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Application Form CEC FINAL

The document is an application form for a Certificate of Environmental Clearance from the City Environmental and Natural Resources Office of Malabon City, Philippines. It collects information about the applicant such as business details, ownership, location, permits, and requires signatures. It also lists the requirements and permits needed for the application.

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malabon.market15
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103 views1 page

Application Form CEC FINAL

The document is an application form for a Certificate of Environmental Clearance from the City Environmental and Natural Resources Office of Malabon City, Philippines. It collects information about the applicant such as business details, ownership, location, permits, and requires signatures. It also lists the requirements and permits needed for the application.

Uploaded by

malabon.market15
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Republic of the Philippines

 
CITY GOVERNMENT OF MALABON
Metropolitan Manila

CITY ENVIRONMENTAL AND NATURAL RESOURCES OFFICE


Tel. No. 281-4999 Local 1019/1020

APPLICATION  FORM  FOR  CERTIFICATE  OF   Control  No:       DATE  OF  APPLICATION  
     
ENVIRONMENT  CLEARANCE  (CEC)  
OWNERSHIP  AND  DOCUMENTATION    
TYPE  OF  APPLICATION   TYPE  OF  BUSINESS  
[        ]  Initial  Application  
[        ]  Sole  Proprietorship   [        ]  Corporation  
[        ]  Renewal  of  CEC  
BUSINESS  AREA  (IN  SQ.   TOTAL  NO.  OF  EMPLOYEES    
M.)  
MALE:   FEMALE:  
[        ]  Partnership   [        ]  Cooperative  

OWNER      (Family  Name,  First  Name,  Middle  Name)   BUSINESS  NAME  

       

OWNER'S  ADDRESS  (No.  of  Street,  Barangay,   BUSINESS  ADDRESS  (No.  of  Street,  Barangay,    
Municipality/City,  Province)   Municipality/City,  Province)  

 NO.  6  ALLAN  ST.,  GABRIEL  SUBD.  II  BRGY.  HULONG  


   
DUHAT,  MALABON  CITY  
       
LINE  OF  BUSINESS   PRODUCTS/SERVICES   CONTACT  NUMBERS  
LANDLINE   MOBILE  NO.  
BRGY.  HULONG  
   
DUHAT,  

 
I  HEREBY  CERTIFY  THAT  ALL  INFORMATION  
  PRINTED  NAME  AND  SIGNATURE  OF  OWNER  

CONTAINED  HEREIN  IS  TRUE  AND  CORRECT  


REMARKS  FINDINGS  AND  RECOMMENDATIONS    

   
 
REVIEWED  BY:   NOTED  BY:  
 
           

ELIZABETH  E.  GUTIERREZ   MARK  LLOYD  A.  MESINA  


EVALUATOR    
DATE     Chief-­CENRO  
REQUIREMENTS  FOR  APPLICATION:     REQUIRED  DENR  PERMITS  FOR  APPLICATION:  (to  be  
  submitted/complied  within  six  (6)  months  upon  issuance  of  
Application  for  Renewal  /  New  Business     CEC)  
  Tax  Order  of  Payment  and  Official  Receipt     ECC  –  Environmental  Compliance  Certificate    
  Official  Receipt  of  Environmental  Inspection  Fee       CNC  –  Certificate  of  Non-­‐Coverage  
                                   (Previous  Year)  FOR  RENEWAL         WDP  –  Waste  Water  Discharge  Permit    
  Certificate  of  Environmental  Compliance  (Previous  Year)       HWP  –  Hazardous  Waste  Permit    
                                   FOR  RENEWAL       PTO  –  Permit  to  Operate  (Air  Pollution)  
    Registered  Pollution  Control  Officer  (PCO)    
 

“SA MALINIS NA MALABON, ANG PAG-UNLAD AY HABANG PANAHON”

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