Form 2 – EMBV – SWM – OD/CD

City/Municipality :
MENRO / SWM :
Focal Person
Contact No. :
Email Address :

BACKGROUND INFORMATION:

Location of Open/Controlled Dump :

Geo-Coordinates :
Elevation :
Land Ownership :
Total Land Area of Open/Controlled Dump :
(hectares)
Current Land Use
Tentative Land Use
Waste Dump Area Used (hectares) :
Height of Waste from Ground Level :
Depth of Waste from Ground Level :
Estimated Volume of Waste Disposed :
Approximate Distance from Municipal Hall :
Distance from Nearest Settlement :
Status of the Dumpsite :
Date of Start of Operation :
Date of End of Operation :
Current Mode of Disposal :
Distance from Nearest Water body (meters) :
Slope Range :
No. of Waste Pickers :
Weight of waste generated per day (kgs) :
No. of Barangays :
No. of operational MRFs :

A. Physical Closure Activities undertaken in the Dumpsite:

1. Site Clearing
Status :

Photo Documentation : (with timestamp and Geographical Coordinates)

2. Site Grading and Stabilization of Critical Slopes

Status:

Photo Documentation : (with timestamp and Geographical Coordinates)

3. Application and Maintenance of Soil Cover

Status

Photo Documentation : (with timestamp and Geographical Coordinates)

4. Provision of Drainage Control System

Status

Monitoring Form for Open and Controlled Dumpsites CY 2020

 Photo Documentation : (with timestamp and Geographical Coordinates)

5. Leachate Management
Status

Photo Documentation : (with timestamp and Geographical Coordinates)

6. Gas Management
Status

Photo Documentation : (with timestamp and Geographical Coordinates)

7. Fencing and Security

Status

Photo Documentation : (with timestamp and Geographical Coordinates)

8. Putting-up of Signage
Status

B. Post Closure Management Activities Undertaken in the Dumpsite:

I. Operation and Maintenance of Facilities

Top Cover
Status

Photo Documentation : (with timestamp and Geographical Coordinates)

Surface Drainage
Status

Photo Documentation : (with timestamp and Geographical Coordinates)

Gas Ventilation
Status

Photo Documentation : (with timestamp and Geographical Coordinates)

Leachate Collection Pipes

Status

Photo Documentation : (with timestamp and Geographical Coordinates)

Leachate Treatment
Status
2

Photo Documentation : (with date and Geographical Coordinates)

Page

Groundwater Monitoring Wells

Monitoring Form for Open and Controlled Dumpsites CY 2020

 Status

Photo Documentation : (with timestamp and Geographical Coordinates)

II. Monitoring of Environmental Pollution

a. Baseline Data :

Leachate :
Disposal Site Gas :
Land Subsidence :
Groundwater :
Surface Water :

b. Monitoring Update : Please include the frequency of monitoring.

Leachate :
Disposal Site Gas :
Land Subsidence :
Groundwater :
Surface Water :

Additional Updates:

Prepared By:

Approved By:

Noted By:
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Monitoring Form for Open and Controlled Dumpsites CY 2020