Province:
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District:
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Location – sketch map attached
( √ )
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Road Name:
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Road No:
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YES
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YES
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Type of Impact Evaluation ( √ ):
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Less than 1 year
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More than 1 year
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Project Closure (also complete Form Annex 10)
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Other..............................................................
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No.
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Description
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Yes
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No
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Comments
(add extra pages)
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L
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M
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H
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I
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Land Acquisition & Resettlement Issues
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1.1
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Land acquisition or moving back of ROW
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1.2
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Loss of agriculture land, including roadside crops
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1.3
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Relocation of structures
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1.4
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Loss of public properties or infrastructures
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1.5
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Loss of public properties or infrastructures
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1.6
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Other please specific...........................................
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II
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Income and Living Standard
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2.1
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Loss of income and living standard
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2.2
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Loss of occupation and business activities
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2.3
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Other please specific...........................................
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III
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Ethnic Issue
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3.1
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Loss of income and living standard of ethnic people
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3.2
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Impact on health and education
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3.3
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Impact on cultural and believe
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3.4
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Other please specific...........................................
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IV
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Severance and Social Disruption
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4.1
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Loss of vegetation (roadside/riverside etc.)
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4.2
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Disruption of roadside water supplies
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4.3
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Destruction or sealing-in of archaeological, historical and cultural values
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4.4
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Disruption to animal migration
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4.5
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Impediment to mineral resources exploitation
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4.6
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Other please specific...........................................
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V
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Mobilization, Establishment and Operation of:
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5.1
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Workforce
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Unrest and dissatisfaction of local communities
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Opportunities on participation in project and other benefits
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Unrest and dissatisfaction among local communities resulting from cultural differences with labour crew
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Other please specific...................................
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5.2
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Equipment
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Introduction of plant and animal pests
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Other please specific...................................
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5.3
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Labour Camps
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Cutting of trees for construct the camp and use as fuel wood for heating and cooking
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Impact on health and social well-being of local communities (introduction of diseases and disruption of existing social relationships)
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Impact on services and regional economy through labour camp development into a permanent settlement
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Impact on local resources, including wildlife through demand for food, fuel and building materials
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Impact on local wildlife through recreational hunting and fishing by workforce
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5.4
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Workshops/Fuel Depots/ Warehouses/ Asphalt Plant and Preparation
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Oil pollution from improper disposal of oil and grease
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Oil pollution from leaks in fuel and lubricants tanks, or during filling of these
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Oil spills from leaks in machinery
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Noise pollution in nearby settlements
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Air pollution (including dust) in nearby settlements
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Cutting of trees for use as fuel wood for heating bitumen
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IV
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Stockpiling of Materials: Run-off or slumping into streams and dust pollution from
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6.1
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Sand
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6.2
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Gravel
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6.3
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Earth and Top Soil
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6.4
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Rock
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6.5
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Other please specific...................................
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VII
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Establishment and Operation of
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7.1
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Borrow Pits
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7.2
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Quarries
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7.3
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Rock Crushing Plant
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7.4
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Removal of Rock /Sand from River/Stream Beds
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Air and noise pollution for nearby settlements
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Vibration impacts on nearby settlements
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Noise and dust impacts on wildlife and natural habitats
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Loss of aesthetic /visual values
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Loss of archaeological or historical values
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Disruption of groundwater supplies
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Run-off of sediment laden water or polluted water into water bodies
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Hazard when quarry or pit is abandoned due to deep water or disease (mosquitoes etc)
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VIII
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Jungle/Bush/Land Clearing and Constructions
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8.1
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Change in natural drainage patterns
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8.2
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Flooding through blocking natural flow
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8.3
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Flooding through inadequate drainage of road and road works
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8.4
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Flooding through increased flows in diversion area
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8.5
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Diversion of water supply away from drinking/washing water supply, irrigation or away from a wetland
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8.6
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Sedimentation and turbidity impacts in receiving waters
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8.7
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Erosion due to changes in drainage
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8.8
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Spoil disposal leading to loss of habitat and sedimentation
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8.9
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Aesthetic /visual impacts of right of way on the landscape
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IX
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Earth Works Associated in Settlements
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9.1
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Disturbance to existing property frontages, tracks or public utilities
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9.2
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Noise, vibration and dust effects
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9.3
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Destruction or sealing of historical, archaeological or cultural features
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X
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Environmentally Sensitive Areas (relevant agencies and organizations should be consulted
on all matters dealing with environmentally sensitive areas)
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10.1
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National or provincial protected areas
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10.2
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Large areas of pristine forest
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10.3
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Large wetland areas or any other important wetland (nominated to the Ramsar list)
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10.4
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Habitat of fauna or flora listed as Category I (under CITES)
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10.5
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Large areas of migratory bird habitat
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10.6
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Urban areas
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10.7
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Areas inhabited predominantly by ethnic minorities
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10.8
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Nationally significant archaeological or historical sites
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10.9
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Areas of high scenic value
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XI
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Gravel Surfacing, Pavement Base Construction etc.
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11.1
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Traffic flow disruption
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11.2
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Traffic hazard due to movement of construction equipment and contractor crew vehicles
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11.3
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Noise, dust and vibration impacts on nearby settlements
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XII
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Bituminous Surfacing
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12.1
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Pollution of waterways or groundwater by bituminous products or solvents
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12.2
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Pollution from discarded drums, spills and equipment
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12.3
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Other please specific...................................
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XIII
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Transport of Project Materials
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13.1
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Dust blown off loads
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13.2
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Traffic hazards
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13.3
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Other please specific...................................
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XIV
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Operation of the Road
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14.1
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Noise
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14.2
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Dust and other air pollution
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14.3
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Traffic accidents
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14.4
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Highway run-off pollution
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14.5
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Accidental spills of hazardous materials
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14.6
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Increased harvesting of environmentally sensitive products
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14.7
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Population increase as a result of in-migration following creation of road access
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14.8
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Illegal settlement as a result of improved access
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14.9
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Impacts on indigenous people
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14.10
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Maintenance of completed road.
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14.11
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Other please specific...................................
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Distributed to
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Yes
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No
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Date
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MPWT -ESD/PTI
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MPWT-DOR
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DPWT – ESU
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MONRE/PONRE
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Others (list below)
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Monitoring Form compiled by:
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Name:
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Designation:
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Signature:
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Date:
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Monitoring Form verified by:
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Name:
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Designation:
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Signature:
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Date:
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With date ___________, one came to realize the final review of the environmental and social aspects corresponding to the activity _________________________, with the intention of verifying the fulfillment of the Measurements of Mitigation contemplated for the project, as well as of verifying if other negative impacts have appeared during the period of time of execution of the work. In this sense there was content the commission integrated by the following persons;
In this section must capture the record of the case in accordance with dates, narrating of summed up form the problem to that one attends and enumerating the recommendations done in previous opportunities?
Here it is necessary to describe in detail, the conditions in which developed the measurements of mitigation, the grade of fulfillment and his current state, exhibiting when it is necessary, and the reasons on which the measurements have not been completed. In order to visualize the above mentioned information, it is recommended fulfill the following evaluation table:
Based on the examination and the results of the evaluation, prepare for themselves the conclusions of the fulfilment of the measurements of mitigation and established recommendations.
Provincial Resettlement Committee (PRC): A chair man is responsible for approval of Unit Cost that proposed by District Resettlement Committee. All Department have right to involve on project process and resettlement activities including grievance redress which It could not solve in District level.
DOR/ESD: Responsibility for regularly monitoring of subprojects and report.
ESD/PTI: Field Quarterly and yearly monitoring and report preparation.
DPWT: Responsibility for coordination between Departments in Province and subprojects
District Resettlement Committee: There is Administration Office that Vice Governor is chairman of Resettlement committee within District (OPWT, ONRE, L WU, Youth Organization, and Office of National Lao Front. It is responsible to coordinate between affected village and subproject to data gathering on affected people, accepted affected assets from the field survey, Approval of Unit Cost Estimation, following up compensation payment, Grievance Redress within District’s level).
Village’s Resettlement Committee: There is Elder, Deputy of Village’s chief, village’s chief, LWU, Youth Organization. RC in village’s level follows up resettlement and compensation payment, grievance redress with in village’s level.
Grievance Redress starts from Village Resettlement committee level up to District resettlement committee, PRC, MPWT/PTI and last step is Lao PDR court.