Appendix 10.1 Record forms

Implementation status proforma

Ref:

Ref**

Environmental Protection Measures *

Implementation Status

* All recommended and requirements resulted during the Course of EIA/EA Process including ACE and/or accepted public comment to the proposed project.

** EIA Ref / EM&A Log Ref / Design Document Ref.

Signed by Environmental Team Leader:	Date:
Audited by Independent Checker (Environment):	Date:

Appendix 10.1 Record forms

Data recovery schedule

Ref:

Date	Air Quality Monitoring					Noise Monitoring					Water Quality Monitoring
	Monitoring Station *					Monitoring Location *					Monitoring Location *
	A1	A2	A3	A4	A5	N1	N2	N3	N4	N5	W1	W2	W3	W4	W5
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
% or R

* Remark type of parameters.

% of R The percentage of data recovery is the actual monitoring over the scheduled monitoring.

Signed by ET Leader: ________________________________________________________ Date: _______________________________

Copy to Independent Checker (Environment): ________________________________________________________ Date: _______________________________

Appendix 10.1 Record forms

Site Inspection corrective Action proforma

Ref:

Date of Observation	Location	Observation / Deficiency	Mitigation Action and By Whom	Description of Actions Taken	Date of Action

This Proforma is an Environmental Protection Instruction for: Issued on:

Please complete the table as required and submit to the ET Leader with copy to ER.

Signed by the Environmental Team Leader: Date:

Appendix 10.1 Record forms

proactive environmental protection proforma

Ref:

Ref *

Proposed Construction Method **

Location / Working Period

Anticipated Impacts

Recommended Mitigation Measures

* EIA Ref / EM&A Ref / Design Document Ref.

** Details of equipment, vehicles, plants, processes technologies for the option of construction method.

Reviewed by Environmental Team Leader:	Date:
Approved by Independent Checker (Environment):	Date:

Appendix 10.1 Record forms

regulatory compliance proforma

Ref:

Ref **

Environmental License / Permit *

Control Area / Facility / Location

Effective Date

* Name of Application, Business Corporation, relevant regulation and remark of license / permit conditions.

** File reference of the licensee / permittee.

Recorded by Environmental Team Leader:	Date:
Signed by Independent Checker (Environment):	Date:

Appendix 10.1 Record forms

ENVIRONMENTAL COMPLAINTS Log

Ref:

Log. Ref.

Date/Location

Complaint/Date of Contact

Details of Complaint

Investigation/Mitigation Action

File Closed

Filed by Environmental Audit Team Leader:

Date:

Appendix 10.1 Record forms

Incident Report on Action Level or Limit Level Non-Compliance

Ref:

Project

Date

Time

Monitoring Location

Parameter

Action and Limit Levels

Measured Level

Possible Reason for Action or Limit Level Non-Compliance

Actions Taken / To Be Taken

Remarks

Prepared by: ___________________________________________________

Designation: ___________________________________________________

Signature: _____________________________________________________

Date: _________________________________________________________

Appendix 10.1 Record forms

Noise Monitoring Field Data Sheet

Ref:

Monitoring Location
Description of Location
Date of Monitoring
Measurement Start Time (hh:mm)
Measurement Time Length (min)
Noise Meter Model/Identification
Calibrator Model/Identification
Measurement Results	L90 [dB(A)]
	L10 [dB(A)]
	Leq [dB(A)]
On-Site Calibration		Initial [dB(A)]
		Final [dB(A)]
Major Construction Noise Source(s) During Monitoring
Other Noise Source(s) During Monitoring
Remarks

	Name & Designation	Signature	Date
Recorded by:
Checked by: