Initial Environmental Examination (IEE) Checklist Report Form for Water Supply Projects

WATER SUPPLY PROJECTS

I.2. PROJECT COMPONENTS

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

Units Capacity Remarks
1. Water distribution system Five(5) 81.25 sq.m. (Indicate service area in m2 and
PUMPING FACILITIES number of households served)
N/A square meters

N/A N/A
DISTRIBUTION PIPELINES
8,847 (CY2025) households

2. Communal box/faucet (new) N/A N/A N/A

3. Communal box/faucet (for rehabilitation) N/A N/A N/A

4. Water pipelines, distribution main (new) 33 KM N/A N/A

5. Water pipelines distribution main (for N/A N/A N/A

rehabilitation)

6. Water pipelines, service line (new) N/A N/A N/A

7. Water pipelines service line (for N/A N/A N/A

rehabilitation)

8. Pumping stations TWO(2) N/A N/A

9. Chemical storage facility ONE(1) 1.00 sq.m. N/A

10. Others, specify N/A N/A N/A

11. Others, specify

12. Others, specify

13. Others, specify

14. Others, specify

Project Name: ____________________________________________________

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 Initial Environmental Examination (IEE) Checklist Report Form for Water Supply Projects

I.3. UTILITIES/REQUIREMENTS (Operation Phase):

Estimated Demand/ Projected Amount from

Utilities Source Breakdown
Consumption (Total) Source specified
Grid KWh
Coop 85.65

Generator Set KWh

Power/Electricity 50 HP 100kVA
KWh
37

Others, please specify: KWh

Office, Pump Room 12

Local Water Utility Provider m3/day

N/A N/A

Well in: (specify location): m3/day

SITIO BEYENG, BRGY. ANGIO, SAN FABIAN, 50LPS or 4,320 CU.M/DAY
PANGASINAN

Spring in: (specify location): m3/day

4,320
N/A N/A
Water 3
m /day

River, Lake or other surface water : m3/day

(specify name & location)
N/A N/A

Others, please specify: m3/day

N/A N/A

Energy/Water Efficiency

Utilities Proposed Estimated Savings for Estimated Total Savings

Efficiency/Conservation each Measure
Measures
Power/ Electricity KWh KWh
N/A N/A N/A

KWh
N/A N/A N/A

Project Name: ____________________________________________________

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 Initial Environmental Examination (IEE) Checklist Report Form for Water Supply Projects

Water Rainwater collection system with m3/day m3/day

total capacity of
N/A N/A N/A

Others, please specify: m3/day

N/A N/A N/A

1.4. MANPOWER & TIMETABLE OF PROJECT PHASES

Proposed Start of Construction JANUARY-2020

DECEMBER-2020
Proposed Start of Commissioning

JANUARY-2021
Proposed Start of Operation

Total Requirement per

Phase Expertise/Skills Requirement per Expertise/Skill
project phase
a. Construction PROJECT ENGINEER ONE (1) ONE (1)

FOREMAN ONE (1) ONE (1)

SKILLED WORKERS FIVE (5) FIVE (5)

LABORERS TEN (10) TEN(10)

b. Operation PROJECT OFFICER ONE(1) ONE(1)

PUMP OPERATOR ONE(1) ONE(1)

PLUMBERS ONE(1) ONE(1)

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1.5. INDICATIVE PROJECT COST (Initial Investment):

5,000,000.00 N/A
PhP ________ __ US $ _________ ____ (specify if with foreign investment)

Project Name: ____________________________________________________

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