Elevation and topography of the area for the Sub-Project: Flat Valley Slope Undulating □ □ □ □ Hill Mountain Depression □ □ □ Elevation and topography of the adjoining areas (within 500 meters radius of the site): Flat Valley Slope Undulating □ □ □ □ Hill Mountain Depression □ □ □ 3.0 Infrastructure The Sub-project would be developed in/on: Undeveloped site Partly developed site Existing route Other (specify) □ □ □ ……………………… The Sub-project involve excavation Yes No □ □ Estimated number and depth of the excavations, etc): ……………………………………………… vi. Are any of the following located on-site or within 50 meters from the edge of the proposed site? Water supply source Yes No □ □ Pipeline Yes No □ □ Power supply source (electric pylon) Yes No □ □ Drainage Yes No □ □ specify: ……………………………………………. 4.0 Environmental and Social Impacts Would the proposed Sub-project: 4.1 Air Quality - i. Emit during subproject works Dust Smoke VOCs □ □ □ ii Expose workers or the public to substantial emissions? Yes No □ □ iii. Result in cumulatively increased emissions in the area? Yes No □ □ vi. Create objectionable odor affecting people? Yes No □ □ the proposed Sub-project: 4.2 Biological Resources - i. Have adverse effect on any reserved area? Yes No □ □ ii. Have adverse effect on wetland through removal, filling, Yes No □ □ hydrological interruption or other means? iii. Interfere substantially with the movement of any wildlife species Yes No □ □ or organisms? vi. Be located within 100m from an Environmentally Sensitive Area? Yes No □ □ 4.3 Existing Population: Will people living in or near the project area be adversely affected
Elevation and topography of the area for the Sub-Project: Flat □ Valley □ Slope □ Undulating □ Hill □ Mountain □ Depression □ Elevation and topography of the adjoining areas (within 500 meters radius of the site): Flat □ Valley □ Slope □ Undulating □ Hill □ Mountain □ Depression □ 3.0 Infrastructure The Sub-project would be developed in/on: Undeveloped site □ Partly developed site □ Existing route □ Other (specify) ……………………… The Sub-project involve excavation Yes □ No □ Estimated number and depth of the excavations, etc): ……………………………………………… vi. Are any of the following located on-site or within 50 meters from the edge of the proposed site? Water supply source Yes □ No □ Pipeline Yes □ No □ Power supply source (electric pylon) Yes □ No □ Drainage Yes □ No □ specify: ……………………………………………. 4.0 Environmental and Social Impacts 4.1 Air Quality - Would the proposed Sub-project: i. Emit during subproject works Dust □ Smoke □ VOCs □ ii Expose workers or the public to substantial emissions? Yes □ No □ iii. Result in cumulatively increased emissions in the area? Yes □ No □ vi. Create objectionable odor affecting people? Yes □ No □ 4.2 Biological Resources - the proposed Sub-project: i. Have adverse effect on any reserved area? Yes □ No □ ii. Have adverse effect on wetland through removal, filling, hydrological interruption or other means? Yes □ No □ iii. Interfere substantially with the movement of any wildlife species or organisms? Yes □ No □ vi. Be located within 100m from an Environmentally Sensitive Area? Yes □ No □ 4.3 Existing Population: Will people living in or near the project area be adversely affected
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