SAFE CLOSURE AND REHABILITATION OF DISPOSAL FACILITIES

(Shall serve as an application for an Authority to Close)

To be prepared by the authorized representative of the LGU. Please fill up the information on the space provided and put
a (√) on the appropriate items.

Name of LGU :

Location of Dumpsite (Brgy./Sitio/City/Municipality/Province):

Mode of Ownership

[ ] TCT/ OCT ____________

[ ] Contract of Lease with ________________________________________

[ ] Others (please specify): ______________________________

Type of disposal facility operation prior to closure:

[ ] open dumpsite (active) [ ] open dumpsite (abandoned)

[ ] controlled dump facility (with NTP) [ ] controlled dump facility (without NTP)

[ ] sanitary landfill

Brief description of the disposal facility:

Period of operation of disposal facility: From (mm/dd/yy) to (mm/dd/yy)

Figure 1: Picture of dumpsite prior to rehabilitation as of (mm/dd/yy)

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PHYSICAL CHARACTERIZATION OF THE DISPOSAL FACILITY

Area covered by dumpsite: m2

Estimated volume prior to rehabilitation: m3 as of (mm/dd/yy)

Estimated carrying capacity: m3

Estimated height (or thickness) of dump wastes prior to rehabilitation:

m as of (mm/dd/yy)

Estimated slope prior to rehabilitation (in ratio or percentage):

Figure 2: Schematic Layout of disposal Facility

Figure 3: Cross section of dumpsite showing height or thickness

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Type of waste dumped in the disposal facility (provide percentage of each waste if
determinable):

[ ] Biodegradable ____% [ ] Non-biodegradable _____%

[ ] Bulky waste (i.e., home appliances, [ ] Hazardous waste / Biohazardous Waste

furniture, etc.) _____% ______%

[ ] Others (please specify) ____________________________________________

Daily volume of disposed waste: tons and m3

ENVIRONMENTAL CHARACTERIZATION OF THE AREA

Site condition prior to use as disposal site:

[ ] flat land [ ] hilly [ ] quarry/mines [ ] swampy area

[ ] others, please specify

Surrounding dominant land use condition (approximately 1km radius)

[ ] agricultural [ ] residential [ ] industrial

[ ] others, please specify

Figure 4: Map showing dominant land use within 1km. radius (Please use color codes for
identification)

Existing nearby surface and ground water body

[ ] Surface water (Creek, Rivers, Sea)

Type of current use _______________________
Distance from dumpsite ______________

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 [ ] Groundwater
[ ] Deep well
[ ] Shallow well
Distance from dumpsite ______________

[ ] Other (please specify and describe use briefly)

_____________________________________________

Existing Drainage System

[ ] present and operational (Please discuss briefly type and use)

______________________________________________________

[ ] none

Ambient air condition (Please briefly discuss the current quality of air in the area)

ISSUES AND CONCERNS DURING OPERATION OF THE DISPOSAL FACILITY

Adverse Impact to surrounding environment

[ ] Pollution in nearby water body

[ ] Contamination of nearby potable water source

[ ] Adverse effect on nearby agricultural land

[ ] Increase Mortality/ Morbidity on nearby residential areas

[ ] Others, please specify

Occurrence of open burning/ spontaneous combustion

[ ] Yes, if yes, discuss briefly the cause of incidence

[ ] No

Occurrence of Hazardous waste dumping (i.e., household hazardous waste, hospital

waste)

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 [ ] Yes, if yes, discuss briefly the cause of incidence

[ ] No

Presence of waste pickers

[ ] Yes, if yes, discuss briefly the number of scavengers and frequency of

visit:

[ ] No

Presence of Squatters within or at the peripheries of the dumpsite

[ ] Yes, if yes, discuss briefly the number of households or occupants:

[ ] No
Other issues and concerns, please specify (use additional sheet if needed):

Is waste covering practiced? [ ] Yes [ ] No

If yes, what type and source of cover material is used?

Frequency of waste covering

[ ] daily [ ] weekly [ ] monthly [ ] others, please specify

________________________

SAFE CLOSURE AND REHABILITATION (SCR) PLAN COMPONENT

(The closure management program extended to particular disposal sites to address significant physical and environmental impacts and these are
the activities that will be scheduled in the Gantt Chart. The sub-activities in every major activity may apply depending on the situation at the
dumpsite).

SCR Plan managed or operated by:

[ ] local government [ ] private sector, pls. specify

__________________________

[ ] others, pls. specify __________________________

Cost / Budget allotment for Rehabilitation:

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 Site clearing shall include:

[ ] stoppage of waste picking

[ ] removal of squatters

[ ] stripping off of top waste layer

[ ] others, please specify _____________________________

Please discuss process/ mode of site clearing: __________________

Site Grading and Stabilization of Critical Slope

[ ] compaction of exposed wastes

[ ] benching

[ ] modified present slope

[ ] side slope at 1 vertical to 3 horizontal or gentler

[ ] steep slope, specify estimates __________________

[ ] provision of retaining wall

[ ] provision of embankment

[ ] others, please specify _____________________________

Please discuss process/ mode of site grading and stabilization of

slopes:

Application and maintenance of soil cover

What type and source of cover material will be used?

Drainage Control System

[ ] construction of canals/ditches

[ ] modification/ improvements on existing drainage

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Leachate Management (follow the guidebook on safe closure and rehabilitation of
disposal facilities)
[ ] installation of leachate collection pipes

[ ] installation of collection pond

[ ] leachate treatment

[ ] evaporation

[ ] re-circulation

[ ] others, please specify and discuss method

[ ] surface water discharge

[ ] natural attenuation

Gas Management (follow the guidebook on safe closure and rehabilitation of

disposal facilities)

[ ] installation of gas vents

number of gas vents to be installed _____________________

type of gas vent to be installed _________________________

Fencing and Security

[ ] fence shall be provided [ ] guards shall be assigned

[ ] checkpoints [ ] other form of security measures

______________________

Signage

Strategic locations: _____________________________

Proposed quotes or announcements to put in:

Other Component of SCR Plan (use additional sheets if needed):

Operating hours: [ ] daytime [ ] nighttime

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 Attached is a GANTT CHART OF IMPLEMENTATION of SCR Plan as Annex 1

Figure 5: Perspective of rehabilitated disposal facility (external view)

Figure 6: Perspective of the cross- section of rehabilitated disposal facility with the required
amenities (gas vents, leachate pipes, etc.)

POST CLOSURE LAND USE (PCLU)

(The closure management of the open dumpsite or the controlled dumpsite should be returned to some form of productive use.)

Site Maintenance

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 [ ] Maintenance of rehabilitated disposal facility

[ ] Soil cover maintenance and monitoring

[ ] Leachate treatment

[ ] Gas management maintenance and monitoring

[ ] Others, please specify

[ ] Integrated Waste Management Facility, pls. specify details

___________________________________________

[ ] Public open space

[ ] Park

[ ] Parking Area or Roads

[ ] Recreational Use

[ ] Golf Course

[ ] Grazing Area or Agriculture

[ ] Building/Housing Units

[ ] Commercial/Industrial Facility

[ ] Others, pls. specify

____________________________________________

Attached is a GANTT CHART OF POST CLOSURE ACTIVITIES of SCR Plan as

Annex 2

PROPOSED SOLID WASTE MANAGEMENT

(The proposed solid waste management plan shall be the alternative approach upon closure of disposal facility)

Biodegradable Waste

[ ] Centralized composting

[ ] barangay composting

[ ] cluster (barangay) composting

[ ] Household composting

Please indicate target barangays of the above approach for bio-waste

management

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 Recyclable Waste

Please discuss briefly the method of handling and management (attach extra
sheets for additional information]:

Residual Waste

[ ] Sanitary landfilling
Estimated volume to be disposed/ schedule of disposal
_______________________________________________

Please discuss briefly the operation of disposal (attach extra sheets for
additional information):

[ ] Residual waste processing technology

Estimated volume to process daily: _____m3

Please briefly discuss technology to adopt

Special Waste (I.e., household hazardous waste, hospital waste)

Please discuss briefly the method of handling and management (attach extra
sheets for additional information)

Attached is a GANTT CHART OF ESWM ACTIVITIES INCLUDING IEC

SCHEDULE IN PREPARATION FOR THE CLOSURE OF EXISTING DISPOSAL
FACILITY,Annex 3

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Prepared by:

Designation:

LGU/Office:

Reviewed and Approved by:

Mayor

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 Annex 1 GANTT CHART OF IMPLEMENTATION of SAFE CLOSURE & REHABILITATION PLAN
INCLUDING ITS POST CLOSURE ACTIVITIES

RESPONSIBLE ENTITY/
TIME FRAME OF IMPLEMENTATION CY 2008 COST REMARKS
ACTIVITIES OFFICE
J F M A M J J A S O N D

Prepared by:
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Annex 2 GANTT CHART OF PROPOSED ESWM ACTIVITES

RESPONSIBLE ENTITY/
TIME FRAME OF IMPLEMENTATION 2008 COST REMARKS
ACTIVITIES OFFICE
J F M A M J J A S O N D

Prepared by:
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 ACCOUNTABILITY STATEMENT

This is to certify that the prepared SAFE CLOSURE AND REHABILITATION PLAN
(SCRP) for the existing disposal facility of the LGU of _________________ is reviewed
and approved by the undersigned. Should I/we learn of any information, which would make
the SCRP inaccurate, I/we shall bring the said information to the attention of the concerned
EMB Regional Office.

In witness whereof, I/we hereby set our hands this __________ day of
_______________ at ___________________________________.

______________________________
Printed Name & Signature

______________________________
Title or Designation

ACKNOWLEDGMENT

BEFORE ME this ______ day of ________________, 20_____ at

___________________, personally appeared __________________________ (name) with
Community Tax Certificate No. _____________________________ issued on
_______________ (date) at ____________________ (place), in his/her capacity as
_______________________ (position) of ___________________________ (company)
and acknowledged to me that this SAFE CLOSURE AND REHABILITATION PLAN
(SCRP) is a requirement of the DENR per DAO No. 9, Series of 2006 with the subject
General Guidelines in the Closure and Rehabilitation of Open and Controlled Waste Disposal
Facilities. This document, which consists of ______________ pages, including the page on
which this acknowledgement is written, is a SCRP.

Witness my hand and seal on the place and date above written.

______________________________
Notary Public
Doc. No. _______
Page No. _______
Book No. _______
Series of _______