Project Name Project Location ECC Reference No. Proponent Pollution Control Officer Tel. NoJFax No./Email Project Type Project Status 11 Size and Type PROJECT CONSIDERATIONS. = wn Keke ANNEX 2.76 PROJECT ENVIRONMENTAL MONITORING AND AUDIT PRIORITIZATION. ‘SCHEME (PEMAPS) QUESTIONNAIRE 1.1 Size based on number of employees: ‘Specify number of employees: 11.2 Type ECP (in elther ECA or Non-ECA) NonECP but in ECA Non-ECP and Non-ECA 1.2 Waste Generation and Management 1.21 Enumerate Waste Type and Specify Quantity of Wastes generated in your facility. (Identify Enumerate) Type Quantiy Category sane Hazardous | Non-Hazardous Waste t as (unis TI ac [Waste 2 I Waste N i = Tunis Ligue = Sia, [units tonsiy] Sold 41.3 Pollution Control System (PCS) 1.3.1 Enumerate PCS or Waste Management Method Used in your facility. (Identiy /Enumerate) PCSiWaste Wanagement Method Category Used Remarks POST a= TI air PCS 2 = PCSN rary - Liquid ‘Secondaly = “Tertiary = Sold cs iANNEX 2-74 PROJECT ENVIRONMENTAL MONITORING AND AUDIT PRIORITIZATION ‘SCHEME (PEMAPS) QUESTIONNAIRE PATHWAYS 2.4. Prevaling wind towards bario or cy? mathe corespondig point) Yes_No_ 2.2 Rainfall (impacts surface & groundwater pathways) 2.2.1 Averoge annual net sinfal Specity amount (units: mm 2.2.2 Maximum 24-hour rant Speciy amount _turits: mm 2.3. Terrain (eolect one and mark) Flat_“ Steep 24 Is the facilty located in a flood-prone area? (selec on vrait) Yes No) 28 Ground Water Depth of groundwater table (meter) (select one and mark) Oto less than 3 he 3t0 10 z Greater than 10 RECEIVING MEDIARECEPTORS 3.1. Air (Distance to nearest community) (select one and mark) Otoless than 0.5 km Z 05 to t km ae Greater than 1 km 32. Receiving Surface Water Body 32.1 Distance to receiving surface water: (select one and mark) Oto less than 0.5 km “ 05 to 1km Seaman Greater than 1 km 322 Size of population using receiving surface water ‘Specify number: 323 Fresh Water 3.2.3.1 Classification of fresh water (select one and mark) Ph oounE 3232 Size of fresh water body Specity size (omits: km?) 132ANNEX 2-14 PROJECT ENVIRONMENTAL MONITORING AND AUDIT PRIORITIZATION ‘SCHEME (PEMAPS) QUESTIONNAIRE 32.33 Drinking Domestic Recreational Fishery Industrial ‘Agricultural 324. Sakwater 3244 SA se sc BK 80 Classification of salt water 3.2.4.2 Economic value of water use Fishery Tourist zone or park Recreational , Inds Ph 33. Ground Water 33.1 Distance to nearest recharge area Oto less than 0.5 km OSto 1 km Greater than 1 km 33.2 Distance to nearest well used Oto less than 0.5 km O5to 1 km Greater than 1 km Economic value of water use (may select more than one of the criteria below) (select one and mark) (may select more than one of the criteria below) {select one and mark) ee (select one and mark) See 33.3 Groundwater use within the nearest well (may select more than one of he eriteria below) Drinking ea Industrial ‘Agricultural ae 34 Land 34.4 Indicate currentiactual land uses wihin 0.5 km radius: may select more than one of he rea below) Residential ae Commerciaiinsttutional Industrial ‘AgnculturalRecreational acegecint Protected Area 1333.4.2 Potentialiproposed land uses within 0.5 km ANNEX 2.74 PROJECT ENVIRONMENTAL MONITORING AND AUDIT PRIORITIZATION. SCHEME (PEMAPS) QUESTIONNAIRE (may select more than one ‘of the criteria below) Residential a Commercialfinstitutional See, Industrial = AgriculturalfRecreational Tengen Protected Area 3.4.3 Number of affected Environmentally Critical Areas within + km: Specify number: 3.44 Distance to nearest ECA Oto less than 0.5km 05101 km Greater than 1 km (elect one and mark) Po. IV, ENVIRONMENTAL PERFORMANCE 3.5. Compliance (pls tke note that tis will be double-checked with PCD fies) ] violation | tbe (bs. specity number oftimes commited) TT. or | adil f STANDARD, an | (checkit Admin | Remarks/Status ‘any) | Emissionfvent! | pmpieg: | Human | Admin | Viclaion | of Compliance Discharge impact | "ECC FRETS i = PASTS RA 66 : 5 PD 1586 RA.000S 3.6 Number of Valid Complaints 36.1 Citizen and NGOs Specify number 362__ Others (other Govt. Agencies, Private Institutions) Specify number: (To be filed up by EMB Personnel) RECOMMENDATIONIS: Gacclos aso fro cot Ue 2 ea Assessed By: Wer Noted By: 134ANNEX 2-74 PROJECT ENVIRONMENTAL MONITORING AND AUDIT PRIORITIZATION SCHEME (PEMAPS) QUESTIONNAIRE ACCOUNTABILITY STATEMENT OF PROJECT PROPONENT “This is to certify that all information in the submitted Project Environmental Monitoring And Audit Prioritization Scheme (PEMAPS) Questionnaire. of a eee accurate and complete. Should | learn of any information, which makes this, inaccurate, 1 shall bring said information to the appropriate Environmental Management Bureau Regional Office. | In witness whereof, 1 hereby set out my hands this day of 200_at PROJECT PROPONENT SUBSCRIBED AND SWORN to before © me this day of 200_| at Afiant exhibiting to me histher Community” Tax Cerificate No. issued. on Doc. No. | Page No. | Book No, Series of 200_ 135,