LIVESTOCK PROJECT

INITIAL ENVIRONMENTAL EXAMINATION (IEE) CHECKLIST REPORT

for

Project name or Title

This IEE Report Checklist Report is applicable to the following: Project Type Livestock Production Pigs / Goats Poultry / Birds Parameter Stock Population Stock Population Threshold 100 heads but < 5,000 heads 10,000 heads but < 100,000 heads

Read the questions carefully and write the required information on the spaces provided or otherwise check () the appropriate boxes or parenthesis ( ). Use additional sheets if necessary and indicate this in the appropriate space. Misleading or erroneous answers are basis for legal actions and/or denial of ECC issuance.

EXECUTIVE SUMMARY PROJECT FACT SHEET

Project Name: ______________________________________________________________ _________________________________________________________

Project Site Location: Project Status: Nature of Project:

______________________________________________________________ ____________________________________________________________ _________________________________________________________

Total Stock Population: Total Project Area: Project Components: Manpower Requirement: Project Cost:

____________________________________________________________ ________________________________________________________ ______________________________________________________

________________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________

Project Proponent: Office Address:

Contact Person/Designation: Contact Information:

_________________________________________________________

PROCESS DOCUMENTATION
EIA Team: Specialist Areas of Expertise

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EIA Study Schedule (for primary data): Activity Date Season

EIA Study Area: Direct Impact Areas: (Complete Barangay, and Municipality/City) ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ Indirect Impact Areas: (Complete Barangay, and Municipality/City) ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________

EIA Methodology:
EIA Study Module METHODOLOGY Type of Data (please Source of Data/Remarks check) (e.g. LGU) Primary* Secondary

Land (Vicinity of Project Area) Land Use Classification Terrestrial Biology Water Water Quality Freshwater or Marine Ecology Air (Vicinity of Project Area) Meteorology/Climatology Air Quality and Noise People * Section or page number where the primary data can be found

I. PROJECT DESCRIPTION
1.1 PROJECT LOCATION AND AREA: Street Name, Barangay, and Municipality/City (Vicinity Map showing sitio, barangay, municipality, province and region boundaries and total project area to be covered. Attach location and vicinity maps and photographs of the project site as ANNEX 1.) ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ _________ Geographic coordinates of project area: Longitude : ___________________ Latitude : ___________________ 1.2 PROJECT RATIONALE: Cite and focus on the need for the project based on national and local economic development and in terms of contribution to sustainable development agenda and current development thrusts of the Philippines. ____________________________________________________________________ ____________________________________________________________________
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____________________________________________________________________ ____________________________________________________________________ 1.3 PROJECT ALTERNATIVES: Reasons for selection of preferred option (please check): Technology Facility Siting Development Design Process/Technology Selection Resource Utilization Others Commercial Environmental Others

1.4 PROJECT COMPONENTS Maximum Stock Population (per growing season): Hog Population ____________ Sows : ____________ heads Boars : ____________ heads Piglets : ____________ heads Fatteners: ____________ heads Broiler : ____________ heads Layer : ____________ heads Native : ____________ heads Ducks: ____________ heads

Poultry Population ____________

Others ______________

Extent of Operations: Breeding Fattening / Finishing Slaughtering Processing

Marketing/Distribution 1. List of Equipment/Facilities: Equipment/Facilities Generator sets Water pump No of Units Capacity

2. Infrastructure: Infrastructure (attach properly scaled site development plan) Infrastructure Poultry House Bldg. Feed Storage Units Floor Area

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Rice Hull storage bldg. Boar House Gestating Compartment Nursing Compartment Admin Bldg. Workers quarters

Support Facilities: No. of Units Pollution Control Device Biogas digester Wastewater treatment facility Facilities Being Served

(Use additional sheet, if necessary.) 1.5 PROCESS/ TECHNOLOGY OPTIONS Water Supply Community Water Demand : [ ] dry season ____ m 3/sec m3/sec [ ] rainy season ______ m 3/sec [ ] annual _____

Water Source [ ] Local Water Utility [ ] surface water S/W Type : [ ] river (Name: _____________) [ ] ground water G/W Type: [ ] well [ ] spring

[ ] rainwater collector [ ] Others ________ [ ] others: ______________________

Location of water source ____________________________________________________________________________ (Sitio/Zone, Barangay, Municipality/City, Province, Region) Water source flow: a) dry season flow: _______ m3/sec b) rainy season: _______ m 3/sec c) annual: ___% (___

Percent & Flow of water source to be tapped: a) dry season: ___ % (_____ m3/sec) b) rainy season: ___% (___ m 3/sec) 3 m /sec)

Location of communal water box/faucet area: ____________________________________________________________ (If water box/faucet area is to be provided) (Lot Number, Street, Sitio/Zone, Barangay, Municipality/City, Province, Region) Communal box/faucet surface area: _____ m 2 ______ m Pipe length from source to water box: _____ m Volume :_______ m3 Distance of box from source:

Pipe Material: [ ] GI pipes [ ] PVC [ ] bamboo___________

3

Overflow of Concrete Water Box: ____ m (height) Target overflow: dry season____ m /sec; 3 rainy season ____m /sec

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Power Supply Sources of Power Supply Local Electric Utility Generator Others, please specify
(Use additional sheet, if necessary)

Yes

No

Estimated Daily Kilowatt consumed:

Waste Management System Type of Waste Wastewater Solid waste Air Dust Noise
(Use additional sheet, if necessary.)

Description/Source of Waste

Volume Per Day

Mode of Treatment

1.6 PROJECT SIZE Total Land Area to be occupied: Is the area owned or leased: If leased, period covered: ___________________________________________________ _________________________________________________ ____________________________________________________

(Attach proof of jurisdiction over the project area, as ANNEX 3)

Expected production volume per growing season Pigs/Goats: ___________________ Poultry: _________________ Others: _________________

1.7 DEVELOPMENT PLAN, DESCRIPTION OF PROJECT PHASES AND CORRESPONDING TIMEFRAMES Pre-Operation/ Construction phase Construction Schedule ACTIVITY Plans/Design Permits/ Clearances Site Preparation Civil Works Finishing Site Clearance Installation Commissioning & Start-up Operation

TIMEFRAME (no. of days)

(Use additional sheet if necessary. Include civil works undertaken as part of the project, e.g., Construction of office for operation, administration, canteen, and other amenities.) 5|I E E C h e c k l i s t R e p o r t f o r L i v e s t o c k P r o j e c t s

Operation Phase Provide brief discussion on the project operation: __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________

Insert Process Flowchart.

Abandonment Phase and schedule Decommissioning Activities Waste Generated Management Measure Restoration Plan

Dismantling of
structures and equipment

Recycling Landfill To be donated Others, please

specify_____

(Use additional sheet, if necessary.)

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1.8 MANPOWER Manpower Requirement Expertise/Skills No. of Women No. of Men Total

1.9 INDICATIVE PROJECT COST Project Ownership

Single Proprietorship Corporation Partnership Others __________________

Project Cost : PhP ___________

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ENVIRONMENTAL IMPACT AND CLIMATE CHANGE RISK MANAGEMENT PLAN I. ENVIRONMENTAL IMPACT MANAGEMENT PLAN Possible Environmental/ Social Impacts Baseline Data Parameter Preventive/ Mitigating Measures Monitoring Parameters/ Implementation Cost of Mitigation/ Monitoring (Assumed to be integrated in project cost per project phase)

Project Phase / Activities

Pre-construction phase Site Selection and Planning/Design

Social problems
resulting from odor generated from animal wastes

Commercial/ Industrial Agricultural/

Institutional

Current land use in the vicinity of the proposed site:

Prohibition of poultry/livestock
projects in areas very near commercial / residential areas

Recreational

Residential
Construction Phase Installation of Equipment / Construction

Soil erosion and siltation

during construction

Water Quality Data in the affected water body:

Project construction during dry Stabilization of embankment with Designate a Spoils Storage Area, Others (Pls. specify): ___________
with topsoil set aside for later use and allow maximum re-use of spoils grasses or other soil cover season

Presence of slope Presence of new

___________ protection in erosionprone areas eroded areas near the site

Slope/ Erosion Control

integrated in Construction Cost:

TSS: __________

Others (Pls. specify):

Tree cutting or
vegetation clearing, and disturbance to wildlife

Existing vegetation in the area:

Compliance with conditions in

permits secured during the Preconstruction Phase

Compliance with
conditions of DENR/LGU SLUP,

Replacement planting
cost depends on area opened up:

Forest

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within the influence area due to noise and other construction activities

Coastal/Marine Marshland Grassland Mangrove Wetland

Others, specify _______________ _______________ _________ Specify the existing flora in the area______________ _________________ _________________ Specify the existing fauna in the area _______ _______________

Implementation of tree planting Promote restoration of damaged or Vegetation to serve also as buffer to Limit land clearing as much as Provide a temporary fencing to
vegetation that will be retained possible wildlife destroyed vegetation where possible; around the facility ;

Area replanted/
revegetated

TCP, ROW, PCA Permit

Compliance with other

permit conditions integrated in Construction Cost:

Presence of fences
and markers

incidence of violation to protection guidelines

Increase in dust and

gases due to movement of vehicles and construction activities

Air quality (TSP):

_____________

Regular water spraying on work Proper maintenance of vehicles

area

Air quality (TSP)

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Installation of Equipment / Construction

Noise generation

from heavy equipment & generator

0-30 dB 31-70 dB 71-80 dB 81-85 dB 86-90 dB 91-95 dB 96-107 dB Others,

Noise level area:

in the

Undertake proper maintenance of Schedule equipment movement Minimize night-time construction

activities residences equipment during non-peak hours of daytime vehicular traffic equipment and use mufflers

Tolerable noise levels No cost for scheduling; in residential areas Mufflers/silencers Presence of schedule integral component of # public complaints
Frequency : ___________ of equipment movement and construction activities received by Proponent/ Contractor

Genset housing

equipment purchase/maintenance integrated in Construction Cost:

Provide housing for gensets, if near Provide silencers/mufflers for heavy

specify________

Operation Phase Water pollution from discharge of wastewater effluents Water Quality Data in the affected water body:

Release of wastewater into receiving

waters after prior treatment or adequate dilution;

Water Quality Data in the affected water body:

TSS: _________ Oil and grease:

_____________

Installation of biogas digester/s

system

BOD: ________ DO: _________ Total coliform: Fecal Coliform:

___________ ___________

Establishment of wastewater
treatment chambers

Installation of drainage canals Provision of three-chambered septic

tank for domestic sewage

TSS Oil and grease BOD DO Total and fecal

coliform

Others (Pls. specify): ___________

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Emission of foul odor due to animal wastes

Regular clean-up of animal houses # public complaints received by Spraying of disinfectant Use of environment-friendly
pesticides Proponent/ Contractor Frequency : ___________

Increase in waste generation

Refer to Waste management table

Others (Pls. specify): ___________ Implementation of the Ecological Presence of Re-use and recycling Proper segregation, collection and
disposal of domestic wastes in designated areas Solid Waste Management Plan (ESWMP);

Absence of mixed Monthly Quarterly Semi-Annual Annually Others,

specify_______ Frequency :

waste/recycling bins for segregation garbage in the facility

Proper collection and treatment of

animal waste into organic fertilizer

Proper collection, labeling and

storage in a hazardous waste storage area for hauling by a DENR

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Noise generation

Location of the nearest establishment/ household: _____ m

0-30 dB 31-70 dB 71-80 dB 81-85 dB 86-90 dB 91-95 dB 96-107 dB Others, Occurrence of airpollution related disease/s within the project vicinity

Noise level area:

in

Proper handling to prevent cackling Noise level in the area: 0-30 dB Provision of continuous lighting at 31-70 dB night 71-80 dB Feeding of stocks on schedule 81-85 dB the 86-90 dB 91-95 dB 96-107 dB
Others, specify________

specify________
the leading causes of morbidity within the project vicinity: _______________ _____________

Baseline data on

Spraying of disinfectant within the

canals and lagoon. Specify frequency:_________________

Baseline data on the

leading causes of morbidity within the project vicinity

Over extraction of
groundwater

Groundwater availability map Groundwater level: _______

Compliance to the NWRB Water Improve efficiency of water supply Implementation of drain water Others (Pls. specify): ___________
system and other water conservation techniques e.g. catchment basins permit

Groundwater level Total Annual Water

Extraction

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II. Project Phase / Activities Climate Change Risk

Baseline Data Parameter

Monitoring Parameters/ Implementation Cost of Adaptation

CLIMATE CHANGE RISK MANAGEMENT PLAN Adaptation Measures

Flooding

Historical data on Protect water recharge areas to

flooding flood recorded _______ cm. (last five years, indicate years) preserve quality and quantity capacities of water supply structures for resilience to greater variations and extremes maps, including climate change projections, and zoning measures to limit/restrict development activities

Review monitoring
systems for water levels, flows, water quality rainfall and temperatures to ensure that trends can be detected, and that sudden episodes (pollution, flood) are documented; document the changes in weather events (precipitation, floods, storms, river flow and other hydrological data) with a view to identifying the most vulnerable components of the water sector;

Maximum height of Increase, when practical, storage In critical areas, develop flood plan Construction of flood control Others: ___________________
structures/ embankments on rivers near project site taking into account climate change to date and projections;

Review and

Drought

Historical data on Improve efficiency of water supply Effectiveness of water drought conservation Implementation of drain water techniques Climatological system and other water conservation Regular inspection of
Normals and Extremes techniques e.g. catchment basins water harvesting system facilities to ensure sustained availability of water

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 Others, please
specify: _________________ _________________

Heat waves / extreme

temperature

Historical data on Proper and adequate ventilation Climatological

Normals and Extremes the occurrence of heat waves in the project area system

Review and
monitoring of weather pattern

Frequent watering of stocks Provision of roof insulation Adaptation of green engineering

design

Storm surge/typhoon

Historical record Climatological

Normals and Extremes

Establishment of adequate barriers Development of emergency Others, specify

___________ response and disaster preparedness plan

Constant communication with concerned line agency Regular inspection of buildings and related facilities and infrastructures Regular monitoring of early warning devices and preparedness systems to ensure their effectiveness 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:

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Attach sketch plan/lay-out of project site

(Use additional sheet if necessary)

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Attach drawing/plan of air pollution source and control installation s (with dimensions and descriptions)

(Use additional sheet if necessary)

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

(Use additional sheet/s if necessary)

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SWORN STATEMENT OF ACCOUNTABILITY OF THE PROPONENT

This is t o certif y that all the inf ormation and commitments in thi s Initial Environmental Examination (IEE) Checklist for the (state name of project)______________ PROJECT are accurate and complete to the best of our knowledge, and that an objective and thorough assessment of the Project was undertaken in accordance with the dictates of professional and reasonable judgment. Should I/we learn of any information which would make this IEE Checklist inaccurate, I shall immediately bring the said information to the attention of DENR-EMB Region _____. I hereby certify that no DENR-EMB personnel was directly involved in the preparation of this IEE Checklist other than to provide procedural and technical advice consistent with the guidelines in the DAO 2003-30 Revised Procedural Manual. 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 __________ ______________________. ____________________ NAME OF PROPONENT HEAD (Position) (Company Name) at

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

____________________ ____________________ ____________________ ____________________

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SWORN STATEMENT OF ACCOUNTABILITY OF PREPARERS (If applicable)

This is to certify that all information in Initial Environmental Examination Checklist REPORT for the (state name of project) PROJECT are accurate and complete to the best of our knowledge, and that an objective and thorough assessment of the Project was undertaken in accordance with the dictates of professional and reasonable judgment. Should we learn of any information which would make IEE Checklist REPORT inaccurate, we shall immediately bring the said information to the attention of the DENR-EMB Region ___. We hereby certify that no DENR personnel was directly involved in the preparation of this IEE Checklist REPORT other than to provide procedural and technical advice consistent with the guidelines in the DAO 03-30 Revised Procedural Manual. We hereby bind ourselves jointly and solidarily to answer any penalty that may be imposed arising from any misrepresentation or failure to state material information in this IEE Checklist REPORT. In witness whereof, I hereby ______________________. set my hand this ____ day of __________ at

Name 1. 2. 3. 4. 5.

Field of Expertise

Signature

SUBSCRIBED AND SWORN TO before me this _____ day of ____________ 2006, affiants exhibiting their Community Tax Certificate information, as follows: Name 1. 2. 3. 4. 5. Community Tax Certificate Information CTC No. Place of Issue Date of Issue

Doc. No. Page No. Book No. Series of

____________________ ____________________ ____________________ ____________________

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