IEE Gasoline
IEE Gasoline
IEE Gasoline
INSTRUCTION MANUAL
Pursuant to the DENR Administrative Order No. 37, Series of 1996 and its procedural
manual, all gasoline, service and refueling station projects are considered projects to be
required by an Initial Environmental Examination (IEE) document and need to secure an
Environmental Compliance Certificate (ECC) from the DENR Regional Offices prior to
project construction and operation.
1.0 CONTENTS
To use this, put a check ( ) mark in the appropriate box. If your answer
does not fall in any of the pre-determined responses, check ( ) OTHERS
and indicate your specific answer in the blank space provided or use
additional sheets as necessary. If some questions are not applicable to
your project, write N/A on the blank space or column;
2.3 For the section on Impact Assessment and Mitigation, check ( ) the
columns of Y or N depending on what expected impact is applicable to
your project and provide the corresponding Mitigation/Enhancement
measures for each identified impact (with a YES answer) in the column
provided.
2.4 For the section on Attachment or Annexes, put a check ( ) on the title or
description of the document that you are annexing in the report. The listed
documents are MUST requirements and should be submitted;
2.5 Answers to the questions should not be strictly confined to the pre-
determined responses. You can elaborate and use as many additional
sheet as you need to be able to provide adequate answers to the required
information. Providing maps, pictures and drawings (e.g. charts, tables,
IEE Checklist for Gasoline Station
diagrams, sketches) and other visuals and attachments will better explain
or describe the information provided in the checklist. This will help
facilitate the review and decision on the project’s application for an ECC.
2.7 Upon completion of the IEE checklist, the project proponent shall submit
the form to the DENR Regional Office-EMPAS where the project is to be
located.
IEE Checklist for Gasoline Station
IEE Checklist for Gasoline Station
for
Address: ___________________________________________________
(complete address: street/sitio, barangay, city/municipality,
province)
___________________________________________________
Tel/Fax: ___________________________________________________
E-mail: ___________________________________________________
(Attach location map with important landmarks and access points indicated as Annex 1)
Filling Station
Curb Pump
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
2.3 Present Land Use Classification (based on the approved land use/zoning
ordinance of the city/municipality)
_____________________
_____________________
_____________________
Attach panoramic view of the project site and its immediate vicinity (north side view from center of the
project site).
Attach panoramic view of the project site and its immediate vicinity (south side view from center of the
project site).
IEE Checklist for Gasoline Station
3.1 Services
1. Manual Washing
3. Shampoo/Vacuum
4. Change Oil
5. Greasing
6. Change Coolant
7. Tune-up
8. Wheel Alignment
9. Free Service
(Air & Water)
3.2 Facilities
1. Service Bay
2. Pumping/Refilling Station
5. Wash Bay
6. Convenience Store
8. Parking Area
9. Office Bldg.
a. Demand
b. Supply/Sources
• Existing Public
Water
1. Creek
2. Spring
3. Stream
4. River
5. Others
IEE Checklist for Gasoline Station
b.4 Rainwater
1. Collected in Storage
Tanks
2. Collected in Reservoir
c. Water Treatment
YES NO
Type of drainage:
What water body (e.g. river/creek/stream) will serve as the out fall of the sewage and
drainage systems? ____________________________________________________
• Sewage Disposal
discharge to an existing public sewerage system
Others: (Specify)_________________________________
Volume: _______________________________
• Disposal System
Recycled
Burning / Incinerator
Sold to re-cyclers
Others, Specify
Others, (specify):_________________________________
YES NO
IEE Checklist for Gasoline Station
Sludge cleaning
Open dumpsite outside of the project site
Others, specify:________________________
• How many people will be employed by the proposed gasoline and service station during:
3.11. Project Schedule (Attach schedule of development activities from pre-Construction; construction;
operation phase)
IEE Checklist for Gasoline Station
1. What is the general elevation of the (Indicate the area per elevation range
proposed gasoline station project or estimate the % to total area)
site?
<100 masl
100-300 masl
301-500 masl
501-1,000 masl
1,000-1,500 masl
>1,500 masl
2. Slope and Topography of the area (Indicate the area per slope category
(within 50 meter radius from center of or estimate the % to total area)
site)
(>50% slope)
Attach photo of the areas topography (choose the view / perspective which shows contours or areas w/
slopes)
A. Physical Environment
{ } Bathing
{ } Washing
{ } Fishing
{ } Source of drinking water
{ } Recreation (swimming,
boating, etc.)
{ } Others:
___________________
A. Physical Environment
B. Biological Environment
{ } Forest
{ } Coastal/ Marine
{ } Grassland
{ } Mangrove
{ } Agriculture
C. Socio-Economic Environment
Households/Families:_____________
Legitimate landowners: ___________
Tenants:_______________________
_
Squatters:______________________
Livelihood Type
[ ] Farming
[ ] Fishing
[ ] Backyard poultry and piggery
[ ] Vending/Buy and Sell
[ ] Sari-sari store
[ ] Others, Pls.
Specify:__________________
[ ] Schools
[ ] Communications
[ ] Health centers/clinics
[ ] Hospitals
[ ] Churches/Chapel
[ ] Transportation
[ ] Roads
[ ] Others, Pls.
Specify:______________________
(Attach photo)
22
Types of Structures:
______________________________
_______________________________
_____________________________
[ ] Entire volume
[ ] Partial only
Mitigation/
Project Activities Affecting the Physical Yes No Impact Description Enhancement
Environment
Measures
Mitigation/
Project Activities Affecting the Biological Yes No Impact Description Enhancement
Environment
Measures
Mitigation/
Project Activities Affecting the Socio-Cultural Yes No Impact Description Enhancement
and
Measures
Economic Environment
domain
Mitigation/
Project Activities Affecting the Physical Yes No Impact Description Enhancement
Environment
Measures
Mitigation/
Project Activities Affecting the Biological Yes No Impact Description Enhancement
Environment
Measures
Mitigation/
Project Activities Affecting the Socio-Cultural Yes No Impact Description Enhancement
and
Measures
Economic Environment
Mitigation/
Project Activities Affecting the Socio-Cultural Yes No Impact Description Enhancement
and
Measures
Economic Environment
MITIGATING/
ACTIVITIES RISKS IMPACTS ENHANCEMENT COST RESPONSIBILITIES
MEASURES
2. Comply with all mitigation/enhancement measures that have been identified in the
report;
5. Construct, maintain and properly operate an adequate and appropriate septic tank for
the liquid wastes;
ATTACHMENTS/ANNEXES
PERMITS/CLEARANCES YES NO
Photocopy of TCT/OCT/TD
NWRB Permit
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 accurate, I/we shall bring said information to the attention of the
appropriate EMB DENR Regional Office
I/We hereby bind myself/ourselves jointly and solidarily for any penalties that may be
imposed from any misrepresentations or failure to state material information in the IEE.
__________________________________
Proponent
___________________________________
Title/Designation
ACKNOWLEDGMENT
IEE Report is his voluntary act and deed, and the voluntary act and deed of the entity
______________________________
Notary Public