Professional Documents
Culture Documents
Reference No:
(to be filled up by DENR only)
We hereby certify that the above information are true and correct.
DELMENDO RICEMILL
Reference No:
DENR Permits/Licenses/Clearances
Environmental
Permits Date of Issue Expiry Date
Laws
A/C No.
P.D. 984
PO No.
ECC 1
PD 1586 ECC 2
ECC 3
DENR
Registry ID
CCO Registry
RA 6969 Importer
Clearance No
Permit to
Transport
A/C No.
RA 8749
PO No.
DELMENDO RICEMILL
Reference No:
Operation
Operating hours/day Operating days/week # of shift/day
Average 3hrs/day 5days/week
Maximum 4hrs/day 6days/week
Operation/Production/Capacity:
Average Daily
3,300 kgs Total Output this Quarter
Production Output
Total Water Consumption Total Electric
this Quarter (cubic N/A Consumption this Quarter 95 kwh
meters) (KwH)
Please use additional sheet/s if necessary
DELMENDO RICEMILL
Reference No:
MODULE 2: RA 6969
For producers
DELMENDO RICEMILL
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Average Daily
Total Output this Quarter
Production Output
Quantity of Stock Quantity of Stock
Inventory (Start of Inventory (End of
Quarter) Quarter)
Name of Buyer Quantity Date of Purchase
Other Information:
Manner of handling storage on-site Treatment on-site
hazardous wastes storage off-site Treatment off-site
Chemical Substitute Yes (please attach copy if not submitted/included in previous report/s or had been revised)
Plan No
DELMENDO RICEMILL
Reference No:
HW Generation:
Remaining HW from
HW HW Generated
HW No. HW Class HW Nature Previous Report
Cataloguing
Quantity Unit Quantity Unit
Waste Storage, Treatment and Disposal:(Please fill-up one table per HW)
HW No,: ___
HW Details Qty of HW Treated: Unit: ___
TSD Location: ___
Name: ___
Storage
Method: ___
HW No,: ___
HW Details Qty of HW Treated: Unit: ___
TSD Location: ___
Name: ___
Storage
Method: ___
DELMENDO RICEMILL
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DELMENDO RICEMILL
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DELMENDO RICEMILL
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New/Additional
Investments in WTP
(Description)
Cost of New/Add
Investments
DELMENDO RICEMILL
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DELMENDO RICEMILL
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Outlet No.
DELMENDO RICEMILL
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Summary of APSE/APCF
Process Equipment Location # of hrs of operations
1. TAGUDIN, ILOCOS SUR 76 HOURS
2.
3.
4.
Fuel Burning Quantity # of hrs of
Location Fuel Used
Equipment Consumed operations
1. TAGUDIN, ILOCOS SUR
2.
3.
4.
5.
6.
Pollution Control Facility Location # of hrs of operations
1. TAGUDIN, ILOCOS SUR
2.
3.
4.
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 (e.g., 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 of improvement of
modification
DELMENDO RICEMILL
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DELMENDO RICEMILL
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DELMENDO RICEMILL
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1.
2.
3.
4.
5.
6.
Please use additional sheet/s if necessary.
1.
2.
3.
4.
5.
6.
Please use additional sheet/s if necessary.
Brief Description of
Solid Waste
Management Plan (e.g.,
waste reduction,
segregation, recycling)
DELMENDO RICEMILL
Reference No:
MODULE 6: OTHERS
Personnel/Staff Training
# of Personnel
Date Conducted Course/Training Description
Trained
I hereby certify that the above information are true and correct.
Name/Signature of PCO
Name/Signature of CEO
SUBSCRIBED AND SWORN before me, a Notary Public, this ________ day of
______________________, affiants exhibiting to me their Community Tax Receipts: