MODULE 1: GENERAL INFORMATION
Reference No. :8894
Year :2024 Quarter: 1
Name of Plant : SAN JOSE DISTRICT HOSPITAL
Notes :
Name of New PCO- JOHN RYAN P. JOLDANERO Note: PCO Accreditation is on Process Date of
PCO Training: April 22-26, 2024
DENR Permits/Licenses/Clearances
Environmental Laws Permits Date Issued Expiry Date
RA 9275
DP No. 0 DP-R4B-21-02079 2021-04-08 2022-04-08
DP No. 1 N/A 2000-01-01 2000-01-01
PD 1586
ECC/CNC No ECC-R4B-0903-054-9410 2000-01-01
RA 6969
DENR Registry ID GR-0451-0009 2000-01-01 2000-01-01
Transporter Registration N/A 2000-01-01 2000-01-01
TSD Registration N/A 2000-01-01 2000-01-01
CCO Registry N/A 2000-01-01 2000-01-01
Importation Clearance No. N/A 2000-01-01 2000-01-01
Permit to Transport N/A 2000-01-01 2000-01-01
Small Quantity Importation N/A 2000-01-01 2000-01-01
Priority Chemical List N/A 2000-01-01 2000-01-01
PMPIN N/A 2000-01-01 2000-01-01
RA 8749
PO No PTO-0L-R4B-2021-01463-R 2021-03-11 2026-03-11
Operation
Operating hours/day Operating days/week # of shift/day
Average 24 7 2
Maximum 24 7 2
Operation/Production/Quality
Average Daily Production Output N/A
Total Water Consumption this Quarter cm3 8640
Total Output this Quarter N/A
Total Electric Consumption 135114
Powered by TCPDF ([Link])
MODULE 2: RA 6969
A. CCO Report
CCO Item No. CCO Substance Common CAS No. Trade Name Intended Use Quantity Issued (in
Name/IUPAC/CAS CCO)
Index Name
No records found
For importers only
CCO Item Importation Quantity Quantity Date of Port of Entry Country of Country of Total Total
No. Clearance Issued (in IC) Imported Arrival Origin Manufacture Quantity Quantity
No. Requested Received
(annual) (annual)
No records
found
For Distributors (importers/non-importers)
CCO Item No. Name of Client License No. Quantity Date of Country of Country of Total Quantity
Distribution Origin Manufacture Distributed
No records
found
For non-importer users
CCO Item No. Name of Distributor Quantity Date of Purchase Total Quantity Purchased
from Distributor
No records found
For Producers
CCO Item No. Average Daily Production Total Output this Quarter Quantity of Stock Quantity of Stock
Output Inventory (Start of Quarter) Inventory (End of Quarter)
No records found
CCO Item No. Name of Buyer Quantity Date of Purchase Total Quantity Sold
No records found
Used in Production (please fill up only if chemical/substance is not main product)
CCO Item No. Average Daily Production Total Output this Quarter Average Quantity Used Total Quantity Used this
Output per month Quarter
No records found
Describe any changes in Production/Process/Operations
Stock Inventory/Waste Chemical Generated
CCO Item No. Average Quantity of Waste Total Quantity of Waste Quantity of Stock Quantity of Stock
Chemical Generated per Chemical Generated this Inventory(Start of quarter) Inventory(End of quarter)
month Quarter
No records found
Other Information
Manner of Handling Hazardous Wastes Changes in Safety Management System Chemical Substitute Plan
B. Hazardous Wastes Generator
HW Generation
HW No. HW Class HW Nature HW Cataloguing Quantity Unit Quantity Unit
M501 Infectious Liquid Toxic (T) 0 0.3953
(Placenta)
M501 Infectious (Shap Solid Toxic (T) 0 0.2434
s/Needles/Syrin
ges/Ampules/Vi
als))
M501 Infectious Solid Toxic (T) 0 1.1561
(Gloves, Mask,
Pampers,
Napkins)
M503 Pharmaceuticals Solid Toxic (T) 0 0.009
and Drugs
I101 Used oil from C/F 0 0.045
generator set
Waste Storage, Treatment and Disposal(please fill-up one table per HW)
HW Details
HW No.: M501 Qty of HW Treated :0.3953 Unit :
Storage
Name : Septic Vault for Infectious Waste Method :Collected and piled inside the septic
vault
Transporter
Name . : N/A Date :N/A
Treater
Name . : N/A Method :N/A Date :N/A
Disposal
ID .: N/A Name:SJDH SEPTIC VAULT Method:DISPOSAL
HW Details
HW No.: M501 Qty of HW Treated :0.2434 Unit :
Storage
Name : HW Storage Area -MRF Method :Collected and stored at large seald
container with proper labelling
Transporter
Name . : N/A Date :N/A
Treater
Name . : N/A Method :N/A Date :N/A
Disposal
ID .: N/A Name:N/A Method:N/A
HW Details
HW No.: M501 Qty of HW Treated :1.1561 Unit :
Storage
Name : Septic Vault for Infectious Waste Method :Collected and piled inside the septic
vault
Transporter
Name . : N/A Date :N/A
Treater
Name . : N/A Method :N/A Date :N/A
Disposal
ID .: N/A Name:SJDH SEPTIC VAULT Method:DISPOSAL
HW Details
HW No.: M503 Qty of HW Treated :0.009 Unit :
Storage
Name : Septic Vault for Infectious Waste Method :Collected and piled inside the septic
vault
Transporter
Name . : N/A Date :N/A
Treater
Name . : N/A Method :N/A Date :N/A
Disposal
ID .: N/A Name:SJDH SEPTIC VAULT Method:DISPOSAL
HW Details
HW No.: I101 Qty of HW Treated :0.045 Unit :
Storage
Name : HW Storage Area -MRF Method :Collected and stored at large sealed
container with proper labelling
Transporter
Name . : N/A Date :N/A
Treater
Name . : N/A Method :N/A Date :N/A
Disposal
ID .: N/A Name:N/A Method:N/A
On-site self Inspection of Storage Area
Date Conducted Premises/Area Inspected Findings and Observations Corrective Action Taken
2024-01-15 MRF Unsegregated wastes Issuance of Policies and
Guidelines regarding the proper
waste segregation.
2024-02-20 Septic Vault for infectious Waste Intact and Sealed Thorough cleaning and
disinfecting
2024-03-20 Hospital Offices Unsegregated wastes Issued Warning Letter
--
--
--
--
C. Hazardous Wastes Treater/Recycler
HW Stored and/Untreated as of End of Quarter
Type of Waste HW Number Wastes Date of Transport Quantity Type of Storage Time Table for
Generator Transport Permit/Date of Container/# of Treatment
Issue Containers
HW Treated and/or Recycled as of End of Quarter
Type of Waste HW Number Wastes Date of Transport Quantity Type of Quantity of
Generator Transport Permit/Date of Treatment of Recycled or
Issue Recycling Treated Product
Process
Residual Wastes Generated from the Treatment and/or Recycling Operation
Type of Waste HW Number Process by which Quantity Type of Storage Disposal Option Time Table for
the Waste is Containers/# Disposal
Generated Number of
Containers
Powered by TCPDF ([Link])
MODULE 3: RA 9275
Water Pollution Data
Domestic wastewater (cubic 10 | Process wastewater (cubic N/A
meters/day) : meters/day) :
Cooling water (cubic meters/day) N/A | Others : Gardening
:
Wash water, equipment (cubic 2.5 | Wash water, floor (cubic 2
meters/day) : meters/day) :
Record Cost of Treatment
Month 1 Month 2 Month 3
Person employed, (# of
employess)
Person employed, (cost)
Cost of Chemicals used by WTP
Utility Costs of WTP(electricity &
water)
Administrative and Overhead
Costs
Cost of operating in-house
laboratory
New/Additional investment in
WTP (description)
Costs of New/Add Investments
WTP Discharge Location
Outlet Number Location of the Outlet Name of Receiving water body
1 Western section or in front of the project To the nearest creek located at the north of
area and into existing public drain the project area and across the Barangay
Road to La Curva
Detailed Report of Wastewater Characteristics for Conventional Pollutants
Outlet No. DATE Effluent Flow BOD (mg/L) TSS (mg/L) Color Ph Oil & Grease Temp Rise Unit
Rate (mg/L) (C)
(m3/day)
2000-01-01
2000-01-01
2000-01-01
Detailed Report of Wastewater Characteristics for Other Pollutants
Outlet No. DATE Effluent Flow
Rate
(m3/day)
/ / / / / / /
2000-01-01
2000-01-01
2000-01-01
Powered by TCPDF ([Link])
MODULE 4: R.A. 8749 (Air Pollution)
Summary of APSE/APCF
Process Equipment. Location # of hours of operation for the quarter
Fuel Burning Equipment Location Fuel Used (indicate % if Quantity Consumed for the# of hours of operations for
mixed composition) quarter the quarter
STAMFORD Stanby Power House at the back Diesel 15 270
Genset of the building (Eastern
Section)
Pollution Control Facility Location # of hours of operation for the quarter
Muffler & Exhaust Stack Outside at the back (Eastern Section) of the 72
building
Record Cost of Treatment
Month 1 Month 2 Month 3
Detailed Report of Air Emission Characteristics
FBE No. DATE Flow Rate CO NOx Particulates
(Ncm/day) (mg/Ncm) (mg/Ncm) (mg/Ncm)
2000-01-01
2000-01-01
2000-01-01
2000-01-01
2000-01-01
Powered by TCPDF ([Link])
MODULE 5: P.D. 1586
Ambient Air Quality Monitoring (if required as part of ECC conditions)
Station DATE Noise Level CO NOx Particulates (mg/Ncm) (mg/Ncm) (mg/Ncm) (mg/Ncm)
Description (dB) (mg/Ncm) (ng/Ncm) (mg/Ncm)
2000-01-01
2000-01-01
2000-01-01
2000-01-01
Ambient Water Quality Monitoring (if required as part of ECC conditions)
Station DATE / / / / / / / /
Description
2000-01-01
2000-01-01
2000-01-01
2000-01-01
Other ECC Conditions
ECC Condition/s Status of Compliance Actions Taken
Submitted necessary permits/clearances to Yes Submitted
all government agencies conforming to the
zoning ordinance of the LGU as required.
Monitoring and reporting conducted by the Yes Monitored regularly
DENR as required.
Trained PCO Yes Renewed every after 3 years
Managing Head Training Yes 1 trainee
SMR submitted Yes Quarterly-submitted online
CMR submitted Yes semi-annually-submitted online
Environmental Management Plan/Program
Enhancement/Mitigation Measures/s Status of Compliance Actions Taken
Installation of septic tanks and Wastewater Yes Implemented
Treatment Facility
Good housekeeping, hygiene and sanitation Yes Implemented proper waste segregation
including proper housekeeping, hygiene and
sanitation
Monitoring of sanitation within the hospital Yes Regular monitoring conducted within the
facilities quarter
Regular Discharging of Septic Tank on a Yes Regular monitoring of septic tanks
quarterly basis or earlier than necessary
Strictly monitoring of waste segregation Yes Strictly monitor every shift/duty
Placement of color coded receptacles Yes Strictly Implemented
Coordination to LGU regarding proper and Yes Regular monitoring of disposal of
regular waste disposal solid/residual waste
Well-individuals are advice to wear facial Yes Strictly prohibited "No Face Mask, No Entry"
mask
Provision of sufficient fire extinguisher Yes Regular monitoring of fire extinguisher every
quarter
No smoking policy within the Hospital Yes Strictly monitored
premises
Implementation of appropriate & effective Yes Attended Pollution Control seminars and
environmental impact DENR conferences.
Realistic and sufficient budget for conducting Yes Within the budget of the Hospital
environmental monitoring and audit activities
Qualified personnel are in-charge with the Yes Conducted environmental orientation
routine monitoring of the project activities in
terms of education, training, knowledge and
experience of the environmental team
Solid Waste Characterization/Information
Recyclable Biodegradable Residual
Average Quantity Generated 0.0706 0.41157 .068667
(tons/ month)
Total Quantity Generated (tons/ 0.2118 1.2347 0.206
quarter)
Average Quantity Collected (tons/ 0 0 .068667
month)
Total Quantity Collected 0 0 0.206
(tons/quarter)
Entity in charge of collection SJDH Waste Staff SJDH Waste Staff LGU- Garbage collector
Brief Description of Solid Waste Management Plan (e.g., waste reduction, segregation, recycling)
1. Use of labeled receptacles/containers : - Biodegradable/non-biodegradable/ Infectious 2.
Disposal:: - Biodegradable- used as food for animals /on site/landfill/pit - Residual- brought and
collected by LGU-Garbage Collector - Hazardous wastes- Holding area/entombment
Powered by TCPDF ([Link])
