Professional Documents
Culture Documents
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Project Type
Project Status
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I.
PROJECT CONSIDERATIONS
Waste
Hazardous
Type
Non-Hazardous
Quantity
Waste 1
Waste 2
Waste N
Air
Liquid
Solid
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
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
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
this
PROJECT PROPONENT
Doc. No.
Page No.
Book No.
Series of 200_