APPLICATION FOR FOREST LAND USE AGREEMENT

Application No.

The Secretary
Department of Environment and Natural Resources
Visayas Avenue, Diliman
Quezon City

Sir:

In consonance with the provision of P.D. 705 as amended, Executive Order No.192, Series of
1987, Executive Order No. 278, Series of 1987 and all pertinent regulations on the matter, I/We hereby
apply for a Forest Landuse Agreement, the particulars of which are as follows:

Type of Forest land Use:

Approximate Area:_________________________ ha.

Location: Province
Municipality/City
Barangay(s)
Sitio(s)

Boundaries: N:
E:
S:
W:

I/We understand that the filing of this application does not convey the right to enter, occupy or
develop the area applied for, until an agreement has been executed between me/us and the Regional
Executive Director of the Department of Environment and Natural Resources.

All application requirements as stipulated in the regulation are enclosed together with the required
non-refundable application fee of P .

Very truly yours

(Applicant)
Postal Address

Contact Number/s

REPUBLIC OF THE PHILIPPINES )

Province of : S.S.
Municipality of )

SUBSCRIBED AND SWORN to before me this day of Affiant

exhibited to me his/her Residence Certificate Number A- issued at
on .

Doc. No.
Page No.
Book No.
Series of 2016

1
 Annex "A-1"

APPLICATION FOR FOREST LANDUSE AGREEMENT

Application No.

The Secretary
Department of Environment and Natural Resources
Visayas Avenue, Diliman
Quezon City

Sir:

In consonance with the provision of P.D. 705 as amended, Executive Order No.192, Series of
1987, Executive Order No. 278, Series of 1987 and all pertinent regulations on the matter, I/We hereby
apply for a Forest Landuse Agreement, the particulars of which are as follows:

Type of Forest land Use: _________________

Approximate Area:______________________ ha.

Location: Province
Municipality/City
Barangay(s)
Sitio(s)

Boundaries: N:
E:
S: __________________________________________
W:

I/We understand that the filing of this application does not convey the right to enter, occupy or
develop the area applied for, until an agreement has been executed between me/us and the Regional
Executive Director of the Department of Environment and Natural Resources.

All application requirements as stipulated in the regulation are enclosed together with the required
non-refundable application fee of P .

Very truly yours

(Applicant)
Postal Address

Contact Number/s

REPUBLIC OF THE PHILIPPINES )

Province of : S.S.
Municipality of )

SUBSCRIBED AND SWORN to before me this day of Affiant

exhibited to me his/her Residence Certificate Number A- issued at
on .

Doc. No.
Page No.
Book No.
Series of 2017

2
 Annex “B”

INDICATIVE MANAGEMENT PLAN

I. INTRODUCTION:

Description of the area

II. OBJECTIVES:

General
Specific

III. PROJECT SCHEDULE:

IV. TECHNICAL ASPECTS:

Project activity
Description of production/development
Site development

V. MANAGEMENT ASPECTS:

Organization
Management strategies/policies

VI. FINANCIAL ASPECTS:

Project cost
Sources of funds
Financial Projections

3
 Annex “C”

Republic of the Philippines

DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
Visayas Avenue, Diliman, Quezon City
Tel. Nos. (632) 929-66-26 to 29
Website: http://www.denr.gov.ph/E-mail:[email protected]

FOREST LAND USE AGREEMENT

(FLAg) No.

Of

(Second Party)

(Location of Area)
This AGREEMENT made and entered into by and between:
The REPUBLIC OF THE PHILIPPINES, through its DEPARTMENT
OF ENVIRONMENT AND NATURAL RESOURCES (“DENR”),
with address at Visayas Avenue, Diliman, Quezon City, herein represented
by its ,
hereinafter collectively referred to as the FIRST PARTY,
-and-

, a
corporation duly organized and existing under Philippine laws, with
business/postal address at ,
herein represented by its ,
, hereinafter referred to as the SECOND
PARTY.

WITNESSETH
WHEREAS, under Executive Order No. 192, promulgated on June 10, 1987, the
DENR is empowered to exercise supervision and control over the forestlands of the
Philippines;
WHEREAS, Section 57 of Presidential Decree No. 705, also known as the
“Revised Forestry Code of the Philippines”, authorizes the special use of forestlands for
beneficial purposes which do not impair the forest resources therein;
WHEREAS, the SECOND PARTY has been issued by
the DENR Regional Office of for the purpose of

WHEREAS, after review and validation of the application by the FIRST

PARTY, the SECOND PARTY was found to have complied with the requirements for
conversion of its SLUP into FLAg;

(FIRST PARTY) (SECOND PARTY)

By: By:

WITNESSES:

4
 WHEREAS, it is in the policy of the State to accelerate the development of
renewable energy resources such as ocean, solar and wind and to encourage greater
private sector investment and participation therein pursuant to existing laws;
NOW, THEREFORE, for and in consideration of the foregoing premises and the
terms and conditions set forth below, the parties agree as follows:
Area, Purpose and Duration
I. The FIRST PARTY hereby grants the SECOND PARTY the exclusive
right to occupy, manage and develop approximately of
public forestland (the “FLAg Area”) for the establishment and operation of
for a period of twenty-five (25) years to expire on
, renewable for another twenty-five (25) years, located at
, the boundaries of which are
shown in the attached map and forms an integral part of this AGREEMENT.
II. The FLAg Area shall be confined within the perimeter of the parcel of
land described in the attached map. No other parcel of public forestland shall be utilized
by the SECOND PARTY without first securing the prior approval of the FIRST
PARTY.
III. The FLAg Area is a public forestland to the best knowledge and belief of
the parties, and the FIRST PARTY confirms that based on applicable land classification
maps, control maps, and available records of the DENR, there are no prior existing rights
therein granted in favor of third parties. The FIRST PARTY shall not be responsible for
any loss that the SECOND PARTY may suffer in case the FLAg Area or portion thereof
is declared with finality by a competent court or authority as the private property of
another, or is found to be covered by a prior existing right.

IV. The SECOND PARTY shall utilize the FLAg Area only for the purpose
for which this AGREEMENT is granted. In the event the said area will be used for a
different purpose, said use shall be subject to prior approval of the Secretary or his duly
authorized representative.

V. The SECOND PARTY shall, within six (6) months from the issuance of
this AGREEMENT, delineate and mark on the ground the boundaries of the FLAg Area
under the supervision of the DENR. It shall preserve the monuments and other landmarks
indicating corners and outlines along the boundaries and within the confines of the FLAg
Area.

Comprehensive Development and Management Plan

VI. The SECOND PARTY shall submit within six (6) months from the
issuance of this AGREEMENT a Comprehensive Development and Management Plan
(“CDMP”) for the FLAg Area. The CDMP shall provide, among others, for appropriate
schemes, arrangements, or activities that will maximize the use of the FLAg Area, which
are compatible with the and shall benefit the
host community. The CDMP shall be submitted to, and approved by, the Regional
Director, DENR Regional Office - , after review and deliberation by a
Review Committee composed mainly of technical staff of the Forest Management Sector.
The approved CDMP shall form part of this AGREEMENT. The implementation of
development activities, except those pertaining to the protection of the area from illegal
entry, forest destruction and other related activities, shall be subject to compliance by the
SECOND PARTY with paragraph XXIX hereof.

(FIRST PARTY) (SECOND PARTY)

By: By:

WITNESSES:

5
 VII. The SECOND PARTY may construct permanent and/or temporary
improvements or infrastructure in the FLAg Area necessary and appropriate for its
development as a pursuant to the approved
CDMP. “Permanent Improvements” refer to the foundation of the turbines, access roads,
and buildings or structures which adhere to the ground in a fixed and permanent manner.
On the other hand, “Temporary Improvements” include those which are detachable from
the foundation or the ground introduced by the SECOND PARTY in the FLAg Area and
which the SECOND PARTY may remove or dismantle upon expiration or cancellation
of this AGREEMENT. Any substantial deviations or modifications from, and/or
additional improvements in, the approved CDMP shall be subject to prior approval of the
Regional Director, or his duly authorized representative. Such deviations, modifications
or additional improvements shall at all times be consistent with the purpose for which the
FLAg Area is granted under paragraph I hereof.

Government Share and Performance Bond

VIII. The SECOND PARTY shall pay annual Government Share of

Philippine Currency, within
thirty (30) days upon approval of this AGREEMENT, and annually thereafter, within the
same month that this AGREEMENT is issued, pursuant to DENR Administrative Order
No. 2004-16, dated June 15, 2004, setting the Government Share for energy projects
within forestlands at Three Thousand Pesos (P3,000), Philippine Currency, per hectare
per annum, subject to a cumulative increase of Ten Percent (10%) per annum (i.e.
P300/ha per annum).

IX. The annual Government Share shall be paid by the SECOND PARTY,
without need of demand, not later than end of the month of the following year that this
AGREEMENT was issued. In case of failure to pay the annual Government Share on the
date due, the SECOND PARTY shall pay additional charges of 8.33% per month of
delay.

X. The Government Share is non-refundable.

XI. Payment of Government Share after the expiration of this AGREEMENT

shall not be construed as an assurance for the renewal thereof.

XII. As guarantee for the faithful performance of the terms and conditions of
this AGREEMENT, and compliance with applicable Forest Laws and Regulations, the
SECOND PARTY shall post a Performance Bond in cash equivalent to twice the amount
of annual Government Share pursuant to DENR Administrative Order No. 2004-16, dated
June 15, 2004.

Obligations of the Second Party

XIII. The SECOND PARTY shall, within ninety (90) days from issuance of
this AGREEMENT, submit an Environmental Compliance Certificate (ECC) for its
proposed in accordance with applicable environmental laws and regulations.

XIV. No trees, regardless of species, shall be cut in the FLAg Area if found
within twenty (20) meters from banks of rivers, creeks or streams and of public roads. In
case the said 20-meter strip is bereft of trees, the same shall be rehabilitated by the
SECOND PARTY.

(FIRST PARTY) (SECOND PARTY)

By: By:

WITNESSES:

6
 XV. The SECOND PARTY shall strictly observe sanitary measures within the
FLAg Area to ensure protection of watershed values;
XVI. The SECOND PARTY shall protect the FLAg Area from forest fires and
other forms of forest destruction.
XVII. The SECOND PARTY shall protect and conserve unique, rare and
endangered flora and fauna, if any, within the FLAg Area pursuant to existing laws, rules
and regulations.
XVIII. The SECOND PARTY shall not impede, obstruct or prevent the entry and
exit through the FLAg Area of legitimate stakeholders and/or forest users authorized by
the DENR.
XIX. The SECOND PARTY shall submit an Annual Report showing
developmental activities undertaken within the FLAg Area in accordance with the
approved CDMP.
XX. All authorized DENR officials and/or employees shall be allowed to enter
and inspect the FLAg Area for the purpose of monitoring compliance with the terms and
conditions of this AGREEMENT and the activities authorized under the approved
CDMP.
Termination
XXI. This AGREEMENT may be terminated or cancelled by the
FIRST PARTY, after giving the SECOND PARTY due notice and opportunity to be
heard, on any of the following grounds:
a) Violation of any of its terms and conditions, or failure to
comply with the obligations under this AGREEMENT;
b) In case this AGREEMENT was determined, after
appropriate proceedings, to have been obtained through fraud,
misrepresentation or omission of material facts existing at the time of filing of
the application;
c) Abandonment of the FLAg Area or failure to utilize the same
for the purpose it was granted within the prescribed period without justifiable
cause;
d) Failure to introduce improvements or develop the FLAg Area
as indicated in the CDMP; and
e) Failure to pay the Government Share and the surcharges
without justifiable cause within one (1) year after the same had become due
and after two (2) notices;
XXII. In the event the FIRST PARTY determines that any of the above grounds
exist, a notice of breach shall be sent to the SECOND PARTY giving the latter at least
fifteen (15) calendar days to submit a written explanation. Before any termination is
resorted to, the parties shall meet and exert best efforts to resolve the dispute, except
when the grounds refer to items (b) and (c) above. The SECOND PARTY shall be given
reasonable time within which to remedy the breach or to implement the agreed remedial
measures.

(FIRST PARTY) (SECOND PARTY)

By: By:

WITNESSES:

7
 XXIII. In case of termination or cancellation of this AGREEMENT due to the
fault of the SECOND PARTY, the Performance Bond shall be forfeited in favor of the
FIRST PARTY, and the SECOND PARTY shall have no right to claim for
reimbursement or compensation of whatever kind for the permanent improvements
introduced within the FLAg Area as defined in paragraph VII hereof. Such improvements,
which shall not include the Temporary Improvements referred to in paragraph VII above,
shall be forfeited in favor, and become the property, of the FIRST PARTY.

XXIV. Upon termination of this AGREEMENT, the SECOND PARTY shall be

allowed to continue to occupy the FLAg Area for a period not exceeding six (6) months
to enable it to remove the Temporary Improvements referred to in paragraph VII above,
and to revert the land to its original condition to the extent possible.

Ownership and Transfer

XXV. The SECOND PARTY shall, with respect to its ownership or capital
stock, and in relation to the right granted herein to use the public forestland described in
the attached map, ensure compliance with the nationality requirement under Article XII,
Section 2 of the 1987 Constitution of the Republic of the Philippines, at all times
throughout the duration of this AGREEMENT. In this regard, the SECOND PARTY
shall secure the approval of the FIRST PARTY or his duly authorized representative in
case of transfer of majority of its shares or capital stock after execution of this
AGREEMENT.

XXVI. The SECOND PARTY may transfer this AGREEMENT or any rights
therein or any assets used therewith, if authorized by the DENR Secretary, subject to the
following conditions:

a) The FLAg has been in existence for at least three (3) years;

b) The SECOND PARTY has been faithfully complying with the terms and
conditions of the FLAg including implementation of CDMP;

c) The transferee has all the qualifications and none of the disqualifications to
hold a FLAg;
d) The transferee shall assume all the obligations and responsibilities of the
transferor specified in the FLAg, CDMP and ECC; and

e) In case the development of the FLAg Area is financed by loan, the

concurrence of the financing institution shall be obtained prior to the transfer.

The Parties, however agree that in case the transfer is made by the SECOND
PARTY in favor of its affiliate, the three (3)-year requirement under item (a) above shall
not apply. An “affiliate” shall mean an entity, corporate or non-corporate, controlling or
controlled by the SECOND PARTY, or associated with the SECOND PARTY through
common controlling or controlled entities. For the purposes hereof, control shall be
deemed to exist if one entity owns, directly or indirectly, through shareholdings or
otherwise, at least fifty-one percent (51%) of the voting shares or other voting units of
participation in another entity. Provided, that the transfer to an affiliate shall not violate
any existing laws and regulations implemented by other government agencies.

(FIRST PARTY) (SECOND PARTY)

By: By:

WITNESSES:

8
Amendment and Renewal

XXVII. This AGREEMENT may be modified, altered or amended upon

agreement in writing by both parties.

XXVIII. This AGREEMENT may be renewed upon filing by the SECOND

PARTY of an application six (6) months prior to the expiration hereof.

Miscellaneous Provisions
XXIX. The SECOND PARTY shall secure such contracts, permits or approvals
as may be required for the establishment and operation of a Hydro Electric Power
Generation System from appropriate government agencies in accordance with existing
laws and regulations
XXX. This AGREEMENT is subject to pertinent DENR Laws, Rules and
Regulations, provided the same shall not impair the contractual obligations of both parties
herein.
IN WITNESS WHEREOF, the parties have affixed their signatures below at
Quezon City, Philippines, this day of , 2017.

(FIRST PARTY) (SECOND PARTY)

By: By:

WITNESSES:

9
 ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES )

QUEZON CITY, PHILIPPINES ) S.S.

BEFORE ME, a Notary Public for and in , Philippines,

this day of , 20 , personally appeared the following:

Name Evidence of Competent Identity

known to me to be the same persons who executed the foregoing instrument, and who
acknowledge to me that the same is their free and voluntary act and deed.

This instrument, which is Forest Landuse Agreement (FLAg) No. ,

consists of seven (7) pages including this page where this Acknowledgement is written
and has been signed by the parties and their witnesses on each and every page hereof.

WITNESS MY HAND AND SEAL, at the place and on the date written.

NOTARY PUBLIC

Doc No.
Page No.
Book No.
Series of 2017.

(FIRST PARTY) (SECOND PARTY)

By: By:

WITNESSES:

10
 Annex “D”

MONITORING AND EVALUATION REPORT FORM

NAME OF AGREEMENT HOLDER:

KIND OF TENURE INSTRUMENT:

FOREST LANDUSE AGREEMENT (FLAgT) NO. ( )

Purpose
FOREST LANDUSE AGREEMENT (FLAg) NO. ( )
Purpose
SPECIAL LAND USE LEASE AGREEMENT (SPLULA) NO. ( )
Purpose
SPECIAL LAND USE PERMIT (SLUP) NO. ( )
Purpose

LOCATION OF THE AREA:_____________________________________________________________

AREA IN HECTARE/S:__________________________________________________________________

DATE CONDUCTED:___________________________________________________________________

CONDUCTED BY:______________________________________________________________________

PURPOSE/S:___________________________________________________________________________

IMPROVEMENTS INTRODUCED IN THE AREA:

Nature of Improvement Dimension Estimated Value

•__________________ ___________ __________________

•__________________ ___________ __________________
•__________________ ___________ __________________
•__________________ ___________ __________________

COMPLIANCE TO THE TERMS AND CONDITIONS OF FLAgT/FLAg/SPLULA/SLUP::

•___________________________________________________________________
•___________________________________________________________________
•___________________________________________________________________
•___________________________________________________________________
•___________________________________________________________________
•___________________________________________________________________

OTHER FINDINGS:
•___________________________________________________________________
•___________________________________________________________________
•___________________________________________________________________
•___________________________________________________________________

COMMENTS/RECOMMENDATIONS:
•___________________________________________________________________
•___________________________________________________________________
•___________________________________________________________________
•___________________________________________________________________

SUBMITTED BY:

COPY FURNISHED
PENRO
RED
FMB
Secretary, DENR
AGREEMENT Holder

11
 Annex “E”

ANNUAL REPORT ON SPECIAL FOREST LANDUSE AGREEMENT

(FLAg) No. for C.Y.

A. BASIC INFORMATION:

Name of AGREEMENT holder:______________________________________________

Postal Address:__________________________________________________________

Kind of Special Forest Land use Agreement (FLAg) No.__________________________

(Type) _________________________________________________________________

Date Issued:_______________________ Date of Expiration: _____________________

Location: Sitios:_____________________ Barangays: __________________________

Municipality________________________ Province _____________________________

Area_________________( in hectares)

B. Improvements introduced in the Area.

Type of improvement Dimension of introduced Previous Current Amount

introduced improvements Year Year Value in
(P)

C. Government share paid (indicate O.R. No., date and amount paid)
.

D. Other Activities:

This is to certify that the above data and information are true and correct to the best
knowledge of the undersigned.

Signature of the AGREEMENT holder

Subscribed and Sworn to before me this day of , 200 , affiant,

exhibited to me his/her Community Tax Certificate No.
issued at on _ and TIN No. , who
executed the foregoing report, and acknowledge to me his free that the same are true and
correct to the best of his/her knowledge.

CENRO/PENRO/RED
(As the case maybe)
Copy Furnished:
CENRO
PENRO
RED
FMB, DIRECTOR
DENR, SECRETARY

12
 Annex “E-1”

ANNUAL REPORT ON SPECIAL FOREST LANDUSE AGREEMENT FOR

NIPA AND HERBAL/MEDICINAL PLANTATION
(FOR C.Y. )

A. BASIC INFORMATION:

Name of AGREEMENT holder:

Postal Address :
Kind of Special Forest Landuse Agreement (FLAg) No.

Date Issued: Date of Expiration:

Location: Sitios: Barangays:
Municipality Province
Area ( in hectares)

B. Improvements introduced in the Area.

B.1 Infrastructures:

Type of improvement Dimension of introduced Previous Current Amount

introduced improvements Year Year Value in
(P)

B.2 Plantation Established:

Name of Area planted Volume harvested

Species (in has.) (in kilograms)
1._________________ _______________ __________________
2._________________ _______________ __________________
3._________________ _______________ __________________
4._________________ _______________ __________________
5._________________ _______________ __________________

C. Government share paid (indicate O.R. No., date and amount paid) .

D. Other Activities:

This is to certify that the above data and information are true and correct to the best knowledge of
the undersigned.

Signature of the AGREEMENT holder

Subscribed and Sworn to before me this day of , 200 , affiant,

exhibited to me his/her Community Tax Certificate No. issued at
on and TIN No. , who executed the foregoing
report, and acknowledge to me his free that the same are true and correct to the best of his/her
knowledge.

CENRO/PENRO/RED
(As the case maybe)

Copy Furnished:
CENRO
PENRO
RED
FMB, DIRECTOR
SECRETARY

13
 Annex “F”

COMPREHENSIVE DEVELOPMENT AND MANAGEMENT PLAN FOR SPECIAL FOREST

LANDUSE AGREEMENT (FLAg)

1. Cover Sheet

Name of AGREEMENT Holder

Approximate Area

Location:

Region
Province
Municipality(s)
Barangay(s)
Sitios

Boundaries:

Coordinates N: __
E:
S:
W:

Physical description:

Submitted by:

Agreement Holder

Date:

14
Introduction
2. Objectives:
3.1 General Objectives
3.2 Specific Objectives
4. Area Description:
4.1 Location
4.2 History of the area
4.3 Topography
4.4 Drainage
4.5 Climate
4.6 Geology of soil
4.7 Vegetation and Forest cover
4.8 Forest Resource Data
4.9 Demographics and community descriptions
4.10 Infrastructure and utilities
4.11 Environmental Information
4.12 Security
4.13 Other Information
5. Development Plan:
5.1 General Strategy
5.2 Boundary and maintenance
5.3 Infrastructure Development
5.3.1 Permanent Improvements
5.3.2 Temporary Improvements
5.3.3 Other Improvements
6. *In Case of Nipa and Herbal/Medicinal Plantation
6.1 Seed procurement
6.2 Nursery operations
6.3 Plantation Establishment and Maintenance
6.4 Plantation Protection
6.5 Harvesting and Transport
7. Monitoring and evaluation
8. Market & Utilization:
8.1 Market Information
8.2 Utilization
9. Organization:
9.1 Company organization
9.2 Project organization
9.2.1 Staff
9.2.2 Labor
10. Financial Aspects:
10.1 Costs
10.1.1 Development
10.1.2 Post Development Phase
10.2 Sources of Finance
10.3 Returns
10.4 Financial analysis

11. Appendices
11.1 Maps

11.1.1 General location with technical description (Survey data)

11.1.2 Roads and Infrastructure Developments
11.1.3 Plantation Establishment (if applicants).

15
 ANNEX “F-1”

CONTENT OF THE INITIAL ENVIRONMENTAL EXAMINATION (IEE)

The following shall be the minimum requirement and format of the IEE

A. COMMUNICATION OF RESULTS.
1. Table of contents
2. Executive summary (brief subscription of the substantive content)
3. List of IEE preparers and their respective area in the IEE
4. Sworn accountability statement of key IEE preparer
5. Sworn accountability statement of project proponent
6. Process documentation
7. Proof of social acceptability
8. Certificate of Locational viability/locational clearance or zoning certificate
9. Reference/bibliography

B. SUBSTANTIVE CONTENT.
1. Project Description to include:

• Description and map of project location

• Project purpose/rationale
• General description of project design/plan
• Description of components and activities by the development phase

…. Pre-construction Phase
…. Operation Phase
…. Abandonment Phase

2. Methodology for data gathering to include process and content description of:
• Secondary data gathered and sources
• Primary baseline data
• Public consultations
• Process documentation of consultative activities

3. Description of Environment setting and receiving environment:

• Delineation/mapping of primary and secondary impact areas
• Description of existing biophysical environment
• Description of existing socio-cultural-economic environment
• Discussion of future environment conditions without the project

4. Impact Identification and Assessment:

• Summary matrix of predicted environment issues/impact and their level

of significance at various stages of development
• Brief discussion of significant impact on the physical and biological
resources
• Brief discussion of significant socio-economic effects/impacts of the
project including discussion of gender issues and population impact

5. Project Area and Space Allocation.

Indicate in a plan the are covered by the project claim in hectares in the same
scale as in item No. 3 showing the allocation of various area, classification of the
subdivision, the unit lot area allocation, & grouping of the type of the building,
commercial area, intend open space allocation like playground, road networks,
domestics and electric power sourcing, domestic waste water treatment,solid
waste disposal, space allocation for septic tanks either communal or individual,
etc.
6. Project Construction Activities.
Submit a flow chart showing actual sequence of project activities, in every stage
of the flow chart, indicate the work force resources needed the volume or amount
of materials extracted if any, to accomplish phase activities and the cost of each
phase should be submitted, A textual description of the flow chart should be
provided.
7. Project Maintenance Throughout Its Lifespan.
Include and describe the maintenance of the project and its surrounding including
its Aesthetic value.
8. Source Of Environmental Impacts.
Identify all possible sources of environmental impacts during the entire project style.

16
 8.1 During construction stage (from the site clearing, earth movement due to
stripping, ground surface leveling, resultant effect of flood water during
heavy rains and typhoons to the water bodies.
8.2 After construction stage (domestic and/or industrial effluent, solid waste).
8.3 Social environmental impacts (effects of pollution and community growth
on transportation, school, market, church, hospital and health clinic
facilities, recreational space facilities, community and social relationship.
Water and power supply.
9. ENVIRONMENTAL MANAGEMENT MEASURES.
Identify and discuss the measures to minimize adverse environmental impacts
caused by the above-mentioned described factors (e.g. soil, erosion, land slides,
solid waste disposal, domestic and industrial pollution, etc.) Also indicate
stockpile area for waste and measures and minimize adverse effects of rub-off.
10. SIGNATURE OF PROJECT OF PERSON PREPARING THE INITIAL
ENVIRONMENTAL EXAMINATION.

ADDITION TO THE PROJECT DESCRIPTION

1. 1:10,000 topographic map or vicinity map. The map should be able to show other land
uses in the vicinities, e.g. other residential areas, agriculture, commercial, industrial, etc.,
if possible, this should be color coded to facilitate review.
2. DESCRIPTION OF ENVIRONMENTAL SETTING.
A. A description of the existing environmental conditions in the proposed site should
accompany the map submitted. Emphases should be given on the following:

A.1 Nearby surface water bodies (quality, uses, classification, etc.)

A.2 Critical ecological system (mangrove, forest land, etc.)
A.3 Land Uses
A.4 Existing Environmental Problems. If any incidence of air and water
pollution soil erosion, etc.)
A.5 Socio-Economic indicator

A.5.1 Total workforce to be employed by the project proponent

Personal :
Laborers :

A.5.2 Existing number of residents in effected areas (proposed site)

3. ENVIRONMENTAL MANAGEMENT PLAN:

• Summary matrix of proposed mitigation and enhancement

measure estimated cost and responsibilities
• Brief discussion of mitigation and enhancement
• Monitoring Plan
• Contingency Plan (if applicable)
• Institutional responsibilities and agreement

4. RECOMMENDATION:

• List of resolved issues

• List of partially resolved issues
• New issues arising from the IEE that have been resolved

NOTE:

All document in ten (10) legible copies and complete electronic file in computer diskettes
shall be submitted.

Procedural Screening Fee .................. P 200.00

Filling Fee ........................................... P 460.00
Processing Fee ..................................... 2,100.00
Legal and Research Fee ......................... 240.00
Total
P 3,000.00
============

17