ANNEX E Access to Sustainable Energy Project (ASEP) Project Screening Form 1 SCREENING FOR POTENTIAL ENVIRONMENTAL AND SOCIAL SAFEGUARDS ISSUES I. Name of Proponent: _______________________________________________ II. General Description of the Subproject Subproject Type/ Name Subproject Size/ Capacity Subproject Category1 Subproject Location / Address Estimated Subproject Cost Estimated Subproject Duration Conclusion and Safeguards Instruments Required: The subproject is classified as a Category ________ project as per World Bank OP4.01, and the following safeguards instruments will be prepared: 1. _____________________________________________________________ 2. _____________________________________________________________ 3. _____________________________________________________________ 4. _____________________________________________________________ 1 According to the Project Categorization of the Department of Environment and Natural Resources (DENR). Please refer to DENR-Environmental Management Bureau (EMB) Memorandum Circular No. 2014-005, The Revised Guidelines for Coverage Screening and Standardized Requirements under the Philippine Environmental Impact Statement System (PEISS). Answer If Yes Documents Questions yes no WB Policy requirement if triggered Yes Are the subproject impacts likely to have significant adverse OP 4.01 Environmental environmental impacts that are Environmental and Social sensitive2, diverse or Assessment Impact unprecedented?3 Assessment Category A (ESIA) Please provide brief description: Do the impacts affect an area broader than the sites or facilities OP 4.01 subject to physical works and are the Environmental significant adverse environmental Assessment ESIA impacts irreversible? Category A Please provide brief description: Is the proposed subproject likely to OP 4.01 have minimal or no adverse Environmental No action environmental impacts?4 Assessment needed beyond screening Please provide brief justification: Category C OP 4.01 Is the subproject neither a Category Environmental Limited ESIA or A nor Category C as defined above?5 Assessment ESMP Please provide brief justification: Category B 2 Sensitive (i.e., a potential impact is considered sensitive if it may be irreversible - e.g., lead to loss of a major natural habitat, or raise issues covered by OP 4.04, Natural Habitats; OP 4.36, Forests; OP 4.10, Indigenous Peoples; OP 4.11, Physical Cultural Resources; or OP 4.12, Involuntary Resettlement; or in the case of OP 4.09, when a project includes the manufacture, use, or disposal of environmentally significant quantities of pest control products); 3 Examples of projects where the impacts are likely to have significant adverse environmental impacts that are sensitive, diverse or unprecedented are large scale infrastructure such as construction of new roads, railways, power plants, major urban development, water treatment, waste water treatment plants and solid waste collection and disposal etc. 4 Examples of projects likely to have minimal or no adverse environmental impacts are supply of goods and services, technical assistance, simple repair of damaged structures etc., 5 Subprojects that do not fall either within OP 4.01 as a Category A or Category C can be considered as Category B. Examples of category B subprojects include small scale in-situ reconstruction of infrastructure projects such as road rehabilitation and rural water supply and sanitation, small schools, rural health clinics etc. Are the subproject impacts likely to OP 4.01 ESIA have significant adverse social Environmental impacts that are sensitive, diverse or Assessment unprecedented6? Category A Please provide brief description: Include a provision in the ESMP for proper disposal of batteries Will the subproject involve the use of OP 4.01 through a Li-ion batteries? registered Transport, Storage and Disposal Facility. Does the subproject involve involuntary land acquisitionor loss of Resettlement assets, access to assets, OP 4.12 Action Plan/ loss of income sources, means of Involuntary Abbreviated livelihood as a result of land Resettlement Resettlement acquisition? Action Plan Please provide brief justification: Are there any ethnic minority communities present in the OP 4.10 Indigenous subproject area? Indigenous Peoples Plan Peoples Please provide brief justification: I. Site Assessment: Issues Site Sensitivity Criteria Rating 6 Generally, subprojects with significant resettlement-related impacts should be categorized as A. Application of judgment is necessary in assessing the potential significance of resettlement-related impacts, which vary in scope and scale from sub project to sub project. Subprojects that would require physical relocation of residents or businesses, as well as subprojects that would cause any individuals to lose more than 10 percent of their productive land area, often are categorized as A. Scale may also be a factor, even when the significance of impacts is relatively minor. Subprojects affecting whole communities or relatively large numbers of persons (for example, more than 1,000 in total) may warrant categorization as A, especially for projects in which implementation capacity is likely to be weak. Subprojects that would require relocation of Indigenous Peoples, that would restrict their access to traditional lands or resources, or that would seek to impose changes to Indigenous Peoples’ traditional institutions, are always likely to be categorized as A. Low Medium High (L/M/H) 1. Involuntary Low population Medium High population Resettlement density; population density; major dispersed density; mixed towns and population; ownership and villages; low legal tenure is land tenure. income families well defined. and/or illegal ownership of land; communal properties. 2. Indigenous No indigenous Dispersed and Indigenous Peoples population. mixed indigenous territories (CADT), populations; reserves and /or highly lands; vulnerable acculturated indigenous indigenous populations. populations. Projects with medium or high ratings will require an ESIA as these indicate a real risk of causing undesirable adverse environmental and social effects, and a more substantial environmental and/or social planning may be required to adequately avoid, mitigate or manage potential effects. II. Areas for Potential Environmental and Social Impact: Yes No A. Environment - Will the subproject: Risk the contamination or access to drinking water or food 1 supply Cause poor water drainage, increase flooding and heighten 2 the risk of vector-borne diseases such as malaria or dengue Harvest or exploit a significant amount of natural resources 3 such as trees, gravel, sand, wood for fuel or water? (e.g. use of illegal quarries) Be located within or nearby environmentally sensitive areas, 4 protected areas (e.g. intact natural forests, mangroves, wetlands or threatened species?) or key biodiversity areas? Create a risk of increased soil degradation, erosion or 5 landslide? Create a risk of increasing soil salinity, salt intrusion or loss 6 in soil productivity? Produce, or increase the production of solid wastes (e.g. 7 water, medical/healthcare, domestic or construction wastes)? 8 Affect the quantity or quality of surface waters (e.g. rivers, streams, wetlands), groundwater (e.g. wells), or community pools? Result in the production of solid or liquid waste, or result in 9 an increase in waste production, during construction or operation? If the answer to any question from 1-9 is “Yes�, please include an Environmental and Social Management Plan (EMP) with the subproject application. B. Land Acquisition and Access to Resources - Will the subproject: 10 Require that land (public or private) be acquired (temporarily or permanently) for its development? 11 Use land that is currently occupied or regularly used for productive purposes (e.g. gardening, farming, pasture, fishing, forests) 12 Displace individuals, families, or businesses? Have any individuals, families, businesses been displaced up to 2 years prior to subproject enrolment? 13 Result in the temporary or permanent loss of crops, fruit trees or household infrastructure such as crop storage facilities, outside toilets and kitchens 14 Result in the involuntary restriction of access by people to legally designated parks and protected areas? If the answer to any of the questions 10 -14 is “Yes�, please provide estimated number of project-affected persons (PAPs). If PAPs total less than 200, prepare an Abbreviated Resettlement Framework. If 200 or more, prepare a Resettlement Action Plan. C. Indigenous Peoples - Will the subproject: 15 Require land used by IPs for productive (food gathering, gardening, farming, pasture, fishing, forests) and/or cultural (sacred ground, place of rites, etc.) purposes? 16 Cover areas covered by a Certificate of Ancestral Domain Title or existing claim to one? 17 Affect IPs in the project area (positive or negative)? 18 Have a significant area that overlaps with the boundaries where IPs have a collective attachment to? 19 Have IPs as among the potential beneficiaries of the subproject? If the answer to any of the questions 15-19 is “Yes�, please prepare IP Plan required under the Indigenous Peoples Framework. III. Categorization of Subproject: In general these are the criteria for categorization of the subproject activities: Category A The activity is likely to have significant adverse environmental and social impacts that are sensitive, diverse or unprecedented. Subprojects under this category require a full-blown ESIA. • In Section II on Site Assessment, a score of at least one (1) High rating; • In Section III on Areas for Potential Environmental and Social Impact, a score of at least one (1) Yes in any of the sections: A. Environment, B. Land Acquisition and Access to Resources, and C. Indigenous Peoples; • Scope of impacts is large in terms of land area; and • Impacts are difficult or to mitigate. Category B The activity has potential adverse environmental impacts on human populations or environmentally important areas – including wetlands, forests, grasslands and other natural habitats, which are less adverse than those of Category A subprojects. As these impacts are site-specific, an Initial Environmental Examination (IEE) is required to identify and assess the potential environmental and social impacts. Few of the impacts are irreversible and in most cases, mitigation measures can be designed more readily than for Category A subprojects. An Environmental Code of Practice (ECoP) is required to accompany the ESMP to provide the overall environmental management approach to contractors. In cases where significant impacts are anticipated, the proponent may be required to prepare a full-blown ESIA. • In Section II on Site Assessment, a score of least one (1) Medium rating; • In Section III on Areas for Potential Environmental and Social Impact, a score of at least one (1) Yes in any of the sections: A. Environment, B. Land Acquisition and Access to Resources, and C. Indigenous Peoples. Category C The activity is likely to have minimal or no adverse environmental impacts. Beyond screening, no further EA action is required for a Category C subproject. CERTIFICATION We certify that we have thoroughly examined all the potential adverse effects of this subproject. To the best of our knowledge, the subproject plan as described in the application and associated planning reports (e.g. ESMP, RAP, IPP), if any, will be adequate to avoid or minimize all adverse environmental and social impacts. Person who conducted the screening: Signature: ______________________ Date: __________________ PMO team representative: Signature: ______________________ Date: __________________