CERTIFICATE OF NON-COVERAGE (CNC)

1-Page Application Form

1.

Name of the Project Project Location

Proposed Seawall Rehabilitation-Sofitel,Manila, Philippines

Street/Sitio/Barangay Zone/Classification (i.e. industrial, residential)

2.

CCP Complex, Roxas Boulevard, Pasay City,Philippines

City/Municipality Province

Commercial C-3
Region IV-A

Pasay City, Philippines

3.

National Capital Region

Proponent Name Proponent Address Contact Person Proponent Means of Contact

Philippine Plaza Holdings Inc.

CCP Complex, Roxas Boulevard, Pasay City, Philippines
Name Designation

4.

5.

President and CEO

Landline No Fax No.

6.

+ 632
Mobile No

551 5555

+632 551 5610

Email

7.

Project Type/ Undertaking

Rehabilitation of Seawall

8.

Project Size Fill up only relevant parameters. Capacity/Others (i.e., m3, heads) Quantity to be Processed (i.e. MT of raw material) Production Rate (i.e. MT/year)

+/- 380 lin.meters

Space Allocation /Area (i.e. km, ha, sqm) = +/- 380 lin.meters Others:

9.

Description of Project Activities (i.e. during preconstruction, construction, operation and abandonment )

Please see attached 1-page Description of Project Activities

Prepared/Submitted by:

Concurred/Approved by:

Ar. Voltaire Villa Vitug Architect/Environmental Planner

Signature over Printed Name

OIC, President and CEO

Owner's/Proponents Signature over Printed Name

* The only requirement for CNC Applications is to fill-up this form. No attachments are necessary. If additional space is needed for the Description of Project Activities, a maximum of 1 page may be attached. ** As a general rule, DENR-EMB will process CNC Applications within the same day of receipt at the designated office. *** Be sure to secure the computer-generated tracking code assigned to your application, to be provided after presentation of proof of payment for the application fee. It will serve as an assurance that your application has already been inputted into the DENR-EMBs CNC Automated Processing System and will be decided upon immediately.