GENERIC EPRMP Checklist Formatted

GENERIC ENVIRONMENTAL PERFORMANCE REPORT AND MANAGEMENT PLAN
(CHECKLIST FORMAT)
____________________________________________
Project name or Title
This Generic ENVIRONMENTAL PERFORMANCE REPORT AND MANAGEMENT PLAN

(EPRMP) shall be used as the interim pro-forma EIA Report requirement (IEE Checklist) for
non environmentally critical projects located within Environmentally Critical Areas (ECA)
requesting expansion or modification
For ECC applications, this EPRMP 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 Checklist Report within twenty (20) working
days upon receipt for completed/duly-accomplished form.
Misleading or erroneous answers are basis for legal actions and/or denial of ECC
issuance.
Generic Environmental Performance Report and Management Plan

PROJECT FACT SHEET
Project Name:
Project Address:
Expansion Category  New product/process : _____________________

Check all applicable
 Increase in production capacity from _____to ____
changes in the
 Increase in production area from _____to _____
proponent’s operation
 Increase in no. of facilities/equipment
 Others __________________________________
,
Existing Land Area
Project Land Area:
Proposed expansion (if any)
Total land area

Footprint Area Existing building footprint
area
Proposed expansion (if any)
Total building footprint area

Project Proponent:
Office Address:
Contact Person:
Designation:
Contact Number/s
Landline : ________________________________________________
Fax Number: ________________________________________________
Mobile : _________________________________________________
E-mail Address: _________________________________________________

I. PROJECT DESCRIPTION
1.1 PROJECT LOCATION AND AREA: Street Name, Barangay, and Municipality/City,
Province
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
See attached vicinity map/s and photographs of the project site and site development/layout
plan (include existing project component in the layout)
Geographic coordinates of the project area (Preferably use PRS 92 datum, otherwise specify
datum used).
Perimeter/Boundary points
(based on OCT/TCT/etc) Longitude Latitude Longitude Latitude
Existing Expansion
Note: delineate boundary points of existing and proposed expansion project
1.2 PROJECT COMPONENTS
Area Specification/ No. Area Specification/

No. of
Facilities (sq. m.) / Description / of (sq. m.) / Description /
Units
Capacity Remarks Units Capacity Remarks
Existing Expansion
Support Facilities
(e.g. emergency
generators,
boilers, etc.)
Admin support
(e.g., canteen,
office, clinic,
quarters, etc.)
Water source /
supply
Waste water
management
Facility
Solid waste
management
facility
Drainage system

(Please list facilities by module/grouping. Use additional sheets if needed)
1.3 UTILITIES/REQUIREMENTS (Operation Phase):
Utilities Source Estimated Source Estimated

Demand/ Demand/
Consumption Consumption
Existing Expansion
Power/Electricity
KWh KWh
(Total)
Power/Electricity
(From Renewable KWh KWh
Energy Sources)
Water
(Total)
Cubic
(Fill-up table below if water Cubic meters/day
meters/day
is not obtained from the
local water utility)
Water
Cubic
(Rainwater Collection Cubic meters/day
meters/day
System)
Water Source(Domestic)
Existing Expansion
[ ] ground water [ ] well [ ] spring [ ] ground water [ ] well [ ]

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

[ ] others: [ ] others:
____________________________ ____________________________
Location of water source Location of water source

______________________________ _____________________________
______________________________ _____________________________
______________ ________________
(Sitio/Zone, Barangay, (Sitio/Zone, Barangay,
Municipality/City, Province, Region) Municipality/City, Province, Region)

Water Source(Operation/Process)
Existing Expansion
[ ] ground water [ ] well [ ] spring [ ] ground water [ ] well [ ]

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

[ ] others: [ ] others:
____________________________ ____________________________
Location of water source Location of water source

______________________________ ______________________________
______________________________ ______________________________
______________ ______________
(Sitio/Zone, Barangay, (Sitio/Zone, Barangay,
Municipality/City, Province, Region) Municipality/City, Province, Region)
Raw Material Requirements

List all raw materials including chemicals to be used and check source, add more space if
necessary
Raw Materials Toxic? (Y/N) Quantity
Energy/Water Efficiency
Utilities Estimated Efficiency/Conservation Estimate Efficiency/Conservation
Savings Measures d Measures
Savings
Existing Expansion
Power/ KWh
Electricity
Water Cubic
meters/day

1.4 MANPOWER / TIMETABLE OF CONSTRUCTION
TIMELINES FOR CONSTRUCTION AND COMMISSIONING OF PROJECT

EXPANSION
Proposed Start of Construction :
Proposed Start of Commissioning :
Proposed Start of Commercial
:
Operation
a. Construction Phase
Manpower Expertise/Skills Total Expertise/Skills Total
Requirement
Existing Expansion
b. Operation Phase
Manpower Expertise/Skills Total Expertise/Skills Total
Requirement
Existing Expansion
1.5 INDICATIVE PROJECT COST
Total Project Cost (PhP): ____________

II. INTEGRATED ENVIRONMENTAL IMPACTS AND MANAGEMENT PLAN
Possible Environmental/ Baseline Environment Preventive/ Mitigating Monitoring Cost of

Social Impacts Measures (for entire project) Parameters/ Mitigation/
Implementation (for Monitoring (for
entire project) entire project)
LAND
 Consistency with land Current land use w/in 1km radius  See attached proof of
use (as per zoning ordinance): compatibility with land use
 Residential
 Commercial/ Institutional  Others: ______________
 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  Compliance with conditions  Annual inspection of  Cost
due to vegetation expansion area: of DENR/LGU CLUP, Tree area replanted/ integrated in
clearing during  Forestland Cutting Permit, ROW, revegetated the
expansion  Marshland Permit construction
 Grassland  Limit land clearing as much  Others, specify /operation
as possible ________________ cost
 Mangrove  Provide temporary fencing

 Wetland for vegetation that will be
retained
 Others, specify
____________________  Promote restoration of
damaged or destroyed
vegetation where possible
(e.g., tree planting);
 Possible tenurial / land Identify tenurial/ land issues:  Obtain appropriate  Regularly monitor  Cost
issue  CARP clearances/ permits from presence/absence of integrated in
complaints the
 CADC/ CADT/ CALC/ CALT concerned agencies
 Regular coordination construction
 ROW  Resettlement Plan with LGU or / operation
prepared cost
 Informal settlers appropriate agencies
 Ecologically sensitive or
 Provide  Others, specify
relocation/disturbance ________________
protected area
compensation packages
 Others, specify
 Ensure participation of IPs
____________
in consultations and
dialogues
 MOA prepared/signed
 Provide adequate buffer
 Others, specify
____________

 Change in surface Slope in expansion area:  Provide erosion control and  Regular inspection  Slope/
landform/ topography/  flat (0-3%) slope protection measures of slope protection Erosion
terrain/slope (in  gently sloping to rolling (3-  Designate a Spoils Storage measures in erosion- Control
expansion area) 18%) Area, with topsoil set aside prone areas Cost:
 steep (>18%) for later use and allow  Regular inspection _________
 Soil Erosion(in maximum re-use of spoils for new eroded areas __
expansion area)  Construction during dry near the site  Others,
season  Others, specify specify
____________
 Stabilization of ___________
embankment with grasses
or other soil cover
 Others, specify
____________
Is the project site’s expansion area
located in an area identified by
MGB/PAG-ASA/ PHIVOLCS as  Compliance with the DENR
hazard prone? Administrative Order No.
2003-30 and DENR
 Yes Administrative Order No.
 No 2000-28, Implementing
Guidelines on Engineering
Geological and Geo-hazard
Assessment (EGGA).

 Soil/Land Existing soil type in the expansion  Implementation of the  Daily inspection of  Cost
contamination due to area: Ecological Solid Waste waste/recycling bins integrated in
improper solid waste  sandy Management Plan for segregation the
disposal (in expansion  clay (ESWMP)  Daily inspection for construction
area)
 sandy-loam  Set-up temporary fence presence of mixed /operation
around the construction garbage in the facility cost
 Others, specify area  Weekly inspection of
____________
 Implement re-use and waste accumulated
recycling of waste materials  Others, specify
 Implement proper _____________
segregation, collection and
disposal of domestic
wastes in designated areas
 Provide receptacles / bins
for solid wastes
 Coordinate with the
municipal / city waste
collectors
 Engage third party
company for waste
collection
 Others, specify
________________

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

 D  Provision of three-  Oil and Grease
chambered septic tank for
If nearest/receiving water body is domestic sewage Frequency
coastal or marine water, specify  Provide ring canals around  Annual
classification: fuelling tanks/ motorpool/  Semi-annual
 SA maintenance areas
 Quarterly
 SB  Others, specify
 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  Regularly monitor  Cost
use surface water: harvesting and similar presence/absence of integrated in
 Depletion of water  ≤ 1,000 persons measures as an alternative complaints the
resources  >1,000 and ≤ 5,000persons source of water  Regular coordination construction
 >5,000person  Observe water with concerned / operation
conservation measures; agencies cost
Available/nearest water source.  Careful selection of project  Regularly monitor
occurrences of water
 Deepwell site to avoid disruption of
shortages
traditional water uses
 Water district/LGU  Others, specify
 Surface water  Obtain Water Permit from
NWRB ____________
 Others, specify  Improve efficiency of water
________________________
supply and distribution
system
 Others, specify
_____________________
 Increased occurrence Is the project site located in an  Use appropriate design for  Regularly monitor  Cost
of flooding area identified by MGB/PAG-ASA project facilities presence/absence of integrated in
as flood prone?
 Implement appropriate complaints the
 Yes drainage system  Regular coordination construction
 No  Regularly remove debris with concerned / operation
agencies cost
and other materials that
may obstruct water flow  Regularly monitor

 Use appropriate technology increased frequency
(e.g. raised hand-pumps) to of flooding
protect drinking water from  Others, specify
flood contamination _________________
 Others, specify
_____________________
AIR / NOISE
 Nuisance due to noise Distance to nearest community:  Properly operate and  Regularly monitor  Cost
generation  0 to less than 0.5 km maintain all noise sources presence/absence of integrated in
 0.5 to 1 km (e.g. vehicles, pumps, complaints the
 More than 1 km generator, etc)  Regular monitoring construction
 Install when applicable, the of buffer zones / operation
appropriate noise control cost
device/s (e.g., mufflers,
silencer, sound barriers,
etc.)
 Implement appropriate
operating hours

and/or planting of trees
 Others, specify
______________________
PEOPLE
 Displacement of Size of population of host  Provide  Regularly monitor  Cost
residents in the project barangay: relocation/disturbance presence/absence of integrated in
site and within its  ≤ 1,000 persons compensation packages complaints the
vicinity  >1,000 and ≤ 5,000persons  Prioritize local residents for  Regular coordination construction
 Displacement of  >5,000person employment with LGU / operation
Indigenous People  Promptly pay local taxes  Others, specify cost
 Enhanced Classification of host barangay: and other financial _________________
obligations
employment and/or  Urban
livelihood  Regular coordination with
opportunities  Rural LGU
 Reduced employment Available services within/near the  Prior consultation &
and/or livelihood host barangay: coordination to minimize
opportunities disruption on daily domestic
 Increased revenues
 Schools (e.g. elementary, high activities & respect for IP
school, college) rights and cultural practices
for LGU
 Disruption/Competition
 Health facilities (e.g., clinics,  Ensure participation of IPs
hospitals, etc.) in consultations and
in delivery of public
services (e.g.,  Peace and order (e.g., police dialogues
education, peace and outpost, brgy. Tanod, etc.)  Provide appropriate
order, etc.)  Recreation and sports facilities traffic/warning signs,
 Enhanced delivery of  Others, specify lighting, etc

public services (e.g., _____________________  Others, specify
education, peace and ________________
order, etc.)
 Increase in traffic
volume and worsening
of traffic flow
 Impacts on community  Regular coordination with  Presence/Absence  Cost

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

 Strictly comply with
requirements of RA 6969
 Others, specify
______________________

III. ENVIRONMENTAL PERFORMANCE
A. PROPONENT’S COMPLIANCE
A.1 Compliance to ECC Conditions
COMPLIED? PROOF OF COMPLIANCE

ECC CONDITIONS
Y N
1
2
3
4
5
6
7
8
9
10
A.2 Compliance to EMP Commitment
Were they
MITIGATING MEASURES
Effective? RECOMMENDATION/s / REMARKS
Which of the following mitigating measures were actually implemented? Y N
LAND
 Compliance with conditions of DENR/LGU SLUP, Tree Cutting Permit,
ROW, PCA Permit
 Limit land clearing as much as possible
 Provide temporary fencing for vegetation that will be retained
 Promote restoration of damaged or destroyed vegetation where possible
(e.g., tree planting);

Were they
MITIGATING MEASURES
 Provide erosion control and slope protection measures
 Designate a Spoils Storage Area, with topsoil set aside for later use and
allow maximum re-use of spoils
 Construction during dry season
 Stabilization of embankment with grasses or other soil cover
 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).
 Implementation of the Ecological Solid Waste Management Plan (ESWMP)

 Set-up temporary fence around the construction area
 Implement re-use and recycling of waste materials
 Implement proper segregation, collection and disposal of domestic wastes
in designated areas
 Provide receptacles / bins for solid wastes
 Coordinate with the municipal / city waste collectors
 Engage third party company for waste collection
 Implement landscaping and other beautification measures
 Compensate adjacent property owners
WATER
 Set-up proper and adequate sanitary facilities

Were they
MITIGATING MEASURES
 Strictly require the contractor and its workers to observe proper waste
disposal and proper sanitation
 Strictly observe proper waste handling and disposal
 Provision of wastewater treatment facility (e.g. septic tank, oil and water
separator, etc.)
 Set up silt trap/stilling ponds to minimize downstream siltation
 Provision of three-chambered septic tank for domestic sewage
 Provide ring canals around fuelling tanks/ motorpool/ maintenance areas
 Implement rainwater harvesting and similar measures as an alternative
source of water
 Observe water conservation measures;
 Careful selection of project site to avoid disruption of traditional water uses
 Obtain Water Permit from NWRB
 Improve efficiency of water supply and distribution system
 Use appropriate design for project facilities
 Implement appropriate drainage system
 Regularly remove debris and other materials that may obstruct water flow
 Use appropriate technology (e.g. raised hand-pumps) to protect drinking
water from flood contamination
AIR
 Properly operate and maintain all emission sources (e.g. vehicles, pumps,
generator, etc)
 Install when applicable, the appropriate air pollution control device/s

Were they
MITIGATING MEASURES
 Strictly enforce good housekeeping practices
 Control vehicle speed to lessen suspension of road dust
 Conduct water spraying to suppress dust sources and minimize discomfort
to nearby residents
 Use covered vehicles to deliver materials that may generate dust
 Properly operate and maintain all noise sources (e.g. vehicles, pumps,
generator, etc)
 Install when applicable, the appropriate noise control device/s (e.g.,
mufflers, silencer, sound barriers, etc.)
 Implement appropriate operating hours
 Provide adequate buffer and/or planting of trees
PEOPLE
 Provide relocation/disturbance compensation packages

 Prioritize local residents for employment
 Promptly pay local taxes and other financial obligations
 Regular coordination with LGU
 Prior consultation & coordination to minimize disruption on daily domestic
activities & respect for IP rights and cultural practices
 Ensure participation of IPs in consultations and dialogues

 Provide appropriate traffic/warning signs, lighting, etc
 Regular coordination with LGU
 Provide appropriate warning signs, lighting and barricades, whenever
practicable

Were they
MITIGATING MEASURES
 Observe proper housekeeping
 Provide on-site medical services for any emergency.
 Participate in public awareness programs on health and safety
 Implement appropriate safety programs for both community and workers
 Strictly comply with fire, safety and similar regulatory requirements

 Strictly comply with requirements of RA 6969

A.3 Air Quality Impact Assessment
Parameters RESULTS OF ANALYSIS FOR DENR Recommendation/Remarks

Sampling Stations THE LAST 3 YEARS STANDARDS Pass/Fail
1st 2nd 3rd

(current
year)
AMBIENT
Sampling Station 1 TSP
Description: PM10
_________________ NOx
SOx
Others
1.
2.
3.
Description: PM10
_________________ NOx
SOx
Others
1.
2.
3.
Description: PM10
_________________ NOx
SOx
others
1.
2.
3.

Parameters RESULTS OF ANALYSIS FOR DENR Recommendation/Remarks
Sampling Stations THE LAST 3 YEARS STANDARDS Pass/Fail
1st 2nd 3rd

(current
year)
PLANT EMISSIONS
Source TSP
Description: PM10
NOx
Sox
Others
1.
2.
3.

A.4 Water Quality Impact Assessment
Parameters DENR Recommendation/Remarks

Sampling RESULTS
STANDAR Pass/Fail
Stations
DS
1st year 2nd year 3rd year
AMBIENT
Sampling BOD5
Station 1 TSS
Description/ Oil and
Location: Grease
__________ Fecal/ Total
______ Coliform
Others
1.
2.
3.
Sampling BOD5
Station 2 TSS
Location: Grease
__________ Fecal/ Total
______ Coliform
Others
1.
2.
3.

Parameters DENR Recommendation/Remarks
Sampling RESULTS
STANDAR Pass/Fail
Stations
DS
1st year 2nd year 3rd year
AMBIENT
Sampling BOD5
Station 3 TSS
Location: Grease
__________ Fecal/Total
______ Coliform
Others
1.
2.
3.
PLANT EFFLUENT
Description/ BOD5
Location of TSS
plant outfall: Oil and
__________ Grease
______ Fecal/Total
Coliform
Others
1.
2.
3.

A.5 Compliance with good practices in HAZARDOUS WASTE Management
TYPE OF ADEQUATE?
HANDLING STORAGE DISPOSAL REMARKS
WASTE Y N
1
2
3
N
A.6 Compliance with good practices in SOLID WASTE Management
TYPE OF ADEQUATE?
HANDLING STORAGE DISPOSAL REMARKS
WASTE Y N
Biodegradable
Non
biodegradable
A.7 Compliance with good practices in CHEMICAL SAFETY Management (for those companies using/producing chemicals listed in EMB’s PCL
and CCO list)
Chemicals ADEQUATE ?* (put  if adequate)

in PCL
Handling & Emergency REMARKS
and CCO Risk Management Training
Storage Preparedness
List

B. COMMUNITY RELATIONS
Yes No
1. Is there a system for identifying and responding to community and stakeholder concerns? □ □
2. Is there a system for informing the community and other stakeholders on environmental matters relative
□ □
to the company’s current operations?
3. Is the company implementing a community development project or any project directed towards
□ □
improving stakeholders
C. COMPLAINTS MANAGEMENT
Yes No
1. Has the company/proponent received any complaints from the surrounding community and/or
□ □
other stakeholders due to pollution or other nuisances caused by its operation?
If yes, please identify area/s of concern:

□ Offensive odor □ Toxic chemical / Oil Spill
□ Corrosive emissions □ Flying debris from construction
□ Particulate/dust emissions □ Scattering / burning of industrial wastes
□ Opaque / black smoke emissions □ Others (pls.specify) __________________
□ Colored / contaminated wastewater discharges
□ Noise
Yes No
2. Has the company/proponent addressed the complaint by implementing a complaints management
□ □
system?
3. Have the appropriate government agencies and other interested parties been informed about the
□ □
resolution of the complaint?

IV. ABANDONMENT /DECOMMISSIONING/REHABILITATION POLICIES ANDGUIDELINES
(if Applicable)
Total Project Life or Service: ___________ years
Provide description of the Abandonment activities for existing and proposed expansion, such as,
dismantling and waste disposal.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
______________________________________________
V. INSTITUTIONAL PLAN FOR INTEGRATED EMP IMPLEMENTATION
Organization Chart (include name of personnel/staff assigned to the positions):

Attach drawing/plan of waste water treatment facility (with dimensions and
descriptions) for existing and proposed project

Attach drawing/plan of air pollution source and control installations (with
dimensions and descriptions) for existing and proposed expansion

SWORN STATEMENT OF ACCOUNTABILITY OF THE PROPONENT
This is to certify that all the information and commitments in this Environmental
Performance Report and Management Plan (EPRMP) 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 EPRMP 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 EPRMP.
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
____________________

GENERIC EPRMP Checklist Formatted

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GENERIC ENVIRONMENTAL PERFORMANCE REPORT AND MANAGEMENT PLAN

Project name or Title

This Generic ENVIRONMENTAL PERFORMANCE REPORT AND MANAGEMENT PLAN

For ECC applications, this EPRMP shall be submitted with:

Project proponents are strongly discouraged to engage the services of

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

Generic Environmental Performance Report and Management Plan

Expansion Category  New product/process : _____________________

Total land area

Proposed expansion (if any)

Total building footprint area

Generic Environmental Performance Report and Management Plan

Note: delineate boundary points of existing and proposed expansion project

1.2 PROJECT COMPONENTS

Area Specification/ No. Area Specification/

Generic Environmental Performance Report and Management Plan

1.3 UTILITIES/REQUIREMENTS (Operation Phase):

Utilities Source Estimated Source Estimated

[ ] ground water [ ] well [ ] spring [ ] ground water [ ] well [ ]

[ ] Surface water [ ] river [ ] lake [ ] Surface water [ ] river [ ] lake

Location of water source Location of water source

Generic Environmental Performance Report and Management Plan

[ ] ground water [ ] well [ ] spring [ ] ground water [ ] well [ ]

[ ] Surface water [ ] river [ ] lake [ ] Surface water [ ] river [ ] lake

Location of water source Location of water source

Raw Material Requirements

Raw Materials Toxic? (Y/N) Quantity

Generic Environmental Performance Report and Management Plan

TIMELINES FOR CONSTRUCTION AND COMMISSIONING OF PROJECT

1.5 INDICATIVE PROJECT COST

Total Project Cost (PhP): ____________

Generic Environmental Performance Report and Management Plan

Possible Environmental/ Baseline Environment Preventive/ Mitigating Monitoring Cost of

Generic Environmental Performance Report and Management Plan

Generic Environmental Performance Report and Management Plan

Generic Environmental Performance Report and Management Plan

Generic Environmental Performance Report and Management Plan

Generic Environmental Performance Report and Management Plan

Generic Environmental Performance Report and Management Plan

Generic Environmental Performance Report and Management Plan

Generic Environmental Performance Report and Management Plan

Generic Environmental Performance Report and Management Plan

 Impacts on community  Regular coordination with  Presence/Absence  Cost

Generic Environmental Performance Report and Management Plan

Generic Environmental Performance Report and Management Plan

A.1 Compliance to ECC Conditions

COMPLIED? PROOF OF COMPLIANCE

A.2 Compliance to EMP Commitment

Generic Environmental Performance Report and Management Plan

 Implementation of the Ecological Solid Waste Management Plan (ESWMP)

 Set-up proper and adequate sanitary facilities

Generic Environmental Performance Report and Management Plan

Generic Environmental Performance Report and Management Plan

 Provide relocation/disturbance compensation packages

 Ensure participation of IPs in consultations and dialogues

Generic Environmental Performance Report and Management Plan

 Implement appropriate safety programs for both community and workers

 Strictly comply with fire, safety and similar regulatory requirements

Generic Environmental Performance Report and Management Plan

Parameters RESULTS OF ANALYSIS FOR DENR Recommendation/Remarks

1st 2nd 3rd

Generic Environmental Performance Report and Management Plan

1st 2nd 3rd

Generic Environmental Performance Report and Management Plan

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