y. Be ee authorized representative. The CENRO may also assist the proponent in accomplishing the checklist. INITIAL ENVIRONMENTAL EXAMINATION (IEE) CHECKLIST for GASOLINE STATION PROJECT 1.0 GENERAL INFORMATION 1.1 Project Name/Title: _GaSOLINE FILLING station ____ 1.2Proponent/Company: r+ S888 p, Ridao Address: Brgy. Guéset Norte, San Manel Pangasinan (complete address: st./sitio, brgy., cily/mun, prov.) Tel./Fax: E-mail: Quirino Steet 1.3 Project Locations ____ Brgy. Guiset Norte, San Manuel, Pangasinan (complete address: st/sitio, bray. city/mun., prov.) (attach location map with important landmarks and access points indicated as Annex 1) 1.4 Project Objectives: gasoline to motorist in tt Generate viditional income of the sroponent and emplyyment of so some people in the locality. 1.5 Project Ownership: 3. Soures of additional fund of the barangay ani muniéipal governments in the form of taxes. Type of Owners: [ ,} Single Proprietorship [ ] Corporation | { ] Partnership/Joint Venture [ ] Cooperative 1 ] Others; pls. speciyeuonnnsuy [ ] pueqysarog [ ] jenqsnpyy [| wisunoy [J lenuaprsoy [=] reamnousy [| (Qnredprumut /q1 aup jo asueUrps0 Supuoz /asn puey parcadde ayy uo paseg) UONeIYISseLD asp) PUET WOT HT apury [*] puey nana [ J UOHEDUISSeID Pury [BLU ET sAypads “sid ‘S124 ~:20} uoneaniddy Supuag yo anata Aq pur’ Jo asea7y] jo amma qo pup go dtyspre mang FH IDL/1D0 50 anata Aq puey ayp Jo diystoUMo, dyysiaumg pur] 7% (ey /zim) vary pury [PIO], ( xauuy se sjuauinsop Jo sardosoioyd ypene) aBesoaod vary W2l04d 17 ~ NOLLATIDSAG LAlOwd 07 eqqsopTdde qou j1eyaq stay ut 339 Ajdde oy uoerodsoo ayy uroyy ALON gL aaa a (wonesodio> /dryssouzed 103) S146 Jo 151'T £1 (= 09 voles rer, 3805 yalord 9°1pads ‘sia ‘soo [ | saredg uado [ } Teprwnos { ] $ ~‘ 3.0 PROJECT COMPONENTS 3.1 Services [Services No. | Area | Capacity | No.of | Chemical | Vol. Of of | (M2) Res- tobe | Water Unit ponsible | used lo be Person Used Body washin, none Engine Washing | none Under Chassis Washin; eee ‘Automatic Car ies Wash ca Change Oil_| none Complete wash/ Vacuum none Greasing, nonei a o e) Change Coolant none 7 Tune-up none . Wheel Alignment none Hh Free Service (Air and Water) Others, Pls. specify ion. 3.2 Facilities Facility No. Of Unit [Area (M2) |” Capacity | & Service Bay if Pumping/ Refilling Station Fusp Tela | + Dispensing Pump for fueling Multi-dispons|ing Po: nozle Fuel Storage Area Uniorgrounitahks 18,009 galb. Wash Bay Convenience Store Stand-By Power Utilities Parking Area_‘* Office Bidgs. Others, Pls. Specify (Attach facilities /lay-out plan General lay-out plan of the gasoline station. 3.3 Utilities and Infrastructure 3.3.1 Water a. Water Demand Estimated daily water requirements of the proposed gasoline station? 1.5000, m b. Water Allocation Services Water Demand Allocation (m3) (Body Washing Engine Washing Under chassis washinj Change Oil [Complete wash with vacuumWaier Source No. of Tanks/Reservoir Capacity Collected in Storage Tanks one (1) 1,000 Liters Collected in Reservoir d. Water Treatment Js there provision for water treatment of your independent water source? YES NO If yes, what type of water treatment? not applicable Chlorinated Filtration Others (specify) 3.4 Drainage System (Attach approved drainage layout plan as Annex) Type of drainage: a) Major Roads: open canal / closed/underground drainage b) Other roads: open canal closed /underground drainage Where does the drainage system drain? J Public drainage system natural outfall/ water body What water body (e.g, river/stream) will serve as the outfall of the sewage and drainage systems? pee Whereis. tt located:___na_ ae eae Leo | 3.5 Power Supply Source of Pow / Local Electric Cooperative Own Generator Capacity: —_____— Others, pls. specify ____— 3.6 Sewage Disposal SystemGreasing, ‘Change coolant Tune-up { Wheel Balancin, Wheel Alignment I Free Services (Air & Water) Others, Pls. Specify c. Water Supply /Sources + Existing Public Water Water Source Yes | No Remarks. Existing Public Water | | x + Surface Water x Water | Nameof | Location | Distance | Modeof | Volume Source Water dev't. or of Body | distribution | Extraction Creek ne. | Spring, - Stream no = River no Others © Deep Well Water No. of Location Depth (m) | Discharge Sources | Wells/Hand (liter/sec) Pump/Tanks Deep well with Manual Hand Pump Deep welll z | with electric} one (1) on site | six (6) mts.) 1.00 or Motor Pump © Rainwater© Sewage System Individual Septic Tank Communal Septic Tank © Sewage Design / 2- chamber septic tank w/leaching, 2- chamber septic tank w/o leaching 3- chamber septic tank w/ leaching 3 - chamber septic tank w/o leaching 4- chamber septic tank w/ leaching 4- chamber septic tank w/o leaching Others, pls. speci = Sewage Disposal [/] discharge to an existing public sewerage system [_ ] treated in a community disposal plant or communal septic tank {J treatment in the individual septic tank with disposal by absorption field or leaching pit [ ] Others: Gpecify) 3.7 Wastewater Treatment Facility: no y:reatnent facility + Capacity of oil water separator: [_ Attach Flowchart on liquid waste management Attach lay-out/detailed plan "+ 9+ 2 Liquid waste facility-main component - Wastewater treatment facilities 3.8 Used Oil Collection and Disposal System © Collection System No. of Drums/month:Volume: none Storage Area: aaa * Disposal System [1 Recycled nies { ] Burning/Incinerator { ] Solid to re-cycles 3.9 Solid Waste Disposal System * Collection System [_] Association/ project-maintained garbage collection system [/] Integrated into the municipal garbage collection system [ ] Others, (specify) + Will there be a waste sorting/segregation system to be employed prior to disposal? (/1 YES [JNO © Disposal System — {J Burning at open dumpsite in the project site [ ] Sludge cleaning [ ] Open dumpsite outside of the project site {| Municipal/city landfill area [ ] Others, specify: + Location of the waste disposal site:__l. garbage site Attach flow pan of the solid waste management - collection to disposal. 3.10 Manpower and Employment (provide listing of manpower requirements as Annex) * How many people will be employed by the proposed gasoline and service station during: a) Pre-Construction Period: 18 b) Operation and Maintenance period: —_3.11 Project Schedule (attach schedule of development activities from pre- construction; construction; operation phase) 4.0 DESCRIPTION OF EXISTING ENVIRONMENT A. Physical Environment ‘Components/ Parameters YES | NO Remarks What is the general elevation of the proposed gasoline and refueling station? < 100 mas 100-300 mas! 301-500 masl 501-1,000 mast 1,000-1,5000 mas! >1,500 mast (To determine elevation, refer to the topographic map where the dlevation per contour line is indicated) Gndicate the area per élevation range or estimate the % to total area) x | 100g AMOK 2 Slope and Topography of the area ‘Terrain is flat or level (0- 3% slope Gently sloping to undulating (3-8% slope) Undulating to rolling (8-18% slope) Rolling to moderately steep (18-30% slope) Steeply rolling (30- 50% slope) Very steep to mountainous (©50% slope) Indicate the area per slope) category or estimate the % to total area) x soos [3._Are areas in the site where Causes of erosion:indications of soil erosion are occurring? If yes, what | activities are causing [ ] Heavy Rains {_ ] Unstable Slopes C1 x erosion? Others, pls. specify 4 Do you know of any Cause of landslide: landsliding occurring or that has occurred in the Earthquake site? x Earthmoving 1 ] Unstable slopes ] ] Others, pls. specify [ [ [ [ Attach photo 0 the areas topography (choose the view/ perspective which shows contours areas with slopes) A. Physical Environment 1} ‘Components/Parameters YES | NO Remarks 5. Has the area experienced Period(s) flooding: any flooding during the wet season or typhoons? If | yes, when was the last time Cause of flooding: the area was flooded? x | { ]low area What caused the flooding? [ | poor drainage { ] water logged areas 6. Soil type ofthearea: Other soil types: [ ]Sandy soil | { ] Clayey soil [x] Sandy loam soil 7. Are there existing water Name of water bodies: bodies found near or within the site e.g. creeks near or streams? If yes, please enumerate them in the opposite space and indicate their location- Nw a eC (If they have no names, indicate the number of water bodies) © these water bodies should be shown inthe topographic map What are the present uses of the waterbodies within or near the project site? Bathing Washing Fishing Source of Drinking water [ ] Recreation (swimming, boating, etc.) [ ] Others: _none [ { [ i No water body in thevicinity| 8. Is there an access road going to the project site? If yes, what is its distance to the si thkm, site i: alonghe road Type of access road: Cemented road ‘9. What is the present land use of the area wherein the proposed gasoline and refueling station —_be located? [_ ] Prime agricultural land (productive/ irrigated) ] Prime agricultural land (idle/ abandoned) [ ]Grassland x] Built up J Orchard | Marshall/ Mangrove | Fishpond. ] Others, pls. specify resi: [ [ [ [ L{vase uoHRAsasar ysoroy 40 paysiayem b ULM JO avou ays ay ST“ -sojdurexa apraoad “sq {2s OUP MINEN 40 AWAKE punoy sofpoq saiem ay UF sonmosor Auaysyy axotN) ALY _“€ sojduexo apraoid “sig gear amt UL punoy ast]PILM Jo suo} Joyo puv spuiq aim ary TZ -sayduuexe aptaoad “sid ‘S04 g1 fous oun ur uonerasaa jo sady somo pur saan Suysixe ait ary “1 SPUR sax | srmauereg/sitauodwo3, juoumomaug peoytioqord “A - squeuyst{qeqse [eyoMeuuoo zo qoxzeM ‘spor aovds asco uy ur way ysty aseaid “504 gf aus paford ayy punose stuatudojaaap 40 saumyanays Suysixo aay NV LL caus yoatord ayy Jo sauepunog aij jo. apisino spaload pue syomau — Sunsixo ayy yim payesSour sony snouea ayy Jo quowusye pur voneroy[e purl uh S1“OL jAredpnmu /ap aM, jo asn pur] poroidde au 0} waosUOI ays ayy S20q ~uc If near, only, how near? nea. m or km If near, only, how near? na. morkm If within, indicated name of the watershed or _ forest reservation area 3. Is the gasoline station adjacent “to a natural ecosystem? [ ] Forest [ ] Coastal/ Marine [ ] Grassland [ ] Mangrove | Agriculture Socio-Economic Environment Components/Parameters ‘Yes No Remarks. 7. Are there existing settlements in the proposed gasoline and — refueling station? If yes, indicate the number of: (within 100m radius) Households/Families: none Legitimate landowners Tenants: Squatters: 2 What is the — total population of -~—_—the community in the project site? 700 Nore or less 3, Average family size: six (6) +) What are their sources(s) of livelihood? EEELivelihood Type [x] Farming [ ] Fishing [ ] Backyard poultry and Piggery [] Vending/Buy and Sell [*] Sari-sari store [x] Others, Pls. Specify: phblid and private mployyee 3. How many of the total population have reached the: Elementary level: 100 _ High School level: 40% College level:__ #04 © Are there other existing local organizations in the area? ‘Are there existing social infrastructure in the barangay? [,,] Schools [x] Communications [x] Health centers/clinics | ] Hospitals [<] Churches/Chapel [x] Transportation [=] Roads [ ] Others, Pls. Specify: (Attach photo)6.0 IMPACT ASSESSMENT AND MITIGATION A. PRE-CONSTRUCTION/CONSTRUCTION PHASE Project Activities Affecting the Physical Environment Yes No | | Impact Description Mitigation/ Enhancement Measures 1. Will there be land vegetation clearing? If yes, what is the total area to be cleared? (ha) Will there be trees to be affected during the clearing? If, yes, how many and what are these species of trees? No. of Trees: n.ae Species: a 3, Will there be demolition of existing, structures: If yes what types of structures willbe demolished: Types of Structure Will there be topsoil removal and replacement? If yes, how much of the removed topsoil w be replaced? [_] Entire volumea et T | Partial only If partial only, where will the rest of the topsoil be deposited? If no, what will happen to the excavated topsoil? Topsoil will be used to level thi a 6. excavation (m): __ Estimated Volume of cut and fill (Cum): Source of _ filling materials:__ Will there be carthmoving activities, eg. excavation work, cut and fill, etc.? If, yes, how deep is the excavation and how much isthe estimated volume of cut and fill? Average depth , of excavated soil Excavation will he done for the aquin- & building found}tion, 2.5 m. for the Usts. 25.00 cu. m 7. Will trees and ornamentals be planted in the site? Total # of trees to be planted: ___3 a Species of trees to be planted: Ave. height of trees to | be planted: 8 Will there be Watering bo mininlize stockpiling of soil, dust emission sand and gravel | Install. inclosure| of materials inthe the project site. project area? 3. Will there be mering - constrhetion drillings, hammering and boring activities? will be conducted] du- the daybine. Provive temp. enclosure,[10. Will there be any slope modifications or ground leveling to be done? Tis there a need to construct an access road going to the site? If yes, what type of access road: [ Jall weathered road length (m)__ width [| concrete [ J asphalt 12, Will temporary quarters or barracks and a field office be provided for construction workers within the project site? Project Activities Affecting the Biological Environment Yes No Impact Description Mitigation/ Enhancement Measures 1. Will there be vegetation clearing? Will clearing activities affect any critical wildlife habitats? Will clearing activities affect any rare, ‘threatened or | endangered plant and animal species? 4. Will there be trees to be affected (e.g. cut down; remove) during the clearing? Ifyes, how many and‘e ~~ what are these species of trees? ==] Project Activities | Yes | No Impact Mitigation/ Affecting the Socio Description Enhancement Cultural and Economic Measures Environment 1. Will there be settlements to be affected? If yes, how many households will be affected? Total No. of Household Families: 2. How will they be handled? Deas Payment of property owners ‘Temporary — relocation site to be provided Permanent relocation site to be established Eviction without compensation Others, Pls. specify 3. Will the project encroach on x ancestral domain 4. Will there be Tocals provide assistanee| to be hired during| x imcone in the form! construction? of wares 5, Will there beanincrease in economic activity in the area or arise in associated | * project? | %. Will the project = station a temp cause an increase x trafic personnel. traffic in major routes due to the entry and exit of — construction equipment? 6.2 Operation and Maintenance Phase Project Activities | Yes | No Impact Mitigation/ Affecting the Physical | Description Enhancement Environment | Measures I. Will there be an = Boe ueey aed x | x disposed of proper -| segregation on-sit will be implenent: 4 Sewage will a1] b increase in solid waste and sewage generation? i inte_a—deptic 2. Will there be an| x | Proper utilizatiortank. increase in water of water willbe demand? enforce. 3. Will there be an| improved drainage| = and water supply system? 4, Will there be an increase in surface x run-of from — the concreting of roads and soil surfaces? | 5. Will there be | reduced infiltration = rate due to impermeable structure over the round?ww \ 6. Is the available domestic water |x supply enough to meet the maximum projected water | consumption of the gasoline station? L Deepwell will be installed. Project Activities | Yes | No | Impact Mitigation/ Affecting the Biological | Description Enhancement Environment Measures 7. Will the sewage out fall and drainage system, drain into the nearby or adjacent surface water body? Will the waste Domestic waste will disposal site be| x be disposed of prpperly adequate to meet the into the Mu. parbaze projected solid | ether wastes in the area? Project Activities | Yes | No Impact Mitigation/ Affecting the Socio- Description Enhancement Cultural and Economic Measures Environment T. Will the project cause T =] ESETIS pesonnel W111 or increase traffic in| * be assigned. the areas? Will the gasoline | station create a x significant increase in | the existing population of the area? 3. Are there existing | transport — services/ facilities routing, the areas?soar LNAWLINNOD Salt TvadG/S,LNINOdOUd jvare ypaload aup Jo Grp ayy uRpEN syuaunysyqeiso Jepsewwos Supsro Apeayje ara aay °S qeare arp ur weiqord Ajddns Jaye, 30 aSeyoys syeM Suyreaaid e aso) stb aug ge Teuoossed | openg © UZTESY, gsvaue ayy Sunnos san ipoey /saisas jaodsue Sunsixe ary ay “S qeare ayy jo. uoneindod Sunsx@ ay asvaiuy quesyndis vara uones auyoseS am STZ + tewuoset opggeay © UBTSSY qovare ayy Ur >Use asvaiuy 40 asne> ypaford ay IM“ somnsvay\ juawasueqs, fone uondrpsaa peduy | on | san quawuorauy onuouoog pur yey -opog am SUD sappy pelord aseyd UOHRMTGeYyeY pur youuOpurqy — £9 qeare palord ay jo Ap on Urpin quaUyst{qerso Tprounuos Bupsixo Apeare aia ary“ jpaae ayy uy suayqoad Sjddns soyea 40 aBeOYs Jaye Suyreaaad ve axoyp S| “+ ~“~ Pat Ve 1/We, am/are committing to. . I. Comply with existing environmental rules and regulations, Guidelines and criteria; yas 2. Comply with all mitigation/enhancement measures that have been identified in the report; 3. Support muiti-partite monitoring efforts to be organized; yes 4 Construct maigiin and properly operate an adequate and appropriate oil- water separator,the liquid wastes; 3, Construct, maintain and properly operate an adequate and appropriate sept tank for the liquid wastes; ves 6. Maintain the cleanliness of the general surroundings; x Participate or contribute towards a communal cleaning effort; yas 8. Strictly implement a risk management plan and safety program; 9. Organize and conduct information, education and communication (IEC) activities on environmental, health and other civic issues; yes 10, Others, please specify 9.0 ATTACHMENTS/ANNEXES A. Government Permits and Clearances (Attach photocopies of documents) PERMITS/CLEARANCES: ‘YES NO Location Map/ Vicinity Map Barangay and MunicipalifCity Indorsement Photocopy of TCT/OCT /TD. Design/ Plan of the Gasoline Station she [ole | Locational Clearance from HLURB JWRB Permit