TOURISM PROJECT

Initial Environmental Examination (IEE) Report

For
___________________________________________
(Project Name or Title)

PROJECT LOCATION:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
(Complete Address: Street, Barangay, Municipality/City, Province)

NAME OF PROPONENT:
_________________________________________________________
ADDRESS:
___________________________________________________________________
(Complete Address: Street, Barangay, Municipality/City, Province)

Telephone:
____________________________________________________________________
Fax:_____________________________ e-
mail:_______________________________________

A. GENERAL CONDITION

1. Project ownership:

[ ] Single Proprietorship [ ] Corporation [ ] Partnership

(attach document as Annex 1)

2. Capitalization & Project Cost

Capitalization [ ] Date Started [ ] Project Cost [ ]

Mode of financing:

[ ] in house [ ] bank [ ] others _________

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 3. List of owners (for partnership/corporation, list top 5 partners/shareholders with
largest holdings)
Name/ Citizenship Address % share/
Position holdings

4. Other related businesses (List down similar projects undertaken/handled by

proponent, both local & international)
Project Name Date Project Description Involvement/Experiences
(inclusive)

B. PROJECT DESCRIPTION

1. Land (attach photocopies of documents in the space provided)

Total Land Area (square meters) [ ]

Land Area to be developed (sq. m.) [ ]
Period of Possession (years) [ ]

Basis for land possession

(pls check appropriate box)

[ ] ownership of the land by virtue of OCT or TCT # _______________________

attach photocopy of document as Annex 2a

[ ] stewardship of land by virtue of _____________________________________

attach photocopy of document as Annex 2b

[ ] lease of the land by virtue of _______________________________________

attach photocopy of document as Annex 2c

[ ] pending application for ___________________________________________

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 attach photocopy of document as Annex 2d

[ ] Others, pls specify ______________________________________________

Attach photocopy of document as Annex 2e

2. Project Component (List of facilities covered by the project – attached

sketched/photos/plans)
Ref Component Name No. of Area Capacity Max. cap. (No.
# unit (sq. m.) (No. of pax) of pax)
1 Rooms, single
2 Rooms, double
3 Rooms, twin
4 Public washrooms/toilets
5 Conference Room
6 Convention Hall
7 Food and Beverage outlets
8 Lobby/Receiving area
9 Swimming Pools
10 Others, pls. specify
11
12
13
14
15
16

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 Attach sketch plan/s of project site

Attach photo, front view of project site

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 Attach photo, left side view of project site

Attach photo, right view of project site

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 Attach photo, back/rear view of project site

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

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 Attach photo, component (Ref #1)

Attach photo, component (Ref #2)

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 Attach photo, component (Ref #3)

Attach photo, component (Ref #4)

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 Attach photo, component (Ref #5)

Attach photo, component (Ref #6)

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 Attach photo, component (Ref #7)

Attach photo, component (Ref #8)

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 Attach photo, component (Ref #9)

Attach photo, component (Ref #10)

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 Attach photo, component (Ref #11)

3.a Water Utilities (attach photographs/layout)

No. of units Source/Methods Capacity (cu.
Meter)/Depth (m)
Rainwater, collection in storage tank
Rainwater, collected in
reservoir/impounding structure
(indicating capacity)
Groundwater, open dug well (indicate
depth)
Groundwater, dug well close with
manual pump (indicate depth)
Groundwater, dug well close with
motor pump (indicate depth/HP)
Groundwater, drilled well with manual
pump (indicate depth)
Groundwater, drilled with motor pump
(indicate depth/HP)
Natural Spring
Surface Water
Local Water District
Others, pls. Specify

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 Total volume of water extracted/utilized per day (maximum)

3.b. Power Utilities (attach photographs/layout)

No. of units Source/Methods Remarks
Generator for electricity (indicate
HP/number of hours of operation or use)
Local Electric Utility (indicate monthly
consumption – Kw-Hr, maximum)
Kerosene/Gas (maximum monthly
consumption in liters)
LPG (maximum monthly consumption)
Others, pls. Specify

Attach photo (panoramic), water utilities: source (e.g., dug well, spring,
etc.)

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 Attach photo (panoramic), water utilities: storage (e.g., dug well, spring,
etc.)

Attach photo (panoramic), water utilities: generator (while operating)

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 Attach sketch of lay-out: generator and nearby structures

4. Waste Management

Liquid waste treatment (check appropriate box):

[ ] Septic tank:
Capacity: _______________________ cu.m
Type: ______________________________

Describe operation (example: maintenance, de-sludging, etc.)

[ ] Pond:
Capacity: _______________________ cu.m.
Type : ______________________________

[ ] others, pls. specify

Capacity: _________________________cu.m.

[ ]
Capacity: _________________________ cu.m.

Solid waste treatment (check appropriate box):

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 [ ] Collection by LGU Sanitation Unit
Volume per collection : ______________ cu.m.
Frequency of burning: ________/ week

[ ] Burning
Volume per burning: ________________ cu.m.
Frequency of burning: ________/ week

[ ] Composting
Volume of composting: ______________ cu.m.
Frequency of composting: ________/ week

[ ] Burial
Volume per burial: __________________ cu.m.
Frequency of burial: __________/ week

[ ] others, pls. specify

Volume per cycle: _________/ week
Frequency of cycle: __________/ week

[ ]
Volume per cycle: _________/ week
Frequency of cycle: __________/ week

Attach photo of entire liquid waste facility (example: septic tank)

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 Attach photo, close up, of liquid waste facility main component (example:
close up view of main chamber of septic tank)

Attach drawing/plan of waste water treatment facilities (w/ dimensions and

descriptions)

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 Attach photo of solid waste facility method 1 (ex. Composting pit)

Attach photo of solid waste facility method 2 (ex. Burial or burning)

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B. DESCRIPTION OF ENVIRONMENTAL SETTINGS

1. Physical Environment (attach photos/drawings/maps)

Components/ Parameters Answer
Y N
Is the terrain flat or level? ( 0 – 3 % slope)
Is the terrain level to undulating? ( 3 – 8 % slope)
Is the terrain undulating? (8 – 18 % slope)
Is the terrain rolling? (8 – 18 % slope)
Is the terrain moderately steep? (18 – 30 % slope)
Is the terrain very steeply mountainous? (above 50 % slope)
Is the site near or with a forest reserve or a protected watershed
area? If yes, how near? _________meters
Does the site have limestone caverns or sinkholes in the bedrock?
Will there be berthing or pier structure along the shoreline/tidal
zone that are prone to storm/monsoonal tidal surges?
Is the area erosion prone? If so, what is the status: slight,
moderate or severe?
Are there existing natural hazards in the area, e.g., landslides,
gullying, subsidence? If yes, enumerate them
1 5
2 6
3 7
4 8
Are there natural drainageways/creeks within the area draining
towards communities downstream?
Is the site within a recharge area of springs downstream?
Is the site situated along a flood prone/storm surge area?
Are you beside or near the shoreline? If yes, how far?
_________meters
Are there water bodies found inside or near the project site? If yes,
please enumerate them.
1 6
2 7
3 8
4 9
5 10

Hpw deep is the water table during the dry season? (meters)
Hpw deep is the water table during the wet season? (meters)
What is the quality of water?
[ ] Fresh

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[ ] Brackish
[ ] Saline/Salty

Attach photo of area topography

(get the view/perspective to show contours or area with slope)

Attach photo of soil profile – level area

(dig to a depth of 1 meter, take close-up photo to show details of the
soil/ground)

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 Attach photo of soil profile – hilly area
(dig to a depth of 1 meter deep or into a steep portion, take close-up photo
to show details of the soil/ground)

Attach photo of water body # 1 (example, lake, creek, gully, river, etc.)

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 Attach photo of water body # 2 (example, lake, creek, gully, river, etc.)

Attach photo of water body # 3 (example, lake, creek, gully, river, etc.)

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2. Ecosystem Description (attached photos/drawings/maps whenever appropriate)

Are you immediately adjacent to a natural Yes No

ecosystem?
If yes, please check on the appropriate box/es:

[ ] Forest [ ] Grassland
[ ] Coastal/Marine [ ] Mangrove
[ ] Marshland [ ] Wetland
[ ] others, pls. specify [ ] others, pls. specify

Had you observe any wildlife in the area? Yes No

If yes and you can identify them, please enumerate:
1 6
2 7
3 8
4 9
5 10

Are there trees within the project site? Yes No

If yes, please identify and enumerate:
1 6
2 7
3 8
4 9
5 10

Are there other vegetation within the project site? Yes No

If yes, please identify and enumerate:
1 6
2 7
3 8
4 9
5 10

3. Socio-Economical Environment

3a. existing Settlement within the project site

Category/Description Number What has happened to them?
(effects of project on them)
Total households affected

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 Previous land owners
Tenants
Settlers
Others, pls. specify

3b. Profile of staff employed in the project/establishment

Age/Gend Male Female Did you employ How many?

er indigenous people?
<15 Aetas
16-20 Others, pls. Specify
21-25 How about vulnerable
groups?
25-30 Elderly
31-35 Children
36-45 Handicapped
>45 Others, pls. Specify

How many of the staff are native (Boracay) residents? [ ]

How many of the staff are transient (non-Boracay) residents? [ ]

Salary Profile Male Female Educational Male Female

(PHP/month) Attainment
< 2,000
2,001 – 3,000
3,001 – 4,000
4,001 – 5,000
5,001 – 6,000
7,001 –
10,000
> 10,000

Are there health facilities (clinic, etc.) within the project site?
Are the required benefits under the Labor Code and other regulations enjoyed by the
staff?
If yes, please enumerate them:

Are the local inhabitants(especially indigenous people) ___Yes ___ No

Benefited by the project? Pls. elaborate.

Are the cultural norms/morals and lifestyle of the local ___Yes ___ No
Inhabitants (especially indigenous people) affected by the project? Pls. Elaborate.

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D. PROJECT IMPACTS
1. Pre-Construction/Construction Details
Components/ Answer (Describe the Describe your
Parameters Yes No impacts) mitigative/enhance
ment measures
Was there land clearing?
Was there vegetation
clearing? Please provide
details.
Was there tree cutting?
Please provide details.
Was there topsoil
removal & replacement?
Was there excavation
works and cut & fill
activities?
Was there other
earthmoving activities?
Was there stockpiling of
sand/gravel materials in
the project area?
Was there drilling boring,
& hammering activities?
Was there any slope
modification or ground
leveling?
Was there increased
traffic (vehicle) movement
in the area?
Was public/community
access to/through the
area affected?
Was public/community
access to the area’s
resources affected?
Was there increased
economic activity in the
area?
Was there increased
availability of
employment?
Was there a rise in

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 associated project
activities?
Was there displacement
of people in the area?
Did the displacement
involve relocation of
affected parties?
Did the project affect or
encroach on ancestral
domain?
Were indigenous or local
people affected?
Were the women and
other vulnerable groups
affected?
Others, pls. Specify

1. Operation and Maintenance Phase

Components/ Answer (Describe the Describe your
Parameters Yes No impacts) mitigative/enhancem
ent measures
Was there and increase in
solid waste generation?
Was there an increase in
waste water generation?
Was there an increase in
water demand
Was there an increase in
surface run-off to other
areas?
Was there a reduced
infiltration rate due to
impermeable structures over
the ground?
Was there improved
landscaping?
Were chemicals (ex.,
pesticides, etc.) introduced in
to the environment?
Were hazardous waste (spent
batteries, expired drugs, etc.)
introduced into the

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 environment?
Was there increased human
movement in the area?
Was there increased traffic
(vehicle) movement in the
area?
Was public/community
access to/through the area
affected?
Was there increased
economic activity in the area?
Was there an increase in
economic opportunities?
Was there increased
availability of employment?
Was there increased
employment of
indigenous/local people?
Was there increased
employment of women?
Was there an increased in
population from migration?
Was there a rise in
associated project activities?
Was there an increase in land
value?
Was there a change in moral
standards of residents in the
area?
Was there an increase in
noise level in the area?
Was there any compliant
about noise from neighbors?
Was there an increase in
crime or security problems in
the area?
Others, pls. Specify

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 1. Abandonment and Rehabilitation Phase
Components/ Answer (Describe the Describe your
Parameters Yes No impacts) mitigative/enhancem
ent measures
Will any of the facilities be
abandoned or demolished at
the end of the project life?
Will any of the facilities need
to be rehabilitated after a
certain period of time?
Will any sanitary or waste
facilities need to be
rehabilitated?
Others, pls. Specify

4. Operation Details

Occupancy Inclusive Expected Visitors

Data Period Stay-in Transient
Peak season
Lean season
Average
(annual)
Remarks

Description of wastes generated (per day basis)

Types of Wastes Solid or Amount How do you dispose of or treat

Liquid? Generated them

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 Chemicals used Active Ingredients Frequency Amt. Used Handling and
(or commercial (per month) (per month) Disposal
name/brand) Measures
Housekeeping
chemicals
(Laundry/Detergents
)

Housekeeping
chemicals
(Disenfectant,
example: chlorox,
lysol, etc.)

Housekeeping
chemicals
(Pesticides, example
termite control, etc.
OR rodenticides)

Housekeeping
chemicals
(Insecticides)

Gardening
chemicals
(Fertilizers)

Gardening
chemicals
(Herbicides)

Gardening
chemicals
(Pesticides)

Swimming/Bathing
facilities chemicals
(Cleaning agents)

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 Swimming/Bathing
facilities chemicals
(Disinfections)

Chemicals used Active Ingredients Frequency (per Amt. Used Handling

(or commercial name/brand) month) (per month) and
Disposal
Measures
Clinics/First Aid
(medicines)

Clinics/First Aid
(expired drugs)

Clinics/First Aid
(other consumables)

E. SUPPLEMENTARY INFORMATION

1. Provision of External Services: Were outside experts/consultants hired to do any

of the following?
Category Name of Firm/Person Scope of Work Remarks
Feasibility Study

Resort Design/Layout

Solid Waste Facilities

Wastewater Facilities

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 Others, pls. Specify

2. Proponent’s Commitments
Are you committing yourself to ……. Answer How much
Yes No per year?
Comply with existing environmental rules and
regulations, guidelines and criteria?
Participate or support multi-partite monitoring efforts?
Abide and conform with the Boracay Master Plan?
Construct, maintain and properly operate an adequate
and appropriate septic tank for your liquid wastes?
Contribute towards the operation and maintenance of a
municipal sewerage facilities for your solid wastes?
Construct, maintain and properly operate an adequate
and appropriate treatment facilities for your solid
wastes?
Contribute towards the operation and maintenance of a
municipal solid waste management/disposal facility?
Maintain the cleanliness of your general surroundings?
Participate or contribute towards a communal beach
cleaning effort?
Extend social benefits to the community?
Formulate and participate in a communal coral reef
protection effort?
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
Boracay as an environmental-friendly tourism area?
Contribute (on cost-sharing basis) in government

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 undertakings on Boracay issues (e.g., workshop,
training, etc.)?
Others, pls. Specify

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

required to: organize a Multipartite Monitoring Team (MMT) and 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? ______ yes _____ no

b. B. establish an EMF/EGF? ______ yes _____ no

If yes, what is your proposed annual contribution? PHP ____________ year

F. ATTACHMENTS

1. Government Permits and Clearances (attach photocopies of documents)

Permits/Clearances Attached? Permits/Clearances Attached?
Bathing Lease/Permit DTI accreditation
(registration of name)
Municipal/city Business Locational Clearance
Permit
Forest Land/Special Permit Safety (Fire) Permit
Sanitation Permit Water Permit
VAT Registration Foreshore Lease
Permit
Tax Identification Number Others, pls. specify
(TIN)
DOT accreditation

2. IEE Attachments (final reminders)

Description Attached? Description Attached?
Ownership Project Vicinity
documents(SEC/DTI) – Annex Map/Sketch
1
Land ownership document/s Photo/Sketches, project
(OCT/TCT) – Annex 2a, b, c, d facilities perspectives

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 or e
Photographs, project site
(different perspectives)
Technical Plan/Drawing Water
System
Technical Plan/Drawing Sewer
System
Technical Plan/Drawing Solid
Waste System
Photo/Drawing/Maps,
Biological Environment
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Project Lay-out Plan
Technical Plan/Drawing
Power System
Photographs, unique
project site features
Photo/Drawing/Maps,
Ecosystems
Photos/sketches/maps,
Existing settlements
Others, pls. Specify
 ACCOUNTABILITY STATEMENT

This is to certify that all the information and commitments in this Initial
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 & Protected Areas Sector
(EMPAS) of DENR (Region VI) Regional Office.

I/we hereby bind myself/ourselves jointly and solidarily for any penalties that may
be imposed arising from any misrepresentations or failure to state material information
in the IEE.

_______________________
_____________________________________
(Date) (Project Proponent/Signature or printed
name)

_______________________
(Title/Designation)

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 ACKNOWLEDGEMENT

BEFORE ME this ____ day of ____________, 20 ____ at (place)

________________________, personally appeared
(Name)________________________________ with Community Tax Certificate No.
_________________ issued on ________________ at
__________________________, in his/her capacity as (position)
____________________________________ at
________________________________, in his/her capacity as (position)
________________________________ of (name of establishment)
__________________________________________________________________ and
acknowledged to me that this voluntary act and deed of the entity he/she represents.
This document, which consists of ____________ pages, including the page on which
this acknowledgement is written, is an Initial Environmental Examination Report
Checklist.

Witness my hand and seal on the place and date above written.

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