No:
Contact Person:__________________________

Acceptable?
Yes
No

Use Plan
communities
__ copies
rd
O.R. #
Date
NOTED BY:
___________________________
Screening Officer
_________________________
EMB Regional Office

Screening Office
Date:
_____________________________
1

Date
ECC APPLICATION SCREENING FORM FOR NEW MINING PROJECTS

st
nd
rd


Contents
Page #
Acceptable?
Page #
Acceptable?
REMARKS

Process Documentation of the conduct of EIA (1 page) (EIA Team,
EIA Study Schedule & Area, EIA Methodology, Public Participation)
and Management & Monitoring Plan, Contingent Liability and
Rehabilitation Fund (CLRF), Mine Rehabilitation Fund
and
Environmental Trust Fund (ETF) commitments
Items to be
Described
1)Project Location
and Area
2)Project Rationale
3)Project
Alternatives

province,
region boundaries,
vicinity,
setting)
site/area
associate economic development, which
design,
process/technology
selection,
resource utilization, including discussion of
the consequences of not proceeding with the
project:
ground
shaking,
ground
rupture,
2
REMARKS

Items to be
Described
Page #

location)
preferred option
feasible.
alternative
technologies,
operation
processes and engineering design.
Resources:
Discuss
the
alternatives
resource to be tapped for power generation
and how the decisions were made in favor of
the preferred resource.
Discuss the
sustainability of the raw materials to be
materials.
4) Project
Components

capacity, number, etc.) TSF
Specify if Extraction only or with Ore/Mineral
Processing (mining)
Identification of other Support Facilities (i.e.
energy/power generating facility, water
3
Acceptable?
REMARKS

Items to be
Described
5) Process/
Page #
supply system)
facilities,
infrastructure
requirements
sewerage,
telecommunications,
Identification of Pollution Control devices
and corresponding facility being served or
connected.
and devices to address
solid waste
materials (domestic and hazardous and
chemicals) air emissions, solid waste
disposal, and wastewater
facilities (if any)
buffers.
Method / Technology for:
Technology
Extraction
Ore/mineral processing (indicate type of raw
material & final product)
streams
Waste Management Systems (tailings pond,
wastewater treatment facility, siltation ponds,
tailings dam, etc.)
6) Project Size
Total Amount of Ore/Mineral Reserves in the

project area based on exploration data
Total amount of Ore/Mineral Reserves to be
extracted, rate of extraction and timetable
If with processing, indicate annual production
rate
hectares
Acceptable?
REMARKS

Items to be
Described
7)Development
Plan, Description
of Project Phases
and
Corresponding
Timeframes
Page #
Phases to be described in terms identifying

timeframes:
Pre-construction (e.g. planning, acquisition
of rights to use land, exploration activities)
handling,
infrastructure
requirements
sewerage,
telecommunications,
waste
management
(character
and
quantities of waste materials, air emissions,
Solid waste disposal, wastewater).
Abandonment
include Land/soil restoration, decontamination
or remediation activities and procedures &
projected schedule.
Discussions should
include strategies and methods for progressive
and final rehabilitation of the environment
disturbed by the project. The final topography
of any excavations, waste areas and dam sites
should be shown. The land use suitability of
the various land disturbance types should also
be described.
project components;
Remediation of contaminated soil and
water resources due to spills and leakage
of chemicals and other materials used in
the operation;
abandoned area;
Acceptable?
REMARKS

Items to be
Described
8)Manpower
Page #
Acceptable?
REMARKS
9)Indicative Project Investment Cost (Philippine Peso)
General Contents
REMARKS

Page #
II. Key
Environmental
Impacts and
Management/
Monitoring Plan
III. Environmental
Risk Assessment
IV. Impact
Management
Plan

V. Social
Development
Plan (SDP) and
IEC Framework
SDP

change
adaptation
measures/options
Community
development
or
livelihood
partner
institutions,
timeframe
of
IEC
VI. Environmental
Compliance
Monitoring
template
Acceptable?

General Contents
REMARKS

Page #

DAO 2003-30).
Environmental Guarantee Fund Commitments,
if with processing

guidelines in annex 3-6 of RPM for DAO
2003-30
VII. Emergency
Preparedness
and Response
Policy and
Generic
Guidelines
The safety policy and generic guidelines shall

be consistent with the Mines and Geosciences
Bureau (MGB) requirements.
Emergency
Preparedness should also consider natural
hazards to the infrastructures and facilities.
VIII. Abandonment/
Decommissioning/

procedures
for
Rehabilitation/
to
be

for EMP
Implementation

Acceptable?

(Requiring EIS for ECC Applications)

List of Key Impacts

Requirements
Required Assessment
1. THE LAND
land use
project area in relation to existing
land use.
Areas (ECAs)
(include map/s).
1.1.3 Possible tenurial / land Identify areas under CARP or with
issue
CADC / CADT/CAL/CALT where the
project is located or near the project
area.
Assessment of the
proposed project in relation
to land use and/or the
coastal resource
LGU, if any.
Specify other conflicting tenurial /

land issues (e.g., IFMA/CBFMA
within COC and within MPSA,
ownership, informal settlers, small
scale mining, etc.)
2 Geology/Geomorphology
landform/ topography/ terrain/
slope
1.2.3Inducement of subsidence,
debris flow, etc.

Map
Geological Cross-Sections;
Sequence Stratigraphic Column of
Rock Units; Geomorphological Map:
G Factor Contour Maps; Seismicity
Map; Differential Settling Map;
Bathymetric and Morpho-structural
Map; Results of Petrographic and

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt. Plan
Page
Monitoring
Plan
Page
Remarks

List of Key Impacts

Requirements
Required Assessment
Mineragraphic Analyses; Results of

Geochemical Analyses of Rock
Samples (applicable areas); Hazard
PHIVOLCS, PAG-ASA)
1.3 Pedology
topsoil/overburden
1.3.2 Change in soil

quality/fertility

loss of habitat

local species
access
Summary of Soil Investigation

Report on soil type and quality;
Erodibility potential; Bank stability

when applicable
Laboratory results on
analysis for N, P, K,
metals e. g. Pb, Hg,
hexavalent, etc.
soil sample
pH, organic
and trace
As, Cd, Cr

aggregate stability of dam);
secondary data: chemical
analysis

or survey report;
of pest
similar incidences
conservation status

floraUse of mist nets, traps,
overall impact to flora and
fauna
Summary
of
abundance,
the project site
2. THE WATER
2.1.1 Change in drainage Drainage map; historical
morphology / Inducement of flooding/drought occurrences,
Flood simulation/modeling,
9

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt. Plan
Page
Monitoring
Plan
Page
Remarks


Requirements
List of Key Impacts
Required Assessment

volumetric flow
stream flow measurements/

estimates; Delineation of watershed
/sub-watersheds/ floodplain; and
consider extreme weather

climate projections
Assessment should include
potential occurrence or
nearby areas

water depth
2.1.3 Depletion of water
use

areas
Spring and well inventory and
location map; depth of water table
the PAG-ASA 2020 and 2050
climate projections
2.2 Oceanography
2.2.1
Change/disruption
circulation pattern
2.3 Water Quality
2.3.1
Degradation
groundwater quality
in
of

Bathymetric map
Physico-Chemical characterization
of water :
pH
BOD5
COD

when applicable
Use DENR standard
Conduct chemical assay of
ore and relate to PhysicoChemical characterization

10

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt. Plan
Page
Monitoring
Plan
Page
Remarks


Requirements
List of Key Impacts
Required Assessment
water quality
DO
of water
Oil and grease
For project with coastal/

marine structures and /or
significant marine / coastal
discharges, conduct
circulation / plume
WWTF). For project with
significant heavy metals
discharges, conduct
sediment transport
modeling.
TSS
Heavy Metals
____________________
Others:
_________________________
sampling site map

conservation status
species
overall impact to
freshwater ecology.
overall impact to freshwater
ecology.
sampling site map

conservation status
species
sampling site map
2.5 Marine Ecology
2.5.1
Threat to existence
and/or loss of important local
species and habitat
Abundance/densities/distribution
of ecologically and economically

11

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt. Plan
Page
Monitoring
Plan
Page
Remarks


Requirements
List of Key Impacts
Required Assessment


grasses)
species
Marine resource map
sampling site map

3. THE AIR
3.1.1 Change in the local Monthly average rainfall and
Tropical cyclones
3.2.1 Degradation of air quality Characterization of ambient air
quality:
TSP
PM10
SOx
NOx
(for sampling methods refer to
Clean Air Act)
sampling site map
level

level
manta tow, marine

resource characterization
data)
ecology
In the assessment,
climate change projections
for 2020 and 2050.
Use DENR standard

If applicable, air dispersion
APCD.
Heavy metals (baseline
and modeling) apply to
selected processing
facilities.
Use DENR standard
for sampling and
12

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt. Plan
Page
Monitoring
Plan
Page
Remarks


Requirements
List of Key Impacts
Required Assessment
sampling site map
measurement.
source capable of
more).
4. THE PEOPLE
Displacement /
disturbance of properties
Change/conflict
ownership
in
land
way
4.2 In-migration
Proliferation
settlers
of

- Number of households and
household size
- Land area
- Population
- Gender and age profile
attainment

devaluation
Settlements map

informal

(especially
on
Indigenous
Peoples, if any)

Housing
ownership
profile
/
informal settlers
Culture/Lifestyle that may be
Availability of public services in
terms of:
Water supply
Power supply
Discuss the impacts on IPs

and Culture/Lifestyle

would affect the delivery of
basic services and may
result in resource
13

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt. Plan
Page
Monitoring
Plan
Page
Remarks

List of Key Impacts

Requirements
Required Assessment

safety
Communications/ transportation
and Private)
Recreational facilities/ sports
facilities
Statistical data / information related
to public services:
Literacy
rate,
profile
of
trend)
including endemic diseases
Environmental
Health
and
Sanitation Profile
Crime rate
Food security
4.6
Generation
of
Local
Enhancement of
employment and
livelihood opportunities
Increased business
opportunities and
associated economic
activities
Discuss the project

in the area
may be affected by climate
change.
Socioeconomic data:
Poverty Incidence
Commercial establishments and
activities
Banking and financial
institutions
LGUs
14

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt. Plan
Page
Monitoring
Plan
Page
Remarks

List of Key Impacts

Requirements
Required Assessment

Existing transportation/traffic
situation
III.

Baseline
Conditions
Page
Impact
Analysis
Page
Mgmt. Plan
Page
Monitoring
Plan
Page
Remarks
Traffic impact assessment,

if applicable (including
capacity of road system in
terms of load/count)

Type of Risks
Scope of Assessment
Safety Risks
ERA REQUIREMENT
circumstances which could be significant in bringing
Quantitative Risk
Fire
about identified safety risks
Explosion
Assessment(QRA)
scenarios
Release of toxic
substances
__________________________
- Description of the hazards, both immediate (acute
Assessment
the environment posed by the release of toxic
substance, as applicable
___________________________
Physical Risks
EMERGENCY PLAN :
scenarios
____________________________
Refer to Annex 2-7e for the
15
ERA
ERP
Page
Page
Monitoring
Plan
Page
Remarks

III.

Type of Risks
Scope of Assessment
- Description of the hazards both immediate (acute
the environment posed by the failure of structure, as
applicable.
Noted By:
ERA
ERP
Page
Page
Signature
Monitoring
Plan
Page
Remarks
Signature
EMB Representatives
1.
1.
2.
2.
3.
3.
4.
Project Proponent:
5.
6.
Resource Person
1.
16
Annex 1 - G
ECC APPLICATION SCREENING FORM FOR SANITARY LANDFILL PROJECTS

Project Title: _____________________________________________________________________________
Address: ________________________________________________________________________________
Contact No:
EIS Consultant: ___________________________________________________________________________
Address: ________________________________________________________________________________
Contact No:
Fax No:
Contact Person:__________________________

Acceptable?
Yes
No

Use Plan
communities
__ copies
rd
O.R. #
Date
NOTED BY:
___________________________
Screening Officer
_________________________
EMB Regional Office

Screening Office
Date:
_____________________________
1

Date


,
I.
Executive Summary (maximum of 5 pages)

Contents
Page #
Acceptable?
Page #
Acceptable?
REMARKS

and Management & Monitoring Plan; and EMF Commitments (if
applicable)
Items to be
Described

1) Project Location
and Area
3) Project
Alternatives

province,
region
boundaries,
vicinity,
setting)
site/area
based on current
and projected waste
generation
Justification for the Project with particular
reference to the economic and social
benefits,
including
employment
and
associated economic development, which
the project may provide.
process/technology
selection,
resource
utilization, including discussion of the
project:
ground
shaking,
ground
rupture,
location)
2
REMARKS

,
Items to be
Described
Page #

preferred option;
feasible.
Resources:
Discuss
the
alternatives
considered in the waste treatment / disposal.
Discussion should also include climate
change considerations.
4) Project
Components

capacity, number, etc.
Specify the operations
Identification of other Support Facilities
Identification of waste handling facilities,
infrastructure
requirements
(transport,
energy, water supply and storage, storm
water
drainage,
sewerage,
telecommunications,
and
other
infrastructure),
facilities (if any)
3
Acceptable?
REMARKS

,
Items to be
Described
5)
Process/
Technology
Page #

buffers.
Technology description
Flow chart of operation
Waste Management Systems (e.g., leachate
pond, methane/ landfill gas collection system,
etc.)
6) Project Size
Daily waste input

hectares/landfill area
7) Development
Plan, Description
of Project Phases
and
Corresponding
Timeframes

timeframes:
of rights to use land,)
handling, infrastructure requirements
Identification of waste handling facilities,
infrastructure requirements (transport,
energy, water supply and storage, storm
water drainage, sewerage,
telecommunications, and other
infrastructure), waste management
Abandonment
include Land/soil restoration, decontamination
or remediation activities and procedures &
projected schedule. The land use suitability of
the various land disturbance types should also
be described.
The proposed decommissioning plan should be
4
Acceptable?
REMARKS

,
Items to be
Described
Page #
Acceptable?
REMARKS
Page #
Acceptable?
REMARKS
in terms of the following:
8) Manpower

project components;
Remediation of contaminated soil and water
resources due to spills and leakage of
chemicals and other materials used in the
operation;
area;
Rehabilitation / restoration plans, if any
General Contents
II. Key
Environmental
Impacts and
Management/
Monitoring Plan
III. Environmental
Risk Assessment
IV. Impact
Management
Plan

V. Social
Development
Plan (SDP) and
IEC Framework
SDP

change
adaptation
measures/options
Community
development
or
livelihood
partner
institutions,
timeframe
of

,
General Contents
Page #
IEC
VI. Environmental
Compliance
Monitoring
Target
sector,
key
messages,
scheme/strategy/methods,
Information
template
Commitments
VII. Emergency
Preparedness
and Response
Policy and
Generic
Guidelines

2003-30
natural hazards to the infrastructure and
facilities.
VIII. Abandonment/
Decommissioning /

procedures
for
Rehabilitation/
Decommissioning/Abandonment.

for EMP
Implementation

Acceptable?
REMARKS


List of Key Impacts

Requirements
Required Assessment
1. THE LAND
1.1.1Change/Inconsistency
in
land use
Areas (ECAs)
1.1.3 Possible tenurial / land

issue

(include map/s).
CADC / CADT/CALT/CALC where the
project is located or near the project
area.
Assessment of the
proposed project in
and/or the coastal
resource management
plan of the LGU, if any.

issues (e.g., IFMA/CBFMA within COC
and within MPSA, ownership, informal
settlers, etc.)
terrain/slope
1.2.2Change in sub-surface/
debris flow, etc.

Geological Cross-Sections; Sequence
Stratigraphic Column of Rock Units;
Geomorphological Map: G Factor
Contour Maps; Seismicity Map;
Differential Settling Map; Hazard Maps
(NAMRIA, NDRRMC, MGB,
PHIVOLCS, PAG-ASA)

Baseline
Impact
Mgmt. Plan
Monitoring
Remarks
Conditions
Analysis
Plan
Page
Page
Page
Page

List of Key Impacts

Requirements
Required Assessment
1.3 Pedology
topsoil/overburden
1.3.2 Change in soil

quality/fertility
1.4
Terrestrial Ecology
loss of habitat

species
access
2. THE WATER
morphology /
Inducement of
volumetric flow


matter, micronutrients and trace
metals, e. g. Pb, Hg, As, Cd, Cr
hexavalent, etc.
survey report;
of pest
similar incidences
status
and distribution
the project site

potential land
project operations. Relate
discussions to soil
characteristics.
aggregate stability of
dam); secondary data:
chemical analysis
flora
Include impact
assessment on
vegetation (e.g.,
and specific management
measures (e.g.,
protection, balling,
transplanting,
replacement, etc.)
Flood simulation/
modeling, consider
extreme weather
climate projections
8

Baseline
Impact
Mgmt. Plan
Monitoring
Remarks
Conditions
Analysis
Plan
Page
Page
Page
Page


Requirements
List of Key Impacts
Required Assessment
Assessment should
include potential
occurrence or
nearby areas.
water depth
2.1.3
Depletion
of
water
use
2.2 Oceanography
2.2.1
Change/disruption
circulation pattern
in
2.3 Water Quality

groundwater quality

water quality

areas
Bathymetric map
water :
pH
BOD5
COD
DO
Oil and grease
TSS
Heavy Metals:
____________________

when applicable
Use DENR standard
for sampling and
analysis.
Groundwater
contamination modeling
should consider worst
control measures, such
as leachate control,
geotextile lining

Others:
__________________________
9

Baseline
Impact
Mgmt. Plan
Monitoring
Remarks
Conditions
Analysis
Plan
Page
Page
Page
Page

List of Key Impacts

Requirements
Required Assessment
sampling site map

species and habitat
conservation status
species
species
overall impact to
freshwater ecology
sampling site map

2.5 Marine Ecology
and habitat
ecologically
and
economically
important
species
(mangroves,
reefs,
algae,
seaweeds,
sea
grasses);
species;
Marine resource map

manta tow, marine
resource
municipal and
data)
overall impact to
marine ecology
sampling site map

3. THE AIR


cyclones
methane, nitrous oxide, carbon
dioxide); Calculation of projected GHG
emission
In the assessment,
climate change
2050.
greenhouse gas
emissions (applicable for
10

Baseline
Impact
Mgmt. Plan
Monitoring
Remarks
Conditions
Analysis
Plan
Page
Page
Page
Page


Requirements
List of Key Impacts
Required Assessment
power and landfill and

possible for mining and
dam)
TSP
PM10
Use DENR standard

for sampling and
analysis.
SOx
NOx
Trace Metals
:____________________
others:______________________
Air Act)

level
sampling site map

sampling site map
4. THE PEOPLE
of properties
Change/conflict
ownership
in
land

- Number
of
households
and
household size
- Land area,
- Population,
Use DENR standard

for sampling and
measurement.
source capable of
more).
devaluation
11

Baseline
Impact
Mgmt. Plan
Monitoring
Remarks
Conditions
Analysis
Plan
Page
Page
Page
Page

List of Key Impacts

Requirements
Required Assessment
way
attainment,
Settlements map
4.2 In-migration
Proliferation
settlers
of
informal

(especially
on
Indigenous
Peoples, if any)

safety

Culture/Lifestyle
that
may
be
of:
Water supply
Power supply
Communications /transportation
and Private)
facilities
public services:
Literacy rate, profile of educational
attainment
(infants and adults - 5-year trend)
Sanitation Profile
Crime rate
Food security



result in resource
Discuss the project
in the area
may be affected by
climate change.
12

Baseline
Impact
Mgmt. Plan
Monitoring
Remarks
Conditions
Analysis
Plan
Page
Page
Page
Page

List of Key Impacts

Requirements
Required Assessment
4.6
Generation of Local
Enhancement of employment
and livelihood opportunities
Increased business opportunities
and associated economic
activities
Socioeconomic data:
Poverty incidence
and activities
Banking and financial
institutions
Traffic impact
load/count)
13

Baseline
Impact
Mgmt. Plan
Monitoring
Remarks
Conditions
Analysis
Plan
Page
Page
Page
Page

III.
Type of Risks
Scope of Assessment
Physical Risks
ERA REQUIREMENT
trigger which could be significant in
bringing about identified physical risks
Assessment
accident scenarios
- Assessment of whether the project
location is projected to have extreme
_____________________________
climate events for 2020 and/or 2050 that
could contribute to the triggering
EMERGENCY PLAN :
- Description of the hazards both
immediate (acute effects) and delayed
______________________________
(chronic effects) for man and the
environment posed by the failure of
criteria outline
structure, as applicable.
14

Monitoring
ERA
ERP
Plan
Page
Page
Page
Remarks

Noted By:
Signature
Signature
EMB Representatives
1.
1.
2.
2.
3.
3.
4.
Project Proponent:
5.
6.
Resource Person
1.
15
Annex 1 - H
ECC APPLICATION SCREENING FORM FOR THERMAL POWER PLANT PROJECTS

Project Title: _____________________________________________________________________________
Address: ________________________________________________________________________________
Contact No:
EIS Consultant: ___________________________________________________________________________
Address: ________________________________________________________________________________
Contact No:
Fax No:
Contact Person:__________________________

Acceptable?
Yes
No

Use Plan
communities
__ copies
rd
O.R. #
Date
NOTED BY:
___________________________
Screening Officer
_________________________
EMB Regional Office

Screening Office
Date:
_____________________________
1

Date



CONTENTS
Page #
Acceptable?
Page #
Acceptable?
REMARKS

Process Documentation of the conduct of EIA (1 page) (EIA Team,
EIA Study Schedule & Area, EIA Methodology, Public Participation)
Summary of Baseline Characterization, Key Environmental Impacts,
Management & Monitoring Plan, and EMF and EGF Commitments
Items to be
Described
1)Project Location
and Area
2)Project Rationale
3)Project
Alternatives

province, region boundaries, vicinity,
setting)
c) Rationale for selection primary & secondary
impact areas
site/area
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.
design,
process/technology
selection,
resource utilization, including discussion of
the consequences of not proceeding with
the project:
ground
shaking,
ground
rupture,
extreme climatologic conditions (data
can be obtained from NDRRMC and
NAMRIA as well as other mandated
agencies)
2
REMARKS

Items to be
Described
Page #

location)
preferred option;
issues, land classification, etc. Discuss
other options on the siting of major
components of the project within the project
area.
alternative
technologies,
operation
processes and engineering design.
Resources:
Discuss the alternatives
considered for power generation and how
the decisions were made. Discussion
should also be in the context of climate
change (e.g., use of non renewable vs.
renewable energy).
delineated
in
terms
of
technical,
commercial,
social
and
natural
environmental aspects.
4) Project
Components

capacity, number, etc.), including the
cooling water system
Identification of other Support Facilities
facilities, infrastructure requirements
sewerage, telecommunications,
3
Acceptable?
REMARKS

Items to be
Described
5) Process/
Technology
Page #
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.)
facilities (if any)
buffers.
Technology Description and Performance
Specifications
Include process flow-sheets for the operations
and the anticipated rates of inputs, wastes
and recycle streams
Waste Management Systems
(water/wastewater treatment facility,
electrostatic precipitators, baghouse filter,
desulfurizer, other air pollution control
devices, ash disposal, cooling system, etc.)
6) Project Size
Total power generating capacity, filter plant

capacity, and port capacity and dimension
hectares
7)Development
Plan, Description
of Project Phases
and
Corresponding
Timeframes
Phases to be described in terms identifying

specific activities (w/ special attention on
timeframes:
Pre-construction (e.g., planning,
acquisition of rights to use land, etc.)
4
Acceptable?
REMARKS

Items to be
Described
Page #
identified above) in terms of raw materials

and fuel requirements, infrastructure
requirements (transportroad/rail/ship,
power, water supply and storage, storm
water drainage, sewerage,
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.
8)Manpower

project components;
Remediation of contaminated soil and
water resources due to spills and leakage
of chemicals and other materials used in
the operation;
abandoned area;
Consistency with long-term zoning and
land use development plan of the
municipality;
Rehabilitation / Restoration plans, if any
9)Indicative Project Investment Cost (Philippine Peso)
Acceptable?
REMARKS

General Contents
Page #
II. Key
Environmental
Impacts and
Management/
Monitoring Plan
III. Environmental
Risk Assessment
IV. Impact
Management Plan

V. Social
Development Plan
(SDP) and IEC
Framework
SDP

change
adaptation
measures/options
Community
development
or
livelihood
partner
institutions,
timeframe
of
IEC
VI. Environmental
Compliance
Monitoring
Target
sector,
key
messages,
scheme/strategy/methods,
Information
template
DAO 2003-30).
Environmental Guarantee and Monitoring
Fund Commitments
(based on a draft AWFP in Annex 3-4
and consistent with guidelines in Annex
3-5 of RPM for DAO 2003-30); and
2003-30.
Acceptable?
REMARKS

General Contents
VII. Emergency
Preparedness and
Response Policy
and Generic
Guidelines
Page #
The safety policy and generic guidelines

should be consistent with the regulatory
requirements.
Emergency Preparedness
should also consider natural hazards to the
infrastructures and facilities.
Note:
The proponents final safety/
contingency/emergency guidelines (based on
safety assessment eg. HAZOP) must be
submitted to EMB prior to operation.
VIII. Abandonment/
Decommissioning/
Statement on proponents policies and

generic
procedures
for
Rehabilitation/
to
be

for EMP
Implementation

Acceptable?
REMARKS


List of Key Impacts

Requirements
Required Assessment
1. THE LAND
1.1.1 Change/Inconsistency in
land use
Areas (ECAs)

(include map/s).
1.1.3
Possible tenurial / land

issue
Assessment of the
proposed project in
and/or the coastal
resource management
plan of the LGU, if any.

CADC / CADT / CALT / CALC where
the project is located or near the
project area.
Specify other conflicting tenurial/land
issues (eg. ROW, informal settlers
etc.)
terrain/slope
1.2.2
Change in sub-surface/

Baseline
Impact
Mgmt. Plan
Monitoring
Conditions
Analysis
Plan
Remarks
Page
Page
Page
Page

List of Key Impacts

Requirements
Required Assessment

liquefaction,
landslides,
mud / debris flow, etc.
1.3 Pedology
topsoil/overburden
1.4
Terrestrial Ecology
loss of habitat

species
Geological Map as needed.; hazard

PHIVOLCS, PAG-ASA)

potential land
project operations. Relate
discussions to soil
characteristics.

survey report;
of pest
similar incidences
status

flora

access

and distribution
the project site
2. THE WATER
morphology /
Inducement of


and fauna
Include impact
assessment on
vegetation (e.g.,
and specific management
measures (e.g.,
protection, balling,
transplanting,
replacement, etc.)

9

Baseline
Impact
Mgmt. Plan
Monitoring
Conditions
Analysis
Plan
Remarks
Page
Page
Page
Page


Requirements
List of Key Impacts
Required Assessment

volumetric flow
extreme weather
climate projections.
Assessment should
include potential
occurrence or
nearby areas.

water depth
2.1.3
Depletion
of
water
use

water use (groundwater/surface water)
in the area and adjacent areas
For project with

significant water
requirement, conduct
analysis

2.2 Oceanography
2.2.1
Change/disruption
circulation pattern
in

Bathymetric map

when applicable
2.3 Water Quality

2.3.1Degradation of groundwater
quality
water:
Use DENR standard

10

Baseline
Impact
Mgmt. Plan
Monitoring
Conditions
Analysis
Plan
Remarks
Page
Page
Page
Page


Requirements
List of Key Impacts
Required Assessment

water quality
pH
BOD5
COD
DO
Oil and grease
TSS
Heavy
Metals:____________________
Others:
__________________________
for sampling and

analysis.
For project with
and /or significant marine/
coastal discharges,
conduct circulation /
plume modeling (include
worst case scenario of
failure of WWTF).
possible contamination
due to leaks/spills
sampling site map

Provide Aquifer
(Groundwater)
vulnerability Assessment
(i.e., discussions on
groundwater
project operation).
species and habitat
conservation status
species
(fishes, benthos, planktons)
species
Include discussions
onoverall impact to
freshwater ecology
sampling site map
11

Baseline
Impact
Mgmt. Plan
Monitoring
Conditions
Analysis
Plan
Remarks
Page
Page
Page
Page


Requirements
List of Key Impacts
Required Assessment
2.5 Marine Ecology

and habitat
ecologically
and
economically
important
species
(mangroves,
reefs,
algae,
seaweeds,
sea
grasses)
species
Marine resource map
sampling site map
3. THE AIR
3.1.1 Change in the local



manta tow, marine
resource
municipal and
data)
overall impact to
marine ecology

cyclones
In the assessment,
climate change
2050.

carbon dioxide, nitrous oxide);
Calculation of projected GHG emission

greenhouse gas
emissions
Use DENR standard

for sampling and
analysis.
TSP
PM10
SOx
12

Baseline
Impact
Mgmt. Plan
Monitoring
Conditions
Analysis
Plan
Remarks
Page
Page
Page
Page


Requirements
List of Key Impacts
Required Assessment
NOx
Trace Metals (for coal fired power
plant only) :_________________
Provide air dispersion

APCD)
others:
__________________________
Air Act)

level
sampling site map

sampling site map
Use DENR standard

for sampling and
measurement.
source capable of
more).
4. THE PEOPLE
of properties
ownership
way

- Number
of
households
and
household size
- Land area,
- Population,
attainment,

devaluation
13

Baseline
Impact
Mgmt. Plan
Monitoring
Conditions
Analysis
Plan
Remarks
Page
Page
Page
Page

List of Key Impacts

Requirements
Required Assessment
4.2 In-migration
Proliferation
settlers
Settlements map
of
informal

(especially
on
Indigenous
Peoples, if any)

safety

Culture/Lifestyle
that
may
be
of:
Water supply
Power supply
Communications /transportation
and Private)
facilities
public services:
Literacy rate, profile of educational
attainment
(infants and adults - 5-year trend)
Environmental
Health
and
Sanitation Profile
Crime rate
Food security



result in resource
Discuss the project

in the area
may be affected by
climate change.
14

Baseline
Impact
Mgmt. Plan
Monitoring
Conditions
Analysis
Plan
Remarks
Page
Page
Page
Page

List of Key Impacts

Requirements
Required Assessment

from the project
Enhancement of employment
and livelihood opportunities
Increased business opportunities
and associated economic
activities
Socioeconomic data:
Poverty Incidence
Commercial establishments and
activities
Banking and financial institutions

Traffic impact
load/count)
15

Baseline
Impact
Mgmt. Plan
Monitoring
Conditions
Analysis
Plan
Remarks
Page
Page
Page
Page

III.

Type of Risks
Scope of Assessment
Safety Risks
Fire
Explosion
Release of toxic
substances
Physical Risks

accident scenarios
release of toxic substance (include unloading
of raw materials/fuel), as applicable
accident scenarios
failure of structure, as applicable.
ERA REQUIREMENT
Quantitative Risk
Assessment(QRA) - Report for
submission prior to operation
________________________
Assessment
__________________________
EMERGENCY PLAN :
________________________
criteria outline
16

Monitoring
Plan
ERA
Page
ERP
Page
Page
Remarks

Noted By:
Signature
Signature
EMB Representatives
1.
1.
2.
2.
3.
3.
4.
Project Proponent:
5.
6.
Resource Person
1.
17
Annex 2 - A
INITIAL ENVIRONMENTAL EXAMINATION (IEE) CHECKLIST REPORT FORM
for
BATCHING AND CRUSHING PLANT PROJECTS
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:
Proof of Compatibility with the existing Land Use Plan
Accountability Statements of Proponent (see attached form) and the Preparer (if any,
following Annexes 2-22 of Revised Procedural Manual for DAO 2003-30)
Photographs or plates/vicinity map of the project site showing impact areas and affected areas
and communities
Duly Accomplished Project Environmental Monitoring & Audit Prioritization Scheme (PEMAPS)
Questionnaire (see Annex 2-7d of Revised Procedural Manual for DAO 2003-30)
(No other documents shall be required as pre-requisite to ECC applications per DENR MC 2010-14.)
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.
consultants/facilitators/preparers to accomplish/fill-up the IEE Checklist Report
Form. The Report Forms have been designed to be user-friendly.
Furthermore, the EMB Regional Office is required to complete the processing of
days upon receipt of duly-accomplished forms with complete attachments.
Misleading or erroneous answers are grounds for legal action and/or denial of ECC
issuance.
OK FOR PRINTING:
________________________________________
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Batching & Crushing Plant Projects
PROJECT FACT SHEET

Name of the Project
Proponent Name
Proponent Address
Proponent Means of
Contact
I.
Name:
Designation:
Landline No.
Fax No.
Mobile No.
Email:
PROJECT DESCRIPTION
Please check project type and indicate size
Project Type
Project Size
Batching & Crushing Plant
Project Size
Parameter
annual production
rate
Other Description Details:

________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
I.1 PROJECT LOCATION AND AREA:

Street/Sitio/Barangay
Zone/Classification (i.e., industrial, residential)
City/Municipality
Province
Total Project Land Area
Total Building Footprint Area
Region
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).
Longitude
Latitude
Perimeter/Boundary points (based
on OCT/TCT/etc.)
I.2 PROJECT COMPONENTS

Facilities
1. Raw material storage facility
(e.g., aggregate, cement, etc.
2. Fuel storage facility
3. Product storage facility/
warehouse/stockpile
4. Processing facility (e.g.,
crushing, mixing, screening, etc.
(please enumerate; use
separate sheet, if necessary
5. Support facilities (e.g., conveyor

belt, generators, admin building,
workers quarter, etc.)
(please enumerate; use
separate sheet, if necessary)
6. Water source/supply
7. Waste water management
facility
8.
Solid waste management facility
9.
Drainage system
10. Others, specify

__________________
__________________
Use additional sheets, if necessary
No. of
Units
Area (sq/M)/
Capacity
Specifications/Description/
Remarks
I.3 UTILITIES/REQUIREMENTS (Operation Phase):

Utilities
Source
Estimated Demand/Consumption
Power/Electricity (Total)
KWh
Power/Electricity
(From Renewable Energy Sources)
KWh
Water (Total)
(Fill-up table below if water is not obtained from
m3/day
the local water utility)
m3/day
Water
(Rainwater Collection System)
Water Source
ground water
well
surface water
river
spring
lake
others: ____________________________
others: ____________________________
Location of water source

____________________________________________________________________
(Sitio/Zone, Barangay, Municipality/City, Province, Region)
Energy/Water Efficiency
Utilities
Proposed Efficiency/Conservation
Measures
Estimated Savings
Power/Electricity
Water
KWh
m /day
I.4 MANPOWER
a. Construction Phase
Manpower Requirement
Expertise/Skills
Total
b. Operation Phase
Expertise/Skills
Total
I.5 INDICATIVE PROJECT COST
Project Cost (PhP): ______________________
6
II. ENVIRONMENTAL IMPACT AND MANAGEMENT PLAN
Possible
Preventive/ Mitigating Measures
Environmental/ Social Baseline Environment
Impacts
Monitoring Parameters/
Implementation
Cost of Mitigation/
Monitoring
LAND
Consistency with
land use
Current land use w/in 1km

radius (as per zoning
ordinance):
See attached proof of compatibility

with land use
Residential
Commercial/ Institutional
Industrial
Agricultural/ Recreational
Protected Areas
Others, specify
______________
Actual land uses w/in 1km

radius:
Disturbance to
wildlife due to
vegetation clearing
Residential
Industrial
Protected Areas
Others, specify
______________
Existing vegetation in the area:
Forestland
Marshland
Grassland
Mangrove
Wetland
Comply with conditions of

DENR/LGU SLUP, Tree Cutting
Permit, ROW, PCA Permit
Limit land clearing as much as
possible
Provide temporary fencing for
vegetation that will be retained
Promote restoration of damaged or
Annual inspection of
area replanted/ revegetated
Cost integrated in the

construction /operation
cost
7
Possible
Environmental/ Social
Impacts
Baseline Environment
Change in surface
landform/
topography/
terrain/slope
Soil Erosion
flat (0-3%)
gently sloping to rolling (318%)
steep (>18%)
Is the project site located in an

area identified by MGB/PAGASA/ PHIVOLCS as hazard
prone?
Soil/Land
contamination due
to improper solid
waste disposal
Yes
No
Existing soil type in the area:
sandy
clay
sandy-loam
Others, specify
____________________
Implementation
Cost of Mitigation/
Monitoring
destroyed vegetation where possible

(e.g., tree planting)
Others, specify
____________
Slope:
Provide erosion control and slope

protection measures
Designate a Spoils Storage Area,
with topsoil set aside for later use
and allow maximum re-use of spoils
Construct during dry season

Stabilize embankment with grasses
or other soil cover
Others, specify
____________
Regular inspection of
slope protection
measures in erosionprone areas
Slope/ Erosion Control

Cost: ___________
Others, specify
_________________
Regular inspection for

new eroded areas near
the site
Others, specify
_________________
Comply with DENR Administrative

Order No. 2003-30 and DENR
Administrative Order No. 2000-28,
Implementing Guidelines on
Engineering Geological and Geohazard Assessment (EGGA).
Implement Ecological Solid Waste
Management Plan (ESWMP)
Set up temporary fence around the
construction area
Implement re-use and recycling of
waste materials
Implement proper segregation,
collection and disposal of domestic
wastes in designated areas
Implement proper collection,
labeling and storage of hazardous
waste
Provide receptacles / bins for solid
wastes
Coordinate with the municipal / city
Daily inspection of
waste/recycling bins for
segregation
Daily inspection for
presence of mixed
garbage in the facility
Weekly inspection of
waste accumulated
Others, specify
_________________

cost
8
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
waste collectors
Impairment of
visual aesthetics
Devaluation of land
values
Presence of visually significant

landforms/
landscape/structures?
Yes
No
Engage third party company for

waste collection
Others, specify
________________
Implement landscaping and other
beautification measures
Provide adequate buffer
Compensate adjacent property
owners
Others, specify
________________
landscaping and other
beautification activities

construction/ operation
cost
Regular monitoring of
buffer zones
Regular monitoring for
presence/absence of
complaints from adjacent
property owners
WATER
Increased siltation
due to project
activities
Water quality
degradation
Others, specify
_____________
Specify nearest/receiving
water body:
_____________________
Distance to nearest/receiving
water body:
0 to less than 0.5 km

0.5 to 1 km
More than 1 km
If nearest/receiving water body

is fresh water, specify
classification:
AA
A
B
C
D
Provide ring canals around fuelling

tanks/ motor pool/ maintenance
areas
Set up proper and adequate sanitary
facilities
Strictly require the contractor and its
workers to observe proper waste
disposal and proper sanitation
Strictly observe proper waste
handling and disposal
Provide wastewater treatment
facility (e.g., septic tank, oil and
water separator, etc.)
Set up silt trap/settling ponds to
minimize downstream siltation
Others, specify
______________
Regular (ocular) inspection

of water body for:
Turbidity and/or silted

condition
Floating wastes or debris

cost
9
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring

is coastal or marine water,
specify classification:
SA
SB
SC
SD
Current Water Use:
Competition in
water use
Depletion of water
resources
Fishery
Tourist Zone / Park
Recreational
Industrial
Agricultural
Size of population using
receiving surface water:
1,000 persons
>1,000 and 5,000

persons
>5,000 persons
Implement rainwater harvesting and

similar measures as an alternative
source of water
Observe water conservation
measures
Others, specify
_________________
Available/nearest water
source.
Deepwell
Water district/LGU
Surface water
Others, specify
________________

presence/absence of
complaints
Regular coordination
with concerned agencies
occurrences of water
shortages
Others, specify
_______________

cost
10
10
Possible
Impacts
Increased
occurrence of
flooding
Implementation
Cost of Mitigation/
Monitoring

area identified by MGB/
PAG-ASA as flood prone?
Yes
No
Use appropriate design for project

facilities
Implement appropriate drainage
system
Limit the depth and area of

workspace
Regularly remove debris and other

materials that may obstruct water
flow
Use appropriate technology (e.g.,

raised hand-pumps) to protect
drinking water from flood
contamination

presence/absence of
complaints
increased frequency of
flooding

cost
Others, specify
__________________
Others, specify____________
AIR/NOISE
Air quality degradation
Distance to nearest
community:
0.5 to 1 km
More than 1 km
Properly operate and maintain all

emission sources (e.g., vehicles,
generator, etc.)
Install, when applicable, the
appropriate air pollution control
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
__________________

presence/absence of
complaints

of:
Absence of white or
black smoke from
vehicles, generator,
etc.
Presence of truck
cover during
deliveries
Quarterly monitoring of
ambient air for the following:
TSP
PM10
NOx

cost
11
11
Possible
Impacts
Nuisance due to
noise generation
Distance to nearest
community:
0.5 to 1 km
More than 1 km

noise sources (e.g., vehicles,
generator, etc.)
appropriate noise control device/s
(e.g., mufflers, silencer, sound
barriers, etc.)
Implementation
Cost of Mitigation/
Monitoring
SOx
CO / CO2
presence/absence of
complaints

cost
buffer zones
noise level
Implement appropriate operating

hours
(e.g., Perimeter planting of trees to
serve as sound buffer and greenbelt)
Others, specify
_________________
PEOPLE
Displacement of
residents in the
project site and
within its vicinity
Displacement of
Indigenous Peoples
Enhanced
employment and/or
livelihood
opportunities
Reduced
employment and/or
livelihood
opportunities
Increased revenues
for LGU
Disruption/
Competition in
Size of population of host

barangay:
1,000 persons
>1,000 and 5,000
persons
>5,000 persons
Classification of host
barangay:
Urban
Rural
Available services within/near

the host barangay:
Schools (e.g.
elementary, high
Provide relocation/disturbance
compensation packages
Prioritize local residents for
employment
Promptly pay local taxes and other
financial obligations
Regular coordination with LGU
Conduct prior consultation and
coordination to minimize disruption of
daily domestic activities and to
ensure respect for IP rights and
cultural practices
Ensure participation of IPs in
consultations and dialogues
Provide appropriate traffic/warning
signs, lighting, etc.

presence/absence of
complaints
with LGU
Others, specify
______________

cost
12
12
Possible
Impacts
delivery of public
services (e.g.,
education, peace
and order, etc.)
Enhanced delivery
of public services
(e.g., education,
peace and order,
etc.)
Increase in traffic
volume and
worsening of traffic
flow
Impacts on
community health
and safety
Others, specify
_______________
school, college)
Health facilities (e.g.,

clinics, hospitals, etc.)
Implementation
Cost of Mitigation/
Monitoring
Others, specify
_________________
Peace and order (e.g.,

police outpost, Brgy.
Tanod, etc.)
Recreation and sports
facilities
Others, specify
________________
Regularly coordinate with LGU
Provide appropriate warning signs,

lighting and barricades, whenever
practicable
Observe proper housekeeping
Provide on-site medical services for

any emergency.
Participate in public awareness
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
___________________________

presence/absence of
complaints
with LGU
Regular submission of
reports to concerned
agency
Others, specify
____________________

cost
13
III. ABANDONMENT / DECOMMISSIONING / REHABILITATION POLICIES AND GENERIC
GUIDELINES (if Applicable)
Project Life or Service: ___________ years

Provide description of the Abandonment activities, such as dismantling and waste disposal.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
IV. INSTITUTIONAL PLAN FOR EMP IMPLEMENTATION
Organization Chart:
4.1. Abandonment Plan (if Applicable)

(same with III)
13
14
Attach drawing/plan of waste water treatment facility (with dimensions and descriptions)
14
15
Process
flow
15
16
Attach drawing/plan of pollution source and control installations (with dimensions and descriptions)
16
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.
By the authority vested in me by the
(Company Name)____________
as ___(Position/Designation)
, I hereby commit to ensure implementation of all
commitments, mitigating measures and monitoring requirements indicated in this IEE Checklist
Report as well as the following:
. Conform to pertinent provisions of applicable environmental laws e.g., R.A.
No. 6969 (Toxic Substances and Hazardous and Nuclear Wastes Control Act
of 1990), R.A. No. 9003 (Ecological Solid Waste Management Act of 2000),
R.A. No. 9275 (Philippine Clean Water Act of 2004), and R.A. No. 8749
(Philippine Clean Air Act of 1999).
Abide and conform to LGU development plan and guidelines.
Promptly pay local taxes and other financial obligations.
Regularly submit reports to concerned agencies.
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.
In witness whereof, I hereby set my hand this ____ day of ___________________ at
_______________________________.
____________________________________
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
__________________________.
Doc No. ___________________________

Page No. __________________________
Book No. __________________________
Series of __________________________
17
Annex 2 - B
for
FISHERY / AQUACULTURE PROJECTS
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:
Photographs or plates/vicinity map of the project site showing impact areas and affected
areas and communities
Duly Accomplished Project Environmental Monitoring & Audit Prioritization Scheme
(PEMAPS) Questionnaire (see Annex 2-7d of Revised Procedural Manual for DAO 2003-30)
Misleading or erroneous answers are grounds for legal actions and/or denial of ECC
issuance.
OK FOR PRINTING:
________________________________________
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Fishery/Aquaculture Projects
PROJECT FACT SHEET

Name of the
Project
Proponent Name
Proponent
Address
I.
Contact Person
Name:
Designation:
Proponent Means
of Contact
Landline No.
Fax No.
Mobile No.
Email Address:
PROJECT DESCRIPTION
Project Type
Project Size
Inland Based Fishery/Aquaculture Projects

Coastal Area Based Fishery/Aquaculture Projects
Project Size
Parameter
Hectares
Hectares

_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
II.

Zone/Classification (i.e. industrial, residential)
City/Municipality
Province
Total Project/Building Footprint Area
Region
Longitude
Latitude
on OCT/TCT/etc)

Facilities
1. Fish cages/pens/ponds
2. Hatchery / Nursery
3. Support Facilities (e.g. feeders,

aerators, generators, etc.)
4. Storage facility
5. Postharvest facility
6. Solid waste management facility
7.
Others, specify
__________________
__________________
No. of
Units
Area (sq/M)/
Capacity
Remarks

Utilities
Source
KWh
Power/Electricity
KWh

3
Water (Total)
m /day
(Fill-up table below if water is not

obtained from the local water utility)
m3/day
Water
Water Source
ground water
well
surface water
river
spring
lake
others: ____________________________
others: ____________________________

____________________________________________________________________
Utilities
Power/Electricity
Water
Estimated
Savings
Proposed Efficiency/Conservation Measures
KWh
m3/day
I.4 MANPOWER
Manpower
Requirement
Expertise/Skills
Total
b. Operation Phase
Manpower
Requirement
Expertise/Skills
Total

Project Cost (PhP): ______________________
II.
ENVIRONMENTAL IMPACT AND MANAGEMENT PLAN
Possible
Impacts
Preventive/ Mitigating
Measures
Implementation
Cost of Mitigation/
Monitoring
LAND
Consistency with
land use
Current land use w/in 1km radius (as

per zoning ordinance):
See attached proof of

compatibility with land use
Residential
Industrial
Protected Areas
Others, specify
____________________
Actual land uses w/in 1km radius:
Disturbance to
wildlife due to
vegetation clearing
Residential
Industrial
Protected Areas
Others, specify
____________________
Forestland
Marshland
Grassland
Mangrove
Wetland
Others, specify
_____________________

DENR/LGU SLUP, Tree
Cutting Permit, ROW, PCA
Permit
Limit land clearing as much
as possible
Provide temporary fencing
for vegetation that will be
retained
Promote restoration of
damaged or destroyed
vegetation where possible
area replanted/
re-vegetated

cost
Possible
Impacts
Change in surface
landform/
topography/
terrain/slope
Soil Erosion
Slope:
Preventive/ Mitigating
Measures
Implementation
Cost of Mitigation/
Monitoring
flat (0-3%)
gently sloping to rolling (3-18%)
steep (>18%)
Is the project site located in an area

identified by MGB/PAG-ASA/
PHIVOLCS as hazard prone?
Impairment of visual
aesthetics
Devaluation of land
values
Yes
No

landforms/landscape/structures?
Yes
No
Provide erosion control

and slope protection
measures
Designate a Spoils Storage
Area, with topsoil set aside
for later use and allow
maximum re-use of spoils
Construct during dry
season
slope protection

Cost: ___________
Others, specify
______________

the site
Others, specify
______________
Stabilize embankment with

grasses or other soil cover
Others, specify
____________
Comply with the DENR
Administrative Order No.
2003-30 and DENR
Administrative Order No.
2000-28, Implementing
Guidelines on Engineering
Geological and Geohazard Assessment
(EGGA).
Implement landscaping
and other beautification
measures
Compensate adjacent
property owners
Others, specify
________________
buffer zones
presence/absence of
complaints from
adjacent property
owners

cost
WATER
Current Water Use:
Water quality
degradation
Others, specify
____________
Fishery
Tourist Zone / Park
Recreational
Set up proper and

adequate sanitary facilities
Strictly observe proper
waste handling and
disposal

of water body for:

cost
Drainage/canal system
Industrial
Agricultural
Distance of project area to the nearest

well used:

0.5 to 1 km
More than 1 km
Use of nearest well:
Increased
occurrence of
flooding
Drinking/Domestic
Industrial
Agricultural

identified by MGB/
PAG-ASA as
flood prone?
Yes
No
Use appropriate design for

project facilities
Implement appropriate
drainage system
Regularly remove debris

and other materials that
may obstruct water flow
Use appropriate
technology (e.g., raised
hand-pumps) to protect
contamination
Others, specify
__________________

presence/absence of
complaints
with concerned
agencies
flooding
Others, specify
_________________

cost
PEOPLE
Displacement of
residents in the
project site and
within its vicinity
Displacement of
Indigenous Peoples
Enhanced
employment and/or
livelihood
opportunities
Reduced
employment and/or
livelihood
opportunities
Increased revenues
for LGU
Disruption/
Competition in
delivery of public
services (e.g.,
education, peace
and order, etc.)
Enhanced delivery of
public services (e.g.,
education, peace
and order, etc.)
Increase in traffic
volume and
flow
Depletion of local
fish populations by
stocking of wild
fry/fingerlings in
ponds
Size of population of host barangay:
1,000 persons
>1,000 and 5,000 persons
>5,000 persons
Classification of host barangay:
Urban
Rural
Available services within/near the host

barangay:
Schools (e.g. elementary, high

school, college)
Health facilities (e.g., clinics,
hospitals, etc.)
Peace and order (e.g., police
outpost, Brgy. Tanod, etc.)
Recreation and sports facilities
Others, specify
___________________
Provide
relocation/disturbance
employment
Promptly pay local taxes
and other financial
obligations
Regular coordination with
LGU
Prior consultation and
coordination to minimize
disruption on daily
domestic activities & to
ensure respect for IP
rights and cultural practices
Ensure participation of IPs
in consultations and
dialogues
Provide appropriate
traffic/warning signs,
lighting, etc
Others, specify
_________________
Presence/Absence of
complaints
with LGU
Others, specify
_________________

cost
Initial Environmental Examination (IEE) Checklist Report Form for Fishery/Aquaculture Projects1010


____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
10
11

_______________________________.
____________________________________
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
__________________________.
Doc No. ___________________________

Page No. __________________________
Book No. __________________________
Series of __________________________
12
Annex 2 - C
for
FOOD, FOOD BY-PRODUCT AND BEVERAGES MANUFACTURING/PROCESSING PLANT PROJECTS
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.
(PEMAPS) Questionnaire (see Annex 2-7d of Revised Procedural Manual for DAO 200330)
consultants/facilitators/preparers to accomplish/fill-up the IEE Checklist
Report Form. The Report Forms have been designed to be user-friendly.
Furthermore, the EMB Regional Office is required to complete the processing
of an ECC application using the IEE Checklist Report within twenty (20)
working days upon receipt of completed/duly-accomplished form.
Misleading or erroneous answers are grounds for legal action and/or denial of ECC issuance.
OK FOR PRINTING:
________________________________________
___________________________
Date
IEE Checklist Report Form for Food & Food By-product & Beverages Manufacturing/Processing Plant Projects2
PROJECT FACT SHEET

Name of the
Project
Proponent Name
Proponent
Address
I.
Contact Person
Name:
Designation:
Proponent Means
of Contact
Landline No.
Fax No.
Mobile No.
Email Address:
PROJECT DESCRIPTION
Project Type
Animal products processing (fish/meat processing,

canning, slaughterhouses, etc.)
Coconut processing plants (including production of
coconut based products)
Distillation and Fermentation Plants ( e.g., bio-ethanol
project)
Fruit and vegetable processing
Other types of food (and other food by-products,
additives, etc.) processing industries
Actual
Project Size
Project Size
Parameter
Thresholds for
IEE Checklist
Daily
production rate
Monthly
production rate
Annual
production rate
Daily
production rate
Annual
production rate
of finished
product
500 kg but <

10,000 kg
< 25,000 MT
< 50,
00 MT
< 500 kg
< 50,000 MT
Processing of dairy products
Monthly
production rate
< 10,000 L
(liquid) or
< 100,000 kg
(solid)
Sugar Mills
Annual
production rate
< 50,000 MT

_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
II.

City/Municipality
Province
Region
Longitude
Latitude
on OCT/TCT/etc)
I.2 PROJECT COMPONENTS (Put NA if Not Applicable)

Facilities
1. Material storage facility
Raw materials (e.g., coconut,
sugarcane, meat, milk, etc.)
Chemical/process materials
(e.g., additives, acids, etc.)
Fuel, lubricants and similar
materials
Finished product (e.g.,
warehouse, freezer, 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
No. of
Units
Area (sq/M)/
Capacity
Remarks
Facilities
No. of
Units
Area (sq/M)/
Capacity
Remarks
Finishing (e.g., freezing, filling,

packaging, etc.)
Others, specify
______________
3. Support Facilities (e.g.,
emergency generators, boilers,
steam generators, etc.)
4. Admin support (e.g., canteen,
office, clinic, quarters, etc.)
5. Water source / supply
facility
8. Drainage system
9.
Others, specify
_____________________
___________________

Utilities
Source
KWh
Power/Electricity
KWh

Water (Total)
m3/day

Water
m /day
Water Source
ground water
well
surface water
river
spring
lake
others: ____________________________
others: ____________________________

____________________________________________________________________
Utilities
Power/Electricity
Water
Estimated Savings
KWh
m3/day
I.4 MANPOWER
Manpower
Requirement
Expertise/Skills
Total
b. Operation Phase
Manpower
Requirement
Expertise/Skills

Project Cost (PhP): ______________________
Total
IEE Checklist Report for Food & Food By-product & Beverages Manufacturing/Processing Plant Projects77
III. ENVIRONMENTAL IMPACT AND MANAGEMENT PLAN

Possible
Impacts
LAND
Consistency with land

use
Current land use w/in 1km radius

(as per zoning ordinance):
Implementation
Cost of Mitigation/
Monitoring
See attached proof of

compatibility with land use
Residential
Industrial
Protected Areas
Others, specify
___________________
Disturbance to wildlife
due to vegetation
clearing
Residential
Industrial
Protected Areas
Others, specify
___________________
Forestland
Marshland
Grassland
Mangrove
Wetland
Others, specify
____________________

possible
Promote restoration of damaged
or destroyed vegetation where
possible (e.g., tree planting)
area replanted/
re-vegetated
Cost integrated in
the construction/
operation cost
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
Slope:
Change in surface
terrain/slope
Soil Erosion
flat (0-3%)
steep (>18%)

area identified by MGB/PAG-ASA/
Soil/Land
improper solid waste
disposal
Yes
No
sandy
clay
sandy-loam
Others, specify
____________

protection measures
and allow maximum re-use of
spoils
slope protection

new eroded areas
near the site
Slope/ Erosion
Control Cost:
___________
Others, specify
____________
Others, specify
___________
Others, specify
____________
Implement the Ecological Solid

Waste Management Plan
(ESWMP)
Set up temporary fence around
the construction area
waste materials
collection and disposal of
domestic wastes in designated
areas
Provide receptacles / bins for
solid wastes
Coordinate with the municipal /
city waste collectors
waste collection
Daily inspection of
waste/recycling bins
for segregation
presence of mixed
waste accumulated
Others, specify
_____________
Cost integrated in
the construction/
operation cost
Possible
Impacts
aesthetics

Devaluation of land
values
Yes
No
Implementation
Cost of Mitigation/
Monitoring
Others, specify
________________

owners
Others, specify
________________
Cost integrated in
the construction/
operation cost
buffer zones
Regularly monitor
presence/absence of
complaints from
adjacent property
owners
WATER
Increased siltation due

to project activities
Water quality
degradation
Others, specify
___________________
Specify nearest/receiving water

body:
____________________________
Distance to nearest/receiving water

body:

0.5 to 1 km
More than 1 km
If nearest/receiving water body is

fresh water, specify classification:
AA
A
B
C
D
Set up proper and adequate

sanitary facilities
Strictly require the contractor and
its workers to observe proper
waste disposal and proper
sanitation
Provision of wastewater treatment
Set up silt trap/stilling ponds to
Provision of three-chambered
septic tank for domestic sewage
Provide ring canals around
fuelling tanks/ motorpool/
maintenance areas
Others, specify
______________________
Regular (ocular)
inspection of:
Drainage / canal
systems
Water treatment
facility (i.e., grease
trap, septic tank, etc.)
Quarterly monitoring of the

following:
pH
TSS concentration
BOD
Total Coliform
Color
Oil and Grease
Cost integrated in
the construction/
operation cost
10
Possible
Impacts
coastal or marine water, specify
classification:
SA
SB
SC
SD
Current Water Use:
Fishery
Tourist Zone / Park
Recreational
Industrial
Agricultural
Distance of project area to the

nearest well used:

0.5 to 1 km
More than 1 km
Use of the nearest well:
Drinking/Domestic
Industrial
Agricultural
Implementation
Cost of Mitigation/
Monitoring
11
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
Competition in water
use
Size of population using receiving

surface water:
Depletion of water
resources
1,000 persons
>5,000 persons
Available/nearest water source.
Deepwell
Water district/LGU
Surface water
Implement rainwater harvesting

and similar measures as an
alternative source of water
measures;
Carefully select project site to

avoid disruption of traditional
water uses
Obtain Water Permit from NWRB
Improve efficiency of water

supply and distribution system

presence/absence of
complaints
with concerned
agencies
Regularly monitor
shortages
Cost integrated in
the construction/
operation cost
Others, specify
____________
Others, specify
_____________________
Others, specify
________________________
Increased occurrence
of flooding

area identified by MGB/PAG-ASA
as flood prone?
Yes
No

facilities

system
Regularly remove debris and

other materials that may obstruct
water flow

contamination
Others, specify
_____________________

presence/absence of
complaints
with concerned
agencies
flooding
Others, specify
_________________
Cost integrated in
the construction/
operation cost
12
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
Distance to nearest community:
AIR / NOISE

0.5 to 1 km
More than 1 km

emission sources (e.g. vehicles,
pumps, generator, etc)
Install when applicable, the
device/s

Nuisance due to noise

generation

0.5 to 1 km
More than 1 km

barriers, etc.)
hours
Provide adequate buffer and/or
NOx
SOx
Annual
Semi-annual
Regular (ocular)
inspection of:
Other, specify
___________________

noise sources (e.g. vehicles,
TSP
Frequency

residents
Cost integrated in
the construction/
operation cost
the following:
Strictly enforce good

housekeeping practices


presence/absence of
complaints
Absence of white
or black smoke
from vehicles,
heavy equipment
and generator
Presence of truck
cover during
deliveries

presence/absence of
complaints
buffer zones
Cost integrated in
the construction/
operation cost
13
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
planting of trees
Others, specify
______________________
PEOPLE
Displacement of
residents in the project
site and within its
vicinity
Displacement of
Indigenous People
Enhanced
employment and/or
livelihood
opportunities
Reduced employment
and/or livelihood
opportunities
Increased revenues
for LGU
Disruption/Competition
in delivery of public
services (e.g.,
education, peace and
order, etc.)
order, etc.)
Increase in traffic
volume and worsening
of traffic flow

barangay:
1,000 persons
>5,000 persons
Urban
Rural
Available services within/near the

host barangay:
Schools (e.g., elementary, high

school, college)
hospitals, etc.)
Others, specify
_____________________
employment
Promptly pay local taxes and
other financial obligations
Conduct prior consultation &
coordination to minimize
disruption on daily domestic
activities and to ensure respect for
IP rights and cultural practices
signs, lighting, etc
Others, specify
________________

presence/absence of
complaints
with LGU
Others, specify
_________________
Cost integrated in
the construction/
operation cost
14
Possible
Impacts
Source of risks
Impacts on community
health and safety
Safety Risks
Fire
Flammable substances
Others
_________________________

Strictly comply with fire, safety
and similar regulatory
requirements
Others, specify
___________________________
Implementation
Cost of Mitigation/
Monitoring

presence/absence of
complaints
buffer zones
with LGU
agency
Others, specify
_________________
Cost integrated in
the construction/
operation cost
III. ABANDONMENT /DECOMMISSIONING/REHABILITATION POLICIES AND GENERIC


____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
15
16
Process Flow
17
18

_______________________________.
____________________________________
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
__________________________.
Doc No. ___________________________
Page No. __________________________
Book No. __________________________
Series of __________________________
19
11
1
Annex 2 - D
for
NON-FOOD (Textile, Rubber, Chemical) MANUFACTURING PLANT PROJECTS
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.
and communities
(No other documents shall be required as pre-requisite to ECC applications per DENR MC 2010-14)
issuance.
OK FOR PRINTING:
________________________________________
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Non-Food Manufacturing Plant Projects
PROJECT FACT SHEET

Name of the Project
Proponent Name
Proponent Address
Proponent Means of
Contact
I.
Name:
Landline No.
Designation:
Fax No.
Mobile No.
Email:
PROJECT DESCRIPTION
Project Type
Project Size
Project Size
Parameter
Manufacture of Other Products

Glass-based products
Metal-based products (including semi-conductor / electronic
industries)
Paper and plastic-based products
Chemical Industries
Manufacturing, processing and/or use of substances included in the
Priority Chemical List
Manufacture of agri-chemicals and other industrial chemicals not in
the PCL
Pharmaceutical industries and manufacture of soap and detergents,
health and beauty products, and other consumer products.
Surface coating industries (paints, pigments, varnishes, lacquers, anticapacity fouling coating, printing inks)
Leather and related industries
annual production rate

quantity of toxic
chemicals to be used
per month

Daily processing rate of
raw hides
Mineral Ore Processing

Metallic Mineral or Ore Processing (e.g., copper, lead, nickel, cobalt,
zinc, silver, magnesium, and manganese, gold, placer with metal
content) with Physical or Mechanical Processing
Annual processing rate

(inputs)

________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________

City/Municipality
Province
Region
Longitude
Latitude

on OCT/TCT/etc.)

Facilities
1.
Material storage facility

Raw, chemical and process
materials
Fuel, lubricants and similar materials
Finished product (e.g. equipment
facilities, silo, hopper, etc.)
Others, specify
________________
2.
Processing facility
Material preparation and handling
(e.g., screening, sorting, conveyor
belt, etc.)
Material size
Heating/Drying (direct heat/energy
application)
Processing (e.g., mixing, blending,
refining, milling, etc.)
Finishing (e.g., sorting, filling,
packaging, etc.)
Others, specify
________________
3.
4.
Support Facilities (e.g. emergency

generators, boilers, steam
generators, etc.)
Admin support (e.g., canteen, office,
clinic, quarters, etc.)
No. of
Units
Area (sq/M)/
Capacity
Remarks
Facilities
No. of
Units
5.
Water source / supply
6.
Waste water management facility
7.
Solid waste management facility
8.
Drainage system
9.
Area (sq/M)/
Capacity
Remarks
Others, specify
_____________________
_____________________

Utilities
Source
KWh
Power/Electricity
KWh
Water (Total)
m3/day
Water
m3/day
Water Source
ground water
well
surface water
river
spring
lake
others: ____________________________
others: ____________________________

____________________________________________________________________
Utilities
Measures
Estimated Savings
Power/Electricity
Water
KWh
m /day
I.4 MANPOWER
Expertise/Skills
Total
b. Operation Phase
Expertise/Skills
Total
Project Cost (PhP): ______________________

Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
LAND
Consistency with
land use

ordinance):

with land use
Residential
Industrial
Protected Areas
Others, specify
______________

radius:
Disturbance to
wildlife due to
vegetation clearing
Residential
Industrial
Protected Areas
Others, specify
______________
Forestland
Marshland
Grassland
Mangrove
Wetland
Others, specify
_______________

possible
area replanted/
re-vegetated

cost
Possible
Impacts
Change in surface
landform/
topography/
terrain/slope
Soil Erosion
Implementation
Cost of Mitigation/
Monitoring
Slope:
flat (0-3%)
steep (>18%)

protection measures

or other soil cover
Others, specify
____________
prone?
Soil/Land
contamination due
to improper solid
waste disposal

Cost: ___________
Others, specify
__________________

the site
Others, specify
_________________

Yes
No
slope protection
sandy
clay
sandy-loam
Others, specify
____________________

Waste Management Plan (ESWMP)
construction area
waste materials
Implement proper collection and
processing of animal waste into
organic fertilizer
waste
wastes
Daily inspection of
segregation
presence of mixed
waste accumulated
Others, specify
_______________

cost
Possible
Impacts
Impairment of
visual
aesthetics
Devaluation of
land values

landforms/landscape/structure
s?
Yes
No
Implementation
Cost of Mitigation/
Monitoring

waste collectors
waste collection
Others, specify
________________
owners
Others, specify
________________

cost
buffer zones
presence/absence of
property owners
WATER
Increased siltation
due to project
activities
Water quality
degradation
Others, specify
_______________
water body:
________________________
water body:

0.5 to 1 km
More than 1 km

classification:
AA
A
B
C
D

areas
facilities
Others, specify
_________________

of water body for:
Turbidity and/or
silted condition
Floating wastes or
debris
Monthly monitoring of the

following:
pH
TSS concentration
BOD
Total Coliform
Color
Oil and Grease
Trace Metals (Pb,
Cd, Hg, Cr6, As)

cost
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring

SA
SB
SC
SD
Current Water Use:
Fishery
Tourist Zone / Park
Recreational
Industrial
Agricultural

nearest well used:

0.5 to 1 km
More than 1 km
Competition in
water use
Depletion of water
resources
Drinking/Domestic
Industrial
Agricultural

1,000 persons
>1,000 and 5,000

persons
>5,000 persons

source of water
measures
Carefully select project site to avoid
disruption of traditional water uses

presence/absence of
complaints
shortages

cost
10
Possible
Impacts
Implementation
source.
Increased
occurrence of
flooding
Deepwell
Others, specify
_____________
Others, specify
____________________
Surface water
Others, specify
________________

area identified by MGB/PAGASA as flood prone?
Water district/LGU
Improve efficiency of water supply

and distribution system
Cost of Mitigation/
Monitoring
Yes
No

facilities

system

flow

contamination

presence/absence of
complaints
flooding

cost
Others, specify
________________
Others, specify
____________________
AIR / NOISE
Distance to nearest
community:
0.5 to 1 km
More than 1 km

boiler, generator, etc)
device/s
practices

presence/absence of
complaints

cost
11
Possible
Impacts

residents
Implementation
Cost of Mitigation/
Monitoring

of:

Others, specify
___________________
Absence of white or
black smoke from
etc.
Presence of truck
cover during
deliveries
ambient air for the following:
Nuisance due to
noise generation
Distance to nearest
community:
0.5 to 1 km
More than 1 km

device/s
practices
Conduct water spraying to suppress
dust sources and minimize
discomfort to nearby residents
Others, specify
____________________
TSP
PM10
NOx
SOx
CO / CO2

presence/absence of
complaints

cost
12
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring

barangay:
PEOPLE
Displacement of
residents in the
project site and
within its vicinity
Displacement of
Indigenous Peoples
Enhanced
employment and/or
livelihood
opportunities
Reduced
employment and/or
livelihood
opportunities
Increased revenues
for LGU
Disruption/Competit
ion in delivery of
public services
(e.g., education,
peace and order,
etc.)
1,000 persons
>1,000 and
5,000persons
>5,000person
barangay:
Urban
Rural

the host barangay:
Enhanced delivery
of public services
(e.g., education,
peace and order,
etc.)
Increase in traffic
volume and
flow
Schools (e.g.,
elementary, high
school, college)
Tanod, etc.)
facilities
Others, specify
_________________
employment
coordination to minimize disruption
of daily domestic activities and to
cultural practices
Others, specify
_________________

presence/absence of
complaints
with LGU
Others, specify
_____________

cost
13
Possible
Impacts
Impacts on
community health
and safety
Others, specify
_____________
Implementation
Cost of Mitigation/
Monitoring

practicable

any emergency.
workers
RA 6969
Others, specify
__________________________

presence/absence of
complaints
with LGU
agency
Others, specify
__________________

cost
III. ABANDONMENT / DECOMMISSIONING/ REHABILITATION POLICIES AND GENERIC


Provide description of the Abandonment activities, such as, dismantling and waste disposal.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Organization Chart:
14
Process Flow
15
16
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.
. Conform to pertinent provisions of applicable environmental laws e.g., R.A. No.
6969 (Toxic Substances and Hazardous and Nuclear Wastes Control Act of
1990), R.A. No. 9003 (Ecological Solid Waste Management Act of 2000), R.A.
No. 9275 (Philippine Clean Water Act of 2004), and R.A. No. 8749 (Philippine
Clean Air Act of 1999).
_______________________________.
____________________________________
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
__________________________.
Doc No. ___________________________

Page No. __________________________
Book No. __________________________
Series of __________________________
18
Annex 2 - E
for
SUBDIVISIONS AND HOUSING PROJECTS
This IEE Checklist Report Form shall be used for proposed SUBDIVISIONS AND HOUSING
PROJECTS required an IEE Report / IEE Checklist for ECC Application.
and communities
issuance.
OK FOR PRINTING:
________________________________________
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Subdivision & Housing Projects
PROJECT FACT SHEET

Name of the Project
Proponent Name
Proponent Address
Proponent Means of
Contact
Name:
Designation:
Landline No.
Fax No.
Mobile No.
Email:
I. PROJECT DESCRIPTION
Please Check Project Type (indicate total land area below)

Low Cost Subdivision or Resettlement Housing
Economic & Socialized Housing
Open Market Housing
Other similar Horizontal Land Development
Total land area, including all common, open and other areas : ___________________ Hectares

_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

City/Municipality
Province
Region
Longitude
Latitude
on OCT/TCT/etc.)

Facilities
1. Residential lots
2. Commercial Area (e.g., banks,
restaurants, outlets, stores, etc.
3. Institutional Area (e.g.,
swimming pools, gym, chapel,
club house, etc.)
4. Open/Common Spaces (e.g.,
reception area, garden, parks,
etc.)
5. Road system
Primary/Main Road
Secondary Road
Alley
6. Common Parking Area
7. Water supply system
8. Drainage system
facility
10. Support facilities (e.g.,
emergency generators, guard
houses/posts, etc.)
facility
13. Others, specify
__________________
__________________
No. of
Units
Area (sq/M)/
Capacity
Remarks

Utilities
Source
KWh
Power/Electricity
KWh
Water (Total)
m3/day
Water
m3/day
Water Source
ground water
well
surface water
river
spring
lake
others: ____________________________
others: ____________________________

____________________________________________________________________
Utilities
Measures
Estimated Savings
Power/Electricity
Water
KWh
m /day
I.4 MANPOWER
Expertise/Skills
Total
b. Operation Phase
Expertise/Skills
Total
Project Cost (PhP): ______________________

Possible
Impacts

ordinance):
Implementation
Cost of Mitigation/
Monitoring
LAND
Consistency with
land use

with land use
Residential
Industrial
Protected Areas
Others, specify
______________

radius:
Disturbance to
wildlife due to
vegetation clearing
Residential
Industrial
Protected Areas
Others, specify
______________
Forestland
Marshland
Grassland

possible
area replanted/
re-vegetated

construction/operation
cost
Possible
Impacts
Change in surface
landform/
topography/
terrain/slope
Soil Erosion
Mangrove
Wetland
Others, specify
____________
Slope:
flat (0-3%)
steep (>18%)

PAG-ASA/ PHIVOLCS as
hazard prone?
Soil/Land
contamination due
to improper solid
waste disposal
Yes
No
sandy
clay
sandy-loam
Others, specify
_________________
Implementation
Cost of Mitigation/
Monitoring

protection measures

or other soil cover
slope protection

Cost: ___________
Others, specify
_____________

the site
Others, specify
______________
Others, specify
____________
construction area
waste materials
wastes
Daily inspection of
segregation
presence of mixed
waste accumulated
Others, specify
_______________

cost
Possible
Impacts
Impairment of
visual
aesthetics
Devaluation of
land values

s?
Yes
No
Implementation
Cost of Mitigation/
Monitoring

waste collectors
waste collection
Others, specify
________________
owners
Others, specify
________________

cost
buffer zones
presence/absence of
property owners
WATER
Increased siltation
due to project
activities
Specify nearest water body:

____________________
Water quality
degradation
Distance to nearest water

body:
Others, specify
____________

0.5 to 1 km
More than 1 km
If nearest water body is fresh

water, specify classification:
AA
A

facilities

of:


facility (e.g., oil and water separator,
etc.)
Provide three-chambered septic
tank for domestic sewage
Others, specify
___________
Drainage / canal
systems
Water treatment facility
(i.e., grease trap, septic
tank, etc.)

following:
pH
TSS concentration
BOD

cost
Possible
Impacts
B
C
D
If nearest water body is

coastal or marine water,
SA
SB
SC
SD
Current Water Use:
Fishery
Tourist Zone / Park
Recreational
Industrial
Agricultural

nearest well used:

0.5 to 1 km
More than 1 km
Drinking/Domestic
Industrial
Agricultural
Implementation
Total Coliform
Color
Oil and Grease
Cost of Mitigation/
Monitoring
10
Possible
Impacts
Competition in
water use
Depletion of water
resources
Implementation
Cost of Mitigation/
Monitoring

proposed water source:
source.
Increased
occurrence of
flooding
>1,000 and 5,000

persons
>5,000 persons
1,000 persons
Deepwell
Water district/LGU
Surface water
Others, specify
_____________

Yes
No

source of water
measures
Careful selection of project site to
avoid disruption of traditional water
uses

presence/absence of
complaints
shortages

cost
Others, specify
_______________
Others, specify
_____________________

facilities

system

flow

contamination

presence/absence of
complaints
flooding

cost
Others, specify
_________________
Others, specify
_________________________
AIR / NOISE
Distance to nearest
community:

0.5 to 1 km
More than 1 km

generator, etc)
practices

presence/absence of
complaints

cost
11
Possible
Impacts
Nuisance due to
noise generation
Distance to nearest
community:
0.5 to 1 km
More than 1 km

Implementation
of:

residents

Others, specify
_________________

generator, etc.)
barriers, etc.)
Cost of Mitigation/
Monitoring
Absence of white or
black smoke from
etc.
Presence of truck
cover during
deliveries

presence/absence of
complaints

cost
buffer zones

hours
planting of trees
Others, specify
_____________________
PEOPLE
Displacement of
residents in the
project site and
within its vicinity

barangay:
Displacement of
Indigenous Peoples
Enhanced
employment and/or
1,000 persons
>1,000 and
5,000persons
>5,000person
employment

presence/absence of
complaints
with LGU
Others, specify
_________________

cost
12
Possible
Impacts
livelihood
opportunities
Reduced
employment and/or
livelihood
opportunities
Increased revenues
for LGU
Disruption/
Competition in
delivery of public
services (e.g.,
education, peace
and order, etc.)
Enhanced delivery
of public services
(e.g., education,
peace and order,
etc.)
Increase in traffic
volume and
flow
Impacts on
community health
and safety
Others, specify
______________
barangay:
Urban
Rural

the host barangay:
Schools (e.g.,
elementary, high
school, college)
Implementation
Cost of Mitigation/
Monitoring

on daily domestic activities and to
cultural practices
Others, specify
_________________

Tanod, etc.)
facilities
Others, specify
__________________

practicable

workers
Others, specify
__________________

presence/absence of
complaints
with LGU
agency
Others, specify
_______________

cost
Initial Environmental Examination (IEE) Checklist Report Form for Subdivision & Housing Projects334
III. ABANDONMENT / DECOMMISSIONING / REHABILITATION POLICIES (if Applicable)

Provide description of the Abandonment activities
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
13
Attach drawing/plan of sewerage treatment facilities (with dimensions and descriptions)
14
_______________________________.
____________________________________
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
__________________________.
Doc No. ___________________________

Page No. __________________________
Book No. __________________________
Series of __________________________
15
1
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.
(PEMAPS) Questionnaire (see Annex 2-7d of Revised Procedural Manual for DAO 2003-30)
working days upon receipt of duly-accomplished forms with complete
attachments.
issuance.
OK FOR PRINTING:
________________________________________
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Building Projects
PROJECT FACT SHEET

Name of the
Project
Proponent Name
Proponent
Address
I.
Contact Person
Name:
Designation:
Proponent Means
of Contact
Landline No.
Fax No.
Mobile No.
Email Address:
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
Medical facilities and other related/similar Institutional facilities
Institutional Structures with laboratory facilities
Motels, Hotels, Condominium/ Apartelles (residential) with commercial space 10% or less of the
total floor area
Storage facilities, non-toxic/hazardous materials, substances or products (e.g., warehouses)
Land transport terminal (for buses, jeepneys and other modes of transportation)
Total gross floor area, including parking and other areas: _____________Hectares

_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

City/Municipality
Province
Region
Longitude
Latitude
on OCT/TCT/etc)

Facilities
1. Residential component (e.g.,

rooms, units, etc.)
2. Commercial component (e.g.,
banks, restaurants, outlets,
stores, 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.

7.
8.
9.
10.
reception area, garden parks,

etc.)
Parking area
Terminal/Passenger Area
Waste water management
facility
Solid waste management
facilities
No. of
Units
Area (sq/M)/
Capacity
Remarks
Facilities
No. of
Units
Area (sq/M)/
Capacity
Remarks
11. Drainage system

12. Others (please specify):
____________________
____________________
Comparative Matrix for Parking Lots

National Building
Code
Local Requirement
Project Provisions
Statutory Requirements
Calculations/Computations
(number of parking lots)
1.3 UTILITIES/REQUIREMENTS (Operation Phase):

Utilities
Source
KWh
Power/Electricity
KWh
Water (Total)
m3/day
Water
m3/day
Water Source
ground water
well
surface water
river
spring
lake
others: ____________________________
others: ____________________________

____________________________________________________________________
Utilities
Power/Electricity
Water
Estimated Savings
Measures
KWh
m3/day
I.4 MANPOWER
Manpower
Requirement
Expertise/Skills
Total
b. Operation Phase
Manpower
Requirement
Expertise/Skills
Project Cost (PhP): ______________________
Total

Possible
Impacts

ordinance):
Implementation
Cost of Mitigation/
Monitoring
LAND
Consistency with
land use

with land use
Residential
Industrial
Protected Areas
Others, specify
______________

radius:
Disturbance to
wildlife due to
vegetation clearing
Residential
Industrial
Protected Areas
Others, specify
______________
Forestland
Marshland
Grassland
Mangrove
Wetland
Others, specify
____________

possible

cost
Possible
Impacts
Change in surface
landform/
topography/
terrain/slope
Soil Erosion
Implementation
Cost of Mitigation/
Monitoring
Slope:
flat (0-3%)
steep (>18%)

prone?
Soil/Land
contamination due
to improper solid
waste disposal


or other soil cover
Others, specify____________
slope protection

Cost: ___________
Others, specify
_________________

the site
Others, specify
______________

Yes
No

protection measures
sandy
clay
sandy-loam
Others, specify
________________

construction area
waste materials
wastes
waste collectors
waste collection
Daily inspection of
segregation
presence of mixed
waste accumulated
Others, specify
_______________

cost
Possible
Impacts
Impairment of
visual aesthetics
Devaluation of land
values

s?
Yes
No
Implementation
Cost of Mitigation/
Monitoring
Others, specify
________________
owners
Others, specify
________________

cost
buffer zones
presence/absence of
property owners
WATER
Increased siltation
due to project
activities
Water quality
degradation
Others, specify
____________
water body:
____________________
water body:

0.5 to 1 km
More than 1 km

classification:
AA
A
B
C
D

facilities

of water body for:


facility (e.g., oil and water separator,
etc.)

following:


Others, specify
___________
Drainage/canal systems
tank, etc.
pH
TSS concentration
BOD
Total Coliform
Color
Oil and Grease

cost
10
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring

SA
SB
SC
SD
Current Use of nearest/

receiving water body:
Fishery
Tourist Zone / Park
Recreational
Industrial
Agricultural

nearest well used:

0.5 to 1 km
More than 1 km
Competition in
water use
Depletion of water
resources
Drinking/Domestic
Industrial
Agricultural
1,000 persons
>1,000 and 5,000
persons

source of water
measures

presence/absence of
complaints

cost
11
Possible
Impacts
Implementation
>5,000 persons
source.
Increased
occurrence of
flooding
Deepwell


shortages
Others, specify
______________
Others, specify
_________________
Water district/LGU
Surface water
Others, specify
_____________


Cost of Mitigation/
Monitoring
Yes
No

facilities

system

flow

contamination

presence/absence of
complaints
flooding

cost
Others, specify
_________________
Others, specify
_____________________
AIR / NOISE
Distance to nearest
community:

0.5 to 1 km
More than 1 km

generator, etc)
practices

presence/absence of
complaints

of:

cost
12
Possible
Impacts

residents
Implementation

Cost of Mitigation/
Monitoring
Absence of white or black

smoke from vehicles,
generator, etc.
Presence of truck cover
during deliveries
Others, specify
_________________
Nuisance due to
noise generation
Distance to nearest
community:

0.5 to 1 km
More than 1 km

generator, etc.)
barriers, etc.)

presence/absence of
complaints

cost
buffer zones
Provide adequate buffer and

planting of trees
Others, specify
_________________
PEOPLE
Displacement of
residents in the
project site and
within its vicinity
Displacement of
Indigenous Peoples
Enhanced
employment and/or
livelihood
opportunities
Reduced
employment and/or
livelihood
opportunities

barangay:
1,000 persons
>1,000 and 5,000
persons
employment
>5,000 persons
barangay:
Urban
Rural

cultural practices

presence/absence of
complaints
with LGU
Others, specify
______________

cost
13
Possible
Impacts
Increased revenues
for LGU
Disruption/
Competition in
delivery of public
services (e.g.,
education, peace
and order, etc.)

the host barangay:
Enhanced delivery
of public services
(e.g., education,
peace and order,
etc.)
Increase in traffic
Schools (e.g. elementary,

high school, college)
Implementation
Cost of Mitigation/
Monitoring

Others, specify
_________________

Tanod, etc.)
facilities
Others, specify
__________________
volume and
flow
Impacts on
community health
and safety
Others, specify
_______________

practicable

any emergency.
workers
Others, specify
_________________

presence/absence of
complaints
with LGU
agency
Others, specify
______________

cost
III. ABANDONMENT /DECOMMISSIONING/REHABILITATION POLICIES AND GENERIC


____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
14
15
Attach drawing/plan of air pollution source and control installations (with dimensions and
descriptions)
16

_______________________________.
____________________________________
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
__________________________.
Doc No. ___________________________

Page No. __________________________
Book No. __________________________
Series of __________________________
17
1
Annex 2 - G
for
CEMETERY, FUNERAL PARLORS, CREMATORIUM, AND COLUMBARIUM PROJECTS
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.
working days upon receipt of completed/duly-accomplished form.
OK FOR PRINTING:
________________________________________
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Cemetery & Other Funeral Facilities Projects
PROJECT FACT SHEET

Name of the
Project
Proponent Name
Proponent
Address
I.
Contact Person
Name:
Designation:
Proponent Means
of Contact
Landline No.
Fax No.
Mobile No.
Email Address:
PROJECT DESCRIPTION
Project Type
Actual Project
Size (hectare)
Cemetery
Project Size Parameter

Area to be developed
Funeral Parlor
total/gross floor area

including parking and
other areas
Crematorium
Columbarium

_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
II.

City/Municipality
Province
Region
Longitude
Latitude
on OCT/TCT/etc)

Cemetery and Funeral Homes
Facilities
1. Area for internment, vaults,
columbarium, etc.
2. Commercial Area (e.g.,
restaurants, food outlets, etc.)
3. Crematorium
4. Wake Chapel, viewing area,
and similar facilities
5. Support facilities (e.g., morgue,
embalming facility, showroom,
etc.)
6. Amenities (e.g., rest room, etc.)
7. Open/Common Spaces (e.g.,
reception area, garden, parks,
etc.)
8. Parking area
facility
10. Solid waste management
facilities
11. Drainage System
____________________
____________________
No. of
Units
Area (sq/M)/
Capacity
Remarks

Utilities
Source
KWh
Power/Electricity
KWh
m3/day
Water (Total)
m3/day
Water
Water Source
ground water
well
surface water
river
spring
lake
others: ____________________________
others: ____________________________

____________________________________________________________________
Utilities
Power/Electricity
Water
Estimated
Savings
KWh
m3/day
I.4 MANPOWER
Manpower
Requirement
Expertise/Skills
Total
b. Operation Phase
Manpower
Requirement
Expertise/Skills
Total
Project Cost (PhP): ______________________

Possible
Impacts

ordinance):
Implementation
Cost of Mitigation/
Monitoring
LAND
Consistency with
land use

with land use
Residential
Industrial
Protected Areas
Others, specify
______________

radius:
Disturbance to
wildlife due to
vegetation clearing
Residential
Industrial
Protected Areas
Others, specify
______________
Forestland
Marshland
Grassland
Mangrove
Wetland

possible

cost
Possible
Impacts
Slope:
Soil Erosion
steep
flat (0-3%)
gently sloping to rolling (3-
18%)
(>18%)

hazard prone?
Soil/Land
contamination due
to improper solid
waste disposal
Yes
No
sandy
clay
sandy-loam
Others, specify
____________________
Cost of Mitigation/
Monitoring

Others, specify
____________
Change in surface
landform/
topography/
terrain/slope
Implementation

protection measures

or other soil cover
Others, specify___________
slope protection

Cost: ___________
Others, specify
______________

the site
Others, specify
________________

construction area
waste materials
waste
Daily inspection of
segregation
presence of mixed
waste accumulated
Others, specify
_________________

cost
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
wastes
Impairment of
visual aesthetics
Devaluation of land
values

landforms/
landscape/structures?
Yes
No

waste collectors
waste collection
Others, specify
________________
owners
Others, specify
________________

cost
buffer zones
presence/absence of
property owners
WATER
Increased siltation
due to project
activities
Water quality
degradation
Others, specify
____________

___________________
body:
0.5 to 1 km
More than 1 km

AA
A
B

facilities

of water body for:
tank, etc.


of water body for:

Others, specify ______________


condition

cost
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
C
D

SA
SB
SC
SD
Current Water Use:
Fishery
Tourist Zone / Park
Recreational
Industrial
Agricultural

nearest well used:
0 to less 0.5 km
0 to 1 km
More than 1 km
Competition in
water use
Depletion of water
resources
Drinking/Domestic
Industrial
Agricultural
1,000 persons
>1,000 and 5,000
persons

source of water
measures

presence/absence of
complaints

cost
10
Possible
Impacts
Implementation
>5,000 persons
Others, specify
_________________
source.
Increased
occurrence of
flooding
Deepwell
Cost of Mitigation/
Monitoring

shortages
Others, specify
________________
Water district/LGU
Surface water
Others, specify
_____________

Yes
No

facilities

system

flow
Others, specify__________

presence/absence of
complaints
flooding

cost
Others, specify
_________________
AIR / NOISE
Distance to nearest
community:
0.5 to 1 km
More than 1 km

emission sources (e.g., generator,
crematorium, etc)
Installappropriate air pollution
control device/s for the
_______________
practices
Others, specify
___________________

presence/absence of
complaints

of:
Absence of white or
black smoke from
etc.

cost
11
PEOPLE
Displacement of
residents in the
project site and
within its vicinity
Displacement of
Indigenous Peoples
Enhanced
employment and/or
livelihood
opportunities
Reduced
employment and/or
livelihood
opportunities
Increased revenues
for LGU
Disruption/Competit
ion in delivery of
public services
(e.g., education,
peace and order,
etc.)
Enhanced delivery
of public services
(e.g., education,
peace and order,
etc.)
Increase in traffic
volume and
flow

barangay:
1,000 persons
>1,000 and 5,000
persons
>5,000 persons
barangay:
Urban
Rural

the host barangay:
Schools (e.g.
elementary, high
school, college)
Tanod, etc.)
facilities
Others, specify
_________________
employment
cultural practices
Others, specify_________________

presence/absence of
complaints
with LGU
Others, specify
________________

cost
12
Impacts on
community health
and safety
Others, specify
_______________

practicable

any emergency.
Others, specify
_________________

presence/absence of
complaints
with LGU
agency
Others, specify
________________

cost


____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
13
descriptions)
14
_______________________________.
____________________________________
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
__________________________.
Doc No. ___________________________

Page No. __________________________
Book No. __________________________
Series of __________________________
15
Annex 2 - H
for
LIVESTOCK/POULTRY PROJECTS
This IEE Checklist Report Form shall be used for proposed LIVESTOCK/POULTRY PROJECTS
and communities
issuance.
OK FOR PRINTING:
________________________________________
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Livestock/Poultry Projects
PROJECT FACT SHEET

Name of the Project
Proponent Name
Proponent Address
Proponent Means of
Contact
I.
Name:
Designation:
Landline No.
Fax No.
Mobile No.
Email:
PROJECT DESCRIPTION
Project Type
Project Size
Livestock Production: Pigs / Goats

Poultry / Birds
Project Size
Parameter
Maximum Stock
Population
Maximum Stock
Population

_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

City/Municipality
Province
Region
Longitude
Latitude
on OCT/TCT/etc.)

Maximum Stock Production (per growing season): ____________________________
Facilities
Cages / Pens / Enclosures
1. Gestating/Nursery Compartment
/ Hatchery
2. Support Facilities (e.g. feeders,
generators, admin building,
workers quarter, etc.)
3. Storage facility
Facility
7. Drainage system
____________________
____________________
No. of
Units
Area (sq/M)/
Capacity
Remarks

Utilities
Source
KWh
Power/Electricity
KWh
Water (Total)
m /day
Water
m /day
Water Source
ground water
well
surface water
river
spring
lake
others: ____________________________
others: ____________________________

____________________________________________________________________
Utilities
Measures
Estimated Savings
Power/Electricity
Water
KWh
m /day
I.4 MANPOWER
Expertise/Skills
Total
b. Operation Phase
Expertise/Skills
Total
Project Cost (PhP): ______________________

Possible
Environmental/Social
Impacts
LAND

use

ordinance):
Implementation
Cost of Mitigation/
Monitoring

with land use
Residential
Industrial
Protected Areas
Others, specify
__________________

radius:
due to vegetation
clearing
Residential
Industrial
Protected Areas
Others, specify
__________________
Forestland
Marshland
Grassland
Mangrove
Wetland
Others, specify
__________________

possible
destroyed vegetation where
area replanted/
re-vegetated
Cost integrated in
the construction/
operation cost
Possible
Impacts
Implementation
Slope:
Change in surface
terrain/slope
Soil Erosion
flat (0-3%)
steep (>18%)

hazard prone?
Soil/Land
improper solid waste
disposal

and allow maximum re-use of
spoils
slope protection

the site
Slope/ Erosion
Control Cost:
___________
Others, specify
_________________
Others, specify
_________________
Others, specify
_______________________
Yes
No

protection measures
Cost of Mitigation/
Monitoring
sandy
clay
sandy-loam
Others, specify
____________________

Waste Management Plan
(ESWMP)
construction area
waste materials
waste
wastes
Daily inspection of
segregation
presence of mixed
waste accumulated
Others, specify
_________________
Cost integrated in
the construction/
operation cost
Possible
Impacts
Impairment of
visual aesthetics
Devaluation of
land values

Yes
No
Implementation
Cost of Mitigation/
Monitoring
waste collectors
waste collection
Others, specify
________________
owners
Others, specify
________________
Cost integrated in
the construction/
operation cost
buffer zones
presence/absence of
complaints from
adjacent property
owners
WATER

Water quality
degradation
Others, specify
_______________

body:
_________________________
water body:

0.5 to 1 km
More than 1 km

classification:
AA
A
B
Set-up proper and adequate

sanitary facilities

of:

its workers to observe proper
waste disposal and proper
sanitation

Provide biogas generator or similar
waste treatment measures
Others, specify
_____________________
Drainage / canal
systems
tank, etc.)

following:
pH
TSS concentration
BOD
Total Coliform
Color

construction/
operation cost
Possible
Impacts
C
D

SA
SB
SC
SD
Current Water Use:
Fishery
Tourist Zone / Park
Recreational
Industrial
Agricultural

nearest well used:

0.5 to 1 km
More than 1 km
Drinking/Domestic
Industrial
Agricultural
Implementation
Oil and Grease
Cost of Mitigation/
Monitoring
10
Possible
Impacts
use
Depletion of water
resources
Implementation
Cost of Mitigation/
Monitoring

1,000 persons
>1,000 and 5,000
persons
>5,000 persons
Increased occurrence
of flooding
Deepwell
Water district/LGU
Surface water

measures;
Carefully select project site to

uses


presence/absence of
complaints
with concerned
agencies
shortages

construction/
operation cost
Others, specify
________________
Others, specify
_________________________
Others, specify
________________

Implement rainwater harvesting

and similar measures as an
alternative source of water
Yes
No

facilities

system

contamination
Others,
specify___________________

presence/absence of
complaints
with concerned
agencies
flooding

construction/
operation cost
Others, specify
____________________
AIR / NOISE

0.5 to 1 km
More than 1 km

generator, etc)
Strictly enforce good
housekeeping practices

presence/absence of
complaints

of:

construction/
operation cost
11
Possible
Impacts

generation

0.5 to 1 km
More than 1 km
Is the wind direction blowing

towards the nearest community
most of the year?
Yes
Implementation

residents

Cost of Mitigation/
Monitoring
Absence of white
or black smoke
from vehicles,
generator, etc.
Presence of truck
cover during
deliveries
Others, specify
___________________
Regular clean-up of animal houses
Use environment-friendly
deodorizer or odor masking
substances

presence/absence of
complaints

construction/
operation cost
Use sprays with natural / microbial

disinfectants
planting of trees
Others, specify
____________________
No
PEOPLE
Displacement of
site and within its
vicinity
Displacement of
Indigenous Peoples
Enhanced
employment and/or
livelihood
opportunities
Reduced employment
and/or livelihood

barangay:
1,000 persons
>1,000 and 5,000

persons
>5,000 persons
Urban
Rural
employment
cultural practices

presence/absence of
complaints
with LGU
Others, specify
_________________

construction/
operation cost
12
Possible
Impacts
opportunities
Increased revenues
for LGU
Disruption/Competitio
n in delivery of public
services (e.g.,
order, etc.)
order, etc.)
Increase in traffic
of traffic flow
health and safety
Others, specify
_______________

the host barangay:
Schools (e.g.,
elementary, high school,
college)

Implementation
Cost of Mitigation/
Monitoring

Others, specify
_________________

Tanod, etc.)
facilities
Others, specify
___________________

practicable
Provide on-site medical services

for any emergency.
Regularly spray disinfectant,
pesticides and other similar
substances when applicable
Others, specify
__________________________

presence/absence of
complaints
with LGU
agency
Others, specify
________________

construction/
operation cost


____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
13
Attach site development/layout plan (with dimensions and descriptions)
14
15
_______________________________.
____________________________________
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
__________________________.
Doc No. ___________________________

Page No. __________________________
Book No. __________________________
Series of __________________________
16
Annex 2 - I
for
RESORTS AND OTHER TOURISM / LEISURE PROJECTS
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.
and communities
issuance.
OK FOR PRINTING:
________________________________________
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Resorts & Other Tourism/Leisure Projects
PROJECT FACT SHEET

Name of the Project
Proponent Name
Proponent Address
Proponent Means of
Contact
I.
Name:
Designation:
Landline No.
Fax No.
Mobile No.
Email:
PROJECT DESCRIPTION
Project Type
Project Size
Resorts
Other Tourism Projects

Project Size
Parameter
Area to be
developed
Area to be
developed
City/Municipality
Province
Region
Longitude
Latitude
on OCT/TCT/etc.)

Facilities
1. Rooms
2. Villas
3. Public washrooms/toilets
4. Swimming pools
5. Function/Convention Hall
6. Lobby/Reception Area
7. Restaurant
8. Parking area
9. Water sports facilities
10. Wharf / Jetty
11. Mini zoo/Park
12. Ecological trail
13. Garden/Landscaping
14. Waste water treatment facility
15. Solid waste management
facilities
16. Drainage system
17. Others, specify:
_____________________
_____________________
No. of
Units
Area (sq/m)/
Capacity
Remarks

Utilities
Source
KWh
Power/Electricity
KWh
Water (Total)
m3/day
Water
m3/day
Water Source
ground water
well
surface water
river
spring
lake
others: ____________________________
others: ____________________________

____________________________________________________________________
Utilities
Measures
Estimated Savings
Power/Electricity
Water
KWh
m /day
I.4 MANPOWER
Expertise/Skills
Total
b. Operation Phase
Expertise/Skills
Total
Project Cost (PhP): ______________________

Possible
Impacts
LAND
Consistency with
land use

ordinance):
Implementation
Cost of Mitigation/
Monitoring

with land use
Residential
Industrial
Protected Areas
Others, specify
______________

radius:
Disturbance to
wildlife due to
vegetation clearing
Residential
Industrial
Protected Areas
Others, specify
___________________
Forestland
Marshland
Grassland
Mangrove
Wetland
Others, specify
____________________

possible
Annual inspection of area

replanted/
re-vegetated
Cost integrated in
the construction
/operation cost
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
Slope:
Change in surface
landform/
topography/
terrain/slope
Soil Erosion
flat (0-3%)
steep (>18%)

prone?
Soil/Land
contamination due
to improper solid
waste disposal


or other soil cover
Regular inspection of slope

protection measures in
erosion-prone areas
Regular inspection for new
eroded areas near the site
Others, specify
_________________
Slope/ Erosion
Control Cost:
___________
Others, specify
________________
__
Others, specify
__________________________
Yes
No

protection measures
sandy
clay
sandy-loam
Others, specify
____________________

construction area
waste materials
Implement proper collection and
processing of animal waste into
organic fertilizer
waste
wastes
Daily inspection of
segregation
presence of mixed garbage
in the facility
Weekly inspection of waste
accumulated
Others, specify
___________________
Cost integrated in
the construction
/operation cost
Possible
Impacts
Impairment of
visual
aesthetics
Devaluation of
land values

landforms/landscape/
structures?
Yes
No
Implementation
Cost of Mitigation/
Monitoring

waste collectors
waste collection
Others, specify
__________________________
owners
Others, specify________________
Cost integrated in
the construction/
operation cost
Regular monitoring of buffer

zones
presence/absence of
property owners
WATER
Increased siltation
due to project
activities
Water quality
degradation
Others, specify
_______________
water body:
______________________
water body:

0.5 to 1 km
More than 1 km

classification:
AA
A
B
C
D

facilities
facility (e.g. septic tank, oil and
Installation of drainage canals
Others, specify ___________
Regular (ocular) inspection of:
Drainage / canal systems

Water treatment facility (i.e.,
grease trap, septic tank,
etc.)

following:
pH
TSS concentration
BOD
Total Coliform
Color
Oil and Grease
Cost integrated in
the construction/
operation cost
Possible
Impacts
SA
SB
SC
SD
Current Water Use:
Fishery
Tourist Zone / Park
Recreational
Industrial
Agricultural

nearest well used:

0.5 to 1 km
More than 1 km
Drinking/Domestic
Industrial
Agricultural
Implementation
Cost of Mitigation/
Monitoring
10
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring

Competition in
water use
Depletion of water
resources
source.
Increased
occurrence of
flooding
>1,000 and 5,000

persons
>5,000 persons
1,000 persons
Deepwell
Water district/LGU
Surface water
Others, specify
________________

Yes
No

source of water
measures

presence/absence of
complaints
concerned agencies
shortages
Cost integrated in
the construction/
operation cost
Others, specify
___________________
Use drought resistant species which

require less water input and hence
have less impact on water tables
Others, specify
______________________
facilities

system

flow

contamination

presence/absence of
complaints
concerned agencies
flooding
Cost integrated in
the construction/
operation cost
Others, specify
___________________
Others, specify
__________________________
AIR / NOISE
Distance to nearest
community:

0.5 to 1 km

generator, etc)

presence/absence of
complaints
Regular (ocular) inspection of:
Cost integrated in
the construction/
operation cost
11
Possible
Impacts
Nuisance due to
generation of
obnoxious/
unpleasant odor
Nuisance due to
noise generation
Distance to nearest
community:

0.5 to 1 km
More than 1 km
Distance to nearest
community:

0.5 to 1 km
Yes
No
More than 1 km

towards the nearest
community most of the year?

device/s
More than 1 km
Implementation

practices

Cost of Mitigation/
Monitoring
Absence of white or
black smoke from
vehicles, generator, etc.
Presence of truck cover
during deliveries

residents
materials that may generate dus
Others, specify
___________________
Regularly clean up animal houses
Use environment-friendly deodorizer

or odor masking substances

presence/absence of
complaints
Cost integrated in
the construction/
operation cost

disinfectants
planting of trees
Others, specify ___________
generator, etc.)
barriers, etc.)
hours
(e.g., Perimeter planting of trees to
serve as sound buffer and greenbelt)

presence/absence of
complaints
Regular monitoring of buffer
zones
noise level
Cost integrated in
the construction/
operation cost
12
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
Others, specify
_____________________
PEOPLE
Displacement of
residents in the
project site and
within its vicinity
Displacement of
Indigenous Peoples
Enhanced
employment and/or
livelihood
opportunities
Reduced
employment and/or
livelihood
opportunities
Increased revenues
for LGU
Disruption/
Competition in
delivery of public
services (e.g.,
education, peace
and order, etc.)
Enhanced delivery
of public services
(e.g., education,
peace and order,
etc.)
Increase in traffic
volume and
flow

barangay:
1,000 persons
>1,000 and
5,000persons
>5,000person
barangay:
Urban
Rural

the host barangay:
Schools (e.g.,
elementary, high
school, college)
Tanod, etc.)
facilities
Others, specify
________________
employment
cultural practices
Others, specify
____________________________

presence/absence of
complaints
LGU
Others, specify
_____________________
Cost integrated in
the construction/
operation cost
13
Possible
Impacts
Impacts on
community health
and safety
Others, specify
____________
Implementation
Cost of Mitigation/
Monitoring

practicable

any emergency.
workers
RA 6969
Others, specify
_____________________

presence/absence of
complaints
LGU
reports to concerned agency
Others, specify
_____________
Cost integrated in
the construction/
operation cost


____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
14
15
_______________________________.
____________________________________
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
__________________________.
Doc No. ___________________________

Page No. __________________________
Book No. __________________________
Series of __________________________
16
1
1
Annex 2 - J
for
ROAD AND BRIDGE PROJECTS
This IEE Checklist Report Form shall be used for proposed ROAD AND BRIDGE PROJECTS
working days upon receipt of duly-accomplished forms with complete
attachments.
issuance.
OK FOR PRINTING:
________________________________________
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Road and Bridge Projects
PROJECT FACT SHEET

Name of the Project
Proponent Name
Proponent Address
Proponent Means of
Contact
I.
Name:
Designation:
Landline No.
Fax No.
Mobile No.
Email:
PROJECT DESCRIPTION
Project Type
Project Size
Bridges and viaducts, new construction
Project Size
Parameter
Length
length with no critical
slope, OR
Roads, new construction, widening

length with critical slope

Elevated roads, flyover/cloverleaf/ interchanges
Length
Tunnels and sub-grade roads and railways

Pedestrian passages

_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

City/Municipality
Province
Region
Longitude
Latitude
on OCT/TCT/etc.)

Facilities
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
_______________________
_____________________
No. of
Units
Area (sq/M)/
Capacity
Remarks

Utilities
Source
KWh
Power/Electricity
KWh
Water (Total)
m3/day
Water
m3/day
Water Source
ground water
well
surface water
river
spring
lake
others: ____________________________
others: ____________________________

____________________________________________________________________
Utilities
Measures
Estimated Savings
Power/Electricity
Water
KWh
m /day
I.3 MANPOWER
Expertise/Skills
Total
b. Operation Phase
Expertise/Skills
Total
Project Cost (PhP): ______________________

Possible
Impacts
LAND
Consistency with
land use

ordinance):
Implementation
Cost of Mitigation/
Monitoring

with land use
Residential
Industrial
Protected Areas
Others, specify
______________

radius:
Disturbance to
wildlife due to
vegetation clearing
Residential
Industrial
Protected Areas
Others, specify
______________
Forestland
Marshland
Grassland
Mangrove
Wetland
Others, specify
____________

possible
area replanted/
re-vegetated

cost
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
Change in surface
landform/
topography/
terrain/slope
Slope:
Soil Erosion
flat (0-3%)
steep (>18%)

hazard prone?
Soil/Land
contamination due
to improper solid
waste disposal
Yes
No
sandy
clay
sandy-loam
Others, specify
____________________

protection measures

or other soil cover
Others, specify
____________
slope protection

Cost: ___________
Others, specify
__________________

the site
Others, specify
_________________

Administrative Order No. 2003-30
and DENR Administrative Order No.
2000-28, Implementing Guidelines
on Engineering Geological and
Geo-hazard Assessment (EGGA).
Implement Ecological Solid Waste
Management Plan (ESWMP)
construction area
waste materials
waste
wastes
waste collectors
waste collection
Daily inspection of
segregation
presence of mixed
waste accumulated
Others, specify
_________________

cost
Possible
Impacts
Encroachment into
protected areas or
ecologicallysensitive areas
Impairment of
visual aesthetics
Devaluation of
land values
Is the project area near

protected areas or ecologicallysensitive areas?
Yes
No

Yes
No
Implementation
Cost of Mitigation/
Monitoring
Others, specify
________________
Obtain appropriate
permits/clearances from concerned
agencies

cost

Others, specify
________________
owners
Others, specify
________________

cost
buffer zones
presence/absence of
complaints from
adjacent property
owners
WATER
Increased siltation
due to project
activities
Water quality
degradation
Others, specify
_______________

__________________________
Distance to nearest water body:

0.5 to 1 km
More than 1 km

AA
A
B
C

sanitary facilities
Set up silt trap(Gabions,
Fascines)/settling ponds to
Others, specify
___________

of:
Drainage / canal
systems
Sanitation facilities

of water body for:

condition
Floating wastes or
debris

cost
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
If nearest water body is coastal

or marine water, specify
classification:
SA
SB
SC
SD
Current Water Use:
Fishery
Tourist Zone / Park
Recreational
Industrial
Agricultural
nearest well used:

0.5 to 1 km
More than 1 km
Competition in
water use
Depletion of water
resources
Drinking/Domestic
Industrial
Agricultural
Size of population using water
source:
1,000 persons
>1,000 and 5,000

persons
>5,000 persons

source of water
measures
Others, specify
_________________

presence/absence of
complaints
shortages

cost
10
Possible
Impacts
Increased
occurrence of
flooding
Cost of Mitigation/
Monitoring
Others, specify
________________
Deepwell
Water district/LGU
Surface water
Others, specify
________________

Implementation
Yes
No

facilities

system

flow
Others, specify
___________________

presence/absence of
complaints
flooding

cost
Others, specify
____________________
AIR / NOISE

0.5 to 1 km
More than 1 km

generator, etc)
device/s
practices
residents

presence/absence of
complaints

of:
Absence of white or
black smoke from
etc.
Presence of truck
cover during
deliveries

cost
11
Possible
Impacts
Nuisance due to
noise generation

0.5 to 1 km
More than 1 km
Implementation
Cost of Mitigation/
Monitoring

Others, specify
___________________
generator, etc.)
barriers, etc.)

presence/absence of
complaints

cost
buffer zones

hours
planting of trees
Others, specify
_____________________
PEOPLE
Displacement of
residents in the
project site and
within its vicinity
Displacement of
Indigenous
Peoples
Enhanced
employment and/or
livelihood
opportunities
Reduced
employment and/or
livelihood
opportunities
Increased

barangay:
1,000 persons
>1,000 and
5,000persons
>5,000 persons
Urban
Rural

the host barangay:
Schools (e.g.,
elementary, high school,
college)
employment
cultural practices
signs, lighting, etc.

presence/absence of
complaints
with LGU
Others, specify
_________________

cost
12
Possible
Impacts
revenues for LGU
Disruption/
Competition in
delivery of public
services (e.g.,
education, peace
and order, etc.)
Enhanced delivery
of public services
(e.g., education,
peace and order,
etc.)

Implementation
Cost of Mitigation/
Monitoring
Others, specify
_________________

Tanod, etc.)
facilities
Others, specify
___________________
Increase in traffic
volume and
flow
Impacts on
community health
and safety
Others, specify
_______________

practicable

any emergency.

workers
Others, specify
_____________________

presence/absence of
complaints
with LGU
agency
Others, specify
________________

cost


____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
13
Attach design/plan/alignment of project (with dimensions and descriptions)
14
_______________________________.
____________________________________
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
__________________________.
Doc No. ___________________________

Page No. __________________________
Book No. __________________________
Series of __________________________
15
Annex 2 - K
for
WATER SUPPLY PROJECTS
This IEE Checklist Report Form shall be used for proposed WATER SUPPLY PROJECTS
and communities
issuance.
OK FOR PRINTING:
________________________________________
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Water Supply Projects
2
PROJECT FACT SHEET

Name of the Project
Proponent Name
Proponent Address
Proponent Means of
Contact
I.
Name:
Designation:
Landline No.
Fax No.
Mobile No.
Email:
PROJECT DESCRIPTION
Project Type
Actual Project
Size

# of wells and other systems
(e.g., infiltration gallery, etc.)
Level
Water Supply Systems (Complete System)

Water Supply System (Distribution Only)

_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

City/Municipality
Province
Region
3
Longitude
Latitude
on OCT/TCT/etc.)
I.2. PROJECT COMPONENTS

Facilities
1. Water collection
Production wells
Infiltration gallery
Diversion/Collection Weir
Others, specify
2. Water treatment facility
Chemical treatment (e.g.,
precipitation, coagulation, etc.)
Physical treatment (e.g.,
screening, sedimentation, etc.)
Disinfection (e.g., chlorination,
etc.)
3. Water distribution system
Communal box/faucet (new)

Communal box/faucet (for
rehabilitation)
Water pipelines, distribution
main (new)
Water pipelines distribution main
(for rehabilitation)
Water pipelines, service line
(new)
Water pipelines service line (for
rehabilitation)
Pumping stations
4. Chemical storage facility
facility
No. of
Units
Area (sq/M)/
Capacity
Remarks
(Indicate service area in m 2 and

number of households served)
__________________ square
meters
__________________ households
4
Facilities
No. of
Units
Area (sq/M)/
Capacity
Remarks
7. Drainage System
8. Others, specify
__________________
__________________

Utilities
Source
KWh
Power/Electricity
KWh
Water (Total)
(Fill-up table below if water is not obtained from
m3/day
the local water utility)
m3/day
Water
Water Source
ground water
well
surface water
river
spring
lake
others: ____________________________
others: ____________________________

____________________________________________________________________
5
Utilities
Measures
Estimated Savings
Power/Electricity
Water
KWh
m /day
I.4 MANPOWER
Expertise/Skills
Total
b. Operation Phase
Expertise/Skills
Total
Project Cost (PhP): ______________________

Possible
Impacts
LAND
Consistency with
land use

ordinance):
Implementation
Cost of Mitigation/
Monitoring

with land use
Residential
Industrial
Protected Areas
Others, specify
________________

radius:
Disturbance to
wildlife due to
vegetation clearing
Residential
Industrial
Protected Areas
Others, specify
_________________
Forestland
Marshland
Grassland
Mangrove
Wetland
Others, specify
__________________

possible
area replanted/
re-vegetated

cost
Possible
Impacts
Change in surface
landform/
topography/
terrain/slope
Soil Erosion
Implementation
Cost of Mitigation/
Monitoring
Slope:
flat (0-3%)
steep (>18%)

protection measures

or other soil cover
slope protection

Cost: ___________
Others, specify
_______________

the site
Others, specify
______________
Others, specify
____________
prone?
Soil/Land
contamination due
to improper solid
waste disposal
Yes
No
sandy
clay
sandy-loam
Others, specify
____________________

Administrative Order No. 2003-30
and DENR Administrative Order No.
2000-28, Implementing Guidelines
on Engineering Geological and Geohazard Assessment (EGGA).
construction area
waste materials
waste
wastes
waste collectors
Daily inspection of
segregation
presence of mixed
waste accumulated
Others, specify
_______________

cost
Possible
Impacts
Impairment of
visual
aesthetics
Devaluation of
land values

s?
Yes
No
Implementation
Cost of Mitigation/
Monitoring

waste collection
Others, specify
________________
owners
Others, specify
________________

cost
buffer zones
presence/absence of
property owners
WATER
Increased siltation
due to project
activities
Water quality
degradation
Others, specify
_____________
water body:
________________________
water body:

0.5 to 1 km
More than 1 km

classification:
AA
A
B

facilities

of:
Drainage / canal
systems
tank, etc.)

facility
tanks/ motorpool/ maintenance
areas
Others, specify
______________

following:
pH
TSS concentration
BOD
Total Coliform
Color
Oil and Grease

cost
Possible
Impacts
C
D

SA
SB
SC
SD
Current Water Use:
Fishery
Tourist Zone / Park
Recreational
Industrial
Agricultural

nearest well used:

0.5 to 1 km
More than 1 km
Drinking/Domestic
Industrial
Agricultural
Implementation
Cost of Mitigation/
Monitoring
10
Possible
Impacts

Competition in
water use
Depletion of water
resources
1,000 persons
>1,000 and 5,000

persons
>5,000 persons
source.
Deepwell
Water district/LGU
Surface water
Others, specify
________________
Increased
occurrence of
flooding

Yes
No

source of water
measures;
Careful selection of project site to
uses
Implementation

presence/absence of
complaints
shortages
Cost of Mitigation/
Monitoring

cost
Others, specify
________________
Implement community ponds and

similar measures as alternative
water source for non-domestic uses
Increase, when practical, storage
capacities of water supply structures
for resilience to greater climate
variations and extremes
Others, specify
_______________________
facilities

system

flow

contamination
Others, specify
________________________

presence/absence of
complaints
flooding
Others, specify
__________________

cost
11
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
AIR / NOISE
Distance to nearest
community:
0.5 to 1 km
More than 1 km
Nuisance due to
noise generation
Distance to nearest
community:
0.5 to 1 km
More than 1 km

device/s

presence/absence of
complaints

cost

of:

practices

residents
Absence of white or
black smoke from
etc.
Presence of truck
cover during
deliveries

Others, specify
_________________
pumps, generator, etc.)
barriers, etc.)
hours
planting trees
Others, specify
_________________

presence/absence of
complaints
buffer zones

cost
12
PEOPLE
Displacement of
residents in the
project site and
within its vicinity
Displacement of
Indigenous Peoples
Enhanced
employment and/or
livelihood
opportunities
Reduced
employment and/or
livelihood
opportunities

barangay:
1,000 persons
>1,000 and 5,000
persons
>5,000 persons
barangay:
Urban
Rural
Increased revenues
for LGU
Disruption/
Competition in
delivery of public
services (e.g.,
education, peace
and order, etc.)
Increase in traffic
volume and
flow
Others, specify
_______________

the host barangay:
Enhanced delivery
of public services
(e.g., education,
peace and order,
etc.)
Impacts on
community health
and safety
employment
cultural practices

presence/absence of
complaints
with LGU

cost
Others, specify
______________

Others, specify
_________________
Schools (e.g.,
elementary, high
school, college)
Tanod, etc.)
facilities
Others, specify
__________________

practicable

presence/absence of
complaints
with LGU

cost
13

any emergency.
workers
RA 6969
Others, specify
________________
agency
Others, specify
________________
III. ABANDONMENT /DECOMMISSIONING / REHABILITATION POLICIES AND GENERIC


____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
14
descriptions)
15
Process flow
16
17
_______________________________.
____________________________________
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
__________________________.
Doc No. ___________________________

Page No. __________________________
Book No. __________________________
Series of __________________________
18
Annex 2 - L
for
IRRIGATION / FLOOD CONTROL/ MINOR DAM PROJECTS
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.
and communities
issuance.
OK FOR PRINTING:
________________________________________
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Irrigation / Flood Control / Minor Dam Projects
PROJECT FACT SHEET

Name of the Project
Proponent Name
Proponent Address
Proponent Means of
Contact
I.
Name:
Designation:
Landline No.
Fax No.
Mobile No.
Email:
PROJECT DESCRIPTION
Project Type
Actual
Project Size
Impounding System or Flood Control Project

Irrigation System (Distribution System Only)
Minor Dam

reservoir flooded area
(hectare) or water storage
capacity (m3)
service area (hectare)
reservoir flooded area
(hectare) or water storage
capacity (m3)

_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

City/Municipality
Province
Region
Longitude
Latitude
on OCT/TCT/etc.)

Facilities
1. Dam
2. Diversion headworks (i.e.,
diversion weir, canal head
regulator, etc.)
3. Impounding System
4. Irrigation canal system
5. Drainage canals
6. Access roads / Farm to market
roads (if applicable)
7. Post harvest facility (if
applicable)
8. Others, specify:
_____________________
_____________________
No. of
Units
Area (sq/M)/
Capacity
Remarks

Utilities
Source
KWh
Power/Electricity
KWh
Water (Total)
m /day
Water
m /day
Water Source
ground water
well
surface water
river
spring
lake
others: ____________________________
others: ____________________________

____________________________________________________________________
Utilities
Measures
Estimated Savings
Power/Electricity
Water
KWh
m /day
I.4 MANPOWER
Expertise/Skills
Total
b. Operation Phase
Expertise/Skills
Total
Project Cost (PhP): ______________________

Possible
Impacts
LAND
Consistency with
land use

ordinance):
Implementation
Cost of Mitigation/
Monitoring

with land use
Residential
Industrial
Protected Areas
Others, specify
___________________

radius:
Disturbance to
wildlife due to
vegetation clearing
Residential
Industrial
Protected Areas
Others, specify
__________________
Forestland
Marshland
Grassland
Mangrove
Wetland
Others, specify
___________________

possible
area replanted/
re-vegetated

cost
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
Slope:
Change in surface
landform/
topography/
terrain/slope
Soil Erosion
flat (0-3%)
steep (>18%)

hazard prone?
Soil/Land
contamination due
to improper solid
waste disposal


or other soil cover
Others, specify
_________________________
slope protection

Cost: ___________
Others, specify
______________

the site
Others, specify
_____________

Yes
No

protection measures
sandy
clay
sandy-loam
Others, specify
____________________

construction area
waste materials
waste
wastes
waste collectors
Daily inspection of
segregation
presence of mixed
waste accumulated
Others, specify
_____________

cost
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring

of:
waste collection
Others, specify
________________
WATER
Increased siltation
due to project
activities
Water quality
degradation
Others, specify
_______________

________________________

body:

0.5 to 1 km
More than 1 km

AA
A
B
C
D
If nearest water body is

coastal or marine water,
SA
SB
SC
SD
Current Water Use:
Fishery

facilities
Others, specify
______________
tank, etc.

of water body for:

condition

cost
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
Tourist Zone / Park

Recreational
Industrial
Agricultural

nearest well used:

0.5 to 1 km
More than 1 km
Competition in
water use
Depletion of water
resources
Drinking/Domestic
Industrial
Agricultural

1,000 persons
>1,000 and 5,000
persons
>5,000 persons
source.
Deepwell
Water district/LGU
Surface water
Others, specify
________________

source of water
measures
Implement community ponds and
similar measures as alternative
water source and options for fish
cultivation
Increase, when practical, storage
capacities of water supply structures
for resilience to greater climate
variations and extremes
Use drought resistant species which

presence/absence of
complaints
shortages
Others, specify
_____________

cost
10
Possible
Impacts
Increased
occurrence of
flooding

Yes
No
Implementation
Cost of Mitigation/
Monitoring
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
_____________________
facilities
system

flow

contamination
Others, specify
_______________________

presence/absence of
complaints
Regular monitor of
flooding
Others, specify
_________________

cost
11
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
Distance to nearest
community:
AIR / NOISE

0.5 to 1 km
More than 1 km
Nuisance due to
noise generation
Distance to nearest
community:
0.5 to 1 km
More than 1 km

device/s

presence/absence of
complaints
of:

practices


cost
Absence of white or
black smoke from
etc.
Presence of truck
cover during
deliveries

Others, specify
__________________
barriers, etc.)
hours
planting of trees
Others, specify
_____________________

presence/absence of
complaints
buffer zones
noise level

cost
12
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
PEOPLE
Displacement of
residents in the
project site and
within its vicinity
Displacement of
Indigenous Peoples
Enhanced
employment and/or
livelihood
opportunities
Reduced
employment and/or
livelihood
opportunities
Increased revenues
for LGU
Disruption/Competit
ion in delivery of
public services
(e.g., education,
peace and order,
etc.)
Enhanced delivery
of public services
(e.g., education,
peace and order,
etc.)
Increase in traffic
volume and
flow
Impacts on
community health
and safety

barangay:
1,000 persons
>1,000 and 5,000

persons
>5,000 persons
barangay:
Urban
Rural

the host barangay:
Schools (e.g.,
elementary, high
school, college)
employment

presence/absence of
complaints
with LGU

cost
Others, specify
___________________

cultural practices
Others, specify
__________________________

Tanod, etc.)
facilities
Others, specify
________________

practicable

presence/absence of
complaints

cost
13
Possible
Impacts
Others, specify
______________
Implementation

any emergency.

workers
Others, specify
_____________________
with LGU
agency
Others, specify
_____________
Cost of Mitigation/
Monitoring


____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
14
_______________________________.
____________________________________
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
__________________________.
Doc No. ___________________________

Page No. __________________________
Book No. __________________________
Series of __________________________
15
Annex 2 - M
for
WASTE MANAGEMENT PROJECTS
This IEE Checklist Report Form shall be used for proposed WASTE MANAGEMENT PROJECTS
and communities
issuance.
OK FOR PRINTING:
________________________________________
___________________________
Date
Initial Environmental Examination (IEE) Checklist Report Form for Waste Management Projects
PROJECT FACT SHEET

Name of the Project
Proponent Name
Proponent Address
Proponent Means of
Contact
I.
Name:
Designation:
Landline No.
Fax No.
Mobile No.
Email:
PROJECT DESCRIPTION
Project Type
Actual Project
Size (MT)
Compost/Fertilizer making

Daily production rate
Quantity of waste to be
treated annually
Kind of activity
Quantity of waste to be
treated annually
Daily waste input
Domestic waste water treatment facility

Materials recovery facility
Receiving facilities, paper, plastic and other material
recycling
Sanitary landfill for domestic waste only

_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

City/Municipality
Province
Region
Longitude
Latitude
on OCT/TCT/etc.)
I.2 PROJECT COMPONENTS (Use additional sheets, if necessary)

Facilities
1. Receiving facility
Transfer station
Segregation/Sorting facilities
Mechanized Materials Recovery
Transport and Facility (MRTF)
Recycling facility
Waste inspection and quarantine
area
Weigh Bridge
Vehicle Washing Facilities
Crasher
Others (Please specify)
2. Treatment and disposal facility
Waste reception area
Waste quarantine area
Waste emplacement cells
Ponds and lagoons
Composting area
Others, specify
_______________
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
No. of
Units
Area (sq/M)/
Capacity
Remarks
Facilities
No. of
Units
Area (sq/M)/
Capacity
Remarks
Others, specify
___________________
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
_____________________
6. Others, specify:
_____________________
_____________________

Utilities
Source
KWh
Power/Electricity
KWh
Water (Total)
m3/day
Water
m3/day
Water Source
ground water
well
surface water
river
spring
lake
others: ____________________________
others: ____________________________

____________________________________________________________________
Utilities
Power/Electricity
Water
Measures
Estimated Savings
KWh
m3/day
I.4 MANPOWER
Expertise/Skills
Total
b. Operation Phase
Project Cost (PhP): ______________________
Expertise/Skills
Total

Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
LAND
Consistency with
land use
Current land use w/in 1km radius

(as per zoning ordinance):

with land use
Residential
Industrial
Protected Areas
Others, specify
___________________
Disturbance to
wildlife due to
vegetation clearing
Residential
Industrial
Protected Areas
Others, specify
__________________
Forestland
Marshland
Grassland
Mangrove
Wetland
Others, specify
___________________

possible
area replanted/
re-vegetated

construction /
operation cost
Possible
Impacts
Change in surface
landform/
topography/
terrain/slope
Soil Erosion
Implementation
Cost of Mitigation/
Monitoring
Slope:
flat (0-3%)
steep (>18%)

area identified by MGB/PAG-ASA/
Soil/Land
contamination due
to improper solid
waste disposal
Yes
No
sandy
clay
sandy-loam
Others, specify
____________________

protection measures
Comply with the standard criteria for
sanitary landfill in DAO 49 and 50

or other soil cover
slope protection

new eroded areas
near the site
Slope/ Erosion
Control Cost:
___________
Others, specify
_______________
Others, specify
__________________
Others, specify
__________________________
construction area
waste materials
waste
wastes
waste collectors
Daily inspection of
for segregation
presence of mixed
waste accumulated
Others, specify
___________________

construction/
operation cost
Possible
Impacts
aesthetics
Devaluation of land
values

landforms/landscape/
structures?
Yes
No
Encroachment into
protected areas or
ecologicallysensitive areas
Is the project area near protected

areas or ecologically-sensitive
areas?
Yes
No
Implementation
Cost of Mitigation/
Monitoring

waste collection
Comply with the minimum standard
for sanitary landfill liner system per
IRR of RA 9003
Others, specify
_______________________
owners
Others, specify
_______________________
Obtain appropriate
permits/clearances from concerned
agencies

construction/
operation cost
buffer zones
presence/absence of
complaints from
adjacent property
owners
with concerned
agencies

construction/
operation cost
Others, specify
________________________
WATER
Increased siltation
due to project
activities

________________________
Water quality
degradation
Distance to nearest water body:
Others, specify
_____________

0.5 to 1 km
More than 1 km

sanitary facilities

of:
Drainage / canal
systems
Water treatment

construction/
operation cost
10
Possible
Impacts

AA
A
B
D
SA
SB
SC
SD
Current Water Use:
Increased
occurrence of
flooding
Fishery
Tourist Zone / Park
Recreational

areas
Limit, where possible, the extent of
impervious (paved) areas
Installation of biogas digester/s
system
Provide at least 50 meters distance
between the landfill and any
perennial lake, stream or river
Provide the minimum standard for
sanitary landfill liner system
Cost of Mitigation/
Monitoring

following:
pH
TSS concentration
BOD
Total Coliform
Color
Oil and Grease

following:
Trace Metals (Pb, Cd,

Hg, Cr6, As)
Install underdrain system
Separate at least two (2) meters

between the top of the liner system
and the underlying groundwater
Others, specify
__________________________
Industrial
Agricultural
PAGASA as flood prone?
If nearest water body is coastal or

marine water, specify
classification:

Implementation
Yes
No

facilities

system

flow

presence/absence of
complaints
with concerned
agencies

construction/
operation cost
11
Possible
Impacts

contamination
Implementation
Cost of Mitigation/
Monitoring
flooding
Others, specify
_________________
Others, specify
________________________
AIR / NOISE

0.5 to 1 km
More than 1 km

device/s
Install methane recovery facility

presence/ absence of
complaints
of:
Install biogas and composting

facility
practices
Nuisance due to
generation of
obnoxious/
unpleasant odor

0.5 to 1 km
More than 1 km
Use environment-friendly
deodorizer or odor masking
substances
disinfectants
Apply soil cover daily
Absence of white or
black smoke from
etc.
Presence of truck
cover during deliveries
ambient air for the
following:

Other, specify _________________

construction/
operation cost
TSP
PM10
NOx
SOx
CO / CO2

presence/absence of
complaints

construction/
operation cost
12
Possible
Impacts

towards the nearest community
most of the year?
Nuisance due to
noise generation
Yes
Implementation
Cost of Mitigation/
Monitoring

planting of trees
Others, specify
_______________________
No

0.5 to 1 km
More than 1 km

noise sources (e.g., vehicles, boiler,
generator, etc.)
barriers, etc.)

presence/absence of
complaints

construction/
operation cost
buffer zones

hours
Provide adequate buffer and plating
of trees
Others, specify
________________________
PEOPLE
Displacement of
residents in the
project site and
within its vicinity
Displacement of
Indigenous Peoples
Enhanced
employment and/or
livelihood
opportunities
Reduced
employment and/or
livelihood
opportunities
Increased revenues
for LGU

barangay:
1,000 persons
>1,000 and 5,000

persons
>5,000 persons
Urban
Rural

host barangay:
employment
cultural practices

presence/absence of
complaints
with LGU
Others, specify
________________

construction/
operation cost
13
Possible
Impacts
Disruption/
Competition in
delivery of public
services (e.g.,
education, peace
and order, etc.)
Enhanced delivery
of public services
(e.g., education,
peace and order,
etc.)
Increase in traffic
volume and
flow
Impacts on
community health
and safety
Others, specify
_______________
school, college)

hospitals, etc.)

Implementation
Cost of Mitigation/
Monitoring

Others, specify
_________________

Others, specify
___________________

practicable

any emergency.
Regularly spray disinfectant,
pesticides and other similar
substances when applicable
workers
RA 6969
Others, specify
__________________

presence/absence of
complaints
with LGU
agency
Others, specify
______________

construction/
operation cost


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.
Provide institutional mechanisms including identification of responsible entities in the event of
abandonment.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
14
Attach sketch plan/lay-out of the project
(Use additional sheet, if necessary)
15
Attach site development/layout plan (with dimensions and descriptions)
16
_______________________________.
____________________________________
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
__________________________.
Doc No. ___________________________

Page No. __________________________
Book No. __________________________
Series of __________________________
17
Annex 2 - N
GENERIC INITIAL ENVIRONMENTAL EXAMINATION (IEE) CHECKLIST REPORT FORM
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.
Accountability Statements of Proponent (see attached form) and the Preparer (if any, following
Annexes 2-22 of Revised Procedural Manual for DAO 2003-30)
Photographs or plates/vicinity map of the project site showing impact areas and affected areas and
communities
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.
consultants/facilitators/preparers to accomplish/fill-up the IEE Checklist Report Form.
The Report Forms have been designed to be user-friendly.
Furthermore, the EMB Regional Office is required to complete the processing of an
ECC application using the IEE Checklist Report within twenty (20) working days upon
receipt of duly-accomplished forms with complete attachments.
OK FOR PRINTING:
________________________________________
___________________________
Date
Generic Initial Environmental Examination (IEE) Checklist Report Form
PROJECT FACT SHEET

Name of the Project
Proponent Name
Proponent Address
Proponent Means of
Contact
I.
Name:
Landline No.
Designation:
Fax No.
Mobile No.
Email:
PROJECT DESCRIPTION

City/Municipality
Province
Region
on OCT/TCT/etc.)
Longitude
Latitude

_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

Facilities
No. of
Units
Area (sq/M)/
Capacity
Remarks
1. Material storage facility

Raw, chemical and process
materials
Fuel, lubricants and similar
materials
Finished product (e.g.,
equipment facilities, silo, hopper,
etc.)
Others, specify
________________
2. Processing facility
Material preparation and
handling (e.g., screening,
sorting, conveyor belt, etc.)
Material size
Heating/Drying (direct
heat/energy application)
Processing (e.g., mixing,
blending, refining, milling, etc.)
Finishing (e.g., sorting, filling,
packaging, etc.)
Others, specify
________________
3. Support Facilities (e.g.,
emergency generators, boilers,
steam generators, etc.)
4. Admin support (e.g., canteen,
office, clinic, quarters, etc.)
facility
8. Drainage system
9.
Others, specify
_____________________
_____________________
(Please list facilities by module/grouping. Use additional sheets if needed)
I.3 UTILITIES/REQUIREMENTS (Operation Phase)

Utilities
Source
KWh
Power/Electricity
KWh
Water (Total)
m3/day
Water
m /day
Water Source
ground water
well
surface water
river
spring
lake
others: ____________________________
others: ____________________________

____________________________________________________________________
Utilities
Power/Electricity
Water
Measures
Estimated Savings
KWh
m3/day
I.4 MANPOWER
Expertise/Skills
Total
b. Operation Phase
Expertise/Skills
Total

Project Cost (PhP): ______________________
6

Possible
Impacts
LAND
Current land use w/in 1km radius (as
per zoning ordinance):
use
Residential
Implementation
Cost of Mitigation/
Monitoring

with land use
Industrial
Protected Areas
Others, specify
___________________
due to vegetation
clearing
Residential
Industrial
Protected Areas
Others, specify
___________________
Forestland
Marshland
Grassland
Mangrove
Wetland
Others, specify
____________________

possible
area replanted/
re-vegetated
Cost integrated
in the
construction/
operation cost
7
Possible
Impacts
Change in surface
terrain/slope
Soil Erosion
Slope:
flat (0-3%)
gently sloping to rolling (3-18%)
steep (>18%)

identified by MGB/PAG-ASA/
Soil/Land contamination
due to improper solid
waste disposal
Yes
No
sandy
clay
sandy-loam
Others, specify
_________________________

protection measures
Implementation

or other soil cover
Others, specify
___________________________
slope protection
Cost of Mitigation/
Monitoring
Regular inspection
for new eroded areas
near the site
Slope/ Erosion
Control Cost:
__________
Others, specify
____________
Others, specify
_________________

construction area
waste materials
wastes
waste collectors
waste collection
Others, specify
___________________________
Daily inspection of
for segregation
presence of mixed
waste accumulated
Others, specify
_________________
Cost integrated
in the
construction/
operation cost
8
Possible
Impacts
aesthetics
Devaluation of land
values
Yes
No

Implementation
landscaping and
other beautification
activities

owners
Others, specify
________________

sanitary facilities
its workers to observe proper waste
Regular (ocular)
inspection of:
Cost of Mitigation/
Monitoring
Cost integrated
in the
construction/
operation cost
buffer zones
Regularly monitor
presence/absence of
complaints from
adjacent property
owners
WATER

Water quality
degradation
Others, specify
___________________

body:
____________________________
Distance to nearest/receiving water
body:

0.5 to 1 km
More than 1 km

fresh water, specify classification:
AA
A
B
C
D

coastal or marine water, specify
classification:
SA
SB
SC

tanks/ motorpool/ maintenance
areas
Others, specify
____________________________
Drainage / canal
systems
Water treatment
the following:
pH
TSS concentration
BOD
Total Coliform
Color
Oil and Grease
Cost integrated
in the
construction/
operation cost
9
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
SD
Current Water Use:
Fishery
Tourist Zone / Park
Recreational
Industrial
Agricultural

nearest well used:

0.5 to 1 km
More than 1 km
use
Depletion of water
resources
Drinking/Domestic
Industrial
Agricultural
Size of population using receiving

surface water:
1,000 persons
>5,000 persons
Deepwell
Water district/LGU
Surface water
Others, specify
________________________

source of water
measures;

Others, specify
_____________________
Regular monitoring
for presence/absence
of complaints
with concerned
agencies
Regular monitoring
for occurrences of
water shortages
Others, specify
__________________
Cost integrated
in the
construction/
operation cost
10
Possible
Impacts
Increased occurrence of
flooding
identified by MGB/PAG-ASA as
flood prone?
Yes
No

facilities
Implementation

system

flow

contamination
Others, specify
_____________________
Regular monitoring
of complaints
with concerned
agencies
Regular monitoring
for increased
frequency of flooding
Cost of Mitigation/
Monitoring
Cost integrated
in the
construction/
operation cost
Others, specify
__________________
AIR / NOISE

0.5 to 1 km
More than 1 km

device/s
practices
Others, specify
___________________
Regular monitoring
of complaints
the following:
TSP
NOx
SOx
Frequency
Annual
Semi-annual
Regular (ocular)
inspection of:
Absence of white or
black smoke from
vehicles, heavy
equipment and
generator
Cost integrated
in the
construction/
operation cost
11
Possible
Impacts
Implementation
Cost of Mitigation/
Monitoring
Presence of truck
cover during
deliveries

generation

0.5 to 1 km
More than 1 km

noise sources (e.g. vehicles,
barriers, etc.)
Regularly monitor
presence/absence of
complaints
buffer zones
Cost integrated
in the
construction/
operation cost

hours
planting of trees
Others, specify
______________________
PEOPLE
Displacement of
site and within its
vicinity
Displacement of
Indigenous People
Size of population of host barangay:
1,000 persons
>1,000 and 5,000persons
>5,000person
Enhanced employment
and/or livelihood
opportunities
Reduced employment
and/or livelihood
opportunities

host barangay:
Increased revenues for

LGU
Disruption/Competition
in delivery of public
services (e.g.,
Urban
Rural

school, college)
hospitals, etc.)
employment
Prior consultation & coordination to
minimize disruption on daily
domestic activities & respect for IP
rights and cultural practices
Others, specify
________________
Regular monitoring
of complaints
with LGU
Others, specify
_________________
Cost integrated
in the
construction/
operation cost
12
Possible
Impacts
order, etc.)
order, etc.)
Implementation
Cost of Mitigation/
Monitoring

Others, specify
_____________________
Increase in traffic
of traffic flow
health and safety
Safety Risks
Fire
Explosion
Release of toxic
materials
Source of risks
Explosives

practicable
Flammable substances
Toxic substances
Others, specify
_________________________

any emergency.
workers
RA 6969
Others, specify
___________________________
Regular monitoring
of complaints
buffer zones
with LGU
Regular submission
of reports to
concerned agency
Others, specify
_________________
Cost integrated
in the
construction/
operation cost
Generic Initial Environmental Examination (IEE) Checklist Report Form13

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
13
14
descriptions)
15
_______________________________.
____________________________________
_____________________________________
Signature
____________________________________
Position
____________________________________
Company Name
__________________________.
Doc No. ___________________________
Page No. __________________________
Book No. __________________________
Series of __________________________
16

DRR-CCA EIA Technical Guidelines

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DRR-CCA EIA Technical Guidelines

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Republic of the Philippines

Environmental Impact Assessment (EIA)

EIA DRR/CCA TECHNICAL GUIDELINES

Overview of the Philippine EIS System

C. PROCEDURES IN USING THE DRR/CCA-ENHANCED SCREENING

The Executive Summary

Section II. Key Environmental Impact and Management/Monitoring Plan

Section III. Environmental/Ecological Risks Assessment

Section IV. Impact Management Plan (IMP)

Section VI. Environmental Compliance Monitoring

Section VII. Emergency Preparedness and Response Policy and

Section VIII. Abandonment/Decommissioning/Rehabilitation Policy

Section IX. Institutional Plan for EMP Implementation

D. PROCEDURES IN USING THE DRR/CCA-ENHANCED IEE CHECKLIST

EIA DRR/CCA TECHNICAL GUIDELINES

2. Use of the IEE Checklist Report Forms

EIA DRR/CCA TECHNICAL GUIDELINES

Acronyms & Abbreviations

Comprehensive Agrarian Reform Program

EIA DRR/CCA TECHNICAL GUIDELINES

Quantitative Risk Assessment

EIA DRR/CCA TECHNICAL GUIDELINES

EIA DRR/CCA TECHNICAL GUIDELINES

EIA DRR/CCA TECHNICAL GUIDELINES

EIA DRR/CCA TECHNICAL GUIDELINES

Please do not delete this page (section break)

EIA DRR/CCA TECHNICAL GUIDELINES

EIA DRR/CCA TECHNICAL GUIDELINES

1. Objectives of the Guidelines

EIA DRR/CCA TECHNICAL GUIDELINES

Note for Users:

2. Scope of the Guidelines

B. GENERAL GUIDANCE FOR MAINSTREAMING DRR/CCA IN EIA

EIA DRR/CCA TECHNICAL GUIDELINES

Mainstreaming DRR/CCA in the EIA Process

EIA DRR/CCA TECHNICAL GUIDELINES

EIA DRR/CCA TECHNICAL GUIDELINES

For projects that require an EIS, DRR/CCA-enhanced EIS Screening

EIA DRR/CCA TECHNICAL GUIDELINES

EIA DRR/CCA TECHNICAL GUIDELINES

For projects that require an EIS, t h e DRR/CCA-enhanced EIS Screening

Impact Mitigation Planning

Preparation of the Environmental Impact Statement (EIS)

EIA DRR/CCA TECHNICAL GUIDELINES

For projects that require an EIS, t h e DRR/CCA-enhanced EIS Screening

Project Monitoring and Evaluation

EIA DRR/CCA TECHNICAL GUIDELINES

C. PROCEDURES IN USING THE DRR/CCA-ENHANCED SCREENING FORMS

2. Use of the EIS Screening Forms

EIA DRR/CCA TECHNICAL GUIDELINES

3. The EIS Screening Forms

EIA DRR/CCA TECHNICAL GUIDELINES

EIA DRR/CCA TECHNICAL GUIDELINES

Section II. Key Environmental Impact and Management / Monitoring Plan

EIA DRR/CCA TECHNICAL GUIDELINES

Projected inventory of hazardous materials

EIA DRR/CCA TECHNICAL GUIDELINES

EIA DRR/CCA TECHNICAL GUIDELINES

D. PROCEDURES IN USING THE DRR/CCA-ENHANCED IEE CHECKLIST

Purpose of the IEE Checklist Report Forms

EIA DRR/CCA TECHNICAL GUIDELINES

2. Use of the IEE Checklist Report Forms

Project proponents are strongly discouraged from engaging the services of