LIVESTOCK/POULTRY PROJECT

INITIAL ENVIRONMENTAL EXAMINATION (IEE) CHECKLIST REPORT

For

Project name or Title

This IEE Checklist Report shall be used for proposed LIVESTOCK/POULTRY PROJECTs to be
located within Environmentally Critical Areas (ECA).

Please check applicable project category:

 Project Type Parameter Threshold
Livestock Production :
Stock Population ≥ 100 heads but < 5,000 heads
Pigs / Goats
≥ 10,000 heads but < 100,000
Poultry / Birds Stock Population
heads

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 completed/duly-accomplished form.

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/Building
Footprint Area ______________________________________________________
(Area actually utilized)
Project Proponent: ______________________________________________________
______________________________________________________

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Office Address:
Contact Person: ______________________________________________________
Designation: ______________________________________________________
Contact Information
Telephone Number: _________________________________________
Fax Number: _________________________________________
Mobile Number: _________________________________________
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.

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

Maximum Stock Population (per growing season): _______________________

Facilities Number of Specification/Description/Remarks

Units (Include number of heads and other size
description)
1. Cages / Pens / Enclosures
2. Gestating/Nursery Compartment /
Hatchery
3. Support Facilities (e.g. feeders,
generators, admin building,
workers’ quarter, etc.)
4. Storage facility
5. Water source / supply
6. Waste water management Facility
7. Solid waste management facility
8. Drainage system
9. Others, specify
_________________

1.3 UTILITIES/REQUIREMENTS:

Utilities Source Estimated

Demand/Consumption
Power/Electricity
KWh
(Total)
Power/Electricity
KWh
(From Renewable Energy

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Sources)
Water
(Total) 3
m /day
(Fill-up table below if water is not obtained
from the local water utility)
Water
3
(Rainwater Collection System) m /day

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

Measures
Power/Electricity KWh

3
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): ____________

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Possible Environmental/ Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/ Monitoring
Social Impacts Implementation
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
Permit
replanted/ revegetated construction /operation cost
clearing
 Marshland
 Limit land clearing as much as possible
 Grassland
 Provide temporary fencing for vegetation
 Mangrove 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/ Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/ Monitoring
Social Impacts Implementation
 Change in surface Slope:  Provide erosion control and slope  Regular inspection of slope  Slope/ Erosion Control
landform/ topography/  flat (0-3%) protection measures protection measures in Cost: ___________
terrain/slope  gently sloping to rolling (3-  Designate a Spoils Storage Area, with erosion-prone areas  Others, specify
18%) topsoil set aside for later use and allow  Regular inspection for new ____________________
 Soil Erosion  steep (>18%) maximum re-use of spoils eroded areas near the site
 Construction during dry season  Others, specify
 Stabilization of embankment with grasses ____________________
or other soil cover
 Others, specify
_______________

Is the project site located in an area

identified by MGB/PAG-ASA/  Compliance with the DENR Administrative
PHIVOLCS as hazard prone? Order No. 2003-30 and DENR
 Yes Administrative Order No. 2000-28,
Implementing Guidelines on Engineering
 No 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
construction area  Daily inspection for presence
 sandy-loam
 Implement re-use and recycling of waste of mixed garbage in the
 Others, specify materials facility
____________________
 Implement proper segregation, collection  Weekly inspection of waste
and disposal of domestic wastes in accumulated
designated areas  Others, specify
 Implement proper collection and _________________
processing of animal waste into organic
fertilizer
 Implement proper collection, labeling and
storage of hazardous waste

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Possible Environmental/ Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/ Monitoring
Social Impacts Implementation
 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 other  Regular inspection of  Cost integrated in the
aesthetics landforms/landscape/structures? beautification measures landscaping and other construction/ operation cost
 Devaluation of land  Yes  Provide adequate buffer beautification activities
values  No  Compensate adjacent property owners  Regular monitoring of buffer
zones
 Others, specify
 Regularly monitor
________________
presence/absence of
complaints from adjacent
property owners

WATER

 Increased siltation due Specify nearest/receiving water  Set-up proper and adequate sanitary Regular (ocular) inspection of:  Cost integrated in the
to project activities body:
____________________________
facilities  Drainage / canal systems construction/ operation cost
 Water quality  Strictly require the contractor and its  Water treatment facility (i.e.,
degradation Distance to nearest/receiving water workers to observe proper waste disposal grease trap, septic tank, etc.)
 Others, specify 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. septic tank, oil and water separator,  TSS concentration
etc.)
 BOD
 Provision of biogas generator or similar
 Total Coliform
waste treatment measures
 Set up silt trap/settling ponds to minimize
 Color

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Possible Environmental/ Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/ Monitoring
Social Impacts Implementation
downstream siltation  Oil and Grease
If nearest/receiving water body is
 Others, specify
___________
fresh water, specify classification:
 AA
 A
 B
 C
 D

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

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Possible Environmental/ Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/ Monitoring
Social Impacts Implementation

Use of the nearest well:

 Drinking/Domestic
 Industrial
 Agricultural

 Competition in water Size of population using receiving  Implement rainwater harvesting and similar  Regularly monitor  Cost integrated in the
use surface water: measures as an alternative source of water presence/absence of construction/ operation cost
 Depletion of water  ≤ 1,000 persons  Observe water conservation measures;
complaints
resources  >1,000 and ≤ 5,000persons  Careful selection of project site to avoid
 Regular coordination with
concerned agencies
 >5,000person disruption of traditional water uses
 Regularly monitor
 Obtain Water Permit from NWRB occurrences of water
Available/nearest water source.
 Improve efficiency of water supply and shortages
 Deepwell distribution system  Others, specify
 Water district/LGU  Others, specify _______________________
 Surface water _________________________
 Others, specify
__________________

 Increased occurrence Is the project site located in an area  Use appropriate design for project facilities  Regularly monitor  Cost integrated in the
of flooding identified by MGB/PAG-ASA as
flood prone?
 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
hand-pumps) to protect drinking water from
 Regularly monitor increased
frequency of flooding
flood contamination
 Others, specify
 Others, specify
_________________
_________________________

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Possible Environmental/ Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/ Monitoring
Social Impacts Implementation
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
pollution control device/s
 More than 1 km 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 nearby
residents
 Use covered vehicles to deliver materials
that may generate dust
 Others, specify
_____________________

 Nuisance due to Distance to nearest community:  Regular clean-up of animal houses  Regularly monitor  Cost integrated in the
generation of  0 to less than 0.5 km  Use of environment-friendly deodorizer or
presence/absence of
complaints
construction/ operation cost
obnoxious/unpleasant
odor  0.5 to 1 km odor masking substances
 More than 1 km  Spraying natural / microbial disinfectants
 Provide adequate buffer and/or planting of
Is the wind direction blowing trees
towards the nearest community  Others, specify
most of the year? ____________________
 Yes
 No

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Possible Environmental/ Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/ Monitoring
Social Impacts Implementation
 Nuisance due to noise Distance to nearest community:  Properly handle animals and implement  Regularly monitor  Cost integrated in the
generation  0 to less than 0.5 km appropriate measures (e.g., continuous presence/absence of
complaints
construction/ operation cost
light, proper feeding) to prevent noise
 0.5 to 1 km generation  Regular monitoring of buffer
 More than 1 km  Properly operate and maintain all noise zones
sources (e.g. vehicles, boiler, 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
 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
financial obligations LGU
Indigenous People
 Regular coordination with LGU  Others, specify
 Enhanced employment Classification of host barangay:
 Prior consultation & coordination to
_________________
and/or livelihood  Urban minimize disruption on daily domestic
opportunities
 Rural activities & respect for IP rights and
 Reduced employment cultural practices
and/or livelihood
opportunities Available services within/near the  Ensure participation of IPs in consultations
host barangay: and dialogues
 Increased revenues for
 Schools (e.g. elementary,  Provide appropriate traffic/warning signs,
LGU
high school, college) lighting, etc
 Disruption/Competition
 Health facilities (e.g.,  Others, specify

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Possible Environmental/ Baseline Environment Preventive/ Mitigating Measures Monitoring Parameters/ Cost of Mitigation/ Monitoring
Social Impacts Implementation
in delivery of public clinics, hospitals, etc.) _________________
services (e.g.,
education, peace and
 Peace and order (e.g.,
police outpost, brgy. Tanod,
order, etc.) etc.)
 Enhanced delivery of  Recreation and sports
public services (e.g., facilities
education, peace and
order, etc.)  Others, specify
 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
 Regular submission of reports
emergency.
to concerned agency
 Participate in public awareness programs
 Others, specify
on health and safety
_________________
 Regularly spray disinfectant, pesticides
and other similar substances when
applicable
 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)

12 | 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 o u l t r y P r o j e c t s
Attach site development/layout plan (with dimensions and descriptions)

13 | 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 o u l t r y P r o j e c t s
Attach drawing/plan of waste water treatment facility (with dimensions and descriptions)

14 | 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 o u l t r y P r o j e c t s
 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 ____________________

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