Name of Plant:

Reference No:

Department of Environment and Natural Resources

Environmental Management Bureau

QUARTERLY SELF-MONITORING REPORT

4TH QUARTER 2010

MODULE 1: GENERAL INFORMATION
Name of the Plant ORIA AGROTECH INC.
Please provide the necessary revised, corrected or updated information not contained in your
General Information Sheet

(use additional sheet/s if necessary)

DENR Permits/Licenses/Clearances
Environmental
Permits Date of Issue Expiry Date
Laws
A/C No.
P.D. 984
PO No. DP-1011-03BU-576 Sept. 16, 2010 Sept. 20, 2011
ECC 1

PD 1586 ECC 2

ECC 3
DENR
Registry ID
CCO Registry
RA 6969 Importer
Clearance No
Permit to
Transport
A/C No.
RA 8749
PO No. POA-10H-03BU-576 Sept. 15, 2010 Sept. 20, 2011

Module 1: General Information page ____ of ____

Name of Plant:
Reference No:

Operation
Operating hours/day Operating days/week # of shift/day
Average 8 6 1
Maximum 24 7 3

Operation/Production/Capacity:
Average Daily Total Output this
Please see below Please see below
Production Output Quarter
Total Water Total Electric
Consumption this 181 Consumption this 6,023
Quarter (cubic meters) Quarter (KwH)
Please use additional sheet/s if necessary

Malathion Tech - 2,934 L - 211,230 L

Cypermethrin Tech - 0.81 T - 58.32 T

Module 1: General Information page ____ of ____

Name of Plant:
Reference No:

MODULE 2: RA 6969

A. CCO Report (please accomplish this section for each chemical/substance)

Common Name/IUPAC/CAS Index Name. N.A. ___

CAS No.: ___
Trade Name: ___

For importers only:

Import
Quantity Date of Quantity Port of Country of Country of
Clearance
Requested Arrival Received* Entry Origin Manufacture
No.

Total Quantity Total Quantity

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

For distributors (importers/non-importers)

Name of Client License No. Quantity Date of Distribution

Total Quantity Distributed

For non-importer users:

Name of Distributor Quantity Date of Purchase

Total Quantity Purchased from Distributor

Module 2A: RA 6969 (CCO Report) page ____ of ____

Name of Plant:
Reference No:

For producers
Average Daily Total Output this
Production Output Quarter
Quantity of Stock Quantity of Stock
Inventory (Start of Inventory (End of
Quarter) Quarter)
Name of Buyer Quantity Date of Purchase

Total Quantity Sold

Used in Production (please fill up only if chemical/substance is not main product)

Average Daily Total Output this
Production Output Quarter
Average Quantity Used Total Quantity Used
per month this Quarter
Describe any changes in Production/Process/Operations:

Stock Inventory/Waste Chemical Generated:

Average Quantity of Total Quantity of Waste
Waste Chemical Chemical Generated
Generated per month this Quarter
Quantity of Stock Quantity of Stock
Inventory (Start of Inventory (End of
Quarter) Quarter)

Other Information:
Manner of handling
storage on-site
Treatment on-site
hazardous wastes
storage off-site
Treatment off-site

Changes in Safety
Yes (please attach copy of revised plan)

Management System
No

Chemical Substitute
Yes (please attach copy if not submitted/included in previous report/s or had been revised)
Plan
No

Module 2A: RA 6969 (CCO Report) page ____ of ____

Name of Plant:
Reference No:

B. Hazardous Wastes Treater/Recyler

HW Stored and/or Untreated as of End of Quarter:

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

HW Treated and/or Recycled as of End of Quarter:

Type of Type &
Transport Treatment Quantity of
Type of HW Wastes Date of
Permit/Date Quantity or Recycled
Wastes Number Generator Transport
of Issue Recycling or Treated
Process Product

Residual Wastes Generated from the Treatment and/or Recycling Operation:

Type of
Process by
Storage
Type of which the Disposal Time Table
HW Number Quantity Container/
Wastes Wastes is Option for Disposal
# of
Generated
containers

Module 2B: RA 6969 (Hazardous Wastes Treater/Recycler) page ____ of ____

Name of Plant:
Reference No:

C. Hazardous Wastes Generator

HW Generation:
Remaining HW from
HW HW Generated
HW No. HW Class HW Nature Previous Report
Cataloguing
Quantity Unit 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: ___
Storage
Method: ___

ID: Name: ___

Transporter
Date: ___

ID: Name: ___

Treater
Method: Date: ___

ID: Name: ___

Disposal
Date: Date: ___

HW No,: ___
HW Details Qty of HW Treated: Unit: ___
TSD Location: ___

Name: ___
Storage
Method: ___

ID: Name: ___

Transporter
Date: ___

ID: Name: ___

Treater
Method: Date: ___

ID: Name: ___

Disposal
Date: Date: ___

Module 2C: RA 6969 (Hazardous Wastes Generator) page ____ of ____

Name of Plant:
Reference No:

On-Site Self Inspection of Storage Area:

Premises/Area Findings & Corrective Action
Date Conducted
Inspected Observations Taken (if any)

Module 2C: RA 6969 (Hazardous Wastes Generator) page ____ of ____

Name of Plant:
Reference No:

MODULE 3: P.D. 984 (Water Pollution)

Water Pollution Data

Domestic wastewater Process wastewater
0.2
(cubic meters/day) (cubic meters/day)
Cooling water Others: ___________
(cubic meters/day) (cubic meters/day)
Wash water, Wash water, floor
0.15
equipment (m3/day) (cubic meters/day)

Record of Cost of Treatment

Month 1 Month 2 Month 3

New/Additional
Investments in WTP
(Description)

Cost of New/Add
Investments
Person employed, (# of
1 1 1
employees)
Person employed,
P 6,000.00 P 6,000.00 P 6,000.00
(cost)
Cost of Chemicals
used by WTP
Utility Costs of WTP
(electricity & water)
Administrative and
Overhead Costs
Cost of operating in-
house laboratory

WTP Discharge Location

Outlet
Location of the Outlet Name of Receiving Water Body
Number
1 N.A. N.A.
2
3
4
5

Module 3: P.D. 984 (Water Pollution) page ____ of ____

Name of Plant:
Reference No:

Detailed Report of Wastewater Characteristics for Conventional Pollutants

None. The wastewater is being contained in a pond, therefore the sample taken and
Outlet No.
tested is an influent sample.
Influent Oil & ________
BOD TSS Temp rise (name)
DATE Flow Rate Color pH Grease
3 (mg/L) (mg/L) (ºC)
(m /day) (mg/L)
(unit)

4-23-18 0.18 200 5 7.03

7-10-10 0.16 200 23 6.80
10-9-10 0.18 200 32 6.61
1-4-11 0.2 200 10 7.5

Please fill-up/accomplish separate form/s for other outlet/s.

Module 3: P.D. 984 (Water Pollution) page ____ of ____

Name of Plant:
Reference No:

Detailed Report of Wastewater Characteristics for Other Pollutants

Outlet No. N.A.

Effluent ________ ________ ________ ________ ________ ________ ________

(name) (name) (name) (name) (name) (name) (name)
DATE Flow Rate
(m3/day)
(unit) (unit) (unit) (unit) (unit) (unit) (unit)

Please fill-up/accomplish separate form/s for other outlet/s.

Please use additional sheet/s if necessary.

Module 3: P.D. 984 (Water Pollution) page ____ of ____

Name of Plant:
Reference No:

MODULE 4: R.A. 8749 (Air Pollution)

Summary of APSE/APCF
Process Equipment Location # of hrs of operations
1. Repacking Table Repacking Area 8
2.
3.
4.
Fuel Burning Equipment Location # of hrs of operations
1.
2.
3.
4.
5.
6.
Pollution Control Facility Location # of hrs of operations
1. Air Filters at Vent Fans Repacking Area 8

2.
3.
4.

Cost of Treatment
Month 1 Month 2 Month 3

Improvement or
modification, if any.
(Description)

Cost of improvement of
modification
Cost of Person
P 6,000.00 P 6,000.00 P 6,000.00
employed, (salary)
Total Consumption of
1.92 1.88 1.96
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

Module 4: RA 8749 (Air Pollution) page ____ of ____

Name of Plant:
Reference No:

Detailed Report of Air Emission Characteristics

Description/Location
N.A.
of PCF
________ ________ ________ ________
Flow Rate CO NOx Particulates (name) (name) (name) (name)
DATE
(Ncm/day) (mg/Ncm) (mg/Ncm) (mg/Ncm)
(mg/Ncm) (mg/Ncm) (mg/Ncm) (mg/Ncm)

Please fill-up/accomplish separate form/s for other PCF/s.

Please use additional sheet/s if necessary.

Module 4: RA 8749 (Air Pollution) page ____ of ____

Name of Plant:
Reference No:

MODULE 5: P.D. 1586

Ambient Air Quality Monitoring (if required as part of ECC conditions)

Description/Location
N.A.
of Monitoring Station
________ ________ ________ ________
Noise CO NOx Particulates (name) (name) (name) (name)
DATE
Level (dB) (mg/Ncm) (mg/Ncm) (mg/Ncm)
(mg/Ncm) (mg/Ncm) (mg/Ncm) (mg/Ncm)

(Please accomplish one table per monitoring station.)

Ambient Water Quality Monitoring (if required as part of ECC conditions)

Description/Location
N.A.
of Sampling Station
________ ________ ________ ________ ________ ________ ________ ________
(name) (name) (name) (name) (name) (name) (name) (name)
DATE
(unit) (unit) (unit) (unit) (unit) (unit) (unit) (unit)

(Please accomplish one table per sampling station.)

Module 5: P.D. 1586 (EIS System) page ____ of ____

Name of Plant:
Reference No:

Other ECC Conditions

Status of Compliance
ECC Condition/s Actions Taken
Yes No
1. Transport, storage and handling of agricultural
chemical wastes/sludge shall conform w/ the standards of ⁄
RA6969.
2. The proponent shall designate a full-time PCO for ⁄
accreditation by the Regional Office.
3. A “Permit to Operate” air pollution and wastewater ⁄
treatment facility shall be secured immediately.
4. PPE shall be provided to all workers during the ⁄
project’s operational phase.
5.
6.
7.
8.
9.
10.
11.
Please use additional sheet/s if necessary.

Environmental Management Plan/Program

Status of
Enhancement/Mitigation Measures Implementation Actions Taken
Yes No

1. Smoke-free plant ⁄ No Smoking Plant

Maintaining cleanliness
2. Clean and green environment ⁄ and beautification of
surroundings.
3. Waste segregation ⁄ Color coded trash cans.
4.
5.
6.
7.
8.
9.
10.
11.
Please use additional sheet/s if necessary.

Module 5: P.D. 1586 (EIS System) page ____ of ____

 Procedural and Reference Manual for DAO 2003-27

MODULE 6: OTHERS

Accidents & Emergency Records

Findings and
Date Area/Location Actions Taken Remarks
Observation

Personnel/Staff Training
# of Personnel
Date Conducted Course/Training Description
Trained

I hereby certify that the above information are true and correct.

Done this January 13, 2011 , in Oria Agrotech Plant, Norzagaray, Bulacan

RICHARD A. BERGANOS
Name/Signature of PCO
ADORITO V. ORIA
Name/Signature of CEO

SUBSCRIBED 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

_____________________ _____________ _______________ ______________

Preparation and Submission of SMR 15