SUBDIVISIONS AND HOUSING PROJECTS

INITIAL ENVIRONMENTAL EXAMINATION (IEE) CHECKLIST REPORT

For

Project name or Title

This IEE Checklist Report shall be used for proposed SUBDIVISION AND HOUSING PROJECTS
(i.e resettlement projects, economic and socialized housing project, open market housing) and
other similar (horizontal) land development projects to be located within Environmentally
Critical Areas (ECA).

For ECC applications, this IEE Checklist Report shall be submitted with:
 Proof of Compatibility with the existing Land Use Plan
 Proof of Authority over the Project Site
 Accountability Statements of Proponent (see attached form) and the Preparer (if
any, following Annexes 2-22 of Revised Procedural Manual for DAO 2003-30)
 Photographs or plates/vicinity map of the project site showing impact areas and
affected areas and communities
 Duly Accomplished Project Environmental Monitoring & Audit Prioritization
Scheme (PEMAPS) Questionnaire (see Annex 2-7d of Revised Procedural Manual for DAO
2003-30)
(No other documents shall be required as pre-requisite to ECC applications per DENR MC 2010-14)

Read the questions carefully and write the required information on the blank spaces
provided or otherwise check () the appropriate boxes □ or parenthesis ( ). Boxes
with check marks() are automatically required. Use additional sheets if necessary
and indicate this in the appropriate space.

Project proponents are strongly discouraged to engage the services of

consultants/facilitators/preparers to accomplish/fill-up the IEE Checklist
Report Form. The Report Forms have been designed to be user-friendly.

Furthermore, EMB Regional Office is required to complete the processing of

an ECC application using the IEE Checklist Report within twenty (20) working
days upon receipt for duly-accomplished forms with complete attachments

Misleading or erroneous answers are basis for legal actions and/or denial of ECC
issuance.

PROJECT FACT SHEET

Project Name: _______________________________________________________

Project Location: _______________________________________________________

Total Project Land Area: _______________________________________________________

Total Project Area _______________________________________________________

(Area actually utilized)
Project Proponent:
Office Address:
Contact Person:
Designation:
Contact Number/s
Landline :
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________

1 IEE Checklist Report for Subdivision and Housing Projects

 Fax Number: _______________________________________________________
Mobile : _______________________________________________________
E-mail Address: _______________________________________________________

I. PROJECT DESCRIPTION

1.1 PROJECT LOCATION AND AREA: Street Name, Barangay, and Municipality/City, Province

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Attach vicinity map/s and photographs of the project site and site development/layout plan and survey plan
approved by Geodetic Engineer.

Geographic coordinates of the project area (Preferably use WGS 84 datum, otherwise specify datum used).
Perimeter/Boundary points
Longitude Latitude
(based on OCT/TCT/etc)

1.2 PROJECT COMPONENTS

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 Facilities No. of Units Area (sq. m.) / Specification/
Capacity Description / Remarks

1. Residential lots
2. Commercial Area (e.g. banks,
restaurants, outlets, stores,
etc.)
3. Institutional Area (e.g. offices,
schools, etc. – please specify)
4. Amenities (e.g. swimming
pools, gym, Chapel, club
house, etc.)
5. Open/Common Spaces (e.g.
reception area, garden, parks,
etc.)
6. Road system
Primary/Main road
Secondary road
Alley
7. Common Parking area
8. Water supply system
9. Drainage system
10. Support facilities (e.g.
emergency generators, guard
houses/posts, etc.)
11. Waste Water Management
Facility
12. Solid waste management
facilities
13. Others, specify
____________________
(Use additional sheets if needed)

1.3 UTILITIES/REQUIREMENTS (Operation Phase):

Utilities Source Estimated Demand/Consumption

Power/Electricity KWh
(Total)
Power/Electricity KWh
(From Renewable Energy
Sources)
Water m³/day
(Total)
(Fill-up table below if water is not
obtained from the local water utility)
Water m³/day
(Rainwater Collection
System)

Water Source
[ ] ground water [ ] well [ ] spring [ ] others: ____________________________

[ ] Surface water [ ] river [ ] lake [ ] others: ____________________________

Location of water source

____________________________________________________________________________
(Sitio/Zone, Barangay, Municipality/City, Province, Region)

Energy/Water Efficiency
Utilities Estimated Savings Proposed Efficiency/Conservation

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 Measures
Power/Electricity KWh

Water m³/day

1.4 MANPOWER

a. Construction Phase
Manpower Expertise/Skills Total
Requirement

b. Operation Phase
Manpower Expertise/Skills Total
Requirement

1.5 INDICATIVE PROJECT COST

Project Cost (PhP): ____________

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 II. ENVIRONMENTAL IMPACTS AND MANAGEMENT PLAN

Possible Environmental/ Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/ Monitoring
Social Impacts Implementation and frequency
LAND
 Consistency with land Current land use w/in 1km radius  See attached proof of compatibility with
use (as per zoning ordinance): land use
 Residential
 Commercial/ Institutional
 Industrial
 Agricultural/ Recreational
 Protected Areas
 Others, specify
________________

Actual land uses w/in 1km radius:

 Residential
 Commercial/ Institutional
 Industrial
 Agricultural/ Recreational
 Protected Areas
 Others, specify
______________

 Disturbance to wildlife Existing vegetation in the area:  Compliance with conditions of DENR/LGU  Annual inspection of area  Cost integrated in the
due to vegetation  Forestland SLUP, Tree Cutting Permit, ROW, PCA replanted/ revegetated construction /operation cost
clearing  Marshland
Permit

 Grassland
 Limit land clearing as much as possible

 Mangrove
 Provide temporary fencing to vegetation
that will be retained
 Wetland  Promote restoration of damaged or
 Others, specify destroyed vegetation where possible (e.g.,
____________________ tree planting);

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Possible Environmental/
Social Impacts
 Change in surface
landform/ topography/
terrain/slope
 Soil Erosion
Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/ Monitoring
Implementation and frequency
Slope:  Provide erosion control and slope  Regular inspection of slope  Slope/ Erosion Control
 flat (0-3%) protection measures protection measures in Cost: ___________
 gently sloping to rolling (3-18%)  Designate a Spoils Storage Area, with erosion-prone areas  Others, specify
 steep (>18%) topsoil set aside for later use and allow  Regular inspection for new ____________
maximum re-use of spoils eroded areas near the site
 Compliance to the standard criteria for  Others, specify
sanitary landfill development DAO 49 and ___________
50.
Is the project site located in an area
identified by MGB/PAG-ASA/
 Construction during dry season
PHIVOLCS as hazard prone?  Stabilization of embankment with grasses
or other soil cover
 Yes
 No
 Others, specify
____________

 Compliance with the DENR Administrative

Order No. 2003-30 and DENR
Administrative Order No. 2000-28,
Implementing Guidelines on Engineering
Geological and Geo-hazard Assessment
(EGGA).

 Soil/Land contamination Existing soil type in the area:  Implementation of the Ecological Solid  Daily inspection of  Cost integrated in the
due to improper solid  sandy Waste Management Plan (ESWMP) waste/recycling bins for construction /operation cost
waste disposal
 clay  Set-up temporary fence around the segregation

 sandy-loam
construction area  Daily inspection for presence

 Others, specify
 Implement re-use and recycling of waste of mixed garbage in the
materials facility
____________________
 Implement proper segregation, collection  Weekly inspection of waste
and disposal of domestic wastes in accumulated
designated areas  Others, specify
 Provide receptacles / bins for solid wastes ____________________
 Coordinate with the municipal / city waste
collectors

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Possible Environmental/
Social Impacts
 Impairment of visual
aesthetics
 Devaluation of land
values
WATER
 Increased siltation due
to project activities
 Water quality
degradation
 Others, specify
___________________
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Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/ Monitoring
Implementation and frequency
 Engage third party company for waste
collection
 Others, specify
________________
Presence of visually significant  Implement landscaping and other  Regular inspection of  Cost integrated in the
landforms/landscape/structures? beautification measures landscaping and other construction/ operation cost
 Yes  Provide adequate buffer beautification activities
 No  Compensate adjacent property owners  Regular monitoring of buffer
zones
 Others, specify
 Regularly monitor
________________
presence/absence of
complaints from adjacent
property owners
Specify nearest/receiving water  Set-up proper and adequate sanitary Regular (ocular) inspection of:  Cost integrated in the
body:
____________________________
facilities  Drainage / canal systems construction/ operation cost
 Strictly require the contractor and its  Water treatment facility (i.e.,
Distance to nearest/receiving water workers to observe proper waste disposal grease trap, septic tank, etc.)
body: and proper sanitation
 0 to less than 0.5 km
 Strictly observe proper waste handling and Quarterly monitoring of the
disposal following:
 0.5 to 1 km
 Provision of wastewater treatment facility  pH
 More than 1 km (e.g. oil and water separator, etc.)  TSS concentration
If nearest/receiving water body is  Set up silt trap/stilling ponds to minimize  BOD
fresh water, specify classification:
downstream siltation
 Total Coliform
 AA
 Provision of three-chambered septic tank
 Color
for domestic sewage
 A
 Others, specify
 Oil and Grease
 B ___________
 C
 D
Possible Environmental/ Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/ Monitoring
Social Impacts Implementation and frequency

If nearest/receiving water body is

coastal or marine water, specify
classification:
 SA
 SB
 SC
 SD

Current Water Use:

 Fishery
 Tourist Zone / Park
 Recreational
 Industrial
 Agricultural

Distance of project area to the

nearest well used:
 0 to less than 0.5 km
 0.5 to 1 km
 More than 1 km

Use of the nearest well:

 Drinking/Domestic
 Industrial
 Agricultural

 Competition in water Size of population using receiving  Implement rainwater harvesting and similar  Cost integrated in the
use surface water: measures as an alternative source of water  Regularly monitor construction/ operation cost
 Depletion of water  ≤ 1,000 persons  Observe water conservation measures presence/absence of
resources  >1,000 and ≤ 5,000persons  Careful selection of project site to avoid
complaints

 >5,000person disruption of traditional water uses

 Regular coordination with

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Possible Environmental/ Baseline Environment
Social Impacts
Available/nearest water source.
 Deepwell
 Water district/LGU
Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/ Monitoring
Implementation and frequency
 Obtain Water Permit from NWRB concerned agencies
 Improve efficiency of water supply and  Regularly monitor
distribution system occurrences of water
 Others, specify
shortages

 Surface water ________________________  Others, specify

____________
 Others, specify
_________________________

 Increased occurrence
of flooding
Is the project site located in an area
identified by MGB/PAG-ASA as
flood prone?
 Use appropriate design for project facilities  Regularly monitor  Cost integrated in the
 Implement appropriate drainage system
presence/absence of
complaints
construction/ operation cost

 Yes  Regularly remove debris and other

 Regular coordination with
materials that may obstruct water flow
 No concerned agencies
 Use appropriate technology (e.g. raised  Regularly monitor increased
hand-pumps) to protect drinking water from frequency of flooding
flood contamination
 Others, specify
 Others, specify
_________________
________________________

AIR / NOISE

 Air quality degradation Distance to nearest community:  Properly operate and maintain all emission  Regularly monitor  Cost integrated in the
 0 to less than 0.5 km sources (e.g. vehicles, generator, etc) presence/absence of construction/ operation cost
 0.5 to 1 km  Install when applicable, the appropriate air
complaints

 More than 1 km pollution control device/s

Regular (ocular) inspection of:
 Strictly enforce good housekeeping
 Absence of white or black
practices
smoke from vehicles,
 Control vehicle speed to lessen generator, etc.
suspension of road dust
 Presence of truck cover
 Conduct water spraying to suppress dust during deliveries
sources and minimize discomfort to
residents
 Use covered vehicles to deliver materials
that may generate dust

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Possible Environmental/ Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/ Monitoring
Social Impacts Implementation and frequency
 Other, specify
____________________________

 Nuisance due to noise Distance to nearest community:  Properly operate and maintain all noise  Regularly monitor  Cost integrated in the
generation  0 to less than 0.5 km sources (e.g. vehicles, generator, etc) presence/absence of construction/ operation cost
 0.5 to 1 km  Install when applicable, the appropriate
complaints

 More than 1 km noise control device/s (e.g., mufflers,  Regular monitoring of buffer
silencer, sound barriers, etc.) zones
 Implement appropriate operating hours
 Provide adequate buffer and/or planting of
trees
 Others, specify
_____________________________

PEOPLE

 Displacement of Size of population of host barangay:  Provide relocation/disturbance  Regularly monitor  Cost integrated in the
residents in the project  ≤ 1,000 persons compensation packages presence/absence of construction/ operation cost
site and within its
 >1,000 and ≤ 5,000persons  Prioritize local residents for employment complaints
vicinity
  Regular coordination with
 Displacement of
 >5,000person Promptly pay local taxes and other
LGU
financial obligations
Indigenous People
Classification of host barangay:  Regular coordination with LGU  Others, specify
 Enhanced employment
 Urban  Prior consultation & coordination to
_________________
and/or livelihood
opportunities  Rural minimize disruption on daily domestic
activities & respect for IP rights and
 Reduced employment
Available services within/near the cultural practices
and/or livelihood
opportunities
host barangay:  Ensure participation of IPs in consultations

  Schools (e.g. elementary, high and dialogues

Increased revenues for
LGU
school, college)  Provide appropriate traffic/warning signs,

  Health facilities (e.g., clinics, lighting, etc

Disruption/Competition
in delivery of public
hospitals, etc.)  Others, specify
services (e.g.,  Peace and order (e.g., police ________________
education, peace and outpost, brgy. Tanod, etc.)

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Possible Environmental/ Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/ Monitoring
Social Impacts Implementation and frequency
order, etc.)  Recreation and sports facilities
 Enhanced delivery of  Others, specify
public services (e.g., _______________________
education, peace and
order, etc.)
 Increase in traffic
volume and worsening
of traffic flow

 Impacts on community  Regular coordination with LGU  Regularly monitor  Cost integrated in the
health and safety  Provide appropriate warning signs, lighting presence/absence of construction/ operation cost
 Others, specify and barricades, whenever practicable complaints
____________________  Observe proper housekeeping  Regular coordination with
LGU
 Provide on-site medical services for any
 Regularly monitor submission
emergency.
of reports to concerned
 Participate in public awareness programs agency
on health and safety
 Others, specify
 Implement appropriate safety programs for _________________
both community and workers
 Strictly comply with fire, safety and similar
regulatory requirements
 Others, specify
________________________

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III. ABANDONMENT /DECOMMISSIONING/REHABILITATION POLICIES AND
GENERIC GUIDELINES (if Applicable)

Project Life or Service : ___________ years

Provide description of the Abandonment activities, such as, dismantling and waste
disposal.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

IV. INSTITUTIONAL PLAN FOR EMP IMPLEMENTATION

Organization Chart:

4.1. Abandonment Plan (if Applicable)

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

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 SWORN STATEMENT OF ACCOUNTABILITY OF THE PROPONENT

This is to certify that all the information and commitments in this Initial
Environmental Examination (IEE) Checklist Report are accurate and complete to the
best of my knowledge.

By the authority vested in me by the _____(Company Name) as

___(Position/Designation), I hereby commit to ensure implementation of all
commitments, mitigating measures and monitoring requirements indicated in this IEE
Checklist Report as well as the following:
 Conform to pertinent provisions of applicable environmental laws e.g.,
R.A. No. 6969 (Toxic Substances and Hazardous and Nuclear Wastes
Control Act of 1990), R.A. No. 9003 (Ecological Solid Waste
Management Act of 2000), R.A. No. 9275 (Philippine Clean Water Act
of 2004), and R.A. No. 8749 (Philippine Clean Air Act of 1999).
 Abide and conform to LGU development plans and guidelines.
 Promptly pay local taxes and other financial obligations.
 Regularly submit reports to concerned agencies.

I hereby bind myself to answer any penalty that may be imposed arising from
any misrepresentation or failure to state material information in this IEE Checklist.

In witness whereof, I hereby set my hand this ____ day of __________ at

______________________.

__________________________
NAME OF PROPONENT HEAD
(Position)
(Company Name)

SUBSCRIBED AND SWORN TO before me this _____ day of ____________ 201__, affiant
exhibiting his/her Community Tax Certificate No. ___________________ issued at
______________________ on __________________________.

Doc. No. ____________________

Page No. ____________________
Book No. ____________________
Series of ____________________

14 IEE Checklist Report for Subdivision and Housing Projects