ULG level Site visit report format

1. Project site___________________________________________

2. Name of the project___________________________________

3. Date of Site visit______________________________________

4. Contacted individuals

4.1. __________________________

4.2. ______________________________

4.3. _______________________________

4.4. ________________________________

4.5. _______________________________

4.6. __________________________________

5. Observations

_____________________________________________________________________________________
_____________________________________________________________________________________
________________________________________________________________

6. Documents reviewed

_____________________________________________________________________________________
_____________________________________________________________________________________
________________________________________________________________

7. Major Gaps and impacts identified (positive and negative impacts)

7.1. Positive Impacts

_____________________________________________________________________________________
_____________________________________________________________________________________
_______________________________________________________

7.2. Negative Impacts

_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________

8. Major remedial actions undertaken during the site visit

_____________________________________________________________________________________
_____________________________________________________________________________________
________________________________________________________________

9. Issues requiring an immediate attention

_____________________________________________________________________________________
_____________________________________________________________________________________
______________________________________________________

Name of Environmental and social safeguard focal persons_________________________

Signature_________________________________________________

Date_____________________________________________________
 1. Sample for contractor’s report on the implementation environmental and social
Management

Date ____________________

To ___________________ ULG

Progress Report on the implementation of environmental impacts

1. Introduction
The subproject ______________________ located in _____ ULG ______ Kebele has been
constructed since ______________ as per the agreement with the city administration on
____________. The contractor received the site on the date ___________________.
On the basis of the agreement the contractor took the following measures.
2. Measures on Environmental and social issues

Environmental and Measures Further action Status of the Date of

social Issues Taken to be taken work completion

Dust Daily No further Completed

showering has action
been don

3. Conclusion
______________________________________________________________________________
Contractor Name _________________________ Signature ____________ Date ______________