Department of Environment and Natural Resources

Environmental Management Bureau

Reference No:

(to be filled up by DENR only)

GENERAL INFORMATION SHEET

Name of the
Establishment/Facility
TERUMO (PHILIPPINES) CORPORATION

Establishment/Facility Street # & Street Name: 124 East main ave., Laguna Technopark
Address Barangay: Loma City/Municipality: Binan
(NOT the company of head
office) Province: Laguna
Name of
Owner/Company
TERUMO (PHILIPPINES) CORPOARATION

Street # & Street Name: 124 East main ave., Laguna Technopark
Address
(if address is not the same as Barangay: Loma City/Municipality: Binan
previous address)
Province: Laguna

Phone Number (049) 554 9230 Fax Number (049) 541 2121

e-mail address Ghia_Andal@terumo.co.jp

Philippine Standard Industry Classification Code No. 2013

Type of Business/
Philippine Standard Industry Descriptor: Plastic Manufacturing
Industry Classification
___

CEO/President. Keiichi Amatatsu

Tel #: (049) 554 9230 Fax #: (049) 541 2121
e-mail address: Keiichi_Amatatsu@terumo.co.jp
Responsible Officer/s:
Plant Manager: Faith L. bautista ___
Tel #: (049) 554 9230 Fax #: (049) 541 2121
e-mail address: Faith_Bautista@terumo.co.jp ___

Name. Ghia_Andal@terumo.co.jp ___

Pollution Control Tel #: (049) 554 9230 Fax #: (049) 541 2121
Officer
e-mail address: Ghia_Andal@terumo.co.jp

 single proprietorship  partnership

Legal Classification ̷ private domestic corporation  government corporation
 Multi-national  ___

We hereby certify that the above information are true and correct.

Analea de Guzman ______ Ryan Reyes __

Name/Signature of CEO/President Name/Signature of PCO
Name of Plant:
Reference No:

Department of Environment and Natural Resources

Environmental Management Bureau

QUARTERLY SELF-MONITORING REPORT

MODULE 1: GENERAL INFORMATION

Name of the Plant MC & JOLLI FOODS
Please provide the necessary revised, corrected or updated information not contained in your General
Information Sheet

(use additional sheet/s if necessary)

DENR Permits/Licenses/Clearances
Environmental
Permits Date of Issue Expiry Date
Laws
A/C No. n/a n/a n/a
P.D. 984
PO No. n/a n/a n/a
ECC 1

PD 1586 ECC 2

ECC 3
DENR
Registry ID OL-GR-R4A 34000113 Aug. 17, 2020 n/a
CCO Registry CCOr-R4A-CN-2020-00036 Feb.12, 2020 n/a
RA 6969 Importer
Clearance No SQI-R4A-2023-032250 Dec.18, 2023 Dec. 18, 2024
Permit to
Transport OLL-PTT-R4A-21-108202 Dec.29, 2023 Jun. 29, 2024
A/C No. n/a n/a n/a
RA 8749
PO No. PTO-OL-R4A-2023-05422-R Jun. 05, 2023 Jun. 05, 2028

Module 1: General Information page ____ of ____

Name of Plant:
Reference No:

Operation
Operating hours/day Operating days/week # of shift/day
Average 24 6 2
Maximum 24 7 2

Operation/Production/Capacity:
Average Daily
Production Output
167,852 pcs Total Output this Quarter 15,442,400 pcs
Total Water Consumption Total Electric
this Quarter (cubic 67,919 cu.m Consumption this Quarter 9,305,995 kwH
meters) (KwH)
Please use additional sheet/s if necessary

Module 1: General Information page ____ of ____

Name of Plant:
Reference No:

MODULE 2: RA 6969

A. CCO Report (please accomplish this section for each chemical/substance)

Common Name/IUPAC/CAS Index Name. 2-Methoxyethyl, 2- Cyanoacrylate (27816-23-5

CAS No.: 27816-23-5 ___
Trade Name: Loctite 408 Instant Adhesive ___

For importers only:

Import
Quantity Date of Quantity Country of Country of
Clearance Port of Entry
Requested Arrival Received* Origin Manufacture
No.
n/a n/a n/a n/a n/a n/a n/a

Total Quantity Requested Total Quantity Received

n/a n/a
(annual) (annual)
* attach copy/s of Bill of Lading

For distributors (importers/non-importers)

Name of Client License No. Quantity Date of Distribution
n/a n/a n/a n/a

Total Quantity Distributed

For non-importer users:

Name of Distributor Quantity Date of Purchase
n/a n/a n/a

Total Quantity Purchased from Distributor

Module 2B: RA 6969 (Hazardous Wastes Generator) page ____ of ____

Name of Plant:
Reference No:

For producers
Average Daily
n/a Total Output this Quarter n/a
Production Output
Quantity of Stock n/a Quantity of Stock n/a
Inventory (Start of Inventory (End of
Quarter) Quarter)
Name of Buyer Quantity Date of Purchase
n/a n/a n/a

Total Quantity Sold

Used in Production (please fill up only if chemical/substance is not main product)

Average Daily
Total Output this Quarter
Production Output
Average Quantity Used Total Quantity Used this
per month Quarter
Describe any changes in Production/Process/Operations:

Stock Inventory/Waste Chemical Generated:

Average Quantity of n/a Total Quantity of Waste n/a
Waste Chemical Chemical Generated this
Generated per month Quarter
Quantity of Stock n/a Quantity of Stock n/a
Inventory (Start of Inventory (End of
Quarter) Quarter)
Other Information:

Manner of handling √ storage on-site  Treatment on-site

hazardous wastes
 storage off-site  Treatment off-site

 Yes (please attach copy of revised plan)

Changes in Safety
Management System √ No
 Yes (please attach copy if not submitted/included in previous report/s or had been revised)
Chemical Substitute
Plan √ No

Module 2B: RA 6969 (Hazardous Wastes Generator) page ____ of ____

Name of Plant:
Reference No:

B. Hazardous Wastes Generator

HW Generation:
Remaining HW from
HW HW Generated
HW No. HW Class HW Nature Previous Report
Cataloguing
Quantity Unit Quantity Unit
D407 Mercury Solid T 0.0736 MT 0.0370 MT
&
Mercury
Compound

Waste Storage, Treatment and Disposal:(Please fill-up one table per HW)
HW No,: D407 ___
HW Details Qty of HW Treated: 0.0260 Unit: MT___
TSD Location: Silang Cavite

Name: Terumo hazardous Waste Storage Area

Storage
Method: Carton Box, Strecth Film
___

ID: OL-TP-R4A-21-000066 Name: Cleanway Environmental Mgt.

Transporter
Date: 09/21/2024

ID: OL-TR-R4A-21-000048 Name: CEMSI

Treater
Method: Bulb Eater / Encapsulation Date: 11/17/2024

ID: n/a Name: CEMSI

Disposal
Date: 02/05/2024

On-Site Self Inspection of Storage Area:

Corrective Action Taken
Date Conducted Premises/Area Inspected Findings & Observations
(if any)
October 2023 Hazardous Waste Storage none none

Module 2B: RA 6969 (Hazardous Wastes Generator) page ____ of ____

Name of Plant:
Reference No:

C. Hazardous Wastes Treater/Recycler

HW Stored and/or Untreated as of End of Quarter:

Type of
Transport Storage Time Table
Wastes Date of
HW Number Permit/Date Valid until Quantity Container/ for
Generator Transport
of Issue # of Treatment
containers
n/a n/a n/a n/a n/a n/a n/a n/a

HW Treated and/or Recycled as of End of Quarter:

Type &
Type of
Transport Quantity of
Type of Wastes Date of Treatment or
HW Number Permit/Date Quantity Recycled or
Wastes Generator Transport Recycling
of Issue Treated
Process
Product
n/a n/a n/a n/a n/a n/a n/a n/a

Residual Wastes Generated from the Treatment and/or Recycling Operation:

Process by Type of
Type of which the Storage Disposal Time Table for
HW Number Quantity
Wastes Wastes is Container/ Option Disposal
Generated # of containers
n/a n/a n/a n/a n/a n/a n/a

Module 2C: RA 6969 (Hazardous Wastes Treater/Recycler) page ____ of ____

Name of Plant:
Reference No:

MODULE 3: P.D. 984 (Water Pollution)

Water Pollution Data

Domestic wastewater Process wastewater
(cubic meters/day)
147.65 (cubic meters/day)
22.15
Cooling water Others: ___________
(cubic meters/day)
391.27
(cubic meters/day)
n/a
Wash water, equipment Wash water, floor
(m3/day)
73.83
(cubic meters/day)
103

Record of Cost of Treatment (Separate entries for separate facilities)

Month 1 Month 2 Month 3
Person employed, (# of
employees)
Person employed, (cost)
Cost of Chemicals used
by WTP
Utility Costs of WTP
(electricity & water)
Administrative and
100,577.75 96,626.30 127,051
Overhead Costs
Cost of operating in-
house laboratory

New/Additional
Investments in WTP
(Description)

Cost of New/Add
Investments

WTP Discharge Location

Outlet
Location of the Outlet Name of Receiving Water Body
Number
1 Terumo Septic Vault Main Outlet Pipe Laguna Water Waste Treatment Plant
2
3
4
5

Module 3: P.D. 984 (Water Pollution) page ____ of ____

Name of Plant:
Reference No:

Detailed Report of Wastewater Characteristics for Conventional Pollutants

Outlet No.

Effluent Oil & ________

BOD TSS Temp rise (name)
DATE Flow Rate Color pH Grease
(mg/L) (mg/L) (ºC)
(m3/day) (mg/L) (unit)

n/a n/a n/a n/a n/a n/a n/a n/a n/a

Please fill-up/accomplish separate form/s for other outlet/s.

Module 3: P.D. 984 (Water Pollution) page ____ of ____

Name of Plant:
Reference No:

Detailed Report of Wastewater Characteristics for Other Pollutants

Outlet No.

Effluent ________ ________ ________ ________ ________ ________ ________

(name) (name) (name) (name) (name) (name) (name)
DATE Flow Rate
(m3/day) (unit) (unit) (unit) (unit) (unit) (unit) (unit)

n/a n/a n/a n/a n/a n/a n/a n/a n/a

Please fill-up/accomplish separate form/s for other outlet/s.

Please use additional sheet/s if necessary.

Module 3: P.D. 984 (Water Pollution) page ____ of ____

Name of Plant:
Reference No:

MODULE 4: R.A. 8749 (Air Pollution)

Summary of APSE/APCF
Process Equipment Location # of hrs of operations
1. n/a n/a n/a
2.

3.
4.
Fuel Burning Quantity # of hrs of
Location Fuel Used
Equipment Consumed operations
1. One (1) unit Beside Power House Diesel
(220Kva Standby 0.0210 1.07
Genset
2. Two (2) Units Power House Diesel
(1920KW) Standby 0.6465 3.18
Genset
3.

4.
5.
6.
Pollution Control Facility Location # of hrs of operations
1. Smoke Tack Power house n/a

2 Day tank Power House n/a

3.

4.

Cost of Treatment
Month 1 Month 2 Month 3
Cost of Person employed,
n/a n/a n/a
(salary)
Total Consumption of
Water (cubic meters)
Total Cost of chemicals
used (e.g., activated n/a n/a n/a
carbon, KMnO4)
Total Consumption of
n/a n/a n/a
Electricity (KwH)
Administrative and
n/a n/a n/a
Overhead Costs
Cost of operating in-
n/a n/a n/a
house laboratory, if any
Improvement or n/a n/a n/a
modification, if any.
(Description)
Cost of improvement of n/a n/a n/a
modification

Module 4: RA 8749 (Air Pollution) page ____ of ____

Name of Plant:
Reference No:

Module 4: RA 8749 (Air Pollution) page ____ of ____

Name of Plant:
Reference No:

Detailed Report of Air Emission Characteristics

Description/Location
of PCF
________ ________ ________ ________
Flow Rate CO NOx Particulates (name) (name) (name) (name)
DATE
(Ncm/day) (mg/Ncm) (mg/Ncm) (mg/Ncm)
(mg/Ncm) (mg/Ncm) (mg/Ncm) (mg/Ncm)
n/a n/a n/a n/a n/a n/a n/a n/a n/a

Note: Exempted on source emission test (Operating hours less than 200 hours per year)

Please fill-up/accomplish separate form/s for other PCF/s.

Please use additional sheet/s if necessary.

Module 4: RA 8749 (Air Pollution) page ____ of ____

Name of Plant:
Reference No:

MODULE 5: P.D. 1586

Ambient Air Quality Monitoring (if required as part of ECC conditions)
Description/Location
of Monitoring
Station
Noise ________ ________ ________ ________
CO NOx Particulates (name) (name) (name) (name)
DATE Level
(mg/Ncm) (mg/Ncm) (mg/Ncm)
(dB) (mg/Ncm) (mg/Ncm) (mg/Ncm) (mg/Ncm)
Note: Schedule of Ambient air temperature and noise quality will be on April 2024

(Please accomplish one table per monitoring station.)

Ambient Water Quality Monitoring (if required as part of ECC conditions)

Description/Location
of Sampling Station
________ ________ ________ ________ ________ ________ ________ ________
(name) (name) (name) (name) (name) (name) (name) (name)
DATE
(unit) (unit) (unit) (unit) (unit) (unit) (unit) (unit)

n/a n/a n/a n/a n/a n/a n/a n/a n/a

(Please accomplish one table per sampling station.)

Module 5: P.D. 1586 (EIS System) page ____ of ____

Name of Plant:
Reference No:

Other ECC Conditions

Status of Compliance
ECC Condition/s Actions Taken
Yes No

1. Separate ECC Compliance report √ See attache ECC report

2.

3.
4.
5.
6.
Please use additional sheet/s if necessary.

Environmental Management Plan/Program

Status of
Enhancement/Mitigation Measures Implementation Actions Taken
Yes No
1. Continues ompliance on zone Conversion of HCFC123
√
depleting Substance to HFC26fa
2.

3.
4.
5.
6.
Please use additional sheet/s if necessary.

Solid Waste Characterization/Information:

Average Quantity of 104,784.59 Total Quantity of Solid 314,554.68
Solid Wastes Generated Wastes Generated this
per month Quarter
Average Quantity of 104,784.59 Total Quantity of Solid 314,554.68
Solid Wastes Collected Wastes Collected this
per month Quarter
Brgy. Pinya Taysan
Entity in charge of Taysan Solid Waste Batangas
Disposal Facility/SLF
collecting solid wastes Mgt.

Brief Description of
Solid Waste
Segregation – to – collection – to – Storage – to – Disposal Sanitary
Management Plan (e.g.,
Landfill
waste reduction,
segregation, recycling)

Module 5: P.D. 1586 (EIS System) page ____ of ____

Name of Plant:
Reference No:

MODULE 6: OTHERS

Accidents & Emergency Records

Findings and
Date Area/Location Actions Taken Remarks
Observation
none none none none none

Personnel/Staff Training
# of Personnel
Date Conducted Course/Training Description
Trained
none none none

I hereby certify that the above information are true and correct.

Done this _______Feb.03, 2024______, in ________________________.

Ghia S. Andal
Name/Signature of PCO
Faith L. Bautista
Name/Signature of CEO

SUBSCRIBED AND SWORN before me, a Notary Public, this _____3rd___ day of
_________Feb. 24, 2024_____________, affiants exhibiting to me their Community
Tax Receipts:

Name CTR No. Issued at Issued on

Ghia S. Andal
Faith L. Bautista P97509764 Philippines Nov. 29, 2018

Module 5: P.D. 1586 (EIS System) page ____ of ____