MARBLE SLAB PROCESSING PLANT PROJECT

INITIAL ENVIRONMENTAL EXAMINATION ( IEE ) CHECKLIST

for

Project Name or Title

Below is the IEE Checklist for Marble slab processing plant project proponents. Read the
question below before answering the space provided. Uses additional sheets if necessary and
indicate this in the appropriate space.

PROJECT LOCATION:
_____________________________________________________________________________
_____________________________________________________________________________
____
(Complete Address: Street, Barangay and Municipality/City, Project) (attach location / Vicinity map)

NAME OF PROPONENT: _________________________________________________________

TIN: _________________________________________________________
ADDRESS:
_____________________________________________________________________________
_____________________________________________________________________________
__________
(Complete Address: Street, Barangay, and Municipality/City)

Telephone: _____________________________
Fax : _____________________________
Email : _____________________________

A. GENERAL INFORMATION

1. Project Ownership : (Attach document as ANNEX 1)

Corporation Single Proprietorship Partnership

Project Ownership (if a corp.)

List of Owners
(for partnership/corporation, list top 5 partners / shareholders with largest holding )
Name / Citizenship Address % Share/ holding
Position

IEE Checklist for Marble Slab Processing Plant

Page 1 of 20
Other related businesses (List down similar projects undertaken/ handled by proponent, both
local and international)
Project Name Date (inclusive) Project Involvement/Experiences
Description

2. Capitalization & Project Cost:

Capitalization : ________________(Pesos) Date Established: ______________________

Project Cost : ________________(Pesos)

Mode of Financing : In- house Bank Others______________

B. PROJECT OBJECTIVES

General:_____________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
_____

Specific:_____________________________________________________________________________
____________________________________________________________________________________
___
____________________________________________________________________________________
__
____________________________________________________________________________________
__
____________________________________________________________________________________
__
____________________________________________________________________________________
__

C. PROJECT DESCRIPTION

1.) Land Ownership (attach photocopies of documents in the space provided and survey plan as
ANNEX 2) ;

Total land area (sq. m. )

Land Area to be developed (sq. m.)

Period of possession (yrs.)

Basis for Land Possession

(please check appropriate box)
 ownership of land by virtue of OCT or TCT #
_______________________________________

IEE Checklist for Marble Slab Processing Plant

Page 2 of 20
 (attach photocopy of document as Annex 2a)

 stewardship of land virtue of

_______________________________________
(attach photocopy of document as Annex 2b)
 lease of the land by virtue of
_______________________________________
(attach photocopy of document as Annex 2c)

 pending application for

_______________________________________
(attach photocopy of document as Annex 2d)

 Others, please specify

_______________________________________
(attach photocopy of document as Annex 2e)

2.) Land Use

Existing Land Use : _______________________________________________________________

Approved Land Use:

Residential
Commercial
Industrial
Light
Heavy
Institutional
Built-up
Agricultural
Conversion Approved by DAR Yes No
Forest Land

Comprehensive Land Use Plan: Approved No

Locational Clearance: Granted by (Attach as Annex 3)

HLURB Deputized Zoning administration

IEE Checklist for Marble Slab Processing Plant

Page 3 of 20
#3 Project Area

Panoramic View of Project Site

Front View of Project Site

IEE Checklist for Marble Slab Processing Plant

Page 4 of 20
Left Side View of Project Site

Right Side View of Project Site

IEE Checklist for Marble Slab Processing Plant

Page 5 of 20
Rear View of Project Site

4.) Brief description of process

(Attach schematic diagram of process flow as Annex 4)

5.) Project Component/Activities

(Attach Site Development Plan as Annex 5)

Ref. No. Component/Activities Brief Description

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18

IEE Checklist for Marble Slab Processing Plant

Page 6 of 20
6. Project Scale

a. Schedule of Project Development (Attach Gantt Chart of Project Timetable as Annex 6)

b. Production Capacity

Type of marble Size in m2 (Dimension of Total Volume (m3)

Finished Product)

c. Sources of Raw Materials

Ref. No. Name of Address Location of ECC No. Volume

Concessionaire/Supplier Quarry Supplied
1
2
3
4
5
6

7. List of Equipment/Facilities (Attach detailed plans equipment layout, photos of machinery and
utilities)

Ref. No. Equipment / Facilities Specification/Description

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

8. Water Utilities (Attach photo/layout)

No. of units Source/Methods Volume Capacity (cu. m.)/

depth(m)
Rainwater, collected in storage tank

IEE Checklist for Marble Slab Processing Plant

Page 7 of 20
 (indicate tank capacity)
Rainwater, collected in
reservoir/impounding structure(indicate tank
capacity)
Ground Water open dug well (indicate
depth)
Groundwater, dug well close with manual
pump (indicate depth)
Groundwater, dug well close with motor
pump (indicate depth/Hp)
Groundwater, drilled well with manual pump
(indicate depth)
Groundwater, drilled well close with manual
pump (indicate depth/HP)
Natural Spring
Surface Water

Local Water District

Others, please specify
Total volume of water extracted/utilized per day (maximum)

Volume of water recycled ___________________ cu. m . /day

Development Phase: ___________________________________ cu. m./day

Operation Phase : ____________________________________ cu. m. /day

Permit : (attach Permit as annex 7) Approve No

NWRB ________________ Local water district ________________ Others _____________

Photo of Water Utilities

IEE Checklist for Marble Slab Processing Plant

Page 8 of 20
9. Power Utilities

No. of Units Source/method Capacity

Generator for Electricity
(indicate HP/ number of hours of operation or
use)
Local Electric utility (indicate monthly
consumption-kW – Hr, maximum)
Kerosene/Gas
Maximum monthly consumption in liters)
LPG (maximum monthly consumption)
Others, please specify

Photo of Power Utilities

IEE Checklist for Marble Slab Processing Plant

Page 9 of 20
10. Manpower Profile

Total number of manpower : _________________________________

Number of Personnel Position

Plant Manager
Plant Engineer
Accountant
Stock Clerk /Checker
Laborers/Workers
Drivers
Auto Mechanic
Security Guard
Others, please identify

Age

Age/Gender Male Female

18-20
21-25
26-30
31-35
36-45
45

Classification of employee/workers Number

Indigenous people

Vulnerable groups
Elderly

Handicapped

 How many of the staff are local residents? ________________________________

 How many of the staff are migrant worker? ________________________________

Salary Profile (PhP/month) Male Female

<2,000
2,001-3,000
3,001-4,000
4,001-5,000
5,001-7,000
7,001-10,000
>10,000

IEE Checklist for Marble Slab Processing Plant

Page 10 of 20
 Educational Attainment Male Female
None
Elementary
High School
College
Vocational
Others

D DESCRIPTION OF ENVIRONMENTAL SETTING

1. PHYSICAL ENVIRONMENT ANSWER

Component Description Y N
Parameter
Terrain Is the terrain flat or level
Is the terrain undulating ? if yes, what’s the slope?

3-18% (rolling)
18-30% (moderately steep)
30-50%(steeply mountainous)
Above 50% (very steeply mountainous)
Forest Is the project site located near or within a forest
Reserve/Watershed reserve/watershed/protected area?
If yes, how near?_____________meter
Cave Are there caves, limestone caverns or sinkholes at the project
site? If yes, describe features under Annex 8
Coastal Is the project site located along coastal area/tidal zone? If yes,
how near ? _________________m.
Geology Is the area prone from soil erosion? If yes, status?
Slight
Moderate
Severe

Are there existing natural hazards in the area? (e.g. landslides,

gullying, subsidence) If yes, describe:

Hydrology Are there natural drainage ways /creeks within the area draining
towards communities downstream?

Is the site within a recharge area of springs downstream?

Is the project site located in the vicinity of a water supply

source? If yes please specify.
___________________________________________________
______
Is the site situated along a flood prone/storm surge area?

Air Quality What is the quality of air? ____ Poor _____ Fair ____ Good
Are there other industries, facilities or undertakings existing in
the vicinity of the area?
If yes, Identify __________________, distance _______ m.

IEE Checklist for Marble Slab Processing Plant

Page 11 of 20
 ___________________, distance _______ m.
___________________, distance _______ m.
___________________, distance _______ m.
Surface Water Are there water bodies along or near the project site? If yes,
identify:___________________________________
Classification: ____________________________

 How deep is the water table during the dry season? (meter)
 How deep is the water table during the wet season?(meter)
 What is the quality of water?
 Fresh
 Brackish
 Saline/Salty

2. NATURAL/BIOLOGICAL ENVIRONMENT ANSWER

Components/ Description Y N
Parameter
Natural Ecosystem Is the project site located immediately adjacent to the
natural ecosystem?
If yes, please check on the appropriate box(es):
 Forest
 Grassland
 Coastal /Marine
 Mangrove
 Wetland
 Others, pls. Specify ____________________________

Wildlife Have you observed any wildlife in the area? If yes, Please
identify and enumerate:
1.
2.
3.
4.
5.

Vegetation Are there important trees/vegetation within the project area?

If yes, please identify and enumerate.
1.
2.
3.
4.
5.

Marine/Aquatic Are there existing marine and aquatic habitat that will be
Resources affected by the project.
If yes, please identify
1.
2.
3.
4.
5.
6.

IEE Checklist for Marble Slab Processing Plant

Page 12 of 20
3. SOCIAL-ECONOMIC ENVIRONMENT ANSWER
Component Description Y N
Parameter
Land / Ancestral Is the project site located with in an ancestral land/domain?
Domain If yes? Identify CADCI/CALCI number
Settlements 1. Are there existing settlements/ tenants within or along
the project area? If yes, indicate the number of
households / families______________
Legitimate landowners______________
Tenants ____________________
Squatters__________________
2. What is the total population of the barangay where the
project is located? Male _______ Female __________
3. Average family size : __________________
4. What are their sources of livelihood
 Farming
 Fishing
 Backyard poultry
 Vending/ buy and \Sell
 Sari-sari store
 Others, Pls. Specify ___________________________
5. What are the existing dwellings made of?
 Temporary
 Semi-permanent
 Permanent
6. Are there existing local organization in the area?
Identify _________________
7. Are there existing social infrastructures in the barangay?
Schools
Communications
Health centers/clinics/hospital
Churches/chapel
Transportation
Roads
Others, pls. Specify
________________________________
8. Are the cultural norms/morals and lifestyle of the local
inhabitants to be affected by the project?
Please elaborate
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
_________________________
Archaeology Is the project site located along an area of
Heritage historical/archaeological significance? If yes, please
identify and enumerate.
1.
2.

IEE Checklist for Marble Slab Processing Plant

Page 13 of 20
3. SOCIAL-ECONOMIC ENVIRONMENT ANSWER
Component Description Y N
Parameter
3.
4.
5.

Aesthetics Is the project site located within a potential or existing

tourist spots?

E. PROJECT IMPACT

Activity/Components/ Answers Describe the Impacts  Describe your

Parameters Yes No Mitigating /
Enhancement
Measures
Site Development Phase / Construction Phase
Is there land clearing?
Is there vegetation/Tree
Cutting/Removing?
Is there
excavation/backfilling?
Is there drilling/boring and
hammering activities ?
Is there slope
modification/ground
leveling ?
Will the air quality be
affected?
Will there be a noise
increase due to the project
activities?
Will the water quality be
affected?
Will the marine /aquatic life
be affected?
Will the wildlife be affected?
Are hazardous toxic waste
to be introduced into the
environment?
Is there an increase in
traffic volume?
Will the traffic/public access
be affected?
Is there an increased
economic activity
Will there be employment
opportunities?
Is there displacement of
inhabitants/settlers?
Will there be encroachment
on ancestral domain?
Will the indigenous people
be affected?

IEE Checklist for Marble Slab Processing Plant

Page 14 of 20
Activity/Components/ Answers Describe the Impacts  Describe your
Parameters Yes No Mitigating /
IS there an effect in Enhancement
women/vulnerable groups?
Will there be solid waste
generation?
Will there be wastewater
generation?
Will it affect water supply?
Will the drainage be
affected?
Will landscape change?
Will there be population
migration
Operation Phase
Is there land clearing?
Is there vegetation/Tree
Cutting/Removing?
Is there
excavation/backfilling?
Is there drilling/boring and
hammering activities ?
Is there slope
modification/ground
leveling ?
Will the air quality be
affected?
Will there be a noise
increase due to the project
activities?
Will the water quality be
affected?
Will the marine /aquatic life
be affected?
Will the wildlife be affected?
Are hazardous toxic waste
to be introduced into the
environment?
Is there an increase in
traffic volume?
Will the traffic/public access
be affected?
Is there an increased
economic activity
Will there be employment
opportunities?
Is there displacement of
inhabitants/settlers?
Will there be encroachment
on ancestral domain?
Will the indigenous people
be affected?
IS there an effect in
women/vulnerable groups?
Will there be solid waste

IEE Checklist for Marble Slab Processing Plant

Page 15 of 20
Activity/Components/ Answers Describe the Impacts  Describe your
Parameters Yes No Mitigating /
generation? Enhancement
Will there be wastewater
generation?
Will it affect water supply?
Will the drainage be
affected?
Will landscape change?
Will there be population
migration?
Abandonment Phase (Attach Abandonment Plan as Annex 9)
Will there be generation of
demolition waste?
Will there be a noise
increase?
Will there be a re-
vegetation?
Will there be a disposal site
rehabilitation?

 (Note: Describe and attached all pertinent details of proposed mitigating and enhancement
measure corresponding to the identified environmental impacts of the proponent in Chapter F,
Item # 6)

F. ENVIRONMENTAL ENHANCEMENT/MITIGATING MEASURES

1. Description of Waste Generated

Waste Stream Type (Solid, Liquid, or Quality Method of Handling/Storage/Treatment

Hazardous) Disposal

2. Description of Waste Water Treatment Facility(Attach schematic diagram of treatment scheme as

Annex 10)

Component Pollutant of Concern Size/Volume % Reduction of

Pollutant

3. Solid Waste/ sludge Management

Collection by LGU Sanitation Unit:

Volume per Collection : ________________________________ cu. m.
Frequency of Collection

Burning :

Volume per burning :______________________________cu. m.

IEE Checklist for Marble Slab Processing Plant

Page 16 of 20
Frequency of burning : __________________________________/week

Composting:
Volume per composting: ________________________________ cu. m.
Frequency of composting : __________________________________/week

Landfill :
Volume per burial : ___________________________________cu. m.
Frequency of burial : ________________________________/week

Others, please specify

Volume per cycle : ________________________________cu. m.
Frequency of cycle : _______________________________/week

4. Air Pollution Control System

Air Pollution Source Air Pollutant of Concentration Level Pollution Control

Concern System

5. Noise Emission Control System

Noise Emission Sources Noise Emission Levels Noise Control

System/Measures

6. Details of proposed mitigating and enhancement measure corresponding to the identified

environmental impacts of the proponent

G. ENVIRONMENTAL MANAGEMENT AND MONITORING PLAN

ENVIRONMENTAL MANAGEMENT PLAN

Project Impact Mitigation Cost of Institutional Schedule Guarantees

Activities Description (if Mitigation Plan (MOAs,
per negative)/E or etc.)
parameter nhancemen Enhancem Contracts
(Physical, t (if ent

IEE Checklist for Marble Slab Processing Plant

Page 17 of 20
 Bio, Visual, negative)
Socio
Economic
1.
2.
3.
4.
5.

ENVIRONMENTAL MONITORING PROGRAM

Project Parameter Location Frequency Responsibility Cost

Activity
Site TSP
Development/ Noise Level
Construction Solid Waste
Plan Vegetation
Plant TSP
Operation TSS
pH
Sludge
Solid Waste
IEC
SDP
Raw Material
Wildlife
Marine
/Aquatic
Post Trees Planted
Operation Disposal Site
Rehabilitation

H. PROPONENT’S COMMITMENTS

Are you committing yourself to … YES NO BUDGET

ALLOCATION
1. Comply with existing environmental rules
and regulations, guidelines and criteria
2. Comply w/ the EMMoP
3. Compensate any damage to life and
property resulting from project implementation
3. Construct, maintain and operate properly
appropriate wastewater treatment facility
4. Provide adequate facilities to ensure proper
management of solid wastes
5. Maintain cleanliness and good house
keeping of your general surrounding
6. Extent Social benefits to the community
7. Disseminate to all the plant personnel, the
condition of the ECC, commitment and
agreements made in relation to this project
8. Others, please specify.

I. ATTACHMENTS

IEE Checklist for Marble Slab Processing Plant

Page 18 of 20
 1. Supporting documents

Attached?
Letter of Application
Location/ Vicinity Map
SEC Registration and Article of Incorporation Annex 1
Photocopy of TCT/OCT/TD Annex 2
Survey Plan Annex 2
Locational Clearance Annex 3
Process Flow Schematic Diagram Annex 4
Site Development Plan Annex 5
Schedule of Project Implementation Annex 6
NWRB/Water Permit Annex 7
Other details/feature Annex 8
Abandoning Plan Annex 9
Wastewater Treatment Scheme Annex 10
Others

2. Government Permits and Clearances

Attached
Endorsement from Local Government Units
Concerned
Barangay
Municipality
NWRB Permit / Local Water District Annex # 7
Others

ACCOUNTABILITY STATEMENT

This is to certify that all the information and commitments in the Initial Environmental
Examination (IEE) Report are true, accurate and complete. Should I/we learn if any information
which would make the IEE inaccurate, I/we shall bring said information to attention of the
Environmental Management Bureau of DENR Regional Office.

IEE Checklist for Marble Slab Processing Plant

Page 19 of 20
 I/We hereby bind myself/ourselves jointly and solidarity for any penalties that may be imposed
arising from and misrepresentations or failure to state material information in the IEE. As permitted under
Section 6c of Article IX of DENR Administrative Order No. 37 Series of 1996.

In witness whereof, we hereby set out hands this _______day of

__________________________________________________at________________________________.

_________________________________________________
Project Proponent

_________________________________________________
Title/Designation

_________________________________________________
Date

ACKNOWLEDGMENT

BEFORE ME this (day) ______________of ________________19__________________at

(place)__________________________, personality appeared
name____________________________________ with Community Tax Certificate No.
_______________________________issued on date_________________At
(place)____________________, in his/her capacity as
______________________(designation_________________at ___________________ and
acknowledged to me that this IEE is his voluntary act and deed, and voluntary
act and deed of the entity he/she represents. This document which consists of
(no)_____________________________pages, including the page of which this acknowledgment is
,is an Initial environmental Examination Report Checklist.

Witness my hand and seal on the place and date above written.

____________________________
Notary Public

Doc. No.___________________
Page No.__________________
Book No.__________________
Series of __________________

IEE Checklist for Marble Slab Processing Plant

Page 20 of 20