INITIAL ENVIRONMENTAL EXAMINATION (IEE) CHECKLIST REPORT

For
COMMUNITY HOUSING PROJECTS

A. GENERAL INFORMATION

PROJECT NAME OR TITLE: _________________________________

NAME OF PROPONENT : _________________________________
NAME OF CONTACT PERSON : ______________________________
ADDRESS OF PROPONENT/OWNER: __________________________
_______________________________________________________
(Complete address : street/sitio, barangay, city/municipality province)
TELEPHONE NO. _________________________________________
CELL PHONE NO. ______________FAX NO. ___________________
PROJECT LOCATION : _____________________________________
(pls. include: street/sitio, barangay, city/municipality province)

[attach location map with important landmarks and access points indicated as Annex 1]

1. Project Ownership

Type of Ownership :

[ ] Single Proprietorship [ ] Partnership or Joint Venture

[ ] Corporation [ ] Cooperatives
[ ] Others ____________________________________________

2. Project Cost

Total Project Cost: [ ]

Mode of Project Financing:

[ ] Self-Financed [ ] Bank Loan

[ ] Gov’t. Financing [ ] Others ________________

Project Objectives
________________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________
B. Project Description

1. Land Ownership

Total Land Area (sq. meters or has.):__________________________

General Land Classification: [ ] Public Land [ ]A&D

If public land, what classification:

[ ] Ancestral Land [ ] Reservation [ ] Others _________

Status of Land Ownership :

[attach photocopy of document as Annex 2]

[ ] owned/title by virtue of:

OCT or TCT # ____________________________________________
CLT/Emancipation Patent No. ________________________________
Free Patent No. ___________________________________________
Homestead Patent No. _____________________________________
[ ] Owned/untitled (tax declaration) __________________________
[ ] stewardship contract: ___________________________________
[ ] lease: Lease Contract No. _______________________________
[ ] others, pls. specify: ____________________________________
___________________________________________________

How do you describe the general location of the project site?

[ ] Developed Area (within a built-up-area with presence of utility systems or network,

especially water supply, roads and power supply)

[ ] Underdevelopment Area (relatively far from the urban center with predominant
absence of utility system)

[provide vicinity map (drawn to scale) indicating adjoining land uses as well as existing
facilities and utilities at least within 1 km from the property boundary as Annex 3]
Attach panoramic view of the project site and its immediate vicinity (north side
view)

Attach panoramic view of the project site and its immediate vicinity (south side
view)

Attach panoramic view of the project site and its immediate vicinity (west side
view)
Attach panoramic view of the project site and its immediate vicinity (east side
view)

2. Land Use Classification (base on approval land use plan of the City or municipality)

[ ] Agricultural [ ] Residential [ ] Others, pls.

[ ] Industrial [ ] Forest Land specify_____________
[ ] Commercial [ ] Open Space
[ ] Tourism [ ] Institutional

3. Proponent Land Use Allocation

Land Use Area Allocation % to Total Land Area
(sq.m./ha)
1. Saleable Area
2. Open Spaces
2.1 park & playgrounds
2.2 community facilities
-multi-purpose center
-chapel
-utilities area
-cooperative store
-parking area
Others (pls. specify)

2.3 circulation system

-major road
-minor road
-Motor court (cul-de-sac)
-alleys
-footpath/pathways
-setbacks
Total

Project Components [attach site development plan/schematic plan duly signed by a

licensed architect/engineer/environmental planner and approved by the LGU as Annex
4]
4.1 Housing

Type of Unit No. of Lot Floor Area Height Max. Max. NO.
Units Area/Unit per Unit (no. of No. of of Toilet &
(sq.m) (sq. m.) floors) Rooms Bath
1. Single
Detached
2. Duplex
Houses
3. Row Houses
4. Multi-Family
Dwelling Units
a. studio type
b. 1 bedroom
c. 2 bedrooms
[attach typical design or housing lay-out as Annex 5]

Will fire exits be provided for multi-family dwelling units?

[ ] Yes [ ] No

HOUSING COMPONENTS CONSTRUCTION MATERIAL TO BE

USED
1. Roofing
2. Walls
3. Windows
4. Partitions/Divisions
5. Toilet and Bath
6. Firewall
7. Flooring
Others, pls. Specify

4.2 Utilities and Infrastructures

4.2.1 Water Supply

Demand

What is the estimated daily water requirement for the entire project during operation?
____________ cu.m.

Water Demand Allocation (cu.m):

Per household connection expressed in liters per person per day (lpcd)
________________
For fire protection, watering of parks and gardens, etc. (specify) ________________

Supply

Is the project going to connect to an existing public water supply system (Level III)?

[ ] Yes [ ] No [if no, proceed to 4.2.1.1]

Area you providing for additional water sources as reserve or for emergency purposes?

[ ] Yes [ ] No

If yes, what will be used as reserve or emergency source of water supply?

[ ] rainwater collected in storage tanks

# of tanks _________ Capacity/tank ___________
[ ] rainwater collected in reservoir
# of reservoirs __________ capacity ___________
[ ] deepwell with manual or hand pump
# of pumps __________
[ ] deepwell with electric or motor pump
rated capacity or HP: _______________
[ ] others, please specify ___________________________________
___________________________________________________

4.2.1.1 If the project is not tapping a public water supply system, what will be the
main source of domestic water supply?

[ ] surface water body (specify whether creek, spring, stream or river)

Water Name of Location Distance from Mode of Volume of

source water site(km) dev’t or extraction
 body distribution (cum/day)
1. Creek
2. Spring
3. Stream
4. River
5. Others

a) impounding dam/reservoir with storage tank and distribution to individual

households by gravity
b) spring box pumped to a reservoir and distributed by gravity
c) others(specify)

[ ] deep well with motor pump and overhead storage tank

No. of wells:__________

Unit Location Depth(m) Discharge(lps)

1. DW #1
2.
3.
4.
5.

No. of overhead storage tank:________ storage capacity/tank (m 3) ______

[ ] deep well with manual/hand pump no. of wells ________

[ ] rainwater collected in storage tanks

# of tanks ______ capacity/tank (cu.m.) ________

[ ] rainwater collected in reservoir

# of reservoirs _______ capacity ________
[ ] others, pls. specify _________________________________________

Water Treatment
Is there provision for water treatment of your independent water source?

[ ] Yes [ ] No

If yes, what type of water treatment? [ ] chlorination [ ] Filtration

[ ] others (specify) ___________________________________________

4.2.2 Drainage System [attachment signed/approved drainage layout plan as Annex 6]

Type of drainage:

a) Major roads: [ ] open canal [ ] closed/underground drainage

b) Other roads: [ ] open canal [ ] closed/underground drainage

Where does the drainage system drain?

[ ] public drainage system [ ] natural outfall/water body

What water body (e.g river, creek or stream) will serve as the outfall of the sewerage
and drainage systems? __________________________________
(name of the water body)

Where is this located? ___________________________________________

(indicate in the topographic map to be attached as Annex 7)

4.2.3 Sewage Disposal System [attach signed/approved sewage design/layout plan as

Annex 8]

Sewage system:

[ ] Individual septic tank [ ] Communal septic tank

Sewage design:

[ ] 2-chamber septic tank w/ leaching

[ ] 3-chamber septic tank w/ leaching
[ ] 3-chamber septic tank w/o leaching
[ ] 4-chamber septic tank w/ leaching
[ ] 4-chamber septic tank w/o leaching
[ ] others, pls. specify ______________________________________

Sewage Disposal :

[ ] disposal to an existing public sewage system

[ ] treated in a community disposal plant or communal septic tank
[ ] treatment in individual septic tank with disposal by absorption field or leaching pit
[ ] Others (specify) __________________________________________

4.2.4 Power Supply [attach signed/approved electrical plan as Annex 9]

Source of power supply:

[ ] Local Electric Cooperation

[ ] Own Generator capacity (HP) _____________
[ ] Others, pls. specify ___________________________
4.2.5 Garbage Disposal System

Collection system:

[ ] Association/project-maintained garbage collection system

[ ] Integrated into the municipal garbage collection system
[ ] Others (specify): _________________________________________

Will there be a waste sorting /segregation system to be employed prior to disposal?

[ ] Yes [ ] No

Disposal system

[ ] Ecological solid waste management (e.g. composting)

[ ] Open dumpsite outside of the project site
[ ] municipal/city landfill area
[ ] others _______________________________________

Location of the Waste Disposal Site: ______________________________

(pls. indicate location in the map)

4.2.6 Operation and Maintenance

What operation and maintenance practices or procedures will be observed?

[ ] regular monitoring of garbage collection and disposal

[ ] maintenance of open spaces, parks and playgrounds through watering, mowing,
trimming, sweeping, etc.
[ ] regular checking and maintenance of water and drainage systems(e.g. tanks,
pump, pipes, etc.)
[ ] others, pls. specify _________________________________________
________________________________________________________

Attach photo of dumpsite/landfill are to be used as disposal site (north side view)
Attach photo of dumpsite/landfill are to be used as disposal site (south side view)

4. Circulation System

4.3.1 Internal Road System

TYPE OF ROAD LENGTH (m/km) WIDTH (m/km) TYPE OF ROAD

SURFACE
1. Major Roads
2. Minor Roads
3. Motor Courts
4. Sidewalks
5. Alleys
6. Footpaths/Pathways
May refer to concrete, asphalt, aggregates, etc.

4.4 Manpower and Employment [provide a listing of manpower requirements as

Annex 10]

How many people will be employed by the project?

During the pre-construction/construction period: ________

During the operation and maintenance period: _________

4.5 Construction Schedule [attach schedule of development activities from pre

construction, construction to the operation phase in a Gantt Chart as Annex 11]
How long will the pre-construction/construction period take? _______

C. DESCRIPTION OF EXISTING ENVIRONMENT

1. Physical Environment
Components/Parameters Y N Remarks
What is the general elevation of the project area? (indicate the area
per elevation range
< 100 masl or estimate the % to
100-300 masl total area)
301-500 masl
501-1,000 masl
1001-1500 masl
>1,500 masl

(To determine elevation, refer to the topographic

map where the elevation per contour line is
indicated)
Slope and topography of the area (indicating the area
per slope category
Terrain is flat or level (0-3% slope)? or estimate the % to
Gently sloping to undulating (3-8% slope)? total area)
Undulating to rolling (8-1830% slope)?
Rolling to moderately steep (18-30% slope)?
Steeply sloping (30-50% slope)?
Very steep to mountainous (>50% slope)?

Are there areas in the site where indications of soil Causes of erosion:
erosion are occurring? If yes, what activities are
causing erosion? [ ] heavy rains
[ ] unstable slopes
 [ ] others, pls.
specify
___________
___________

Do you know of any landsliding occurring or that has Causes of landslide:

occurred in the site?
[ ] earthquake
[ ] unstable slopes
[ ] earthmoving
[ ] others, pls.
specify
___________
___________

Has the area experienced any flooding during the Period(s) of

wet season or typhoons? If yes, when was the last flooding:
time the area was flooded? What caused the ___________
flooding? ___________

Causes of flooding:
[ ] low
area/elevation
[ ] poor drainage
[ ] water logged
area

Soil type of the area: Other soil types:

[ ] sandy soil ___________

[ ] clayey soil ___________
[ ] sandy loam soil
Are there existing water bodies bodies found near or
within the site, e.g. creeks or streams? If yes, please
enumerate them in the opposite space and indicate
their location.

If they have no names, indicate the number of water

bodies. [ these waterbodies should be shown in the
topographic map]
Is there an access road going to the project site? Type of access
If yes, what is its distance to the site ______km road:

Does the site conform to the approved land use plan

of the city/municipality?
Are there existing structures or developments around
the project site? If yes, please list them in the space
below or in the opposite space.

What are the present uses of the water bodies within or near the project site?

[ ] bathing [ ] washing [ ] fishing [ ] source of drinking water

[ ] recreation (e.g. swimming, boating, etc.) [ ] others _____________

What is the present land use of the area?

[ ] Prime Agriculture Land [ ] Orchard

[ ] Grassland [ ] Marshland/Mangrove
[ ] Built-up [ ] Fishpond
[ ] Others, pls. specify ________________________________

Is the land allocation and alignment of the various utilities integrated with the existing
networks and projects outside of the boundaries of the project site?

[ ] Yes [ ] No

2. Biological Environment
Components/Parameters Y N Remarks
Are there existing trees and other types of vegetation
in the site? If yes, please provide examples.
Are there birds and other forms of wildlife found in the
area?
Are there fishery resources in the water bodies found
near or within the site?
Is the site near or within a watershed or forest
reservation area?

If near only, how near? _________ m or km

If within, indicate name of the watershed or forest

reservation area.

If answer is yes to the above answers, please provide examples of these species
(common or local name) in the table provided below.

Birds and Other Wildlife Trees and Other Important Fishery Resources
Vegetation
1.
2.
3.
4.
5.
.
3. Socio-Economical Environment
Components/Parameters Total Number
Are there existing settlements in the
project area? [ ] Yes [ ] No

If yes, how many households or families? __________________

How many are legitimate landowners?
How many are tenants? __________________
How many are squatters?
__________________
__________________

What is the total population of the

barangay(s) covered by the project?
Average family size:
What are their source(s) of livelihood?

Livelihood Type
[ ] farming
[ ] fishing
[ ] backyard poultry and piggery
[ ] vending / buy and sell
[ ] sari-sari store
[ ] others, pls. specify
__________________________________
________________________

How many of the total population have

reached the elementary level?
High school level?
College level?

Are there other existing local organizations in the area? [ ] Yes [ ] No

If yes, please list down these organized groups e.g. associations, cooperatives, etc.
below:

1. __________________________________________________________
2. __________________________________________________________
3. __________________________________________________________
4. __________________________________________________________
5. __________________________________________________________
6. __________________________________________________________
Are there existing social infrastructure in the barangay? [ ] yes [ ] No

If yes, please list down these organized groups e.g. association, cooperatives, etc.
below:

1. ____________________________________________________
2. ____________________________________________________
3. ____________________________________________________
4. ____________________________________________________
5. ____________________________________________________
6. ____________________________________________________

Are there existing social infrastructures in the barangay? [ ] Yes [ ] No

If yes, what are these social infrastructures? (pls. Check)

[ ] schools [ ] communication (e.g.radio, TV, mail, Newspaper)

[ ] health centers/clinics [ ] churches/chapel
[ ] hospitals [ ] roads
[ ] transportation [ ] others, _________________________

Project Activities affecting Y N Impact Description Mitigation/Enhancemen

the Physical Environment t Measures
9. Are you constructing an
access road going to the
site? If yes, what type of
access road:

[ ] all-weather road
[ ] concrete
[ ] asphalt

length (m) ________

width (m) ________

Project Activities affecting Y N Impact Description Mitigation/Enhancemen

the Biological Environment t Measures
1. Will there be vegetation
clearing?
2. will trees be affected (e.g.
cut down the clearing? If yes,
how many and what are
these species of trees?
# of trees: _______
species of trees:

_________________
_________________
_________________
_________________

3. will clearing activities

affect any critical wildlife
habitats?

4. Will clearing activities

affect any rare, threatened or
endangered plant and animal
species?
5. Will landscaping be
undertaken in the open
spaces?

6. Will trees and ornamentals

be planted in the site?

Total no. of trees to be

planted : _________
Ave. height of trees to be
planted (m) : ________

Project Activities Affecting Y N Impact Description Mitigation/enhancemen

the Socio-Cultural an t Measures
Economical Environment
1. will there be settlements to
be affected? If yes, how
many households will be
affected?

Total no. of families/HHs:

__________________

How will they be handled?

[ ] payment of property
owners
[ ] temporary relocation site
to be provided
[ ] permanent relocation site
to be established
[ ] eviction without
compensation
[ ] others, pls specify
___________________
___________________
___________________

2. Will there be locals to be

hired during the
construction?
3. Are there existing public
trails or routes (regularly
used) that traverse the
property?

4. Will the public or local

community still have access
to the property in terms of
passing through or entering it
to reach their house or
residence?

5. Will there be an increase

in economic activity in the
area or a rise in associated
projects?
6. Will the project cause an
increase in traffic or disrupt
traffic in major routes due t
the entry and exit of
construction equipment?
7. Are there prevailing peace
and problems in the site
which can affect the project?
OPERATION AND MAINTENANCE PERIOD
Project Activities Affecting Y N Impact Description Mitigation/Enhancemen
the Physical Environment t Measures
1. Will there be an increase
in solid waste and sewage
generation?
2. Will there be an increase
in water demand?
3. Will there be an improved
drainage and water supply
system?
4. Will there be an increase
in surface run-off from the
concreting of roads and soil
surfaces?
5. Will there be reduced
infiltration rate due to
impermeable structures over
the ground?
6. Will the landscape be
improved?
7. Is the available domestic
water supply enough to meet
the maximum projected
water consumption of the
project?
Others, pls. Specify

Project Components Y N Impact Description Mitigation/Enhancemen

Affecting the Socio-Cultural t Measures
and Economic Environment
1. Will the sewage outfall and
drainage system drain into
the nearby or adjacent
surface water body?
2. Will the waste disposal
site be adequate to meet the
projected solid wastes in the
area?
Others, pls. Specify

Project components Affecting Y N Impact Description Mitigation/Enhancemen

the Socio-Cultural and t Measures
Economical Environment
1. will the project be better
than the regular types of
socialized housing projects in
terms of the type of
facilities/amenities offered
and housing
design/structures?
2. Will the project provide
reasonable payment terms?
3. Will the project cause or
increase traffic in the area?
4. Is the project located near
populated or settlement
areas and commercial
centers (within 15 kms)?
5. Will the project create a
significant increase in the
existing population of the
area?
6. Are there existing
transport services/facilities
routing the area?
7. will the prevailing land
value in the area increase
with the project?
8. Is there a prevailing water
shortage or water supply
problem in the area?
9. Are there already existing
comm’l establishments within
the vicinity of the project
area?
10. Is there a provision for
the proper transfer of
responsibilities for the
operation and maintenance
of the common service
facilities?
Others, pls. Specify

PROPONENT’S COMMITMENTS
I commit myself to observe the following:
Comply with existing environmental rules and regulation, guidelines and criteria?
Comply with all mitigation and enhancement measures that have been identified in the
report?
Participate or support any multi-partite monitoring efforts to be organized?
Abide and conform with the prescribed rules and standards for community housing
projects as contained in BP 220?
Construct, operate and maintain well-designed sewage and drainage facilities?
Observe proper waste management practices by providing adequate garbage
receptacles in strategic points within the housing facility and by observing regular
garbage collection and disposal in an approved disposal site?
Established adequate open spaces within the housing area through the provision of a
common park and playground with tree-lined roads and pathways?
Maintain the cleanliness of the general surroundings?
Organize and conduct information, education and communication (IEC) activities on the
environmental merits of properly designed and constructed community housing
projects?
Properly brief or orient the project Administrator about the ECC conditions,
commitments and agreements made about the project?
Support continuing government efforts to promote environmentally sound community
housing projects?
Undertake proper and appropriate transfer of responsibilities of the operation and
maintenance of common service facilities to the Homeowners Association?
Others, pls. specify

A. ATTACHMENTS/ANNEXES

1. Documentation Requirements (attach photocopies of documents)

Title or Description Put a check ( \/ )mark
1. Location Map
2. Vicinity Map
3. Photocopy of TCT/OCT/CLT, etc.
4. Site Development Map (1:10,000)
5. Design or Housing Lay-out by the
Engineer (signed & sealed)
6. Drainage Lay-out by the Engineer
(signed & sealed)
7. sewage Design/Lay-Out Plan (signed &
sealed)
8. water Distribution Line/Plan (signed &
sealed)
9.List of Manpower Requirements during
Construction Period (estimate)
10. Schedule of Development Activities
per Component
DAR Conversion Clearance or Exemption
Certificate
Locational Viability
Topographic Map (1:25,000)
NWRB Application
Endorsement of the Barangay or Municipal
or city Council

ACCOUNTABILITY STATEMENT

This is to certify that all the information and commitments in this Initial Environmental
Examination (IEE) Report are accurate and complete. Should we learn of any information which
would make this IEE inaccurate, I/we shall bring said information to the attention of the
appropriate EMB DENR Regional Office.
 We hereby bind ourselves jointly and solidarily to any penalty that may by imposed
arising from any misrepresentation of failure to state material information in this IEE report.

In witness whereof, we hereby set our hands this ______ day of ________ at
_________________

_________________________
Project Proponent

_________________________
Title or designation

ACKNOWLEDGMENT

BEFORE ME this (day) ______________of

________________2000__________________at (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 __________________