TELECOMMUNICATION ANTNENNAS, MOBILE PHONE CELL SITES AND

SIMILAR FACILITIES

Initial Environmental Examination (IEE) Checklist

Guide for Proponents

Instruction for Use

This IEE checklist presents a simplified reporting format for government and private
sector proponents applying for Environmental Compliance Certificate (ECC) of
proposed Telecommunications Antennas, Mobile Phone Cell Sites and Similar
Facilities. The ECC is a requirement to be secured prior to actual development as part
of the Philippine EIS System

The information contained in this checklist will serve as a basis for the review and
assessment of ECC application for the proposed project. However, should additional
information be required in order to have and informed decision, the proponent will be
requested to submit such. Misleading or erroneous answers are basis for legal actions
and/or denial ECC.

GENERAL INSTRUCTIONS AND PROCEDURES FOR USE

This IEE checklist is applicable to Telecommunications Antennas, Mobile Phone

Cell Sites and Similar Facilities which are:

1. Located within an applied area of 1000 square meters or more;

2. Involving road network establishment;
3. Having an underground cable with a minimum length of less than 10 km.;
4. Located in small islands classified under DAO 2000-83 ;
5. Located within a protected area covered by NIPAS; and
6. Located in an area with critical slope (lands with slope of 50 % or above)

This is generally divided into 4 major sections as follows:

Section 1 refers generally to information regarding the proponent, project location, and
components during the development phase

Section 2 provides information describing the existing environmental condition of the

project site relative to the physical, and biological environment.

Section 3 generally refers to the listing of possible potential impacts that may occur in
the various stages of the project and the corresponding mitigation and enhancement
measures to prevent the occurrence of adverse impact and strengthen the positive
effects of the project and provides the commitment of the proponent to follow the
mitigation and enhancement measures indicated..
IEE Checklist and Requirements for Telecommunications Facilities
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All additional information are to be incorporated in the annexes as support documents.

The IEE checklist is to be accomplished through the following procedures:

1. Answer questions by selecting from a list of pre-determined answers enclosed in

the box.

To use this, put a check ( / ) mark in the appropriate box. If your answer does
not fall in any of the pre-determined responses, check ( / ) OTHERS and indicate
your specific answer in the blank space provided or use additional sheets as
necessary.

If some questions are not applicable to your project, write N/A on the blank
space or column.

2. For questions answerable by YES or NO, just check ( / ) the column under Y or N
and provide the required answer in the available blank spaces.

3. For the section on Impact Assessment and Mitigation, check ( / ) the impact
depending on what expected impact is applicable to your project and provide the
corresponding Mitigation/enhancement measures other than those provided in
the menu.

4. For the section on Attachments or Annexes, put a check ( / ) on the title or

description of the document that you are annexing in the report. The listed
documents are MUST requirements and should be submitted.

5. Answers to the questions should not be strictly confined to the pre-determined

responses. You can elaborate and use as many additional sheets as you need to
be able to provide adequate answers to the required information. Providing
maps, pictures and drawings (e. g. charts, tables, diagrams, sketches ) and other
visuals and attachments will better explain or describe the information provided in
the checklist. This will help facilitate the review and decision on the project’s
application for an ECC.

6. The review, processing and issuance of the ECC shall be in accordance with the
provisions of DAO 96-37 and the Procedural Manual for project’s application for
an ECC.

NOTE: This checklist need not be accomplished by a consultant. This can be

done by the proponent or any of his or her authorized representative. The EMB may
also assist the proponent in accomplishing the checklist.

IEE Checklist and Requirements for Telecommunications Facilities

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 INITIAL ENVIRONMENTAL EXAMINITION ( IEE) CHECKLIST
For Telecommunications Antennas, Mobile Phone Cell Sites and Similar Facilities

1.0 GENERAL INFORMATION

PROJECT NAME OR TITLE :

_________________________________________________
PROJECT LOCATION:
_______________________________________________________
(Street, Barangay, Municipality/City, Province)
NAME OF
PROPONENT:____________________________________________________
________________________________________________________________
TIN:_____________________________________________________________
ADDRESS:________________________________________________________
_________________________________________________________________
TELEPHONE:_____________________________________________________
FAX NO:__________________________________E-MAIL : ________________

1.1 Project Cost : P ____________________________

3
4 1.2 Description of the Project Area
5
3.1 Total land area : _____________________sq. m.

3.2 Total floor area: _____________________ sq. m.

(Attach Vicinity/Location Maps)

3.3 General Land Classification :

[ ] Public Land
Specify ___________________
[ ]A&D

1.2.4 Zoning Classification: ___________________ (with attachment)

1.2.5 Project Components :

Access road: Length ______m. ; Width _____m.
Ht. of tower : _________ m.

Utilities:

Water supply

Estimated daily water requirement: _____________cum/day.

Water supply source : __________________________
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 Sewage Disposal System

[ ] Individual septic tank [ ] Public sewerage system

[ ] Communal Septic tank [ ] Others, ____________

Power supply

[ ] Local Electric Cooperation [ ] Others, pls. specify,

[ ] Own Generation: Capacity ______________kV
[ ] Stand by generator: Capacity ______________kV

Attach Pictures of project site with prominent landmark

1.3 Project Objectives

________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________

2.0 DESCRIPTION OF PROJECT SITE

2.1 Physical Environment and Biological

Components/ Parameters Yes No Remarks
Slope and topography of the site:

Below 50 %

50 % or above
Are there existing trees and vegetation
in the site?
If yes, indicate the number and type

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3.0 IMPACT ASSSESSSMENT AND MITIGATION
Project Activity Impact Identification and
Assessment
Site Preparation [ ] Vegetation Loss [ ] Landscaping the area
[ ] Siltation
[ ] Erosion
[ ] Noise Generation of
Equipment (please
specify the type and
number of equipment
[ ] Dust Generation
[ ] Slope modification
[ ] Waste generation
[ ] Blocking or drainage
pattern alteration
[ ] Others (please
specify)
Underground [ ] Vegetation Loss
cable installation
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Mitigation
[ ] Minimal cutting of trees
[ ] Confine disturbance to area
that will be utilized
[ ] Transfer of trees that can be
transferred, compensate,
compensate those with
commercial value
[ ] Provide sediment traps or
straw bale barrier
[ ] Provide protection of
stockpile or minimize
stockpiling
[ ] Stabilize excavated soil
[ ] Construction of structural
prevention
[ ] Construction to be done
during daytime only
[ ] Proper maintenance of
construction equipment
[ ] Provide noise barriers in
work areas
[ ] Regular sprinkling of water
within the work areas
[ ] Minimize land modification
following established design
consideration
[ ] Reduce, reuse and recycle
materials
[ ] Proper disposal of wastes
[ ] Follow established design
consideration
[ ] Proper housekeeping after
one activity
[ ] Others (please specify)
[ ] Landscaping the area
[ ] Minimal cutting of trees
[ ] Confine disturbance to area
Project Activity Impact Identification and
Assessment
[ ] Siltation
[ ] Erosion
[ ] Noise Generation of
Equipment (please
specify the type and
number of equipment
[ ] Dust Generation
[ ] Slope modification
[ ] Waste generation
[ ] Blocking or drainage
pattern alteration
[ ] Traffic congestion
[ ] Others (please
specify)
Building/Tower [ ] Noise Generation of
Construction Equipment (please
specify the type and
number of equipment
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Mitigation
that will be utilized
[ ] Transfer of trees that can be
transferred, compensate,
compensate those with
commercial value
[ ] Provide sediment traps or
straw bale barrier
[ ] Provide protection of
stockpile or minimize
stockpiling
[ ] Stabilize excavated soil
[ ] Construction of structural
prevention
[ ] Proper maintenance of
construction equipment
[ ] Provide noise barriers in
work areas
[ ] Construction to be done
during daytime only
[ ] Regular sprinkling of water
within the work areas
[ ] Minimize land modification
following established design
consideration
[ ] Reduce, reuse and recycle
materials
[ ] Proper disposal of wastes
[ ] Proper housekeeping after
one activity
[ ] Follow established design
consideration
[ ] Coordination with LGUs or
concerned agencies (please
specify)
[ ] Putting of signages in
strategic areas
[ ] Proper scheduling of delivery
of materials
[ ] Others (please specify)
[ ] Proper maintenance of
construction equipment
[ ] Provide noise barriers in
work areas
[ ] Construction to be done
during daytime only
Project Activity Impact Identification and
Assessment
[ ] Dust Generation [ ] Regular sprinkling of water
[ ] Waste generation
[ ] Handling of
construction material
will pose hazard to
nearby residents
[ ] Others (please
specify)
Mitigation
within the work areas
[ ] Reduce, reuse and recycle
materials
[ ] Proper disposal of wastes
[ ] Proper handling of materials
based on recommendations
of the manufacturers
[ ] Others (please specify)

Abandonment Plan

Project Life or Service : ___________ years

Provide description of the Abandonment activities, such as, dismantling and

disposal of facilities.

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4.0 Attachments/ Annexes

Government Permit And Clearance (attach photocopies of documents)

Permits/Clearance Attached
1. Copy of the Vicinity/Location Map (superimposing
the site Development Plan) submitted to HLURB or
LGU and duly certified/authenticated by the same
offices;
2. Site-specific Radio Frequency Evaluation from the
Radiation Health Service (RHS) of the Department
of Health (DOH);

3. Height Clearance Permit from the Air

Transportation Office (ATO) of the Department of
Transportation and Communication (DOTC);

4. Frequency Assignment / Certification from the

Frequency Management Division, National
Telecommunication Commission (NTC), DOTC,
stating that “the Radio Base Communication
stations and microwave links will not cause
radiation frequency interference to any Electronic
or Device Information Technology Equipment,
Radio Frequency Facilities or Systems, and
Aviation Maritime Communication Equipment and
Navigation Systems”;

5. Zoning Certification from HLURB/MPDC/Deputized

Zoning Administrator based on the approved
comprehensive land use plan;
6. Consent from the concerned government agencies
(ex. PAMB/PAWB/PAWS if located within a NIPAS
Area)
7. Neighbor’s Consent (within the radius = height of
the tower + 10 meters) / Certification from the
Homeowner’s Association (if located within a
residential area or subdivision); or Barangay
Resolution endorsing the project / minutes of
consultation or nay proof of consultation;
8. Accountability Statement of Project Proponent and
IEE Preparer/s;

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 ACCOUNTABILITY STATEMENT

This is to certify that all the information and commitments in the Initial
Environmental Examination (IEE) Report are true, accurate and complete. Should
I/we learn if any information which would make the IEE inaccurate, I/we shall bring
said information to attention of the Environmental Management Bureau of DENR
Regional Office.

I/We hereby bind myself/ourselves jointly and solidarity for any penalties that
may be imposed arising from and misrepresentations or failure to state material
information in the IEE.

_________________________________________________
Project Proponent

_________________________________________________
Title/Designation

_________________________________________________
Date

ACKNOWLEDGMENT

BEFORE ME this (day) ___________________of

________________19______________at place)__________________________,
personality appeared name____________________________________ with
Community Tax Certificate No. _______________________________ issued on
date____________________At (place)____________________, in his/her capacity as
______________________(designation _________________at
___________________ and acknowledged to me that this IEE is his voluntary act and
deed, and voluntary act and deed of the entity he/she represents. This document
which consists of (no)_pages, including the page of which this acknowledgment is
written, is an Initial environmental Examination Report Checklist.

Witness my hand and seal on the place and date above written.

___________________________
Notary Public

Doc. No.___________________
Page No.__________________
Book No.__________________
Series of __________________
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