GENERAL INFORMATION SHEET Name of the Establishment/ Facility Establishment/Facility Address (Not the company of head office) Name

of Owner/Company Address (if address is not the same as previous address) Phone Number e-mail address Type of Business/Industry Classification Responsible Officer/s Pollution Control Officer Legal Classification Fax Number:

We hereby certify that the above information are true and correct

Name/Signature of CEO

Name/Signature of PCO

Department of Environmental and Natural Resources Environmental Management Bureau QUARTERLY SELFMONITORIGN REPORT 1st QUARTER 2009 MODULE 1: GENERAL INFORMATION Name of the Plant
Please provide the necessary revised, corrected or updated information not contained in your

General Information Sheet The Lazland Mini-Sawmillis the owner of a sawmill plant which will process unproductive gemilina trees and other legally cut planted trees into commercial cut Lumber using locally assembled sawmilling equipments which are provided with the corresponding air pollution control divice to safeguard the environmental during operations.

(use additional sheet if necessary) DENR Permits/Licenses/Clearances Environmental Laws PD 984 PD 1586 Permits A/C No. PO No. ECC 1 ECC 2 ECC 3 DENR Registry ID CCO Registry Importer Clearance No Permit to Transport A/C No. PO No. Date of Issue Expiry Date

RA 6969

RA 8749

Operation Operating Hours/day Average 8Hrs Maximum 8Hrs Operation/Production/Capacity: Average Daily Production Output 4.5 Tons/day Total Water Consumption this None Quarter (cubic meters) Operating days/week 6 7 Total Output this Quarter Total Electric Consumption this Quarter (KWH) # of shift/day 250 Tons 18,000 Kw-Hrs

MODULE 2: RA 6969 A. CCO Report (please accomplish this section for each chemical/substance) Common Name/UPAC/CAS Index Name ___________________________________ ____________________________________Case No. _________________________ Trade Name: __________________________________________________________ For importers only: Quantity Import Requested Clearance

Date of Arrival None

Quantity Received

Port of Entry

Counter of Origin

Country of Manufacture

Total Quantity Requested (annual) *attach copy/s of Bill of Lading

Total Quantity Received (annual)

For distributors (importers/non-importers) Name of Client License No. Quantity None Total Quantity Distributed

Date of Distribution

For non importer users: Name of Distributor

Quantity None

Date of Purchase

For Producers Average Daily Production Output Quantity of Stock Inventory (Start of Quarter) Name of Buyer

Quantity

Total Output this Quarter Quantity of Stock Inventory (end of Quarter) Date of Purchase

Total Quantity Sold Use and Production (please fill up only if chemical/substance is not main product) Average Daily Total Output this Production Output Quarter Average Quantity Total Quantity Used per month Used this month Describe any changes in Production/Process/operations:

Stock Inventory/Waste Chemical Generated: Average Quantity Total Quantity of of Waste Chemical waste Chemical Generated per Generated this Month Quarter Quantity of Stock Quantity of Stock Inventory (stock of Inventory (end of Quarter) Quarter)

Other information: Manner of Handling hazardous waste Changes in safety Management System Chemical Substitute Plan

Storage on site Treatment on site Storage off site Treatment off site Yes(please attach copy of revised plan) No. Yes (please attach copy if not submitted/included in report/s or had been revised) No. Remaining HW from previous report Quantity Unit

B. Hazardous Wastes Treater/ Recycler HW No. HW Class HW Nature HW cataloguing HW Generated Quantity Unit

Waste Storage, Treatment and Disposal: (please fill up one table per HW) HW No. HW Details Qty of HW Treated: Unit TSD Location: Name: None Storage Method: ID: Name Transporter Date: ID: Name Treater Method Disposal ID: Name Date:

MODULE 2C: RA 6969 (Hazardous Wastes Treater/Recycler) C. Hazardous Wastes Treater/Recycler Date Conducted Premises/Area Findings & Corrective Action Inspected Observations taken (if any)

HW Stored and/or Untreated as of end of Quarter

HW Number Wastes Generator Date of Transport Transport Permit/Date of issue Valid Until Quantity Quantity Type of Storage Container /# of containers Time Table for Treatment

HW Treated and/or Recycled as of End of Quarter

Types of Wastes Wastes Generate d Transport Type of Permit/Date Transport of issue Type of Treatmen t or Recycling Process Type of Quantity of Recycled or Treated Product

HW Number

Quantity

Residual Wastes Generated from the Treatment and/or recycling Operation Types of HW Process Quantity Type of Disposal Time Wastes Number by which Storage Option Table for the wastes Container/# Disposal is of Generated containers

MODULE 3: P.D. 984 (WATER POLLUTION) Water Pollution Data Domestic wastewater (cubic meters/day) Cooling water (cubic meters/day) Wash water, equipment (m3/day) Process wastewater (cubic meters/day) Others:___________ (cubic meters/day) Wash water, floor (cubic meters/day)

Record of Cost Treatment (separate entries for separate facilities) Month 1 Month 2 Month 3 Person employed,(# of employees) Person employed, (cost) Cost of Chemicals used by WTP Utility Costs of WTP (electricity & water) Administrative and Overhead Costs Costs of Operating in-house laboratory New/Additional Investment in WTP (Description Cost of New/Add Investments WTP Discharge Location Outlet Number 1 2 3 4 5 Location of the Outlet Name of Receiving Water Body

Detailed Report of Wastewater Characteristics for other Pollutants Outlet No.

DATE

Effluent flow rate (m3/day)

(name) (unit)

(name) ______ (unit)

(name) _____ (unit)

(name) (unit)

(name) (unit)

(name) (unit)

(name) (unit)

Please fill up/accomplish separate forms for other outlet/s Please use additional sheet/s if necessary

Detailed Report of Wastewater Characteristics for Conventional Pollutants No discharge of waste water treatment facilities . Outlet No.
Effluent flow Rate (m3/day) BOD (mg.L) TSS (mg/L) Oil & Grease (mg/L) Temp rise (oC) (name) (unit)

DATE

Color

PH

02/29/08

260

132

55

9.1

MODULE 4 R.A. 8749 (Air Pollution) Summary of APSE/APCF Process Equipment 1. 2. 3. 4. Fuel Burning Location Equipment 1. 2. 3. 4. Pollution Control Facility 1. 2. 3. 4. Cost of Treatment Cost of Person employed, (salary) Total Consumption of water (cubic meters) Total cost of chemicals used (e.g., activated carbon, KmnO4) Total Consumption of Electricity (KwH) Administrative and Overhead Costs Cost of Operating in-house laboratory, if any Improvement or modification, if any. (Description) Cost of improvement of modification Month 1 Included in the payroll 3-95-tons Month 2 Included in the payroll 2.42-tons Month 3 Included in the payroll 5.48-tons Location # of hours of Operation

Fuel Used

Quantity Consumed

# of hours of Operation

Location

# of hours of Operation

Detailed Report of Air Emission Characteristics Description/ Location of PCF DATE

Flow Rate Ncm/day CO(mg/N cm) NOx (mg/Ncm) Particulat es (mg/Ncm ) (name) (mg/Nc m) (name) (mg/Nc m) (name) (mg/Nc m) (name) (mg/Nc m) (name) (mg/Nc m)

Ambient Water Quality Monitoring (if required as part of ECC conditions) Description/Location of Monitoring Station DATE (name) (unit) (name) (unit) (name) (unit) (name) (unit) (name) (unit) (name) (unit) (name) (unit) (name) (unit)

(please accomplish one table per sampling station

Other ECC Conditions ECC Conditions Status of Compliance Yes No Action Taken 1. Adequate wastewater treatment 2. Facilities shall be properly designed. 3. Utilized and maintained at all times 4. Hog manure shall be properly collected and disposed Environmental Management Plan/Program Enhancement/Mitigation Status of Compliance Measures 1. Disposal of solid waste at proper designated place 2. Please use additional sheet/s if necessary Solid Waste Characteristics/Information Average of solid Total Quantity of Waste Generated Solid Wastes per month Generated this Quarter Average Quantity Total Quantity of of Solid Wastes Solid Wastes collected per month Collected this Quarter Entity in charge of Collecting solid wastes Brief description of Solid Waste Management Plan (e.g., waste reduction, segregation, recycling)

Action Taken

MODULE 6: OTHERS Accidents & Emergency/Records Date Area/Location Findings and Observation Action taken Remarks No cases of accidents & Emergency cases for the past quarter. Personnel/Staff Training Date Conducted Course/Training description No training seminar for this quarter # of Personnel Trained

I hereby certify that the above information are true and correct. City Done this ______________________________ in Brgy. San Isidro, Koronadl , Philippines.

Name/Signature of CEO

Name/Signature of PCO

SUBSCRIBE AND SWORN before me, a Notary Public, this ___________ day of _____________, affiants exhibiting to me their Community Tax Receipts: Name _________ CTR No. _________ Issued at _________ Issued on

Doc No. ________ Page No. ________ Book No. _______ Series No. _______

FRANCISCA PIGGERY FARM 11

Brgy. Santa Cruz , Tampakan, South Cotabato

October 10,2008 DATU TUNGKO M. SAIKOL Regional Director Environmental Management Bureau Department of Environment and Natural Resources Regional Office XII Koronadal City THRU: ENGR. RONIE L. SALMON Chief, Pollution Control Division EMB-DENR R-XII Sir: Respectfully submitted to your office is the 2nd Quarter Self Monitoring Report (SMR) for CY 2008.In compliance to DAO 26 series of 1991. Thank you

Very truly yours, MS. MARY ANN BARROSO Manager Francisca Piggery Farm 11