Sample Self Monitoring Report 2d4o6n
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Name of Plant /Establishment: CORAL JEM GASOLINE STATION
Reference No.
Department of Environment and Natural Resources Environmental Management Bureau Regional Office No. 1, Government Center, Sevilla, City of San Fernando 1st QUARTER SELF – MONITORING REPORT (January to April 2016) MODULE 1. GENERAL INFORMATION Name of the Plant: CORAL JEM GASOLINE STATION 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 Laws A/C No. P.D. 984 R.A. 9275 PD 1586 RA 6969
RA 8749
PO 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.
RO1 – 1405 - 0095
Date of Issue
Expiry date
May 13, 2014
POA-
Module 1: General Information
Page 1 of 9
Name of Plant /Establishment: CORAL JEM GASOLINE STATION
Reference No.
Operation Average Maximum
Operating hours/day 8 10
Operating days/week 7 7
# of shift/day 1 1
Operation/ Production/capacity: Average Daily Volume Sales Output (Liters)
Total Sales Output this Quarter (Liters)
Gasoline
450 Liters
Gasoline
40,500 liters
Regular Gasoline
500 Liters
Regular Gasoline
45,000 liters
Diesel Fuel Total water Consumption this Quarter (cubic meters)
625 Liters
Diesel Fuel Total Electricity Consumption this Quarter (KWH)
56,250 liters
30 cu. m.
2,750 kwhr
Please use additional sheet/s if necessary
Module 1: General Information
Page 2 of 9
Name of Plant /Establishment: CORAL JEM GASOLINE STATION
Reference No.
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)
0.5
0
Process wastewater (cubic meters/day) Others: __________ (cubic meters/day) Wash water, floor (cubic meters/day)
0
0
Record of Cost of treatment (separate entries for separate facilities) October November December Person employed (# of Employees) Person employed. (cost) Cost of chemicals Used by WTP Utility costs of WTP (electricity & water) istrative and overhead costs Cost of operating in house laboratory New additional Investments in WTP ( ) Description Cost of New/Add Investments
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
Third Party Testing
Third Party Testing Third Party Testing
None
None
None
None
None
None
WTP Discharge Location Outlet Location of the outlet number 1 Septic Tank 2 3
Name of receiving water Body None
Module 3:P.D. 984 (Water pollution)
Page 3 of 9
Name of Plant /Establishment: CORAL JEM GASOLINE STATION
Reference No.
Detailed Report of Wastewater characteristics for other Pollutants Outlet No. Septic Tank DATE Effluent BOD5 Flow (name) (name) (name) (name) (name) (name) (name) rate Mg/L (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.
Page 4 of 9
Name of Plant /Establishment: CORAL JEM GASOLINE STATION
Reference No.
Module 3:P.D. 984 (Water pollution)
Summary of APSE/APCF Process Equipment
# of Hrs of Operations 920 920 920
Location
1 Gasoline Fuel Dispenser 2 Regular Gasoline Fuel Dispenser 3 Diesel fuel dispenser 4 Fuel burning Location equipment
Refilling Station Refilling Station Refilling Station
1. 46 KW ‘Isuzu’ C190 Diesel Engine Generating Set 2. 3. 4. 5. 6. Pollution Control Facility
Fuel used
Quantity consumed
# of Hrs of Operations
Diesel Fuel
9 Liters
9
Location Front corner of the refilling station
1. Underground tank vent (20 ft high) 3. 4.
# of Hrs of Operations 920
Cost of treatment October
November
December
none
none
None
Total consumption of water (cubic meters)
60
45
60
Total cost of chemicals
n/a
n/a
n/a
Used (e.g.,activated) Carbon, KMnO4)
n/a
n/a
n/a
Total consumption of electricity (KWH)
n/a
n/a
n/a
istrative and overhead costs
n/a
n/a
n/a
Improvement or modification, if any. (description
none
none
None
Cost of improvement of modification
none
none
None
Cost of person Employed (salary)
Module 4:RA 8749 (Air pollution)
Page 5 of 9
Name of Plant /Establishment: CORAL JEM GASOLINE STATION
Reference No.
Emission Estimates for the Quarter EG (ton/quarter) = ER (mg/L) * Vgd (L/mo) * 3 mo. * CF Where: EG = Annual Gas Emission (ton/quarter) Vgd = Volume of dispersed gasoline (Liters/ Quarter) CF – conversion factor ( 1 ton/ 9.07 x 108 mg) Combined volume of and Unleaded Regular Gasoline for the Quarter is 85,500 liters. Emissio Emission n Rate, Computations for this mg/l Quarter Filling underground tank (Stage I) Submerged Filling 880 (880 x 85,500)/ 9.07 x 108 0.082955 Underground tank breathing 120 (120 x 85,500)/ 9.07 x 108 and emptying 0.011312 Vehicle refueling operations (Stage II) Displaced losses 1,320 (1,320 x 85,500)/ 9.07 x 108 (uncontrolled) 0.124432 8 Spillage 80 (80 x 85,500)/ 9.07 x 10 0.007541 Total >>> 0.22624 Diesel Engine Generating Set Air Emission Estimates Emissions Pollutants Computations (This Quarter) NOx 18.848 x 46 kw x 9 hrs ÷ 9.07 x 105 0.0086 5 CO 4.0614 x 46kw x 9 hrs ÷ 9.07 x 10 0.0019 SOx 1.2464 x 46 kw x 9 hrs ÷ 9.07 x 105 0.0006 5 PM10 1.368 x 46 kw x 9 hrs ÷ 9.07 x 10 0.0006 CO2 699.2 x 46 kw x 9 hrs ÷ 9.07 x 105 0.3191 Aldehydes 2.815 x 46 kw x 9 hrs ÷ 9.07 x 105 0.0013 Emission Source
TOC Exhaust Crankcase
1.5018 x 46 kw x 9 hrs ÷ 9.07 x 105 2.6813 x 46 kw x 9 hrs ÷ 9.07 x 105
0.0007 0.0012
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 6 of 9
Name of Plant /Establishment: CORAL JEM GASOLINE STATION
Reference No.
MODULE 5: PD. 1586 Amblent Air Quality Monitoring (if required as part of ECC conditions) Description/Location of Monitoring Station DATE Noise CO Level (mg/Ncm) (db) (mg/Ncm)
NO
Particulates (mg/Ncm)
(Name)
(Name)
(Name)
(mg/Ncm (mg/Ncm (mg/Ncm ) ) ) NO AVAILABLE PORTABLE EQUIPMENT FOR NOISE TESTING
(Name) (mg/Ncm)
(Please accomplish one table per monitoring station) Amblent Air Quality Monitoring (if required as part of ECC conditions) Description/Location of Sampling station DATE
(name)
(name)
(name)
(name)
(name)
(name)
(name)
(unit)
(unit)
(unit)
(unit)
(unit)
(unit)
(unit)
(Please accomplish one table per sampling station)
Module 5:P.D. 1586 (EIS System)
Page 7 of 9
Name of Plant /Establishment: CORAL JEM GASOLINE STATION
Other ECC Conditions ECC Condition/s
Status of Compliance Yes No
Reference No.
Actions Taken
(Please use additional sheet/s if necessary) Environmental Management Plan/Program Enhancements/Mitigatio n Measures 1. Periodic inspection of underground tanks for leaks 2. Periodic maintenance of all fuel dispensers for a leak free refilling of fuel to vehicles
Status of Implementation Yes No
Actions Taken Proper monitoring of dispensed fuel against inventory. Coordination with the supplier for proper maintenance of fuel dispensers quarterly.
Yes
Yes
(Please use additional sheet/s if necessary) Solid waste Characterization/Information Average Quantity of Solid wastes Generated per month Average Quantity of Solid wastes Collected Per month Entity in charge of Collecting solid wastes Brief Description of Solid waste Management plan (e.g., waste reduction, Segregation, recycling)
Total Quantity of Solid Wastes Generated this Quarter 10 kgs 30 kgs Municipal garbage collector
30 kgs
Segregation of waste according to classifications
n/a
Module 5:P.D. 1586 (EIS System)
Page 8 of 9
Name of Plant /Establishment: CORAL JEM GASOLINE STATION
Reference No.
MODULE 6: OTHERS Accidents & Emergency records Date
Area/Location
Findings and observation
Actions Taken
Remarks
None
Personnel/Staff Training Date Conducted
Course/Training Description NONE FOR THE QUARTER
# of Personnel Trained
I hereby certify that the above information are true and correct. Done this _______ day of January 2016 in Laoag City, Ilocos Norte. IMELDA B. CRISTOBAL Pollution Control Officer DR.MODESTY IRMINA A. CORPUZ
OWNER SUBSCRIBED AND SWORN before me, a Notary Public, this __________ day of __________________, affiants exhibiting to me their Government Issued ID: Name
Govt. Issued ID
Issued at
Issued on
DR. MODESTY IRMINA A. CORPUZ ______________
____________
________________
IMELDA B. CRISTOBAL
________ .
________________
______________
NOTARY PUBLIC
Page 9 of 9
Reference No.
Department of Environment and Natural Resources Environmental Management Bureau Regional Office No. 1, Government Center, Sevilla, City of San Fernando 1st QUARTER SELF – MONITORING REPORT (January to April 2016) MODULE 1. GENERAL INFORMATION Name of the Plant: CORAL JEM GASOLINE STATION 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 Laws A/C No. P.D. 984 R.A. 9275 PD 1586 RA 6969
RA 8749
PO 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.
RO1 – 1405 - 0095
Date of Issue
Expiry date
May 13, 2014
POA-
Module 1: General Information
Page 1 of 9
Name of Plant /Establishment: CORAL JEM GASOLINE STATION
Reference No.
Operation Average Maximum
Operating hours/day 8 10
Operating days/week 7 7
# of shift/day 1 1
Operation/ Production/capacity: Average Daily Volume Sales Output (Liters)
Total Sales Output this Quarter (Liters)
Gasoline
450 Liters
Gasoline
40,500 liters
Regular Gasoline
500 Liters
Regular Gasoline
45,000 liters
Diesel Fuel Total water Consumption this Quarter (cubic meters)
625 Liters
Diesel Fuel Total Electricity Consumption this Quarter (KWH)
56,250 liters
30 cu. m.
2,750 kwhr
Please use additional sheet/s if necessary
Module 1: General Information
Page 2 of 9
Name of Plant /Establishment: CORAL JEM GASOLINE STATION
Reference No.
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)
0.5
0
Process wastewater (cubic meters/day) Others: __________ (cubic meters/day) Wash water, floor (cubic meters/day)
0
0
Record of Cost of treatment (separate entries for separate facilities) October November December Person employed (# of Employees) Person employed. (cost) Cost of chemicals Used by WTP Utility costs of WTP (electricity & water) istrative and overhead costs Cost of operating in house laboratory New additional Investments in WTP ( ) Description Cost of New/Add Investments
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
Third Party Testing
Third Party Testing Third Party Testing
None
None
None
None
None
None
WTP Discharge Location Outlet Location of the outlet number 1 Septic Tank 2 3
Name of receiving water Body None
Module 3:P.D. 984 (Water pollution)
Page 3 of 9
Name of Plant /Establishment: CORAL JEM GASOLINE STATION
Reference No.
Detailed Report of Wastewater characteristics for other Pollutants Outlet No. Septic Tank DATE Effluent BOD5 Flow (name) (name) (name) (name) (name) (name) (name) rate Mg/L (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.
Page 4 of 9
Name of Plant /Establishment: CORAL JEM GASOLINE STATION
Reference No.
Module 3:P.D. 984 (Water pollution)
Summary of APSE/APCF Process Equipment
# of Hrs of Operations 920 920 920
Location
1 Gasoline Fuel Dispenser 2 Regular Gasoline Fuel Dispenser 3 Diesel fuel dispenser 4 Fuel burning Location equipment
Refilling Station Refilling Station Refilling Station
1. 46 KW ‘Isuzu’ C190 Diesel Engine Generating Set 2. 3. 4. 5. 6. Pollution Control Facility
Fuel used
Quantity consumed
# of Hrs of Operations
Diesel Fuel
9 Liters
9
Location Front corner of the refilling station
1. Underground tank vent (20 ft high) 3. 4.
# of Hrs of Operations 920
Cost of treatment October
November
December
none
none
None
Total consumption of water (cubic meters)
60
45
60
Total cost of chemicals
n/a
n/a
n/a
Used (e.g.,activated) Carbon, KMnO4)
n/a
n/a
n/a
Total consumption of electricity (KWH)
n/a
n/a
n/a
istrative and overhead costs
n/a
n/a
n/a
Improvement or modification, if any. (description
none
none
None
Cost of improvement of modification
none
none
None
Cost of person Employed (salary)
Module 4:RA 8749 (Air pollution)
Page 5 of 9
Name of Plant /Establishment: CORAL JEM GASOLINE STATION
Reference No.
Emission Estimates for the Quarter EG (ton/quarter) = ER (mg/L) * Vgd (L/mo) * 3 mo. * CF Where: EG = Annual Gas Emission (ton/quarter) Vgd = Volume of dispersed gasoline (Liters/ Quarter) CF – conversion factor ( 1 ton/ 9.07 x 108 mg) Combined volume of and Unleaded Regular Gasoline for the Quarter is 85,500 liters. Emissio Emission n Rate, Computations for this mg/l Quarter Filling underground tank (Stage I) Submerged Filling 880 (880 x 85,500)/ 9.07 x 108 0.082955 Underground tank breathing 120 (120 x 85,500)/ 9.07 x 108 and emptying 0.011312 Vehicle refueling operations (Stage II) Displaced losses 1,320 (1,320 x 85,500)/ 9.07 x 108 (uncontrolled) 0.124432 8 Spillage 80 (80 x 85,500)/ 9.07 x 10 0.007541 Total >>> 0.22624 Diesel Engine Generating Set Air Emission Estimates Emissions Pollutants Computations (This Quarter) NOx 18.848 x 46 kw x 9 hrs ÷ 9.07 x 105 0.0086 5 CO 4.0614 x 46kw x 9 hrs ÷ 9.07 x 10 0.0019 SOx 1.2464 x 46 kw x 9 hrs ÷ 9.07 x 105 0.0006 5 PM10 1.368 x 46 kw x 9 hrs ÷ 9.07 x 10 0.0006 CO2 699.2 x 46 kw x 9 hrs ÷ 9.07 x 105 0.3191 Aldehydes 2.815 x 46 kw x 9 hrs ÷ 9.07 x 105 0.0013 Emission Source
TOC Exhaust Crankcase
1.5018 x 46 kw x 9 hrs ÷ 9.07 x 105 2.6813 x 46 kw x 9 hrs ÷ 9.07 x 105
0.0007 0.0012
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 6 of 9
Name of Plant /Establishment: CORAL JEM GASOLINE STATION
Reference No.
MODULE 5: PD. 1586 Amblent Air Quality Monitoring (if required as part of ECC conditions) Description/Location of Monitoring Station DATE Noise CO Level (mg/Ncm) (db) (mg/Ncm)
NO
Particulates (mg/Ncm)
(Name)
(Name)
(Name)
(mg/Ncm (mg/Ncm (mg/Ncm ) ) ) NO AVAILABLE PORTABLE EQUIPMENT FOR NOISE TESTING
(Name) (mg/Ncm)
(Please accomplish one table per monitoring station) Amblent Air Quality Monitoring (if required as part of ECC conditions) Description/Location of Sampling station DATE
(name)
(name)
(name)
(name)
(name)
(name)
(name)
(unit)
(unit)
(unit)
(unit)
(unit)
(unit)
(unit)
(Please accomplish one table per sampling station)
Module 5:P.D. 1586 (EIS System)
Page 7 of 9
Name of Plant /Establishment: CORAL JEM GASOLINE STATION
Other ECC Conditions ECC Condition/s
Status of Compliance Yes No
Reference No.
Actions Taken
(Please use additional sheet/s if necessary) Environmental Management Plan/Program Enhancements/Mitigatio n Measures 1. Periodic inspection of underground tanks for leaks 2. Periodic maintenance of all fuel dispensers for a leak free refilling of fuel to vehicles
Status of Implementation Yes No
Actions Taken Proper monitoring of dispensed fuel against inventory. Coordination with the supplier for proper maintenance of fuel dispensers quarterly.
Yes
Yes
(Please use additional sheet/s if necessary) Solid waste Characterization/Information Average Quantity of Solid wastes Generated per month Average Quantity of Solid wastes Collected Per month Entity in charge of Collecting solid wastes Brief Description of Solid waste Management plan (e.g., waste reduction, Segregation, recycling)
Total Quantity of Solid Wastes Generated this Quarter 10 kgs 30 kgs Municipal garbage collector
30 kgs
Segregation of waste according to classifications
n/a
Module 5:P.D. 1586 (EIS System)
Page 8 of 9
Name of Plant /Establishment: CORAL JEM GASOLINE STATION
Reference No.
MODULE 6: OTHERS Accidents & Emergency records Date
Area/Location
Findings and observation
Actions Taken
Remarks
None
Personnel/Staff Training Date Conducted
Course/Training Description NONE FOR THE QUARTER
# of Personnel Trained
I hereby certify that the above information are true and correct. Done this _______ day of January 2016 in Laoag City, Ilocos Norte. IMELDA B. CRISTOBAL Pollution Control Officer DR.MODESTY IRMINA A. CORPUZ
OWNER SUBSCRIBED AND SWORN before me, a Notary Public, this __________ day of __________________, affiants exhibiting to me their Government Issued ID: Name
Govt. Issued ID
Issued at
Issued on
DR. MODESTY IRMINA A. CORPUZ ______________
____________
________________
IMELDA B. CRISTOBAL
________ .
________________
______________
NOTARY PUBLIC
Page 9 of 9
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