Table 1: Environmental Screening Checklist (Contd.) Environmental impacts Status Mitigation Measures (if the status is Notes Is the site to be restored to The site to be completely restored to original or better Yes original or better condition condition. No ditches or surplus soil will be left behind. after the works completion? No No debris, wastes, un-used construction materials, scrap, disused tools, equipment, or scaffolding will be left behind at the site. Checklist filled by (Name, Designation, Signature): Date: Checklist reviewed by (Name, Designation, Signature): Date
Table 1: Environmental Screening Checklist (Contd.) Environmental impacts Status Mitigation Measures (if the status is Notes Is the site to be restored to original or better condition after the works completion? Yes No The site to be completely restored to original or better condition. No ditches or surplus soil will be left behind. No debris, wastes, un-used construction materials, scrap, disused tools, equipment, or scaffolding will be left behind at the site. Checklist filled by (Name, Designation, Signature): Date: Checklist reviewed by (Name, Designation, Signature): Date