INSTRUCTIONS ON THE PREPARATION AND SUBMISSION OF THE IEE

CHECKLIST

This section discusses how the project proponent will fill-up and answers the
various questions and information stated in the checklist. Likewise this section
will also inform the project proponent the permit requirements to be attached to
the checklist, where to submit and process such application and the timeframe
for DENR processing.

A.

Contents of the IEE Checklist

The IEE Checklist is a simplified form designed to assist proponents batching

project/s in complying with the EIS system. The IEE Checklist, to be
accomplished and submitted before undertaking a project, consists of a series of
questions that deals with issues and concerns about the proposed project and its
environment. The questions will also provide the proponents with information on
environmental impacts, both positive and negative, which will be caused by the
proposed project.. The IEE Checklist has to be submitted by all government and
private sector proponents applying for an ECC covering the abovementioned
projects. The information contained herein will serve as a basis for the review
and assessment of the EMB Regional Office for the issuance and/or denial of the
ECC.
The IEE Checklist is divided into four (4) major sections:

Section A: consists of the general information regarding the proponent;

Section B: project location, plan/design components and activities during the

development and operation phase;

Section C: consists of the information regarding the description of the existing

environmental condition where the road or bridge will be located
the physical biological, socio-cultural and economic environment;

Section D: consists of the listing of possible potential impacts that may occur
in the various stages of the project establishment and operation;
corresponding mitigation and enhancement measures to prevent
the occurrence of adverse impacts and strengthen the positive
effects of the project;

Section E: provides the commitment of the proponent

Attachments:

consists of the information required to be submitted as part

of the IEE Checklist

B.

Instructions on the Preparation of the IEE Checklist

1. The IEE Checklist can be prepared by the proponent or any of his/her
authorized representative e.g. EMB Memorandum Circular No. 04, Series of
1998 (17 August 1998). The proponent's signature in the report shall be
sufficient. The proponent may seek the help of the DENR personnel by
clarifying questions in the IEE Checklist.
2. To use the Checklist, the proponent may put a check

(4) mark in the

appropriate box. If your answer does not fall in any of the pre-determined
responses, check (4) OTHERS and indicate your specific answer in the blank
space provided or use additional sheets as necessary. If some questions are
not applicable to your project, write N/A on the blank space or column

3. To facilitate and assist the proponent in answering Section D of this checklist,

a menu is provided to serve as a guide and reference. However, it should be
noted that this only serves as a menu checklist hence, proponents are highly
encouraged to identify additional impacts and mitigation/enhancement
measures other than those provided in the menu

The proponent may put a check (4) to the columns of Y or N on the predetermined and identified Mitigation/Enhancement measures column. The
proponent may choose the mitigating measures appropriate to the impacts
identified for the proposed project.

4. For the section on Attachment write

a check mark

description of the document to be submitted.

(4) on the title or

The listed documents are

MUST requirements and should be submitted. Otherwise, the application will

not accepted.

5. Answers to the questions are not be strictly confined to the pre-determined

responses. The proponent may elaborate and use as many additional sheet
as needed to be able to provide adequate answers to the required
information.

Maps, pictures, drawings (e.g. charts, tables, diagrams,

sketches) and other visual aids is deemed to provide better description of the
information provided in the Checklist. These will help EMB in understanding
the proposed project, and make decision on the application for ECC.

C.

Instructions on the Submission of the IEE Checklist

6. Upon completion of the IEE checklist, the project proponent shall submit one
(1) set of the Checklist at the EIA Section of the EMB Regional Office, EIA
Section where the project is to be located. A duly accomplished Procedural
Screening Form shall accompany the IEE Checklist submission.

7. Upon the presentation/submission of the Checklist, the Screening Officer

shall immediately determine its completeness and conformance with the
DENR prescribed requirements. Immediate determination shall mean
completion of the Procedural Review within the same day of IEE checklist
submission.

8. The Screening Officer shall indicate, through a check/tick mark under the
Yes, No or Not applicable column, the presence or absence of a particular
information required.

9. The determination of the completeness of the IEE Checklist will be based on

the sufficiency of responses to all questions or checklist and information
provided in the matrix.

10. If the IEE Checklist is complete, it will be formally accepted. The proponent
will be furnished a copy of the accomplished procedural form duly signed by
the Screening Officer.

11. If the Checklist is incomplete, it shall be immediately returned to the

proponent for revision or submission of the missing requirement/information.
The reason for non-acceptance shall be stated in writing at the appropriate
place in the form.

12. If the IEE Checklist has complied with all the DENR prescribed requirements,
the proponent shall submit 3 copies of the documents to EIA Section of the
concerned EMB Regional Office.

The proponent shall pay the amount of P3,000.00 at the Cashier Section of
concerned EMB Regional Office upon submitting the required number of
copies at the Record Section of the same office.

13. All IEE Checklist not going following the said standard procedures shall not
be considered as valid applications and therefore, shall not be used as a
basis for recommendation on the issuance or denial of the ECC.

14. The project proponent or his duly recognized representative shall be the one
who will follow-up the said application to respective EMB Regional Office.
The processing time including the issuance and/or denial of the ECC will take
a maximum of 30 days.

14. The EIA Section of the EMB Regional Office, in the course of substantial
review, may conduct site visits or ocular inspections in coordination with the
project proponent

15. If the EMB finds that the IEE Checklist Report has substantially addressed all

the significant impacts and relevant issues by way of mitigation and

enhancement measures, it shall recommend the issuance of the ECC. The
EMB Regional Office will call for a technical Conference to explain to the
project proponent the relevance of the ECC and the various conditions stated
therein for compliance by the project proponent.

BATCHING PLANT PROJECT

INITIAL ENVIRONMENTAL EXAMINATION (IEE) REPORT
for

Project name or Title

Below is the IEE Report Checklist for Batching Plant Proponents. Read the questions
carefully before answering the space provided. Uses additional sheets if necessary and indicate
this in the appropriate space. Misleading or erroneous answers are basic for legal actions and/or
ECC.

A. GENERAL INFORMATION
PROJECT LOCATION: Complete drops Street, Barangay, and Municipality/City)
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
NAME OF PROPONENT: ________________________________________________________
TIN: __________________________
ADDRESS (Complete Address: Street, Barangay, and Municipality/City)
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Telephone: ________________________________
Fax
: ________________________________
Email: ____________________________________

B. PROJECT DESCRIPTION
1. Project Ownership : (Attach document as ANNEX 1)
Single Proprietorship
Partnership

Corporation

2. Capitalization & Project Cost:

2.a Capitalization:
Authorized

Paid-Up:

2.b Project Cost :

2.b.1 Site Development:
2.b.2 Batching Plant:
2.b.3 Building Structures:

3. Type of batching Process:

Dry-type

Wet-type

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 location 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 Clearance
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 Requirement
5.a.3.1.
Water Supply
No. Of Units

Source of Water supply

Local Water District
Surface Water
Deepwell
Others, please specify
(Use additional sheet, if necessary)

CONSUMPTION/DAY

5.a.3.2 Power Supply

No. Of Units

Source of Power Supply

Local Electric Utility
Generator
Others, please specify
(Use additional sheet, if necessary)

CONSUMPTION/DAY

5.b. Operation Phase

5.b.1 Production Capacity/Day:
5.b.2. Raw Materials
No
RAW MATERIALS
1
Cement
2
Gravel
3
Sand
4
Water
5
Admixture
(Use additional sheet, if necessary.)

CONSUMPTION /DAY

5.b.3 Production ProcessAttach description and flowchart of process as ANNEX 5.)

5.b.4 Plant Machinery and Equipment
No. of Units

Machinery/Equipment
Cement Silos
Aggregate Hopper
Belt Conveyor
Transit Mixers
Payload
Generator Set
Fuel Storage Tank

Specification

5.b.5 Manpower Requirement

No. of personnel

Position
Plant Manager
Plant Engineers
Accountant
Stock Clerk/ Checker
Laborers/ Workers
Drivers
Auto Mechanic
Security Guard

(Use additional sheet, if necessary.)

Type of
Source of Waste
Waste
Liquid
Air
Dust
Noise
Solid
(Use additional sheet, if necessary.)

5.b.7 Abandonment Phase and schedule

Facilities to be
Waste Generated
Abandoned

(Use additional sheet, if necessary.)

Volume Per Day

Mode of Treatment

Mode of Disposal

Restoration Plan

C. DESCRIPTION OF ENVIRONMENTAL SETTING

1. Physical Environment
1.a Description of terrain (% slope)
Flat or Level (0-3)
Level of Undulating (3-8)
Undulating to Rolling (8-18)
Rolling of Moderately Steep (18-30)
Moderately Steep to Steeply mountainous (30-50)
Very Steeply mountainous (above 50)
1.b Is the area erosion prone? ________________
If so, what is the status:
Slight
Moderate

Severe

1.c. Are the existing natural hazardous in the area, e.g., landslides, gullying, and
subsidence. Etc.?______
If yes please enumerate then: ______________________________________________
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?
1.h What is the quality of air?

Fresh

Brackish
Poor

Fair

Saline/Sally
Good

2.Ecosystem Description
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 wild life 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-Economic Environment
3.a Total Household to be affected?
________Families
What will happen to them?
_______________________________________________________________________
3.b Will you employ vulnerable groups?
__________No
If yes, please identify and enumerate:_____Elderly_____Children _____Handicapped
3.c Are there health facilities (e.g., clinic, etc.) within the project site?

No

Yes

3.d Are the required benefits under the Labor Code and other regulations to be enjoy by
the staff?_________________ If yes, please enumerate:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
3.e Are the local inhabitants to be benefits by the project?_________Please elaborate.
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
3.f Are the cultural norms/morals and lifestyle of the local inhabitants to be affected by the
project?____________
Pls.Elaborate._______________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________

3.g Are there any opposition on the project?

No
Yes
( Attach document to support the
answer as ANNEX 6.)

D.
1.

PROJECT IMPACTS
Pre- Construction / Construction Details

Components/
Parameters

ANSWERS
Yes

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 stockpiling
of sand gravel
material in the site?
Is there drilling,
boring, &
hammering activities?
Is there any slope
modification or
ground leveling?
Is there increased
traffic movement in
the area?
Is the
public/community
access to/though the
area affected?
Is there an increase
economic activity in
the area?

No

Describe the
impacts

Describe your Mitigating

/Enhancement Measures

Is there increase in
the availability of
employment?
Is there displacement
of people in the area?
Is the displacement
involve relocation of
affected parties?
(use additional sheet if necessary)

2. Operation and Maintenance Phase

Components/
ANSWERS
Describe the impacts
Parameters
Yes
No

Describe your
Mitigating
/Enhancement
Measures

Will the project

generate
wastewater?
Is there an effect on
the quality of the
receiving body of
water?
Is there an increase
in surface run- off to
other areas?
Is there increase in
water demand?
Is there dust
emission into the
environment?
Will it affect the
ambient air quality of
the area?
Is there air pollution
sources equipment
to be installed?
Are hazardous/
Toxic waste to be
improve in the
environment?
Is there any pollution
complaint from the
near by residents?
Is there an increased
in crime / security
concern in the area?
Others, please
specify.
2. Operation and Maintenance Phase
Components/
ANSWERS
Describe the impacts
Parameters
Yes
No
Is there a generation
of solid waste?
Is there an increase
traffic movement in
the area.

Describe your
Mitigating
/Enhancement
Measures

Is there an effect on
the road system of
the community?
Is there an increase
in the availability of
employment?
Is there an increase
in population from
migration?
Is there an increase
in land value?
Is there project
structure affected or
obstruct the view from
adjacent areas?
Is there an increased
in crime / security
concern in the area?
(Use additional sheet if necessary)

3. Abandonment & Rehabilitation Phase

Components/
ANSWERS
Describe the impacts
Parameters
Yes
No
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?
Is there a generation
of solid waste?
Is there an increase
traffic movement in
the area.
Is there an effect on
the road system of
the community
Is there an increase
in the availability of
employment?
Is there an increase
in population from
migration?
Is there an increase
in land value?
Is there project
structure affected or
obstruct the view from
adjacent areas?
Is there an increased
in crime / security
concern in the area?
Is there an increase
in noise level in the
area?

Describe your Mitigating

/Enhancement Measures

Attach photo, panoramic view of project site and its immediate vicinity

Attach photo, front view of the project site

Attach photo, left side view of the project site

Attach photo, right view of the project site

Attach photo, back/rear view of the project site

Attach sketch plan/lay-out of project site

Attach drawing/plan of air pollution source and control installation s (with dimensions
and descriptions)

(Use additional sheet if necessary)

Attach drawing /plan of waste water treatment facilities (with dimensions and
descriptions)

(Use additional sheet if necessary)

ATTACHMENTS
1. Government Permits and Clearance (attach photocopies of documents)
PERMITS/CLEARANCES
Demolition Permit
Electrical Permit
Sanitary Permit
Building Permit
Water Rights Permit (NWRB)

ATTACHED?

PERMITS/CLEARANCES
Location Clearance / Certificate of Locational Viability
DTI?SEC Registration
Safety (Fire) Permit
Municipal/Business Permit

ATTACHED?

PERMITS/CLEARANCES
Transfer Certificate of the Title
Colored photo of the site (different perspectives)
Project Vicinity Map/Sketch
Project Lay-out Plan
Sewerage and Drainage Plan
WTP Plan

ATTACHED?

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

ATTACHED?

PROPONENT S COMMITMENTS
ARE YOU WILLING TO
Comply with environmental rules and regulation, guidelines and criteria?
Participate or support multi-Partite monitoring efforts?
Constructed maintain and properly operate an adequate and appropriate
Treatment facility for your liquid wastes?
Contribute towards the operation and maintenance of the municipal sewerage
facility?
Construct maintains and properly operate an adequate and appropriate storage
and disposal facilities for your solid waste?
Contribute toward the operation and maintenance of a municipal solid waste
management/disposal facility?
Maintain the cleanliness of your general surrounding?
Extent social benefits to the community?
Organize and conduct information, education and communication (IEC) activities
on environmental, health and other civic issues?
Pay environmental tax or fee should this be deemed necessary by the
appropriate authority to maintain an environmental-friendly area?
Contribute (on cost-sharing basis) in government undertaking on pertinent (fastfood related ) issues (e.g., workshop, training, etc.)
Other, please specify

YES

NO

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

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

a) participate or support a Multipartite Monitoring Team?

b) Establish an EMF/EGF?
If yes, what is your proposed annual contribution?

________yes ______no
________yes ______no
_______________PhP/year

ACCOUNTABILITY STATEMENT

This is to certify that all the information and commitments in the Initial Environmental
Examination (IEE) Report are true,
accurate and complete.
Should I/we learn if any
information which would make the IEE inaccurate, I/we shall bring said information to attention of
the Environmental Management Bureau of DENR Regional Office.
I/We hereby bind myself/ourselves jointly and solidarity for any penalties that may be
imposed arising from and misrepresentations or failure to state material information in the IEE.

_________________________________________________
Project Proponent
_________________________________________________
Title/Designation
_________________________________________________
Date

ACKNOWLEDGMENT

________________ 20______ at
BEFORE ME this __(day) _ of
__________(place)___________, personality appeared ____________(name)___________ with
Community Tax Certificate No. ____________________ issued on ____(date)____ at
_________(place)__________, in his/her capacity as __________(designation)___________ at
___________________ and acknowledged to me that this IEE is his voluntary act and deed,
and voluntary act and deed of the entity he/she represents. This document which consists of
(no)___________pages, including the page of which this acknowledgment is
,is an Initial
environmental Examination Report Checklist.
Witness my hand and seal on the place and date above written.

____________________________
Notary Public

Doc. No.___________________
Page No.__________________
Book No.__________________
Series of __________________