Department of Environment and Natural Resources

Environmental Management Bureau

Reference No:

(to be filled up by DENR only)

G E N E R A L I N F O R M AT I O N S H E E T

Name of the
COLUMBUS PLAZA
Establishment/Facility

Establishment/Facility Street # & Street Name: Osmena St. Cor. Champaca St.
Address Barangay: DAGIANGAS EAST City/Municipality: GENERAL SANTOS
(NOT the company of head
office) Province: SOUTH COTABATO
Name of
Keys Realty & Development Corporation
Owner/Company
Street # & Street Name: Fr. George Willmann Centre, Gen. Luna St. Cor.
Address Sta. Potenciana St.
(if address is not the same
as previous address) Barangay: Intramuros City/Municipality: MANILA
Province: NCR

Phone Number 02-527-2221 Fax Number 02-527-2238

e-mail address Keysrealty2012@yahoo.com.ph

Type of Business/ Philippine Standard Industry Classification Code No. 55104

Industry
Classification Philippine Standard Industry Descriptor: Real Estate Developer

CEO/President. Arsenio Isidro G. Yap

Tel #: 02-527-2221 Fax #: 02-527-2238

Responsible e-mail address: keysrealty2012@yahoo.com.ph

Officer/s: Plant Manager: Mr. Edison D. Impang, Jr.
Tel #: 083-552-7988 Fax #: 083-552-7988
e-mail address: columbusplazahotel@gmail.com

Name. ALBERTO V. FERNANDEZ

Pollution Control
Tel #: 083-552-7988 Fax #: 083-552-7988
Officer
e-mail address: columbusplazahotel@gmail.com

 single proprietorship  partnership

Legal Classification X private domestic corporation  government corporation
 Multi-national  ___

We hereby certify that the above information are true and correct.

EDISON D. IMPANG, JR. ALBERTO V. FERNANDEZ

Name/Signature of CEO/President Name/Signature of PCO
Name of Plant:
Reference No:

Department of Environment and Natural Resources

Environmental Management Bureau

Q U A R T E R LY S E L F - M O N I T O R I N G R E P O R T

MODULE 1: GENERAL INFORMATION

Name of the Plant COLUMBUS PLAZA

Columbus Plaza Hotel Columbus Plaza Hotel offers timeless hospitality service in the heart of
General Santos City. Situated in GenSan, the Tuna capital of the Philippines, Columbus Plaza boasts
easy access to business, entertainment and recreational options.
Our mission is to make the most of your stay. Whether you are here for an important business
meeting, wants to explore the city or reconnect with old friends, you’ll find yourself surrounded by
enthusiastic insiders who delight in sharing the best of what Gensan has to offer.
Guestrooms are designed to provide an optimal level of comfort with welcoming decor and some
offering convenient amenities like internet access – wifi connection, non-smoking rooms, air
conditioning, hot and cold shower, electronic door lock, cable tv and wake-up service.
With 29 non-smoking guest rooms that will definitely gives you a complete comfort, the rooms at
Columbus Plaza are your perfect base for a memorable time in Gensan city! Room categories are as
follows: Single Room, Standard Room, Premium Room and Family Room.

(use additional sheet/s if necessary)

DENR Permits/Licenses/Clearances
Environmental
Permits Date of Issue Expiry Date
Laws
A/C No. N/A N/A N/A
P.D. 984
PO No. N/A N/A N/A
PD 1586 ECC 1 N/A N/A N/A
ECC 2 N/A N/A N/A

Module 1: General Information page ____ of ____

Name of Plant:
Reference No:

ECC 3 N/A N/A N/A

DENR
Registry ID
N/A N/A N/A
CCO Registry N/A N/A N/A
RA 6969 Importer
Clearance No
N/A N/A N/A
Permit to
Transport
N/A N/A N/A
A/C No. N/A N/A N/A
RA 8749 November 15, November 5,
PO No. 15-POA-J-1265-0342
2015 2020

Module 1: General Information page ____ of ____

Name of Plant:
Reference No:

Operation
Operating hours/day Operating days/week # of shift/day
Average 24 7 3
Maximum 24 7 3

Operation/Production/Capacity:
Average Daily Total Output this
18 Rooms 547 Rooms
Production Output Quarter
Total Water Total Electric
Consumption this 225 Consumption this 20,237
Quarter (cubic meters) Quarter (KwH)
Please use additional sheet/s if necessary

Module 1: General Information page ____ of ____

Name of Plant:
Reference No:

MODULE 4: R.A. 8749 (Air Pollution)

Summary of APSE/APCF
Process Equipment Location # of hrs of operations
1. N/A N/A N/A
2.
3.
4.
Fuel Burning Quantity # of hrs of
Location Fuel Used
Equipment Consumed operations
1.One (1) unit 275
121hrs & 34
KVA Cummins Diesel GENSET AREA Diesel 402.12
mins.
Engine Generator Set
2.
3.
4.
5.
6.
Pollution Control Facility Location # of hrs of operations
1. One (1) muffler w/ insulation GENSET AREA 121 hrs & 34 mins

2.
3.
4.

Cost of Treatment
Month 1 Month 2 Month 3
Cost of Person
1 1 1
employed, (salary)
Total Consumption of
N/A N/A N/A
Water (cubic meters)
Total Cost of chemicals
used (e.g., activated N/A N/A N/A
carbon, KMnO4)
Total Consumption of
N/A N/A N/A
Electricity (KwH)
Administrative and
P20,000.00 P20,000.00 P20,000.00
Overhead Costs
Cost of operating in-
N/A N/A N/A
house laboratory, if any
Improvement or N/A N/A Regular Cleaning of
modification, if any. smoke stack
(Description)
N/A N/A N/A
Cost of improvement of

Module 1: General Information page ____ of ____

Name of Plant:
Reference No:

modification

MODULE 6: OTHERS

Accidents & Emergency Records

Findings and
Date Area/Location Actions Taken Remarks
Observation

4/16/2016 GENSET AREA Spill of stored Clean-up &

used oil installment of
secondary
containment

Personnel/Staff Training
# of Personnel
Date Conducted Course/Training Description
Trained

February 16-20, 2016 40 hours PCO Traning 1

April 13, 2016 8 hours PCO Training for owners, 1
Managers Head

I hereby certify that the above information are true and correct.

Done this _________________________, in General Santos City.

ALBERTO V. FERNANDEZ
Name/Signature of PCO
EDISON D. IMPANG, JR.
Name/Signature of CEO

Module 1: General Information page ____ of ____

Name of Plant:
Reference No:

SUBSCRIBED AND SWORN before me, a Notary Public, this ________ day of
______________________, affiants exhibiting to me their Community Tax Receipts:

Name CTR No. Issued at Issued on

ALBERTO V. FERNANDEZ

EDISON D. IMPANG, JR.

Module 1: General Information page ____ of ____