GENERIC ENVIRONMENTAL PERFORMANCE REPORT AND MANAGEMENT PLAN

(CHECKLIST FORMAT)

Project name or Title

This Generic ENVIRONMENTAL PERFORMANCE REPORT AND MANAGEMENT PLAN (EPRMP) shall be used as the interim pro-
forma EIA Report requirement (IEE Checklist) for non environmentally critical projects located within Environmentally Critical Areas
(ECA) requesting expansion or modification

For ECC applications, this EPRMP shall be submitted with:

 Proof of Compatibility with the existing Land Use Plan
 Proof of Authority over the Project Site
 Accountability Statements of Proponent (see attached form) and the Preparer (if any, following Annexes 2-22 of Revised
Procedural Manual for DAO 2003-30)
 Photographs or plates/vicinity map of the project site showing impact areas and affected areas and communities
 Duly Accomplished Project Environmental Monitoring & Audit Prioritization Scheme (PEMAPS) Questionnaire (see Annex 2-7d of
Revised Procedural Manual for DAO 2003-30)

Read the questions carefully and write the required information on the blank spaces provided or otherwise check () the
appropriate boxes □ or parenthesis ( ). Boxes with check marks () are automatically required. Use additional sheets if necessary
and indicate this in the appropriate space.

Misleading or erroneous answers are basis for legal actions and/or denial of ECC issuance.

Generic Environmental Performance Report and Management Plan

 PROJECT FACT SHEET

Project Name: _______________________________________________________

Project Location:
_______________________________________________________
Expansion Category :  New product/process : _____________________
Check all applicable changes in  Increase in production capacity from ________to ________
the proponent’s operation
 Increase in production area from ________to ________

 Increase in no. of facilities/equipment

 Others,

Total Project Land Area: _______________________________________________________

Existing Land Area

Proposed Expansion
Land Area (if any)
Total Footprint Area
Existing Footprint _______________________________________________________
Area
Proposed Expansion
Footprint Area (if
any)
Project Proponent: _______________________________________________________
_______________________________________________________
Office Address:
Contact Person: _______________________________________________________

Generic Environmental Performance Report and Management Plan

 Designation: _______________________________________________________
Contact Number/s
Landline : _______________________________________________________
Fax Number: _______________________________________________________
Mobile : _______________________________________________________
E-mail Address: _______________________________________________________

I. PROJECT DESCRIPTION

1.1 PROJECT LOCATION AND AREA: Street Name, Barangay, and Municipality/City, Province

____________________________________________________________________________________________________________
______________________________________________________________________________________________________

See attached vicinity map/s and photographs of the project site and site development/layout plan (include existing project component in the layout)

Geographic coordinates of the project area (Preferably use WGS 84 datum, otherwise specify datum used).
Perimeter/Boundary points
(based on OCT/TCT/etc) Longitude Latitude Longitude Latitude

Existing Expansion

Note: delineate boundary points of existing and proposed expansion project

Generic Environmental Performance Report and Management Plan

1.2 PROJECT COMPONENTS

Area (sq. Area (sq.

No. of Specification/ No. of Specification/
Facilities m.) / m.) /
Units Description / Remarks Units Description / Remarks
Capacity Capacity
Existing Expansion

Support Facilities (e.g. emergency

generators, boilers, etc.)
Admin support (e.g., canteen, office,
clinic, quarters, etc.)
Water source / supply

Waste water management Facility

Solid waste management facility

Drainage system
(Please list facilities by module/grouping. Use additional sheets if needed)

1.3 UTILITIES/REQUIREMENTS (Operation Phase):

Utilities Source Estimated Source Estimated

Demand/ Demand/
Consumption Consumption

Existing Expansion
Power/Electricity
KWh KWh
(Total)
Power/Electricity
KWh KWh
(From Renewable Energy

Generic Environmental Performance Report and Management Plan

 Sources)
Water
(Total)
(Fill-up table below if water is Cubic meters/day Cubic meters/day
not obtained from the local
water utility)
Water
(Rainwater Collection Cubic meters/day Cubic meters/day
System)

Water Source
Existing Expansion

[ ] ground water [ ] well [ ] spring [ ] others: [ ] ground water [ ] well [ ] spring [ ] others:
____________________________ ____________________________

[ ] Surface water [ ] river [ ] lake [ ] others: [ ] Surface water [ ] river [ ] lake [ ] others:
____________________________ ____________________________

Location of water source Location of water source

_________________________________________________ _________________________________________________
_________________________ _________________________
(Sitio/Zone, Barangay, Municipality/City, Province, Region) (Sitio/Zone, Barangay, Municipality/City, Province, Region)

Raw Material Requirements

List all raw materials including chemicals to be used and check source, add more space if necessary
Raw Materials Toxic? (Y/N) Quantity

Generic Environmental Performance Report and Management Plan

Energy/Water Efficiency
Utilities Estimated Efficiency/Conservation Measures Estimated Efficiency/Conservation Measures
Savings Savings
Existing Expansion
Power/ KWh
Electricity

Water Cubic
meters/day

1.4 MANPOWER / TIMETABLE OF CONSTRUCTION

TIMELINES FOR CONSTRUCTION AND COMMISSIONING OF PROJECT EXPANSION

Proposed Start of Construction :
Proposed Start of Commissioning :
Proposed Start of Commercial Operation :

a. Construction Phase

Generic Environmental Performance Report and Management Plan

 Manpower Expertise/Skills Total Expertise/Skills Total
Requirement
Existing Expansion

b. Operation Phase
Manpower Expertise/Skills Total Expertise/Skills Total
Requirement
Existing Expansion

1.5 INDICATIVE PROJECT COST

Total Project Cost (PhP): ____________

Generic Environmental Performance Report and Management Plan

 II. INTEGRATED ENVIRONMENTAL IMPACTS AND MANAGEMENT PLAN

Possible Environmental/ Baseline Environment Preventive/ Mitigating Measures (for entire Monitoring Parameters/ Cost of Mitigation/ Monitoring
Social Impacts project) Implementation (for entire (for entire project)
project)
LAND
 Disturbance to wildlife Existing vegetation in the expansion
area:
 Compliance with conditions of DENR/LGU  Annual inspection of area  Cost integrated in the
due to vegetation SLUP, Tree Cutting Permit, ROW, PCA replanted/ revegetated construction /operation cost
clearing during  Forestland Permit
expansion  Marshland  Limit land clearing as much as possible
 Grassland  Provide temporary fencing for vegetation
 Mangrove that will be retained
 Wetland  Promote restoration of damaged or
destroyed vegetation where possible (e.g.,
 Others, specify tree planting);
____________________
 Change in surface Slope in expansion area:  Provide erosion control and slope  Regular inspection of slope  Slope/ Erosion Control
landform/ topography/  flat (0-3%) protection measures protection measures in Cost: ___________
terrain/slope (in  gently sloping to rolling (3-18%)  Designate a Spoils Storage Area, with erosion-prone areas  Others, specify
expansion area)
 steep (>18%) topsoil set aside for later use and allow  Regular inspection for new ____________
maximum re-use of spoils eroded areas near the site
 Soil Erosion(in  Construction during dry season  Others, specify
expansion area)
 Stabilization of embankment with grasses ___________
or other soil cover
 Others, specify
____________

Is the project site’s expansion area  Compliance with the DENR Administrative
located in an area identified by Order No. 2003-30 and DENR
MGB/PAG-ASA/ PHIVOLCS as Administrative Order No. 2000-28,
hazard prone? Implementing Guidelines on Engineering
 Yes Geological and Geo-hazard Assessment
(EGGA).
 No

Generic Environmental Performance Report and Management Plan

Possible Environmental/
Social Impacts
 Soil/Land
contamination due to
improper solid waste
disposal (in expansion
area)
 Impairment of visual
aesthetics
 Devaluation of land
values
WATER
 Increased siltation due
to project activities
 Water quality
degradation
 Others, specify
___________________
Generic Environmental Performance Report and Management Plan
Baseline Environment Preventive/ Mitigating Measures (for entire Monitoring Parameters/ Cost of Mitigation/ Monitoring
project) Implementation (for entire (for entire project)
project)
Existing soil type in the expansion
area:
 Implementation of the Ecological Solid  Daily inspection of  Cost integrated in the
Waste Management Plan (ESWMP) waste/recycling bins for construction /operation cost
 sandy  Set-up temporary fence around the segregation
 clay construction area  Daily inspection for presence
 sandy-loam  Implement re-use and recycling of waste of mixed garbage in the
facility
 Others, specify materials

____________  Implement proper segregation, collection Weekly inspection of waste
accumulated
and disposal of domestic wastes in
designated areas  Others, specify
 Provide receptacles / bins for solid wastes _____________
 Coordinate with the municipal / city waste
collectors
 Engage third party company for waste
collection
 Others, specify ________________
Presence of visually significant
landforms/landscape/structures?
 Implement landscaping and other  Regular inspection of  Cost integrated in the
beautification measures landscaping and other construction/ operation cost
 Yes  Provide adequate buffer beautification activities
 No  Compensate adjacent property owners  Regular monitoring of buffer
zones
 Others, specify
 Regularly monitor
________________
presence/absence of
complaints from adjacent
property owners
Specify nearest/receiving water  Set-up proper and adequate sanitary Regular (ocular) inspection of:  Cost integrated in the
body:
____________________________
facilities  Drainage / canal systems construction/ operation cost
 Strictly require the contractor and its  Water treatment facility (i.e.,
Distance to nearest/receiving water workers to observe proper waste disposal grease trap, septic tank, etc.)
body: and proper sanitation
 0 to less than 0.5 km  Strictly observe proper waste handling and Quarterly monitoring of the
Possible Environmental/ Baseline Environment
Social Impacts
 0.5 to 1 km
 More than 1 km
If nearest/receiving water body is
fresh water, specify classification:
Preventive/ Mitigating Measures (for entire Monitoring Parameters/ Cost of Mitigation/ Monitoring
project) Implementation (for entire (for entire project)
project)
disposal following:
 Provision of wastewater treatment facility  pH
(e.g. septic tank, oil and water separator,
etc.)
 TSS concentration
 Set up silt trap/stilling ponds to minimize
 BOD

 AA downstream siltation  Total Coliform

 A  Provision of three-chambered septic tank  Color

 B
for domestic sewage  Oil and Grease
 Provide ring canals around fuelling tanks/
 C motorpool/ maintenance areas
 D  Others, specify
___________
If nearest/receiving water body is
coastal or marine water, specify
classification:
 SA
 SB
 SC
 SD

Current Water Use:

 Fishery
 Tourist Zone / Park
 Recreational
 Industrial
 Agricultural

Distance of project area to the

nearest well used:
 0 to less than 0.5 km
 0.5 to 1 km

Generic Environmental Performance Report and Management Plan

Possible Environmental/ Baseline Environment Preventive/ Mitigating Measures (for entire Monitoring Parameters/ Cost of Mitigation/ Monitoring
Social Impacts project) Implementation (for entire (for entire project)
project)
 More than 1 km

Use of the nearest well:

 Drinking/Domestic
 Industrial
 Agricultural

 Competition in water Size of population using receiving

surface water:
 Implement rainwater harvesting and similar  Regularly monitor  Cost integrated in the
use measures as an alternative source of water presence/absence of construction/ operation cost
 Depletion of water  ≤ 1,000 persons  Observe water conservation measures; complaints
resources  >1,000 and ≤ 5,000persons  Careful selection of project site to avoid  Regular coordination with
 >5,000person disruption of traditional water uses concerned agencies
 Obtain Water Permit from NWRB  Regularly monitor
Available/nearest water source. occurrences of water
 Deepwell
 Improve efficiency of water supply and shortages
distribution system
  Others, specify
Water district/LGU  Others, specify ____________
 Surface water _____________________
 Others, specify
________________________

 Increased occurrence Is the project site located in an area

identified by MGB/PAG-ASA as
 Use appropriate design for project facilities  Regularly monitor  Cost integrated in the
of flooding
flood prone?  Implement appropriate drainage system presence/absence of
complaints
construction/ operation cost

 Yes  Regularly remove debris and other

 Regular coordination with
materials that may obstruct water flow
 No concerned agencies
 Use appropriate technology (e.g. raised
 Regularly monitor increased
hand-pumps) to protect drinking water from
flood contamination frequency of flooding
 Others, specify  Others, specify
_____________________ _________________

Generic Environmental Performance Report and Management Plan

Possible Environmental/
Social Impacts
AIR / NOISE
 Air quality degradation
 Nuisance due to noise
generation
Generic Environmental Performance Report and Management Plan
Baseline Environment
Distance to nearest community:
 0 to less than 0.5 km
 0.5 to 1 km
 More than 1 km
Distance to nearest community:
 0 to less than 0.5 km
 0.5 to 1 km
 More than 1 km
Preventive/ Mitigating Measures (for entire Monitoring Parameters/ Cost of Mitigation/ Monitoring
project) Implementation (for entire (for entire project)
project)
 Properly operate and maintain all emission  Regularly monitor  Cost integrated in the
sources (e.g. vehicles, pumps, generator, presence/absence of construction/ operation cost
etc) complaints
 Install when applicable, the appropriate air
Regular (ocular) inspection of:
pollution control device/s
 Strictly enforce good housekeeping  Absence of white or black
practices smoke from vehicles,
heavy equipment and
 Control vehicle speed to lessen generator
suspension of road dust
 Presence of truck cover
 Conduct water spraying to suppress dust during deliveries
sources and minimize discomfort to nearby
residents
 Use covered vehicles to deliver materials
that may generate dust
 Other, specify
___________________
 Properly operate and maintain all noise  Regularly monitor  Cost integrated in the
sources (e.g. vehicles, pumps, generator, presence/absence of construction/ operation cost
etc) complaints
 Install when applicable, the appropriate  Regular monitoring of buffer
noise control device/s (e.g., mufflers, zones
Possible Environmental/
Social Impacts
Baseline Environment Preventive/ Mitigating Measures (for entire Monitoring Parameters/ Cost of Mitigation/ Monitoring
project) Implementation (for entire (for entire project)
project)
silencer, sound barriers, etc.)
 Implement appropriate operating hours
 Provide adequate buffer and/or planting of
trees
 Others, specify
______________________

PEOPLE

 Displacement of Size of population of host barangay:  Provide relocation/disturbance  Regularly monitor  Cost integrated in the
residents in the project
 ≤ 1,000 persons
compensation packages presence/absence of construction/ operation cost
site and within its
 >1,000 and ≤ 5,000persons
 Prioritize local residents for employment complaints
vicinity
  Regular coordination with
 Displacement of  >5,000person
Promptly pay local taxes and other
financial obligations LGU
Indigenous People
 Regular coordination with LGU  Others, specify
 Enhanced employment
Classification of host barangay:
_________________
and/or livelihood  Urban  Prior consultation & coordination to
opportunities  Rural
minimize disruption on daily domestic
activities & respect for IP rights and
 Reduced employment cultural practices
and/or livelihood Available services within/near the
opportunities host barangay:  Ensure participation of IPs in consultations
 Increased revenues for  Schools (e.g. elementary, high
and dialogues
LGU school, college)  Provide appropriate traffic/warning signs,
 Disruption/Competition  Health facilities (e.g., clinics,
lighting, etc
in delivery of public hospitals, etc.)  Others, specify
services (e.g.,  Peace and order (e.g., police
________________
education, peace and outpost, brgy. Tanod, etc.)
order, etc.)
 Recreation and sports facilities
 Enhanced delivery of
 Others, specify
public services (e.g.,
_____________________
education, peace and
order, etc.)

Generic Environmental Performance Report and Management Plan

Possible Environmental/ Baseline Environment Preventive/ Mitigating Measures (for entire Monitoring Parameters/ Cost of Mitigation/ Monitoring
Social Impacts project) Implementation (for entire (for entire project)
project)
 Increase in traffic
volume and worsening
of traffic flow

 Impacts on community  Regular coordination with LGU  Presence/Absence of  Cost integrated in the
health and safety  Provide appropriate warning signs, lighting complaints construction/ operation cost
 Others, specify and barricades, whenever practicable  Regular coordination with
_______________  Observe proper housekeeping LGU
 Provide on-site medical services for any  Regular submission of reports
emergency. to concerned agency
 Participate in public awareness programs  Others, specify
on health and safety _________________

 Implement appropriate safety programs for

both community and workers
 Strictly comply with fire, safety and similar
regulatory requirements
 Strictly comply with requirements of RA
6969
 Others, specify
______________________

Generic Environmental Performance Report and Management Plan

III. ABANDONMENT /DECOMMISSIONING/REHABILITATION POLICIES ANDGUIDELINES (if Applicable)

Total Project Life or Service: ___________ years

Provide description of the Abandonment activities for existing and proposed expansion, such as, dismantling and waste disposal.
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________

IV. INSTITUTIONAL PLAN FOR INTEGRATED EMP IMPLEMENTATION

Organization Chart (include name of personnel/staff assigned to the positions):

Generic Environmental Performance Report and Management Plan

 Attach drawing/plan of waste water treatment facility (with dimensions and descriptions) for existing and proposed project

Generic Environmental Performance Report and Management Plan

 Attach drawing/plan of air pollution source and control installations (with dimensions and descriptions) for existing and
proposed expansion

Generic Environmental Performance Report and Management Plan

 SWORN STATEMENT OF ACCOUNTABILITY OF THE PROPONENT

This is to certify that all the information and commitments in this Environmental Performance Report and Management Plan (EPRMP) are
accurate and complete to the best of my knowledge.

By the authority vested in me by the ____(Company Name) as ___(Position/Designation), I hereby commit to ensure implementation of all
commitments, mitigating measures and monitoring requirements indicated in this EPRMP as well as the following:
 Conform to pertinent provisions of applicable environmental laws e.g., R.A. No. 6969 (Toxic Substances and Hazardous and Nuclear
Wastes Control Act of 1990), R.A. No. 9003 (Ecological Solid Waste Management Act of 2000), R.A. No. 9275 (Philippine Clean Water
Act of 2004), and R.A. No. 8749 (Philippine Clean Air Act of 1999).
 Abide and conform to LGU development plans and guidelines.
 Promptly pay local taxes and other financial obligations.
 Regularly submit reports to concerned agencies.

I hereby bind myself to answer any penalty that may be imposed arising from any misrepresentation or failure to state material information in
this EPRMP.

In witness whereof, I hereby set my hand this ____ day of __________ at ______________________.

__________________________
NAME OF PROPONENT HEAD
(Position)
(Company Name)

SUBSCRIBED AND SWORN TO before me this _____ day of ____________ 201__, affiant exhibiting his/her Community Tax Certificate No. ___________________ issued at
______________________ on __________________________.

Doc. No. ____________________

Page No. ____________________
Book No. ____________________
Series of ____________________

Generic Environmental Performance Report and Management Plan