1st 2nd 3rd 4th
Screening
FORM 1-C : PROCEDURAL EVALUATION (SCREENING) FOR
Environmental Performance Report and Management Plan (EPRMP-IEE
Limits)
Project Title : ___________________________________________________________________________
Project Location:_________________________________________________________________________
Project Proponent : ______________________________________________________________________
Address: ______________________________________________________________________________
[Link]. ____________ Fax No. _______ Contact Person : ______________________________________
EIS Consultant :__________________________________._______________________________________
Address: _______________________________________________________________________________
Tel. No._____________ Fax: __________ Contact Person : ______________________________________
Date Submitted for Screening : _____________________________________________________________
Status of Application : ( ) Existing w/ previous ECC
ECC # __________________ Issuing Office: ________________________
ECC Scope : _________________________________________________
__________________________________________________________
( ) Existing w/o ECC but started implementation prior to 1982
Date of Implementation : _____________________________________
( ) Existing w/o ECC but started implementation after to 1982
Date of Implementation : ______________________________________
Project Group Based on Tresholds only:
( ) Single, Group 2 in ECA ; Project Code _________________
( ) Group IV / Co-located
( ) Group V / Unclassified _______________________________
Project Size : Floor Area :
_______________________________________________
Lot Area :
_______________________________________________
Production/Storage Capacity ____________________________________
PSIC Code (based on DTI Registration) : ________________________________________
Checklist of EPRMP Requirements
EPRMP Requirements
Casehandlers Evaluation
Pag
e
Acceptable
?
Remarks
Project Fact Sheet
TABLE OF CONTENTS
EXECUTIVE SUMMARY
Brief Project Description
Brief Summary of Projects EIA Process
Brief description of the existing project vis--vis the proposed
expansion or changes
Summary on the EIA Findings on the Key Significant Impacts of
the Project and corresponding EMP highlights
Summary of the Environmental Monitoring Plan on the most
significant impacts and key measures
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DRAFT MAIN EPRMP
1.
BASIC PROJECT INFORMATION
2.
DESCRIPTION OF THE PROJECTS EIA
PROCESS
2.0
2.1
2.2
2.3
2.4
Terms of Reference of the EIA Study
EIA Team (Proponent & Preparer Team members, module of
involvement, expertise)
EIA Study Schedule
EIA Study Area (project area up to extent of coverage of study)
EIA Methodology (per module)
2.5
EIA Public Participation (if any)
3.
PROJECT DESCRIPTION
3.1
Basic Project Background and Information
3.2 Project Rationale
3.3 Complete project location (barangay, municipality, province, etc)
with geographic coordinates.
3.4 Project Site Considerations
3.5
Description of Project Phases & Activities
3.6 Resource & Utility Requirements, Manpower, Cost
Screening for (Project Title/Proponent): ______________________________________
1st 2nd 3rd 4th
Screening
EPRMP Requirements
Casehandlers Evaluation
Pag
e
Acceptable
?
Remarks
3.7 Waste Generation & Built-in Management Measures
Summary of Comparison of the new and old projects
4.
BASELINE
ENVIRONMENTAL CONDITIONS FOR CRITICAL
ENVIRONMENTAL PARAMETERS, IMPACT
ASSESSMENT & MITIGATION (limit to relevant
modules)
4.0
4.1
4.2
4.3
5.
The Land
The Water
The Air
The People
ENVIRONMENTAL
PERFORMANCE BASED ON THE ORIGINAL
ECC-COVERED ENVIRONMENTAL
MANAGEMENT PLAN
5.1.
5.2.
Impact(s) Mitigation Plan (IMP)
Environmental Monitoring Plan (EMoP) and other Monitoring
Modes
5.3.
Information, Education and Communication (IEC) and Social
Development Program (SDP) or Community Assistance Program
(CAP)
5.4.
Environmental Risk Management and Emergency Response
Programs (ERP)
5.5.
Abandonment/Rehabilitation Programs
5.6.
Institutional Set-up
5.7.
Achievements/Awards and Outstanding Accomplishments on the
Environment
6.0 ENVIRONMENTAL RISK ASSESSMENT
7.0 ENVIRONMENTAL RISK CATEGORIZATION
(PEMAPS)
8.0 ENVIRONMENTAL MANAGEMENT PLAN (EMP)
FOR CURRENT PROJECT & PROPOSED
MODIFICATION/ EXPANSION including EMF and
EGF
9.0 BIBLIOGRAPHY
10.0
ANNEXES
Commitments or Agreements
Accountability Statements of Preparers & Proponent
Photographs or plates of the project site, impact areas an affected
areas and communities
Copy of Previous ECC (if any)
If w/ ECC, Copy of the latest Self Monitoring Report (EIA Module
Only) & SMR Evaluation Results by EMB (if any)
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ACTION TAKEN: (Please check to indicate corresponding action taken)
Document accepted; please submit _____ copies
EIARC Needed? ( ) Yes ( ) No Expertise Needed: __________________________
Processing Fee : PhP 3,000 (Pay at EMB Cashier) Review Fund: Based on WFP (Pay at
NRDC)
Document not accepted
O.R. No.
Date
NOTED BY:
(signature over printed name)
SCREENING OFFICER
PURA VITA G. PEDROSA____
Screening for (Project Title/Proponent): ______________________________________
1st 2nd 3rd 4th
Screening
(signature over printed name)
___________________________
SCREENING OFFICE
Date
Screening for (Project Title/Proponent): ______________________________________
