IEE Checklist for

Small Water Impounding System Project

INITIAL ENVIRONMENTAL EXAMINATION (IEE)

CHECKLIST FOR
SMALL WATER IMPOUNDING PROJECT

1. GENERAL INFORMATION:

1.1 Project Name/Title ______________________________________________

1.2 Name of Project Proponent/ : _______________________________________

Contact Person/Designation : _______________________________________
Address : _______________________________________
(complete address street/sitio/ barangay, city/municipality, province)
Telephone/Fax No: : _______________________________________
E-mail : _______________________________________

1.3 Project Location : _______________________________________

(complete address street, sitio, barangay, city/municipality, province)

(Attach location map with important landmarks and access points indicated as
Annex 1)

1.4. Project Objectives :

[ ] Proposed ( ) Existing ( )Expansion
( ) Rehabilitation ( ) Area
( ) Demolition & Put up ( ) Additional facilities
Specify _________________________

Purpose : [] irrigation
[ ] rice [ ] sugar ( ] others
[] other purposes: ________________________________

1.5 Total Cost (civil works and equipment): P _____________ (range)

Mode of Project Financing

[ ] Self-Financed [ ] Bank Loan
[ ] Government Financing [ ] Others

1.6 Project Ownership :

[ ] Single Proprietorship [ ] Corporation

[ ] Partnership/Joint Venture [ ] Cooperative
[ ] Others, please specify ___________________________

1.7 List of Owners (For Partnership/Corporation)

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

Page 1 of 16
 IEE Checklist for
Small Water Impounding System Project

2. PROJECT DESCRIPTION:

2.1 Project Area Coverage

Total impounding area ( sq. m / hectare) : ________________________
Total height of the dam crest (m.) : ________________________
Total length of the service canal : ________________________

2.2 Land Ownership

 Ownership of the land by virtue of OCT/TCT # _____________________________
 Stewardship of the land by virtue of _____________________________________
 Lease of land by virtue of _____________________________________________
 Pending application for _______________________________________________
 Others, please specify ________________________________________________

(Please attach pertinent document)

Basis for utilization of water channels Water Rights

(pls. check appropriate box) attach photocopy of document

Others_______________________
attach photocopy of document

Pending application for Water Rights

___________________________________
attach photocopy of document

Others, pls. specify

2.3 General Land Classification

[ ] Public land [ ] Alienable and disposable

[ ] Private land

2.4 Project Facilities

(Attach complete lay-out/site development plan including expansion plan of the

proposed building)

Facility Area (sq. m )/ Capacity/ No.

Page 2 of 16
 IEE Checklist for
Small Water Impounding System Project

Land Use of the Project Site:

Land Use of the Project site (dam location) [ ] Agricultural [ ] Industrial
Based on the proposed/approved [ ] Residential [ ] Tourism
Land Use Plan [ ] Commercial [ ] Institutional
[ ] Forest Land [ ] Open Space

Existing Land Use of the area traverse by the service canal:

[ ] Agricultural [ ] Industrial
[ ] Residential [ ] Tourism
[ ] Commercial [ ] Institutional
[ ] Forest Land [ ] Open Space

Attach photo, panoramic view of project site where the dam will be located and its immediate
vicinity (provide captions)

Attach photo of the area where the service canal will traverse (provide captions)

Page 3 of 16
 IEE Checklist for
Small Water Impounding System Project

Utilities and Infrastructure:

Water Utilities
Name of water source Classification (i.e. river, spring, etc.) Discharge rate
in Cu.
Meter/second

Total volume of water extracted/utilized in cu. Meter/second (maximum)

What is the estimated total area to be served by the project?____________ in hectares.

What are the total water requirements of the area served by the project? _________in cu.
Meter/Sec.

Page 4 of 16
 IEE Checklist for
Small Water Impounding System Project

3. DESCRIPTION OF ENVIRONMENTAL SETTINGS

(To be prepared with the assistance of the DENR Regional staff)

1. Physical Environment of the area where the dam will be located: Components/
Parameters
Answer
Y N
Is the terrain flat or level? (0 - 3% slope)
Is the terrain level to undulating? (3 – 8% slope)
Is the terrain undulating to rolling? (8 - 18% slope)
Is the terrain rolling to moderately steep? (18 - 30% slope)
Is the terrain moderately steep to steeply mountainous? (30 - 50% slope)
Is the terrain very steeply mountainous? (above 50% slope)
Is the site near or with a forest reserve or a protected watershed area? If yes,
how near? ___________ meters

Does the site have limestone caverns or sinkholes in the bedrock?

Is the area erosion prone? If so, what is the status: slight, moderate or severe?
Are there existing natural hazards in the area, e.g., landslides, gullying,
subsidence? If yes, enumerate them
1. 5.
2. 6.
3. 7.
4. 8.
Are there natural drainage ways/creeks within the area draining towards
communities downstream?
Has the area experienced any flooding during wet season or typhoons? If YES,
when was the last time this was happened?____________________
What cause the flooding?
[ ] Water Logged area?
[ ] poor drainage?
[ ] low area/elevation
What is the soil type of the project area?
[ ] sandy
[ ] clayey
[ ] sandy loam
Are you beside or near the shoreline? If yes, how far? _____________ meters

Are there water bodies found inside or near the project site? If yes, please
enumerate them.
1. 2.
Are there any existing structures or development around the project site? If YES,
please list them in the space below

Page 5 of 16
 IEE Checklist for
Small Water Impounding System Project

How deep is the river water during the dry season? (meters)

How deep is the river water during the wet season? (meters)

What is the quality of water? Fresh

Brackish

2. Biological Environment where the dam will be located (attached photos/drawings/maps

whenever appropriate)
Are you immediately adjacent to a natural ecosystem? yes no

If yes, please check on the appropriate box/es:

Forest Grassland

Residential Agricultural

Have you observed any wildlife in the area? yes no

If yes and you can identify them, please enumerate:
1. 6.
2. 7.
3. 8.
4. 9.
5. 10.

Are there trees within the project site? yes no

If yes, please identify and enumerate:
1. 6.
2. 7.
3. 8.
4. 9.
5. 10.

Are there other vegetation within the project site where the dam yes no
will be located?
If yes, please identify and enumerate:
1. 2.
3. 4.
5. 6.

3. Socio-Economic Environment
3a. Existing Settlements within the project site

Page 6 of 16
 IEE Checklist for
Small Water Impounding System Project

Category/Description Number What has happened to them?

(effects of project on them)
Total households affected

Total Population of the

Barangay where the project is
located?

Average Family Size

Source of their Livelihood

Number of family/s to be
relocated

Are there existing infrastructures in the Barangay? [ ] YES [ ] NO

If YES what are these structure? What is the distance from the project site?

3b. Proposed/ Profile of staff employed in the project/establishment (dam and service canal)

Male Female

During Pre/Construction Phase

During Operation
Total Number of Employee

How many of the proposed staff will come from the residents in the area?

Are there health facilities (clinic, etc.) within the project site? yes no

Are the required benefits under the Labor Code and other yes no
regulations enjoyed by the staff?
If yes, please enumerate them:
1. 2.
3. 4.
5. 6.

Are the local inhabitants yes no

benefited by the project? Pls. elaborate.
______

______

_____________________________________________________________________
4. PROJECT IMPACTS
Page 7 of 16
 IEE Checklist for
Small Water Impounding System Project

(To be prepared with the assistance of the DENR Regional staff)

(+) / D/Ind L/S R / Ir Describe your mitigating/

( -)
(Describe the impacts) Enhancement measures
1. Pre-Construction/Construction Details (both dam and service canal)
[] Siltation of drainage’s [] set-up temporary silt
traps/pond along water bodies to
or waterways from
prevent siltation.
unconfined stockpiles [] proper stockpiling of spoils on
flat areas and away from
of soil and other
drainage areas.
materials. [] avoid long exposure of open
[] topsoil removal, loss cuts.
and soil erosion from [] installation of barrier nets.
earthmoving activities. [] provide site for spoil disposal.
[] soil disturbance
and displacement
from transport and
hauling activities,
access road/trail
construction, erosion
from exposed cuts,
etc.
[] damages distinctive to [] earth-ball small to medium-
existing vegetation from sized trees for transplanting in
cutting, clearing or designated areas (above 20 cm.
removal of weeds, In diameter will not be cut).
grasses and other types [] replace every tree cut with not
of vegetation during site less than 10 nursery grown trees
preparation. of the same species of at least
[] damages or 1m high.
disturbance to existing [] retention of matured trees
wildlife and vegetation species.
from transport and [] provide temporary fencing
hauling. around important species to be
[] loss of vegetation. retained.
[]decrease or [] use of markers and fences to
disturbance to rare, direct heavy equipment traffic in
endangered or the construction site and avoid
threatened plants or damaging important species
animals species present
in the area.
[]disturbance or loss of
habitants of birds and
other wildlife species.

Page 8 of 16
 IEE Checklist for
Small Water Impounding System Project

[] damages or [] plant indigenous tree species

disturbance to existing and ornamental plants
wildlife and vegetation preferably native in the area.
from transport and [] avoid critical habitat areas and
hauling. flora and fauna that maybe
[] loss of vegetation. considered rare or endangered
[]decrease or by re-routing permanent
disturbance to rare, structures.
endangered or [] re-established or simulate the
threatened plants or habitat in other suitable areas.
animals species present
in the area.
[]disturbance or loss of
habitants of birds and
other wildlife species.
[] loss of top soil [] stockpile the topsoil and used
[] soil erosion from as the final grading materials or
earthmoving activities final layer.
[] provide site for spoil disposal
[] installation of barrier nets
proper stockpiling of spoils
[] soil disturbance and [] stockpile the topsoil and used
displacement from as final grading material.
transport and hauling [] conduct access road
activities, access construction during dry season.
road/trail construction, [] removed soil/mud from tires of
erosion from exposed trucks and equipment before
cuts. proceeding to the highway.
[] increase in solid waste
generation from
excavation works.
[] increase in dust
generation. Increase on
noise generation.

Page 9 of 16
 IEE Checklist for
Small Water Impounding System Project

[] increase in dust [] regular watering of unpaved

generation from civil roads or exposed soils/grounds.
works, clearing and [] speed-up earthmoving
earthmoving activities. activities.
[] increase in noise [] hauling trucks should cover
generation from site their loads with canvass or any
preparation/construction equivalent materials.
activities [] set-up temporary fence around
the construction site.
[] set-up temporary disposal site
within the construction area and
properly disposed to generated
solid waste at the existing
dumpsite of the city/Municipality.
[] re-use as much construction
spoils as possible in the
construction activities.
[] set-up proper and adequate
temporary toilet facilities.
[] conduct orientation of workers
on proper waste disposal and
proper sanitation.
[] schedule noisy construction
activities during daytime.
[] undertake proper maintenance
of equipment and use of muffler
for certain equipment.
[] dust generation. [] regular watering of stockpile
[] siltation of nearby are.
water bodies [] provide enclosure on stockpile
area.

[] hazards caused by [] undertake detailed

sitting structures in geotechnical studies prior to
geologically unstable construction to determine proper
areas. siting of structures.
[] proper engineering design.
[] probable landslide. [] use of benching method to
[] siltation and/or erosion stabilize the slope.
on the nearby water [] riprapping of cut areas .
bodies due to slope [] stabilization of the slope
modification and ground through planting of vegetation.
levelling [] provide proper drainage and
silt traps along the slope.

Page 10 of 16
 IEE Checklist for
Small Water Impounding System Project

[] increase in dust [] regular watering of unpaved

generation due to traffic roads.
movement. [] speed-up earth moving
[] increase in noise activities.
generation due to traffic [] hauling truck should be
movement. covered with canvass or
equivalent materials.
[] schedule hauling during day
time
[] undertake proper maintenance
of equipment and use of muffler
for certain equipment.
[] increase in business [] priority shall be given to
and income purchasing some of the required
opportunities for the building and food supplies from
local communities. the local business
establishment.
[] generation of [] priority shall be given to the
employment hiring of local workers.

[] rise in associated [] interested community

projects or economic members can set-up a
activities in the cooperative to corner the service
surrounding areas. requirements of the contractor.

[] displacement of [] provide compensation based

existing settlements in on negotiation and mutual
the area. agreement.
[] provide relocation site and
alternative livelihood program, if
necessary.
[] Traffic problems during [] schedule transport and hauling
hauling of construction activities during non-peak hours
materials. when there is less or no traffic.
[] site the entry and exit points in
areas where there is no
congestion or which are not
traffic gridlock/choke points.

Page 11 of 16
 IEE Checklist for
Small Water Impounding System Project

[] conflict of right of way [] conduct consultations with the

concerned parties prior to
finalizing any project layout and
design.
[] a mutually agreed terms or
conditions of settlement which
may be in the forms of
compensation.
[] compensation of affected
household based on mutually
agreed upon packages.
[] provisions of relocation sites.

2. Operation and Maintenance Phase

[] increase in solid waste [] provide a regular garbage
and sewage generation collection and disposal system
which may cause either by hiring a local
pollution of nearby water contractor, by availing of the
bodies and affect water municipal/city garbage collection
quality. services or setting up your own
sanitary disposal site.
[] provide adequate sewage
facilities in the project, i.e. septic
tank with disposal by absorption
field or leaching pit.
[] provide adequate garbage
containers or receptacles in
strategic areas around the
project site and provide regular
collection of garbage.
[] conduct regular inspection and
maintenance of septic tanks to
prevent leakage.

[] improved drainage and [] provide adequate and

water system which can appropriate drainage system, i.e.
promote a more efficient perimeter drainage, interceptor.
use of water supply. [] conduct regular inspection and
[] increased surface run- proper maintenance of both
off which may result to drainage and water systems.
flooding or flash floods in [] conduct regular cleaning of
the area. drain inlets.
[] reduced surface [] provide adequate open spaces
infiltration rates which and greenbelts within project
may decrease recharges site.
of the water table.

Page 12 of 16
 IEE Checklist for
Small Water Impounding System Project

[] traffic and congestion [] provide proper setting of

entrance and exits to and from
the site to avoid traffic gridlock
[] provide adequate parking
space within the project site.
[] provide adequate width of
access road networks.

[] rise in associated [] strict implementation of land

projects use plan

[] increase of land [] strict implementation of land

values. use plan.
[]decrease in land
values.
[] increase in individual [] priority shall be given to local
income residence for hiring.
[] increase in family
income
[] increase in local tax
collection
[] changes in land use [] all open space and pathways
which will affect habitat should be planted with
of birds and wildlife. ornamental and indigenous tree
species that will attract birds and
other wildlife.
[] damage and [] provide treatment facility.
disturbance to aquatic [] conduct regular monitoring.
habitat cause by solid
waste and sewage
pollution
[] increase in noise [] undertake proper maintenance
generation during of equipment.
operation. [] provide noise reduction facility.

Legend:
(+) - positive (-)- negative
D -direct I- indirect
S- short term L- Long term
R -reversible Ir- irreversible

Page 13 of 16
 IEE Checklist for
Small Water Impounding System Project

5.0 ENVIRONMENTAL MANAGEMENT PLAN (EMP)

Project Impacts Mitigating Cost Responsible Guarantee

Activity Measures Person/Unit
Phase
(Indicate here all (Indicate here all
possible impacts mitigating
listed in section 4 measures
corresponding to
the identified
impacts)

6. PROPONENT COMMITMENT

I/We am/are committing to ………

Comply with existing environmental rules and regulations, guidelines and criteria?

Comply with all mitigation and enhancement measures and environmental management plan
that are indicated in the report.
Undertake/ comply with the contingency management plan formulated for the project.

Extend social benefits to the community?

Properly brief and orient employees about the ECC conditions, commitment and agreement
made about the project.

Others, to be specified by DENR

_______________________________________
Signature of the Proponent

Page 14 of 16
 IEE Checklist for
Small Water Impounding System Project

7.0 ATTACHMENTS/ANNEXES

PERMITS/CLEARANCES YES NO
Location Map/Vicinity Map
Documents Pertaining to land ownership i.e. TCT, OCT, TD)

Design/Plan of the Small Water Impounding Project

SEC Registration and Article of Incorporation

Location Clearance from HLURB or local Government Unit

NWRB Permit
Listing of manpower requirements

Schedule of activities from pre-construction, construction and operation

phase
Pictures of the proposed site
Payment of filing and processing fees: P 2,130.00

Page 15 of 16
 IEE Checklist for
Small Water Impounding System Project

ACCOUNTABILITY STATEMENT

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

I/We hereby bind myself/ourselves jointly and solidarily for any penalties that may be
imposed arising from any misrepresentations or failure to state material information in the IEE.

In witness whereof, I/we hereby set our hands this ___________day of ____________at
______________________________________.

__________________________________
Project Proponent

Title or Designation

ACKNOWLEDGEMENT

BEFORE ME this ______ day of ________________, 19 _____ at

_______________________________, personally appeared (Place)
_____________________ (Name) ______________________________with Community
Tax Certificate No. ____________________ issued on _________________ at
__________________, in his/her capacity as _____________________________(position)
of___________________________ and ( name of establishment) __________________
acknowledged to me that this IEE is his voluntary act and deed, and the voluntary act and deed
of the entity he/she represents. This document, which consists of ______________ pages,
including the page on which this acknowledgement is written, 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 ____

Page 16 of 16