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
Acknowledgement v
Memorandum Circular #005 vi
A. INTRODUCTION 1
1. Context/Rationale 1
2. Objectives of the Guidelines 2
3. Scope of the Guidelines 3
B. GENERAL GUIDELINES FOR MAINSTREAMING DRR/CCA IN EIA 3

1. Overview of the Philippine EIS System 3
2. Mainstreaming DRR/CCA in the EIA Process 4
Basic Project Considerations 4
Project Screening 5
Project Scoping 5
Impact Analysis 6
Impact Mitigation Planning 8
Preparation of the Environment Impact Statement (EIS) 8
Review Process 9
Project Monitoring and Evaluation 9
C. PROCEDURES IN USING THE DRR/CCA-ENHANCED SCREENING

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FORMS
1. Purpose of the EIS Screening Forms 10
2. Use of the EIS Screening Form 10
3. The EIS Screening Forms 11
The Executive Summary 11
Section I. Project Description 12
Section II. Key Environmental Impact and Management/Monitoring Plan 13
Section III. Environmental/Ecological Risks Assessment 14
Section IV. Impact Management Plan (IMP) 14
Section V. Social Development Plan (SDP) and IEC Framework 15
Section VI. Environmental Compliance Monitoring 15
Section VII. Emergency Preparedness and Response Policy and
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Generic Guidelines
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 16

REPORT
1. Purpose of the IEE Checklist Report Forms 16
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2. Use of the IEE Checklist Report Forms 17

3. Coverage and Scope 17
4. The IEE Checklist Report Forms 20
Executive Summary (Project Fact Sheet) 21
Project Description 21
Environmental Impact and Management Plan 21
Abandonment/Decommissioning/Rehabilitation Policies and Generic
22
Guidelines
Institutional Plan for EMP Implementation 22
5. Documentary Requirements 22
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 Comprehensive Agrarian Reform Program
CADC/CADT Certificate of Ancestral Domain Claim/Certificate of Ancestral Domain Title
CCA Climate Change Adaptation
CNC Certificate of Non-Coverage
COC Coal Operating Contract
DAO DENR Administrative Order
DENR Department of Environment and Natural Resources
DRA Disaster Risk Assessment
DO Dissolved Oxygen
DRR Disaster Risk Reduction
ECA Environmentally Critical Area
ECC Environmental Compliance Certificate
EIA Environmental Impact Assessment
EIARC Environmental Impact Assessment Review Committee
EIS Environmental Impact Statement
EGF Environmental Guarantee Fund
EMF Environmental Monitoring Fund
EMB Environmental Management Bureau
EMB-RO Environmental Management Bureau-Regional Office
EMoP Environmental Monitoring Plan
EMP Environmental Management Plan
EPRMP Environmental Performance Report and Management Plan
EU European Union
IFMA/CBFMA Integrated Forest Management Agreement/Community Based Forest Management
Agreement
GDP Gross Domestic Product
IEC Information, Education, and Communication
IEE Initial Environmental Examination
IP Indigenous Peoples
IPCC Inter-governmental Panel on Climate Change
LGU Local Government Unit
M&E Monitoring & Evaluation
MC Memorandum Circular
MDGF Millennium Development Goal Achievement Fund
MGB Mines and Geo-Sciences Bureau
MMT Multi-Partite Monitoring Team
MPSA Mineral Production Sharing Agreement
MSDS Material Safety Data Sheet
MT Metric Ton
NAMRIA National Mapping and Resource Information Authority
NDCC National Disaster Coordinating Council
NDRRMC National Disaster Risk Reduction Management Council
NEDA National Economic and Development Authority
NGO Non-Government Organization
NOx Nitrogen Oxides
OCT Original Certificate of Title
PAGASA Philippine Atmospheric, Geophysical and Astronomical Services Administration
PDS Project Description for Scoping
PEISS Philippine Environmental Impact Statement System
PHIVOLCS Philippine Institute of Volcanology and Seismology
PCL Priority Chemical List
PEPRMP Programmatic Environmental Performance Report and Management Plan
RPM Revised Procedural Manual
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QRA Quantitative Risk Assessment

ROW Right of Way
SDP Social Development Plan
SOx Sulfur Oxides
TCT Transfer Certificate of Title
TSP Total Suspended Particulate
TSS Total Suspended Solids
UNDP United Nations Development Programme
USLE Universal Soil Loss Equation
WFP Work and Financial Plan
WWTF 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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NEDA-UNDP-EU, Guidelines on Mainstreaming Risk Reduction in Sub-national Development and land use/physical planning in the Philippines
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NEDA-UNDP-EU, Guidelines on Mainstreaming Risk Reduction in Sub-national Development and land use/physical planning in the Philippines
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Inter-governmental Panel on Climate Change (IPCC). Fourth Assessment Report: Climate Change 2007 (The Physical Science Basis)
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drought in mid-latitudes and semi-arid latitudes, increased water stress in many parts of the world,
increased damage from storms, and coastal flooding affecting millions more people each year.
The IPCC also concludes in the report of Working Group II that there are documented associations
between changes in temperature and observations of changes in physical and biological systems in the
aquatic, terrestrial and marine environments. These are environmental receptors that are typically
covered in EIAs. As such, it is imperative for the EIA to not only focus on possible environmental
degradation but to also ensure that the disaster- and climate-related consequences of potential projects
are carefully spelled out as part of the assessment process and taken into account in project design. For
instance, clearing mangroves to make way for prawn farming or tourism development may generate
substantial livelihood opportunities, but it also increases exposure to storm surges and tsunamis.
To ensure that natural hazard- and climate-related factors are incorporated in the EIA, the following need
to be observed:
Natural hazards, climate change and related risks should be considered as a fundamental first
step in broader project scoping and the findings should be used to determine if disaster and/or
climate change risks should be examined in further detail in other components of the project
appraisal process.
Systematic analysis of the potential disaster/climate risk-related consequences of a project via its
impact on the environment should be included as a central component of the assessment
process, especially in hazard-prone areas.
Measures to address identified environmental issues, including disaster risk reduction/climate
change adaptation (DRR/CCA) concerns should be formulated for incorporation in the final
design and implementation of the project.
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.
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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.
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The EIA process in the Philippines consists of seven (7) steps presented in brief below. Each step is
equally important in determining the overall environmental performance of the project:
1. Screening. This first step in the EIA process serves to determine whether a proposed project is
covered under the PEISS and, if covered, the level of assessment required.
2) Scoping. This step identifies the key issues and corresponding impact that should be the focus
of the EIA. This stage also defines the spatial boundary and time limit of the study.
3) Impact analysis. This step includes gathering of baseline information as well as identification
and prediction of the likely environmental and social impact of the proposed project and the
evaluation of its significance.
4) Mitigation. This step involves the formulation of recommended actions to reduce and avoid
the potential adverse environmental consequences of development activities.
5) Reporting. At this stage, the results of the EIA in the form of a report (i.e., EIA report) is
prepared for submission to the EMB.
6) Review of EIA/Project Appraisal. Here, the EMB examines the adequacy and appropriateness
of the EIA report. The EMB also ensures that information necessary for decision-making is
contained in the EIA report.
7) Project Implementation and Monitoring. At this stage, the project is commissioned. The
Project Monitoring and Evaluation (M&E) system is designed to ensure that the actual impact of
the project does not exceed the legal standards, and implementation of the mitigation
measures are consistent with those in the EIA report.
2. 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
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harm, and that precautionary measures should be taken even if some cause and effect relationships are
not fully established scientifically.
Project Screening
Screening of projects for coverage and EIA Requirement under the PEISS involves the consideration of
the project type (i.e., ECP) and thresholds, as well as its location in Environmentally Critical Areas
(ECAs).
Conceptually, projects would undergo additional screening by determining if their environmental impact
are highly likely to contribute to increased vulnerability to natural hazards and climate change. This
impact would be site-specific, typically reversible and, in most cases, risk reduction/mitigation measures
could easily be incorporated in the EMP/EMoP.
Under the EIA DRR/CCA Technical Guidelines, the screening process will be strengthened with the use
of hazard maps generated by mandated agencies (e.g., PHIVOLCS, MGB) and funded projects (e.g.,
READY Project). The screening process is further refined with the use of the climate change projections
generated by PAGASA.
Project Scoping
This stage of the process is critical as it defines the scope of the EIA to be required. EIA reports should, in
general, present detailed information concerning the nature, scope, setting (legal, financial, institutional)
and timing for the proposed project or activity. The level of information that may be required shall be
within what is relevant and available at the Feasibility Study Stage specific detailed engineering design
shall not be required. The project description to be submitted for purposes of scoping should contain
sufficient information to frame the scope of the EIA investigation so that time and resources are focused
on relevant issues.
It is important to note that scoping simply indicates whether or not there are concerns that need to be
addressed. It does not determine the extent of an effect, or whether an effect will actually occur. Public
concern raised at a meeting is sufficient at this stage to flag an issue as important enough to be included
in the scoping task. It is at this stage that scoping must also determine whether natural hazards and/or
climate change is/are relevant and should be included in the EIA whether in relation to potential
changes to the environment, or in consideration of the effects of the environment on the project.
Scoping must consider both natural hazards and climate change in relation to:
Project design criteria current project design criteria and code-related issues (i.e., regulatory
requirements such as safety, structural) must be reviewed and justified with respect to predicted
climatic changes and to the physical environment over the life span of the project. If
necessary, the project design criteria must be amended appropriately and/or modified design
factors must be applied to the project.
Ecological, socio-economic and physical factors possible changes and/or additions to
critical environmental receptors to be studied (e.g., health and safety, or pathways) due to
natural hazards and/or climate changes over the 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
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determined, and the existing definitions of significance should be used to evaluate the impact of the
project after climate change considerations have been integrated.
The EIA, being ideally conducted at the project planning stage, has a lot of uncertainties, thus the need to
consider options and alternatives. The analysis of environmental impact shall consider range of
assumptions on production capacity, areas of development, process technologies, emissions, discharges
and other wastes. Under the DRR/CCA-enhanced guidelines, the PAGASA climate projections for 2020
and 2050 in the province where the project is to be located should be integrated into the project impact
analysis. Examination of the consequences of climate variability and changes, as well as the
effectiveness, costs and feasibility of adaptations that can reduce vulnerability at the project level shall
also be included in the impact analysis.
Ideally, the EIA shall consider the potential effects of the project (during construction, operation and, if
relevant, decommissioning) on the frequency, intensity and consequences of significant natural hazards
and the impact of these hazards, in turn, on the project. The assessment should take into account
relevant natural hazards and climate change concerns (e.g., how a rise in sea level might affect storm
surges, or how changes in precipitation might affect drought and flooding). In some cases, findings of
mathematical and computer-based hazard modeling exercises in the project area (for instance,
modeling of earthquake, flood or windstorm) should be used. Such exercises, if not available, should be
undertaken for large projects in high-risk areas.
On the other hand, the EIA process provides an excellent means to ensure that environmental effects on
the project are considered and factored into project decision-making. Possible adverse effects of the
environment (in terms of natural hazards and/or climate change) on the project may include:
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.
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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.
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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
9
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 pre-
planning 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 should be
considered/studied and incorporated in the project design
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 Criteria/Limit

(Threshold)
Batching and Crushing Regardless of size and capacity
Plant (those that are mobile or to be
----
operated for less than 1 year may be
issued CNC)
Fishery/Aquaculture For projects using fresh or brackish
1 hectare but < 25 hectares
water
For projects located in coastal or
marine area (off-shore)
Food & Food By-product Animal products processing
125 MT but < 2,500 MT
and Beverages (fish/meat processing, canning,
(Annual production/rated capacity)
Manufacturing Plants slaughterhouses, etc.)
Coconut processing plants
< 25,000 MT
(including production of coconut-
(Monthly rated/production rate)
based products)
Distillation and Fermentation Plants < 50,000 MT
( e.g. bio-ethanol project) (Annual production/rated capacity)
< 125 MT
Fruit and vegetable processing
(Annual production/rated capacity)
Other types of food (and other food by- < 50,000 MT
products, additives, etc.) processing (Annual rated/production rate of
industries finished product)
< 10,000 L (liquid)
or
Processing of dairy products
< 100 MT (solid)
(Monthly production rate)
< 50,000 MT
Sugar Mills
(Annual rated/production rate)
Non-Food (Textile, 30,000 MT
Glass-based products
Rubber, Chemical) (Annual rated/production rate)
Manufacturing Plants Metal-based products (including
15,000 MT
semi-conductor / electronic
industries)
15,000 MT
Paper and plastic-based products
Manufacturing, processing and/or use >0.001 MT but < 1.0 MT
of substances included in the Priority (quantity of toxic chemicals to be
Chemical List (PCL) used per month)
Manufacture of agri-chemicals and
> 200 MT but < 30,000 MT
other industrial chemicals not in the
PCL
Pharmaceutical industries and
manufacture of soap and
> 200 MT but < 50,000 MT
detergents, health and beauty
products, and other consumer
products.
Surface coating industries (paints,
pigments, varnishes, lacquers, anti- > 200 MT but < 30,000 MT
capacity fouling coating, printing (Annual rated/production rate)
inks)
<50,000 MT
Textile, Wood, Rubber Industries
250 MT
Leather and related industries (Annual rated/production rate of raw
hides)
Metallic Mineral or Ore Processing
(e.g., copper, lead, nickel, cobalt, zinc,
silver, magnesium, and manganese, >200 MT but <70,000 MT
gold, placer with metal content) with (Annual processing (inputs))
Physical or Mechanical Processing
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(Threshold)
Subdivision and Housing Subdivision and housing
projects, resettlement projects,
economic and socialized housing > 10 hectares
project, open market housing and (total land area, including all common,
other similar (horizontal) land open and other areas)
development projects
(Per Memorandum dated 31 May 2012, implementation of
this was deferred. Hence, threshold is >1 hectares)
Low-cost subdivision/housing
and resettlement area projects
(including amenities)
Building Commercial, [business centers with
residential units (mixed use), malls,
1 hectare but <2.5 hectares
supermarkets, public markets]
(total/gross floor area including
Fast food/Restaurant Projects
parking and other areas)
Commercial Establishments
(i.e., Showrooms)
Commercial [office spaces only],
1 hectare (total/gross floor area
Institutional and other related facilities:
including parking and other areas)
religious, government, and educational
Institutional and other related Primary and Secondary hospitals or
facilities: medical facilities Medical Facilities
Institutional and other structures
Regardless of size or area
with laboratory facilities
Motels, Hotels, Condominiums /
1 hectare (total/gross floor area
Apartelles (residential) with
including parking and other areas)
commercial space 10% or less of
the total floor area
Storage facilities, non-toxic/non- 1 hectare
hazardous materials, substances or (total/gross floor area including
products parking and other areas)
Storage facilities, toxic/hazardous 0.1 MT but < 1,000 MT
materials, substances or products (total storage capacity)
Land transport terminal (for buses,
jeepneys and other modes of
(total land area)
transportation) with service facilities
Cemetery & other Cemetery, memorial park and > 5 hectares
Funeral Facilities similar projects (total land area)
1 hectare
Columbarium and similar projects (total/gross floor area including
parking and other areas)
Livestock /Poultry Pigs / Goats 100 heads but < 5,000 heads
(Stock Population)
10,000 heads but < 100,000
Poultry / Birds
heads (Stock Population)
Resorts and other >0.1 hectare but <25 hectares
----
Tourism/Leisure Projects (total area to be developed)
Roads and Bridges Bridges and viaducts, new
80 m but < 10.0 km ( length)
construction
Bridges and viaducts, rehabilitation 50% increase in capacity
and/or improvement (or in terms of length/width)
2 km but < 20.0 km, (length
with no critical slope)
Roads, new construction
OR
(including RO-RO facilities)
2 km but < 10.0 km
(length with critical slope)
Roads, widening, rehabilitation
50% increase in capacity
and/or improvement
(or in terms of length/width)
Elevated roads, flyover/cloverleaf/
Regardless of length and width
Interchanges
19

(Threshold)
Tunnels and sub-grade roads and
< 1.0 km ( length)
railways
All underpass projects
----
(Pedestrian passages)
Water Supply Water Supply Systems (Complete 6 wells and other systems (e.g.,
System) infiltration gallery, etc.)
Water Supply System (Distribution Level III with household
Only) connection and water treatment
Irrigation/Flood < 25 hectares
Control/Minor Dam OR
Impounding System or Flood
3
Control Project impounded water 20 million m
(reservoir flooded area or water
storage capacity)
Irrigation System (Distribution 300 hectares but < 1,000 hectares
System Only) (service area)
Waste Management 3,750 MT
Compost/Fertilizer making
(Annual rated/ production rate)
< 5,000 cubic meter (Quantity of
Domestic waste water treatment
waste to be treated annually)
facility
With composting facilities of 3,750
Materials recovery facility MT or more annual
rated/production rate
< 300,000 MT
OR
Receiving facilities, paper, plastic
involving the use of chemicals
and other material recycling
(Quantity of waste to be treated
annually)
Sanitary Landfill Category 1: Net Residual Waste
Sanitary landfill for domestic waste Generated or Net Residual
only 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:
Executive Summary (Project Fact Sheet)

Project Description
o Project Location and Area
o Project Components
o Utilities Requirement
o Manpower Requirement
o Indicative Project Cost
Environmental Impact and Management Plan

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

Institutional Plan for EMP Implementation
Executive Summary (Project Fact Sheet)
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.
Environmental Impact and Management Plan
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.
Institutional Plan for EMP Implementation
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

Acceptable?
To be filled-up upon submission of EIS Screening Officers Remarks
Yes No
Environmental Impact Statement (EIS)1
Proof of Compatibility with the existing Land
Use Plan
Proof of Authority over the Project Site
Accountability Statements of Preparers &
Proponents (see Annexes 2-21 & 2-22 of
Revised Procedural Manual for DAO 2003-30)
Photographs or plates of the project site,
impact areas and affected areas and
communities
Duly Accomplished Project Environmental
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:
1
Please refer to attached checklist of EIS Contents
1

I. Executive Summary (maximum of 5 pages)
Contents 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 Page # Acceptable?

REMARKS
II. I. Project Description
1) Project Location and a) Map showing sitio, barangay, municipality,

Area province, region boundaries, vicinity, proposed
buffers surrounding the area and primary &
secondary impact areas
b) Geographic coordinates (shape file data) of
project area (use PRS 92 datum - GPS setting)
c) Rationale for selection of primary & secondary
impact areas
d) Discussion on the accessibility of the project
site/area
2) Project Rationale Cite and focus on the need for the project
based on national and regional/local
economic development in terms of
contribution to sustainable development
agenda or current development thrusts.
Describe the justification for the project with
particular reference to the economic and
social benefits, including employment and
associate economic development which the
project may provide. The status of the project
should be discussed in a regional and
national context.
3) Project Alternatives 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.
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.
4) Project Components 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

REMARKS
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 PAG-
ASA 2020 and 2050 projected
rainfall/temperature data.
5) Process/ Technology 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, Phases to be described in terms of identifying

Description of Project specific activities (with special attention on those
Phases and with significant environmental impacts as well as
Corresponding
climate change adaptation options relevant to the
Timeframes
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 start-
up/commissioning/full operation of various
project components) include discussion on the
operation of various components (as identified
above) in terms of material/product handling,
infrastructure requirements (transport
4

REMARKS

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 Page # Acceptable? REMARKS
II. Key Environmental See attached checklist of contents

Impacts and
Management/ When applicable, include appropriate climate
Monitoring Plan change adaptation measures/options (embedded
in each sector).
III. Environmental Risk See attached checklist of contents

Assessment
IV. Impact Limit to most significant impacts per project

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 SDP
Plan (SDP) and IEC
Framework 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)
VI. Environmental Environmental Monitoring Plan ( Self Monitoring)
Compliance Monitoring
Use Annex 2-20 of RPM for DAO 2003-30 as
5
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)
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)
VII. Emergency The safety policy and generic guidelines should
Preparedness and be consistent with the regulatory requirements.
Response Policy and Emergency Preparedness should also consider
Generic Guidelines natural hazards to the infrastructures and
facilities.
VIII. Abandonment/ Statement on proponents policies and generic

Decommissioning/ procedures for Decommissioning/Abandonment.
Rehabilitation Policy
IX. Institutional Plan for Discuss the organizational scheme of the

EMP Implementation proponent including line of command and
reporting procedures as well as manpower
complement and relationships with other
operating departments.
6

Key Environmental Impacts and Management/Monitoring Plan
for completeness during procedural screening; page numbers should be provided
Baseline Data Parameter Required Assessment upon submission of the EIS
List of Key Impacts
Requirements Methodology/Approach Baseline Impact Mgmt. Monitoring
Conditions Analysis Plan Plan Remarks
During scoping: Unless otherwise specified as agreed during scoping, all items listed are required. Write Page Page Page Page
specific instructions (if any) on the blanks/spaces provided.
1. THE LAND
1.1 Land Use and Classification
1.1.1 Change/Inconsistency in land Description & Map showing the Assessment of the
use project area in relation to existing land compatibility of the
use. proposed project in
1.1.2 Encroachment in Identify ECA where the project is relation to land use
Environmentally Critical located or near the project area. and/or the coastal
Areas (ECAs) resource management
Identify areas vulnerable/susceptible plan of the LGU, if any
to natural hazards where the project
is located or near the project area
(include map/s).
1.1.3 Possible tenurial / land issue Identify areas under CARP or with
CADC / CADT where the project is
located or near the project area.
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/ Slope and Elevation/Topographic
topography/ terrain/slope Map
1.2.2 Change in sub-surface/ Regional/General Geological Map
underground geomorphology
1.2.3 Inducement of subsidence, Geological Maps as needed; Hazard Include discussions on
liquefaction, landslides, mud / Maps (NAMRIA, NDRRMC, MGB, impacts/effects of natural
debris flow, etc. PHIVOLCS, PAG-ASA) hazard on the project.
1.3 Pedology
1.3.1 Soil erosion / Loss of topsoil/ Summary of Soil Investigation Report USLE / similar modeling
overburden on soil type and quality; Erodibility when applicable.
potential; Bank stability
If applicable, provide
discussions on possible
soil contaminations due
to project operation
7

List of Key Impacts
1.3.2 Change in soil quality/fertility Laboratory results on soil sample Physical analysis (water
analysis for N, P, K, pH, organic holding capacity;
matter, micronutrients secondary data:
chemical analysis
1.4 Terrestrial Ecology
1.4.1 Vegetation removal and loss Flora and fauna species inventory Quadrat sampling for
of habitat or survey report flora
Historical occurrences of pest
infestation, forest/grass fire and/or Use of mist nets, traps,
similar incidences transect walk for fauna
1.4.2 Threat to existence and/or Summary of endemicity/ conservation
loss of important local species status Include discussions on
1.4.3Threat to abundance, Summary of abundance, frequency overall impact to flora
frequency and distribution of and distribution and fauna
important species Economic importance and uses of
significant flora and fauna Include impact
1.4.4 Hindrance to wildlife access Sampling / survey map in relation to assessment on
the project site vegetation (e.g.,
likelihood of destruction)
and specific
management measures
(e.g., protection, balling,
transplanting,
replacement, etc.)
2. THE WATER
2.1. Hydrology/Hydrogeology
2.1.1 Change in drainage Drainage map; historical Discuss possible
morphology/Inducement of flooding/drought occurrences, stream impacts of the project on
flooding/ Reduction in stream flow measurements/estimates; the occurrence of
volumetric flow Delineation of watershed /sub- flooding and vice versa.
watersheds/ floodplain; and Consider extreme
identification of aquifers, if any weather conditions and
the PAG-ASA 2020 and
2050 climate projections.
Assessment should
include potential
occurrence or
8

List of Key Impacts
aggravation of flooding
in nearby areas.
2.1.2 Change in stream, lake water Regional hydrogeological map
depth
2.1.3 Depletion of water resources / Identification of current / projected For project with
competition in water use water use in the area and adjacent significant water
areas requirement, conduct
water balance / budget
Spring and well inventory and location analysis.
map; depth of water table
If applicable, provide
Analysis/estimation of water Aquifer (Groundwater)
availability taking into consideration vulnerability Assessment
the PAG-ASA 2020 and 2050 climate (ie. discussions on
projections groundwater
contamination due to
project operation) or
groundwater
contamination modeling
2.2 Oceanography
2.2.1 Change/disruption in Predicted tides; 24-hour tidal cycles;
circulation pattern Surface current system
2.2.2 Change in bathymetry Bathymetric map USLE / similar modeling
when applicable
2.3 Water Quality
2.3.1 Degradation of groundwater Physico-Chemical characterization of Use DENR standard
quality water : methods and procedures
pH for sampling and
BOD5 analysis.
DO
2.3.2 Degradation of surface water Oil and grease
quality TSS
9

List of Key Impacts
2.3.3 Degradation of coastal/ pesticide analysis
marine water quality others:
__________________________
sampling site map
2.4 Freshwater Ecology

2.4.1 Threat to existence and/or Summary of endemicity/ Include discussions on
loss of important local species conservation status overall impact to
and habitat Abundance of ecologically and freshwater ecology
economically important species
(fishes, benthos, planktons);
Presence of pollution indicator
species
sampling site map

2.4.2 Threat to abundance,
frequency and distribution of
species
2.5 Marine Ecology
2.5.1 Threat to existence and/or Abundance/densities/distribution of Quadrat, transect, line
loss of important local species and ecologically and economically intercept, spot dive,
habitat important species (mangroves, manta tow, marine
2.5.2 Threat to abundance, fishes, benthos, planktons, coral resource
frequency and distribution reefs, algae, seaweeds, sea characterization
grasses); (e.g., municipal and
Presence of pollution indicator commercial fisheries
species; data)
Historical occurrences of red tide,
fish kill or any related event Include discussions on
Marine resource map overall impact to marine
ecology
sampling site map
10

List of Key Impacts
3. THE AIR
3.1 Meteorology/Climatology
3.1.1 Change in the local climate, Monthly average rainfall and In the assessment,
e.g., local temperature temperature of the area; consider the PAG-ASA
Climatological normals/extremes; climate change
Wind rose diagrams; Frequency of projections for 2020 and
Tropical cyclones 2050.
3.1.2 Contribution in terms of Data on Greenhouse gasses (i.e., Discuss the projects
greenhouse gas emissions/ carbon dioxide, methane, nitrous contribution in terms of
sequestration oxide); Calculation of projected GHG greenhouse gas
emission/sequestration emissions/sequestration
3.2 Air Quality (and Noise)

3.2.1 Degradation of air quality Characterization of ambient air Use DENR standard
quality: methods and procedures
TSP for sampling and
PM10 analysis.
SOx
NOx
others:
__________________________
(for sampling methods refer to Clean

Air Act)
sampling site map
3.2.2 Increase in ambient noise Characterization of ambient noise Use DENR standard
level level methods and procedures
for sampling and
sampling site map measurement.
Noise attenuation
modeling (applicable if
there is a source
capable of generating
11

List of Key Impacts
200 dB or more) or with
presence of residential
area in the project
vicinity
4. THE PEOPLE
4.1 Displacement of settler/s Demographic data of impact area: Discuss how the project
- Number of households and would affect existing
household size properties in the area in
Displacement / disturbance of - Land area, terms of relocation and
properties - Population, devaluation
- Population density /growth
Change/conflict in land - Gender and age profile,
ownership - Literacy rate, profile of educational
attainment,
Change/conflict in right of way
4.2 In-migration Settlements map Discuss the in-migration
patterns as a result of
Proliferation of informal Census of population / property that project implementation
settlers will be displaced / disturbed
Housing ownership profile /

availability of housing/ number of
informal settlers
4.3 Cultural/Lifestyle change Demographic data on Indigenous Discuss the impacts on
(especially on Indigenous Peoples, Peoples (if any) and existing IPs and Culture/Lifestyle
if any) Culture/Lifestyle that may be
significantly affected
4.4 Threat to delivery of basic Availability of public services in terms Discuss how the project
services /resource competition of: would affect the delivery
Water supply of basic services and
Power supply may result in resource
Communications/transportation competition in the area
Health resources (Government
4.5 Threat to public health and and Private) Discuss the project
safety Peace and order / crime implementations threat
Education facilities to public health vis--vis
12

List of Key Impacts
Recreational facilities / sports the baseline health
facilities conditions in the area
Statistical data / information related to Analysis of diseases that

public services: may be affected by
Literacy rate, profile of climate change.
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
4.6 Generation of Local Benefits Socioeconomic data:
from the project Main sources of Income
Employment rate/ profile
Enhancement of Sources of livelihood
employment and livelihood Poverty Incidence
opportunities Commercial establishments
and activities
Increased business Banking and financial
opportunities and associated institutions
economic activities
Increased revenue of LGUs

4.7 Traffic congestion Road network/ systems Traffic impact
Existing transportation/traffic situation assessment if applicable
(including capacity of
road system in terms of
load/count)
13
III. Environmental Risk Assessment
for completeness during procedural screening; page numbers should

be provided upon submission of the EIS
Type of Risks Scope of Assessment Report/Output Required ERA ERP Monitoring
Plan Remarks
During scoping: Check () required/applicable items; items with are automatically required; write specific instructions ( if Page Page Page
any) on the blanks/spaces provided.

Safety Risks - Identification of conditions, events and ERA REQUIREMENT
circumstances which could be significant in
bringing about identified safety risks Quantitative Risk
Release of toxic - Description & assessment of the possible
substances Assessment(QRA)
accident scenarios
- Assessment of whether the project location is Specific Instructions:
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 Descriptive/Qualitative Risk
release of toxic substance, as applicable Assessment
Specific Instructions:
_________________________
EMERGENCY PLAN :
_________________________
Refer to Annex 2-7e for the decision

criteria outline
14
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
ECC APPLICATION SCREENING FORM FOR FOOD AND FOOD BY-PRODUCT AND BEVERAGES
MANUFACTURING PLANTS PROJECTS
st nd rd
1 2 3 ___ th Screening

Project Title: _____________________________________________________________________________
Address: ________________________________________________________________________________
OKAY FOR PRINTING: _____________________________________________ ________________________________

Contact No: Fax No:______________Contact Person:__________________________
EIS Consultant: ___________________________________________________________________________
Address: ________________________________________________________________________________
Project Classification Code (Refer to RPM for DAO 2003-30): ______________________________________
Project Size based on Classification: __________________________________________________________
Date
Acceptable?
Yes No
Use Plan
communities


rd
authorized 3 Party Review Fund Manager)
O.R. #
Date
NOTED BY:
___________________________ _________________________
EMB Regional Office

_____________________________
1
1
st nd rd

Contents Page # Acceptable? REMARKS


Management & Monitoring Plan; and EMF Commitments (if applicable)
Items to be
Specific Data Requirement Page # Acceptable? REMARKS
Described
I. Project Description
1) Project Location a) Map showing sitio, barangay, municipality,

and Area province, region boundaries, vicinity,
proposed buffers surrounding the area and
primary & secondary impact areas
project area (use PRS 92 datum - GPS
setting)
c) Rationale for selection of primary &
site/area
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.
3) Project a) Cite criteria used in determining preliminary
Alternatives options for facility siting, development
design, process/technology selection,
resource utilization including discussion of
the consequences of not proceeding with the
project:
as well as mandated agencies)
2
st nd rd
Items to be
Described
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;
including factors significant to the selection

alternative technologies, operation
processes and engineering design
Discuss alternative measures to prevent

occurrence of major impacts

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 Identification of major components (including

Components technical details, such as area
planted/cultivated and types of crops,
processing/manufacturing facilities, capacity,
number, etc.)
etc.)
3
st nd rd
Items to be
Described
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
5) Process/ Processing/Manufacturing
Technology
material balances for the processing plant, and
the anticipated rates of inputs, along with
similar data on products, wastes and recycle
streams
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.
6) Project Size Daily/Monthly/Annual Production rate
Total Project Area in square meters or

hectares
7) Development Phases to be described in terms of identifying

Plan, Description specific activities (with special attention on
of Project Phases those with significant environmental impacts
and
as well as climate change adaptation options
Corresponding
Timeframes 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
st nd rd
Items to be
Described
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
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:
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
Page # Acceptable?
General Contents Specific Content Requirement REMARKS
II. Key See attached checklist of contents
Environmental
Impacts and When applicable, include appropriate climate
Management/ change adaptation measures/options
Monitoring Plan (embedded in each sector).
5
st nd rd
Page # Acceptable?
III. Environmental See attached checklist of contents

Risk Assessment

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

Development Plan
(SDP) and IEC Community development or livelihood
Framework programs/activities, projected beneficiaries,
partner institutions, timeframe of
implementation as well as source and amount
allotted per activity/component (See Annex 2-
IEC (if applicable)

scheme/strategy/methods, Information
medium, timelines and frequency, cost (See
VI. Environmental Self-Monitoring Plan

Compliance
Monitoring Use Annex 2-20 of RPM for DAO 2003-30 as
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
6
st nd rd
Page # Acceptable?
VII. Emergency The safety policy and generic guidelines

Preparedness and should be consistent with the regulatory
Response Policy requirements. Emergency Preparedness
and Generic should also consider natural hazards to the
Guidelines infrastructures and facilities.

Decommissioning/ procedures for
Rehabilitation Policy Decommissioning/Abandonment.
IX. Institutional Plan Discuss the organizational scheme of the

for EMP proponent including line of command and
Implementation reporting procedures as well as manpower
7
ECC APPLICATION SCREENING FORM FOR FOOD AND FOOD BY-PRODUCT AND BEVERAGES MANUFACTURING PLANTS PROJECTS
st nd rd

upon submission of the EIS
Baseline Data Parameter Required Assessment
List of Key Impacts
Requirements Methodology/Approach Baseline Impact Mgmt. Plan Monitoring
Conditions Analysis Plan Remarks
1. 1. THE LAND
1.1.1 Change/Inconsistency in Description & Map showing the Assessment of the
land use project area in relation to existing compatibility of the
land use. proposed project in relation
1.1.2 Encroachment in Identify ECA where the project is to land use and/or the
Environmentally Critical located or near the project area.
coastal resource
Areas (ECAs)
Identify areas vulnerable/susceptible management plan of the
to natural hazards where the project LGU, if any
(include map/s).
1.1.3 Possible tenurial / land Identify areas under CARP or with
issue CADC / CADT where the project is
Specify other conflicting tenurial /
land issues (e.g., IFMA/CBFMA
within COC and within MPSA, etc.)
1.2.1 Change in surface Slope and Elevation/Topographic
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 Include discussions on
subsidence, liquefaction, maps (NAMRIA, NDRRMC, MGB, impacts/effects of natural
landslides, mud / debris PHIVOLCS, PAG-ASA) hazard on the project.
flow, etc.
1.3 Pedology
1.3.1 Soil erosion / Loss of Summary of Soil Investigation USLE / similar modeling
topsoil/overburden Report on soil type and quality; when applicable
Erodibility potential; Bank stability
8
st nd rd

List of Key Impacts
Requirements Methodology/Approach
Baseline Impact Mgmt. Plan Monitoring
1.3.2 Change in soil quality/ Laboratory results on soil sample Physical analysis (water
fertility analysis for N, P, K, pH, organic holding capacity;
matter, micronutrients secondary data: chemical
analysis
1.4.1 Vegetation removal and Flora and fauna species inventory Quadrat sampling for flora;
loss of habitat or survey report;
Historical occurrences of pest Use of mist nets, traps,
infestation, forest/grass fire and/or transect walk for fauna
similar incidences
1.4.2 Threat to existence and/or Summary of endemicity /
loss of important local conservation status
species
1.4.3 Threat to abundance, Summary of abundance,
frequency and distribution frequency and distribution
of important species Economic importance and uses of
significant flora and fauna
1.4.4 Hindrance to wildlife Sampling / survey map in relation to
access the project site
2. THE WATER
2.1 Hydrology/Hydrogeology
2.1.1 Change in drainage Drainage map; historical Discuss possible impacts
morphology / Inducement of flooding/drought occurrences, of the project on the
flooding/ Reduction in stream stream flow occurrence of flooding and
volumetric flow measurements/estimates; vice versa. Consider
Delineation of watershed /sub- extreme weather conditions
watersheds/ floodplain; and and the PAG-ASA 2020
identification of aquifers, if any and 2050 climate
projections
2.1.2 Change in stream, lake Regional hydrogeological map
water depth
2.1.3 Depletion of water Identification of current / projected For project with significant
resources / competition in water water use in the area and adjacent water requirement, conduct
use areas water balance / budget
analysis
9
st nd rd

List of Key Impacts
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
when applicable
2.3 Water Quality
2.3.1 Degradation of Physico-Chemical characterization Use DENR standard
groundwater quality of water : methods and procedures
2.3.2 Degradation of surface

pH for sampling and analysis.
For project with
water quality BOD5 coastal/marine structures
2.3.3 Degradation of coastal/ DO and /or significant marine /
coastal discharges,
marine water quality
Oil and grease conduct circulation / plume
TSS modeling (include worst
fecal / total coliform case scenario of failure of
WWTF)
pesticide analysis
others:
_________________________
sampling site map

2.4.1 Threat to existence Summary of endemicity/
and/or loss of important conservation status
local species and habitat Abundance of ecologically and
2.4.2 Threat to abundance, economically important species
10
st nd rd

List of Key Impacts
frequency and distribution of (fishes, benthos, planktons);
species Presence of pollution indicator
species;
sampling site map

2.5 Marine Ecology
3.5.1 Threat to existence Abundance/densities/distribution Quadrat, transect, line
and/or loss of important local of ecologically and economically intercept, spot dive,
species and habitat important species (mangroves, manta tow, marine
2.5.2 Threat to abundance, fishes, benthos, planktons, coral resource characterization
frequency and distribution reefs, algae, seaweeds, sea (e.g., municipal and
grasses); commercial fisheries
Presence of pollution indicator data)
species;
Historical occurrences of red-tide,
fish kill or any related event
Marine resource map
sampling site map

3. THE AIR
3.1.1 Change in the local Monthly average rainfall and In the assessment,
climate, e.g., local temperature temperature of the area; consider the PAG-ASA
Climatological normals/extremes; climate change projections
Wind rose diagrams; Frequency of for 2020 and 2050.
Tropical cyclones

3.2.1 Degradation of air quality characterization of ambient air Use DENR standard
TSP for sampling and analysis.
PM10
SOx
11
st nd rd

List of Key Impacts
NOx
others:
_________________________

Air Act)
sampling site map
for sampling and
If applicable, noise
attenuation modeling
(applicable if there is
source capable of
generating 200 dB or
more)
4. THE PEOPLE
4.1 Displacement of settler/s Demographic data of impact area:
- Number of households and Discuss how the project
Displacement / household size would affect existing
disturbance of properties - Land area, properties in the area in
- Population, terms of relocation and
Change/conflict in land - Population density /growth devaluation
ownership - Gender and age profile,
- Literacy rate, profile of educational
Change/conflict in right of attainment,
way
4.2 In-migration settlements map Discuss the in-migration
12
st nd rd

List of Key Impacts

informal settlers
4.3 Cultural/Lifestyle change Demographic data on Indigenous Discuss the impacts on IPs
(especially on Indigenous Peoples (if any) and existing and Culture/Lifestyle
Peoples, if any) Culture/Lifestyle that may be
4.4 Threat to delivery of basic Availability of public services in Discuss how the project
services /resource competition terms of: would affect the delivery of
Water supply basic services and may
Power supply result in resource
Communications competition in the area
/transportation
4.5 Threat to public health and Health resources Discuss the project
safety (Government and Private) implementations threat to
Peace and order / crime public health vis--vis the
Education facilities baseline health conditions
Recreational facilities / in the area
sports facilities
Analysis of diseases that
Statistical data / information related may be affected by climate
to public services: change.
Literacy rate, profile of
Morbidity and mortality
rates (infants and adults -
5-year trend)
diseases;
Sanitation Profile;
Crime rate
Food security
13
st nd rd

List of Key Impacts
4.6 Generation of Local Socioeconomic data:
Benefits from the project Main sources of Income
employment and Commercial establishments
livelihood opportunities and activities
Banking and financial
Increased business institutions
opportunities and
associated economic
activities
Increased revenue of
LGUs
4.7 Traffic congestion Road network/ systems Traffic impact assessment
Existing transportation/traffic if applicable (including
situation capacity of road system in
terms of load/count)
14
st nd rd

for completeness during procedural screening; page numbers
Type of Risks Scope of Assessment Report/Output Required should be provided upon submission of the EIS
ERA ERP Monitoring
Plan Remarks
During scoping: Check () required/applicable items; items with are automatically required; write specific instructions ( if any) Page Page Page
on the blanks/spaces provided.

circumstances which could be
Release of toxic significant in bringing about identified Quantitative Risk Assessment(QRA)
substances (e.g. safety risks
ammonia from cold - Description & assessment of the Specific Instructions :
storage facility) possible accident scenarios _____________________________
- Assessment of whether the project
location is projected to have extreme Descriptive/Qualitative Risk
climate events for 2020 and/or 2050 Assessment
that could contribute to the triggering
identified scenarios Specific Instructions :
- 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 Specific Instructions :
__________________________

criteria outline
15
st nd rd
1. 1.
2. 2.
3. 3.
5.
Resource Person
1.
16
Annex 1 - C
ECC APPLICATION FORM FOR NON-FOOD MANUFACTURING PLANTS PROJECTS
st nd rd

Project Title: _____________________________________________________________________________

Address: ________________________________________________________________________________
EIS Consultant: ___________________________________________________________________________
Address: ________________________________________________________________________________
Project Classification Code (Refer to RPM for DAO 2003-30): _____________________________________
Project Size based on Classification: _________________________________________________________
Date
Acceptable?
Yes No
Use Plan

communities

rd
O.R. #
Date
NOTED BY:
___________________________ _________________________
EMB Regional Office

_____________________________
1
1
st nd rd

Page # Acceptable?
Contents REMARKS

Summary of Baseline Characterization, Key Environmental Impacts

and Management & Monitoring Plan; and EMF Commitments (if
applicable)
Items to be Page # Acceptable?

Specific Data Requirement REMARKS
Described

setting)
site/area
Describe the justification for the Project with
associated economic development, which
Alternatives options for facility siting, development design,
project:
2
st nd rd

Described
as well as mandated agencies)
preferred option;
including factors significant to the selection

and engineering design


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 Identification of major components (including

Components technical details, such as area
planted/cultivated, specifications, capacity,
number, etc.)
Identification of other Support Facilities (e.g.,
etc.)
3
st nd rd

Described
Identification of Pollution Control devices and
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
5) Process/ Indicative process flow-sheets showing
Technology material balances for the processing plant, and
streams
Waste Management Systems (e.g., wastewater

treatment facility, baghouse filter, desulfurizer,
other pollution control devices
6) Project Size Daily/Monthly/Annual production rate (refer to
Annex 2-1b)

of Project Phases those with significant environmental impacts as
and
well as climate change adaptation options
Corresponding
timeframes:

Construction (e.g., land/site clearing,
4
st nd rd

Described
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;
nature & estimated number of jobs available
for men, women, and indigenous peoples (if
sited in IP ancestral land);

Environmental

Risk Assessment

V. Social SDP (if applicable)

Development Plan
5
st nd rd

IEC (if applicable)

VI. Environmental Environmental Monitoring Plan ( Self

Compliance Monitoring)
Monitoring
Use Annex 2-20 of RPM for DAO 2003-30 as
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 2003-
30).
Environmental Guarantee and Monitoring Fund
Commitments (if applicable)

2003-30
Response Policy Emergency Preparedness should also consider
and Generic natural hazards to the infrastructures and
Guidelines facilities.

Decommissioning/ procedures for Decommissioning/
Rehabilitation Policy Abandonment.

6
ECC APPLICATION FORM FOR PROPOSED NON-FOOD MANUFACTURING PLANTS PROJECTS
st nd rd

List of Key Impacts Baseline Impact Mgmt. Plan Monitoring Remarks
Requirements Methodology/Approach Conditions Analysis Plan
1. THE LAND
1.1.1 Change/Inconsistency in Description & Map showing the project Assessment of the
land use area in relation to existing land use. compatibility of the
1.1.2 Encroachment in Identify ECA where the project is proposed project in
Environmentally Critical Areas located or near the project area. relation to land use and/or
(ECAs)
the coastal resource
Identify areas vulnerable/susceptible to management plan of the
natural hazards where the project is LGU, if any.
located or near the project area
(include map/s).
issue CADC/ CADT where the project is

issues (e.g., IFMA/CBFMA within COC
and within MPSA, etc.)
1.2.1 Change in surface Slope and Elevation/Topographic Map
landform/ topography/
terrain/slope
underground
geomorphology
liquefaction, landslides, maps (NAMRIA, NDRRMC, MGB, impacts/effects of natural
mud / debris flow, etc. PHIVOLCS, PAG-ASA) hazard on the project.
1.3 Pedology
1.3.1 Soil erosion / Loss of Summary of Soil Investigation Report USLE / similar modeling
topsoil/overburden on soil type and quality; Erodibility when applicable

7
st nd rd
1.4.1 Vegetation removal and Flora and fauna species inventory or Quadrat sampling for
loss of habitat survey report; flora
infestation, forest/grass fire and/or
similar incidences
1.4.2 Threat to existence and/or Summary of endemicity / conservation Use of mist nets, traps,
loss of important local status transect walk for fauna
species
1.4.3Threat to abundance, Summary of abundance, frequency
frequency and distribution and distribution
2. THE WATER
morphology / Inducement of flooding/drought occurrences, stream of the project on the
flooding/ Reduction in stream flow measurements/estimates; occurrence of flooding
volumetric flow Delineation of watershed /sub- and vice versa. Consider
watersheds/ floodplain; and extreme weather
identification of aquifers, if any conditions and the PAG-
ASA 2020 and 2050
climate projections
water depth
2.1.3 Depletion of water Identification of current / projected For project with significant
resources / competition in water water use in the area and adjacent water requirement,
use areas conduct water balance /
Spring and well inventory and location budget analysis
Analysis/estimation of water availability
taking into consideration the PAG-ASA
2020 and 2050 climate projections
2.2 Oceanography
8
st nd rd
when applicable
2.3 Water Quality
2.3.1 Degradation of Physico-Chemical characterization of Use DENR standard
groundwater quality water : methods and procedures
pH for sampling and analysis.
BOD5
For project with
COD coastal/marine structures
DO and /or significant marine/

Oil and grease coastal discharges,
water quality TSS conduct circulation /
plume modeling (include
2.3.3 Degradation of Heavy Metals :_______________
worst case scenario of
coastal/marine water quality fecal / total coliform
failure of WWTF)
others:
__________________________ For project with significant
heavy metals discharges,
conduct sediment
sampling site map transport modeling

loss of important local species conservation status
and habitat Abundance of ecologically and
(fishes, benthos, planktons)
2.4.2 Threat to abundance, Presence of pollution indicator
frequency and distribution of species
species
sampling site map
2.5 Marine Ecology

loss of important local species ecologically and economically intercept, spot dive,
and habitat important species (mangroves, manta tow, marine
fishes, benthos, planktons, coral resource
9
reefs, algae, seaweeds, sea characterization (e.g.,
grasses); municipal and
st nd rd
2.5.1 Threat to existence and/or
loss of important local species
and habitat
3. THE AIR
e.g., local temperature temperature of the area; Climatological consider the PAG-ASA
normals/extremes; Wind rose climate change
diagrams; Frequency of Tropical projections for 2020 and
cyclones 2050.
3.1.2 Contribution in terms of Data on Greenhouse gasses (i.e. Discuss the projects
greenhouse gas emissions carbon dioxide, methane, nitrous contribution in terms of
oxide); Calculation of projected GHG greenhouse gas
emission emissions (applicable for
power and landfill and
possible for mining and
dam)
3.2.1 Degradation of air quality Characterization of ambient air quality: Use DENR standard
TSP methods and procedures
PM10
for sampling and analysis.
SOx If applicable air

NOx dispersion modeling
Trace Metals: (include worst case
____________________ scenario of failure of
others: APCD)
__________________________
(for sampling methods refer to Clean Heavy metals (baseline
Air Act) and modeling) apply to
selected chemical
industries
sampling site map
3.2.2 Increase in ambient noise Characterization of ambient noise level Use DENR standard
level methods and procedures
sampling site map for sampling and
10
st nd rd
measurement.
(applicable if there is a
source capable of
more)
4. THE PEOPLE
Displacement / disturbance - Number of households and Discuss how the project

of properties household size would affect existing
- Land area, properties in the area in
Change/conflict in land - Population, terms of relocation and
ownership - Population density /growth devaluation
- Gender and age profile,
Change/conflict in right of
attainment,
way
Proliferation of informal project implementation
settlers Census of population / property that
will be displaced / disturbed
Housing ownership profile / availability

of housing/ number of informal settlers
(especially on Indigenous Peoples (if any) and existing IPs and Culture/Lifestyle
Water supply of basic services and may
11
st nd rd
Communications competition in the area
/transportation
Health resources
4.5 Threat to public health and (Government and Private) Discuss the project
safety Peace and order / crime implementations threat to
Education facilities public health vis--vis the
Recreational facilities / sports baseline health conditions
facilities in the area

climate change.
trend)
Common diseases in the area
including endemic diseases;
Sanitation Profile;
Crime rate
Food security

from the project
Main sources of Income
Enhancement of Employment rate/ profile
employment and livelihood Sources of livelihood
opportunities Commercial establishments
and activities
Increased business Banking and financial
opportunities and institutions
associated economic
activities
12
st nd rd
LGUs

assessment if applicable
Existing transportation/traffic situation (including capacity of
load/count)
13
st nd rd

ERA ERP Monitoring
Plan
Remarks
circumstances which could be significant in
Fire bringing about identified safety risks Quantitative Risk
Explosion - Description & assessment of the possible Assessment(QRA)
Release of toxic accident scenarios
substances - Assessment of whether the project location Specific Instructions :
is projected to have extreme climate
events for 2020 and/or 2050 that could __________________________
contribute to the triggering identified
scenarios Descriptive/Qualitative Risk
- Description of the hazards, both immediate Assessment
(acute effects) and delayed (chronic
effects) for man and the environment Specific Instructions :
posed by the release of toxic substance,
as applicable ____________________________
Physical Risks - Identification of conditions, events and
trigger which could be significant in EMERGENCY PLAN :
(Failure of Structure which bringing about identified physical risks
could endanger life, property - Description & assessment of the possible Specific Instructions :
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
st nd rd
1. 1.
2. 2.
3. 3.
5.
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: ________________________________________________________________________________

EIS Consultant: ___________________________________________________________________________
Address: ________________________________________________________________________________
Date
Acceptable?
Yes No
Use Plan
communities


authorized 3rd Party Review Fund Manager)
O.R. #
Date
NOTED BY:
___________________________ _________________________
EMB Regional Office

1
1

Contents Page # Acceptable?

REMARKS


Management & Monitoring Plan, and EMF Commitments (if applicable)
Items to be REMARKS
Specific Data Requirement Page # Acceptable?
Described

setting)
site/area
Describe the justification for the project with
associate economic development which the
project may provide. The status of the
2
Items to be REMARKS
Described

project:
as well as other mandated agencies).
option for which the EIS is prepared.
preferred option.
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.



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.
3
Items to be REMARKS
Described

4) Project Identification of major components including
Components 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.)
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.
5) Process/ Indicative process flow-sheets showing material
Technology 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.

and
well as climate change adaptation options
Corresponding
Timeframes relevant to the project and project activities) and
4
Items to be REMARKS
Described
corresponding projected implementation

timeframes:

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;
nature and estimated number of jobs
5

Page # Acceptable?

Environmental

Risk Assessment

V. Social SDP
Development Plan
IEC

scheme/strategy/methods, Information medium,
timelines and frequency, cost (See Annex 2-19
of RPM for DAO 2003-30)

Compliance
template

applicable)

MMT, basis for selection, proposed role, and
30).

Present a proposed amount of EMF (based

on a draft AWFP in Annex 3-4 and
6

Page # Acceptable?

2003-30

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

7
st nd rd

List of Key Impacts
1. THE LAND
1.1.1 Change/Inconsistency in land Description & Map showing the Assessment of the
use project area in relation to existing land compatibility of the
Areas (ECAs) Identify areas vulnerable/susceptible resource management
to natural hazards where the project plan of the LGU, if any
(include map/s).
CADC / CADT where the project is
1.2.1 Change in surface landform/ Slope and Elevation/Topographic
topography/ terrain/slope Map
liquefaction, landslides, mud / Maps (NAMRIA, NDRRMC, MGB, impacts/effects of natural
debris flow, etc. PHIVOLCS, PAG-ASA) hazard on the project.
1.3 Pedology
potential; Bank stability;
analysis for N, P, K, pH, organic holding capacity
matter, micronutrients
8
st nd rd

List of Key Impacts
Conditions
Analysis Plan Plan Remarks
1.4.1 Vegetation removal and loss Flora and fauna species inventory Quadrat sampling for
of habitat or survey report flora
loss of important local species conservation status Include discussions on
1.4.3Threat to abundance, Summary of abundance, frequency overall impact to flora
frequency and distribution of and distribution and fauna
important species Economic importance and uses of
1.4.4 Hindrance to wildlife access Sampling / survey map in relation to assessment on
the project site vegetation (e.g.,
and specific
management measures
transplanting,
replacement, etc.)
2. THE WATER
2.1. Hydrology/Hydrogeology
morphology/Inducement of flooding/drought occurrences, stream of the project on the
ASA 2020 and 2050
climate projections
2.1.2 Change in stream, lake water Regional hydrogeological map
depth
2.1.3 Depletion of water resources / Identification of current / projected
competition in water use water use in the area and adjacent
areas
9
st nd rd

List of Key Impacts
Conditions
Spring and well inventory and location
the PAG-ASA 2020 and 2050 climate
projections
2.2 Oceanography
when applicable
2.3 Water Quality
for sampling and
pH analysis.
2.3.2 Degradation of surface water DO For projects with

quality Oil and grease coastal/marine structures
and /or significant
2.3.3Degradation of coastal/marine
water quality
TSS marine / coastal
others: discharges, conduct
__________________________ circulation / plume
modeling (include worst
sampling site map case scenario of failure
of WWTF)
2.4.1 Threat to existence and/or Summary of endemicity / Include discussions on
loss of important local species conservation status overall impact to
and habitat Abundance of ecologically and freshwater ecology
species
10
st nd rd

List of Key Impacts
Conditions
sampling site map

2.5 Marine Ecology (if applicable)
frequency and distribution reefs, algae, seaweeds, sea characterization
grasses); (e.g., municipal and
species; data)
Historical occurrences of red tide,
Marine resource map overall impact to marine
ecology
sampling site map
3. THE AIR
Monthly average rainfall and In the assessment,
3.1.1 Change in the local climate, temperature of the area; consider the PAG-ASA
e.g., local temperature Climatological normals/extremes; climate change
greenhouse gas emissions/ carbon dioxide, methane, nitrous contribution in terms of
sequestration oxide); Calculation of projected GHG greenhouse gas
emission/sequestration emissions/sequestration
3.2.1 Degradation of air quality, if Characterization of ambient air Use DENR standard
with processing quality: methods and procedures
TSP for sampling and
analysis.
SOx
NOx
11
st nd rd

List of Key Impacts
Conditions
(for sampling methods, refer to Clean
Air Act)
sampling site map

for sampling and
source capable of
more)
4. THE PEOPLE
household size properties in the area in
Displacement / disturbance of - Land area, terms of relocation and
properties - Population, devaluation
- Population density /growth
Change/conflict in land - Gender and age profile,
ownership - Literacy rate, profile of educational
attainment,
Change/conflict in right of way
Settlements map
Census of population / property that


informal settlers
12
st nd rd

List of Key Impacts
Conditions
4.2 In-migration Discuss the in-migration
Settlers
Communications/transportation competition in the area
Recreational facilities / sports the baseline health
facilities conditions in the area

trend)
diseases
Sanitation Profile
Crime rate
Food security
13
st nd rd

List of Key Impacts
Conditions
employment and livelihood Commercial establishments
opportunities and activities
Banking and financial
Increased business institutions
opportunities and associated
economic activities

Existing transportation/traffic situation assessment if applicable
load/count)
14
st nd rd
for completeness during procedural screening; page numbers should

be provided upon submission of the EIS
Type of Risks Scope of Assessment Report/Output Required ERA ERP Monitoring
Plan
Remarks

- Identification of conditions, events and
Safety Risks circumstances which could be significant in
bringing about identified safety risks ERA REQUIREMENT
Fire - Description & assessment of the possible
Release of toxic accident scenarios Quantitative Risk
- Assessment of whether the project location is Assessment(QRA)
substances
(acute effects) and delayed (chronic effects) _________________________
for man and the environment posed by the
release of toxic substance, as applicable Descriptive/Qualitative Risk
- Identification of conditions, events and trigger Assessment
Physical Risks which could be significant in bringing about
identified physical risks Specific Instructions:
- Description & assessment of the possible
(Failure of Structure which
accident scenarios _________________________
could endanger life, property
- Assessment of whether the project location is
and/or the environment)
projected to have extreme climate events for EMERGENCY PLAN :
triggering identified scenarios Specific Instructions:
- Description of the hazards both immediate
(acute effects) and delayed (chronic effects) _________________________
failure of structure, as applicable
criteria outline
15
st nd rd
1. 1.
2. 2.
3. 3.
5.
Resource Person
1.
16
Annex 1 - E
ECC APPLICATION SCREENING FORM FOR HYDROPOWER/DAM PROJECTS

Project Title: _____________________________________________________________________________
Address: ________________________________________________________________________________

EIS Consultant: ___________________________________________________________________________
Address: ________________________________________________________________________________
Date
Acceptable?
Yes No
1
Environmental Impact Statement (EIS)
Use Plan
communities


rd
O.R. #
Date
NOTED BY:
___________________________ _________________________
EMB Regional Office

1
1
ECC APPLICATION SCREENING FORM FOR HYDROPWER/DAM PROJECTS



and Management & Monitoring Plan; EGF and EMF Commitments
Items to be
Described

III.
setting)
site/area
associate economic development, which the
project may provide. The status of the
project:
2
Items to be
Described

as well as other mandated agencies)
preferred option;
feasible.


occurrence of major impacts.

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).


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
Items to be
Described
warning/alarm system, etc.)

Identification of infrastructure requirements
(transportroad/rail/ship, energy, storm
water drainage, sewerage,
other infrastructure),Identification of
materials/product handling facilities,
infrastructure requirements (transport
other infrastructure)
connected.
wastewater
facilities (if any)
buffers.
5) Process/ Technology Description and Performance
Technology Specifications
Indicative process flow-sheets including

efficiency of power generation
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
Items to be
Described
area

Environmental
(embedded in each sector).
Monitoring Plan
III.Environmental See attached checklist of contents

Risk Assessment

Management phase and per environmental component
Plan arising from key environmental aspects (See
V. Social SDP
Development
Plan (SDP) and Community development or livelihood
IEC Framework programs/activities, projected beneficiaries,
IEC


Compliance
Use Annex 2-20 of RPM for DAO 2003-30
as template
5
Monitoring Multi-Sectoral Monitoring Framework

30).


2003-30
VIII. Abandonment Statement on proponents policies and generic

/Decommissioning procedures for Rehabilitation/
/Rehabilitation Policy Decommissioning/Abandonment to be

6

List of Key Impacts Baseline Impact Mgmt. Monitoring
Requirements Methodology/Approach Conditions Analysis Plan Plan Remarks
1. THE LAND
land use project area in relation to existing land compatibility of the
Areas (ECAs) Identify areas vulnerable/susceptible resource management
to natural hazards where the project plan of the LGU, if any
(include map/s).
CADC / CADT/ CALC/ CALT where
the project is located or near the
project area.

landform/ topography/ Map
terrain/slope
1.2.3 Inducement of subsidence, Geological Cross-Sections; Sequence Include discussions on
liquefaction, landslides, mud/ Stratigraphic Column of Rock Units; impacts/effects of natural
debris flow, etc. Geomorphological Map: G Factor hazard on the project.
Contour Maps; Seismicity Map;
Differential Settling Map; Results of
Geochemical Analyses of Rock
Samples (applicable areas); Hazard
maps (NAMRIA, NDRRMC, MGB,
PHIVOLCS, PAG-ASA)
7

Requirements Methodology/Approach Conditions
1.3 Pedology
analysis for N, P, K, pH, organic holding capacity, texture
matter, micronutrients aggregate stability of
dam); secondary data:
chemical analysis

1.4.1 Vegetation removal and Flora and fauna species inventory Quadrat sampling for
loss of habitat or survey report; flora
1.4.2 Threat to existence and/or Summary of endemicity / Impact inundation on
loss of important local conservation status terrestrial ecology
species
1.4.3Threat to abundance, Summary of abundance, frequency Include discussions on
frequency and distribution of and distribution overall impact to flora
important species Economic importance and uses of and fauna
1.4.4 Hindrance to wildlife access Sampling / survey map in relation to Include impact
the project site assessment on
vegetation (e.g.,
and specific
management measures
transplanting,
replacement etc.)
2. THE WATER
2.1.1 Change in drainage Drainage map; historical Flood simulation/
morphology / Inducement of flooding/drought occurrences, stream modeling should
8

flooding/ Reduction in stream flow measurements/estimates; consider extreme
volumetric flow Delineation of watershed /sub- weather conditions and
watersheds/ floodplain; and the PAG-ASA 2020 and
identification of aquifers, if any 2050 climate projections
Assessment should
include potential
occurrence or
aggravation of flooding in
nearby areas.
water depth
2.1.3 Depletion of water Identification of current / projected
resources/competition in water use water use in the area and adjacent
areas

the PAG-ASA 2020 and 2050 climate
projections
2.2 Oceanography
when applicable
2.3 Water Quality
2.3.2 Degradation of surface water

pH for sampling and
analysis.
quality BOD5
Oil and grease
2.3.3 Degradation
marine water quality
of coastal/
TSS
9

sampling site map

2.4.1 Threat to existence and/or Summary of endemicity/ Include discussions on
loss of important local conservation status overall impact to
species and habitat Abundance of ecologically and freshwater ecology
species
sampling site map

2.5 Marine Ecology (if applicable)
frequency and distribution reefs, algae, seaweeds, sea characterization (e.g.,
species; data)
fish kill or any related event Impact on inundation
Marine resource map on marine ecology.
sampling site map Include discussions on

overall impact to
marine ecology
3. THE AIR
e.g., local temperature temperature of the area; consider the PAG-ASA
Climatological normals/extremes; climate change
greenhouse gas emissions/ carbon dioxide, methane); Calculation contribution in terms of
10

sequestration of projected GHG emission greenhouse gas
emissions
3.2.1 Degradation of air quality, if characterization of ambient air quality: Use DENR standard
with processing TSP methods and procedures
for sampling and
(for sampling methods, refer to Clean analysis.
Air Act)
For construction phase
sampling site map only
for sampling and
4. THE PEOPLE
Displacement / disturbance household size properties in the area in
of properties - Land area, terms of relocation and
- Population, devaluation
Change/conflict in land - Population density /growth
way
4.2 In-migration settlements map Discuss the in-migration

informal settlers
11

Communications/ competition in the area
transportation
Health resources
4.5 Threat to public health and (Government and Private) Discuss the project
Recreational facilities / the baseline health
sports facilities conditions in the area

trend)
diseases
Sanitation Profile
Crime rate
Food security
employment and livelihood Poverty incidence
opportunities
12

Increased business Commercial establishments
opportunities and and activities
associated economic Banking and financial
activities institutions

assessment, if applicable
load/count)
13

should be provided upon submission of the EIS
Type of Risks Scope of Assessment Report/Output Required
ERA ERP Monitoring
Plan
Remarks
During scoping: Check () required/applicable items; items with are automatically required; write specific instructions ( if
Page Page Page

circumstances which could be significant in bringing
Fire about identified safety risks Quantitative Risk
Release of toxic - Description & assessment of the possible accident Assessment(QRA)
substances scenarios
- Assessment of whether the project location is Specific Instructions :
projected to have extreme climate events for 2020
and/or 2050 that could contribute to the triggering __________________________
identified scenarios Descriptive/Qualitative Risk
- Description of the hazards, both immediate (acute Assessment
effects) and delayed (chronic effects) for man and
the environment posed by the release of toxic Specific Instructions :
substance, as applicable
Physical Risks - Identification of conditions, events and trigger ____________________________
which could be significant in bringing about EMERGENCY PLAN :
(Failure of Structure which identified physical risks
could endanger life, property - Description & assessment of the possible accident Specific Instructions :
and/or the environment) scenarios
- Assessment of whether the project location is _____________________________
projected to have extreme climate events for 2020 Refer to annex 2-7e for the
and/or 2050 that could contribute to the triggering decision criteria outline
identified scenarios
- Description of the hazards both immediate (acute
the environment posed by the failure of structure, as
applicable
14
1. 1.
2. 2.
3. 3.
5.
Resource Person
1.
15
Annex 1 - F
ECC APPLICATION SCREENING FORM FOR NEW MINING PROJECTS
st nd rd

Project Title: _____________________________________________________________________________

Address: ________________________________________________________________________________
EIS Consultant: ___________________________________________________________________________
Address: ________________________________________________________________________________
Date

Acceptable?
Yes No
Use Plan

communities

rd
O.R. #
Date
NOTED BY:
___________________________ _________________________
EMB Regional Office

_____________________________
1
1

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 Specific Data Requirement Page # Acceptable?

REMARKS
Described
1)Project Location a) Map showing sitio, barangay, municipality,

setting)
site/area
2)Project Rationale Cite and focus on the need for the project
associate economic development, which
3)Project a) Cite criteria used in determining preliminary
resource utilization, including discussion of
the consequences of not proceeding with the
project:
2

REMARKS
Described
preferred option
feasible.

processes and engineering design.


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.


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

REMARKS
Described
supply system)
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.
5) Process/ Method / Technology for:
Technology
Extraction
Ore/mineral processing (indicate type of raw
material & final product)
material balances for the processing plant, and
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
4

REMARKS
Described
7)Development Phases to be described in terms identifying
and as well as climate change adaptation options
Corresponding
relevant to the project and project activities)
Timeframes
timeframes:
Pre-construction (e.g. planning, acquisition

of rights to use land, exploration activities)
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;
5

REMARKS
Described
8)Manpower Tabulate the following per project phase:
9)Indicative Project Investment Cost (Philippine Peso)
REMARKS
General Contents Specific Content Requirement
Page # Acceptable?

Environmental

Risk Assessment

V. Social SDP
Development
IEC


Compliance
template
6
REMARKS
General Contents Specific Content Requirement
Page # Acceptable?
Multi-Sectoral Monitoring Framework

DAO 2003-30).
Environmental Guarantee Fund Commitments,

if with processing

guidelines in annex 3-6 of RPM for DAO
2003-30
VII. Emergency The safety policy and generic guidelines shall
Preparedness be consistent with the Mines and Geosciences
and Response Bureau (MGB) requirements. Emergency
Policy and Preparedness should also consider natural
Generic hazards to the infrastructures and facilities.
Guidelines

Decommissioning/ procedures for Rehabilitation/

7
(Requiring EIS for ECC Applications)

List of Key Impacts
1. THE LAND
land use project area in relation to existing compatibility of the
land use. proposed project in relation
1.1.2 Encroachment in Identify ECA where the project is to land use and/or the
Environmentally Critical located or near the project area. coastal resource
Areas (ECAs)
management plan of the
Identify areas vulnerable/susceptible
to natural hazards where the project LGU, if any.
(include map/s).
issue CADC / CADT/CAL/CALT where the
project is located or near the project
area.
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/ Map
slope
1.2.3Inducement of subsidence, Geological Cross-Sections; Include discussions on
liquefaction, landslides, mud / Sequence Stratigraphic Column of impacts/effects of natural
debris flow, etc. Rock Units; Geomorphological Map: hazard on the project.
G Factor Contour Maps; Seismicity
Map; Differential Settling Map;
Bathymetric and Morpho-structural
Map; Results of Petrographic and
8

List of Key Impacts
Conditions
Analysis Plan Remarks
Mineragraphic Analyses; Results of
Geochemical Analyses of Rock
Samples (applicable areas); Hazard
maps (NAMRIA, NDRRMC, MGB,
PHIVOLCS, PAG-ASA)
1.3 Pedology
1.3.1 Soil erosion / Loss of Summary of Soil Investigation USLE / similar modeling
topsoil/overburden Report on soil type and quality; when applicable
Erodibility potential; Bank stability
1.3.2 Change in soil Laboratory results on soil sample Physical analysis (water
quality/fertility analysis for N, P, K, pH, organic holding capacity, texture
matter, micronutrients and trace aggregate stability of dam);
metals e. g. Pb, Hg, As, Cd, Cr secondary data: chemical
hexavalent, etc. analysis

1.4.1 Vegetation removal and Flora and fauna species inventory Quadrat sampling for
loss of habitat or survey report; floraUse of mist nets, traps,
Historical occurrences of pest transect walk for fauna
infestation, forest/grass fire and/or
similar incidences Include discussions on
1.4.2 Threat to existence Summary of endemicity / overall impact to flora and
and/or loss of important conservation status fauna
local species
1.4.3Threat to abundance, Summary of abundance,
frequency and distribution frequency and distribution
2. THE WATER
2.1.1 Change in drainage Drainage map; historical Flood simulation/modeling,
morphology / Inducement of flooding/drought occurrences,
9

List of Key Impacts
Conditions
flooding/ Reduction in stream stream flow measurements/ consider extreme weather
volumetric flow estimates; Delineation of watershed conditions and the PAG-
/sub-watersheds/ floodplain; and ASA 2020 and 2050
identification of aquifers, if any
climate projections
Assessment should include

potential occurrence or
nearby areas
water depth
resources / competition in water water use in the area and adjacent
use areas
Spring and well inventory and

location map; depth of water table
the PAG-ASA 2020 and 2050
climate projections
2.2 Oceanography
when applicable
2.3 Water Quality
2.3.1 Degradation of Physico-Chemical characterization Use DENR standard
groundwater quality of water : methods and procedures
pH
Conduct chemical assay of
BOD5
ore and relate to Physico-
COD Chemical characterization
10

List of Key Impacts
Conditions
water quality
2.3.3 Degradation of
DO of water
coastal/marine water quality Oil and grease For project with coastal/
TSS marine structures and /or
Heavy Metals
significant marine / coastal
discharges, conduct
____________________
circulation / plume
fecal / total coliform modeling (include worst
Others: case scenario of failure of
_________________________ WWTF). For project with
significant heavy metals
discharges, conduct
sampling site map sediment transport
modeling.
2.4.1 Threat to existence Summary of endemicity / Include discussions on
and/or loss of important conservation status overall impact to
local species and habitat Abundance of ecologically and freshwater ecology.
2.4.1 Threat to existence (fishes, benthos, planktons); Include discussions on
Presence of pollution indicator overall impact to freshwater
and/or loss of important
species ecology.
local species and habitat
sampling site map
Summary of endemicity/
conservation status
Abundance of ecologically and
species
sampling site map

2.5 Marine Ecology
2.5.1 Threat to existence Abundance/densities/distribution Quadrat, transect, line
and/or loss of important local of ecologically and economically intercept, spot dive,
species and habitat
11

List of Key Impacts
Conditions
2.5.2 Threat to abundance, important species (mangroves, manta tow, marine
frequency and distribution fishes, benthos, planktons, coral resource characterization
reefs, algae, seaweeds, sea (e.g., municipal and
grasses)
commercial fisheries
data)
species
overall impact to marine
Marine resource map
ecology
sampling site map
3. THE AIR
climate, e.g., local temperature temperature of the area; consider the PAG-ASA
Climatological normals/extremes; climate change projections
Wind rose diagrams; Frequency of for 2020 and 2050.
Tropical cyclones
3.2.1 Degradation of air quality Characterization of ambient air Use DENR standard
TSP
If applicable, air dispersion
PM10
SOx case scenario of failure of
NOx APCD.
(for sampling methods refer to
Clean Air Act) Heavy metals (baseline
and modeling) apply to
sampling site map selected processing
facilities.
for sampling and
12

List of Key Impacts
Conditions
source capable of
more).
4. THE PEOPLE
Displacement / - Number of households and Discuss how the project

disturbance of properties household size would affect existing
- Land area properties in the area in
Change/conflict in land - Population terms of relocation and
- Population density /growth devaluation
ownership
- Gender and age profile
Change/conflict in right of attainment
way
settlers Census of population / property that

informal settlers
4.3 Cultural/Lifestyle change Demographic data on Indigenous Discuss the impacts on IPs
(especially on Indigenous Peoples (if any) and existing and Culture/Lifestyle
4.4 Threat to delivery of basic Availability of public services in Discuss how the project
services /resource competition terms of: would affect the delivery of
Water supply basic services and may
13

List of Key Impacts
Conditions
Communications/ transportation competition in the area
and Private)
4.5 Threat to public health and Peace and order / crime Discuss the project
safety Education facilities implementations threat to
Recreational facilities/ sports public health vis--vis the
facilities baseline health conditions
in the area
Statistical data / information related
to public services:
Analysis of diseases that
educational attainment may be affected by climate
Morbidity and mortality rates change.
trend)
including endemic diseases
Sanitation Profile
Crime rate
Food security

Benefits from the project
Main sources of Income
Enhancement of Employment rate/ profile
employment and Sources of livelihood
livelihood opportunities Poverty Incidence
Commercial establishments and
Increased business activities
opportunities and Banking and financial
associated economic institutions
activities
LGUs
14

List of Key Impacts
Conditions
4.7 Traffic congestion Road network/ systems Traffic impact assessment,
if applicable (including
Existing transportation/traffic capacity of road system in
situation terms of load/count)

ERA ERP Monitoring
Plan
During scoping: Check () required/applicable items; items with are automatically required; write specific instructions ( if Page Page Page Remarks
circumstances which could be significant in bringing
Fire about identified safety risks Quantitative Risk
Explosion - Description & assessment of the possible accident Assessment(QRA)
Release of toxic scenarios
substances - Assessment of whether the project location is Specific Instructions:
projected to have extreme climate events for 2020 __________________________
and/or 2050 that could contribute to the triggering
identified scenarios Descriptive/Qualitative Risk
- Description of the hazards, both immediate (acute Assessment
the environment posed by the release of toxic Specific Instructions :
substance, as applicable ___________________________
Physical Risks - Identification of conditions, events and trigger
which could be significant in bringing about EMERGENCY PLAN :
could endanger life, property - Description & assessment of the possible accident Specific Instructions :
and/or the environment) scenarios
- Assessment of whether the project location is ____________________________
projected to have extreme climate events for 2020
Refer to Annex 2-7e for the
and/or 2050 that could contribute to the triggering
decision criteria outline
15

ERA ERP Monitoring
Plan
- Description of the hazards both immediate (acute
the environment posed by the failure of structure, as
applicable.
1. 1.
2. 2.
3. 3.
5.
Resource Person
1.
16
Annex 1 - G
ECC APPLICATION SCREENING FORM FOR SANITARY LANDFILL PROJECTS

Project Title: _____________________________________________________________________________
Address: ________________________________________________________________________________

EIS Consultant: ___________________________________________________________________________
Address: ________________________________________________________________________________
Date
Acceptable?
Yes No
1
Use Plan
communities


rd
O.R. #
Date
NOTED BY:
___________________________ _________________________
EMB Regional Office

_____________________________
1
1
,
Page # Acceptable?
Contents REMARKS


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

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.
utilization, including discussion of the
project:
2
,
Items to be
Described

preferred option;
feasible.



considered in the waste treatment / disposal.
Discussion should also include climate
change considerations.

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
telecommunications, and other
infrastructure),
facilities (if any)
3
,
Items to be
Described

buffers.
5) Process/ Technology description
Technology
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

and well as climate change adaptation options
Corresponding
timeframes:

of rights to use land,)
Identification of waste handling facilities,
infrastructure requirements (transport,
energy, water supply and storage, storm
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
,
Items to be
Described
in terms of the following:

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

Environmental

Risk Assessment
V. Social SDP
Development
5
,
IEC

Compliance
template

30).

Commitments


2003-30
Preparedness be consistent with the regulatory requirements.
and Response Emergency Preparedness should also consider
Policy and natural hazards to the infrastructure and
Generic facilities.
Guidelines

Decommissioning / procedures for Rehabilitation/
Rehabilitation Policy Decommissioning/Abandonment.

6

1. THE LAND
1.1.1Change/Inconsistency in Description & Map showing the project Assessment of the
1.1.2 Encroachment in Identify ECA where the project is proposed project in
Environmentally Critical located or near the project area. relation to land use
Areas (ECAs) Identify areas vulnerable/susceptible to and/or the coastal
natural hazards where the project is resource management
located or near the project area plan of the LGU, if any.
(include map/s).
issue CADC / CADT/CALT/CALC where the
project is located or near the project
area.

issues (e.g., IFMA/CBFMA within COC
and within MPSA, ownership, informal
settlers, etc.)
terrain/slope
1.2.3 Inducement of subsidence, Geological Cross-Sections; Sequence Include discussions on
liquefaction, landslides, mud / Stratigraphic Column of Rock Units; impacts/effects of natural
debris flow, etc. Geomorphological Map: G Factor hazard on the project.
Contour Maps; Seismicity Map;
Differential Settling Map; Hazard Maps
(NAMRIA, NDRRMC, MGB,
PHIVOLCS, PAG-ASA)
7

Analysis Plan
1.3 Pedology
1.3.1 Soil erosion / Loss of Summary of Soil Investigation Report Include discussions on
topsoil/overburden on soil type and quality; Erodibility potential land
potential; Bank stability contamination due to
project operations. Relate
discussions to soil
characteristics.
1.3.2 Change in soil Laboratory results on soil sample Physical analysis (water
quality/fertility analysis for N, P, K, pH, organic holding capacity, texture
matter, micronutrients and trace aggregate stability of
metals, e. g. Pb, Hg, As, Cd, Cr dam); secondary data:
hexavalent, etc. chemical analysis
1.4.2 Threat to existence and/or Summary of endemicity / conservation
loss of important local status Include impact
species assessment on
1.4.3Threat to abundance, Summary of abundance, frequency vegetation (e.g.,
frequency and distribution and distribution likelihood of destruction)
of important species Economic importance and uses of and specific management
significant flora and fauna measures (e.g.,
1.4.4 Hindrance to wildlife Sampling / survey map in relation to protection, balling,
access the project site transplanting,
replacement, etc.)
2. THE WATER
2.1.1 Change in drainage Drainage map; historical Flood simulation/
morphology / Inducement of flooding/drought occurrences, stream modeling, consider
flooding/ Reduction in stream flow measurements/estimates; extreme weather
volumetric flow Delineation of watershed /sub- conditions and the PAG-
watersheds/ floodplain; and ASA 2020 and 2050
identification of aquifers, if any climate projections
8

Analysis Plan
Assessment should
include potential
occurrence or
nearby areas.
water depth
resources / competition in water water use in the area and adjacent
use areas
2.2 Oceanography
when applicable
2.3 Water Quality
2.3.1 Degradation of Physico-Chemical characterization of Use DENR standard
groundwater quality water : methods and procedures
pH for sampling and
analysis.
BOD5
2.3.2 Degradation of surface COD Groundwater
contamination modeling
water quality
2.3.3 Degradation of
DO should consider worst
coastal/marine water quality Oil and grease case scenario of failure of
TSS control measures, such
as leachate control,
Heavy Metals: geotextile lining
____________________
fecal / total coliform
Others:
__________________________
9

Analysis Plan
sampling site map

2.4.1 Threat to existence and/or Summary of endemicity / Include discussions on
loss of important local conservation status overall impact to
species
sampling site map

2.5 Marine Ecology
frequency and distribution reefs, algae, seaweeds, sea characterization (e.g.,
species; data)
Marine resource map overall impact to
marine ecology
sampling site map
3. THE AIR
e.g., local temperature temperature of the area; Climatological consider the PAG-ASA
diagrams; Frequency of Tropical projections for 2020 and
cyclones 2050.
greenhouse gas emissions methane, nitrous oxide, carbon contribution in terms of
dioxide); Calculation of projected GHG greenhouse gas
emission emissions (applicable for
10

Analysis Plan
power and landfill and
possible for mining and
dam)
TSP methods and procedures
for sampling and
PM10 analysis.
SOx
NOx
Trace Metals
:____________________
others:______________________
Air Act)
sampling site map

measurement.
source capable of
more).
4. THE PEOPLE
Displacement / disturbance household size properties in the area in
of properties - Land area, terms of relocation and
- Population, devaluation
Change/conflict in land - Population density /growth
11

Analysis Plan
way
Settlements map
4.2 In-migration Discuss the in-migration
Census of population / property that patterns as a result of
Proliferation of informal will be displaced / disturbed project implementation
settlers
Communications /transportation competition in the area
safety Peace and order / crime implementations threat to
Education facilities public health vis--vis the
Recreational facilities / sports baseline health conditions
facilities in the area

Literacy rate, profile of educational climate change.
attainment
(infants and adults - 5-year trend)
Sanitation Profile
Crime rate
Food security
12

Analysis Plan
Benefits from the project Main sources of Income
Enhancement of employment Sources of livelihood
and livelihood opportunities Poverty incidence
Commercial establishments
Increased business opportunities and activities
and associated economic Banking and financial
activities institutions
Existing transportation/traffic situation assessment, if applicable
load/count)
13

ERA ERP Monitoring
Plan
Physical Risks - Identification of conditions, events and ERA REQUIREMENT
trigger which could be significant in
(Failure of Structure which bringing about identified physical risks Descriptive/Qualitative Risk
could endanger life, property - Description & assessment of the possible Assessment
and/or the environment)
accident scenarios
- Assessment of whether the project Specific Instructions :
location is projected to have extreme _____________________________
climate events for 2020 and/or 2050 that
could contribute to the triggering EMERGENCY PLAN :
- Description of the hazards both Specific Instructions :
immediate (acute effects) and delayed ______________________________
(chronic effects) for man and the
environment posed by the failure of Refer to Annex 2-7e for the decision
structure, as applicable. criteria outline
14
1. 1.
2. 2.
3. 3.
5.
Resource Person
1.
15
Annex 1 - H
ECC APPLICATION SCREENING FORM FOR THERMAL POWER PLANT PROJECTS

Project Title: _____________________________________________________________________________

Address: ________________________________________________________________________________
EIS Consultant: ___________________________________________________________________________
Address: ________________________________________________________________________________
Date

Acceptable?
Yes No
1
Use Plan

communities

rd
O.R. #
Date
NOTED BY:
___________________________ _________________________
EMB Regional Office

_____________________________
1
1

Page # Acceptable?
CONTENTS 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
REMARKS
Described
1)Project Location a) Map showing sitio, barangay, municipality,
setting)
c) Rationale for selection primary & secondary
impact areas
site/area
2)Project Rationale Cite and focus on the need for the project
Describe the justification for the Project
with particular reference to the economic
and social benefits, including employment
and associate economic development,
which the project may provide. The status
of the project should be discussed in a
regional and national context.
3)Project a) Cite criteria used in determining preliminary
resource utilization, including discussion of
the consequences of not proceeding with
the project:
extreme climatologic conditions (data
can be obtained from NDRRMC and
NAMRIA as well as other mandated
agencies)
2
Items to be
REMARKS
Described
preferred option;
issues, land classification, etc. Discuss
other options on the siting of major
components of the project within the project
area.

processes and engineering design.


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.

capacity, number, etc.), including the
cooling water system
Identification of other Support Facilities

3
Items to be
REMARKS
Described
Identification of pollution control devices
including other waste management and
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.
5) Process/ Technology Description and Performance
Technology 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 Phases to be described in terms identifying

Plan, Description specific activities (w/ special attention on
and as well as climate change adaptation options
Corresponding
relevant to the project and project activities)
Timeframes
timeframes:
Pre-construction (e.g., planning,

acquisition of rights to use land, etc.)
4
Items to be
REMARKS
Described
identified above) in terms of raw materials
and fuel requirements, infrastructure
requirements (transportroad/rail/ship,
power, water supply and storage, storm
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.


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
8)Manpower Tabulate the following per project phase:
9)Indicative Project Investment Cost (Philippine Peso)
5

Environmental
Risk Assessment

V. Social SDP
Development Plan
IEC

Compliance
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.
6
VII. Emergency The safety policy and generic guidelines

Preparedness and should be consistent with the regulatory
Response Policy requirements. Emergency Preparedness
and Generic should also consider natural hazards to the
Guidelines 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/ Statement on proponents policies and

Decommissioning/ generic procedures for Rehabilitation/

7

List of Key Impacts Baseline Impact Mgmt. Plan Monitoring
Requirements Methodology/Approach Conditions Analysis Plan Remarks
1. THE LAND
1.1.1 Change/Inconsistency in Description & Map showing the project Assessment of the
proposed project in
and/or the coastal
Environmentally Critical located or near the project area.
resource management
Areas (ECAs) plan of the LGU, if any.
Identify areas vulnerable/susceptible to
natural hazards where the project is
located or near the project area
(include map/s).

issue 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

8

1.2.3 Inducement of subsidence, Geological Map as needed.; hazard Include discussions on
liquefaction, landslides, maps (NAMRIA, NDRRMC, MGB, impacts/effects of natural
mud / debris flow, etc. PHIVOLCS, PAG-ASA) hazard on the project.
1.3 Pedology
1.3.1 Soil erosion / Loss of Summary of Soil Investigation Report Include discussions on
topsoil/overburden on soil type and quality; Erodibility potential land
potential; Bank stability contamination due to
project operations. Relate
discussions to soil
characteristics.
1.4.2 Threat to existence and/or Summary of endemicity / conservation
loss of important local status Include discussions on
species
overall impact to flora
1.4.3Threat to abundance, Summary of abundance, frequency
frequency and distribution and distribution and fauna
1.4.4 Hindrance to wildlife Sampling / survey map in relation to assessment on
access the project site vegetation (e.g.,
and specific management
measures (e.g.,
protection, balling,
transplanting,
replacement, etc.)
2. THE WATER
morphology / Inducement of flooding/drought occurrences, stream of the project on the
9

ASA 2020 and 2050
climate projections.
Assessment should
include potential
occurrence or
nearby areas.
water depth
2.1.3 Depletion of water Identification of current / projected For project with

resources / competition in water water use (groundwater/surface water) significant water
use in the area and adjacent areas requirement, conduct
water balance / budget
Spring and well inventory and location analysis

2.2 Oceanography

when applicable
2.3 Water Quality
2.3.1Degradation of groundwater Physico-Chemical characterization of Use DENR standard
quality water: methods and procedures
10

water quality
pH for sampling and
analysis.
BOD5
2.3.3 Degradation of COD For project with
coastal/marine water quality
DO coastal/marine structures
Oil and grease and /or significant marine/
coastal discharges,
TSS
conduct circulation /
Heavy plume modeling (include
Metals:____________________ worst case scenario of
fecal / total coliform failure of WWTF).
Others:
__________________________ Include discussions on
possible contamination
due to leaks/spills
sampling site map
Provide Aquifer
(Groundwater)
vulnerability Assessment
(i.e., discussions on
groundwater
project operation).
2.4.1 Threat to existence and/or Summary of endemicity / Include discussions
loss of important local conservation status onoverall impact to
(fishes, benthos, planktons)
species
sampling site map
11

2.5 Marine Ecology
fishes, benthos, planktons, coral resource
2.5.2 Threat to abundance, reefs, algae, seaweeds, sea
characterization (e.g.,
frequency and distribution grasses)
Presence of pollution indicator municipal and
species commercial fisheries
Historical occurrences of red-tide, data)
fish kill or any related event
Marine resource map Include discussions on
overall impact to
sampling site map marine ecology
3. THE AIR
climate, e.g., local temperature temperature of the area; Climatological consider the PAG-ASA
projections for 2020 and
diagrams; Frequency of Tropical
2050.
cyclones
greenhouse gas emissions carbon dioxide, nitrous oxide); contribution in terms of
Calculation of projected GHG emission greenhouse gas
emissions

methods and procedures
TSP
for sampling and
analysis.
PM10
SOx
12

NOx Provide air dispersion
Trace Metals (for coal fired power case scenario of failure of
plant only) :_________________ APCD)
others:
__________________________
Air Act)
sampling site map

measurement.
source capable of
more).
4. THE PEOPLE
would affect existing
Displacement / disturbance - Number of households and properties in the area in
of properties household size terms of relocation and
- Land area,
devaluation
Change/conflict in land - Population,
ownership - Population density /growth
- Gender and age profile,
Change/conflict in right of - Literacy rate, profile of educational
way attainment,
13


Communications /transportation
competition in the area
and Private)
Peace and order / crime
Education facilities
4.5 Threat to public health and Discuss the project
Recreational facilities / sports
safety
facilities implementations threat to
public health vis--vis the
Statistical data / information related to baseline health conditions
public services: in the area
Literacy rate, profile of educational
attainment Analysis of diseases that
Morbidity and mortality rates may be affected by
(infants and adults - 5-year trend) climate change.
Sanitation Profile
Crime rate
Food security
14

Enhancement of employment Sources of livelihood
and livelihood opportunities Poverty Incidence
Commercial establishments and
Increased business opportunities activities
and associated economic Banking and financial institutions
activities

assessment, if applicable
load/count)
15

ERA ERP Monitoring
Plan
circumstances which could be significant in Quantitative Risk
Fire bringing about identified safety risks Assessment(QRA) - Report for
Explosion - Description & assessment of the possible
submission prior to operation
Release of toxic accident scenarios
substances - Assessment of whether the project location is
2020 and/or 2050 that could contribute to the Specific Instructions :
triggering identified scenarios ________________________
(acute effects) and delayed (chronic effects) Descriptive/Qualitative Risk
Assessment
release of toxic substance (include unloading
of raw materials/fuel), as applicable
Physical Risks - Identification of conditions, events and trigger Specific Instructions :
which could be significant in bringing about __________________________
could endanger life, property - Description & assessment of the possible EMERGENCY PLAN :
and/or the environment) accident scenarios
- Assessment of whether the project location is Specific Instructions :
________________________
- Description of the hazards both immediate Refer to Annex 2-7e for the decision
criteria outline
(acute effects) and delayed (chronic effects)
failure of structure, as applicable.
16
1. 1.
2. 2.
3. 3.
5.
Resource Person
1.
17
1
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 2
PROJECT FACT SHEET
Name of the Project
Proponent Name
Proponent Address
Proponent Means of Name: Designation:

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

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

Street/Sitio/Barangay Zone/Classification (i.e., industrial, residential)
City/Municipality Province Region
Total Project Land Area Total Building Footprint Area
See attached vicinity map/s and photographs of the project site and site development/layout plan.
Geographic coordinates of the project area (Preferably use PRS 92 datum; otherwise, specify datum used).
Perimeter/Boundary points (based Longitude Latitude
on OCT/TCT/etc.)
I.2 PROJECT COMPONENTS
Facilities No. of Area (sq/M)/ Specifications/Description/

Units Capacity Remarks
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

I.3 UTILITIES/REQUIREMENTS (Operation Phase):

Utilities Source Estimated Demand/Consumption
Power/Electricity (Total) KWh
Power/Electricity KWh
(From Renewable Energy Sources)
Water (Total) m3/day

(Fill-up table below if water is not obtained from
the local water utility)
Water m3/day
(Rainwater Collection System)
Water Source
ground water well spring others: ____________________________
surface water river lake others: ____________________________
Location of water source
____________________________________________________________________
(Sitio/Zone, Barangay, Municipality/City, Province, Region)
Energy/Water Efficiency
Proposed Efficiency/Conservation
Estimated Savings
Utilities Measures
3
Water m /day
I.4 MANPOWER
a. Construction Phase
Manpower Requirement Expertise/Skills Total
b. Operation Phase
I.5 INDICATIVE PROJECT COST
Project Cost (PhP): ______________________

6
II. ENVIRONMENTAL IMPACT AND MANAGEMENT PLAN
Possible Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Baseline Environment Preventive/ Mitigating Measures
Implementation Monitoring
Impacts
LAND
Consistency with Current land use w/in 1km See attached proof of compatibility
land use radius (as per zoning with land use
ordinance):
Residential
Commercial/ Institutional
Industrial
Agricultural/ Recreational
Protected Areas
Others, specify
______________
Actual land uses w/in 1km

radius:
Residential
Industrial
Protected Areas
Others, specify
______________
Disturbance to Existing vegetation in the area: Comply with conditions of Annual inspection of Cost integrated in the
wildlife due to DENR/LGU SLUP, Tree Cutting area replanted/ re- construction /operation
vegetation clearing Forestland Permit, ROW, PCA Permit vegetated cost
Marshland
Limit land clearing as much as
possible
Grassland Provide temporary fencing for
Mangrove vegetation that will be retained
Wetland Promote restoration of damaged or
7
Impacts
Others, specify destroyed vegetation where possible
(e.g., tree planting)
____________
Change in surface Slope: Provide erosion control and slope Regular inspection of Slope/ Erosion Control
landform/ protection measures slope protection Cost: ___________
topography/ flat (0-3%) Designate a Spoils Storage Area, measures in erosion- Others, specify
terrain/slope prone areas
gently sloping to rolling (3- with topsoil set aside for later use _________________
18%) and allow maximum re-use of spoils Regular inspection for
Soil Erosion steep (>18%) Construct during dry season new eroded areas near
the site
Stabilize embankment with grasses
Others, specify
or other soil cover
_________________
Others, specify
____________
Is the project site located in an

area identified by MGB/PAG- Comply with DENR Administrative
Order No. 2003-30 and DENR
ASA/ PHIVOLCS as hazard Administrative Order No. 2000-28,
prone? Implementing Guidelines on
Yes Engineering Geological and Geo-
hazard Assessment (EGGA).
No
Soil/Land Existing soil type in the area: Implement Ecological Solid Waste Daily inspection of Cost integrated in the
contamination due Management Plan (ESWMP) waste/recycling bins for construction /operation
to improper solid sandy Set up temporary fence around the segregation cost
waste disposal
clay construction area Daily inspection for
sandy-loam
Implement re-use and recycling of presence of mixed
waste materials garbage in the facility
Others, specify
Implement proper segregation, Weekly inspection of
____________________ waste accumulated
collection and disposal of domestic
wastes in designated areas Others, specify
Implement proper collection, _________________
labeling and storage of hazardous
waste
Provide receptacles / bins for solid
wastes
Coordinate with the municipal / city
8
Impacts
waste collectors
Engage third party company for
waste collection
Others, specify
________________
Impairment of Presence of visually significant Implement landscaping and other Regular inspection of Cost integrated in the
visual aesthetics landforms/ beautification measures landscaping and other construction/ operation
Devaluation of land landscape/structures? Provide adequate buffer beautification activities cost
values Compensate adjacent property Regular monitoring of
Yes owners buffer zones
No Others, specify
Regular monitoring for
________________ presence/absence of
complaints from adjacent
property owners
WATER
Increased siltation
Specify nearest/receiving Provide ring canals around fuelling Regular (ocular) inspection Cost integrated in the
water body: tanks/ motor pool/ maintenance of water body for: construction/ operation
due to project _____________________ areas cost
activities
Set up proper and adequate sanitary Turbidity and/or silted
Water quality Distance to nearest/receiving facilities condition
degradation water body:
Strictly require the contractor and its Floating wastes or debris
Others, specify workers to observe proper waste
_____________ 0 to less than 0.5 km disposal and proper sanitation
0.5 to 1 km Strictly observe proper waste
More than 1 km handling and disposal
Provide wastewater treatment
If nearest/receiving water body facility (e.g., septic tank, oil and
is fresh water, specify water separator, etc.)
classification: Set up silt trap/settling ponds to
AA minimize downstream siltation
A Others, specify
B ______________
C
D
9
Impacts
If nearest/receiving water body
is coastal or marine water,
specify classification:
SA
SB
SC
SD
Current Water Use:

Fishery
Tourist Zone / Park
Recreational
Industrial
Agricultural
Competition in Size of population using Implement rainwater harvesting and Regular monitoring for Cost integrated in the
water use receiving surface water: similar measures as an alternative presence/absence of construction/ operation
Depletion of water source of water complaints cost
resources 1,000 persons Observe water conservation Regular coordination
>1,000 and 5,000 measures with concerned agencies
persons Others, specify Regular monitoring for
>5,000 persons _________________ occurrences of water
shortages
Others, specify
Available/nearest water _______________
source.
Deepwell
Water district/LGU
Surface water
Others, specify
________________
10
Impacts
Increased Is the project site located in an
area identified by MGB/
Use appropriate design for project Regular monitoring for Cost integrated in the
occurrence of facilities presence/absence of construction/ operation
PAG-ASA as flood prone?
flooding
Implement appropriate drainage
complaints cost
Yes system Regular coordination
No Limit the depth and area of
with concerned agencies
workspace Regular monitoring for
increased frequency of
Regularly remove debris and other flooding
materials that may obstruct water
flow Others, specify
__________________
Use appropriate technology (e.g.,
raised hand-pumps) to protect
drinking water from flood
contamination
Others, specify____________
AIR/NOISE
Air quality degradation Distance to nearest Properly operate and maintain all Regular monitoring for Cost integrated in the
community: emission sources (e.g., vehicles, presence/absence of construction/ operation
generator, etc.) complaints cost
0 to less than 0.5 km Install, when applicable, the
0.5 to 1 km appropriate air pollution control Regular (ocular) inspection
of:
More than 1 km
device/s
Strictly enforce good housekeeping Absence of white or
practices black smoke from
Control vehicle speed to lessen vehicles, generator,
etc.
suspension of road dust
Conduct water spraying to Presence of truck
suppress dust sources and cover during
minimize discomfort to nearby deliveries
residents
Quarterly monitoring of
Use covered vehicles to deliver ambient air for the following:
materials that may generate dust
Others, specify
TSP
__________________ PM10
NOx
11
Impacts
SOx
CO / CO2
Nuisance due to Distance to nearest Properly operate and maintain all Regular monitoring for Cost integrated in the
noise generation community: noise sources (e.g., vehicles, presence/absence of construction/ operation
0 to less than 0.5 km Install, when applicable, the Regular monitoring of
0.5 to 1 km appropriate noise control device/s buffer zones
More than 1 km
(e.g., mufflers, silencer, sound Quarterly monitoring of
barriers, etc.) noise level
Implement appropriate operating
hours
Provide adequate buffer
(e.g., Perimeter planting of trees to
serve as sound buffer and greenbelt)
Others, specify
_________________
PEOPLE
Displacement of Size of population of host Provide relocation/disturbance Regular monitoring for Cost integrated in the
residents in the barangay: compensation packages presence/absence of construction/ operation
project site and Prioritize local residents for complaints cost
within its vicinity
1,000 persons employment Regular coordination
Displacement of
>1,000 and 5,000 Promptly pay local taxes and other with LGU
Indigenous Peoples
persons financial obligations Others, specify
Enhanced
>5,000 persons
Regular coordination with LGU ______________
employment and/or
livelihood
Conduct prior consultation and
Classification of host coordination to minimize disruption of
opportunities
barangay: daily domestic activities and to
Reduced
Urban
ensure respect for IP rights and
employment and/or cultural practices
livelihood Rural
Ensure participation of IPs in
opportunities
consultations and dialogues
Increased revenues Available services within/near
the host barangay: Provide appropriate traffic/warning
for LGU
Disruption/ Schools (e.g.
signs, lighting, etc.
Competition in elementary, high

12
Impacts
delivery of public school, college) Others, specify
services (e.g.,
education, peace
Health facilities (e.g., _________________
clinics, hospitals, etc.)
and order, etc.)
Enhanced delivery
Peace and order (e.g.,
police outpost, Brgy.
of public services Tanod, etc.)
(e.g., education,
peace and order, Recreation and sports
etc.) facilities
Increase in traffic Others, specify
volume and ________________
worsening of traffic
flow
Impacts on Regularly coordinate with LGU Regular monitoring for Cost integrated in the
community health Provide appropriate warning signs, presence/absence of
complaints
construction/ operation
cost
and safety lighting and barricades, whenever
Others, specify practicable Regular coordination
_______________ Observe proper housekeeping with LGU
Provide on-site medical services for
Regular submission of
any emergency. reports to concerned
agency
Participate in public awareness
programs on health and safety
Others, specify
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
___________________________
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)
14
Attach drawing/plan of waste water treatment facility (with dimensions and descriptions)
15
Process flow
16
Attach drawing/plan of pollution source and control installations (with dimensions and descriptions)
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 __________________________
1
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 2
PROJECT FACT SHEET
Name of the
Project
Proponent Name
Proponent
Address
Contact Person Name: Designation:
Proponent Means Landline No. Fax No.

of Contact
Mobile No. Email Address:
Project Type Project Size Project Size

Parameter
Inland Based Fishery/Aquaculture Projects Hectares
Coastal Area Based Fishery/Aquaculture Projects Hectares
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
II.

Street/Sitio/Barangay Zone/Classification (i.e. industrial, residential)
Total Project Land Area Total Project/Building Footprint Area
Perimeter/Boundary points (based
Longitude Latitude
on OCT/TCT/etc)

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

aerators, generators, etc.)
4. Storage facility
5. Postharvest facility
7. Others, specify
__________________
__________________


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

obtained from the local water utility)
Water m3/day
Water Source
____________________________________________________________________
Estimated Proposed Efficiency/Conservation Measures
Utilities Savings
Water m3/day
I.4 MANPOWER
Manpower Expertise/Skills Total
Requirement
b. Operation Phase
Requirement
Project Cost (PhP): ______________________


Possible Baseline Environment Preventive/ Mitigating Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Measures Implementation Monitoring
Impacts
LAND
Consistency with Current land use w/in 1km radius (as See attached proof of
land use per zoning ordinance): compatibility with land use
Residential
Industrial
Protected Areas
Others, specify
____________________
Actual land uses w/in 1km radius:

Residential
Industrial
Protected Areas
Others, specify
____________________
wildlife due to DENR/LGU SLUP, Tree area replanted/ construction /operation
vegetation clearing Forestland Cutting Permit, ROW, PCA
Permit
re-vegetated cost
Marshland Limit land clearing as much

Grassland as possible
Mangrove Provide temporary fencing
Wetland for vegetation that will be
retained
Others, specify
Promote restoration of
_____________________
damaged or destroyed
vegetation where possible
Possible Baseline Environment Preventive/ Mitigating Monitoring Parameters/ Cost of Mitigation/

Environmental/ Social Measures Implementation Monitoring
Impacts
Change in surface Slope: Provide erosion control Regular inspection of Slope/ Erosion Control
landform/ flat (0-3%) and slope protection slope protection Cost: ___________
topography/
gently sloping to rolling (3-18%)
measures measures in erosion- Others, specify
terrain/slope
Designate a Spoils Storage prone areas ______________
Soil Erosion steep (>18%) Area, with topsoil set aside Regular inspection for
for later use and allow new eroded areas near
maximum re-use of spoils the site
Construct during dry Others, specify
season ______________
Stabilize embankment with
grasses or other soil cover
Others, specify
____________
Comply with the DENR

Is the project site located in an area Administrative Order No.
2003-30 and DENR
identified by MGB/PAG-ASA/
Administrative Order No.
PHIVOLCS as hazard prone? 2000-28, Implementing
Guidelines on Engineering
Yes Geological and Geo-
No hazard Assessment
(EGGA).
Impairment of visual Presence of visually significant Implement landscaping Regular inspection of Cost integrated in the
aesthetics landforms/landscape/structures? and other beautification landscaping and other construction/ operation
Devaluation of land measures beautification activities cost
values Yes Provide adequate buffer Regular monitoring of
No Compensate adjacent buffer zones
property owners Regular monitoring for
Others, specify
presence/absence of
complaints from
________________
adjacent property
owners
WATER
Current Water Use: Set up proper and Regular (ocular) inspection Cost integrated in the
of water body for:
Fishery
adequate sanitary facilities construction/ operation
Water quality
Strictly observe proper cost
degradation Tourist Zone / Park waste handling and Drainage/canal system
Others, specify Recreational disposal
____________ Industrial
Agricultural
Distance of project area to the nearest

well used:
0 to less than 0.5 km
0.5 to 1 km
More than 1 km
Use of nearest well:

Drinking/Domestic
Industrial
Agricultural
Increased Is the project site located in an area Use appropriate design for Regular monitoring for Cost integrated in the
occurrence of identified by MGB/ PAG-ASA as project facilities presence/absence of construction/ operation
flooding flood prone?
Implement appropriate
complaints cost
drainage system Regular coordination
Yes Regularly remove debris
with concerned
No and other materials that
agencies
may obstruct water flow Regular monitoring for
Use appropriate flooding
technology (e.g., raised
hand-pumps) to protect Others, specify
drinking water from flood _________________
contamination
Others, specify
__________________
PEOPLE
Displacement of
Size of population of host barangay:
Provide Presence/Absence of Cost integrated in the
residents in the relocation/disturbance complaints construction/ operation
project site and compensation packages Regular coordination cost
within its vicinity 1,000 persons Prioritize local residents for with LGU
Displacement of >1,000 and 5,000 persons employment Others, specify
Indigenous Peoples >5,000 persons Promptly pay local taxes _________________
Enhanced and other financial
employment and/or obligations
livelihood Classification of host barangay: Regular coordination with
opportunities LGU
Reduced Urban Prior consultation and
employment and/or
livelihood
Rural coordination to minimize
disruption on daily
opportunities domestic activities & to
Increased revenues Available services within/near the host ensure respect for IP
for LGU barangay: rights and cultural practices
Disruption/ Ensure participation of IPs
Competition in Schools (e.g. elementary, high in consultations and
dialogues
delivery of public school, college)
services (e.g.,
Health facilities (e.g., clinics, Provide appropriate
education, peace traffic/warning signs,
hospitals, etc.)
and order, etc.) lighting, etc
Enhanced delivery of
Peace and order (e.g., police
Others, specify
outpost, Brgy. Tanod, etc.)
public services (e.g., _________________
education, peace Recreation and sports facilities
and order, etc.) Others, specify
Increase in traffic ___________________
volume and
flow
Depletion of local
fish populations by
stocking of wild
fry/fingerlings in
ponds
Initial Environmental Examination (IEE) Checklist Report Form for Fishery/Aquaculture Projects1010 10

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:



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

Page No. __________________________
Book No. __________________________
Series of __________________________
1
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 2003-
30)

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 2
PROJECT FACT SHEET
Name of the
Project
Proponent Name
Proponent
Address

of Contact
Project Type Actual Project Size Thresholds for

Project Size Parameter IEE Checklist
Animal products processing (fish/meat processing, Daily 500 kg but <
canning, slaughterhouses, etc.) production rate 10,000 kg
Coconut processing plants (including production of Monthly
< 25,000 MT
coconut based products) production rate
Distillation and Fermentation Plants ( e.g., bio-ethanol Annual < 50,
project) production rate 00 MT
Daily
Fruit and vegetable processing < 500 kg
production rate
Annual
Other types of food (and other food by-products, production rate
< 50,000 MT
additives, etc.) processing industries of finished
product
< 10,000 L
Monthly (liquid) or
Processing of dairy products < 100,000 kg
production rate
(solid)
Annual
Sugar Mills < 50,000 MT
production rate
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
II.

on OCT/TCT/etc)
I.2 PROJECT COMPONENTS (Put NA if Not Applicable)
No. of Area (sq/M)/ Specifications/Description/

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

Facilities
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
_____________________
___________________


3
Water m /day

Water Source
____________________________________________________________________
Utilities Estimated Savings Proposed Efficiency/Conservation Measures
Water m3/day
I.4 MANPOWER
Requirement
b. Operation Phase
Requirement
Project Cost (PhP): ______________________

IEE Checklist Report for Food & Food By-product & Beverages Manufacturing/Processing Plant Projects77 7
III. ENVIRONMENTAL IMPACT AND MANAGEMENT PLAN

Possible
Monitoring Parameters/ Cost of Mitigation/
Impacts
LAND
Consistency with land Current land use w/in 1km radius See attached proof of
use (as per zoning ordinance): compatibility with land use
Residential
Industrial
Protected Areas
Others, specify
___________________
Residential
Industrial
Protected Areas
Others, specify
___________________
Disturbance to wildlife Existing vegetation in the area: Comply with conditions of Annual inspection of Cost integrated in
due to vegetation DENR/LGU SLUP, Tree Cutting area replanted/ the construction/
clearing Forestland Permit, ROW, PCA Permit re-vegetated operation cost
Marshland Limit land clearing as much as
Grassland
possible
Provide temporary fencing for
Wetland Promote restoration of damaged
Others, specify or destroyed vegetation where
____________________ possible (e.g., tree planting)
Possible
Impacts
Change in surface Slope: Provide erosion control and slope Regular inspection of Slope/ Erosion
landform/ topography/ protection measures slope protection Control Cost:
terrain/slope flat (0-3%) Designate a Spoils Storage Area, measures in erosion- ___________
gently sloping to rolling (3- with topsoil set aside for later use prone areas Others, specify
18%) and allow maximum re-use of Regular inspection for ____________
Soil Erosion steep (>18%) spoils new eroded areas
Construct during dry season near the site
Stabilize embankment with Others, specify

grasses or other soil cover ___________
Others, specify
____________
Comply with DENR Administrative

Is the project site located in an Order No. 2003-30 and DENR
area identified by MGB/PAG-ASA/ Administrative Order No. 2000-28,
PHIVOLCS as hazard prone? Implementing Guidelines on
Engineering Geological and Geo-
Yes
No
Soil/Land Existing soil type in the area: Implement the Ecological Solid Daily inspection of Cost integrated in
contamination due to Waste Management Plan waste/recycling bins the construction/
improper solid waste sandy (ESWMP) for segregation operation cost
disposal
clay Set up temporary fence around Daily inspection for
presence of mixed
sandy-loam
the construction area
Implement re-use and recycling of garbage in the facility

Others, specify waste materials Weekly inspection of
____________
Implement proper segregation, waste accumulated
collection and disposal of Others, specify
domestic wastes in designated _____________
areas
Provide receptacles / bins for
solid wastes
Coordinate with the municipal /
city waste collectors
waste collection
Possible
Impacts
Others, specify
________________
Impairment of visual Presence of visually significant Implement landscaping and other Regular inspection of Cost integrated in
aesthetics landforms/landscape/structures? beautification measures landscaping and other the construction/
Devaluation of land Provide adequate buffer beautification activities operation cost
values Yes
Compensate adjacent property Regular monitoring of
No owners buffer zones
Others, specify
Regularly monitor
complaints from
adjacent property
owners
WATER
Increased siltation due Specify nearest/receiving water Set up proper and adequate Regular (ocular) Cost integrated in
to project activities body: sanitary facilities inspection of: the construction/
Water quality
____________________________ Strictly require the contractor and operation cost
degradation its workers to observe proper Drainage / canal
Distance to nearest/receiving water systems
Others, specify
waste disposal and proper
___________________
body: sanitation Water treatment
Strictly observe proper waste facility (i.e., grease
0 to less than 0.5 km handling and disposal trap, septic tank, etc.)
0.5 to 1 km Provision of wastewater treatment
More than 1 km facility (e.g., septic tank, oil and
water separator, etc.) Quarterly monitoring of the
Set up silt trap/stilling ponds to
following:
If nearest/receiving water body is minimize downstream siltation
fresh water, specify classification: Provision of three-chambered
pH
septic tank for domestic sewage TSS concentration
AA Provide ring canals around BOD
A fuelling tanks/ motorpool/ Total Coliform
maintenance areas
B Color
C
Others, specify
Oil and Grease
______________________
D
Possible
Impacts
If nearest/receiving water body is
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
Possible
Impacts
Competition in water Size of population using receiving Implement rainwater harvesting Regular monitoring for Cost integrated in
use surface water: and similar measures as an presence/absence of the construction/
Depletion of water alternative source of water complaints operation cost
>1,000 and 5,000 persons measures; with concerned
>5,000 persons Carefully select project site to
agencies
avoid disruption of traditional Regularly monitor
water uses occurrences of water
shortages
Available/nearest water source. Obtain Water Permit from NWRB
Improve efficiency of water
Others, specify
Deepwell supply and distribution system
____________
Water district/LGU Others, specify

Surface water _____________________
Others, specify
________________________
Increased occurrence Is the project site located in an Use appropriate design for project Regular monitoring for Cost integrated in
of flooding area identified by MGB/PAG-ASA facilities presence/absence of the construction/
as flood prone? Implement appropriate drainage
complaints operation cost
system Regular coordination
Yes Regularly remove debris and
with concerned
No other materials that may obstruct
agencies
water flow Regular monitoring for
Use appropriate technology (e.g., flooding
drinking water from flood Others, specify
contamination _________________
Others, specify
_____________________
Possible
Impacts
AIR / NOISE
Air quality degradation Distance to nearest community: Properly operate and maintain all Regular monitoring for Cost integrated in
emission sources (e.g. vehicles, presence/absence of the construction/
0 to less than 0.5 km pumps, generator, etc) complaints operation cost
0.5 to 1 km Install when applicable, the
More than 1 km appropriate air pollution control Regular monitoring of
device/s the following:
Strictly enforce good TSP
housekeeping practices NOx
Control vehicle speed to lessen SOx
Conduct water spraying to Frequency
suppress dust sources and Annual
minimize discomfort to nearby
residents Semi-annual
Use covered vehicles to deliver Regular (ocular)
materials that may generate dust inspection of:
Other, specify Absence of white
___________________ or black smoke
from vehicles,
heavy equipment
and generator
Presence of truck
cover during
deliveries
Nuisance due to noise Distance to nearest community: Properly operate and maintain all Regular monitoring for Cost integrated in
generation noise sources (e.g. vehicles, presence/absence of the construction/
0 to less than 0.5 km pumps, generator, etc) complaints operation cost
0.5 to 1 km Install, when applicable, the Regular monitoring of
More than 1 km appropriate noise control device/s
(e.g., mufflers, silencer, sound
buffer zones
barriers, etc.)
hours
Provide adequate buffer and/or
Possible
Impacts
planting of trees
Others, specify
______________________
PEOPLE
Displacement of Size of population of host Provide relocation/disturbance Regular monitoring for Cost integrated in
residents in the project barangay: compensation packages presence/absence of the construction/
site and within its Prioritize local residents for complaints operation cost
vicinity
Displacement of
>1,000 and 5,000 persons Promptly pay local taxes and with LGU
Indigenous People other financial obligations Others, specify
Enhanced >5,000 persons
Regularly coordinate with LGU _________________
employment and/or
livelihood
Conduct prior consultation &
Classification of host barangay: coordination to minimize
opportunities
disruption on daily domestic
Reduced employment
Urban
activities and to ensure respect for
and/or livelihood IP rights and cultural practices
opportunities Rural
Increased revenues consultations and dialogues
for LGU
Available services within/near the Provide appropriate traffic/warning
Disruption/Competition
host barangay: signs, lighting, etc
in delivery of public
services (e.g.,
Others, specify
education, peace and Schools (e.g., elementary, high ________________
order, etc.) school, college)
Enhanced delivery of Health facilities (e.g., clinics,
public services (e.g., hospitals, etc.)
education, peace and Peace and order (e.g., police
order, etc.) outpost, Brgy. Tanod, etc.)
Increase in traffic Recreation and sports facilities
volume and worsening
of traffic flow Others, specify
_____________________
Possible
Impacts
Impacts on community Source of risks Regularly coordinate with LGU Regular monitoring for Cost integrated in
health and safety Observe proper housekeeping presence/absence of the construction/
Flammable substances
Strictly comply with fire, safety
Others and similar regulatory Regular monitoring of
Safety Risks _________________________ buffer zones
requirements
Fire
Others, specify Regular coordination
___________________________ with LGU
reports to concerned
agency
Others, specify
_________________
III. ABANDONMENT /DECOMMISSIONING/REHABILITATION POLICIES AND GENERIC

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
Process Flow



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

Page No. __________________________
Book No. __________________________
Series of __________________________
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 2
PROJECT FACT SHEET
Name of the Project
Proponent Name
Proponent Address
Proponent Means of Name:

Contact
Designation:
Mobile No. Email:

Parameter
Manufacture of Other Products
Glass-based products annual production rate
Metal-based products (including semi-conductor / electronic
annual production rate
industries)
Paper and plastic-based products annual production rate
Chemical Industries
quantity of toxic
Manufacturing, processing and/or use of substances included in the chemicals to be used
Priority Chemical List
per month
Manufacture of agri-chemicals and other industrial chemicals not in
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, anti-
capacity fouling coating, printing inks)
Textile, Wood, Rubber Industries
Textile, Wood, Rubber Industries annual production rate
Daily processing rate of
Leather and related industries
raw hides
Mineral Ore Processing
Metallic Mineral or Ore Processing (e.g., copper, lead, nickel, cobalt,
Annual processing rate
zinc, silver, magnesium, and manganese, gold, placer with metal
(inputs)
content) with Physical or Mechanical Processing

________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________

on OCT/TCT/etc.)

Raw, chemical and process
materials
Fuel, lubricants and similar materials
Finished product (e.g. equipment
facilities, silo, hopper, etc.)
Others, specify
________________
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.)

6. Waste water management facility
8. Drainage system
9. Others, specify
_____________________
_____________________


Water m3/day
Water Source
____________________________________________________________________
Utilities Estimated Savings
Measures
3
Water m /day
I.4 MANPOWER
b. Operation Phase
Project Cost (PhP): ______________________


Possible Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/
Environmental/ Social Implementation Monitoring
Impacts
LAND
ordinance):
Residential
Industrial
Protected Areas
Others, specify
______________

radius:
Residential
Industrial
Protected Areas
Others, specify
______________
wildlife due to Forestland DENR/LGU SLUP, Tree Cutting
Permit, ROW, PCA Permit
area replanted/
re-vegetated
construction /operation
cost
vegetation clearing
Marshland
Grassland possible
Mangrove Provide temporary fencing for
Wetland vegetation that will be retained
Others, specify Promote restoration of damaged or
_______________ destroyed vegetation where possible
Impacts
gently sloping to rolling (3- with topsoil set aside for later use __________________
the site
Others, specify
or other soil cover
_________________
Others, specify
____________
Is the project site located in an Comply with DENR Administrative

area identified by MGB/PAG- Order No. 2003-30 and DENR
Administrative Order No. 2000-28,
ASA/ PHIVOLCS as hazard Implementing Guidelines on
prone? Engineering Geological and Geo-
Yes
No
Soil/Land Existing soil type in the area: Implement the Ecological Solid Daily inspection of Cost integrated in the
contamination due Waste Management Plan (ESWMP) waste/recycling bins for construction /operation
waste disposal
sandy-loam Implement re-use and recycling of presence of mixed

Others, specify
Implement proper collection and _______________
processing of animal waste into
organic fertilizer
Implement proper collection,
waste
wastes
Impacts

waste collectors
waste collection
Others, specify
________________
visual landforms/landscape/structure beautification measures landscaping and other construction/ operation
aesthetics s?
Provide adequate buffer beautification activities cost
Devaluation of Compensate adjacent property Regular monitoring of
land values Yes owners buffer zones
No Others, specify
presence/absence of
________________
property owners
WATER
Increased siltation Specify nearest/receiving

Regular (ocular) inspection
of water body for:
Cost integrated in the
due to project water body: construction/ operation
facility (e.g., septic tank, oil and
activities ________________________
water separator, etc.) Turbidity and/or cost
Water quality
Provide ring canals around fuelling
silted condition
degradation Distance to nearest/receiving
water body: tanks/ motor pool/ maintenance Floating wastes or
Others, specify
areas debris
_______________ Set up proper and adequate sanitary
0.5 to 1 km facilities
Monthly monitoring of the
following:
More than 1 km Strictly require the contractor and its pH
workers to observe proper waste
If nearest/receiving water body disposal and proper sanitation TSS concentration
is fresh water, specify
classification: Strictly observe proper waste BOD
AA
handling and disposal Total Coliform
Set up silt trap/stilling ponds to Color
A

minimize downstream siltation
Oil and Grease
B Others, specify Trace Metals (Pb,
C _________________ Cd, Hg, Cr6, As)
D
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
Competition in Size of population using Implement rainwater harvesting and Regular monitoring for Cost integrated in the
water use receiving surface water: similar measures as an alternative presence/absence of construction/ operation
persons Carefully select project site to avoid Regular monitoring for
>5,000 persons disruption of traditional water uses occurrences of water
shortages
Obtain Water Permit from NWRB
Impacts
Available/nearest water
source.
Improve efficiency of water supply Others, specify
and distribution system _____________
Deepwell Others, specify
Water district/LGU ____________________
Surface water
Others, specify
________________
Increased Is the project site located in an Use appropriate design for project Regular monitoring for Cost integrated in the
occurrence of area identified by MGB/PAG- facilities presence/absence of construction/ operation
flooding ASA as flood prone?
complaints cost
Yes Regularly remove debris and other
No materials that may obstruct water Regular monitoring for
flow increased frequency of
flooding
raised hand-pumps) to protect Others, specify
drinking water from flood ________________
contamination
Others, specify
____________________
AIR / NOISE
community: emission sources (e.g. vehicles, presence/absence of construction/ operation
boiler, generator, etc) complaints cost
0.5 to 1 km appropriate air pollution control
More than 1 km
device/s
Strictly enforce good housekeeping
practices
Control vehicle speed to lessen
Impacts
Conduct water spraying to Regular (ocular) inspection

of:
suppress dust sources and
minimize discomfort to nearby Absence of white or
residents black smoke from
Use covered vehicles to deliver vehicles, generator,
etc.
Others, specify Presence of truck
___________________ cover during
deliveries
ambient air for the following:
TSP
PM10
NOx
SOx
CO / CO2
noise generation community: emission sources (e.g. vehicles, presence/absence of construction/ operation
boiler, generator, etc) complaints cost
More than 1 km
device/s
practices
Conduct water spraying to suppress
dust sources and minimize
discomfort to nearby residents
Use covered vehicles to deliver
Others, specify
____________________
Impacts
PEOPLE
within its vicinity 1,000 persons employment Regular coordination
Displacement of >1,000 and Promptly pay local taxes and other with LGU
Indigenous Peoples 5,000persons financial obligations Others, specify
Enhanced >5,000person Regular coordination with LGU _____________
employment and/or
livelihood
coordination to minimize disruption
opportunities Classification of host of daily domestic activities and to
Reduced barangay: ensure respect for IP rights and
livelihood
opportunities
Urban Ensure participation of IPs in
Rural consultations and dialogues

Increased revenues
for LGU
Provide appropriate traffic/warning
signs, lighting, etc
Disruption/Competit Available services within/near
Others, specify
ion in delivery of the host barangay:
_________________
public services
(e.g., education, Schools (e.g.,
peace and order, elementary, high
etc.) school, college)
Enhanced delivery Health facilities (e.g.,
of public services clinics, hospitals, etc.)
(e.g., education,
peace and order, Peace and order (e.g.,
etc.) police outpost, Brgy.
Tanod, etc.)
Increase in traffic
Recreation and sports
volume and
worsening of traffic facilities
_________________
Impacts
complaints
cost
_____________ Observe proper housekeeping with LGU
agency
Others, specify
__________________
Implement appropriate safety
workers
RA 6969
Others, specify
__________________________
III. ABANDONMENT / DECOMMISSIONING/ REHABILITATION POLICIES AND GENERIC

Provide description of the Abandonment activities, such as, dismantling and waste disposal.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Organization Chart:
Process Flow
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 __________________________
1
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 2
PROJECT FACT SHEET
Name of the Project
Proponent Name
Proponent Address

Contact
Mobile No. Email:
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
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

on OCT/TCT/etc.)

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
__________________
__________________



Water m3/day
Water Source
____________________________________________________________________
Measures
3
Water m /day
I.4 MANPOWER
b. Operation Phase
Project Cost (PhP): ______________________


Baseline Environment Preventive/ Mitigating Measures
Impacts
LAND
ordinance):
Residential
Industrial
Protected Areas
Others, specify
______________

radius:
Residential
Industrial
Protected Areas
Others, specify
______________
wildlife due to DENR/LGU SLUP, Tree Cutting area replanted/ construction/operation
vegetation clearing Forestland Permit, ROW, PCA Permit re-vegetated cost
Marshland
possible

Impacts
Wetland
Promote restoration of damaged or
destroyed vegetation where possible
Others, specify (e.g., tree planting)
____________
gently sloping to rolling (3- with topsoil set aside for later use _____________
the site
Stabilize embankment with grasses Others, specify
or other soil cover ______________
Others, specify
____________
area identified by MGB/ Comply with DENR Administrative
PAG-ASA/ PHIVOLCS as Administrative Order No. 2000-28,
hazard prone? Implementing Guidelines on
Yes hazard Assessment (EGGA).
No
contamination due Waste Management Plan (ESWMP) waste/recycling bins for construction/operation
waste disposal
sandy-loam Implement re-use and recycling of presence of mixed

Others, specify
_________________
Weekly inspection of
collection and disposal of domestic Others, specify
wastes in designated areas _______________
wastes

Impacts
waste collectors
waste collection
Others, specify
________________
visual landforms/landscape/structure beautification measures landscaping and other construction/operation
aesthetics s? Provide adequate buffer beautification activities cost
No Others, specify
property owners
WATER
Increased siltation Specify nearest water body: Set up proper and adequate sanitary Regular (ocular) inspection Cost integrated in the
due to project facilities of: construction/operation
____________________
activities Strictly require the contractor and its cost
Water quality Distance to nearest water workers to observe proper waste Drainage / canal
degradation body: disposal and proper sanitation systems
Others, specify Strictly observe proper waste Water treatment facility
____________ 0 to less than 0.5 km handling and disposal (i.e., grease trap, septic
0.5 to 1 km Provide wastewater treatment tank, etc.)
facility (e.g., oil and water separator,
More than 1 km etc.)
Quarterly monitoring of the
Set up silt trap/stilling ponds to following:
If nearest water body is fresh minimize downstream siltation
water, specify classification: Provide three-chambered septic pH
tank for domestic sewage
TSS concentration
AA Others, specify
BOD
A
___________

Impacts
B Total Coliform
C Color
D Oil and Grease
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

Impacts
Competition in Size of population using
proposed water source:
Implement rainwater harvesting and Regular monitoring for Cost integrated in the
water use similar measures as an alternative presence/absence of construction/operation
Depletion of water 1,000 persons source of water complaints cost
resources >1,000 and 5,000 Observe water conservation Regular coordination
persons measures with concerned agencies
>5,000 persons Careful selection of project site to Regular monitoring for
avoid disruption of traditional water occurrences of water
Available/nearest water uses shortages
source. Obtain Water Permit from NWRB Others, specify
Deepwell Improve efficiency of water supply
_______________
Water district/LGU and distribution system
Surface water Others, specify
Others, specify
_____________________
_____________
occurrence of area identified by MGB/ facilities presence/absence of construction/operation
flooding PAG-ASA as flood prone? Implement appropriate drainage
complaints cost
flooding
contamination
Others, specify
_________________________
AIR / NOISE
Air quality degradation Distance to nearest
community:
Properly operate and maintain all Regular monitoring for Cost integrated in the
emission sources (e.g. vehicles, presence/absence of construction/operation
0 to less than 0.5 km generator, etc) complaints cost
0.5 to 1 km Strictly enforce good housekeeping
More than 1 km practices

Impacts
Control vehicle speed to lessen Regular (ocular) inspection
suspension of road dust of:
Conduct water spraying to
suppress dust sources and Absence of white or
minimize discomfort to nearby black smoke from
residents vehicles, generator,
etc.
materials that may generate dust Presence of truck
cover during
Others, specify
deliveries
_________________
noise generation community: noise sources (e.g., vehicles, presence/absence of construction/operation
More than 1 km
barriers, etc.)
hours
planting of trees
Others, specify
_____________________
PEOPLE
residents in the barangay: compensation packages presence/absence of construction/operation
within its vicinity
Displacement of
>1,000 and Promptly pay local taxes and other with LGU
Indigenous Peoples
5,000persons financial obligations Others, specify
Enhanced
>5,000person
employment and/or

Impacts
livelihood
opportunities
Classification of host Conduct prior consultation and
barangay: coordination to minimize disruption
Reduced on daily domestic activities and to
employment and/or Urban ensure respect for IP rights and
livelihood cultural practices
Rural
opportunities Ensure participation of IPs in
Increased revenues consultations and dialogues
for LGU Available services within/near Provide appropriate traffic/warning
Disruption/ the host barangay: signs, lighting, etc
Competition in Others, specify
delivery of public
services (e.g.,
Schools (e.g., _________________
elementary, high
education, peace school, college)
and order, etc.)
Enhanced delivery
Health facilities (e.g.,
of public services
(e.g., education, Peace and order (e.g.,
peace and order, police outpost, Brgy.
etc.) Tanod, etc.)
Increase in traffic Recreation and sports
volume and facilities
worsening of traffic Others, specify
flow __________________
community health
and safety
Provide appropriate warning signs, presence/absence of
complaints
construction/operation
cost
lighting and barricades, whenever
______________ Observe proper housekeeping with LGU
agency
workers
Strictly comply with fire, safety and Others, specify
similar regulatory requirements _______________
Others, specify
__________________
Initial Environmental Examination (IEE) Checklist Report Form for Subdivision & Housing Projects334 13
III. ABANDONMENT / DECOMMISSIONING / REHABILITATION POLICIES (if Applicable)
Provide description of the Abandonment activities
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
Attach drawing/plan of sewerage treatment facilities (with dimensions and descriptions)




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

Page No. __________________________
Book No. __________________________
Series of __________________________
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 2
PROJECT FACT SHEET
Name of the
Project
Proponent Name
Proponent
Address

of Contact
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
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

on OCT/TCT/etc)

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.
reception area, garden parks,
etc.)
7. Parking area
8. Terminal/Passenger Area
facility
10. Solid waste management
facilities

11. Drainage system
12. Others (please specify):
____________________
____________________
Comparative Matrix for Parking Lots
National Building Local Requirement Project Provisions

Code
Statutory Requirements
Calculations/Computations
(number of parking lots)
1.3 UTILITIES/REQUIREMENTS (Operation Phase):


Water m3/day
Water Source
____________________________________________________________________
Measures
Water m3/day
I.4 MANPOWER
Manpower
Expertise/Skills Total
Requirement
b. Operation Phase
Manpower
Expertise/Skills Total
Requirement
Project Cost (PhP): ______________________

7
Initial Environmental Examination (IEE) Checklist Report Form for Building Projects

Impacts
LAND
ordinance):
Residential
Industrial
Protected Areas
Others, specify
______________

radius:
Residential
Industrial
Protected Areas
Others, specify
______________
Marshland
possible
Others, specify
____________
8

Impacts
gently sloping to rolling (3- with topsoil set aside for later use _________________
the site
Others, specify
or other soil cover
______________
Others, specify____________

area identified by MGB/PAG-
Yes
No
contamination due sandy Waste Management Plan (ESWMP) waste/recycling bins for construction /operation
to improper solid
clay Set up temporary fence around the segregation cost
waste disposal construction area Daily inspection for
sandy-loam
Others, specify waste materials garbage in the facility
________________
collection and disposal of domestic waste accumulated
Provide receptacles / bins for solid _______________
wastes
waste collectors
waste collection
9

Impacts
Others, specify
________________
visual aesthetics landforms/landscape/structure beautification measures landscaping and other construction/operation
Devaluation of land
s?
Provide adequate buffer beautification activities cost
No Others, specify
presence/absence of
________________
property owners
WATER
Increased siltation
Specify nearest/receiving
Set up proper and adequate sanitary
Regular (ocular) inspection Cost integrated in the
water body: of water body for: construction/operation
due to project facilities
____________________ cost
activities Strictly require the contractor and its
Drainage/canal systems
Water quality Distance to nearest/receiving workers to observe proper waste
degradation water body:
disposal and proper sanitation Water treatment facility
Others, specify Strictly observe proper waste (i.e., grease trap, septic
tank, etc.
handling and disposal
____________ 0 to less than 0.5 km
0.5 to 1 km
Provide wastewater treatment Quarterly monitoring of the
facility (e.g., oil and water separator,
More than 1 km etc.)
following:
Set up silt trap/stilling ponds to pH

If nearest/receiving water body minimize downstream siltation
Provide three-chambered septic
TSS concentration
classification: tank for domestic sewage BOD
AA Others, specify Total Coliform
A ___________ Color
B Oil and Grease
C
D
10

Impacts
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

Drinking/Domestic
Industrial
Agricultural
11

Impacts
>5,000 persons Carefully select project site to avoid Regular monitoring for
disruption of traditional water uses occurrences of water
Obtain Water Permit from NWRB
shortages
Available/nearest water
Improve efficiency of water supply
Others, specify
source. ______________
and distribution system
Deepwell
Others, specify
_________________
Water district/LGU
Surface water
Others, specify
_____________
flooding PAG-ASA as flood prone?
complaints cost
flooding
contamination
Others, specify
_____________________
AIR / NOISE
community: emission sources (e.g. vehicles, presence/absence of construction/operation
generator, etc) complaints cost
0 to less than 0.5 km Strictly enforce good housekeeping
0.5 to 1 km practices
More than 1 km Control vehicle speed to lessen of:
12

Impacts
Conduct water spraying to Absence of white or black
suppress dust sources and smoke from vehicles,
minimize discomfort to nearby generator, etc.
residents Presence of truck cover
Use covered vehicles to deliver during deliveries
Others, specify
_________________
noise generation community: noise sources (e.g., vehicles, presence/absence of construction/ operation
More than 1 km
barriers, etc.)
Provide adequate buffer and
planting of trees
Others, specify
_________________
PEOPLE
project site and
1,000 persons
Prioritize local residents for complaints cost
within its vicinity employment Regular coordination
Displacement of >1,000 and 5,000 Promptly pay local taxes and other with LGU
Indigenous Peoples persons financial obligations Others, specify
Enhanced >5,000 persons ______________
employment and/or Regularly coordinate with LGU
livelihood
opportunities Classification of host Conduct prior consultation and
Reduced barangay:
of daily domestic activities and to
employment and/or Urban ensure respect for IP rights and
livelihood
opportunities
Rural cultural practices
13

Impacts
Increased revenues Available services within/near Ensure participation of IPs in
for LGU the host barangay: consultations and dialogues
Disruption/ Schools (e.g. elementary, Provide appropriate traffic/warning
Competition in high school, college) signs, lighting, etc
delivery of public
services (e.g.,
Health facilities (e.g., Others, specify
clinics, hospitals, etc.) _________________
education, peace
and order, etc.) Peace and order (e.g.,
Enhanced delivery Tanod, etc.)
of public services
(e.g., education, Recreation and sports
peace and order, facilities
etc.) Others, specify
Increase in traffic __________________
volume and
flow
community health
and safety
complaints
cost
Provide on-site medical services for Regular submission of
agency
Others, specify
______________
workers
Others, specify
_________________
III. ABANDONMENT /DECOMMISSIONING/REHABILITATION POLICIES AND GENERIC

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



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

Page No. __________________________
Book No. __________________________
Series of __________________________
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.

30)


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 2
PROJECT FACT SHEET
Name of the
Project
Proponent Name
Proponent
Address

of Contact
Project Type Actual Project Project Size Parameter

Size (hectare)
Cemetery Area to be developed
Funeral Parlor
total/gross floor area
Crematorium including parking and
Columbarium other areas
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
II.

Longitude Latitude
on OCT/TCT/etc)
Cemetery and Funeral Homes

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
facilities
11. Drainage System
____________________
____________________



Water m3/day
Water Source
____________________________________________________________________
Estimated
Utilities Proposed Efficiency/Conservation Measures
Savings
Water m3/day
I.4 MANPOWER
Requirement
b. Operation Phase
Requirement
Project Cost (PhP): ______________________

6
Initial Environmental Examination (IEE) Checklist Report Form for Cemetery & Other Funeral Facilities Projects

Impacts
LAND
ordinance):
Residential
Industrial
Protected Areas
Others, specify
______________

radius:
Residential
Industrial
Protected Areas
Others, specify
______________
Marshland
possible
Grassland
Provide temporary fencing for
7

Impacts
Others, specify destroyed vegetation where possible
____________
landform/ flat (0-3%) protection measures slope protection Cost: ___________
gently sloping to rolling (3-

topography/ Designate a Spoils Storage Area, measures in erosion- Others, specify
terrain/slope with topsoil set aside for later use prone areas ______________
18%)
Soil Erosion and allow maximum re-use of spoils Regular inspection for
steep (>18%)
Construct during dry season new eroded areas near
the site
Others, specify
or other soil cover
________________
Others, specify___________

PAG-ASA/ PHIVOLCS as Administrative Order No. 2000-28,
hazard prone? Implementing Guidelines on
No
waste disposal
sandy-loam
Others, specify
waste
8

Impacts
wastes
waste collectors
waste collection
Others, specify
________________
visual aesthetics landforms/ beautification measures landscaping and other construction/operation
Devaluation of land landscape/structures? Provide adequate buffer beautification activities cost
No Others, specify
presence/absence of
________________
property owners
WATER
Specify nearest water body: Regular (ocular) inspection Cost integrated in the
Increased siltation ___________________
Set up proper and adequate sanitary of water body for: construction/operation
due to project facilities cost
activities
Distance to nearest water Strictly require the contractor and its Drainage/canal systems
Water quality body: workers to observe proper waste
Water treatment facility
degradation disposal and proper sanitation
Others, specify
0 to less than 0.5 km Strictly observe proper waste
(i.e., grease trap, septic
tank, etc.
____________ 0.5 to 1 km handling and disposal
More than 1 km Provide wastewater treatment
facility (e.g., septic tank, oil and Regular (ocular) inspection
water separator, etc.) of water body for:
If nearest water body is fresh Set up silt trap/settling ponds to
water, specify classification: minimize downstream siltation Turbidity and/or silted
AA Others, specify ______________ condition
A Provide three-chambered septic Floating wastes or debris
B tank for domestic sewage
9

Impacts
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

Drinking/Domestic
Industrial
Agricultural
receiving surface water:
10

Impacts
>5,000 persons Others, specify Regular monitoring for
_________________ occurrences of water
Available/nearest water shortages
source. Others, specify
Deepwell ________________
Water district/LGU
Surface water
Others, specify
_____________
flooding PAG-ASA as flood prone?
complaints cost
flooding
Others, specify__________
Others, specify
_________________
AIR / NOISE
community: emission sources (e.g., generator, presence/absence of construction/operation
crematorium, etc) complaints cost
0 to less than 0.5 km Installappropriate air pollution
0.5 to 1 km control device/s for the
More than 1 km _______________
of:
Absence of white or
practices
black smoke from
Others, specify vehicles, generator,
___________________ etc.
11
PEOPLE
Displacement of Provide relocation/disturbance Regular monitoring for Cost integrated in the

residents in the Size of population of host compensation packages presence/absence of construction/operation
project site and barangay: Prioritize local residents for complaints cost
Displacement of 1,000 persons with LGU
Indigenous Peoples
>1,000 and 5,000 Promptly pay local taxes and other Others, specify
Enhanced persons financial obligations ________________
employment and/or
>5,000 persons Regularly coordinate with LGU
livelihood
opportunities
Classification of host coordination to minimize disruption
Reduced barangay: on daily domestic activities and to
employment and/or ensure respect for IP rights and
Urban
opportunities
Increased revenues Rural consultations and dialogues
for LGU
Disruption/Competit Available services within/near signs, lighting, etc
ion in delivery of
public services
the host barangay: Others, specify_________________
(e.g., education,
peace and order, Schools (e.g.
etc.) elementary, high
Enhanced delivery
school, college)
of public services Health facilities (e.g.,
(e.g., education, clinics, hospitals, etc.)
peace and order,
etc.)
Increase in traffic Tanod, etc.)
volume and Recreation and sports
flow
Others, specify
_________________
12
complaints
cost
Provide on-site medical services for Regular submission of
any emergency.
agency
Others, specify
________________
Others, specify
_________________

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
descriptions)



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

Page No. __________________________
Book No. __________________________
Series of __________________________
1
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 2
PROJECT FACT SHEET
Name of the Project
Proponent Name
Proponent Address

Contact
Mobile No. Email:
Project Type Project Size

Project Size
Parameter
Maximum Stock
Livestock Production: Pigs / Goats Population
Maximum Stock
Poultry / Birds Population

_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

on OCT/TCT/etc.)
Maximum Stock Production (per growing season): ____________________________

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
____________________
____________________


3
3
Water m /day
Water Source
____________________________________________________________________
Estimated Savings
Utilities Measures
3
Water m /day
I.4 MANPOWER
b. Operation Phase
Project Cost (PhP): ______________________


Environmental/Social Baseline Environment Preventive/ Mitigating Measures
Impacts
LAND
Consistency with land Current land use w/in 1km See attached proof of compatibility
use radius (as per zoning with land use
ordinance):
Residential
Industrial
Protected Areas
Others, specify
__________________

radius:
Residential
Industrial
Protected Areas
Others, specify
__________________
Disturbance to wildlife Existing vegetation in the area: Comply with conditions of Annual inspection of Cost integrated in
due to vegetation
clearing
Forestland
DENR/LGU SLUP, Tree Cutting
area replanted/
re-vegetated
the construction/
operation cost
Marshland Limit land clearing as much as
Grassland possible
Wetland
vegetation that will be retained
Others, specify destroyed vegetation where
__________________ possible (e.g., tree planting)

Impacts
landform/ topography/ flat (0-3%) protection measures slope protection Control Cost:
terrain/slope
gently sloping to rolling (3- Designate a Spoils Storage Area, measures in erosion- ___________
18%) with topsoil set aside for later use prone areas Others, specify
and allow maximum re-use of Regular inspection for _________________
Soil Erosion steep (>18%) spoils new eroded areas near
Construct during dry season the site
Stabilize embankment with Others, specify
grasses or other soil cover _________________
Others, specify
_______________________

PAG-ASA/ PHIVOLCS as Implementing Guidelines on
hazard prone? Engineering Geological and Geo-
Yes
No
improper solid waste
sandy
Waste Management Plan
(ESWMP)
waste/recycling bins for
segregation
the construction/
operation cost
disposal clay
Set up temporary fence around the Daily inspection for
sandy-loam construction area presence of mixed
Others, specify Implement re-use and recycling of garbage in the facility
____________________ waste materials Weekly inspection of
collection and disposal of domestic Others, specify
wastes in designated areas _________________
waste
wastes

Impacts
waste collectors
waste collection
Others, specify
________________
Impairment of Presence of visually significant Implement landscaping and other Regular inspection of Cost integrated in
visual aesthetics landforms/landscape/structures? beautification measures landscaping and other the construction/
Devaluation of Yes Provide adequate buffer beautification activities operation cost
land values No Compensate adjacent property Regular monitoring of
owners buffer zones
Others, specify
presence/absence of
________________
complaints from
adjacent property
owners
WATER
Increased siltation due Specify nearest/receiving water Set-up proper and adequate Regular (ocular) inspection Cost integrated in the
to project activities body: sanitary facilities of: construction/
Water quality _________________________ Strictly require the contractor and operation cost
degradation its workers to observe proper Drainage / canal
Distance to nearest/receiving systems
Others, specify
waste disposal and proper
_______________
water body: sanitation Water treatment facility
0 to less than 0.5 km Strictly observe proper waste (i.e., grease trap, septic
0.5 to 1 km
handling and disposal tank, etc.)
More than 1 km Provide wastewater treatment

facility (e.g., septic tank, oil and
water separator, etc.) Quarterly monitoring of the
following:
If nearest/receiving water body Provide biogas generator or similar
is fresh water, specify waste treatment measures
classification: Set up silt trap/settling ponds to
pH
TSS concentration
AA

A
Others, specify BOD
_____________________ Total Coliform
B
Color

Impacts
C Oil and Grease
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

Impacts
Competition in water Size of population using Implement rainwater harvesting Regular monitoring for Cost integrated in the
use receiving surface water: and similar measures as an presence/absence of construction/
Depletion of water 1,000 persons alternative source of water complaints operation cost
measures; with concerned
persons
>5,000 persons Carefully select project site to
agencies
avoid disruption of traditional water Regular monitoring for
uses occurrences of water
shortages
Available/nearest water source. Obtain Water Permit from NWRB
Others, specify
Deepwell Improve efficiency of water supply ________________
Water district/LGU
and distribution system
Surface water
Others, specify
_________________________
Others, specify
________________
Increased occurrence Is the project site located in an Use appropriate design for project Regular monitoring for Cost integrated in the
of flooding area identified by MGB/PAG- facilities presence/absence of construction/
ASA as flood prone? Implement appropriate drainage
Yes system Regular coordination
No Use appropriate technology (e.g.,
with concerned
agencies
drinking water from flood Regular monitoring for
contamination increased frequency of
flooding
Others,
specify___________________ Others, specify
____________________
AIR / NOISE
Air quality degradation Distance to nearest community: Properly operate and maintain all Regular monitoring for Cost integrated in the
emission sources (e.g. vehicles, presence/absence of construction/
0 to less than 0.5 km generator, etc) complaints operation cost
0.5 to 1 km Strictly enforce good
More than 1 km housekeeping practices
of:

Impacts
Control vehicle speed to lessen Absence of white
suspension of road dust or black smoke
Conduct water spraying to from vehicles,
generator, etc.
minimize discomfort to nearby Presence of truck
residents cover during
Use covered vehicles to deliver deliveries
Others, specify
___________________
Nuisance due to noise Distance to nearest community: Regular clean-up of animal houses Regular monitoring for Cost integrated in the
generation 0 to less than 0.5 km Use environment-friendly
presence/absence of construction/
0.5 to 1 km deodorizer or odor masking
More than 1 km
substances
Use sprays with natural / microbial
disinfectants
Is the wind direction blowing Provide adequate buffer and/or
towards the nearest community planting of trees
most of the year? Others, specify
Yes ____________________
No
PEOPLE
residents in the project barangay: compensation packages presence/absence of construction/
site and within its
1,000 persons Prioritize local residents for complaints operation cost
vicinity Regular coordination
>1,000 and 5,000
employment
Displacement of persons Promptly pay local taxes and other with LGU
Indigenous Peoples
financial obligations Others, specify
Enhanced
>5,000 persons
Regular coordination with LGU _________________
employment and/or
livelihood
Classification of host barangay: coordination to minimize disruption
opportunities
Reduced employment Urban
and/or livelihood Rural cultural practices

Impacts
opportunities Available services within/near Ensure participation of IPs in
Increased revenues the host barangay: consultations and dialogues
for LGU Schools (e.g., Provide appropriate traffic/warning
Disruption/Competitio elementary, high school, signs, lighting, etc
n in delivery of public college) Others, specify
services (e.g.,
education, peace and
Health facilities (e.g., _________________
order, etc.)
Enhanced delivery of
public services (e.g., Tanod, etc.)
order, etc.) Recreation and sports
facilities
Increase in traffic
Others, specify
of traffic flow ___________________
Impacts on community Regularly coordinate with LGU Regular monitoring for Cost integrated in the
health and safety Provide appropriate warning signs, presence/absence of construction/
Others, specify lighting and barricades, whenever complaints operation cost
_______________ practicable Regular coordination
Observe proper housekeeping with LGU
Provide on-site medical services Regular submission of
for any emergency. reports to concerned
agency
Others, specify
________________
Regularly spray disinfectant,
pesticides and other similar
substances when applicable
Others, specify
__________________________

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
Attach site development/layout plan (with dimensions and descriptions)




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

Page No. __________________________
Book No. __________________________
Series of __________________________
1
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
2
Initial Environmental Examination (IEE) Checklist Report Form for Resorts & Other Tourism/Leisure Projects
PROJECT FACT SHEET
Name of the Project
Proponent Name
Proponent Address

Contact
Mobile No. Email:

Parameter
Area to be
Resorts developed
Area to be
Other Tourism Projects
developed

on OCT/TCT/etc.)
3

Facilities No. of Area (sq/m)/ Specifications/Description/
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

facilities
16. Drainage system
17. Others, specify:

_____________________
_____________________

4


Water m3/day
Water Source
____________________________________________________________________
5
Estimated Savings
Utilities Measures
3
Water m /day
I.4 MANPOWER
b. Operation Phase
Project Cost (PhP): ______________________

6

Possible
Impacts
LAND
ordinance):
Residential
Industrial
Protected Areas
Others, specify
______________

radius:
Residential
Industrial
Protected Areas
Others, specify
___________________
Disturbance to Existing vegetation in the area: Comply with conditions of Annual inspection of area Cost integrated in
wildlife due to DENR/LGU SLUP, Tree Cutting replanted/ the construction
vegetation clearing Forestland Permit, ROW, PCA Permit re-vegetated /operation cost
Marshland
possible
Others, specify
____________________
7
Possible
Impacts
Change in surface Slope: Provide erosion control and slope Regular inspection of slope Slope/ Erosion
landform/ flat (0-3%) protection measures protection measures in Control Cost:
topography/ gently sloping to rolling (3- Designate a Spoils Storage Area, erosion-prone areas ___________
terrain/slope 18%) with topsoil set aside for later use Regular inspection for new Others, specify
Soil Erosion steep (>18%) and allow maximum re-use of spoils eroded areas near the site ________________
Construct during dry season Others, specify __
Stabilize embankment with grasses _________________
or other soil cover
Others, specify
__________________________

area identified by MGB/PAG- Administrative Order No. 2000-28,
Yes
No
contamination due Waste Management Plan (ESWMP) waste/recycling bins for the construction
to improper solid sandy Set up temporary fence around the segregation /operation cost
waste disposal
sandy-loam
Implement re-use and recycling of presence of mixed garbage
waste materials in the facility
Others, specify
Implement proper segregation, Weekly inspection of waste
____________________ accumulated
Implement proper collection and ___________________
processing of animal waste into
organic fertilizer
waste
wastes
8
Possible
Impacts
waste collectors
waste collection
Others, specify
__________________________
Impairment of Presence of visually significant

landforms/landscape/
Implement landscaping and other Regular inspection of Cost integrated in
visual beautification measures landscaping and other the construction/
structures?
aesthetics
Provide adequate buffer beautification activities operation cost
Devaluation of Yes
Compensate adjacent property Regular monitoring of buffer
land values No owners zones
Others, specify________________
presence/absence of
property owners
WATER
Increased siltation Specify nearest/receiving

Regular (ocular) inspection of: Cost integrated in
due to project water body:
facilities Drainage / canal systems the construction/
activities ______________________
Strictly require the contractor and its Water treatment facility (i.e.,
operation cost
Water quality
Distance to nearest/receiving workers to observe proper waste grease trap, septic tank,
degradation disposal and proper sanitation etc.)
water body:
Others, specify
0 to less than 0.5 km Strictly observe proper waste Quarterly monitoring of the
_______________ handling and disposal
0.5 to 1 km

following:
More than 1 km
facility (e.g. septic tank, oil and
pH
water separator, etc.) TSS concentration
is fresh water, specify Set up silt trap/stilling ponds to BOD
classification: minimize downstream siltation Total Coliform
AA Installation of drainage canals Color
A Others, specify ___________ Oil and Grease
B
C
D
9
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
10
Possible
Impacts
receiving surface water:
Implement rainwater harvesting and Regular monitoring for Cost integrated in
water use similar measures as an alternative presence/absence of the construction/
Depletion of water 1,000 persons source of water complaints operation cost
resources >1,000 and 5,000 Observe water conservation Regular coordination with
persons measures concerned agencies
Available/nearest water Obtain Water Permit from NWRB
shortages
source.
Deepwell and distribution system
___________________
Water district/LGU Use drought resistant species which
Surface water require less water input and hence
Others, specify
have less impact on water tables
________________ Others, specify
______________________
Increased Is the project site located in an Use appropriate design for project Regular monitoring for Cost integrated in
occurrence of area identified by MGB/ facilities presence/absence of the construction/
system Regular coordination with
concerned agencies
flooding
drinking water from flood ___________________
contamination
Others, specify
__________________________
AIR / NOISE
Air quality degradation Distance to nearest
community:
Properly operate and maintain all Regular monitoring for Cost integrated in
emission sources (e.g. vehicles, presence/absence of the construction/
0 to less than 0.5 km generator, etc) complaints operation cost
0.5 to 1 km Install, when applicable, the
Regular (ocular) inspection of:
11
Possible
Impacts
More than 1 km appropriate air pollution control
device/s
Absence of white or
black smoke from
Strictly enforce good housekeeping vehicles, generator, etc.
practices Presence of truck cover
Control vehicle speed to lessen during deliveries
residents
materials that may generate dus
Others, specify
___________________
Nuisance due to Distance to nearest Regularly clean up animal houses Regular monitoring for Cost integrated in
community:
generation of
obnoxious/
Use environment-friendly deodorizer
presence/absence of
complaints
the construction/
operation cost
or odor masking substances
unpleasant odor 0 to less than 0.5 km
0.5 to 1 km disinfectants
More than 1 km Provide adequate buffer and/or
planting of trees
Others, specify ___________
Nuisance due to Distance to nearest
community:
Properly operate and maintain all Regular monitoring for Cost integrated in
noise generation noise sources (e.g., vehicles, presence/absence of the construction/
0 to less than 0.5 km generator, etc.) complaints operation cost
0.5 to 1 km Install when applicable, the Regular monitoring of buffer
More than 1 km appropriate noise control device/s zones
Is the wind direction blowing barriers, etc.) noise level
towards the nearest Implement appropriate operating
community most of the year? hours
Provide adequate buffer
Yes (e.g., Perimeter planting of trees to
serve as sound buffer and greenbelt)
No
12
Possible
Impacts
Others, specify
_____________________
PEOPLE
Displacement of Size of population of host Provide relocation/disturbance Regular monitoring for Cost integrated in
residents in the barangay: compensation packages presence/absence of the construction/
project site and 1,000 persons Prioritize local residents for complaints operation cost
within its vicinity
>1,000 and employment Regular coordination with
Displacement of 5,000persons Promptly pay local taxes and other LGU
Indigenous Peoples
>5,000person financial obligations Others, specify
Enhanced Regular coordination with LGU _____________________
employment and/or
livelihood
Classification of host
barangay:
opportunities
Urban of daily domestic activities and to
Reduced
Rural ensure respect for IP rights and
livelihood
opportunities
Available services within/near Ensure participation of IPs in
the host barangay: consultations and dialogues
Increased revenues
Schools (e.g., Provide appropriate traffic/warning
for LGU
elementary, high signs, lighting, etc
Disruption/ school, college) Others, specify
Competition in
delivery of public
Health facilities (e.g., ____________________________
services (e.g.,
education, peace Peace and order (e.g.,
and order, etc.) police outpost, Brgy.
Enhanced delivery
Tanod, etc.)
of public services Recreation and sports
(e.g., education, facilities
peace and order, Others, specify
etc.) ________________
Increase in traffic
volume and
flow
13
Possible
Impacts
Impacts on Regularly coordinate with LGU Regular monitoring for Cost integrated in
community health
and safety
complaints
the construction/
operation cost
Others, specify practicable Regular coordination with
____________ Observe proper housekeeping LGU
reports to concerned agency
any emergency.
Participate in public awareness Others, specify
_____________
workers

RA 6969
Others, specify
_____________________
Initial Environmental Examination (IEE) Checklist Report Form for Resorts & Other Tourism/Leisure Projects 14

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:



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

Page No. __________________________
Book No. __________________________
Series of __________________________
1 1
1
Annex 2 - J
for
ROAD AND BRIDGE PROJECTS
This IEE Checklist Report Form shall be used for proposed ROAD AND BRIDGE PROJECTS

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 Road and Bridge Projects 2
PROJECT FACT SHEET
Name of the Project
Proponent Name
Proponent Address

Contact
Mobile No. Email:

Parameter
Bridges and viaducts, new construction Length
length with no critical
Roads, new construction, widening slope, OR
length with critical slope
Elevated roads, flyover/cloverleaf/ interchanges
Tunnels and sub-grade roads and railways Length

Pedestrian passages
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

on OCT/TCT/etc.)

1. Road
2. Intersections
3. Bridge/s
4. Access roads/Ramp
5. Drainage facilities
(i.e. Reinforced Concrete Box
Culverts (RCBC);Reinforced
Concrete Pipe Culverts (RCPC),
others)
6. Associated facilities (i.e.
Guardrails, Traffic signs, etc.)
8. Others, specify
_______________________
_____________________



Water m3/day
Water Source
____________________________________________________________________
Estimated Savings
Utilities Measures
3
Water m /day
I.3 MANPOWER
b. Operation Phase
Project Cost (PhP): ______________________


Possible
Impacts
LAND
ordinance):
Residential
Industrial
Protected Areas
Others, specify
______________

radius:
Residential
Industrial
Protected Areas
Others, specify
______________
area replanted/
re-vegetated
construction /operation
cost
vegetation clearing
Marshland
Grassland possible
Others, specify
____________ destroyed vegetation where
possible (e.g., tree planting)
Possible
Impacts
landform/ flat (0-3%) protection measures slope protection Cost: ___________
topography/
terrain/slope gently sloping to rolling (3- Designate a Spoils Storage Area, measures in erosion-
prone areas
Others, specify
18%) with topsoil set aside for later use __________________
Soil Erosion
steep (>18%)
and allow maximum re-use of spoils Regular inspection for
Construct during dry season new eroded areas near
the site
Others, specify
or other soil cover
_________________
Others, specify
____________
area identified by MGB/ Comply with the DENR
Administrative Order No. 2003-30
PAG-ASA/ PHIVOLCS as
and DENR Administrative Order No.
hazard prone? 2000-28, Implementing Guidelines
on Engineering Geological and
Yes Geo-hazard Assessment (EGGA).
No
Soil/Land Existing soil type in the area: Implement Ecological Solid Waste Daily inspection of Cost integrated in the
contamination due Management Plan (ESWMP) waste/recycling bins for construction /operation
waste disposal
sandy-loam
Others, specify
waste
wastes
waste collectors
waste collection
Possible
Impacts
Others, specify
________________
Encroachment into Is the project area near Obtain appropriate Regular coordination Cost integrated in the
protected areas or protected areas or ecologically- permits/clearances from concerned with concerned agencies construction/ operation
ecologically- sensitive areas? agencies cost
sensitive areas Provide adequate buffer
Yes Others, specify
No ________________
visual aesthetics landforms/landscape/structures? beautification measures landscaping and other construction/ operation
Devaluation of Provide adequate buffer beautification activities cost
land values Yes
No owners buffer zones
Others, specify
complaints from
adjacent property
owners
WATER
Specify nearest water body: Set up proper and adequate Regular (ocular) inspection Cost integrated in the
Increased siltation __________________________ sanitary facilities of: construction/ operation
due to project
Strictly require the contractor and its Drainage / canal cost
activities Distance to nearest water body: systems
workers to observe proper waste
Water quality 0 to less than 0.5 km disposal and proper sanitation Sanitation facilities
degradation 0.5 to 1 km Strictly observe proper waste
Others, specify More than 1 km handling and disposal Regular (ocular) inspection
of water body for:
_______________
Set up silt trap(Gabions,
If nearest water body is fresh Fascines)/settling ponds to Turbidity and/or silted
water, specify classification: minimize downstream siltation condition
AA Others, specify Floating wastes or
debris
A ___________
B
C
Possible
Impacts
D
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

Drinking/Domestic
Industrial
Agricultural
Competition in Size of population using water Implement rainwater harvesting and Regular monitoring for Cost integrated in the
water use source: similar measures as an alternative presence/absence of construction/ operation
persons Others, specify Regular monitoring for
>5,000 persons _________________ occurrences of water
shortages
Possible
Impacts
Available/nearest water source. Others, specify
________________
Deepwell
Water district/LGU
Surface water
Others, specify
________________
occurrence of area identified by MGB/ facilities presence/absence of construction/ operation
flooding PAG-ASA as flood prone? Implement appropriate drainage complaints cost
flooding
Others, specify
___________________ Others, specify
____________________
AIR / NOISE
emission sources (e.g. vehicles, presence/absence of construction/ operation
0 to less than 0.5 km generator, etc) complaints cost
0.5 to 1 km Install, when applicable, the
More than 1 km appropriate air pollution control
device/s
of:

Absence of white or
black smoke from
practices
vehicles, generator,
Control vehicle speed to lessen etc.
Presence of truck
Conduct water spraying to cover during
suppress dust sources and deliveries
residents
Possible
Impacts
Others, specify
___________________
Nuisance due to Distance to nearest community: Properly operate and maintain all Regular monitoring for Cost integrated in the
noise generation noise sources (e.g., vehicles, presence/absence of construction/ operation
0 to less than 0.5 km generator, etc.) complaints cost
0.5 to 1 km Install, when applicable, the Regular monitoring of
buffer zones
barriers, etc.)
hours
planting of trees
Others, specify
_____________________
PEOPLE
project site and 1,000 persons Prioritize local residents for complaints cost
within its vicinity
>1,000 and employment Regular coordination
Displacement of 5,000persons Promptly pay local taxes and other with LGU
Indigenous
>5,000 persons
Peoples
Enhanced
Classification of host barangay: Conduct prior consultation and
employment and/or Urban coordination to minimize disruption
livelihood Rural ensure respect for IP rights and
opportunities
cultural practices
Reduced Available services within/near
the host barangay: Ensure participation of IPs in
employment and/or
livelihood Schools (e.g.,
opportunities elementary, high school, Provide appropriate traffic/warning
Increased college) signs, lighting, etc.
Possible
Impacts
revenues for LGU Health facilities (e.g., Others, specify
Disruption/ clinics, hospitals, etc.) _________________
Competition in
delivery of public
services (e.g., Tanod, etc.)
education, peace
and order, etc.) Recreation and sports
facilities
Enhanced delivery
of public services Others, specify
(e.g., education, ___________________
peace and order,
etc.)
Increase in traffic
volume and
flow
complaints
cost
Others, specify practicable
_______________ Observe proper housekeeping Regular coordination
with LGU
any emergency.
Participate in public awareness agency
Others, specify
Implement appropriate safety ________________
workers
Others, specify
_____________________

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
Attach design/plan/alignment of project (with dimensions and descriptions)




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

Page No. __________________________
Book No. __________________________
Series of __________________________
1 1
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
2
PROJECT FACT SHEET
Name of the Project
Proponent Name
Proponent Address

Contact
Mobile No. Email:
Actual Project
Project Type Project Size Parameter
Size
# of wells and other systems
Water Supply Systems (Complete System)
(e.g., infiltration gallery, etc.)
Water Supply System (Distribution Only) Level
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

3
on OCT/TCT/etc.)
I.2. PROJECT COMPONENTS

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 (Indicate service area in m 2 and
number of households served)
__________________ square
meters
__________________ households
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
4

7. Drainage System
8. Others, specify
__________________
__________________


(Fill-up table below if water is not obtained from
the local water utility)
Water m3/day
Water Source
____________________________________________________________________
5
Estimated Savings
Utilities Measures
3
Water m /day
I.4 MANPOWER
b. Operation Phase
Project Cost (PhP): ______________________


Impacts
LAND
ordinance):
Residential
Industrial
Protected Areas
Others, specify
________________

radius:
Residential
Industrial
Protected Areas
Others, specify
_________________
wildlife due to DENR/LGU SLUP, Tree Cutting area replanted/ construction/operation
vegetation clearing Forestland Permit, ROW, PCA Permit re-vegetated cost
Marshland
possible
Others, specify
__________________
Impacts
topography/
terrain/slope
flat (0-3%) Designate a Spoils Storage Area, measures in erosion-
prone areas
Others, specify
gently sloping to rolling (3- with topsoil set aside for later use _______________
the site
Others, specify
or other soil cover
______________
Others, specify
____________
area identified by MGB/PAG- Comply with the DENR
Administrative Order No. 2003-30
ASA/ PHIVOLCS as hazard
and DENR Administrative Order No.
prone? 2000-28, Implementing Guidelines
on Engineering Geological and Geo-
No
contamination due Waste Management Plan (ESWMP) waste/recycling bins for construction/operation
waste disposal
sandy-loam
Others, specify
_______________
waste
wastes
waste collectors
Impacts
waste collection
Others, specify
________________
visual landforms/landscape/structure beautification measures landscaping and other construction/operation
aesthetics s? Provide adequate buffer beautification activities cost
No Others, specify
property owners
WATER
Increased siltation
Specify nearest/receiving
Regular (ocular) inspection Cost integrated in the
water body: of: construction/operation
due to project facilities
________________________ cost
activities Strictly require the contractor and its
Drainage / canal
Water quality Distance to nearest/receiving workers to observe proper waste
systems
degradation disposal and proper sanitation
Others, specify
water body:
Strictly observe proper waste Water treatment facility
handling and disposal (i.e., grease trap, septic
_____________ 0 to less than 0.5 km tank, etc.)
0.5 to 1 km
facility
More than 1 km Set up silt trap/stilling ponds to Quarterly monitoring of the
minimize downstream siltation following:
If nearest/receiving water body Provide ring canals around fuelling
tanks/ motorpool/ maintenance pH
classification:
areas TSS concentration
Others, specify BOD
______________
AA Total Coliform
A Color
B Oil and Grease
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
Impacts
Competition in Size of population using Implement rainwater harvesting and Regular monitoring for
presence/absence of
water use receiving surface water: similar measures as an alternative construction/operation
complaints
Depletion of water source of water

cost
>1,000 and 5,000 measures;

persons Careful selection of project site to Regular monitoring for
occurrences of water
>5,000 persons avoid disruption of traditional water
uses shortages
Obtain Water Permit from NWRB Others, specify
________________
Available/nearest water Improve efficiency of water supply
source. and distribution system
Implement community ponds and
Deepwell similar measures as alternative
Water district/LGU water source for non-domestic uses
Surface water Increase, when practical, storage
capacities of water supply structures
Others, specify for resilience to greater climate
________________ variations and extremes
Others, specify
_______________________
occurrence of area identified by MGB/PAG- facilities presence/absence of construction/operation
flooding ASA as flood prone? Implement appropriate drainage
complaints cost
flooding
drinking water from flood __________________
contamination
Others, specify
________________________
Impacts
AIR / NOISE
community: emission sources (e.g. vehicles, presence/absence of construction/operation
pumps, generator, etc) complaints cost
of:
More than 1 km
device/s

etc.
Presence of truck
cover during
deliveries
residents
Others, specify
_________________
pumps, generator, etc.) complaints cost
More than 1 km
barriers, etc.)
hours
planting trees
Others, specify
_________________
PEOPLE
Displacement of Provide relocation/disturbance Regular monitoring for Cost integrated in the

residents in the compensation packages presence/absence of construction/operation
Displacement of Size of population of host Promptly pay local taxes and other with LGU
Indigenous Peoples barangay: financial obligations
1,000 persons Regular coordination with LGU
Others, specify
Enhanced
>1,000 and 5,000 Conduct prior consultation and ______________
persons coordination to minimize disruption
employment and/or
livelihood >5,000 persons of daily domestic activities and to
opportunities Classification of host
cultural practices
Reduced barangay:
employment and/or
livelihood Urban
opportunities
Rural
Increased revenues
for LGU Others, specify
Disruption/ Available services within/near _________________
Competition in the host barangay:
delivery of public
services (e.g., Schools (e.g.,
education, peace elementary, high
and order, etc.) school, college)
Enhanced delivery Health facilities (e.g.,
of public services clinics, hospitals, etc.)
(e.g., education,
peace and order, Peace and order (e.g.,
etc.) police outpost, Brgy.
Tanod, etc.)
Increase in traffic
Recreation and sports
volume and
Impacts on
__________________ Regularly coordinate with LGU Regular monitoring for Cost integrated in the
complaints
cost
Provide on-site medical services for reports to concerned

agency
any emergency.
Participate in public awareness Others, specify
programs on health and safety ________________
workers
RA 6969
Others, specify
________________
III. ABANDONMENT /DECOMMISSIONING / REHABILITATION POLICIES AND GENERIC

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
descriptions)
Process flow



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

Page No. __________________________
Book No. __________________________
Series of __________________________
1
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 2
PROJECT FACT SHEET
Name of the Project
Proponent Name
Proponent Address

Contact
Mobile No. Email:
Actual
Project Type Project Size Project Size Parameter
reservoir flooded area
Impounding System or Flood Control Project (hectare) or water storage
capacity (m3)
Irrigation System (Distribution System Only) service area (hectare)
reservoir flooded area
Minor Dam (hectare) or water storage
capacity (m3)
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

on OCT/TCT/etc.)

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:
_____________________
_____________________


3
3
Water m /day
Water Source
____________________________________________________________________
Estimated Savings
Utilities Measures
3
Water m /day
I.4 MANPOWER
b. Operation Phase
Project Cost (PhP): ______________________


Possible
Impacts
LAND
ordinance):
Residential
Industrial
Protected Areas
Others, specify
___________________

radius:
Residential
Industrial
Protected Areas
Others, specify
__________________
area replanted/
re-vegetated
cost
vegetation clearing
Marshland
Grassland possible
Others, specify
___________________ destroyed vegetation where possible
Possible
Impacts
topography/
terrain/slope
flat (0-3%) Designate a Spoils Storage Area, measures in erosion-
prone areas
Others, specify
gently sloping to rolling (3- with topsoil set aside for later use ______________
the site
Others, specify
or other soil cover
_____________
Others, specify
_________________________

area identified by MGB/ Order No. 2003-30 and DENR
PAG-ASA/ PHIVOLCS as
Implementing Guidelines on
hazard prone? Engineering Geological and Geo-
Yes
No
waste disposal
sandy-loam
Others, specify
Implement proper collection, _____________
waste
wastes
waste collectors
Possible
Impacts
waste collection
Others, specify
________________
WATER
Increased siltation Specify nearest water body: Regular (ocular) inspection Cost integrated in the
due to project ________________________ of: construction/operation
activities cost
Water quality Drainage/canal systems
degradation Distance to nearest water
Water treatment facility
Others, specify
body: (i.e., grease trap, septic
_______________ 0 to less than 0.5 km tank, etc.
0.5 to 1 km
More than 1 km Set up proper and adequate sanitary
facilities
of water body for:
Strictly require the contractor and its
If nearest water body is fresh workers to observe proper waste
water, specify classification: disposal and proper sanitation Turbidity and/or silted
condition
Strictly observe proper waste
AA
handling and disposal Floating wastes or debris
A
B facility (e.g., septic tank, oil and
C water separator, etc.)
D Set up silt trap/settling ponds to
Others, specify
If nearest water body is ______________
coastal or marine water,
SA
SB
SC
SD
Current Water Use:
Fishery
Possible
Impacts
Tourist Zone / Park
Recreational
Industrial
Agricultural

nearest well used:
0.5 to 1 km
More than 1 km

Drinking/Domestic
Industrial
Agricultural

Available/nearest water Obtain Water Permit from NWRB
shortages
source.
Deepwell and distribution system _____________
Water district/LGU Implement community ponds and
Surface water similar measures as alternative
water source and options for fish
Others, specify cultivation
________________
Increase, when practical, storage
capacities of water supply structures
for resilience to greater climate
variations and extremes
Use drought resistant species which
Possible
Impacts
require less water input and hence
have less impact on water tables
Modify irrigation techniques,
including amount, timing or
technology
Improve water management to
prevent water logging, erosion and
leaching
Modify crop calendars and/or
implement seasonal climate
forecasting (e.g., timing or location
of cropping activities)
Others, specify
_____________________
complaints cost
No materials that may obstruct water Regular monitor of
flooding
contamination
Others, specify
_______________________
Possible
Impacts
AIR / NOISE
community: emission sources (e.g., vehicles, presence/absence of construction/operation
0 to less than 0.5 km Install, when applicable, the Regular (ocular) inspection
0.5 to 1 km appropriate air pollution control of:
More than 1 km
device/s

Control vehicle speed to lessen etc.
Conduct water spraying to suppress
Presence of truck
cover during
dust sources and minimize deliveries
Others, specify
__________________
More than 1 km
barriers, etc.) noise level
hours
planting of trees
Others, specify
_____________________
Possible
Impacts
PEOPLE
project site and
1,000 persons Prioritize local residents for complaints cost
Displacement of >1,000 and 5,000
Promptly pay local taxes and other with LGU
persons
Indigenous Peoples financial obligations Others, specify
Enhanced >5,000 persons
Regular coordination with LGU ___________________
employment and/or
livelihood Classification of host Conduct prior consultation and
barangay: coordination to minimize disruption
opportunities
Reduced Urban ensure respect for IP rights and
employment and/or Rural cultural practices
livelihood
opportunities
Available services within/near consultations and dialogues
Increased revenues the host barangay:
for LGU Schools (e.g., signs, lighting, etc
Disruption/Competit elementary, high
Others, specify
ion in delivery of school, college)
__________________________
public services
(e.g., education,
Health facilities (e.g.,
peace and order,
etc.) Peace and order (e.g.,
Enhanced delivery Tanod, etc.)
of public services
(e.g., education, Recreation and sports
peace and order, facilities
etc.) Others, specify
Increase in traffic ________________
volume and
flow
complaints
cost
practicable
Possible
Impacts
Others, specify Observe proper housekeeping Regular coordination
______________ Provide on-site medical services for with LGU
any emergency. Regular submission of
agency
Implement appropriate safety Others, specify
_____________
workers
Others, specify
_____________________

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:



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

Page No. __________________________
Book No. __________________________
Series of __________________________
1
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 2
PROJECT FACT SHEET
Name of the Project
Proponent Name
Proponent Address

Contact
Mobile No. Email:
Project Type
Actual Project
Project Size Parameter
Size (MT)
Compost/Fertilizer making Daily production rate
Quantity of waste to be
Domestic waste water treatment facility
treated annually
Materials recovery facility Kind of activity
Receiving facilities, paper, plastic and other material Quantity of waste to be
recycling treated annually
Sanitary landfill for domestic waste only Daily waste input
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

on OCT/TCT/etc.)
I.2 PROJECT COMPONENTS (Use additional sheets, if necessary)

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

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:
_____________________
_____________________


Water m3/day
Water Source
____________________________________________________________________
Estimated Savings
Utilities Measures
Water m3/day
I.4 MANPOWER
b. Operation Phase
Project Cost (PhP): ______________________


Impacts
LAND
Consistency with Current land use w/in 1km radius See attached proof of compatibility
land use (as per zoning ordinance): with land use
Residential
Industrial
Protected Areas
Others, specify
___________________

Residential
Industrial
Protected Areas
Others, specify
__________________
wildlife due to DENR/LGU SLUP, Tree Cutting area replanted/ construction /
vegetation clearing Forestland Permit, ROW, PCA Permit re-vegetated operation cost
Marshland possible
Others, specify
destroyed vegetation where
___________________

Impacts
landform/ protection measures slope protection Control Cost:
topography/ flat (0-3%) Designate a Spoils Storage Area, measures in erosion- ___________
terrain/slope
gently sloping to rolling (3- with topsoil set aside for later use prone areas Others, specify
Soil Erosion 18%) and allow maximum re-use of spoils Regular inspection for _______________
steep (>18%) Comply with the standard criteria for new eroded areas
near the site
sanitary landfill in DAO 49 and 50
Construct during dry season Others, specify
__________________
or other soil cover
Others, specify
__________________________

area identified by MGB/PAG-ASA/ Order No. 2003-30 and DENR
PHIVOLCS as hazard prone? Administrative Order No. 2000-28,
Implementing Guidelines on
No
contamination due sandy Waste Management Plan (ESWMP) waste/recycling bins construction/
to improper solid
clay Set up temporary fence around the for segregation operation cost
waste disposal construction area Daily inspection for
sandy-loam
Others, specify waste materials garbage in the facility
____________________
Implement proper collection, ___________________
waste
wastes
waste collectors

Impacts
waste collection
Comply with the minimum standard
for sanitary landfill liner system per
IRR of RA 9003
Others, specify
_______________________
Impairment of visual Presence of visually significant

landforms/landscape/
Implement landscaping and other Regular inspection of Cost integrated in the
aesthetics beautification measures landscaping and other construction/
structures?
Provide adequate buffer beautification activities operation cost
Devaluation of land Yes
values No owners buffer zones
Others, specify Regular monitoring for
_______________________ presence/absence of
complaints from
adjacent property
owners
Encroachment into Is the project area near protected Obtain appropriate Regular coordination Cost integrated in the
protected areas or areas or ecologically-sensitive permits/clearances from concerned with concerned construction/
ecologically- areas? agencies agencies operation cost
sensitive areas
Yes Provide adequate buffer
No Others, specify
________________________
WATER
Increased siltation Specify nearest water body: Set up proper and adequate
due to project ________________________ of:
sanitary facilities construction/
activities
Water quality Distance to nearest water body: Strictly require the contractor and its Drainage / canal
operation cost
workers to observe proper waste systems
degradation
disposal and proper sanitation
Others, specify 0 to less than 0.5 km
Strictly observe proper waste
Water treatment
_____________ 0.5 to 1 km handling and disposal
facility (i.e., grease
trap, septic tank, etc.)
More than 1 km

Impacts
If nearest water body is fresh Provide wastewater treatment
water, specify classification: facility (e.g., septic tank, oil and
water separator, etc.) following:
AA Set up silt trap/settling ponds to pH
A minimize downstream siltation TSS concentration
B Provide ring canals around fuelling BOD
tanks/ motor pool/ maintenance
C areas Total Coliform
D Limit, where possible, the extent of Color
impervious (paved) areas Oil and Grease
If nearest water body is coastal or Installation of biogas digester/s
marine water, specify system
classification: Provide at least 50 meters distance
following:
between the landfill and any
perennial lake, stream or river
SA
SB
Provide the minimum standard for
Trace Metals (Pb, Cd,
Hg, Cr6, As)
sanitary landfill liner system
SC
Install underdrain system
SD
Current Water Use:

Separate at least two (2) meters
between the top of the liner system
Fishery and the underlying groundwater
Tourist Zone / Park Others, specify
Recreational __________________________
Industrial
Agricultural
occurrence of area identified by MGB/ PAG- facilities presence/absence of construction/
flooding ASA as flood prone? Implement appropriate drainage
with concerned
No materials that may obstruct water
agencies
flow Regular monitoring for

Impacts
Use appropriate technology (e.g., flooding
contamination
Others, specify
________________________
AIR / NOISE
0 to less than 0.5 km emission sources (e.g. vehicles, presence/ absence of construction/
0.5 to 1 km
boiler, generator, etc)
More than 1 km
Install, when applicable, the Regular (ocular) inspection
appropriate air pollution control of:
device/s
Install methane recovery facility Absence of white or
black smoke from
Install biogas and composting vehicles, generator,
facility etc.
Strictly enforce good housekeeping Presence of truck
practices cover during deliveries
Control vehicle speed to lessen Quarterly monitoring of
suspension of road dust ambient air for the
Conduct water spraying to suppress following:
dust sources and minimize
TSP

PM10
materials that may generate dust NOx
Other, specify _________________ SOx
CO / CO2
Nuisance due to Distance to nearest community: Use environment-friendly Regular monitoring for Cost integrated in the
generation of 0 to less than 0.5 km deodorizer or odor masking presence/absence of construction/
obnoxious/
0.5 to 1 km
substances
unpleasant odor
More than 1 km
disinfectants
Apply soil cover daily

Impacts
Is the wind direction blowing Provide adequate buffer and/or
towards the nearest community planting of trees
most of the year? Others, specify
Yes _______________________
No
Nuisance due to Distance to nearest community: Properly operate and maintain all Regular monitoring for Cost integrated in the
noise generation 0 to less than 0.5 km noise sources (e.g., vehicles, boiler, presence/absence of construction/
0.5 to 1 km
generator, etc.)
More than 1 km
Install, when applicable, the Regular monitoring of
appropriate noise control device/s buffer zones
barriers, etc.)
hours
Provide adequate buffer and plating
of trees
Others, specify
________________________
PEOPLE
residents in the barangay: compensation packages presence/absence of construction/
project site and 1,000 persons Prioritize local residents for complaints operation cost
within its vicinity
>1,000 and 5,000 employment Regular coordination
Displacement of
Indigenous Peoples
persons Promptly pay local taxes and other with LGU
Enhanced >5,000 persons financial obligations Others, specify

employment and/or Regularly coordinate with LGU ________________
livelihood Classification of host barangay:
opportunities Urban coordination to minimize disruption
Reduced Rural on daily domestic activities and to
employment and/or ensure respect for IP rights and
Available services within/near the
opportunities Ensure participation of IPs in
Increased revenues
host barangay:
for LGU Schools (e.g. elementary, high

Impacts
Disruption/ school, college) Provide appropriate traffic/warning
Competition in Health facilities (e.g., clinics, signs, lighting, etc
delivery of public
services (e.g.,
hospitals, etc.) Others, specify
education, peace
Peace and order (e.g., police _________________
outpost, Brgy. Tanod, etc.)
and order, etc.)
Enhanced delivery Recreation and sports facilities
of public services Others, specify
(e.g., education, ___________________
peace and order,
etc.)
Increase in traffic
volume and
flow
complaints
construction/
operation cost
any emergency.
agency
Others, specify
Regularly spray disinfectant, ______________
pesticides and other similar
substances when applicable
workers
RA 6969
Others, specify
__________________

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:
Attach sketch plan/lay-out of the project
(Use additional sheet, if necessary)

Attach site development/layout plan (with dimensions and descriptions)




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

Page No. __________________________
Book No. __________________________
Series of __________________________
1
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 2
PROJECT FACT SHEET
Name of the Project
Proponent Name
Proponent Address
Proponent Means of Name:

Contact
Designation:
Mobile No. Email:
1

Longitude Latitude
on OCT/TCT/etc.)
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

Facilities

Raw, chemical and process
materials
Fuel, lubricants and similar
materials
Finished product (e.g.,
equipment facilities, silo, hopper,
etc.)
Others, specify
________________
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)


3
Water m /day
Water Source

____________________________________________________________________
Estimated Savings
Utilities Measures
Water m3/day
I.4 MANPOWER
b. Operation Phase
Project Cost (PhP): ______________________

6
Generic Initial Environmental Examination (IEE) Checklist Report Form

Possible
Impacts
LAND
Consistency with land Current land use w/in 1km radius (as See attached proof of compatibility
use per zoning ordinance): with land use
Residential
Industrial
Protected Areas
Others, specify
___________________

Residential
Industrial
Protected Areas
Others, specify
___________________
Disturbance to wildlife Existing vegetation in the area: Comply with conditions of Annual inspection of Cost integrated
due to vegetation Forestland DENR/LGU SLUP, Tree Cutting area replanted/ in the
clearing Marshland
Permit, ROW, PCA Permit re-vegetated construction/
Grassland
Limit land clearing as much as operation cost
possible
Others, specify Promote restoration of damaged or
____________________ destroyed vegetation where
7
Possible
Impacts
landform/ topography/ flat (0-3%) protection measures slope protection Control Cost:
terrain/slope gently sloping to rolling (3-18%) Designate a Spoils Storage Area, measures in erosion- __________
steep (>18%) with topsoil set aside for later use prone areas Others, specify
Soil Erosion and allow maximum re-use of spoils Regular inspection ____________
Construct during dry season for new eroded areas
near the site
Others, specify
or other soil cover
_________________
Others, specify
___________________________
Is the project site located in an area Comply with DENR Administrative

identified by MGB/PAG-ASA/ Order No. 2003-30 and DENR
PHIVOLCS as hazard prone? Administrative Order No. 2000-28,
Yes Implementing Guidelines on
No hazard Assessment (EGGA).
Soil/Land contamination Existing soil type in the area: Implement the Ecological Solid Daily inspection of Cost integrated
due to improper solid sandy Waste Management Plan (ESWMP) waste/recycling bins in the
waste disposal
clay Set up temporary fence around the for segregation construction/
sandy-loam
construction area Daily inspection for operation cost
Others, specify
_________________________
Provide receptacles / bins for solid _________________
wastes
waste collectors
waste collection
Others, specify
___________________________
8
Possible
Impacts
Impairment of visual Presence of visually significant
landforms/landscape/structures?
Implement landscaping and other Regular inspection of Cost integrated
aesthetics beautification measures landscaping and in the
Devaluation of land Yes Provide adequate buffer other beautification construction/
values No Compensate adjacent property
activities operation cost
owners Regular monitoring of

buffer zones
Others, specify
Regularly monitor
________________
presence/absence of
complaints from
adjacent property
owners
WATER
Increased siltation due Specify nearest/receiving water

body:
Set up proper and adequate Regular (ocular)
inspection of:
Cost integrated
to project activities sanitary facilities in the
Water quality
____________________________
Strictly require the contractor and Drainage / canal construction/
degradation its workers to observe proper waste systems operation cost
Distance to nearest/receiving water
Others, specify body:
disposal and proper sanitation Water treatment
___________________ 0 to less than 0.5 km Strictly observe proper waste facility (i.e., grease
handling and disposal trap, septic tank, etc.)
0.5 to 1 km
More than 1 km facility (e.g., septic tank, oil and
the following:
water separator, etc.)
If nearest/receiving water body is
Set up silt trap/stilling ponds to
pH
fresh water, specify classification:
minimize downstream siltation TSS concentration
AA
Provide three-chambered septic BOD
A tank for domestic sewage Total Coliform
B Provide ring canals around fuelling Color
C tanks/ motorpool/ maintenance
Oil and Grease
areas
D
Others, specify
If nearest/receiving water body is ____________________________
coastal or marine water, specify
classification:
SA
SB
SC
9
Possible
Impacts
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
Competition in water Size of population using receiving

surface water:
Implement rainwater harvesting and Regular monitoring Cost integrated
use similar measures as an alternative for presence/absence in the
Depletion of water 1,000 persons source of water of complaints construction/
resources >1,000 and 5,000 persons Observe water conservation Regular coordination operation cost
>5,000 persons measures; with concerned

Carefully select project site to avoid
agencies
Available/nearest water source. disruption of traditional water uses Regular monitoring
for occurrences of
Deepwell Obtain Water Permit from NWRB water shortages
Water district/LGU Improve efficiency of water supply Others, specify
Surface water and distribution system
Others, specify Others, specify __________________
________________________ _____________________
10
Possible
Impacts
Increased occurrence of Is the project site located in an area
identified by MGB/PAG-ASA as
Use appropriate design for project Regular monitoring Cost integrated
flooding facilities for presence/absence in the
flood prone?
of complaints construction/
Yes system Regular coordination operation cost
No Regularly remove debris and other
with concerned
agencies
materials that may obstruct water
flow Regular monitoring
for increased
Use appropriate technology (e.g., frequency of flooding
drinking water from flood Others, specify
contamination
__________________
Others, specify
_____________________
AIR / NOISE
Air quality degradation Distance to nearest community: Properly operate and maintain all Regular monitoring Cost integrated
0 to less than 0.5 km emission sources (e.g., vehicles, for presence/absence in the
0.5 to 1 km pumps, generator, etc.) of complaints construction/
More than 1 km Install, when applicable, the

operation cost
appropriate air pollution control Regular monitoring of
device/s the following:
Strictly enforce good housekeeping TSP
practices NOx
Control vehicle speed to lessen SOx
Conduct water spraying to suppress Frequency
dust sources and minimize Annual
Semi-annual
materials that may generate dust Regular (ocular)
Others, specify inspection of:
___________________ Absence of white or
black smoke from
vehicles, heavy
equipment and
generator
11
Possible
Impacts
Presence of truck
cover during
deliveries
Nuisance due to noise Distance to nearest community: Properly operate and maintain all Regularly monitor Cost integrated
generation noise sources (e.g. vehicles, presence/absence of in the
0 to less than 0.5 km pumps, generator, etc) complaints construction/
0.5 to 1 km Install when applicable, the Regular monitoring of operation cost

buffer zones
barriers, etc.)
hours
planting of trees
Others, specify
______________________
PEOPLE
Displacement of Size of population of host barangay: Provide relocation/disturbance Regular monitoring Cost integrated
for presence/absence
residents in the project 1,000 persons compensation packages
of complaints
in the
site and within its
>1,000 and 5,000persons
Prioritize local residents for construction/
vicinity employment Regular coordination operation cost
Displacement of
>5,000person
Promptly pay local taxes and other
with LGU
Indigenous People
Classification of host barangay:
Regular coordination with LGU
_________________
Enhanced employment
Urban
and/or livelihood
Rural
Prior consultation & coordination to
opportunities minimize disruption on daily
Reduced employment
Available services within/near the
domestic activities & respect for IP
and/or livelihood rights and cultural practices
host barangay:
opportunities
Increased revenues for
Schools (e.g. elementary, high
school, college)
LGU
Disruption/Competition
Health facilities (e.g., clinics,
hospitals, etc.)
in delivery of public
Peace and order (e.g., police
Others, specify
services (e.g., ________________
education, peace and outpost, Brgy. Tanod, etc.)
12
Possible
Impacts
order, etc.) Recreation and sports facilities
Enhanced delivery of Others, specify
public services (e.g., _____________________
order, etc.)
Increase in traffic
of traffic flow
Impacts on community Source of risks Regularly coordinate with LGU Regular monitoring Cost integrated
health and safety Explosives Provide appropriate warning signs, for presence/absence in the
Flammable substances lighting and barricades, whenever of complaints construction/
Safety Risks
Toxic substances
practicable Regular monitoring of operation cost
Fire buffer zones
Others, specify
Observe proper housekeeping

Explosion _________________________ Provide on-site medical services for Regular coordination
Release of toxic any emergency. with LGU
materials Participate in public awareness
Regular submission
programs on health and safety of reports to
concerned agency
Others, specify
workers _________________
RA 6969
Others, specify
___________________________
Generic Initial Environmental Examination (IEE) Checklist Report Form13 13

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Organization Chart:
descriptions)


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

Page No. __________________________
Book No. __________________________
Series of __________________________

DRR-CCA EIA Technical Guidelines

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DRR-CCA EIA Technical Guidelines

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Environmental Impact Assessment (EIA)

(EIA DRR/CCA Technical Guidelines)

B. GENERAL GUIDELINES FOR MAINSTREAMING DRR/CCA IN EIA 3

C. PROCEDURES IN USING THE DRR/CCA-ENHANCED SCREENING

D. PROCEDURES IN USING THE DRR/CCA-ENHANCED IEE CHECKLIST 16

2. Use of the IEE Checklist Report Forms 17

Annex 1: EIS Screening Forms

Annex 2: IEE Checklist Reports Forms

Acronyms & Abbreviations

QRA Quantitative Risk Assessment

Director Juan Miguel Cuna

Engr. Pura Vita G. Pedrosa

Dr. Jacob S. Tio

1. Objectives of the Guidelines

Note for Users:

The EIA Technical Guidelines on DRR/CCA is intended t o guide proponents and

2. Scope of the Guidelines

B. GENERAL GUIDANCE FOR MAINSTREAMING DRR/CCA IN EIA

involve the public in an open, transparent and participatory manner

2. Mainstreaming DRR/CCA in the EIA Process

Basic Project Considerations

the nature of the project and its setting

Environmental impact possible environmental impact (including cumulative effects, if

For projects that require an EIS, DRR/CCA-enhanced EIS Screening

destruction of the project or components of the project

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

Impact Mitigation Planning

Note for Users:

The mainstreaming o f DRR/CCA in the PEISS is focused at the project level. As

Preparation of the Environmental Impact Statement (EIS)

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

The PEISS review process is premised on the following criteria:

Project Monitoring and Evaluation

C. PROCEDURES IN USING THE DRR/CCA-ENHANCED SCREENING FORMS

1. Purpose of the EIS Screening Forms

assessment needs in terms of specific impact of each industry type

2. Use of the EIS Screening Forms

3. The EIS Screening Forms

The EIS Screening Form is composed of four (4) major parts:

Checklist of EIS Contents

Checklist of Key Environmental Impact

Environmental Risk Assessment Requirement Checklist

The Executive Summary

Section I. Project Description

Section II. Key Environmental Impact and Management / Monitoring Plan

Key Environmental Impact

Environmental Monitoring Plan (EMoP)

Section III. Environmental / Ecological Risks Assessment

The preparer/proponent shall undertake initial screening (for ERA coverage)

- Projected inventory of hazardous materials

Section IV. Impact Management Plan (IMP)

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

Social Development Plan (SDP)

Information, Education and Communication (IEC) Framework

Section VI. Environmental Compliance Monitoring

Safety Management Policy

Section VIII. Abandonment / Decommissioning / Rehabilitation Policy

Section IX. Institutional Plan for EMP Implementation

D. PROCEDURES IN USING THE DRR/CCA-ENHANCED IEE CHECKLIST

specific impact expected of specific industry types

2. Use of the IEE Checklist Report Forms

Project proponents are strongly discouraged from engaging the services of

Furthermore, EMB Regional Offices are required to complete the processing of