Department of Environment and Natural Resources Environmental Management BureauReference No: GENERAL INFORMATION SHEET Name of the Establishment/Facility Establishment/Facility Address (NOT the company of head office) ZPI Plastic Corporation Street # & Street Name: Barangay: Province: CEPZ Cavite Lot 15, Block 20, Phase IV City/Municipality: ___ Rosario ___ Name of Owner/Company Address (if address is not the same as previous address) ZPI Plastic Corporation Street # & Street Name: Barangay: Province: (046) 971-0646
[email protected] Philippine Standard Industry Classification Code No. Philippine Standard Industry Descriptor: CEO/President: Mr. Katsuhiko Sasaki Tel #: (046) 437-0646 / 971-1100 to 03 Fax #: (046) 437-2595 e-mail address: Tel #: e-mail address: Name: Engr. Robert E. Ulatan Fax #:
[email protected] Manufacturing Industry Fax Number (046) 437-2595 (Same as above) City/Municipality: ___ ___ Phone Number e-mail address Type of Business/ Industry Classification Responsible Officer/s: General Manager - Operations: Pollution Control Officer Tel #: (046) 437-0646 / 971-1100 to 03 Fax #: (046) 437-2595 e-mail address: single proprietorship Legal Classification
[email protected] or
[email protected] partnership government corporation private domestic corporation Multi-national We hereby certify that the above information are true and correct. Engr. Robert E. Ulatan Name/Signature of PCO Mr. Katsuhiko Sasaki Name/Signature of President 1 Department of Environment and Natural Resources Environmental Management Bureau 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) 11.88 m3 11.72 m3 0.15 m3 Process wastewater (cubic meters/day) Others: ___________ (cubic meters/day) Wash water, floor (cubic meters/day) Record of Cost of Treatment (Separate entries for separate facilities) Month 1 Person employed, (# of employees) Person employed, (cost) Cost of Chemicals used by WTP Utility Costs of WTP (electricity & water) Administrative and Overhead Costs Cost of operating inhouse laboratory New/Additional Investments in WTP (Description) Cost of New/Add Investments -NA-NA-NA-NA-NA-NANONE NONE -NA-NA-NA-NA-NA-NANONE NONE Month 2 -NA-NA-NA-NA-NA-NANONE NONE Month 3 WTP Discharge Location Outlet Number Location of the Outlet Name of Receiving Water Body 1 2 3 4 5 2 Department of Environment and Natural Resources Environmental Management Bureau Reference No: Detailed Report of Wastewater Characteristics for Conventional Pollutants Outlet No. DATE Effluent Flow Rate (m3/day) BOD (mg/L) TSS (mg/L) Color pH Oil & Grease (mg/L) Temp rise (ºC) ________ (name) (unit) 15-15-05 3-30-10 46 8 72 55 80 50 8.97 8.78 2 1.5 25 25 Please fill-up/accomplish separate form/s for other outlet/s. We hereby certify that the above information are true and correct. Done this 19th of July 2010, in PEZA-CEZ, Rosario, Cavite. Engr. Robert E. Ulatan Name/Signature of PCO Mr. Katsuhiko Sasaki Name/Signature of CEO/President SUBSCRIBED AND SWORN before me, a Notary Public, this __________________ ______________________, affiants exhibiting to me their Community Tax Receipts: Name Mr. Katsuhiko Sasaki Engr. Robert E.Ulatan CTR No. TZ562001 CC1200915813383 Issued at Manila, Phil. Gen. Trias Issued on June 23, 2008 Jan. 11, 2010 Doc. No. : ________ Page No. : ________ Book No.: ________ Series of : ________ 3