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Water Supply Projects

INITIAL ENVIRONMENTAL EXAMINATION (IEE) CHECLIST REPORT
For
Project name or Title
This IEE Checklist Report shall be used for proposed WATER S!PPL" PRO#ECTs to be located
within E$%&ro$'e$tally Cr&t&cal Areas (ECA)(
Please check applicable project category
 Type T)res)ol*
Water upply ystems !Complete ystem"
≤ # wells and other systems !e$g$
infiltration gallery% etc$"
Water upply ystem !&istribution 'nly"
(e)el III * with household connection
and water treatment
+or ECC appl&cat&o$s, t)&s IEE C)ec-l&st Report s)all .e su.'&tte* /&t)0
• Proof of Compatibility with the e+isting (and ,se Plan
• Proof of -uthority o)er the Project ite
• -ccountability tatements of Proponent !see attached form" and the Preparer !if
any% following -nne+es ./.. of Re)ised Procedural 0anual for &-' .112/21"
• Photographs or plates3)icinity map of the project site showing impact areas and
affected areas and communities
• &uly -ccomplished Project En)ironmental 0onitoring 4 -udit Prioriti5ation
cheme !PE0-P" 6uestionnaire !see -nne+ ./7d of Re)ised Procedural 0anual for &-'
.112/21"
(No other documents shall be required as pre-requisite to ECC applications per DENR MC 2010-14)
Read the 8uestions carefully and write the re8uired information on the blank spaces
pro)ided or otherwise check !" the appropriate bo+es 9 or parenthesis ! "$ :o+es
with check marks!" are automatically re8uired$ ,se additional sheets if necessary
and indicate this in the appropriate space$
Project proponents are strongly *&scoura1e* to engage the ser)ices
of consultants3facilitators3preparers to accomplish3fill/up the IEE
Checklist Report Form$ The Report Forms ha)e been designed to be
user/friendly$
Furthermore% E0: Regional 'ffice is re8uired to complete the
processing of an ECC application using the IEE Checklist Report
within twenty !.1" working days upon receipt for duly/accomplished
forms with complete attachments$
Misleading or erroneous answers are basis for legal actions and/or denial of ECC issuance.
PRO#ECT +ACT SHEET
Project Na'e0 ;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;
Project Locat&o$0 ;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;
Total Project La$* Area0
1
Total Project2+ac&l&t&es
Area
!-rea actually utili5ed"
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Project Propo$e$t0 ;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;
O33&ce A**ress0
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Co$tact Perso$0 ;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;
4es&1$at&o$0 ;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;
Co$tact I$3or'at&o$
Telep)o$e Nu'.er0
+a5 Nu'.er0
Mo.&le Nu'.er0
E6'a&l A**ress0

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I( PRO#ECT 4ESCRIPTION
7(7 PRO#ECT LOCATION AN4 AREA0 treet <ame% :arangay% and 0unicipality3City% Pro)ince
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ee attached )icinity map3s and photographs of the project site and site de)elopment3layout plan
=eographic coordinates of the project area !Preferably use W= >? datum 6 8PS sett&$1, otherwise
specify datum used"$
Per&'eter29ou$*ary po&$ts
(.ase* o$ OCT2TCT2etc)
Lo$1&tu*e Lat&tu*e
2
7(: PRO#ECT COMPONENTS
(se additional sheets i! needed)
"""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""
7(; !TILITIES2RE<!IREMENTS !'peration Phase"0
!t&l&t&es Source Est&'ate* 4e'a$*2Co$su'pt&o$
Power3Electricity
(Total)
@Wh
Power3Electricity
(+ro' Re$e/a.le E$er1y
Sources)
@Wh
Water
(Total)
!Fill/up table below if water is not
obtained from the local water utility"
m
3
3day
Water
(Ra&$/ater Collect&o$
Syste')
m
3
3day
+ac&l&t&es Nu'.er o3
!$&ts
Spec&3&cat&o$24escr&pt&o$2Re'ar-s
!Include capacity% length or other si5e
description"
A$ Water collection
Production wells
Infiltration gallery
&i)ersion3Collection Weir
'thers% specify
.$ Water treatment facility
Chemical treatment !e$g$%
precipitation% coagulation% etc$"
Physical treatment !e$g$%
screening% sedimentation% etc$"
&isinfection !e$g$% chlorination%
etc$"
2$ Water distribution system !Indicate ser)ice area in m
.
and number of
households ser)ed"
;;;;;;;;;;;;;;;;;; s8uare meters
;;;;;;;;;;;;;;;;;; households
Communal bo+3faucet !new"
Communal bo+3faucet !for
rehabilitation"
Water pipelines% distribution main
!new"
Water pipelines distribution main
!for rehabilitation"
Water pipelines% ser)ice line !new"
Water pipelines ser)ice line !for
rehabilitation"
Pumping stations
?$ Chemical storage facility
B$ Waste water management facility
#$ olid waste management facility
7$ &rainage ystem
>$ 'thers% specify
;;;;;;;;;;;;;;;;;;;;;
3
Water ource
C D ground water C D well C D spring C D othersE ;;;;;;;;;;;;;;;;;;;;;;;;;;;;
C D urface water C D ri)er C D lake C D othersE ;;;;;;;;;;;;;;;;;;;;;;;;;;;;
(ocation of water source
;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;
(#itio$%one& 'aran(a)& Municipalit)$Cit)& *ro+ince& Re(ion)
E$er1y2Water E33&c&e$cy
!t&l&t&es Est&'ate* Sa%&$1s Propose* E33&c&e$cy2Co$ser%at&o$
Measures
Power3Electricity @Wh
Water m
2
3day
7(= MANPOWER
a( Co$struct&o$ P)ase
Ma$po/er
Re>u&re'e$t
E5pert&se2S-&lls Total
.( Operat&o$ P)ase
Ma$po/er
Re>u&re'e$t
E5pert&se2S-&lls Total
7(? IN4ICATIVE PRO#ECT COST
Project Cost !PhP"E ;;;;;;;;;;;;
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II( ENVIRONMENTAL IMPACTS AN4 MANA8EMENT PLAN
Possible En)ironmental3
ocial Impacts
:aseline En)ironment Pre)enti)e3 0itigating 0easures 0onitoring Parameters3
Implementation
Cost of 0itigation3 0onitoring
(-<&
Consistency with land
use
Current land use w3in Akm radius
!as per 5oning ordinance"E
 Residential
 Commercial3 Institutional
 Industrial
 -gricultural3 Recreational
 Protected -reas
 'thers% specify
;;;;;;;;;;;;
-ctual land uses w3in Akm radiusE
 Residential
 Commercial3 Institutional
 Industrial
 -gricultural3 Recreational
 Protected -reas
 'thers% specify
;;;;;;;;;;;;;
ee attached proof of compatibility with
land use
 &isturbance to wildlife
due to )egetation
clearing
E+isting )egetation in the areaE
 Forestland
 0arshland
 =rassland
 0angro)e
Compliance with conditions of &E<R3(=,
(,P% Tree Cutting Permit% R'W% PC-
Permit
(imit land clearing as much as possible
Pro)ide temporary fencing to )egetation
that will be retained
-nnual inspection of area
replanted3 re)egetated
 Cost integrated in the
construction 3operation cost
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Possible En)ironmental3
ocial Impacts
:aseline En)ironment Pre)enti)e3 0itigating 0easures 0onitoring Parameters3
Implementation
Cost of 0itigation3 0onitoring
 Wetland
 'thers% specify
;;;;;;;;;;;;;
Promote restoration of damaged or
destroyed )egetation where possible !e$g$%
tree planting"F
 Change in surface
landform3 topography3
terrain3slope
 oil Erosion
lopeE
 flat !1/2G"
 gently sloping to rolling !2/A>G"
 steep !HA>G"
Is the project site located in an area
identified by 0=:3P-=/--3
PIIJ'(C as ha5ard proneK
 Les
 <o
 Pro)ide erosion control and slope
protection measures
 &esignate a poils torage -rea% with
topsoil set aside for later use and allow
ma+imum re/use of spoils
 Construction during dry season
 tabili5ation of embankment with grasses
or other soil co)er
 'thers% specify
;;;;;;;;;;;;;;
 Compliance with the &E<R -dministrati)e
'rder <o$ .112/21 and &E<R
-dministrati)e 'rder <o$ .111/.>%
Implementing =uidelines on Engineering
=eological and =eo/ha5ard -ssessment
!E==-"$
 Regular inspection of slope
protection measures in
erosion/prone areas
 Regular inspection for new
eroded areas near the site
 'thers% specify
;;;;;;;;;;;;;;
 lope3 Erosion Control
CostE ;;;;;;;;;;;
 'thers% specify
;;;; ;;;;;;;;
 oil3(and contamination
due to improper solid
waste disposal
E+isting soil type in the areaE
 sandy
 clay
 sandy/loam
 'thers% specify
;;;;;;;;;;;;;;;;
 Implementation of the Ecological olid
Waste 0anagement Plan !EW0P"
 et/up temporary fence around the
construction area
 Implement re/use and recycling of waste
materials
 Implement proper segregation% collection
and disposal of domestic wastes in
designated areas
 Implement proper collection% labeling and
storage of ha5ardous waste
 &aily inspection of
waste3recycling bins for
segregation
 &aily inspection for presence
of mi+ed garbage in the
facility
 Weekly inspection of waste
accumulated
 'thers% specify
;;;;;;;;;;;
 Cost integrated in the
construction 3operation cost
6
Possible En)ironmental3
ocial Impacts
:aseline En)ironment Pre)enti)e3 0itigating 0easures 0onitoring Parameters3
Implementation
Cost of 0itigation3 0onitoring
 Pro)ide receptacles 3 bins for solid wastes
 Coordinate with the municipal 3 city waste
collectors
 Engage third party company for waste
collection
 'thers% specify
;;;;;;;;;;;;;;;;
 Impairment of
)isual aesthetics
 &e)aluation of land
)alues
Presence of )isually significant
landforms3landscape3structuresK
 Les
 <o
 Implement landscaping and other
beautification measures
 Pro)ide ade8uate buffer
 Compensate adjacent property owners
 'thers% specify
;;;;;;;;;;;;;;;;
 Regular inspection of
landscaping and other
beautification acti)ities
 Regular monitoring of buffer
5ones
 Regularly monitor
presence3absence of
complaints from adjacent
property owners
 Cost integrated in the
construction3 operation cost
W-TER
 Increased siltation due
to project acti)ities
 Water 8uality
degradation
 'thers% specify
;;;;;;;;;;
pecify nearest3recei)ing water
bodyE
;;;;;;;;;;;;;;;;;;;;;;;;;;;;
&istance to nearest3recei)ing water
bodyE
 1 to less than 1$B km
 1$B to A km
 0ore than A km
If nearest3recei)ing water body is
fresh water% specify classificationE
 --
 -
 et/up proper and ade8uate sanitary
facilities
 trictly re8uire the contractor and its
workers to obser)e proper waste disposal
and proper sanitation
 trictly obser)e proper waste handling and
disposal
 Pro)ision of wastewater treatment facility
 et up silt trap3stilling ponds to minimi5e
downstream siltation
 Pro)ide ring canals around fuelling tanks3
motorpool3 maintenance areas
 'thers% specify
Regular !ocular" inspection ofE
 &rainage 3 canal systems
 Water treatment facility !i$e$%
grease trap% septic tank% etc$"
6uarterly monitoring of the
followingE
 pI
 T concentration
 :'&
 Total Coliform
 Cost integrated in the
construction3 operation cost
7
Possible En)ironmental3
ocial Impacts
:aseline En)ironment Pre)enti)e3 0itigating 0easures 0onitoring Parameters3
Implementation
Cost of 0itigation3 0onitoring
 :
 C
 &
If nearest3recei)ing water body is
coastal or marine water% specify
classificationE
 -
 :
 C
 &
Current Water ,seE
 Fishery
 Tourist Mone 3 Park
 Recreational
 Industrial
 -gricultural
;;;;;;;;;;;;;;
 Color
 'il and =rease
&istance of project area to the
nearest well usedE
 1 to less than 1$B km
 1$B to A km
 0ore than A km
,se of the nearest wellE
 &rinking3&omestic
 Industrial
8
Possible En)ironmental3
ocial Impacts
:aseline En)ironment Pre)enti)e3 0itigating 0easures 0onitoring Parameters3
Implementation
Cost of 0itigation3 0onitoring
 -gricultural
 Competition in water
use
 &epletion of water
resources
i5e of population using recei)ing
surface waterE
 N A%111 persons
 HA%111 and N B%111persons
 HB%111person
-)ailable3nearest water source$
 &eepwell
 Water district3(=,
 urface water
 'thers% specify
;;;;;;;;;;;
 Implement rainwater har)esting and similar
measures as an alternati)e source of water
 'bser)e water conser)ation measuresF
 Careful selection of project site to a)oid
disruption of traditional water uses
 'btain Water Permit from <WR:
 Impro)e efficiency of water supply and
distribution system
 Implement community ponds and similar
measures as alternati)e water source for
non/domestic uses
 Increase% when practical% storage
capacities of water supply structures for
resilience to greater climate )ariations and
e+tremes
 'thers% specify ;;;;;;;;;;;;;;;;
 Regularly monitor
presence3absence of
complaints
 Regular coordination with
concerned agencies
 Regularly monitor
occurrences of water
shortages
 'thers% specify
;;;;;;;;;;
 Cost integrated in the
construction3 operation cost
 Increased occurrence
of flooding
Is the project site located in an area
identified by 0=:3P-=/-- as
flood proneK
 Les
 <o
 ,se appropriate design for project facilities
 Implement appropriate drainage system
 Regularly remo)e debris and other
materials that may obstruct water flow
 ,se appropriate technology !e$g$ raised
hand/pumps" to protect drinking water from
flood contamination
 'thers% specify
;;;;;;;;;;;;;;;;
 Regularly monitor
presence3absence of
complaints
 Regular coordination with
concerned agencies
 Regularly monitor increased
fre8uency of flooding
 'thers% specify
;;;;;;;;;;;;;
 Cost integrated in the
construction3 operation cost
-IR 3 <'IE
9
Possible En)ironmental3
ocial Impacts
:aseline En)ironment Pre)enti)e3 0itigating 0easures 0onitoring Parameters3
Implementation
Cost of 0itigation3 0onitoring
 -ir 8uality degradation
&istance to nearest communityE
 1 to less than 1$B km
 1$B to A km
 0ore than A km
 Properly operate and maintain all emission
sources !e$g$ )ehicles% pumps% generator%
etc"
 Install when applicable% the appropriate air
pollution control de)ice3s
 trictly enforce good housekeeping
practices
 Control )ehicle speed to lessen
suspension of road dust
 Conduct water spraying to suppress dust
sources and minimi5e discomfort to nearby
residents
 ,se co)ered )ehicles to deli)er materials
that may generate dust
 'ther% specify
;;;;;;;;;;;;;;;;;;;
 Regularly monitor
presence3absence of
complaints
Regular !ocular" inspection ofE
 -bsence of white or black
smoke from )ehicles%
generator% etc$
 Presence of truck co)er
during deli)eries
 Cost integrated in the
construction3 operation cost
 <uisance due to noise
generation
&istance to nearest communityE
 1 to less than 1$B km
 1$B to A km
 0ore than A km
 Properly operate and maintain all noise
sources !e$g$ )ehicles% pumps% generator%
etc"
 Install when applicable% the appropriate
noise control de)ice3s !e$g$% mufflers%
silencer% sound barriers% etc$"
 Implement appropriate operating hours
 Pro)ide ade8uate buffer and3or planting of
trees
 'thers% specify
;;;;;;;;;;;;;;
 Regularly monitor
presence3absence of
complaints
 Regular monitoring of buffer
5ones
 Cost integrated in the
construction3 operation cost
PE'P(E
10
Possible En)ironmental3
ocial Impacts
:aseline En)ironment Pre)enti)e3 0itigating 0easures 0onitoring Parameters3
Implementation
Cost of 0itigation3 0onitoring
 &isplacement of
residents in the project
site and within its
)icinity
 &isplacement of
Indigenous People
 Enhanced employment
and3or li)elihood
opportunities
 Reduced employment
and3or li)elihood
opportunities
 Increased re)enues for
(=,
 &isruption3Competition
in deli)ery of public
ser)ices !e$g$%
education% peace and
order% etc$"
 Enhanced deli)ery of
public ser)ices !e$g$%
education% peace and
order% etc$"
 Increase in traffic
)olume and worsening
of traffic flow
i5e of population of host barangayE
 N A%111 persons
 HA%111 and N B%111persons
 HB%111person
Classification of host barangayE
 ,rban
 Rural
-)ailable ser)ices within3near the
host barangayE
 chools !e$g$ elementary% high
school% college"
 Iealth facilities !e$g$% clinics%
hospitals% etc$"
 Peace and order !e$g$% police
outpost% brgy$ Tanod% etc$"
 Recreation and sports facilities
 'thers% specify
;;;;;;;;;;;;;;
 Pro)ide relocation3disturbance
compensation packages
 Prioriti5e local residents for employment
 Promptly pay local ta+es and other
financial obligations
 Regular coordination with (=,
 Prior consultation 4 coordination to
minimi5e disruption on daily domestic
acti)ities 4 respect for IP rights and
cultural practices
 Ensure participation of IPs in consultations
and dialogues
 Pro)ide appropriate traffic3warning
signs% lighting% etc
 'thers% specify
;;;;;;;;;;;;;;
 Regularly monitor
presence3absence of
complaints
 Regular coordination with
(=,
 'thers% specify
;;;;;;;;;;;;;;
 Cost integrated in the
construction3 operation cost
 Impacts on community
health and safety
 'thers% specify
;;;;;;;;;;
 Regular coordination with (=,
 Pro)ide appropriate warning signs% lighting
and barricades% whene)er practicable
 'bser)e proper housekeeping
 Pro)ide on/site medical ser)ices for any
emergency$
 Regularly monitor
presence3absence of
complaints
 Regular coordination with
(=,
 Regularly monitor
submission of reports to
 Cost integrated in the
construction3 operation cost
11
Possible En)ironmental3
ocial Impacts
:aseline En)ironment Pre)enti)e3 0itigating 0easures 0onitoring Parameters3
Implementation
Cost of 0itigation3 0onitoring
 Participate in public awareness programs
on health and safety
 Implement appropriate safety programs for
both community and workers
 trictly comply with fire% safety and similar
regulatory re8uirements
 trictly comply with re8uirements of R-
#O#O
 'thers% specify
;;;;;;;;;;;;;;;;;;;;
concerned agency
 'thers% specify
;;;;;;;;;;;;;;
12
III( A9AN4ONMENT 24ECOMMISSIONIN82REHA9ILITATION POLICIES AN4
8ENERIC 8!I4ELINES !if -pplicable"
Project (ife or er)ice E ;;;;;;;;;;; years
Pro)ide description of the -bandonment acti)ities% such as% dismantling and waste
disposal$
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IV( INSTIT!TIONAL PLAN +OR EMP IMPLEMENTATION
'rgani5ation ChartE
IV(7( -bandonment Plan !if -pplicable"
13
Attac) *ra/&$12pla$ o3 a&r pollut&o$ source a$* co$trol &$stallat&o$s (/&t)
*&'e$s&o$s a$* *escr&pt&o$s)
14
Process +lo/
15
Attac) *ra/&$12pla$ o3 /aste /ater treat'e$t 3ac&l&ty (/&t) *&'e$s&o$s a$*
*escr&pt&o$s)
16
SWORN STATEMENT O+ ACCO!NTA9ILIT" O+ THE PROPONENT
This is to certify that all the information and commitments in this Initial
En)ironmental E+amination !IEE" Checklist Report are accurate and complete to the
best of my knowledge$
:y the authority )ested in me by the ;;;;;(Compan) Name) as
;;;(*osition$Desi(nation)& I hereby commit to ensure implementation of all
commitments% mitigating measures and monitoring re8uirements indicated in this IEE
Checklist Report as well as the followingE
• Conform to pertinent pro)isions of applicable en)ironmental laws e$g$%
R$-$ <o$ #O#O !,o-ic #ubstances and .a/ardous and Nuclear 0astes
Control 1ct o! 1220"% R$-$ <o$ O112 !Ecolo(ical #olid 0aste
Mana(ement 1ct o! 2000"% R$-$ <o$ O.7B !*hilippine Clean 0ater 1ct
o! 2004"% and R$-$ <o$ >7?O !*hilippine Clean 1ir 1ct o! 1222"$
• -bide and conform to (=, de)elopment plans and guidelines$
• Promptly pay local ta+es 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
;;;;;;;;;;;;;;;;;;;;;;$
;;;;;;;;;;;;;;;;;;;;;;;;;;
<-0E 'F PR'P'<E<T IE-&
!Position"
!Company <ame"
,:CRI:E& -<& W'R< T' before me this ;;;;; day of ;;;;;;;;;;;; .1A;;%
affiant e+hibiting his3her Community Ta+ Certificate <o$ ;;;;;;;;;;;;;;;;;;;
issued at ;;;;;;;;;;;;;;;;;;;;;; on ;;;;;;;;;;;;;;;;;;;;;;;;;;$
&oc$ <o$ ;;;;;;;;;;;;;;;;;;;;
Page <o$ ;;;;;;;;;;;;;;;;;;;;
:ook <o$ ;;;;;;;;;;;;;;;;;;;;
eries of ;;;;;;;;;;;;;;;;;;;;
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