Name of Plant: DIGOS DOCTORS’ HOSPITAL INC.

Self-Monitoring Report (SMR) System

For 2nd Quarter of CY 2018

Name of Company: DIGOS DOCTORS’ HOSPITAL INC.

Address: Mc Arthur Highway, Kiagot, Digos City

“no name” Katarina Ivanovic

International Internet Exhibition and Competition of Children's Environmental Art Works and Photographs

Environmental Management Bureau

DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES

Module 1: General Information page 01 of 09

 Reference No:
Name of Plant: DIGOS DOCTORS’ HOSPITAL INC.

GENERAL INFORMATION SHEET

Name of the
DIGOS DOCTORS’ HOSPITAL INC.
Establishment/Facility
Establishment/Facility
Street # & Street Name: Mc Arthur Highway
Address
Barangay: Kiagot City/Municipality: Digos City
(NOT the company of
Province: Davao del Sur
head office)
Name of
DIGOS DOCTORS’ HOSPITAL INC.
Owner/Company
Address
Street # & Street Name: Mc Arthur Highway
(if address is not the
Barangay: Kiagot City/Municipality: Digos City
same as previous
Province: Davao del Sur
address)
Phone Number (082) 553-3517 Fax Number (082) 553-3584
e-mail address digosdoctorshospital@yahoo.com
Philippine Standard Industry Classification Code No. 121
Type of 122
Business/Industry 123
Classification
Philippine Standard Industry Description: Private Hospital (Tertiary)
CEO/President: Dr. Nieto L. Dangcalan
Tel #: (082) 553-3517 Fax #: (082) 553-3584
e-mail address: digosdoctorshospital@yahoo.com
Responsible Officers
Plant Manager: Dr. Nieto L. Dangcalan
Tel #: (082) 553-3517 Fax #: [082) 553-3584
e-mail address: digosdoctorshospital@yahoo.com
Name : Ms. Roselyn D. Hinos. R.N.
Pollution Control
Tel #: (082) 553-3517 Fax #: (082) 553-3584
Officer
e-mail address: rodaytochinos@yahoo.com
[ ] Single proprietorship [ ]partnership
Legal Classification [ X ] Private domestic corporation [ ]government corporation
[ ] Multi-national [ ] _______________________
We hereby certify that the above informations are true and correct.

NIETO L. DANGCALAN, M.D. ROSELYN D. HINOS, R.N.

Name/Signature of CEO/President Name/Signature of PCO

Module 1: General Information page 02 of 09

Department of Environment and Natural Resources
Environmental Management Bureau
 Reference No:
Name of Plant: DIGOS DOCTORS’ HOSPITAL INC.

Period Covered: APRIL-JUNE 2018

MODULE 1: GENERAL INFORMATION

Name of Plant DIGOS DOCTORS’ HOSPITAL INC.
Please provide the necessary revised, corrected or updated information not contained in your
General Information Sheet

-NONE-

(use additional sheet/s if necessary)

DENR Permits/Licenses/Clearances
Environmental
Permits Date Issue Expiry Date
Laws
2014-WDP-1-
PO No. ON PROCESS
RA 9275 1124-1861

CNC n/a
ECC-R11-1409- SEPTEMBER 25,
PD 1586 ECC 1 NONE
0222 2014
ECC 2 n/a
DENR Registry
GR-R11-24-00061 MARCH 9, 2016 NONE
ID #
CCO Registry
RA 6969 Importer
Clearance No.
Permit to
Transport
2013-POA-H-1124
PO No. OCT. 21,2013 AUG. 1.2018
RA 8749 1816

Module 1: General Information page 03 of 09

Operation
 Reference No:
Name of Plant: DIGOS DOCTORS’ HOSPITAL INC.

Operating hours/day Operating days/week # of shift/day

Average 24 hrs/day 7 days/week 3 shifts/day

Maximum 24 hrs/day 7 days/week 3 shifts/day

Operation/Production/Capacity:
Average Daily Total Output this
n/a n/a
Production Output Quarter
Total Water Total Electric
Consumption this 4,395 cu.m Consumption this 273 kwh
Quarter (cubic meters) Quarter (KwH)
Please use additional sheet/s if necessary.

Module 1: General Information page 04 of 09

B. Hazardous Wastes Generator

 Reference No:
Name of Plant: DIGOS DOCTORS’ HOSPITAL INC.

HW Generator:

Remaining HW
HW HW form Previous HW Generator
HW Class HW Nature
No. Cataloguing Report
Quantity Unit Quantity Unit
M Solid
Infectious toxic 415.45 Kg 332.89 kg
501 (needles/sharps)
Solid
toxic 2875 Kg 3874.8 kg
(General Waste)
Pathologic Solid toxic 9.450 Kg 16.380 kg
Liquid toxic 7.720 Cc 16.760 cc
M Pharmaceutical
Solid toxic 5 kg 7.5 kg
503 Waste
Waste Storage, Treatment and Disposal:

HW No: M 501 (Sharps – Solid)

Qty of HW Treated: 1,402.5 Unit: kg
HW Details
TSD Location: DiDH Septic Vault (Separate vault for sharps &
Pathologic waste
Name: Digos Doctors Hospital Inc.
Storage
Method: Containment – Septic Vault
ID:__________n/a___________ Name:__________________________
Transporter
Date: __________________
ID: GR-R11_24-00061 Name: Digos Doctors Hospital Inc.
Treater
Date: Dumping – Septic Vault
ID: GR 6411-24-0204 Name: Digos Doctors Hospital Inc.
Disposal
Date: Septic Tank Date: ___________________
HW No: M 503 (Pharmaceutical Waste)
HW Details Qty of HW Treated: 7.5 Unit: kg
TSD Location: Returned to Supplier
Name: Digos Doctors Hospital Inc.
Storage
Method: Dumping on Site
ID: ______n/a____________ Name: __________________
Transporter
Date: __________________
ID: _______n/a_____________ Name: __________________
Treater
Method: _____________________________________________
ID: ____________________ Name: __________________
Disposal
Date: Returned to Supplier

Module 2B: RA 6969 (Hazardous Wastes Generator) page 05 of 09

On-Site Self Inspection of Storage Area:

Premises/Areas Findings & Corrective

Date Conducted
Inspected Observations Action/Taken (if)
May 17, 2018 Septic Vault near Full
 Reference No:
Name of Plant: DIGOS DOCTORS’ HOSPITAL INC.

*still looking for

accredited/recommended
Laundry Building
3rd party transporter

*Engr. Matillano were

Septic Vault for followed up. For board
Placenta near presentation & approval
June 16, 2018, ALMOST FULL
Maintenance
Building

Septic Vault, plastic Still wating for WDP

container dumping permit to have MOA with
Huge volume of
area near the recommended 3rd prty
June 21, 2018 Dialyzer, IVF tubings
laundry building transporter
& bottles

Module 2B: RA 6969 (Hazardous Wastes Generator) page 06 of 09

MODULE 4: RA 8749 (Air Pollution)

Summary of APSE/APCF
 Reference No:
Name of Plant: DIGOS DOCTORS’ HOSPITAL INC.

Process Equipment Location # of hrs of operations

n/a

Quantity # of hrs of
Fuel Burning Equipment Location Fuel Used
Consumed operations
438 KVA Perkins Diesel 14 hrs& 58
Motorpool Diesel 486.11 liters
Engine mins.

Pollution Control Facility Location # of hrs of operations

Cost of Treatment

Month 1 Month 2 Month 3

Cost of Person
employed (salary)
Total Consumption of
Water (cubic meters)
Total Cost of
chemicals used (1.g.
n/a
activated carbon,
KMnO4)
Total Consumption of
Electricity (KwH)
Administrative and
Overhead costs
Cost of operating in-
house laboratory, if
any
Improvement or
modification, if any
(Description)
Cost on improvement
of modification

Module 4: RA 8749 (Air Pollution) page 07 of 09

Other ECC Conditions
Status of Compliance
ECC Conditions Actions Taken
Yes No
1.Mitigating Measures in the IEE
Yes
checklist
 Reference No:
Name of Plant: DIGOS DOCTORS’ HOSPITAL INC.

2 Cistern was
2. Cistern Yes
installed
Adopted the Teril
Farmers Association
3.Tree Panting Yes
@ Binaton,
Kapatagan, Digos City
4.RA 6969 On Process
5.
6.
7.
Please use additional sheet/s if necessary.

Environmental Management Plan/Program

Status of Implementation
Enhancement/Mitigation Measure Actions Taken
Yes No
1. n/a
2.
3.
4.
5.
6.
7.
Please use additional sheet/s if necessary.

Solid Waste Characterization/Information:

Average Quantity of
Solid Wastes
1,189.4 kg.
Generalized per
month
Average Quantity of
Solid Wastes
Collected per month
Entity in charge of
CENRO – Digos City
collecting solid wastes
Brief Description of
Solid Waste
Management Plan (e.g
waste reduction,
segregation, recycling)
Total Quantity of
Solid Wastes
3568.24 kg
Generated this
Quarter
Total Quantity of
975 Solid Wastes 2925 kg
Collected this Quarter
- Empty vials of medicine were sterilized & recycled as specimen
bottles for Culture and Sensitivity Test and Histopath.
- Plastic Containers, big boxes, steel bars, cans, were gathered
and sold to junk shop.
- Empty dextrose bottle were sterilized and recycled for
containers of Daikins & 3rd Solution, and for feeding purposes.
- Punctured proof empty plastic galloons were used as containers
for needles & sharps & ampules.

Module 5: P.D. 1586 (EIS System) page 08 of 09

MODULE 6: OTHERS

Accidents & Emergency Records

Date Area/Location Findings and Actions Taken Remarks
 Reference No:
Name of Plant: DIGOS DOCTORS’ HOSPITAL INC.

Observation

May 3, 2018 Workplace:RDU Punctured *Dressing of *Use of PPE

wound R thumb wound must be strictly
*TT 0.5cc IM followed
* For HBSAg & *To complete
Anti HCV Hepa B vaccine
screening

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

January 17-19, 2018 3 Day Basic Training 1

& Refresher Course for
PCO

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

Done this July 5, 2018 in Digos City.

ROSELYN D. HINOS, R.N.

Name/Signature of PCO
TIN No: 181-131-741

DR. NIETO L. DANGCALAN

Name/Signature of CEO
TIN No: 102-440-093

SUBSCRIBED AND SWORN before me, a Notary Public, this 5th day of JULY 2018, affiants
exhibiting to me their Community Tax Receipts.

Name CTR No. Issued at Issued on

Dr. Nieto L. Dangcalan 27562681 Digos City January 3, 2018

Module 5: P.D. 1586 (EIpS System) page 09 of 09