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PHILIPPINE RURAL DEVELOPMENT PROJECT a
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ENVIRONMENTAL AND SOCIAL SAFEGUARDS u
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COMPLIANCE MONITORING FORM s
(Communal Irrigation System)

INSTRUCTIONS: The SES personnel shall accomplish the FORM. Check ( )the appropriate column to indicate level of compliance with the
environmental management measures listed below. If compliance could not be determined for a particular environmental management
measure, marked the column as “NA” or Not Applicable. Give additional information or remarks, if any. Use the back page of this FORM for
additional space to write on. Accomplished Form should be signed by the SES personnel and should be posted in the field office.

Project Name: ______________________________________________________________________________________________ F

Project Location: ______________________________________________________________________________________________ i
Name of Contractor: ______________________________________________________________________________________________
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Project Duration: ______________________________________________________________________________________________
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Project Cost: ______________________________________________________________________________________________
Date Monitor/Inspection: ______________________________________________________________________________________________ P
Project Activities: ______________________________________________________________________________________________ e
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COMPLIANT
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Mitigation Measures Additional Information/ Remarks o
YES NO N. A. d
A. Field Office Requirement
1 ESMP/CEMP/Approved OSH Plan properly posted

2 Archaelogical/Paleontological Chance Finds Procedures posted

3 GRM Posters installed

4 SES Monitoring Checklist posted

5 ECC, Cutting Permits,NWRB and other related permits posted

Site Acquisition Agreement signed (e.i RROW, Bunk house,
6 Batching Plant, Dumping Site for surplus excavations, Parcellary
Map of PAPs)
7 Approved DOLE OSH Plan Posted

B. Environmental Safeguards
Proper waste management is performed onsite. (i.e. waste
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segregations, house keeping)
The river banks and riverbed within and adjacent to site is
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protected from oil/grease, and other wastes.

Stilling ponds or catchment basin installed at the end of mitre

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drains or turn outs to minimize siltation in creeks/rivers

4 Surface drainage flow unobstructed by construction activities.

The river flow is not affected by the works within and adjacent to
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sites.
on geo-hazard prone areas, buffer zones and other relevant
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mitigation measures were applied

7 the diverted water flow is free from constructions and other debris

Excess construction materials, debris, waste and refuse are sorted

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or disposed of properly and safely.
Cut trees and coconuts are consistent and compliant to the
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approved cutting permit (DENR/PCA)
Quarry Site [Selection Operation Abandonment] guidelines
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complied
Gravel, sand and backfill materials are obtained only from
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approved quarry sites
River and tidal flows are not affected from the works within and
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adjacent to site
mangrove, coral, seaweed, and marine life within the adjacent to
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site is protected
the impounded water is free from pollutants (leaves, dust, waste
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materials etc.)
minimal no obstruction of water flow is done due to construction of
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water source
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Project Cost: ______________________________________________________________________________________________
Date Monitor/Inspection: ______________________________________________________________________________________________ P
Project Activities: ______________________________________________________________________________________________ e
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COMPLIANT
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Mitigation Measures Additional Information/ Remarks o
YES NO N. A. d
impounded water/water source is properly regularly maintained for
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public safety
low lying/adjacent areas are protected from flooding due to water
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flow diversion
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Project Cost: ______________________________________________________________________________________________
Date Monitor/Inspection: ______________________________________________________________________________________________ P
Project Activities: ______________________________________________________________________________________________ e
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COMPLIANT
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Mitigation Measures Additional Information/ Remarks o
YES NO N. A. d
C. Social Safeguards
Right-of-Way Acquisition cleared is consistent or compliant to
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Right-of-Way acquired.

Damage during construction justly compensated/properly

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rehabilitated.

Existing structures with IP tribal/community importance are

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preserved or protected within allocated project area.

c.2 Community Health and Safety

Feedbacks and complaints documented, properly addressed, and
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resolved
Access ramps provided for safe accessibility and mobility of the
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community

6 provision of cover canals along the residential areas

Construction materials not encroaching on road and posing a

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hazard to motorists.

Construction aggregates and excavated materials are transported

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properly (i.e. trucks are covered).

Adequate Traffic Safety Devices (e.g. bollard,delineator posts,

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barricades, lighting etc.) installed
Construction routes/roads damaged during construction
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maintained and repaired

The community did not observe any cases of abuse, harassment,

11 crime, cultural conflict, spread of communicable diseases since
the construction started

D. Occupational safety and Health

Workers are provided with a temporary house/bunk house in base
1 camp with electricity, potable water and proper ventilation with
separate kitchen
Workers have access to adequate and prescribed pit latrines or
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toilet facility.
Good housekeeping is observed at the workers base camp/bunk
3 house (i.e. bunkhouse is clean, walking surfaces are clear of
debris)

E. Local Government Unit

1 Vulnerable PAPs are given additional assistance

Protection of the remaining forests within or near project influence

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area is implemented

3 Indigenous Peoples Plan (IP Plan) implemented

4 Replacement of cut trees implemented

5 Functional GRM Hotline

6 Community is aware of the GRM

Feedbacks and complaints documented, properly addressed, and

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resolved by the LGU (Brgy, MLGU, PLGU)

GRM Tarpaulin (with GRM Process flow poster) installed at the

8 Barangay and at start and end of project (and other strategic
locations) and feedback box available at the Barangay Hall.

Deduction of donated lands in the taxable properties (tax

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declaration) is done
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Project Cost: ______________________________________________________________________________________________
Date Monitor/Inspection: ______________________________________________________________________________________________ P
Project Activities: ______________________________________________________________________________________________ e
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COMPLIANT
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Mitigation Measures Additional Information/ Remarks o
YES NO N. A. d
Awareness campaigns or local ordinances on healthy and safe
work place or signages against transmitable diseases (e.g. HIV,
10 vector-borne diseases, and other communicable/transmissible
diseases, anti-smoking campaign, drug- free working environment)
displayed in camp site

Monitored / Inspected by: Noted By:

_____________________ ______________________________
MLGU/PLGU-SES Contractor

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RPCO - SES

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PSO - SES

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NPCO - SES