Name of Establishment: ____________________________________________

Address: ____________________________________________
Name of Owner/Managing Head: ____________________________________________
Name of Pollution Control Officer: ____________________________________________

CHECKLIST OF REQUIREMENTS FOR THE APPLICATION FOR

POLLUTION CONTROL OFFICER (PCO) ACCREDITATION

Primary Documents:

1. Letter of Designation/Appointment as Pollution Control Officer

2. Application Form (template form) with ID Picture of the appointed/designated PCO
3. Curriculum Vitae with ID Picture of the appointed/designated PCO
4. Affidavit of Joint Undertaking of the PCO and the Managing Head (Notarized)
5. Affidavit of Undertaking if Managing Head/Owner as PCO (Notarized)
6. For the Managing Head. Certificate of Training for eight (8) hours on environmental management
7. For New PCO Accreditation. Certificate of Training for forty (40) hours of Basic PCO Training
8. For Renewal of PCO Accreditation. Certificate of Training at least forty (40) hours of cumulative
relevant Advance PCO Training.
Attachments:

Educational Background: (photocopy: any of the following)

Official Transcript of Records (OTR)

College Diploma
Certification of Units Earned (if undergraduate)
Latest School ID Card (if undergraduate)

Government Issued Identification Card: (at least one Valid ID)

PRC ID (photo copy) if applicable / for Category B

GSIS
Unified Multi-Purpose ID (UMID)
Social Security System (SSS) Card
LTO Drivers License
Postal ID
Phil health ID
HDMF ID
Senior Citizen ID
Voter’s ID
Tax Identification Number (TIN) Card

Payment:
Five Hundred Pesos (PhP500.00) PCO Accreditation Fee for three (3) years validity
O.R. Number: _______________ Date of Payment: ___________________

Remarks and Evaluation:

Lacking Documents/Attachments:

Recommendation:
For PCO Accreditation
For Submission of Lacking Requirement/s

Evaluated by: ____________________ Date: _____________

asd2019