CBIM 2021 Form 21

Environmental and Social Management Plan

KALAHI-CIDSS NCDDP Additional Financing

Environment and Social Management Plan (ESMP)

Region : ______________________________ Subproject Title : ________________________________

Province : ______________________________ Subproject Total Cost : ________________________________
Municipality : ______________________________ Group : ________________________________
Barangay : ______________________________ Phase : ________________________________

Mitigation/Enhancement
Potential Impacts
Measures
A. Environment
□ Cutting of trees □ Acquisition of tree
cutting permit
□ Compliance with
conditions in secured
permits
Time Frame/Schedule
Status of Compliance
for the Implementation
Cost of Mitigating with
Monitoring Parameter of
Measure Mitigation/Enhancement
Mitigation/Enhancement
Measures
Measures
□ Presence of permit □ Prior to SP planning □ On-going compliance
□ Prior to SP □ Complied
implementation □ Included in the POW
□ As reflected in the □ Others ____________
POW
□ Others ___________

□ Soil/Land □ Implement proper □ Presence of waste □ Prior to SP planning □ On-going compliance

contamination segregation, collection segregation □ Prior to SP □ Complied
due to solid and disposal of facilities implementation □ Included in the POW
waste disposal wastes □ Identified waste □ As reflected in the □ Others ____________
□ Soil/Water/Air □ Provide bins for solid disposal sites POW
CBIM 2021 Form 21
Environmental and Social Management Plan

quality wastes □ Presence of □ Others ____________

degradation □ Strictly enforce good signage, checklists
housekeeping
practices

□ Improper □ Appropriate □ Inspection report □ Prior to SP planning □ On-going compliance

disposal of dismantling and □ Prior to SP □ Complied
waste from disposal of materials implementation □ Included in the POW
demolished from temporary □ As reflected in the □ Others ____________
structures structures POW
□ Others ____________

B. Social
□ Minimal □ Conduct of separate □ Attendance Sheet □ Prior to SP planning □ On-going compliance
participation of consultation with IP □ Minutes of Meeting □ Prior to SP □ Complied
IPs/Difficulty in groups □ Others ________ implementation □ Included in the POW
ensuring IPs’ □ Ensure IP □ As reflected in the □ Others ____________
participation membership in the POW
expanded □ Others ____________
M/BDRRMC

□ Proposed project □ Repair: Technical
for construction design includes
or repair is retrofitting of the
located in a high proposed structure
risk or no build (not just restoration to
zone areas former design)
□ Construction:
Mitigation measures is
considered in the
design
□ Signed and □ Prior to SP planning □ On-going compliance
approved technical □ Prior to SP □ Complied
design implementation □ Included in the POW
□ Appropriate □ As reflected in the □ Others ____________
clearances/permits POW
are in place □ Others ____________
□ Prepared and
posted disaster
contingency/evacu
ation plan
CBIM 2021 Form 21
Environmental and Social Management Plan

□ Disaster
contingency/evacuatio
n plan is prepared and
posted
□ No dwelling is strictly
enforced
□ Appropriate
clearances/permits
are acquired

□ Temporary □ Appropriate □ List of signage, list □ Prior to SP planning □ On-going compliance

structures may information of precautionary □ Prior to SP □ Complied
pose physical dissemination on measures implementation □ Included in the POW
and/or social potential hazards □ As reflected in the □ Others ____________
hazards POW
□ Others ____________

□ Increased risk to □ Provide appropriate □ Presence of □ Prior to SP planning □ On-going compliance

community/perso warning signs and signage and □ Prior to SP □ Complied
nal health and lighting lighting implementation □ Included in the POW
safety during □ Use of personal □ □ As reflected in the □ Others ____________
construction protective equipment POW
activities (PPE) during □ Others ____________
construction
□ Strict implementation
of health protocols

□ Possible land □ Execute agreement □ Signed and □ Prior to SP planning □ On-going compliance
conflict between the Project, notarized □ Prior to SP □ Complied
owner and LGU agreement implementation □ Included in the POW
□ Secure LARR □ Signed and □ As reflected in the □ Others ____________
CBIM 2021 Form 21
Environmental and Social Management Plan

document notarized LARR POW

document □ Others ____________
□ Proposed □ Mitigation measure is □ Signed and □ Prior to SP planning □ On-going compliance
subproject may considered in the notarized □ Prior to SP □ Complied
affect the technical design agreement implementation □ Included in the POW
livelihood of □ Execute agreement □ Signed and □ As reflected in the □ Others ____________
some community between the Project, notarized LARR POW
members owner and LGU document □ Others ____________
□ Secure LARR
document

Other Potential Impacts and Mitigating Measures adopted

e.g. These are context-specific
CBIM 2021 Form 21
Environmental and Social Management Plan

Instructions in accomplishing the ESMP template:

1. Check relevant items under (i) Potential Impacts, (ii) Mitigation/Enhancement Measures, (iii) Monitoring Parameter, (iv) Time
Frame/Schedule for the Implementation of Mitigation/Enhancement Measures, and (v) Status of Compliance with
Mitigation/Enhancement Measures;
2. Compute and provide the costs necessary for implementing the mitigating measure/s;

Prepared by:

_____________________________ ______________________________ ______________________________

Name and Signature of PPT Member Name and Signature of PPT Member Name and Signature of PPT Member

Assisted by:

_______________________ _______________________ ______________________ _______________________

ACT TF MCT TF ACT CEF MCT CEF

Noted:

_______________________ ______________________ _______________________ _______________________

ACT AC MCT AC BDC TWG Chairperson BDRRMC Head