Land acquisition funded by the proposed If Yes, proposal must be rejected. If □ □ □ subproject? Unknown, additional information is required before proposal can be Involuntary resettlement?* considered. Do the proposed activities or budget If Yes, proposal must be rejected. If □ □ □ include any of the Project negative list Unknown, additional information is (see Section 2.5 of the ESMF) : required before proposal can be considered. Environmental triggers: Mitigation: must comply with local Does the sub-project involve alterations or construction in areas regulations; EIA is required. If adjacent to or within any of the following environmentally sensitive unknown, additional information is areas? required before proposal can be considered. DOCUMENTATION REQUIRED. Protected Area, Wildlife Reserve, □ □ □ Buffer Zone, or other conservation area Wetland □ □ □ Other: □ □ □ Potential Environmental Impacts Mitigation: must comply with Will the SUBProject cause: regulations. EMP is required. If unknown, additional information is required before proposal can be considered. DOCUMENTATION REQUIRED. Impairment of downstream water □ □ □ quality and therefore, impairment of downstream beneficial uses of water? Noise or dust from construction □ □ □ equipment? Are risks of soil erosion? □ □ □ Are there any pollution and/or public □ □ □ health risks Other: □ □ □ Required E&S DocumentS: Simple Environmental Management □ □ Plan (EMP)? Full Environmental Assessment (IEE)? □ □ □ □ ………………………………………. Other Remarks:
Land acquisition funded by the proposed subproject? Involuntary resettlement?* □ □ □ If Yes, proposal must be rejected. If Unknown, additional information is required before proposal can be considered. Do the proposed activities or budget include any of the Project negative list (see Section 2.5 of the ESMF) : □ □ □ If Yes, proposal must be rejected. If Unknown, additional information is required before proposal can be considered. Environmental triggers: Does the sub-project involve alterations or construction in areas adjacent to or within any of the following environmentally sensitive areas? Mitigation: must comply with local regulations; EIA is required. If unknown, additional information is required before proposal can be considered. DOCUMENTATION REQUIRED. Protected Area, Wildlife Reserve, Buffer Zone, or other conservation area □ □ □ Wetland □ □ □ Other: □ □ □ Potential Environmental Impacts Will the SUBProject cause: Mitigation: must comply with regulations. EMP is required. If unknown, additional information is required before proposal can be considered. DOCUMENTATION REQUIRED. Impairment of downstream water quality and therefore, impairment of downstream beneficial uses of water? □ □ □ Noise or dust from construction equipment? □ □ □ Are risks of soil erosion? □ □ □ Are there any pollution and/or public health risks □ □ □ Other: □ □ □ Required E&S DocumentS: Simple Environmental Management Plan (EMP)? □ □ Full Environmental Assessment (IEE)? □ □ ………………………………………. □ □ Other Remarks:
E45000REVISED00Box385203B00PUBLIC0.docx