Initial Environmental Examination (IEE) Checklist Report

For

_______________________________________________
Project Name or Title

Below is the IEE Report Checklist for Land Transportation (Bus,

Jeepney) Terminal. Read the questions carefully before answering in
the space provided. Use additional sheets if necessary and indicate this
in appropriate space.
Misleading or erroneous answer are basis for legal actions and/or
denial of ECC.

PROJECT LOCATION: (Complete Address: Street, Barangay,

Municipality/City)

________________________________________________________
________________________________________________________

Telephone : _________________________
Fax : _________________________ E-mail :______________

A. GENRAL INFORMATION

1. Project Ownership: (Attached document as ANNEX 1)

[ ] Single Proprietorship [ ] Partnership [ ]
Corporation
[ ] Gov’t
2. Capitalization & Project Cost:

2.a Capitalization:
Authorized: [ ] Paid-Up: [ ]
2.b Project Cost:
2.b.1 Site Development: [ ]
2.b.2 Building structure: [ ]

3. Project Components

[ ] Bus Org. [ ] Jeep Org. [ ] Both

3.1 Refilling Station

3.2 Food Station
3.3 Service Bay
3.4 Rest Rooms

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4. Project Site: (Attach location and vicinity maps and photographs
of front, left, right, and rear views of the project site as ANNEX
2.)

4.a Land
4.a.1 Total Land Area, sq. m.
4.a.2 Land Area to be occupied, sq. m.
4.a.3 Is the area owned or leased
4.a.3.1. If leased, period covered
(Attach document, TCT, as ANNEX 3)

4.b Classification (attach photocopy of locational clearance as

ANNEX 4)

[ ] Industrial [ ] Residential
[ ] Commercial [ ] Others, pls. Specify
___________________________________________________

5. Description of Project Phases

5.a Pre-Operation/Construction Phase

5.a.1 Construction Schedule

No. ACTIVITY TIMEFRAME
1 Plans/Design
2 Permits/Clearances
3 Site Preparation & Clearing
4 Excavation
5 Civil Works
6 Finishing/Site Cleaning
7 Installation of Equipment
8 Commissioning & Start-up Operation
(Use additional sheet if necessary. Include civil works undertaken as part of the
project, e.g, construction of office for operation, administration, canteen, and other
amenities.)

5.a.2 Manpower Requirement: [ ]

5.a.3 Facilities Requirements
5.a.3.1 Water Supply

No. Source of Water Supply CONSUMTION/DAY

of
Units
Local Water district
Surface Water
Deepwell
Others, please specify
(Use additional sheet, if necessary.)
5.a.3.2 Power Supply
No. Source of Power Supply CONSUMTION/DAY
of
Units
Local Electric Utility
Generator

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 Others, please specify
(Use additional sheet, if necessary.)

5.b. Operation Phase

5.b.1 Production Capacity/Day: [ ]

5.b.2 Production Process: (attach description and flowchart of process
as ANNEX 5.)
5.b.3 Manpower Requirement
No. of Personnel Position
Terminal Supervisor
Cashier
Accountant/Bookkeeper
Accounting Clerk
Drivers
Auto Mechanics
Security Guard
(Use additional sheet, if necessary.)

5.b.4 Waste Production Scheme

Type of Sources of Waste Volume Mode of Treatment
Waste Per Day
Liquid
Air
Dust
Noise
Solid
(Use additional sheet, if necessary.)

5.b.5 Abandonment Phase

Facilities to be Waste Mode of Restoration Plan
Abandoned Generated Disposal

(Use additional sheet, if necessary.)

B. DESCRIPTION OF ENVIRONMENTAL SETTING

1. Physical environment

1.a Description of terrain (% slope)

[ ] Flat or level (0-3) [ ] Level to undulating
(3-8)
[ ] Undulating to Rolling(8-18) [ ] Rolling to Moderately
steep (18-30)
[ ] Moderately steep to steeply Mountainous (30-50)

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 [ ] Very steeply Mountainous (above 50)

1.b Is the area erosion prone? __________

If so, what is the status : [ ] Slight [ ] Moderate
[ ] severe
1.c Are there existing natural hazards in the area, e.g.,
landslides, gullying, subsidence, etc.?_____
If yes, please enumerate them:
______________________________________
1.d Is the site situated along a flood prone/storm surge area?
_______________
1.e Is the project beside or near the shoreline? ___________
If yes, how far? _________ meters
1.f Are there water bodies found inside or near the project
site? ______
If yes, please enumerate them:
_________________________
1.g What is the quality of water? [ ] Fresh [ ] Brackish
[ ]Saline/Salty

1.h What is the quality of water? [ ] Fresh [ ] Fair

[ ] Good

2. Biological Environment

2.a Is the project immediately adjacent to a natural

ecosystem? __________
If yes, please check on the appropriate box:
[ ] Forest [ ] Coastal/Marine [ ]
Marshland
[ ] Grassland [ ] Mangrove [ ]
Wetland
[ ] Others, please specify ________________________
2.b Are there any wildlife in the area? __________
If yes, please identify and enumerate:
_______________________________________________
_______________________________________________
2.c are there trees within the project site? ________________
If yes, please identify and enumerate:
_______________________________________________
_______________________________________________
2.d Is there other vegetation within the project site? ________
If yes, please identify and enumerate:
_______________________________________________
__________________________________________

3. Socio-Economical Environment

3.a Total Households to be Affected? _________ Families

What will happen to them? _________________________
3.b Will you employ vulnerable groups? _______ No
If yes, please enumerate: _____ Elderly ___ Children
____ Handicapped

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 3.c Are there health facilities (e.g., clinic, etc.) within the
project site?
[ ] Yes [ ] No
3.d Are the required benefits under the Labor code and other
regulations to be enjoyed by the staff? ________
If yes, please enumerate:
_______________________________________________
_______________________________________________
_______________________________________________
3.e Are the local inhabitants to be benefit by the project? ____
Please elaborate
_______________________________________________
_______________________________________________
_______________________________________________
3.f Are the cultural norms/morals and lifestyle of the local
inhabitants to be affected by the project?
______________ Please elaborate.
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
3.g Are there any opposition on the project? [ ]No [ ]Yes
(Attach document to support the answer as ANNEX 6.)

4. Project Impacts

1. Pre-Construction/Construction Phase Details

Components Answer Describe the Describe your
/ impacts Mitigating/
Parameters Yes No Enhancement
Measures
Is there land
clearing?
Is there
vegetation
clearing?
Is there tree
cutting?
Is there
topsoil
removal
replacement
?
Is there
excavation
works and
cut & fill
activities?
Is there
other
earthmoving
activities?
Is there

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stockpiling
of
sand/gravel
materials in
the site?
Is there
drilling,
boring, &
hammering
activities?
Is there any
slope
modification
of ground
leveling?
Is there
increased
traffic
movement
in the area?
Is there
public/comm
unity access
to/through
the area
affected?
Is there as
increased
economic
activity in
the area?
Is there as
increased
availability
of people in
the area?
Is there
displacemen
t of people
in the area?
Is the
displacemen
t involve
relocation of
affected
parties?
(Use additional sheet, if necessary.)

2. Operation and Maintenance Phase

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Components Answer Describe the Describe your
/ impacts Mitigating/
Parameters Yes No Enhancement
Measures
Will the
project
generate
wastewater?
Is there an
effect on the
quality of
the
receiving
body of
water?
Is there as
increase in
surface run-
off to other
area?
Is there an
increase in
water
demand?
Is there air
pollution
sources
equipment
to be
installed?
Is there a
generation
of solid
waste?
Is there an
increase
traffic
movement
in the area?
Is there an
increased
availability
of
employment
?
Is there an
increase in
pollution
from
migration?
Is there an
increase in
land value?

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Is the
project’s
structure
affect or
obstruct the
view from
adjacent
areas?
Is there an
increase in
noise level
in the area?
Will it affect
the peace
order in the
area?
Others,
please
specify.
(Use additional sheet, if necessary.)

Abandonment & Rehabilitation Phase

Components Answer Describe the Describe your
/ impacts Mitigating/
Parameters Yes No Enhancement
Measures
Will any of
the facilities
be
abandoned
or
demolished
after the
project life?
Will any of
the facilities
need to be
rehabilitated
after a
certain
period of
time?
Other,
please
specify.
(Use additional sheet, if necessary.)

PROPONENT’S COMMITMENTS

The Proponent hereby Commits to: Yes No

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Comply with existing environmental rules and
regulations, guidelines and criteria?
Comply w/ the MMoP
Construct, maintain and properly operate an adequate
and appropriate treatment facility for your liquid
wastes?
Contribute towards the operation and maintenance of a
municipal sewerage facility?
Construct, maintain and properly operate an adequate
and appropriate storage and disposal facility for your
solid waste?
Contribute towards the operation and maintenance of a
municipal solid waste management/disposal facility?
Maintain the cleanliness of your general surroundings?
Extend social benefits to the community?
Organize and conduct information, education and
communication (IEC) activities on environmental,
health and other civic issues?
Pay environment tax of free should this be deemed
necessary by the appropriate authority to maintain an
environmental – friendly area?
Contribute (cost-sharing basis) in government
undertakings on pertinent ( fast-food related) issued
( e.g., workshop, training, etc.)
Other, please specify

As stated in Article VI Section 10 and Article V Sections 1 to 6, certain

projects are required to : a) organize a Multipartite Monitoring Team
(MMT) and b) establish Environmental Monitoring Fund
(EMF)/Environment Guarantee Fund (EGF). In case an Environmental
Compliance Certificate (ECC) is issued for this project, area you willing
to:

a) Participate or support a Multipartite Monitoring Team?

____Yes _____ No

b) Establish an EMF/GF?
If yes, what is your proposed annual contribution?
____Yes _____ No
______________PhP/year

ATTACHMENTS

1. Governmental Permits and Clearances (Attached Photocopies of

documents)

PERMITS/CLEARANCES ATTACHED?
Demolition Permit
Excavation Permit
Electrical Permit
Sanitary Permit

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Building Permit
Water Rights Permit (NWRB)
.
PERMITS/CLEARANCES ATTACHED?
Locational Clearance/Certificate of
Locational Viability
DTI/SEC Registration
Safety (Fire) Permit
Municipal/Business Permit

2. IEE Attachments (final reminders)

DESCRIPTION ATTACHED?
Transfer Certificate of Title
Colored Photos of the site
(different perspectives)
Project Vicinity Map/sketch

DESCRIPTION ATTACHED
Map/delineation of primary &
secondary impact areas
Endorsement from the LGU
(Barangay Certificate)
Construction schedule in chart
from

ACCOUNTABILITY STATEMENT

This is to certify that all the information and commitments in the

Environmental examination (IEE) Report are true, accurate and
complete. Should I/we learn of any information which would make the
IEE inaccurate, I/we shall bring said information to the attention of the
Environmental Management and Protected Area Sector (EMPAS) of
DENR (National Capital Region) Regional Office.

I/we hereby bring myself/ourselves jointly and solidarily for any

penalties that may be imposed arising from any misrepresentations of
failure to state material information in the IEE.

__________________________________________
(Projects Proponent’s Signature Over Printed Name)

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