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 (a) 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

2 IEE Checklist Report for Subdivision and Housing Projects

 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 m/day
(Total)
(Fill-up table below if water is not
obtained from the local water utility)
Water m/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

3 IEE Checklist Report for Subdivision and Housing Projects

 Measures
Power/Electricity KWh

Water m/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): ____________

4 IEE Checklist Report for Subdivision and Housing Projects

TAL IMPACTS AND MANAGEMENT PLAN

/ Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of M

Implementation and frequency

Current land use w/in 1km radius ; See attached proof of compatibility with
(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
______________

Existing vegetation in the area: ; Compliance with conditions of DENR/LGU ; Annual inspection of area ; Cost
Forestland SLUP, Tree Cutting Permit, ROW, PCA replanted/ revegetated const
Permit
Marshland
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);

EE Checklist Report for Subdivision and Housing Projects

/ Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of M
Implementation and frequency
Slope: Provide erosion control and slope Regular inspection of slope Slope
flat (0-3%) protection measures protection measures in Cost:
gently sloping to rolling (3-18%) Designate a Spoils Storage Area, with erosion-prone areas Othe
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).

on Existing soil type in the area: ; Implementation of the Ecological Solid ; Daily inspection of ; Cost
sandy Waste Management Plan (ESWMP) waste/recycling bins for const
clay Set-up temporary fence around the segregation

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

EE Checklist Report for Subdivision and Housing Projects

/ Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of M
Implementation and frequency
Engage third party company for waste
collection
Others, specify
________________

Presence of visually significant

landforms/landscape/structures?
Implement landscaping and other Regular inspection of ; Cost
beautification measures landscaping and other const
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

e Specify nearest/receiving water ; Set-up proper and adequate sanitary Regular (ocular) inspection of: ; Cost
body:
____________________________
facilities Drainage / canal systems const
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
downstream siltation
fresh water, specify classification: Total Coliform
AA
Provision of three-chambered septic tank
Color
for domestic sewage
A
Others, specify
Oil and Grease
B ___________
C
D

EE Checklist Report for Subdivision and Housing Projects

/ Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of M
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

Size of population using receiving Implement rainwater harvesting and similar ; Cost
surface water: measures as an alternative source of water ; Regularly monitor const
1,000 persons ; Observe water conservation measures presence/absence of
complaints
>1,000 and 5,000persons Careful selection of project site to avoid
>5,000person disruption of traditional water uses ; Regular coordination with

EE Checklist Report for Subdivision and Housing Projects

/ Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of M
Implementation and frequency
Obtain Water Permit from NWRB concerned agencies
Available/nearest water source.
; Improve efficiency of water supply and ; Regularly monitor
Deepwell distribution system occurrences of water
shortages
Water district/LGU Others, specify
Surface water ________________________ Others, specify
____________
Others, specify
_________________________

Is the project site located in an area

identified by MGB/PAG-ASA as
Use appropriate design for project facilities ; Regularly monitor ; Cost
presence/absence of const
flood prone? Implement appropriate drainage system
complaints
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
_________________
________________________

n Distance to nearest community: Properly operate and maintain all emission ; Regularly monitor ; Cost
0 to less than 0.5 km sources (e.g. vehicles, generator, etc) presence/absence of const
complaints
0.5 to 1 km Install when applicable, the appropriate air
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

EE Checklist Report for Subdivision and Housing Projects

/ Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of M
Implementation and frequency
Other, specify
____________________________

e Distance to nearest community: Properly operate and maintain all noise ; Regularly monitor ; Cost
0 to less than 0.5 km sources (e.g. vehicles, generator, etc) presence/absence of const
complaints
0.5 to 1 km Install when applicable, the appropriate
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
_____________________________

Size of population of host barangay: Provide relocation/disturbance ; Regularly monitor ; Cost

t 1,000 persons compensation packages presence/absence of const
; complaints
>1,000 and 5,000persons Prioritize local residents for employment
; ; Regular coordination with
>5,000person Promptly pay local taxes and other
LGU
financial obligations
Classification of host barangay: ; Regular coordination with LGU Others, specify
nt _________________
Urban Prior consultation & coordination to
Rural minimize disruption on daily domestic
activities & respect for IP rights and
Available services within/near the cultural practices
host barangay: Ensure participation of IPs in consultations

or
Schools (e.g. elementary, high and dialogues
school, college) Provide appropriate traffic/warning signs,

n
Health facilities (e.g., clinics, lighting, etc
hospitals, etc.) Others, specify
Peace and order (e.g., police ________________
outpost, brgy. Tanod, etc.)

EE Checklist Report for Subdivision and Housing Projects

/ Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of M
Implementation and frequency

y ; Regular coordination with LGU ; Regularly monitor ; Cost

Recreation and sports facilities Provide appropriate warning signs, lighting presence/absence of
complaints
const
and barricades, whenever practicable
Others, specify
; 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
________________________

EE Checklist Report for Subdivision and Housing Projects

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)

12 IEE Checklist Report for Subdivision and Housing Projects

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

13 IEE Checklist Report for Subdivision and Housing Projects

 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