Permitting Procedures Chemicals

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    TOXIC CHEMICAL SUBSTANCES

    Permits Required

    The use, storage, importation, sale, distribution, manufacture, transport or processing ofa chemical substance not listed in the Philippine Inventory of Chemicals and ChemicalSubstances (PICCS) after December 31, 1993 requires a permit granted by theDepartment/Bureau. (Section 17, DAO 29, Rules and Regulations of R.A. 6969)

    The Chemical Control Order (CCO) issued for a priority chemical which poses anunreasonable risk or hazard to public health and environment. The CCO provides thatits importer, manufacturer, including distributor or user for some, need to registerand/orsecure importation clearancefrom the Bureau. Any person, entity or premises involvedin the treatment, storage, transport and disposal of such priority chemical-bearing orcontaminated wastes are also required to be registered. (Sec. 20, DAO 29- Rules and

    Regulation of R.A. 6969 and relevant DAO-Chemical Control Order for specificsubstances and priority chemicals)

    All waste generators are required to notify or registerwith the Department the type andquantity of waste generated; and to secure permitfor its transport and the premises forstorage, treatment, recycling, reprocessing or disposal (Sec. 26, 27 and 30, DAO 29,Rules and Regulations of R.A. 6969)

    Finally, the importation and exportation of hazardous substances or wastes shall alsoobtain prior written approval from the Department or Bureau. (Sec. 31, DAO 29, Rulesand Regulations of R.A. 6969).

    A. For Toxic Substances and Chemicals (Title II):

    EMB REGIONAL OFFICE

    I. Small Quantity Importation (SQI) Clearance

    Certification for Small Quantity Importation is required prior to importation ofsmall quantity (less than 1000 kg) pure chemical substances or component

    chemicals in percentage by weight of product, mixture not listed in the PICCS.

    Requirements:

    a. Accomplished and notarized application formb. Material Safety Data Sheet (MSDS).c. Submit PMPIN if amount exceeds SQI requirements

    The Regional Office shall

    a. Verify if the applied chemical components are in the PICCS, or in the PCL or

    in the CCO.b. Review the MSDS of the applied chemical components specifically, on the

    ecological and toxicological properties.c. Notify the applicant of its approval within (20) working days from date of

    receipt of the application.

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    d. Provide color coded copies of permits for the following: blue-applicant/importer, green-BOC, white-file copy of the regional offices (cc:EMB-CO)

    e. Reserve the right to request proof of compliance during the approved period.f. Monitor that the amount of the chemicals does not exceeds 1,000 kg/yr.

    Through the Bill of lading or Air Way Lading.g. Ensure that all information submitted on Small Quantity Importation (SQI) ofchemicals under RA 6969 are held confidential and shall be disclosed onlyupon approval by the EMB Director.

    h. Submit Quarterly Report to the EMB-CO on issuance of SQI clearances.

    Procedural Flow

    Small Quantity Importation (SQI) Clearance

    ? Accomplished and notarizedapplication form

    ? Material Safety Data Sheet

    ? Submit PMPIN if amount exceeds SQIrequirements

    Proponent

    Screening Officer

    (Application Form +Requirements)A

    Complete?

    PCD-CMS

    No

    Yes

    2 days

    2 days

    1 day

    ORD (Approval/Disapproval)

    PCD

    Records (Receiving)

    Records (Releasing)

    A

    15 days evaluation** - which may include inspection/sampling

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    Steps:

    a. The applicant submits filled-up application form and complete requirements forSQI Clearance.

    b. The Screening Officer of the Chemical Management Section (CMS) - PCDchecks completeness of application- If complete, pay the required fees (P500.00/chemical)- If not complete return to the applicant

    c. Records section receives filled up application form and the completerequirements and forwards to CMS-PCD

    d. The CMS evaluates application, prepares report and forwards to Chief, PollutionControl Division (PCD)

    e. The Chief PCD reviews and recommends for issuance of SQI Clearance andforwards to Regional Director.

    f. The EMB Regional Director approves/disapproves the Clearance

    Note: A maximum of twenty (20) working days is required for the processing andissuance of SQI Clearance from the submission of complete documents.

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    SMALL QUANTITY IMPORTATION (SQI)(Please type or print answers)

    1. Type of application

    ? New

    ? Renewal (Previous EMB approval as Annex ______)2. Information on chemical importer in the Philippines

    Registered business name and complete address in the Philippines

    Name of contact personDesignationTelephone

    Fax.E-mail

    3. Type of importer ? Distributor ? End-user

    Country of originName of manufacturer

    Address of manufacturer

    4. Information on chemical substance (subject of application)

    Chemical nameCAS numberChemical/structural formula

    Product Name Country of Manufacture

    5. Inventory status of substance (Check all applicable chemical inventories where the chemical substanceis currently listed.)

    ? US TSCA ? Europe EINECS or ELINCS

    ? Australia AICS ? JAPAN MITI

    ? Canada DSL or NDSL ? Korea KECI

    ? China CICS

    ? Philippines not a PCL substance

    6. Information on product/mixture, containing the chemical substance

    Name of product/mixture (as it will appear on bill of lading)Concentration of SQI chemical in product/mixture (%)

    Allowed annual import volume of product/mixture based on ?1000 kg/yr limit (kg)

    Units of allowed import of product/mixture (e.g., gallons, drum, containers)

    7. The Material Safety Data Sheet (MSDS) of the chemical substance is attached as Annex ______

    Other attachments (Please specify.)

    8. Signature over complete name of applicant Date submitted:

    9. Signature over complete name of EMB receiving officer Date received:

    10. Fees_______________________OR#_________________Date _________________

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    II. Philippine Inventory of Chemicals and Chemical Substances (PICCS)Certification

    PICCS Certification is issued upon request of the importers and manufacturers

    for whatever purpose it may serve. Purposely, for information of the Bureau ofCustoms upon entry of the chemicals listed in PICCS.

    Requirements:

    a. Application formb. Letter of request for PICCS Certification stating reasons for such request.c. Material Safety Data Sheet (in ISO Format).d. Chemical Name (IUPAC Nomenclature).e. Common and other namesf. Trade Name

    g. Molecular Formulah. If a component of a product, please include? Product name

    ? Other components of the product.i. Claims for confidentiality can be included.

    Note:PICCS Certification can be made in the product name to facilitate dealings withthe Bureau of Customs.

    The Regional Office Shall:

    a. Check the chemical composition of the product from the Material Safety DataSheet (MSDS) which should be in its ISO format (16 items MSDS)

    b. Verify the components chemical of the product in the PICCS together with itsChemical Abstract Service Registry Number (CAS RN).

    c. When no CAS RN is indicated, verify from other existing databases (internetor other reference materials such as UN publications, among others.

    d. Check whether the chemical is in the Priority Chemical Listing or subject to aChemical Control Order (CCO).

    e. When the chemical components are in the PCL, refer to the EMB-Centraloffice for the submission of Biennial Report and DENR Hazardous Waste IDno.

    f. When the chemical is subject under a CCO, refer to the specific DENRAdministrative Order for registration and importation clearance requirements.

    g. When the chemical is not listed in both PCL and CCO, issuance of PICCSCertification maybe issued if requested by company. The PICCS Certificationstates that the chemical is in the PICCS, and is not a new chemical and canbe imported without any Pre-Manufacture Pre-Importation notification fromthe EMB-Central Office.

    h. The PICCS Certification does not preclude other requirements from otherRegulatory agencies like the Fertilizer and Pesticides Authority (FPA),Philippine Drug and Enforcement Agency (PDEA) Philippine National Police(PNP), Bureau of Food and Drug (BFAD), etc.

    i. Confidentiality should always be observed.

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    Procedural Flow

    Philippine Inventory of Chemicals and Chemical Substances (PICCS) Certification

    Proponent

    Screening Officer

    (Application Form +Requirements)A

    Complete?

    PCD-CMS

    No

    Yes

    2 days

    2 days

    1 day

    ORD (Approval/Disapproval)

    PCD

    Records (Receiving)

    PICCS Certification - Records

    ? Application form? Letter of request for PICCS

    Certification stating reasons forsuch request.

    ? Material Safety Data Sheet (inISO Format).

    ? Chemical Name (IUPAC

    Nomenclature).? Common and other names

    ? Trade Name? Molecular Formula

    ? If a component of a product,please includeo Product nameo Other components of the

    product.? Claims for confidentiality can be

    included.

    A

    10 days evaluation** - which may include inspection/sampling

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    Steps:

    a. The applicant submits filled-up application and complete requirements for PICCSCertification

    b. The Screening Officer of the Chemical Management Section (CMS) checkscompleteness of application

    - if compete, pay the required fees (P450.00/chemical)- if not complete return to the applicant

    c. The records section receives the filled up application form and the competerequirements and forwards to the CMS-PCD

    d. The CMS evaluates application, prepares report and forwards to the Chief,Pollution Control Division (PCD)

    e. The Chief PCD reviews and recommends for issuance of PICCS Certificationand forwards to Regional Director.

    f. The EMB Regional Director approves/disapproves the Certification

    Note: A maximum of fifteen (15) working days is required for the processing andissuance of PICCS Certification from the submission of complete documents.

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    PHILIPPINE INVENTORY OF CHEMICALS AND CHEMICALSUBSTANCES (PICCS) APPLICATION FORM

    (Please Type or Print Answers )

    A. Company Profile

    Name of Applicant/Company : ________________________________________________________________________________________________

    Business Address:__________________________________________________________________________________________________________________________

    StorageFacility /Plant Address (if different from the above)_____________________________________________________________

    Telephone No. : ____________________________Facsimile No. : ____________________________E-mail address : ____________________________Contact Person : _____________________________Designation : ______________________________

    Category of Applicant : (Check one or more categories, as appropriate)

    ? importer? distributor? user / manufacturer

    ? transporter of chemical? others (pls. specify) _______________________________________

    B. Chemical Information

    Name of Chemical* CAS Registry No. ________________________ ___________________________ ________________________ ___________________________

    * In the absence of CAS Registry No., use the IUPAC Nomenclature

    Trade names/generic names are not acceptable

    C. Attachment: Material Safety Data Sheet (MSDS)

    D. Certification:

    I certify that the data and information hereto stated in this form and attachmentsare true and correct. I understand that any false or misleading statements may result inpermanent denial of my/my companys application or cancellation of my/my companysregistration.

    Date of application : _________________________________

    Signature of Authorized Person : _________________________________

    Printed Name : _________________________________

    Title/Designation : _________________________________

    Fees___________________OR #_____________________Date___________

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    III. Registration for Importer/User/Manufacturer/Distributor/Transporter ofChemicals under Chemical Control Order (CCO)

    Registration Certificate is required for importer, user, manufacturer andtransporter/distributor of those priority chemicals subjected to Chemical Control

    Order (CCO) such as Cyanide, Mercury, and Asbestos.

    Requirements:

    a. Duly Accomplished and notarized CCO Application Form (as appropriate forAsbestos, or for Cyanide, Mercury

    b. Current receipt of Business/Mayors Permitc. SEC/DTI Registration Certificated. Process/production flow chart for manufacturing operatione. Chemical Management Plan

    f. Photo documentation of the plants operation, storage facilities, etc.

    The Regional Office shall:

    1. Screen initially the completeness of the submission according to all thenecessary documentary requirements i.e. payment of fees, relevantendorsements from Bureau of Fisheries and Aquatic Resources, Bureau ofMines and Geosciences.

    2. Check compliance to the two environmental permits: Environmental ComplianceCertificate (ECC) for storage facility and Permit to Operate (PO)for AntiPollution Control Facilities.

    3. Review the sufficiency of the documents according to the substantiveRequirements that is, referring to the specific DENR Administrative Order foreach subject Chemical Control Orders for Cyanide, Mercury, and Asbestos an

    4. Verify and inspect the storage facility and the existing practices as stated in theSubmitted documents.

    5. Verify the requested volume of importation per annum and validate thetruthfulness of the submitted registered users for importers.

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    Procedural Flow

    Registration for Importer/User/Manufacturer of Chemicals underChemical Control Order (CCO)

    Proponent

    Screening Officer

    (Application Form +Requirements)A

    Complete?

    PCD-CMS

    No

    Yes

    2 days

    2 days

    1 day

    ORD (Approval/Disapproval)

    PCD

    Records (Receiving)

    Records (Releasing)

    ? Duly Accomplished and notarized CCORegistration Forms (as appropriate forAsbestos, or for Cyanide and Mercury)

    ? Current Receipt of Business/Mayors Permit

    ? SEC Registration? Process/production flow chart for

    manufacturing operation? Chemical Management Plan* Results of air monitoring data at the

    workplace for manufacturing operation (forAsbestos only)

    ? Certification of liabilities of parties tocompensate for damage to life andproperties in case of emergencies andaccidents.

    ? Photo documentation of the plantsoperation, storage facilities, etc.

    A

    20-25 days evaluation** - which may include inspection/sampling

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    Steps:

    a. The applicant submits duly accomplished and notarized CCO Registration Form

    (appropriately for Cyanide, Mercury and Asbestos) complete withrequirements

    b. The Screening Officer of the Chemical Management Section (CMS) checkscompleteness of application

    - if complete, pay the required fees (P2,250.00/chemical, renewalP1,450.00/chemical)

    - if not complete return to the applicant

    c. The records section receives the filled-up application form and the completerequirements and forwards to the CMS-PCD

    d. The CMS evaluates, conducts site inspection, prepares report and forwards tothe Chief, Pollution Control Division (PCD)

    e. The Chief PCD reviews and recommends for issuance of Registration andforwards to Regional Director

    f. The EMB Regional Director approves/disapproves the Certification

    Note: A maximum of thirty (30) working days is required for the processing andissuance of Registration from the submission of complete documents.

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    CHEMICAL CONTROL ORDER REGISTRATION FORM

    CYANIDE AND MERCURY APPLICATION

    f(Please Type or Print Answers )

    1. Name of Applicant/Company : ________________________________________________________________________________________________

    2. Category of Applicant : (Check one or more categories, as appropriate )

    ? importer? distributor? user? transporter of chemical? waste transporter

    ? waste treater? waste disposer

    3. Type of chemical(s) CAS No. and chemical compound (s) to behandled and the corresponding Chemical Abstract Service (CAS) No.

    __________________________________________________________________________________________________________________________

    4. Business Address:__________________________________________________________________________________________________________________________

    StorageFacility /Plant Address (if different from the above)

    __________________________________________________________________________________________________________________________

    5. Telephone No. : ____________________________Facsimile No. : ____________________________E-mail address : ____________________________

    6. Contact Person : _____________________________Designation : ______________________________

    7. Business Permit No. Validity Date Region/City

    ________________ ______________ ___________

    SEC Registration No. Validity Date Region/City

    _________________ ______________ ___________

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    8. Annual Chemical(s) Requirement (kg or MT)__________________________________________________________________________________

    9. Status of Compliance to Environmental Permit

    Date of issuance/ Region/Cityvalidity date

    ECC No. _______________ __________ ____________Permit to Operate Number

    air _______________ __________ ____________water ______________ __________ ____________

    10. Attachments (Please attach a photocopy of the following)

    Business Permit

    SEC RegistrationChemical Management PlanCopy of Environmental Permits

    11. Certification:

    I certify that the data and information hereto stated in this form and attachmentsare true and correct. I understand that any false or misleading statements may result inpermanent denial of my/my companys application or cancellation of my/my companysregistration.

    Date of application : _________________________________

    Signature of Authorized Person : _________________________________Printed Name : _________________________________Title/Designation : ________________________________

    _____________________________________________________________________DO NOT WRITE IN THIS SPACE

    Chemical(s) Applied For : ________________________________Endorsement and Inspection Report Date:____________________Information checked by : ________________________________Fee : ________________ Official Receipt No. ___________First Verification Date : _________________

    Second Verification Date : _________________

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    ECCNo. _____________PO. No.______________

    REGION _____________O.R. No. _____________

    ASBESTOS REGISTRATION FORM

    I. GENERAL INFORMATION

    1. COMPANY NAME_________________________________________________

    OFFICE ADDRESS__________________________________________________________________________________________________________________

    PLANT ADDRESS/STORAGE FACILITY (If different from the above)_________________________________________________________________

    __________________________________________________________________

    2. TELEPHONE NUMBER ________________________________________________

    FAX NUMBER ___________________________________________________

    3. CONTACT PERSON/DESIGNATION

    ___________________________________________________________________________________________________________________________________

    4. CATEGORY OF APPLICANT/TYPE OF BUSINESS

    ? Importer

    ? Manufacturer? Owner of industrial, commercial and institutional structures

    With sprayed-on and friable asbestos

    ? Waste Service Provider (transporter, treater, disposer)

    5. STATUS OF COMPLIANCE TO ENVIRONMENTAL AND OTHER PERMITS

    Date Issued Validity Date

    ?

    Environmental Compliance Certificate? Permit to Operate (air)? Permit to Operate (water)

    ? TSD Permit? SEC Registration

    ? Business Permit

    II ASBESTOS SPECIFIC INFORMATION (For all categories, if applicable)

    A. IMPORTATION/PRODUCTION INFORMATION

    1. AVERAGE -ANNUAL/QUANTITIES IMPORTED/DISTRIBUTED ANDUSED________________________________________________________________

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    2. QUANTITY OF PRODUCTS PRODUCED (In kilos/year) _________________

    3. QUANTITY OF BULK ASBESTOS (In kilos/year) _______________________

    4. LIST OF ASBESTOS CONTAINING PRODUCTS

    IMPORTED/DISTRIBUTED AND/OR MANUFACTURED____________________________________ ________________ ton/kg.

    ____________________________________ ________________ ton/kg. _______________________________________ _________________ ton/kg. _______________________________________ _________________ ton/kg.

    5. TYPE OR VARIETY OF ASBESTOS _________________________________

    6. PROCESS FLOW CHART AND TYPE OF ACTIVITY EXPOSED TOASBESTOS (Use additional sheet, if necessary)

    7. QUANTITY OF ASBESTOS WASTE PRODUCED/GENERATED

    ANNUALLY/QUARTERLY? Friable (In Kilos/year) _____________________

    ? Non-Friable (In kilos/year) _________________

    III. MANAGEMENT INFORMATION

    1. TOTAL NUMBER OF WORKFORCE ___________________

    2. NUMBER & CATEGORY OF EMPLOYEES THAT MAY BE EXPOSED TOASBESTOS RELEASES. ASSESS THE NATURE AND EXTENT OF

    EXPOSURE TO ASBESTOS (INCLUDE MAXIMUM NUMBER OF

    WORKERS AND MAXIMUM HOURS PER DAY OF EXPOSURE AND ANYMEDICAL SUPERVISION OF PERSONS WHO ARE EXPOSED TOASBESTOS)________________________________________________________________

    3. EDUCATION AND TRAINING PROGRAM ORGANIZED FOR ASBESTOS

    HANDLING OVER THE LAST THREE YEARS (NO.) __________________

    DETAILS OF THOSE TRAINING PROGRAMS ORGANIZED?

    Title/Name Organizer Date/Duration

    _________________________ ____________________ _________________________________________ ____________________ _________________________________________ ____________________ ________________

    _________________________ ____________________ ________________

    IV. PREVENTIVE AND CONTROL MEASURES

    1. DESCRIBE THE GENERAL PREVENTIVE AND CONTROL PROGRAM OFTHE COMPANY FOR ASBESTOS INCLUDING ITS VENTILATION SYSTEM.

    ______________________________________________________________________

    ______________________________________________________________________________________________________________________________________________

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    2. DESCRIBE HOUSEKEEPING PRACTICES DEVELOPED AND IMPLEMENTED

    ________________________________________________________________________

    _______________________________________________________________________

    _______________________________________________________________________________________________________________________________________________

    3. IDENTIFY & DESCRIBE EQUIPMENT USED

    ______________________________________________________________________________________________________________________________________________________________________________________________________________________

    ________________________________________________________________________

    4. LIST OF RESPIRATORY PROTECTIVE EQUIPMENT AVAILABLE FORPERSONNEL/WORKER DURING HANDLING AT THE PREMISE AND

    DURING TRANSPORTING._______________________________________________________________________________________________________________________________________

    ________________________________________________________________________________________________________________________________________________

    5. DESCRIBE IN BRIEF THE CONTINGENCY PROCEDURES/PLAN (In case ofemergency)

    ______________________________________________________________________________________________________________________________________________________________________________________________________________________

    _______________________________________________________________________

    V. TREATMENT, STORAGE & DISPOSAL INFORMATION (For all categories)

    1. DESCRIBE STORAGE METHODS, PROCEDURES, FACILITIES ANDLOCATION.

    ________________________________________________________________________

    ________________________________________________________________________________________________________________________________________________________________________________________________________________________

    2. DESCRIBE PROCEDURES FOR TRANSPORTATION OF RAW FIBER ANDFINISHED PRODUCTS.

    ________________________________________________________________________________________________________________________________________________

    _______________________________________________________________________________________________________________________________________________

    3. ANY PLANNED RENOVATION(S) AND/OR REMOVAL OR MAJORIMPROVEMENTS TO BE MADE IN THE NEXT 12 MONTHS?

    o Yes

    o No

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    4. LIST OF ATTACHMENTS0 Pertinent Environmental Permits 0 Process Flow Chart

    0 Results of air monitoring data of asbestos 0 Bill of Lading of all shipment per year

    0 Certification of liabilities of parties to compensate for damage to properties and lifeincase of emergencies & accidents..

    0 Photo documentation of the plant's operation, storage facilities and others.

    VI. NOTARIZED CERTIFICATION

    THE UNDERSIGNED CERTIFY THAT THE INFORMATION PROVIDED IN THIS

    FORM IS TRUE AND ACCURATE.

    NAME ___________________________________

    DESIGNATION/POSITION___________________

    SIGNATURE______________________________DATE________________________

    I acknowledge that this application form is a legally binding document, and I declare,

    under the penalties of perjury, that the same has been accomplished in good faith, verifiedby me, and, to the best of my knowledge and belief, is true and correct pursuant to the

    regulations issued under authority thereof.

    ____________________________(Notary Public)

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    IV. Importation Clearance and Its renewal under Chemical Control Order (CCO)(Cyanide, Mercury and Asbestos)

    Requirements:

    a. Duly accomplished Application Form for Cyanide, Mercury and Asbestos by theconcerned Importers, Manufacturers and Distributors.b. Registration Certificate for Cyanide, Mercury and Asbestosc. Bill of Lading or Airway Ladingd. Copy of results of air monitoring data at the workplace for manufacturing

    operation for Asbestos only.e. Certification of liabilities of parties to compensate for damage to life and

    properties in case of emergencies and accidents. (as attachment to the form,)f. Bureau of Fisheries and Aquatic Resources Endorsement for Cyanide Importer

    onlyg. Bureau of Mines and Geosciences Endorsement for Mercury Importer only

    h. List of registered distributors/users for Importer of Cyanide and Mercury only.

    The Regional Office shall:

    1. Screen initially the completeness of the submission according to all thenecessary documentary requirements i.e. payment of fees, relevantendorsements from Bureau of Fisheries and Aquatic Resources (for Cyanideimporters), Bureau of Mines and Geosciences (for Mercury importers) andRegistration Certificate and the above-mentioned requirements.

    2. Check compliance to the two environmental permits: Environmental ComplianceCertificate (ECC) for storage facility and Permit to Operate (PO) for AntiPollution Control Facilities.

    3. Review the sufficiency of the documents according to the substantiverequirements that is, referring to the specific DENR Administrative Order foreach subject Chemical Control Orders for Cyanide, Mercury, Asbestos andOzone Depleting Substances

    4. Verify and inspect the storage facility and the existing practices as stated in thesubmitted documents.

    5. Review the results of air monitoring data at the workplace for manufacturingoperation for Asbestos only).

    6. Verify the requested volume of importation per annum and validate thetruthfulness of the submitted registered users list from the previous submissionsand quarterly reports from other EMB Regional Offices i.e. in Cebu, Davao,National Capital Region, Region IV-A (CALABARZON), among others throughthe Focal Points.

    7. Consider the compliance to the Terms and Conditions of the CCOs RegistrationCertificate and other post requirements as required i.e. Bill of Lading/AirwayLading and Notice of Commencement.

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    Procedural Flow

    Importation Clearance under Chemical Control Order (CCO)(Cyanide, Mercury and Asbestos)

    Proponent

    Screening Officer

    (Application Form +Requirements)A

    Complete?

    PCD-CMS

    No

    Yes

    2 days

    2 days

    1 day

    ORD (Approval/Disapproval)

    PCD

    Records (Receiving)

    Records (Releasing)

    ? Registration Certificate for Cyanide,Mercury and Asbestos by the concernedImporters, Manufacturers and Distributors.

    ? Verification of the requested volume ofimportation per annum in relation to theissued Registration Certificate.

    ? Bill of Lading, Airway Lading and otherpost condition requirements

    ? Bureau of Fisheries and AquaticResources (BFAR) Endorsement ForCyanide importer only

    ? Bureau of Mines and GeosciencesEndorsement for Mercury only.

    ? List of registered users for Cyanide andMercury only.

    A

    15 days evaluation** - which may include inspection/sampling

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    Steps:

    a. Importer/applicant submits duly accomplished form together with the completerequirements;

    b. The Screening officer of the CMS-PCD checks completeness of application- if complete, pay the required fees (P700.00/chemical)- if not complete return to the applicant

    c. EMB Records Section receives filled-up application form with completerequirements and forwards to CMS-PCD;

    d. CMS-PCD evaluates, prepares report and forwards to Chief; Pollution ControlDivision (PCD)

    e. The PCD Chief reviews and recommends approval to the Regional Directorf. The EMB Regional Director approves/disapproves clearance.

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    IMPORTATION CLEARANCE FOR CHEMICALS WITH CHEMICAL CONTROL

    ORDERS OF CYANIDE, MERCURY AND ASBESTOS

    Date Appl ied : _____________

    Application Control Number : _____________

    Official Receipt Number : __________________

    Registry Reference Code ______________________

    Date Issued _________________________________

    I. Applicants Name:___________________________________________________________________

    II. Business Address: __________________________________ Contact Number: ______________

    III. Contact Person: ___________________________________ Contact Number: ______________

    IV. Position / Designation: ________________________________ Fax Number: _________________

    V. Type of Importer / Distributor of: ____________________________________

    Storage Facility Address: _________________________________ Contact Number: ______________

    VI. Environmental and Other Permits IssuedECC No. ______________PO No. ______________Business Permit No. ______________

    VII. List of Importers / End-users

    Storage Facility Address: _________________________________ Contact Number: ______________

    Storage Facility Address: _________________________________ Contact Number: ______________

    Storage Facility Address: _________________________________ Contact Number: ______________

    Storage Facility Address: _________________________________ Contact Number: ______________

    Storage Facility Address: _________________________________ Contact Number: ______________

    Storage Facility Address: _________________________________ Contact Number: ______________

    Storage Facility Address: _________________________________ Contact Number: ______________

    VIII Data on Substance Subject to Importation:

    Brand / Trade / Commercial Name ______________________________________________Quantity (in kg): ________________________Intended Use: _______________________________________________________________________

    IX Shippers Information / Transaction Data

    Country of Origin __________________________________________

    Name of Exporting Company ___________________________________________________________

    Business Address ___________________________________________________________________Mode of Shipment (by air/by sea) _______________________

    Expected Port of Entry/Loading _________________________________

    Port Address _______________________________________________________________________

    Expected Date of Arrival ____________________

    X. Present Inventory of Same Substance Subject for Importation (under applicants custody)

    Quantity (in kg): __________________________ Size of Storage Area (in m2): ___________________

    XI. Attachments : Certificate of Accountability, Proporma Invoice and other documents as required inthe Permits Terms and Conditions

    XII. Fees__________________OR #__________________ Date___________________

    I acknowledge that this application form is a legally binding document, and I declare, under thepenalties of perjury, that the same has been accomplished in good faith, verified by me, and, to the best ofmy knowledge and belief, is true and correct pursuant to the regulations issued under authority thereof.

    ___________________________________(Authorized Signature over Printed Name)

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    EMB CENTRAL OFFICE

    I. Pre-Manufacturing and Pre-Importation Notification (PMPIN)

    Certification/ Interim Status Permit

    The chemical or chemical substance subject of manufacture or importationneeds prior notification/registration, and the corresponding PMPIN Certificationissued at least Ninety (90) to One Hundred Eighty (180) days from the time ofsubmission of complete requirements. Under special circumstances, the EMBCentral may issue an interim status permit (ISP) for import or manufacturer of anew chemical. This will be issued only to manufacturers and importers of newchemicals provided that the premise has completed and submitted theappropriate PMPIN form and paid the fee at the time of notification.

    Requirements:

    a. Duly accomplished PMPIN Form (Abbreviated or Detailed as appropriatepursuant to Sec. 15, DAO 29) (Forms A are as shown below)

    b. Material Safety Data Sheet (MSDS)c. Certification/Relevant Studies as attachments to the PMPIN Form.

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    PROCEDURAL FLOW:

    Pre-Manufacturing and Pre-Importation Notification (PMPIN) Certification

    ProponentFill up forms notarized andcom lete the re uirements

    Screening Officer checkscompleteness and

    sufficiency

    EQD-CQMSSchedule for Chemical

    Review Committee

    Meeting

    No

    Yes

    Director, EMBApproval and Issuance

    of PMPIN Certificate

    ProponentSubmit Additional

    Information

    Records (Receiving)

    Reviews of submitteddocuments by Inter

    agency ChemicalReview Committee

    EQD - CMSAdditional

    Information

    A

    ? Duly accomplished PMPIN Form(Abbreviated or Detailedas appropriate)

    ? Material Safety Data Sheet (MSDS)

    ? Certification/Relevant Studies asattachments to the PMPIN Form.

    A

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    Steps:

    a. The applicant submits a duly accomplished and notarized PMPIN Form(Abbreviated or Detailedas appropriate) in four (4) copies with the prescribedrequirements as stated above.

    b. The Screening Officer of the Chemical Management Section (CMS) checkscompleteness of the application/notification:

    - If complete, pay the required fees (Abbreviated formP2,150.00/chemical, Detailed form P3,750.00/chemical)- If not complete return to applicant

    c. The Record Officer receives the application and forwards to Environmental

    Quality Division (EQD)

    d. The EQD-CMS schedules a meeting of the Chemical Review Committee(CRC). The CRC review PMPIN documents and subsequent additionalinformation as requested.

    e. CRC recommends approval of PMPIN Certification to the Director

    f. EMB Director approves/disapproves PMPIN Certification

    Note: A maximum of one hundred eighty (180) working days is required for theprocessing and issuance of the PMPIN Certification.

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    FORM A:

    PMPIN ABBREVIATED FORM

    Section A: Premise Information CBI ( )

    1. Premise Name (in case of joint submission, the principal premise is required tocomplete this section)

    2. Premise Physical Location and Telephone Number

    3. Name of the Responsible Authority

    4. Mailing Address and Telephone/Fax Number

    5. Circle: Manufacture Import

    Section B: Chemical Identification Information CBI ( )

    6. Chemical Name:

    CAS Registry Name IUPAC Common Name

    7. CAS Number (if available)

    8. RTECS Number (if available)

    9. Molecular Formula

    10.Synonyms for the New Chemical

    11.Trade Name of the New Chemical

    Section C: Production, Import and Intended Use CBI ( )

    12.Total quantity produced or imported in the first 12 months (Kg)

    13. Estimate the quantity of the new chemical used in any of the

    following categories (kg):

    Site Limited Industrial Commercial Consumer

    Section D: Regulatory Status in Other Countries

    14. Country Name:

    15.Regulatory Status of the New Chemical in that country:

    16.Is MSDS available for the new chemical in the country referred: Yes (attach MSDS)No

    (Use a separate page if there are more than one country)

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    PMPIN ABBREVIATED FORM

    Section E: Statement on Physicochemical Characteristics (if available)

    Boiling Point Vapor PressureMelting Point Purity

    S. Gravity Water/Octanol PartitionCoefficient Solubility in Water

    Section F: Statement on Toxicological Effects of the Chemical

    (Refer to instruction for the type of test results required)

    Section G: Statement on Environmental Effects of the Chemical

    Section H: List other companies and their address if this is a joint submission

    Section I: List of Attachments

    Certification:

    I hereby certify that all the information provided in this form and the supportdocuments attached are true and accurate.

    Signed:

    Name: Position: Date:

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    PMPIN DETAILED FORM

    Section F: Statement on Toxicological Effects of the Chemical

    14. Country Name:

    15. Regulatory Status of the New Chemical in that country:

    16. Is MSDS available for the new chemical in the country referred:

    Yes (attach MSDS) No

    (Use a separate page if there are more than one country)

    Section G: Physiochemical Test Results

    17. Tests Conducted by (Name and Address of the Laboratory):

    18. Test Results Attached Yes No

    (Refer to instruction for the type of test results required)

    Section H: Toxicological Effects Test Results

    19. Tests Conducted by (Name and Address of the Laboratory)

    20. Test Results Attached Yes No

    (Refer to instruction for the type of test results required)

    Section I: Environmental Effects Test Results

    21. Tests Conducted by (Name and Address of the Laboratory)

    22. Test Results Attached Yes No

    (Refer to instruction for the type of test results required)

    Section J: List other companies and their address if this is a joint submission

    Section K: List of Attachments

    Certification:

    I hereby certify that all the information provided in this form and the support documentsattached are true and accurate.

    Signed:

    Name: Position: Date:

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    Confidential Business Information (CBI)Mark X if you claim CBI for any of sections A, B, or C. Please provide in separate page justification for claiming CBI andattach.

    Section A

    Fill in the information about the premise/firm that is considered the principal submitter of this form.

    Section B

    Provide the chemical identity information. Consult DENR if you need assistance in obtaining the information required. Theresults of an X-ray diffraction (non-organic chemicals) or Mass Spectrum (organic chemicals) analysis must be submitted along

    with this form to enable DENR review committee for correct identification of the chemical notified.

    Section C

    Estimate the total quantity of new chemical to be manufactured or imported during the first 12 months of operations. Undersubsection 13 estimate how much of the intended production or import will be used in any of the four categories on an annual

    basis (the total should be equal to the figure provided in subsection 12).

    Section D (not applicable to importers)

    Estimate the type of activities the workers will be engaged in the use and production of the new chemical. For each type ofactivity provide information about the maximum number of workers and maximum hours per day that they will be exposed to the

    new chemical.

    Section E (not applicable to importers)

    Estimate the quantity of the new chemical that will possibly be released through air, surface water, groundwater, and soil. Also,provide a brief statement regarding release control measures planned.

    Section F

    Submission of the information concerning the regulatory status of this chemical in other countries will expedite the reviewprocess.

    Section G

    Provide any test results on the physicochemical characteristics of the new chemical notified. Documented research data fromother countries will be helpful. Notifiers with such information will assist DENR to expedite the review process. The test resultsshould include:

    Boiling Point, Vapor Pressure, Melting Point, Purity, S. Gravity, Water/Octanol partition Coefficient, Solubility in Water, andsolubility in organic compounds.

    Section H

    Present the test results of potential toxicological effects of the new chemical and provide any document describing those effects.

    Submit documented research data and journal articles from academia in the Philippines and other countries. When you submit

    the test results, ensure that the full name and address of the laboratory which conducted the tests in the Philippines or in othercountries are clearly indicated. The health effects data may include carcinogenicity, mutagenicity, teratogenicity, sensitization,acute and chronic toxicity and irritation. Notifiers with such information will assist DENR to expedite the review process.

    DENR may require full meeting of the new chemical notified if it determines that the information submitted is not adequate toassess the potential risk of the new chemical.

    Section I

    Present the test results of potential environmental effects of the new chemical and provide any document describing those effects.

    Submit documented research data and journal articles from academia in the Philippines and other countries. When you submitthe test results ensure that the full name and address of the laboratory which conducted the tests in the Philippines or in othercountries are clearly indicated. Environmental effects may include acute and chronic toxicity to animals (fish in particular) andterrestrial plant toxicity. Information concerning the fate of the chemical upon release to environment will be important and must

    be submitted if available. Notifiers with such information will assist DENR to expedite the review process. DENR may requirefull testing of the new chemical notified if it determines that the information submitted is not adequate to assess the potential riskof the new chemical.

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    II. Certificate of Registration for the Importation of Ozone DepletingSubstances (ODS) and Alternative Chemical Substance

    Any person, natural or juridical, who imports ozone-depleting substance (regardlessof source as allowed under agreements of the Montreal Protocol) in any of the forms

    defined under Article I paragraph 4 of the Montreal Protocol as clarified underDecisions I/12A and II/4, respectively, of the First and Second Meetings of theParties, and with respect to any industry or activity of which list was derived fromAnnex D of the Montreal Protocol must be duly registered with and may be granted aCertificate of Registration by DENR-EMB. (Sec. 4, DAO 2000-18, CCO for ODS)

    Requirements:

    a. Duly accomplished Application Form for Registration(shown below)b. ECC

    c. SEC Registration or DTI Registrationd. Certification as to capability on effective Handling and Storage of Chemicalse. Certificate of Awareness on Ozone Layerf. Material safety Data Sheet (MSDS)

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    PROCEDURAL FLOW

    Registration for the Importation of Ozone-Depleting Substances andAlternative Chemical Substances

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    Important Note:Accomplish this form in three (3) copies, each with aphotocopy of the previous EMB Certificate ofRegistration for the Importation of ODS and AlternativeChemical Substances (if applicable). To facilitateprocessing, all information must be supplied accurately.

    AAPPPPLLIICCAATTIIOONN FFOORR RREEGGIISSTTRRAATTIIOONN FFOORR TTHHEE IIMMPPOORRTTAATTIIOONN OOFFOOZZOONNEE--DDEEPPLLEETTIINNGG SSUUBBSSTTAANNCCEESS AANNDD AALLTTEERRNNAATTIIVVEE CCHHEEMMIICCAALL SSUUBBSSTTAANNCCEESS

    Date Applied : _____________

    Registration Number : _____________

    Document Number : _____________

    I. Applicants (Juridical) Name: _______________________________________________________________

    II. Business Address: _________________________________________ Contact Number: ______________

    III. Point Person : __________________________________ Contact Number: ______________

    Position / Designation : __________________________________

    IV. Training / Seminar / Workshop Attended by the Point Person (attach a photocopy of the Certificate)

    Date: Title of Training / Seminar / Workshop: Conducted by: _________________ _______________________________________ _____________________

    V. SEC / DTI Registration Number (attach a photocopy of SEC/DTI Registration Certificate with list of officers):______________________________________________________________________________________

    VI. Type of Importer: (please mark X the appropriate box/boxes and fill-up the fields corresponding to it/them)

    Importer - Distributor

    Address of Storage Facility : __________________________________ Contact Number: ______________Importer - End-user

    Address of Storage Facility : __________________________________ Contact Number: ______________

    VII. Environmental Compliance Certificate (ECC) / Certificate of Non-Coverage (CNC) Number (attach aphotocopy of the ECC / CNC): _____________________________________________________________

    VIII. Profile of Business: ______________________________________________________________________

    IX. Data on Substance Subject to Importation:Brand / Trade / Commercial Name/s (attach the appropriate Material Safety Data Sheet or MSDS for each):

    ______________________________________________________________________________________

    Intended Use: __________________________________________________________________________

    (please mark X the appropriate box and fill-up the fields corresponding to it)

    Substance of Single Chemical Composition

    Generic Name: _____________________________ Chemical Formula: _____________

    Substance of Multiple Chemical Composition Blend Generic Name: __________

    Percent: ______ Generic Name: _____________________________ Chemical Formula: _____________

    Percent: ______ Generic Name: _____________________________ Chemical Formula: _____________

    Percent: ______ Generic Name: _____________________________ Chemical Formula: _____________

    Percent: ______ Generic Name: _____________________________ Chemical Formula: _____________

    Percent: ______ Generic Name: _____________________________ Chemical Formula: _____________

    Republic of the PhilippinesDepartment of Environment and Natural Resources

    ENVIRONMENTAL MANAGEMENT BUREAU

    PHILIPPINEOZONEDESK2nd Floor, Human Resources Development Training Center

    DENR compound, Visayas Avenue, Diliman, Quezon City

    Tel. Nos.:925-2344 / 928-1244E-mail Add.:[email protected]

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    X. Size of Storage Area (in m2): ______________________________________________________________

    XI. Chemical Handler : __________________________ Position / Designation: ________________________

    XII. Training / Seminar / Workshop Attended by the Chemical Handler (attach a photocopy of the Certificate)Date: Title of Training / Seminar / Workshop: Conducted by:

    _________________ _______________________________________ _____________________

    XIII Fee: _____________ OR # __________________________ Date: ____________________

    I acknowledge that this application form is a legally binding document, and I declare, under thepenalties of perjury, that the same has been accomplished in good faith, verified by me, and, to the best of

    my knowledge and belief, is true and correct pursuant to the regulations issued under authority thereof.

    __________________________________(Authorized Signature over Printed Name)

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    Steps:

    a. Importer applicant submits duly accomplished Application Form for Registrationtogether with the complete requirements;

    b. Screening Officer checks the filled up application and the complete requirements- if complete pay the required fees (P2,250.00/chemical)- if not complete return to the applicant

    c. EMB Records Section receives filled up application form and completerequirements and assigns Document No. and forwards to Philippine Ozone Desk(POD);

    d. POD evaluates/processes application, prepares Certificate of Registration andsubmits to EMB- Environmental Quality Division (EQD);

    e. The EMB-EQD further reviews and recommends issuance Certificate ofRegistration to the EMB Director

    f. EMB Director approves/disapproves Certificate of Registration

    Note: The applicant also submits requirements for Pre-Shipment ImportationClearance (PSIC) simultaneously

    Maximum of fifteen (15) working days for processing of the Certificate ofRegistration

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    III. Pre-shipment Importation Clearance of Ozone-Depleting Substances (ODS)And Alternative Chemical Substances

    The substances listed as Annex C and Annex E of the Montreal Protocol are notcovered by the control measures and phase-out schedules provided under Section 3of the CCO for ODS until such time that the Senate of the Philippines ratifies theamendments and adjustments to the Protocol. However, any importation of thesesubstances (Annex C and E) is subject registration and issuance of Pre-ShipmentImportation Clearance from the EMB prior to entry in any area within the PhilippineTerritory. (Sec 2.2 and 6, DAO 2000-18: CCO for ODS)

    Requirements:

    a. A copy of approved Certificate of Registration (per chemical substance), for old

    applicant; if new applicant, apply for a Certificate of Registration for Importationof ODSb. Form A (Application for Pre-shipment Importation Clearance of ODS and

    Alternative Chemical Substances) attached with Pro-forma Invoicec. Form B (Record of actual Arrival of Shipment, RAAS) with Bill of Lading and

    Commercial Invoiced. Form C (Summary of Transaction for Previous Inventory and Immediately

    Proceeding Importation of Same Substance)e. Form D (List of Intended Buyers and/or Users)f. Copy of Material Safety Data Sheet (MSDS)g. Certificate of Conformance from the DTI Bureau of Product Standards for

    alternative or substitute substances

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    PROCEDURAL FLOW.

    Pre-shipment/Importation Clearance for Ozone-Depleting Substances (ODS)Alternative Chemical Substances

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    Steps:

    a. Importer applicant submits duly accomplished Forms (A, B, C, D) together withthe aforementioned requirements;

    b. Screening officer of POD checks the filled-up application and the completerequirements:- if complete, pay the required fees (P700.00/chemical)- if not complete return to the applicant

    c. EMB Records Section receives application form with complete requirements andassigns Document No. and forwards to Philippine Ozone Desk (POD);

    d. POD evaluates applications, prepares report and forwards to Chief;Environmental Quality Division (EQD)

    e. The Chief, EQD further reviews and recommends approval to the EMB Directorf. EMB Director approves/disapproves clearance.

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    Important Note:Accomplish this form in three (3) copies, each with aphotocopy of ProformaInvoice. To facilitate processing,all information must be supplied accurately. Please takenote of the correct units of measure for each entry. For

    clarification and/or additional information, do not hesitateto contact POD-EMB-DENR.

    FORM AAAPPPPLLIICC AATTIIOONN FFOORR PPRREE--SSHHIIPPMMEENNTT IIMMPPOORRTTAATTIIOONN CCLLEEAARRAANNCCEE OOFF

    OOZZOONNEE--DDEEPPLLEETTIINNGG SSUUBBSSTTAANNCCEESS AANNDD AALLTTEERRNNAATTIIVVEE CCHHEEMMIICCAALL SSUUBBSSTTAANNCCEESS

    Original Copy

    Date Applied : _____________

    ProformaInvoice Number : _____________

    Application Control Number : _____________

    Document Number : _____________

    I. Applicants (Juridical) Name: _______________________________________________________________

    II. Business Address: _________________________________________ Contact Number: ______________

    III. Point Person : __________________________________ Contact Number: ______________

    Position / Designation : __________________________________

    IV. Type of Importer: (please mark X the appropriate box/boxes and fill-up the fields corresponding to it/them)

    Importer - Distributor

    Address of Storage Facility : __________________________________ Contact Number: ______________

    Importer - End-user

    Address of Storage Facility : __________________________________ Contact Number: ______________

    V. Data on Substance Subject to Importation:

    Brand / Trade / Commercial Name: _________________________________________________________

    Quantity (in kg): __________________________Purchase Price (in $ / kg): _____________________

    Intended Use: __________________________________________________________________________

    (please mark X the appropriate box and fill-up the fields corresponding to it)

    Substance of Single Chemical Composition

    Generic Name: _____________________________ Chemical Formula: _____________

    Substance of Multiple Chemical Composition Blend Generic Name: ___________

    Percent: ______ Generic Name: _____________________________ Chemical Formula: _____________

    Percent: ______ Generic Name: _____________________________ Chemical Formula: _____________

    Percent: ______ Generic Name: _____________________________ Chemical Formula: _____________

    Percent: ______ Generic Name: _____________________________ Chemical Formula: _____________

    Percent: ______ Generic Name: _____________________________ Chemical Formula: _____________

    VI. Transaction Data:

    Name of Manufacturing Company: __________________________________________________________

    Business Address: _________________________________________ Contact Number: ______________

    Name of Exporting Company: ______________________________________________________________

    Republic of the PhilippinesDepartment of Environment and Natural Resources

    ENVIRONMENTAL MANAGEMENT BUREAU

    PHILIPPINEOZONEDESK2nd Floor, Human Resources Development Training Center

    DENR compound, Visayas Avenue, Diliman, Quezon City

    Tel. Nos.:925-2344 / 928-1244E-mail Add.:[email protected]

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    Business Address: _________________________________________ Contact Number: ______________

    Port of Loading: ______________________ Port Address: ______________________________________

    Expected Date of Arrival: _________________________________________________________________

    Expected Port of Arrival: _______________ Port Address: ______________________________________

    VII. Present Inventory of Same Substance Subject for Importation (under applicants custody)

    Quantity (in kg): _____________________________ Size of Storage Area (in m2): ___________________

    VIII. Fees; ____________________OR # _________________________Date__________________

    I acknowledge that this application form is a legally binding document, and I declare, under thepenalties of perjury, that the same has been accomplished in good faith, verified by me, and, to the best of

    my knowledge and belief, is true and correct pursuant to the regulations issued under authority thereof.

    ___________________________________(Authorized Signature over Printed Name)

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    Important NoteThis document provides information relevant to theimmediately preceding importation for the samesubstance applied for and is a vital requirement forprocessing any subsequent import application. It mustbe fully accomplished and submitted with the appropriate

    FORM BRREECCOORRDD OOFF AACCTTUUAALL AARRRRIIVVAALL OOFF SSHHIIPPMMEENNTT ((RRAAAASS))

    Enclosure / Attachment of

    Application Control Number: _____________

    1. Company Name : ___________________________________________________________________

    2. Preceding Pre-Shipment Importation Clearance Information

    a. Application Control Number : ____________________________________________________

    b. Brand / Trade / Commercial Name : ____________________________________________________

    c. Issued Quantity (in kg) : ____________________________________________________

    d. Date Issued : ____________________________________________________

    e. Expiration Date : ____________________________________________________

    3. Actual Arrival of Import

    Bill of Lading (please mark X the box if Bill of Lading is attached)

    a. Date of Actual Arrival : _______________________Unit Cost / Net Weight (in kg): _______________

    b. Actual Arrival Quantity / Net Weight (in kg) : _______________________________________

    c. Bill of Lading No.: ___________________________ Bill of Lading Quantity: ____________________

    d. Invoice No. of : ______________________________ Invoice No. Quantity: _____________________

    4. Port of Arrival and Address: ____________________________________________________________

    5. Substance Identity

    a. Single or Multiple Chemical Composition : _____________________________________________

    b. For Single Chemical Composition

    Generic Name: ________________________________ Chemical Formula: _____________

    c. For Multiple Chemical Composition Blend Generic Name: ______________

    Percent: ______ Generic Name: ________________________________ Chemical Formula: _____________

    Percent: ______ Generic Name: ________________________________ Chemical Formula: _____________

    Percent: ______ Generic Name: ________________________________ Chemical Formula: _____________

    Percent: ______ Generic Name: ________________________________ Chemical Formula: _____________

    Percent: ______ Generic Name: ________________________________ Chemical Formula: _____________

    AUTHORIZED SIGNATURE :

    ____________________________________________________________

    NAME : ____________________________________________________________

    POSITION : ____________________________________________________________

    DATE : ____________________________________________________________

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    Important NoteThis document describes how previous inventory andimportation of the same substance applied for weredistributed to suppliers and end-users. This is crucial incross-checking the previously declared actualtransactions. All information must be supplied

    FORM C

    SSUUMMMMAARRYY OOFF TTRRAANNSSAACCTTIIOONNSS FFOORR PPRREEVVIIOOUUSS IINNVVEENNTTOORRYY AANNDD IIMMMMEEDDIIAATTEELLYYPPRREECCEEDDIINNGG IIMMPPOORRTTAATTIIOONN OOFF TTHHEE SSAAMMEE SSUUBBSSTTAANNCCEE

    Enclosure / Attachment of

    Application Control Number : _________________

    BRAND / TRADE / COMMERCIAL NAME: _______________________________________________________

    PRECEDING PRE-SHIPMENT IMPORTATION CLEARANCE

    APPLICATION CONTROL NUMBER: ________________________________________________PREVIOUS INVENTORY QUANTITY (in kg)_______________________________________________QUANTITY APPLIED (in kg) : ________________________________________________ACTUAL ARRIVAL QUANTITY (in kg): ________________________________________________

    TOTAL QUANTITY DISTRIBUTED (in kg) : ______________________________________________

    Name ofPerson orCompany

    AddressContactNumber

    Nature ofEnterprise (dealer

    and/orend-user)

    Intended Use(for end-

    user)

    QuantityDistributed (in kg)

    OfficialReceiptNumber

    Date ofSale

    DATE ACCOMPLISHED: _____________________________________________________________________

    SIGNATURE : ______________________________________________________________________

    NAME : ______________________________________________________________________

    POSITION : ______________________________________________________________________

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    TOTAL QUANTITY DISTRIBUTED (in kg) : ________________________________________________

    Name ofPerson orCompany

    AddressContactNumber

    Nature ofEnterprise (dealer

    and/orend-user)

    Intended Use(for end-

    user)

    QuantityDistributed (in kg)

    OfficialReceiptNumber

    Date ofSale

    DATE ACCOMPLISHED: _____________________________________________________________________

    SIGNATURE : ______________________________________________________________________

    NAME : ______________________________________________________________________

    POSITION : ______________________________________________________________________

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    Important NoteThis document enumerates all persons, natural or

    juridical, to whom the substance to be imported will bedistributed. The same will be validated by thetransaction records to be appended on the succeedingapplications.

    FORM D

    LLIISSTT OOFF IINNTTEENNDDEEDD UUSSEERRSS FFOORR TTHHEEPPRREE--SSHHIIPPMMEENNTT IIMMPPOORRTTAATTIIOONN CCLLEEAARR AANNCCEE AAPPPPLLIICCAATTIIOONN

    Enclosure / Attachment of

    Application Control Number: _____________

    BRAND / TRADE / COMMERCIAL NAME: _______________________________________________________

    QUANTITY TO BE IMPORTED (in kg) : __________________________________

    TOTAL QUANTITY INTENDED TO BE DISTRIBUTED (in kg) : __________________________________

    Name of

    Person orCompany

    AddressContactNumber

    Nature ofEnterprise

    (dealerand/or

    end-user)

    Intended Use(for end-user)

    IntendedQuantity to beDistributed (in

    kg)

    Purchase Order

    Number Coveredby Transaction

    DATE ACCOMPLISHED: _____________________________________________________________________

    SIGNATURE : ______________________________________________________________________

    NAME : ______________________________________________________________________

    POSITION : ______________________________________________________________________