REPUBLICOFTHEPHILIPPINES

DEPARTMENTOFEDUCATION
EducationFacilitiesDivision
DepEdComplex,MeralcoAvenue,PasigCity

SITEAPPRAISALFORM
School:Balugo Primary School SchoolID: 121237

Address: Balugo. Capoocan Leyte NameofPrincipal: Rona Q. Suganob

No. Street Baranggay City/Municipality Province

Division: Leyte
Region: VIII

I. SITEINFORMATION

SiteOwnership: Titledunderthenameof ContractofUsufruct DeedofDonation TaxDeclaration

DepED Private/Others Withconditions Absolute DepED

LGU PerpectualUse WithCondition LGU

DeedofSale PresidentialProclamation Others/specify:

Location:
Urban Lowland Island Coastal Others/specify:

Rural Highland/Upland w/about kmboatridefromthemainland

Distancetonearestpublicschool: (m/km) Distancetonearestprivateschool: (m/km)

Nameofnearestpublicschool: Nameofnearestprivateschool:

w/ cut & fill works (

Topography: Level/Flat Sloping Rolling
Others/specify:
m)/needssiteimprovement

FloodLevel: (m) OftenutilizedasEvacuationCenterduringDisaster/Emergencies Yes No

SoilCondition:
Rocky Sandy Clayey Others/specify:

PowerSupply:
NPC Line Cooper Gener Others/
ative ator

WaterSupply:
Potable(drinking) Local Water Spring
Others/specify:
DistrictDistance from Tapping Point: (m)
NotPotable
Deepwell Shallowwell

Depth: (m) Depth: (m)

Access:
Cemented km. Asphalt km. Gravelbed km. Rough km

Hiking km.
Others/specify: Byboat km.

MaterialSource:Distancefromtheschoolsite:

II. SITEDEVELOPMENTPLAN Totallotarea: (sqmtr./hectare) Proposedtotalbuildablespaceforconstruction: sq/mtr.

III. FEASIBILITY
A. SCHOOLBUILDING

Condition
No.of
Type ofBuilding ForR Remarks
Units Good NeedsReplacement
epair
AcademicClassrooms 2
ScienceLaboratory 0 * Indicatejustificationonthefollowingco
0 nditions:
Home Economics
IndustrialArts 0 - needsreplacement
Kindergarten 0 - fordemolition
MakeshiftClassrooms 2 - forcondemnation
Total: 4 - heritageschoolbuildingford
AnxiliaryRooms emolition/condemnation
AdminOffices 1
Library 0
Canteen 0
Others 0
Total: 1
WASHFacilities
AttachedToilets
Urinals 0
Toilet 1
ToiletforPWD 0
DetachedToilets
Urinals 0
Toilet 1
HandwashingFacilities 1
Total: 3

B. AVAILABLESPACEFORCONSTRUCTION
(For thissection,location/softhe available space forconstruction(ifany)should be reflected in the Site DevelopmentPlan)

Buildingfootprintcanbeaccomodatedintheav
Remarks(AdditionalSiteIn
ailablespace?*
No.ofUnits(B formatione.g.
Type of Building
uilding) Yes,butwithd
Embankment,SlopeProt
Yes
Yes,butwithd
esignmodifica No ection,Haulingetc.)
emolition
tion
1. Gonzales Type
2. DPWH-BOD School Building

* Ifthe site willrequire demolition ofan old or condemnable structure,specify in the remarks column the type and number ofbuildings and classrooms to be demolished.Ifthe site willrequire some modifications inthe
design,specify in the remarks columns the particular modifications to be made in the design of the building.

C. SCHOOLPROFILE
StudentPopulation: 75 No.ofClasses: 4

ELEMENTARY Kinder I II III IV V VI Total

No. of Enrollment 13 9 9 12 13 11 8 75

No.of Sections 1 1 1 1 1 1 1 7

SECONDARY Y1 Y2 Y3 Y4 Total
NoofEnrollment

No.ofSections

SENIORHIGH Y1 Y2 Total
NoofEnrollment

No.ofSections

AdditionalRemarks(ifany):

Appraisedby: Noted:

RAMON DE VEYRA RONA Q. SUGANOB

DepEdEngineer SchoolHead/Principal/Teacher-in-charge DateofInspection