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PROJECT ENVIRONMENTAL MONITORING AND AUDIT PRIORITIZATION

SCHEME (PEMAPS) QUESTIONNAIRE


Project Name
Project Location
Proponent
Pollution Control Officer
Tel. No./Fax No./Email

:
:
:
:
:

Project Type
Project Status

:
:

I.

PROJECT CONSIDERATIONS

Size and Type


Size based on number of employees
Specify number of employees:
Type
ECP
Non-ECP but in ECA
Non-ECP and Non-ECA
Waste Generation and Management
Enumerate Waste Type and Specify Quantity of Wastes generated in your facility. (Identify
/Enumerate)
Category

Waste

Hazardous

Type
Non-Hazardous

Quantity

Waste 1
Waste 2
Waste N

Air
Liquid
Solid

Pollution Control System (PCS)


Enumerate PCS or Waste Management Method Used in your facility.
(Identify /Enumerate)
Category
Air
Liquid

PCS/Waste Management Method Used


PCS 1
PCS 2
PCS N
Primary
Secondary
Tertiary

Remarks

Solid
PATHWAYS
Prevailing wind towards barrio or city? (mark the corresponding point) Yes ____ No ____
Rainfall (impacts surface & groundwater pathways)
Average annual net rainfall:
Specify amount:
Maximum 24-hour rainfall:
Specify amount:
Terrain (select one and mark) Flat ____ Steep ____

Is the facility located in a flood-prone area? (select one and mark) Yes ____ No ____
Ground Water
Depth of groundwater table (meter)
0 to less than 3
3 to 10
Greater than 10
RECEIVING MEDIA/RECEPTORS
Air (Distance to nearest community)
0 to less than 0.5 km
0.5 to 1 km
Greater than 1 km
Receiving Surface Water Body
Distance to receiving surface water:
0 to less than 0.5 km
0.5 to 1 km
Greater than 1 km

(select one and mark)

(select one and mark)

(select one and mark)

Size of population using receiving surface water


Specify number:
Fresh Water
Classification of fresh water
AA
A
B
C
D

(select one and mark)

Size of fresh water body


Specify size:
Economic value of water use
(may select more than one of the criteria below)
Drinking
Domestic
Recreational
Fishery
Industrial
Agricultural
Salt water
Classification of salt water
SA
SB
SC
SD

(select one and mark)

Economic value of water use


(may select more than one of the criteria below)
Fishery
Tourist zone or park
Recreational
Industrial
Ground Water
Distance to nearest recharge area
(select one and mark)
0 to less than 0.5 km
0.5 to 1 km
Greater than 1 km

Distance to nearest well used

(select one and mark)

0 to less than 0.5 km


0.5 to 1 km
Greater than 1 km
Groundwater use within the nearest well
(may select more than one of the criteria below)

Drinking
Industrial
Agricultural
Land
Indicate current/actual land uses within 0.5 km radius:
(may select more than one of the criteria below)

Residential
Commercial/Institutional
Industrial
Agricultural/Recreational
Protected Area
Potential/proposed land uses within 0.5 km
(may select more than one of the criteria below)

Residential
Commercial/Institutional
Industrial
Agricultural/Recreational
Protected Area
Number of affected Environmentally Critical Areas within 1 km:
Specify number:
Distance to nearest ECA
0 to less than 0.5km
0.5 to 1 km
Greater than 1 km

(select one and mark)

IV.
ENVIRONMENTAL PERFORMANCE
Compliance (pls. take note that this will be double-checked with PCD files)
Type (pls. specify number of times committed)
Violation
STANDARD
Law
(check if
Emission/Effluent/
Human Admin/
any)
Ambient
Discharge
Impact
ECC
RA 8749
RA 9275
RA 6969
PD 1586
RA 9003
Number of Valid Complaints
Citizen and NGOs
Specify number:
Others (other Govt. Agencies, Private Institutions)
Specify number:
(To be filled up by EMB Personnel)
RECOMMENDATION/S:

Assessed By:
Noted By:

Type of
Admin
Violation

Additional
Remarks/Status
of Compliance

ACCOUNTABILITY STATEMENT OF PROJECT PROPONENT


This is to certify that all information in the submitted Project Environmental
Monitoring And Audit Prioritization Scheme (PEMAPS) Questionnaire of
_______________________ located at _______________________ is true,
accurate and complete. Should I learn of any information, which makes this
inaccurate, I shall bring said information to the appropriate Environmental
Management Bureau Regional Office.
In
witness
whereof,
I
hereby
set
out
my
hands
_______________________ day of 200_ at _______________________.

this

PROJECT PROPONENT

SUBSCRIBED AND SWORN to before me this _______________________


day of _______________________ 200_ at _______________________. Affiant
exhibiting to me his/her Community Tax Certificate No. _______________________
issued on _______________________.

Doc. No.
Page No.
Book No.
Series of 200_