PROJECT YEAR 5 WORK PLAN

USAID INDONESIA URBAN WATER, SANITATION AND HYGIENE

PENYEHATAN LINGKUNGAN UNTUK SEMUA (IUWASH PLUS)

OCTOBER 2020

This report is made possible by the support of the American People through the United States Agency for International Development (USAID). The

contents of this report are the sole responsibility of DAI Global, LLC and do not necessarily reflect the views of USAID or the United States

Government.

PROJECT YEAR 5 WORK PLAN

Attachment A ENVIRONMENTAL MITIGATION AND MONITORING PLAN

CONTRACT NO. AID-497-TO-16-00003

USAID IUWASH PLUS

USAID INDONESIA URBAN WATER, SANITATION AND HYGIENE PENYEHATAN LINGKUNGAN UNTUK SEMUA (IUWASH PLUS)


Attachment A ENVIRONMENTAL MITIGATION AND MONITORING PLAN

CONTRACT NO. AID-497-TO-16-00003

Project Title: USAID IUWASH PLUS: Indonesia Urban Water Sanitation and

Hygiene Penyehatan Lingkungan untuk Semua

Sponsoring USAID Office: USAID/Indonesia Office of Environment

Contract Number: AID-497-TO-16-00003

Contractor: DAI Global, LLC

Date of Publication: October 2020

Author: DAI Global, LLC

II

TABLE OF CONTENTS

TABLE OF CONTENTS ...................................................................................................................ii

ACRONYMS.......................................................................................................................................iii

1 INTRODUCTION ......................................................................................................................1

1.1 BACKGROUND ................................................................................................................................ 1

1.2 USAID ENVIRONMENTAL POLICY AND PROCEDURES ................................................... 1

1.3 USAID ENVIRONMENTAL REVIEW OF USAID IUWASH PLUS ........................................ 2

1.4 THE USAID IUWASH PLUS EMMP ............................................................................................... 3

2 SCREENING OF PROJECT ACTIVITIES ..............................................................................5

2.1 INTRODUCTION ............................................................................................................................. 5

2.2 COMPONENT 1: IMPROVE HOUSEHOLD WASH SERVICES........................................... 5

2.3 COMPONENT 2: STRENGTHEN CITY AND DISTRICT WASH INSTITUTIONAL

PERFORMANCE ................................................................................................................................. 7

2.4 COMPONENT 3: STRENGTHEN THE WASH FINANCING ENVIRONMENT ............. 9

2.5 COMPONENT 4: ADVANCING NATIONAL WASH ADVOCACY,

COORDINATION AND COMMUNICATIONS .................................................................... 10

2.6 USAID-SECO PARTNERSHIP ....................................................................................................... 12

2.7 LOCAL SUSTAINABILITY AND INNOVATION COMPONENT (LSIC) ........................ 13

3 THE USAID IUWASH PLUS EMMP.................................................................................... 16

3.1 PERSONNEL IMPLEMENTING THE EMMP .............................................................................. 25

3.2 EMMP PROCEDURES ..................................................................................................................... 26

ANNEX ............................................................................................................................................. 31

III

ACRONYMS

Akatirta Akademi Tirta Wiyata/Tirta Wiyata Environmental Engineering Academy

AMDAL Analisis Mengenai Dampak Lingkungan Hidup/Enviromental Impact Analysis

APBD Anggaran Pendapatan dan Belanja Daerah/Local Government Budget

B40 Bottom 40% of the population in terms of wealth

B2B Business to Business

Bappenas Badan Perencanaan Pembangunan Nasional/National Development Planning Agency

BC Behavior Change

BDS Business Development Services

BEO Bureau Environmental Officer

BLUD Badan Layanan Umum Daerah/Regional Public Service Agency

BOD Biochemical Oxygen Demand

BTAM Balai Teknologi Air Minum/Center for Water Technology

CB Capacity Building

CBNRM Community Based Natural Resource Management

CEM Citizen Engagement Mechanism

CFR Code of Federal Regulation

COR Contracting Officer’s Representative

CSR Corporate Social Responsibility

DAK Dana Alokasi Khusus/Special Allocation Fund

DAI Development Alternatives Incorporated Global, LLC

DCOP Deputy Chief of Party

DED Detailed Engineering Design

DMA District Meter Area

Dirjen Direktur Jenderal/General Director

EA Environmental Assessment

EIA Environmental Impact Analysis

EIS Environmental Impact Statement

EE Energy Efficiency

EMMP Environmental Mitigation and Monitoring Plan

EMMR Environmental Mitigation and Monitoring Report

EMS Environmental Management System

EO Environmental Officer

ES Essential Services

ERF Environmental Review Form

ERR Environmental Review Report

IV

ETD Environmental Threshold Decision

Forkalim Forum Komunikasi Air Limbah/Communication Forum for Wastewater

FS Feasibility Study

FSM Fecal Sludge Management

GMO Genetically Modified Organism

Godex Governance Index

GOI Government of Indonesia

GIS Geographic Information System

GHG Greenhouse Gas

HIV/AIDS Human Immunodeficiency Virus/Acquired Immunodeficiency Virus

IEC Information Education Communication

IEE Initial Environmental Examination

IPAL Instalasi Pengolahan Air Limbah/Wastewater Treatment Plant

IPLT Instalasi Pengolahan Lumpur Tinja/Septage Treatment Plant (STP)

Jabodetabek Jakarta, Bogor, Depok, Tangerang, Bekasi

Kemendes Kementerian Desa, Pembangunan Daerah Tertinggal, dan Transmigrasi/Ministry of Village,

Development of Disadvantaged Regions, and Transmigration

KKMA Kajian Kerentanan Mata Air/Spring Vulnerability Assessment and Action Plan

KLHK Kementerian Lingkungan Hidup dan Kehutanan/Ministry of Environment and Forestry

IUWASH PLUS Indonesia Urban Water, Sanitation and Hygiene Penyehatan Lingkungan untuk Semua

LG Local Government

LPS Liter Per Second

LSIC Local Sustainability and Innovation Component

LLTT Layanan Lumpur Tinja Terjadwal/Scheduled Desludging Service

M&E Monitoring and Evaluation

MCK Mandi, Cuci, Kakus/Bath, Laundry, and Toilet Central

MEO Mission Environmental Officer

MFI Micro Finance Institutions

MIS Management Information System

MOH Ministry of Health

MPWH Ministry of Public Works and Housing (PUPR)

NAWASIS National Water and Sanitation Information Services

NGO Non-Governmental Agency

NRW Non-Revenue Water

O&M Operation and Maintenance

OJK Otoritas Jasa Keuangan/Financial Services Authority

PBG Performance Based Grant

V

PDAM Perusahaan Daerah Air Minum/Municipal Drinking Water Company

PD PAL Perusahaan Daerah Pengelolaan Air Limbah/Municipal Wastewater Management

Company

PERPRES Peraturan Presiden/President Regulation

PIAP Performance Improvement Action Plan

PKK Pemberdayaan Kesejahteraan Keluarga/Family Welfare Movement

Pokja PPAS/ Kelompok Kerja Perumahan, Permukiman, Air Minum dan Sanitasi/Air Minum dan

AMPL Penyehatan Lingkungan/Working groups for Housing, Settlements, Water Supply, and

Sanitation/Water Supply and Sanitation

PT SMI PT Sarana Multi Inftrastruktur

PUPR Pekerjaan Umum dan Perumahan Rakyat/Public Works and Housing

PY5 Project Year 5

PVO Private Voluntary Organizations

RAD Rencana Aksi Daerah/Regional Action Plan

RC Readiness Criteria

REA Regional Environmental Advisor

RKP Rencana Kerja Pemerintah/Government Annual Work Plan

RPAM Rencana Pengamanan Air Minum/Water Safety Plan

RPJMN Rencana Pembangunan Jangka Menengah Nasional/National Medium Term

Development Plan

RPJMD Rencana Pembangunan Jangka Menengah Daerah/Regional Medium Term Development

Plan

SDG Sustainable Development Goal

SECO State Secretariat of Economic Affairs

SK Surat Keputusan/Decision Letter

SME Small and Medium Enterprise

SNI Standar Nasional Indonesia/Indonesian National Standard

SOP Standard Operating Procedure

SPAM Sistem Penyediaan Air Minum/Water Supply System

SPALD Sistem Pengelolaan Air Limbah Domestic/Domestic Wastewater Management System

SPM Standar Pelayanan Minimal/Minimum Service Standard

SPPL Surat Pernyataan Pengelolaan Lingkungan/Statement of Environmental Management

STBM Sanitasi Total Berbasis Masyarakat/Community-Based Total Sanitation program

TAMIS Technical and Administrative Management Information System

TOCOR Task Order Contracting Officer’s Representative

UKL Upaya Pengelolaan Lingkungan Hidup/Environmental Management

UPL Upaya Pemantauan Lingkungan Hidup/Environmental Monitoring

VI

UPTD Unit Pelaksana Teknis Daerah/Regional Technical Implementing Unit

USAID United States Agency for International Development

US EPA United States Environmental Protection Agency

USWSS Urban Senior Water Supply Specialist

VAT Value Added Tax

WASH Water, Sanitation and Hygiene

WSP Water Safety Plan

WTP Water Treatment Plant

WQQ Water Quality and Quantity

USAID IUWASH PLUS PROJECT YEAR 5 WORK PLAN | 1

ATTACHMENT A: ENVIRONMENT MITIGATION AND MONITORING PLAN

1 INTRODUCTION

1.1 BACKGROUND

The USAID Indonesia Urban Water, Sanitation and Hygiene, Penyehatan Lingkungan Untuk Semua

(IUWASH PLUS) program is a five-and-a-half-year initiative designed to assist the Government of

Indonesia (GOI) in increasing access to water supply and sanitation services as well as improving key

hygiene behaviors among urban poor and vulnerable populations. USAID IUWASH PLUS works with

governmental agencies, the private sector, NGOs, communities and others to achieve the following

"high level" results:

1. An increase of 1,100,000 people in urban areas with access to improved water supply

service quality of which at least 500,000 are from the poorest 40% of the population; and

2. An increase of 500,000 people in urban areas with access to safely managed sanitation.

To ensure that improvements in access to WASH services are sustained, USAID IUWASH PLUS is

guided by a development hypothesis that focuses on strengthening service delivery systems, so they can

more effectively reach the poorest and most vulnerable segments of the population. In order to achieve

this at scale, the program undertakes activities through four interrelated components, including: 1)

improving household WASH services; 2) strengthening city WASH institutional performance; 3)

strengthening the WASH financing environment; and 4) advancing national WASH advocacy,

coordination and communication. The program also implements a Local Sustainability and Innovation

Component (LSIC) to promote innovations in science, technology and partnership that complement

other areas of activity and contribute to meeting the project’s overall objectives.

1.2 USAID ENVIRONMENTAL POLICY AND PROCEDURES

USAID environmental policy and procedures are set forth Title 22, Code of Federal Regulations, Part

216 (22CFR216) as regulated in Initial Environmental Examination (IEE) Asia 15-061 on December 2014,

and amandemen IEE # 1 for Essential Service (Asia 19-018) which is designed to ensure that

environmental factors and values are integrated into the USAID decision-making process. In the

conduct of its mandate to help upgrade the quality of life of the poor in developing countries, USAID

conducts a broad range of activities that address such basic problems as hunger, malnutrition,

overpopulation, disease, disaster, deterioration of the environment and the natural resource base,

illiteracy as well as the lack of adequate housing and transportation. Within this framework, it is USAID

policy to:

1. Ensure that the environmental consequences of its activities are identified and considered

by both USAID and the host country prior to proceeding and that appropriate

environmental safeguards are adopted;

2. Assist developing countries to strengthen their capabilities to appreciate and effectively

evaluate potential environmental effects of proposed development strategies and projects,

and to select, implement and manage effective environmental programs;

3. Identify impacts resulting from USAID actions upon the environment; and

4. Define environmental limiting factors that constrain development and identify and carry out

activities that assist in restoring the renewable resource base on which sustained

development depends.

2 | USAID IUWASH PLUS PROJECT YEAR 5 WORK PLAN


Some useful definitions in USAID’s policy are summarized as follows:

• Categorical Exclusion: Activities which do not have a pronounced effect on the natural or

physical environment and for which for an Initial Environmental Examination, Environmental

Assessment and Environmental Impact Statement are not generally required.

• Environmental Assessment (EA): A detailed study of the reasonably foreseeable significant

effects, both beneficial and adverse, of a proposed action on the environment of a foreign

country or countries.

• Environmental Impact Statement (EIS): A detailed study of the reasonably foreseeable

environmental impacts, both positive and negative, of a proposed USAID action. It is a specific

document having a definite format and content as described in the above CFR.

• Environmental Mitigation and Management Plan (EMMP): A document that identifies

the activities requiring mitigation, describes the environmental threats posed by the program

activities as well as the mitigation measures planned to combat the identified threats, and

indicates the plan for monitoring the implementation of these mitigation measures.

• Initial Environmental Examination (IEE): The first review of the reasonably foreseeable

effects of a proposed action on the environment. Its function is to provide a brief statement of

the factual basis for a Threshold Decision as to whether an Environmental Assessment or an

Environmental Impact Statement will be required.

• Threshold Decision: A formal Agency decision which determines, based on an Initial

Environmental Examination, whether a proposed Agency action is a major action significantly

affecting the environment.

Notably, USAID policy also draws a distinction between activities that it fully controls and those for

which functions as a “Minor Donor”. More specifically, USAID does not require adherence to the above

policy when USAID (or a USAID-funded project such as IUWASH PLUS) does not control the planning

or design of the activity and either: 1) contributes less than 25 percent of the estimated project cost; or

2) the environmental procedures of the “donor in control” of the planning or design of the project are

followed and determined as adequate by USAID. This distinction can be important given that USAID

IUWASH PLUS relies heavily on partnering with and leveraging resources from other agencies and

programs.

1.3 USAID ENVIRONMENTAL REVIEW OF USAID IUWASH PLUS

Prior to award of the USAID IUWASHS PLUS contract and as part of the overall project design

process, USAID in Indonesia conducted an Initial Environmental Examination (IEE) that covered its

entire Essential Services (ES) program, including USAID IUWASH PLUS. The IEE encompassed a review

of anticipated USAID IUWASH PLUS activities to ensure the design complied with USAID’s broad

environmental policies outlined above. The IEE concluded that certain activities anticipated under

USAID IUWASH PLUS merited a “categorical exclusion” per Title 22, Code of Federal Regulations,

Part 216 (22CFR216) while others fell into the category of “negative determination with conditions”.

Activities recommended for Categorical Exclusion in the IIE for USAID IUWASH PLUS included:



• Training, capacity building, demand creation, behavior change and networking for healthcare

providers, civil society, and local government support of improved water, sanitation and hygiene

(WASH);

• Development, testing and scaling up communications innovations in support of improved

WASH service delivery and outcomes;

• Sanitation marketing for improving WASH outcomes;

• Policy and strategy development including the formulation of standard procedures,

accreditation, financial management guidelines, local government policies, regulation and

institutional arrangements; and

• Monitoring, studies, surveys/public health surveillance and other data-gathering assessments that

do not involve research of human subjects, models and dissemination of resulting information,

documentation of lessons learned and best practices.

Activities that USAID recommended for a Negative Determination with Conditions were those

deemed as potentially having a direct or indirect adverse environmental impact if not designed and

implemented using sound environmental safeguards. These activities included:

• On the Job Training which enables impact on personal and environment such as construction

training for mason & community, septic-tank desludging training, survey of the septic tanks

conditions that have to open septic-tank holes

• Studies and or detailed engineering design that require field surveys such as topographic survey,

soil investigations, water flow & pressure measurement in NRW reduction activities, energy &

electricity measurement in energy efficiency activities including water and waste water sampling,

etc.

• Construction small scale water supply and sanitation facilities that are designed to extend access

to safe water and sanitation to the poorest and most vulnerable communities; and

• Installation and/or rehabilitation of individual and communal water and sanitation systems such

as house and communal water connections, installation of individual toilet and communal

sanitation treatment facilities, etc.

When managed poorly, these activities could result in the contamination of surface and ground water

supplies, help spread water borne diseases, contribute to the degradation of ecosystems, deplete fresh

water resources and increase disease transmission from standing and stagnant water.

1.4 THE USAID IUWASH PLUS EMMP

Since conducting the IEE and the award of the USAID IUWASH PLUS contract, USAID continues to

ensure compliance of its environmental policy through both periodic reviews of project activities, as

well as through the review and approval of the USAID IUWASH PLUS Environmental Mitigation and

Monitoring Plan (EMMP). USAID IUWASH PLUS developed an initial EMMP as part of its first Annual

Work Plan, updates it on an annual basis, and provides the updated version as part of subsequent

Annual Work Plan submissions.

This is an updated version of the EMMP that is submitted as part of its Annual Work Plan for PY05, and

is organized into three main sections consisting of:



• This introductory section;

• An updated screening of USAID IUWASH PLUS activities which identifies which project

activities are classified as “Categorical Exclusion” and do not require an EA or EIS and which

are classified as “Negative Determination with Conditions” and merit more detailed

environmental impact reviews and monitoring; and

• A description of the USAID IUWASH PLUS Environmental Mitigation and Monitoring Plan,

including reporting requirements and procedures the project will follow.

Several Annexes contain further monitoring and reporting guidelines and review and reporting forms.



2 SCREENING OF PROJECT ACTIVITIES

2.1 INTRODUCTION

The sections below contain a brief description of each USAID IUWASH PLUS component followed by

tables that list the types of activities the project anticipates supporting under each subcomponent. Using

the USAID IEE as an initial guide and based on subsequent reviews with USAID, USAID IUWASH PLUS

carries out a two-step screening to identify activities that require further environmental analysis and

review:

• Step One: This involves determining if an activity should be classified as meeting the threshold

for a “categorical exclusion” or a “negative determination with conditions”. Activities

designated as meeting the “negative determination with conditions” threshold in the tables

below are highlighted in yellow.

• Step Two: This entails examining potential environmental risks associated with those activities

classified as “negative determination with conditions”. As many activities are designed and

carried out in partnership with partner LGs, other development programs, etc., such

examinations are conducted during the activity design process with relevant partners.

Using this initial screening as a guide, it is estimated between 10 and 20% of activities supported by

USAID IUWASH PLUS may merit more detailed environmental reviews and potential mitigation,

monitoring and reporting.

2.2 COMPONENT 1: IMPROVE HOUSEHOLD WASH SERVICES

Component 1 addresses the barriers that impede increased household access to and usage of WASH

services. The USAID IUWASH PLUS approach is twofold: unlock household demand while

strengthening the capacity of private and public sector suppliers alike. Household demand for both

water and sanitation services is significant in Indonesia, with financing representing a critical enabler to

translate this demand into more WASH facility. Unlocked demand must, however, be balanced by

commensurate supply to meet expectations and avoid service gaps. The Component 1 team therefore

also works with suppliers to ensure product/service supply/availability, build capacity, and support a

more robust sanitation market. Reinforced by the poor-inclusive approach that will not just strengthen

community capacity to participate in the demand creation process, but also amplifies the engagement

between relevant decision makers to deliver better outcomes for the poor.

The associated sub-components, activities, and IEE determinations for Component 1 are as follows:

Sub-Component 1.1. Focal Activities Targeting Community and Household Level Stakeholders in PY5

No Anticipated USAID IUWASH PLUS Activities IEE Determination

1.1.1 Assist partner LGs in the implementation of Urban STBM activities at new locations which includes local stakeholder engagement, capacity building, participatory assessment, triggering, action planning, and participatory

monitoring and evaluation).

Categorical Exclusion

(Technical Assistance)

1.1.2 Expand the number of “Hotspots” targeted by LG partners Categorical Exclusion




Sub-Component 1.1. Focal Activities Targeting Community and Household Level Stakeholders in PY5


1.1.3 Ensure dissemination of WASH promotion and marketing support materials re: priority behaviors identified in the Project's BC Strategy under the “Good

Neighbor” (“Tetangga Panutan”) theme



1.1.4 Support communities in influencing LG budgeting processes through

improved community-based M&E, planning and advocacy.



1.1.5 Ensure on-going communication and collaboration with other stakeholders Categorical Exclusion


1.1.6 Oversee capacity building programs (training, etc.) for health center staff,

community health volunteers, PKK members etc.


(Training)

Sub-component 1.2. Focal Activities Targeting Private Sector Stakeholders in PY5


1.2.1 Implementation of Sanitation Marketing Strategy Categorical Exclusion


1.2.2 Development of WASH market segmentation in collaboration and

coordination with LG and private sector partners



1.2.3 Development of guidance for promotion and businesses management for

WASH Categorical Exclusion

(Desk Study)

1.2.4 Enterprises including WASH product marketing tools / toolkits for use by

WASH entrepreneurs and promoters, MFIs, and others.


(Desk Study)

1.2.5 Monitor WASH business performance (including product development and

sales)


(Meeting &Training)

1.2.6 Strengthening linkage between WASH business actors and related

stakeholders.


(Meeting)

1.2.7 Strengthen the delivery of BDS support such as through the provision of assistance to private sector partners in business plan development, technical

training, financial management, performance monitoring, etc.



1.2.8 Conduct National Meeting for BDS Categorical Exclusion

(Meeting)

Subcomponent 1.3. Focal Activities Targeting Governmental Stakeholders in PY5


1.3.1 Engage with the MOH and BAPPENAS to improve the adaptation of Urban

STBM


(Workshop)

1.3..2 With the MOH, disseminate BC Strategy and Urban WASH promotion and

marketing materials, including via a national campaign


(Information Transfer)

1.3.3 Establishing WASH citizen engagement mechanisms (CEM) through civic forums, media and other platforms to give voice to the aspirations of the

public


(Meeting)

1.3.4 National review of WASH information and public relations mechanisms

(CEM) used at the LG level





2.3 COMPONENT 2: STRENGTHEN CITY AND DISTRICT WASH INSTITUTIONAL

PERFORMANCE

The USAID IUWASH PLUS Component 2 team applies a demand-driven, evidence-based approach that

establishes clear performance baselines; a portfolio of targeted, mutually agreed-upon capacity-building

measures that are built into service provider plans and budgets; and a monitoring and evaluation (M&E)

framework that links program investments to performance objectives. Performance indices have been

used to not only measure improvement in service delivery, but also evaluate increased access together

with partners. Key service providers are further encouraged to provide inclusive service to low income

communities, using customer data, case studies, financial analysis and incentives and geospatial

visualizations to pinpoint both the gaps and the opportunities to support GOI next targets of RPJMN

2020-2024 and SDGs 2030. To anticipate degradation of spring capacity, the water team is also

promoting spring vulnerability assessment and begin to initiate implementation of infiltration pond

construction in locations that already completed the assessment.


Subcomponent 2.1: Improve PDAM Performance


2.1.1 PDAM Performance Index review and facilitating LG for sustainability of the index Categorical Exclusion

(Workshop)

2.1.2 Collaboration with MPWH, Akatirta Wiyata and the World Bank to support PDAM Performance Based Grant programs on NRW reduction (5 PDAM) and Energy

efficiency (4 PDAM)

Negative Determination

with Condition (Field

Training and measurement)

2.1.3 Finding an Effective Approach and Incentive to Increase Water Access for B40 Categorical Exclusion

(Study)

2.1.4 Development of GIS Operational SOPs for sustainable development of SPAM and

facilitating GIS devt of PDAM Kota Bogor, Kab.Bogor



2.1.5 Installation of web-based GIS / mapping customer relationship application Categorical Exclusion


2.1.6 Support Review Business Plan (Medan, Sibolga, Makassar, Ternate, Kota

Probolinggo)



2.1.7 Support, monitor and supervise program Water Hibah (PUPR): Karawang, Wonosobo, Sragen, Sukoharjo, Surakarta, Gresik, Sidoarjo, Kab Probolinggo, Lumajang, Barru, Bantaeng, Maluku Tengah, Bulukumba, Medan, Deliserdang,

Pematangsiantar, Tebing (DAK)



2.1.8 Technical support to regional programs on Master Meter Medan dan Surakarta and non-PDAM piped water access SPAM Komunal (Bekasi, Bogor, Depok, Tangerang,

Wonosobo, Sidoarjo, Gresik, Kab. Probolinggo, Lumajang, Kab. Malang, Deli

Serdang, Sibolga, Ternate, Jayapura)


with Condition (Field

Training and measurement)

2.1.9 Collaboration with National Stakeholders on improving coordination and implementation of Water Safety Planning in Indonesia on implementing the RPAM

pilot project implementation in 3 sites: Kota Makassar, Kota Sibolga and Kab.

Sidoarjo





Subcomponent 2.2: Develop and Improve Local Sanitation Unit Performance


2.2.1 Sanitation Performance Index review (collection, verification, reporting) and share results with National partners, and facilitation of LGs in adopting the index for

sanitation performance monitoring


(Workshop)

2.2.2 Collaboration with MPWH, Bappenas, donors, etc. on coordinating improved urban

sanitation



2.2.3 Support MPWH in formulation of PDAM to manage domestic waste water Categorical Exclusion

(Classroom Training)

2.2.4 Support all regions with implementation of sanitation improvement programs

(including establish UPTD, SOP, roadmap, IPLT review, LLTT, MIS)


(Technical assistance )

2.2.5 Update Flipchart SPALD Categorical Exclusion

(Study & Design)

2.2.6 Develop Pocket Book LLTT Categorical Exclusion

(Study & Design)

2.2.7 Support Capacity Building for FORKALIM as National Waste Water Association,

including implementation National Twinning program



2.2.8 Support FSM6 (31 May – 4 June 2021) Categorical Exclusion


2.2.9 Support LSIC programs in Sanitation (upgrade septic tanks, private engagement in desludging services, sludge dewatering technology, inter regional desludging services

synergy)


with Condition

2.2.10 Support three UPTDs (Bekasi, Makassar, Gresik) in transformation process to BLUD Categorical Exclusion


Subcomponent 2.3: Strengthen WASH Enabling Environment within LGs


2.3.1 Updating and Monitoring Go-Dex (including 3 Kab/Kota IUWASH PLUS new area) Categorical Exclusion

(Workshop)

2.3.2 Serial events with Ministries PUPR, Finance and Home Affairs on national policy for

WASH and SPM


(Study)

2.3.3 Analyses of minimum regulation on LLTT Categorical Exclusion

(Study)

2.3.4 Analyses of Indices Categorical Exclusion

(Study)

2.3.5 Facilitation of operator transformation from UPTD to BLUD in Makassar, Gresik,

and Bekasi



2.3.6 Acceleration the target outcome on Planning and Budgeting Documents

(RPJMD/RKP/RAD/Roadmap/SPM)



2.3.7 Support Regional teams in Advocacy on increasing APBD for WASH through Pokja

AMPL





Subcomponent 2.4: Improve the Protection, Management, and Allocation of Raw Water Resources


2.4.1 Baseline collection WQQ in 7 locations (Kota Malang, Kab. Probolinggo, Kab.

Lumajang, Kota Siantar, Kota Medan, Kab. Bantaeng, Kab. Bulukumba)


with Condition

2.4.2 National Support on infiltration pond scaling up with Kemendes and KLHK Categorical Exclusion

(workshop)

2.4.3 Continue LSIC CB and pilot project for infiltration pond in 8 LGs Negative Determination

with Condition

2.4.4 Continue capacity building and pilot project for infiltration pond in Bantaeng,

Bulukumba, Pematang Siantar, and Medan

Negative Determination with Condition

2.4.5 Continue raw water study to support FS SPAM Barombong Makassar Categorical Exclusion

(Study)

2.4.6 Progress Monitoring KKMA Document and Action Plan in Pematangsiatar

(Nagahuta) dan Medan (Sibolangit)



2.4.7 Monitoring KKMA and Infiltration pond program Categorical Exclusion


2.4 COMPONENT 3: STRENGTHEN THE WASH FINANCING ENVIRONMENT

The flow of WASH financing connects the actors of the urban WASH ecosystem, providing the

resources for LGs and PDAMs to meet the needs of their citizens. As the financing environment

evolves, USAID IUWASH PLUS works with the Indonesian Government and financing partners (donors,

banks, MFIs, etc.) to capitalize on new opportunities and work toward more systematic and sustainable

WASH financing. Through component 3, USAID IUWASH PLUS supports the GOI to: improve WASH

financing policies and regulations; maximize the use and effectiveness of national and local government

budgets; increase private sector investment in WASH services; improve the financial management

capacity and performance of local WASH institutions; and improve the ability of B40 households to

access WASH improvements such as through microfinance.


Subcomponent 3.1: Facilitate a Supportive Enabling Environment for WASH Financing


3.1.1 Develop the SOP to compliment the toolkit as part of material for OJK

recommendation of WASH microfinance



3.1.2 Develop the policy paper of WASH microfinance to support the regulation of WASH

microfinance.



3.1.3 Support to OJK and Bappenas for WASH Microfinance Regulation development Categorical Exclusion


3.1.4 Support the Ministry of Cooperatives and SMEs for WASH microfinance being

provided by cooperative


(Study)

3.1.5 Support the MOPWH to develop ministerial regulation and SK DIRJEN Cipta Karya for recommendation and evaluation of water supply project being financed by

PERPRES 46/2019


(Study)

3.1.6 Analyze the APBD 2020 realization/ spending compared to the APBD 2020. Categorical Exclusion




Subcomponent 3.1: Facilitate a Supportive Enabling Environment for WASH Financing


3.1.7 Update the APBD WASH Tracking Tool for 2021 local budgets. Categorical Exclusion


3.1.8 Facilitate the development of government regulation of VAT exemption for waste

water and service


(Study)

Subcomponent 3.2: Facilitate Increased Access to Capital Expenditure Finance for WASH


3.2.1 Continue to support PDAM Kabupaten Bogor on tender process and its evaluation

for developing new 150 lps WTP being funded by B2B scheme



3.2.2 Continue to facilitate PDAM Kota Makassar to finalize feasibility study for 100 lps

WTP in Barongbong being financed by provincial budget



3.2.3 Support PDAM Kabupaten Malang to develop feasibility study to build new WTP and distribution line to serve Southern area of Malang being financed by LG and

possible private sector



3.2.4 Support LGs of Kabupaten/Kota Medan, Deli Serdang and others in developing

private septage collection/transportation services



Subcomponent 3.3: Provide Technical Assistance to Key Financing Facilities


3.3.1 Provide technical assistance to PT SMI in evaluation of the FS of water supply

projects being financed by long-term loan provided by PT SMI, also; provided training

of water sector knowledge for PT SMI staff

Categorical Exclusion (Information Transfer)

3.3.2 Implement capacity building with respective GOI offices and agencies Categorical Exclusion (Training/Workshop)

Subcomponent 3.4: Increase Household Access to Finance for WASH Services


3.4.1 Develop WASH financing product among MFI partners using Microfinance Tool Kit Categorical Exclusion


3.4.2 Advocacy on WASH Microfinance to OJK Regional Offices Categorical Exclusion


3.4.3 WASH Microfinance promotion provincial level Categorical Exclusion


2.5 COMPONENT 4: ADVANCING NATIONAL WASH ADVOCACY,

COORDINATION AND COMMUNICATIONS

Under Component 4, the USAID IUWASH PLUS team seeks to bring to scale successes registered

under its other areas of activity and inform the national WASH agenda in support of broader sector

transformation. The Component 4 team works to capture, disseminate, and integrate lessons learned

and best practices to improve national policies and programs while also strengthening the coordination



of WASH programming among national government agencies. Also, it provides a platform for

promoting results and lessons learned under Components 1, 2, and 3 to wider WASH stakeholders.


Subcomponent 4.1: Build Capacity of National WASH Coordination Agencies


4.1.1 Support Pokja PPAS/AMPL in developing and tested the enabling environment index/tools for tracking the achievement of RPJMN 2020-2024 targets by the local

government



4.1.2 Develop advocacy and IEC materials to support Pokja PPAS/AMPL in building capacity of Pokja AMPL regional in understanding various strategy and approach that

are critical for meeting the RPJMN 2020-2024 and SDGs 2030 target


(Training & Technical

Assistance)

4.1.3 Develop a microsite under the NAWASIS portal for ensuring the USAID IUWASH PLUS knowledge products can be accessed by WASH stakeholders after the project

is closed


(Study & Technical

Assistance)

4.1.4 Continue strengthening capacity of FORKALIM as National Waste Water

Association through development of knowledge product Categorical Exclusion


Subcomponent 4.2: Strengthen National-level WASH Policy and Regulatory Environment


4.2.1 Continue support the Government of Indonesia to finalize a roadmap manual for

implementing the RPAM national framework



4.2.2 Develop recommendation on the effective approach and incentive for PDAM to

serve the urban poor


(Study and Workshop)

4.2.3 Support Balai Teknik Air Minum to develop roadmap for continuing E-Learning

development and implementation



4.2.4 Finalize guideline to support WASH stakeholders in creating sustainable CSR

partnership for WASH



4.2.5 Development of signature program to support GOI in institutionalization and scaling

up USAID IUWASH PLUS key programs



4.2.6 Support Ministry of Village, Disadvantage Region, and Transmigration in

institutionalization and scaling up the groundwater conservation program



Subcomponent 4.3: Share and Mainstream Lessons Learned and Best Practices through Toolkits, Manuals, Events, and

Online Dissemination


4.3.1 Maintain sharing and communication platforms of USAID IUWASH PLUS Categorical Exclusion


4.3.2 Conduct knowledge events to share analyses, lessons learned, and best practices

from the program


(Training/Workshop)

4.3.3 Develop evidence-based knowledge products on several WASH topics, including

learning videos on various topics of WASH as an innovative tool for learning



4.3.4 Develop success stories and other relevant knowledge products to support the

signature programs



4.3.5 Develop final publication of the USAID IUWASH PLUS assistance to local government partners as part of the initiative to pave the way toward journey to self-

reliance

Categorical Exclusion (Information Transfer and

Training/Workshop)



Subcomponent 4.3: Share and Mainstream Lessons Learned and Best Practices through Toolkits, Manuals, Events, and

Online Dissemination


4.3.6 Continue engaging and build capacity of the media and blogger/social media players Categorical Exclusion (Information Transfer and

Training/Workshop)

2.6 USAID-SECO PARTNERSHIP

The overall objective of the USAID-SECO partnership program or “SECO Program” is to improve the

technical and financial performance of seven water utilities (PDAMs) in two USAID IUWASH PLUS

regions, West and Central Java. The focus of the program (and main components) include: A) non-

revenue water (NRW) reduction in six PDAMs; B) increased energy efficiency in four PDAMs; and C)

increased institutional capacity among all seven PDAMs.

The associated sub-components, activities, and IEE determinations for USAID-SECO partnership are as

follows:

Component A: Non-Revenue Water Reduction

No Anticipated USAID-SECO Partnership Activities IEE Determination

5.1.1 Agreement on most effective activities to reduce NRW commercial for

each PDAM


(Meeting)

5.1.2 Installation of Smart Meters Negative Determination with Condition

(Field Activities)

5.1.3 Validation / Calibration of Production meters Negative Determination with Condition

(Field Activities)

5.1.4 Two large Field Survey (for total estimated 70.000 HH) Categorical Exclusion

(Study)

5.1.5 Finalize SOP & regulation related to NRW reduction Categorical Exclusion

(Technical assistance)

5.1.6 Implement NRW Commercial Reduction Negative Determination with Condition

(Field Activities)

5.1.7 Physical Leak Detection and fixing largest leaks Negative Determination with Condition

(Field measurement)

5.1.8 Evaluate/improve existing DMA and DED new DMA Negative Determination with Condition

(Field measurement)

5.1.9 Package of Technical Training Categorical Exclusion


5.1.10 Monitoring NRW values for 7 PDAMs and support PBG Baselines Categorical Exclusion

(Monitoring)

Component B: Increase Energy Efficiency


5.2.1 Complete Procurement of pumping equipment for two PDAM in West

Java and two in Central Java


(Procurement of goods)

5.2.2 Measure EE internal Baselines for 5 PDAMs and monitoring EE

reductions


(Field measurement)



Component B: Increase Energy Efficiency


5.2.3 Supervise installation of pump equipment for two PDAM in West Java

and two in Central Java



5.2.4 Energy Efficiency Audit and foundational EE training for PDAM Kota

Magelang.


(Field measurement)

5.2.5 Procure and install pump equipment for PDAM Kota Magelang. Categorical Exclusion

(Procurement of goods)

5.2.6 Staff Training and SOP on Pumping O&M Categorical Exclusion


5.2.7 Validate GHG factor and determine GHG emission reduction Categorical Exclusion


5.2.8 PBG support to complete PBG baseline and RC Categorical Exclusion

(Meeting)

Component C: Capacity Building


5.3.1 Finalization of National Roadmap for Capacity Building Categorical Exclusion


5.3.2 Develop PDAM Training Centre Categorical Exclusion


5.3.3 Prepare occupancy mapping Categorical Exclusion


5.3.4 Development of Videos on SPAM system Categorical Exclusion


5.3.5 Development of Web-based GIS Mapping Application Categorical Exclusion

(Study)

5.3.6 Development of Concept PDAM Decree of B-to-B Cooperation Categorical Exclusion

(Study)

5.3.7 Training implementation and training monitoring (PIAP) Categorical Exclusion


5.3.8 Develop four competence- based training modules Categorical Exclusion

(Study)

5.3.9 Develop SOP on finance / admin and technical topics Categorical Exclusion

(Study)

5.3.10 Review and update PDAM Business Plan Categorical Exclusion

(Study)

2.7 LOCAL SUSTAINABILITY AND INNOVATION COMPONENT (LSIC)

The LSIC provides an opportunity to push the boundaries of WASH programming in Indonesia through

the engagement of a diverse set of stakeholders in open innovation approaches that build local capacity.

LSIC will use a mix of grants, subcontracts, special activities and in-kind mechanisms to incentivize

Indonesia’s private sector and universities to take risks, stimulate innovation, and deliver sustainable

solutions to significant WASH sector challenges, through:



• Grant prizes to entities that solve WASH challenges. These could involve partnerships

between city governments or PDAMs and private companies, NGOs, and/or universities that

address critical challenges in WASH. Examples of grant award are development of sustainable

Master Meter systems and prototypes for septic tank upgrade.

• Subcontract awards that test sustainable WASH service models to expand access,

particularly to the urban poor. These subcontracts will support the preparation and piloting of

service models that are poor-inclusive and address key service gaps. Examples of subcontract

award are septage management program and development marketing strategy for wastewater

operators.

• Special activities/events for promoting LSIC or generating new ideas and approaches.

An activity or event will only be used in association with a broader LSIC initiative and in cases

where it is more appropriate for USAID IUWASH PLUS to implement it itself, rather than through

a third party. Examples of such activities or events include stakeholder engagement and capacity

building for WASH partners/stakeholders.

In accordance with the revised LSIC Implementation Guidelines and Plan, the following are the likely-

hood of an environmental determination under LSIC Program:

Grants (3.1) and Subcontract (3.2) can be categorized into:

• Categorical Exclusion, if the activity has no environmental impact.

• Categorical Negative Determination with Condition, if there are acceptable impacts if conditioned

that required to develop ERR

Event or activities (3.3) can be categorized into:

• Categorical Exclusion, it is not required to develop ERF

• Categorical Negative Determination with Condition, any events or activities that might have

acceptable impacts if conditioned are required to develop Standard Operating Procedure (SOP)

The following table categorizes the types of initiatives funded through grants and/or fixed price

subcontracts under the auspices of the LSIC. The activities and IEE determinations for LSIC are as

follows, but not limited:


6.1 Finalization of Upgrading Septic Tank in Kota Medan and Kab.

Deli Serdang

Negative Determination with Condition (Field

activities)

6.2

Finalization of Spring Vulnerability Assessment (KKMA) Capacity Development for Akatirta (baseline collection of

water quality & quantity)


(Field activities)

6.3 Continue strengthening FORKALIM as National Association for

Domestic Waste Water Operators


(Training/Workshop)

6.4 Implementation of PD PAL Jaya Marketing Strategy and Action

Plan


(Training/Workshop)

6.5 Finalization of Capacity building for NRW Reduction & Energy

Efficiency Categorical Exclusion


6.6 Engaging private desludging companies to increase safely-

managed sanitation access (LLTT) Negative Determination with Condition

(Field activities)




6.7 Finding effective approach and incentive to serve B40 by

PDAMs Categorical Exclusion

(Training/Workshop)

6.8 Develop technology options on sludge dewatering for

'challenging areas' Negative Determination with Condition

(Field activities)

6.9 Building capacity of PDAMs for implementing NRW reduction Negative Determination with Condition

(Field activities)

6.10 Building capacity of PDAMs for improving energy efficiency Negative Determination with Condition

(Field activities)

6.11 Pilot for implementing the adjusted WSP (RPAM) framework

and approach

Categorical Exclusion (Study and Workshop)

6.12 Building capacity of LGs in sustaining water recharge initiative

through infiltration ponds Negative Determination with Condition

(Field activities)

6.13 Enhancing Capacity Building Program for PDAM through E-

learning under BTAM Categorical Exclusion


6.14 Facilitate harmonization of regulations and tariff among

wastewater operators (PD & UPTD) in Jabodetabek



6.15 Building capacity of BDS as provider for WASH entrepreneurs

and be part of sanitation supply chains


(Training/Workshop)



3 THE USAID IUWASH PLUS EMMP

As described in Section 2, and while USAID IUWASH PLUS primarily carries out activities that are

recommended for Categorical Exclusion, it also oversees small grants and contracts related to the

construction of small-scale, community-based water supply and sanitation systems. These activities

include civil works such as for individual and communal latrines and septic tanks, Master Meter water

supply systems, small above-ground water reservoirs, desludging services, or infiltration wells. These

activities are classified as having a “Negative Determination with Conditions”. For each such activity,

and as detailed in the table below, USAID IUWASH PLUS has identified potential adverse

environmental impacts, and the steps the IUWASH-PLUS team will take to mitigate these risks and

monitor and report on the results.

For each identified risk and associated set of mitigation actions, the USAID IUWASH PLUS team, prior

to implementation of activities, carries out an activity screening using an Environmental Review Form

(ERF) and completes an Environmental Review Report (ERR). These documents are incorporated into

the project’s Technical Assistance Management Information System (TAMIS). The project team

monitors and reports on the results of its mitigation actions using the Environmental Mitigation and

Monitoring Report (EMMR) that team members fill out on an on-going basis. The format of the EMMR

is also incorporated into TAMIS and each designated environmental officer in each region completes the

report on a quarterly basis.

Importantly, special mention needs to be made of work related to the development engineering

feasibility studies (FS) and detailed engineering designs (DEDs) which has been added as an activity

category in the EMMP (under both Water Supply and Sanitation sections in the table below). In brief,

and based on the request of partner agencies and programs, USAID IUWASH PLUS may provide

support the development of FS / DEDs which aids both program partners that often have limited

technical capacity to undertake such work, as well as USAID IUWASH PLUS itself in light of its efforts

to leverage funding from other agencies and programs. While in and of themselves FS / DEDs do not

generate environmental impacts, civil works that may be contracted based on such FS / DEDs most

certainly can.

In response to the above, USAID IUWASH PLUS will endeavor to ensure that such works are based on

environmentally sound design principles and that contracts issued to service providers for such works

require the review of potential environmental impacts and mitigation measures, and that estimated

budgets reflect the cost of compliance. Note further that USAID IUWASH PLUS will work with its GOI

partners to ensure, to the extent possible, that their own compliance requirements are properly

addressed. In the case of GOI-financed projects, such requirements are principally set forth in:

1. Minister of Environment Regulation No. 05 of 2012 regarding when Environmental Impact

Analyses (“EIA” or Analisis Mengenai Dampak Lingkungan Hidup, “AMDAL”) are required; and

2. Minister of Environment Regulation No. 13 of 2010 regarding environmental management

(Upaya Pengelolaan Lingkungan or “UKL”), environmental monitoring (Upaya Pemantauan

Lingkungan or “UPL”) and environmental management capacity (as reflected in the Surat

Pernyataan Pengelolaan Lingkungan or “SPPL”).



USAID IUWASH PLUS Environmental Mitigation and Monitoring Plan for Water Supply

Type of

Activity

Activity

Category Activity Potential Adverse Impact

Mitigation

Measure(s)

Monitoring

Indicator(s)

Monitoring, Reporting

Frequency/ Parties

Responsible

No

Screening

WATER SUPPLY

Institutional

Water

Supply

System

(PDAM)

Raw Water

Extraction

Raw water

Intake from

river

• Sedimentation

• Water conflict

• Contamination of ground or

surface water when hazardous construction materials are

spilled of dumped

• Use Gabion construction

• Designed by qualified Civil

Engineers

• Socialization before

construction

• No sedimentation in water

body

• Labor-based constructed

gabions or rip-rap and well supervised by qualified Civil

Engineers

• Construction supervised by

qualified water engineers.

• Community Organization, Local government monitoring

and reporting quarterly/Community and

respective local government

units

NA

Spring Capture • Erosion and Sedimentation

• Water conflict

• Contamination with polluted surface water entering water

source

• Diversion of ground water

flow decreasing water discharge at other water

sources nearby

• Socialization before and after

construction

• Construction of embankments to divert water run-off

entering water source

• Construct alternative intakes

for communities to have access

to clean water

• Protection zones developed

• Not over used and well

maintained

• Stable water discharge

• No conflict on water use

among communities

• Embankment constructed to

protect water source from

pollution

Monitoring and reporting by

community and water utility

and respective local

government by quarter

NA

Spring

Protection

Water quality

and quantity

monitoring

• Incident due to improper use and discharge of

chemical/reagent

• Use protective equipment

• Develop SOP for use and

discharge of equipment

• No incident for the user and no pollution to the

environment

Monitoring and reporting by the

participants during the event

2.4.1

6.2

Infiltration

ponds

construction

• Erosion and Sedimentation

• Stagnant water due to clogging

at inlet

• Overflowing due to poor

maintenance

• Correct land-fill, compaction,

and layering of materials

• Establish community caretaker

group


construction

• No erosion and sedimentation


• No water inundation


community and respective local


2.4.3

2.4.4

6.12

Transmission

Pipe

Piping and

fitting

Installation

• Erosions and Sedimentation

• Land Conflict

• Create pools of stagnant water

due to poor construction


construction

• Land-fill done correctly and

compacted according to

standard

• Transmission pipe well placed

and constructed

• Tranches dug and filled

according to engineering

standard


experienced technicians from

water utility, the contractor on

quarterly basis

NA




Type of

Activity

Activity


Mitigation

Measure(s)

Monitoring

Indicator(s)


Frequency/ Parties

Responsible

No

Screening

• Potential collapse of pipe due

to faulty engineering material

• Clogging of pipe

• Pipe well coated to protect

from corrosion

• Pipes well joints and no leakage

• No other construction on top

of the pipe line

• No water contamination from

faulty engineering

Water

Production

Units

Water

Treatment

Plant

• Land conflict

• Erosion and sedimentation

• Contamination of nutrients,

pathogens and excreta

(diarrheal and parasitic)

• Noise during construction

• Construction implemented by

certified engineers

• Community well informed

prior to construction

• Foundation and embankments

constructed according to

specification

• No standing water

• Water quality in accordance to

standard


• Monitoring and reporting by experienced technicians on

quarterly basis

Ground

Reservoir and

Supporting

Building

• Land conflict


• Contamination of nutrients, pathogens and excreta

(diarrheal and parasitic)

• Noise during construction

• Construction implemented by

certified engineers



• Foundation and embankments constructed according to

specification

• No standing water


standard



quarterly basis

Mechanical &

Electrical

Equipment

• Noise pollution

• Electricity hazard


construction



• Pump site well organized and

maintained

• Standard Operation Procedures (SOP) developed

and used in operating and maintenance of electric pump

and structure


community organization quarterly

5.2.2

Energy

Efficiency

• Noise pollution



construction




maintained


and used in operating and maintenance of electric pump

and structure



2.1.2

5.2.2.

6.10

Water

Distribution

Distribution

Pipe laying and

accessories

• Erosions and Sedimentation

• Land Conflict

• Contamination of ground or surface water from erosion to

nearby water sources.

• materials are spilled of

dumped


construction

• Construction base on specification and use less toxic

alternative product

• Distribution pipe well placed

and constructed


of the pipe line

• No leakage at pipe connection

• Monitoring and reporting by experienced technicians from water utility, the contractor on

quarterly basis, including

photos

2.1.2

5.1.2

5.1.3

6.9




Type of

Activity

Activity


Mitigation

Measure(s)

Monitoring

Indicator(s)


Frequency/ Parties

Responsible

No

Screening

• Damage to ecosystem and

degradation of surface water

quality







standard

• Pipe well coated to protect

from corrosion

Water

services unit

Installation of

customer

connection

• None • Installation done by certified

plumbers

• Meter function normally as

standard


quarterly basis

2.1.2

5.1.6

Non

Revenue

Water

Main water

mater

installation in

production unit

• None • Construction and installation

base on specification

• Construction and/or

maintenance conducted by experienced

engineers/technicians

• Main water meter at correct

place


quarterly basis

2.1.2

5.1.2

5.1.3

6.9

District Meter

Area (DMA)

• None • Construction base on

specification

• Construction and/or maintenance conducted by

experienced

engineers/technicians

• District meter area at correct

place


quarterly basis

2.1.2

5.1.7

5.1.8

6.9

Rehabilitation of

water

distribution pipe





• Socialization before stop flow

water

• Pipe rehabilitation base on

specification

• Land-fill done correctly and compacted according to

standard


and constructed


of the pipe line




photos

Energy

Efficiency

Improvement

of pump

performance

including

• Noise pollution



construction




maintained


and used in operating and



2.1.2

5.2.2

5.2.4

6.10




Type of

Activity

Activity


Mitigation

Measure(s)

Monitoring

Indicator(s)


Frequency/ Parties

Responsible

No

Screening

electrical

system

maintenance of electric pump

and structure

Community

based water

supply

Piping

system

Raw water

extraction

Spring capture • Sedimentation

• Water conflict

• Contamination of ground or

surface water when hazardous construction materials are

spilled of dumped

• Use Gabion construction

• Designed by qualified Civil

Engineers


construction

• No sedimentation in water

body

• Labor-based constructed

gabions or rip-rap and well supervised by qualified Civil

Engineers

• Construction supervised by

qualified water engineers.

• Community Organization, Local government monitoring

and reporting quarterly/Community and

respective local government

units

2.1.8

Deep well • Erosion and Sedimentation

• Water conflict

• Contamination with polluted surface water entering water

source

• Diversion of ground water flow decreasing water

discharge at other water

sources nearby


construction

• Construction of embankments to divert water run-off entering

water source

• Construct alternative intakes

for communities to have access

to clean water

• Protection zones developed

• Not over used and well

maintained


• No conflict on water use

among communities

• Embankment constructed to

protect water source from

pollution


community and water utility

and respective local


2.1.8

Water

Distribution

Distribution

Pipe laying and

accessories

including pipe

equipment

(blow off, valve,

etc.

• Materials are spilled of dumped





construction

• Pipe installation base on

specification



standard


and constructed


of the pipe line




photos

2.1.8

Simple water

treatment

Sedimentation

and Filtration

• In adequate installation


• Filter backwash

• Ensure adequate site selection

technology



• Communities are assured of their ownership and secure

community tenure rights


standard

• Community Organization

• Regular water quality check

2.1.8

Water

services unit

Installation of

customer

connection

• None • Installation done by certified

plumbers

• Meter function normally as

standard


quarterly basis

2.1.8

Engineer-

ing Support

All of the

above

Feasibility

Studies (FS)

and Detailed

• Lack of environmental compliance measures in civil works emanating from FS and

• Possible environmental threats

are identified in FS /DEDs.

• Mitigation measures are

identified in FS / DEDs, and

• Monitoring measures as identified above are integrated into contracts for civil works

emanating from FS and DEDs.

• Recommended monitoring and reporting will be established within each FS /DED, as well as

responsible parties.

All the

above




Type of

Activity

Activity


Mitigation

Measure(s)

Monitoring

Indicator(s)


Frequency/ Parties

Responsible

No

Screening

Engineering

Designs

(DEDs)

DEDs can lead to adverse

impacts as identified above.

fully accounted for in estimated

budgets.



USAID IUWASH PLUS Preliminary Environmental Mitigation and Monitoring Plan for Sanitation

Type of

Activity

Activity


Mitigation

Measure(s)

Monitoring

Indicator(s)

Monitoring,

Reporting

Frequency/ Parties

Responsible

No

Scre

en

in

g

SANITATION

Off-site

sanitation

system

City wide

sewerage

system

Sewage pipe

system

• Traffic disrupted

• Erosions and change of land surface

• Land conflict

• Contamination of ground or surface water

when pipes leak

• Odorous nuisance and/or increase in insect

and flies.

• Potential collapse of pipe due to faulty

engineering, material and/or misuse of land


construction

• Construction base on specification

• Avoid heavy construction built on

top of pipe

• Avoid plants growing near sewer

pipes

• Provide sewer pipe sign

• Socialization done prior to

construction or rehabilitation

• No leakage

• Proper safety signs installed

• Sewer pipes clear from

grease, tree roots and other

blockage conducted

• Monitoring and reporting by experienced engineers

on quarterly basis

customer

connections

wastewater

• Land and social conflict

• Change of land surface



• Pipe clogging

• Socialization before construction



top of pipe

• Place sign of pipe location

• Sign of pipe location correctly

place

• No leakage and stagnant of

water

• Monitoring and reporting by experienced

technicians on

quarterly basis

Small scale

sewerage

system

Sewage pipe

system

• Traffic disrupted


• Land conflict

• Contamination of ground or surface water

when pipes leak


and flies.




construction



top of pipe

• Avoid plants growing near sewer

pipes

• Provide sewer pipe sign



• No leakage


• Sewer pipes clear from

grease, tree roots and other

blockage conducted


on quarterly basis

wastewater

treatment

plant (IPAL

Kawasan)


• Land conflict

• Contamination of ground water with

bacterial and biochemical pollutants

• Contamination of the in-pipe and end-pipe

pollution prevention


and flies.

• Non aesthetic


construction

• Embankments well-constructed

• Regular testing of ground water

quality

• Testing of in-pipe and end-pipe

pollution prevention

• Reducing odor problem

• Landscaping



• No leakage


• Drainage and buffer zone well

maintained

• There are well trained staff

for operating and maintaining

the plant


on quarterly basis




Type of

Activity

Activity


Mitigation

Measure(s)

Monitoring

Indicator(s)

Monitoring,

Reporting

Frequency/ Parties

Responsible

No

Scre

en

in

g

customer

connections

wastewater

• Land and social conflict



• Pipe clogging

• Socialization before construction


• Sign of pipe location correctly

place

• No leakage and stagnant of

water

• Monitoring and reporting by

experienced technicians on

quarterly basis

On-site

sanitation

system

Communal

sanitation

Septic Tank

Communal,

• Contamination of ground or surface water from overflow of waste with nutrients,

pathogens, BOD and suspended solid (SS)


and flies.

• Methane Gas Explosion Risk/Fire Risk



• Periodic measurement of the

combined sludge and scum depth

• High vent pipes are used

• Effluent screen checks regularly

• Keep clean site

• Adequate SOP and training for

operator

• Communal septic tank

function normally

• No odor

• Sludge removal follow SOP

• Compound clean.

• Record kept well.


on quarterly basis

2.2.9

6.1

Individual

sanitation

New/upgradi

ng septic

tank


• Land conflict

• Sedimentation

• Contamination of ground or surface from

leakage of septic tank


and flies.

• Possible wastewater/by product run off

• Methane Gas Explosion Risk/Fire Risk

• Pathogens remain immature due to

insufficient time for maturity of compost



• Evaluate dept to the water table including seasonal fluctuations and

ground water hydrology

• Ensure a reliable system for safe

sludge removal and transportation

• Ensure that collected sludge is adequately treated and not directly

apply to field

• Sites for septic tanks and drainage fields must be a minimum of 10 m

from any groundwater sources

• Septic tank function normally

• No odor

• No spilling during sludge

removal

• Monitoring and reporting by

experienced engineers

on quarterly basis

2.2.9

6.1

6.6

Fecal Sludge

Management

Desludging

and

transportatio

n to IPLT

• Contamination of ground water with

bacterial and biochemical pollutants


and flies.

• Non aesthetic


desludging

• Reducing odor problem


desludging

• No leakage



on quarterly basis

2.2.9

6.6

6.8




Type of

Activity

Activity


Mitigation

Measure(s)

Monitoring

Indicator(s)

Monitoring,

Reporting

Frequency/ Parties

Responsible

No

Scre

en

in

g

IPLT

construction


• Land conflict

• Contamination of ground or surface from

leakage of septic tank

• Pathogens remain immature due to

insufficient time for maturity of compost

• Potential collapse of pipe or construction due to faulty engineering, material and/or

misuse of land

• Evaluate dept to the water table including seasonal fluctuations and

ground water hydrology

• Ensure a reliable system for safe

sludge removal and transportation

• Ensure that collected sludge is

adequately treated and not directly

apply to field

• IPLT function normally

• No odor

• No spilling during sludge

removal


on quarterly basis

Engineer-

ing Support

All of the

above

Feasibility

Studies (FS)

and Detailed

Engineering

Designs

(DEDs)

• Lack of environmental compliance measures in civil works emanating from FS and DEDs

can lead to adverse impacts as identified

above.

• Possible environmental threats are

identified in FS /DEDs.

• Mitigation measures are identified in

FS / DEDs, and fully accounted for in

estimated budgets.

• Monitoring measures as identified above are

integrated into contracts for civil works emanating from FS

and DEDs.

• Recommended monitoring and

reporting will be established within

each FS / DED, as well

as responsible parties.

All the

above

INDONESIA URBAN WATER SANITATION AND HYGIENE PENYEHATAN LINGKUNGAN UNTUK SEMUA (IUWASH PLUS)





3.1 PERSONNEL IMPLEMENTING THE EMMP

Implementing the EMMP requires that the USAID IUWASH PLUS team integrates environmental

analysis, planning and monitoring from activity planning through activity implementation. Through this

approach, the project is able to assist implementing partners comply with their requirements while

meeting those of USAID. As a field-oriented project, much of the responsibility for integrating

environmental analyses and monitoring into activity design falls to regional specialists with backup

support from USAID IUWASH PLUS Jakarta-based technical and M&E staff. Responsibilities of specific

staff are as follows:

Regional Specialists:

• Screening all proposed activities in their respective districts and cities during the initial planning

staff to identify any potential environmental impacts.

Completing the Environmental Review Forms (ERF) and with support from the regional

managers and Jakarta technical teams, define needed mitigation measures for low-risk and

moderate risk activities.

Reviewing the implementation of mitigation measures by local partners and the project to

improve performance.

Drafting required monitoring reports and participating in periodic reviews of compliance

with USAID environmental policy.

Tracking ongoing activities and archiving completed activities using the Environmental

Compliance module in TAMIS.

Regional Managers:

• Supporting Regional Specialists during the initial review of planned activities to ensure that activities

rated as low-risk and moderate-risk are properly identified and have completed ERFs.

• In collaboration with the Monitoring and Evaluation Associate, carry out periodic reviews of

USAID IUWASH PLUS supported activities to ensure the Field teams are following project

environmental review, mitigation and monitoring guidelines.

• Conduct due diligence of potential local implementing partners and grantees to define required

environmental monitoring technical assistance.

• Ensures IP agreements have complete environmental terms and compliance.

Deputy Chief of Party / Programs (DCOP/Programs):

• Supporting Regional Specialists and Regional Managers during the initial review of planned activities

to ensure that activities are properly screened and have completed ERFs.

• Participate in periodic reviews of USAID IUWASH PLUS supported activities to ensure that field

teams are following project environmental review, mitigation and monitoring guidelines.

• Mobilize technical expertise to support Regional Specialists and Regional Managers in their review

of planned activities and development of mitigation and monitoring activities.

• Lead assessments of potential national implementing partners and grantees in terms of their

internal environmental review, mitigation and monitoring processes.

• Review IP agreements have complete environmental terms and compliance.



Urban Senior Water Supply Specialist/Environmental Officer (USWSS/EO) will be responsible for:

• Managing overall environmental compliance implementation reporting to USAID.

• Reviewing initial screening and sub-activity categorization as completed by the Regional Specialists

and Regional Managers.

• Drawing on Jakarta–based technical staff to review and advise on all medium risk activities to

ensure subproject ERF and EMMP completeness and clears forms for submission to USAID for

approval.

• Providing training to regional and national staff in compliance system management and its specific

requirements.

3.2 EMMP PROCEDURES

To comply with USAID Regulation 216 and Indonesian environmental laws, USAID IUWASH PLUS with

support from USAID/MEO provides environmental compliance training workshop involving Regional

Specialists, Regional Managers, the DCOP, USAID IUWASH PLUS technical team members and the

Environmental Officer to review USAID’s environmental requirements and the process for identifying,

reviewing and integrating environmental mitigation and monitoring actions into activity designs and

implementation. USAID IUWASH PLUS has a comprehensive environmental management system

(EMS) that facilitates the team’s implementation of USAID environmental guidelines. Figure 1 below

shows the EMS process and is followed by the steps the USAID IUWASH PLUS team will follow in

complying with USAID’s Regulation 216 requirements.

Figure 1 - Environmental Management System



Step 1: Environmental Screening project funded by USAID

Step 1.1 During initial activity planning with local partners, identify those activities under each Task and Sub-Task using the initial screening guide above that will require more thorough environmental

reviews.

Step 1.2 Create activity in Environmental Compliance Module in TAMIS (see below)

Step 1.3 Determine activity type using ERF Step 3a (Annex 4) as applicable.

Step 1.4 Determine activity type and risk category as follows:

1. Categorical Exclusion (Risk Category 1): activities that do not have an effect on the natural or physical environment. Review Annex I: Screening Tool for Activities with No Foreseen Risk, if ALL sub-project activities meet one or more of the criteria in the

tool, no additional mitigation or monitoring ties are required. Proceed with activity.

2. Negative Determination (Risk Category 2): Activities with no significant adverse effects with normal good practices. Complete Environmental Review Form (ERF)

confirming negative determination and associated Environmental Review Report.

3. Negative Determination with Conditions (Risk Category 3): Activities with

potential adverse effects but which can be mitigated and monitored with normal good practices. Complete Environmental Review Form (ERF) confirming negative determination and associated Environmental Review Report. Develop activity EMMP

incorporating applicable lines from USAID IUWASH PLUS Project Environmental Mitigation, Monitoring and Reporting Plan (EMMP). Submit for USAID/Indonesia MEO

for approval.

4. Positive Determination, High Risk Activities (Risk Category 4): Activities for high potential for adverse biophysical or health impacts. Activity will require IEE

Amendment, Environmental Assessment or Environmental Impact Statement. Activity will require Bureau Environmental Officer (BEO), Agency’s Environmental

Coordinator, and the Office of General Counsel approval.

Note – we do not anticipate carrying out activities considered high risk under USAID IUWASH

PLUS

Step 1.5 Develop activity EMMP and Activity ERF per ERF instructions

Step 1.6 Prior to obligating any USAID funds, USAID Environmental Officer’s approval of the determination and threshold decisions as determined for those activities in Risk Categories 2,

3 and 4 will be submitted to the COR and Mission Environmental Officer (MEO) for approval.

Step 1.7 Incorporate EMMP and Activity ERF mitigation measures in implementing partner agreement, or

grant using model language (see Annex)

Step 2: Environmental Mitigation and Monitoring project funded by USAID

Step 2.1 Review mitigation measures, responsibilities for implementation, responsibilities for monitoring

with implementing partners and/or beneficiaries.

Step 2.2 Monitor implementation of mitigation measures as described in the activity EMMP.

Step 2.3 Periodic review of implementation of mitigation measures.

Step 2.4 Activity EMMP Report filled. Reported to USAID quarterly while activities are ongoing and at

activity completion. Process data for reports.

Step 2.5 At completion of activity, complete activity EMMP in TAMIS and mark activity as completed.

If during the course of USAID IUWASH PLUS implementation there are activities that are outside the

scope of the two documents mentioned above, the project will coordinate with the USAID to develop

a respective “individual IEE”. USAID IUWASH PLUS will not undertake new activities before receiving

written USAID approval of environmental documentation amendments. All proposed activities planned



to be implemented fall under either categorical exclusion and/or negative determination with conditions

as defined in the USAID rules and regulation 22 CFR 216. The proposed activities under the USAID

IUWASH PLUS project in are further distinguished between activities that are related to increasing safe

drinking water supply and those that are aimed at increasing access to improved sanitation.

Water Supply: The activities include protection of raw water, narrow tranches for small diameter

pipe installations, water production, water distribution, and water connection services. The sub-

activities will include:

• Raw Water: Supporting improved quality and quantity of raw water distribution, the project

will ensure that the local government, the private sector and water utilities will improve the

watershed area with tree planting, installation of infiltration wells, protection of springs, well

designed small scale below and/or above ground reservoirs. It might also be with small-scale

construction of river cascade, protection of pollutant to river flow and ground water, bore

wells and pumps.

• Pipe Installation: The digging, earth fill and compaction of small tranches for the installation of

transmission pipes and distribution pipes (including water meters) to deliver safe drinking water

to poor household to improve quality of life. The project will assist partners in the planning and

design and ensure that the installations are done according to the Indonesia National Standard

(SNI).

• Water Production: The project will implement activities that will have an impact to better

quality, quantity, and continuity of water production through capacity building and better

management of the water boards (PDAMs) such as training in Non-Revenue Water, facilitating

of Energy efficiency, business plan development and O&M Management. USAID IUWASH PLUS

will directly support activities such as the construction of water treatment plants, water

chlorination and filtration. These types of activities will be financed and implemented by USAID

IUWASH PLUS partners – either PDAMs or their respective local governments.

• Water Distribution: USAID IUWASH PLUS will be involved in the distribution of water from

the PDAM master meter to households or PDAM direct connection via the microfinance

mechanism. Included are also the installation of water taps and water meter at household level.

• Services: Improving services to customers through water meter calibration, water meter

replacement, pipe and water meter replacement, and improving billing system and payment

points.

Sanitation: The activities include planning, designing, construction and maintenance of city-wide

sanitation systems, communal sanitation systems and individual sanitation systems.

• City-wide Sanitation System: Assisting the local government with the support of other

private sector partners and community in the planning, design, construction of pipe laying,

sewerage system, waste water treatment plan and management. Ensuring best environmental

practices in using high pressure flushing equipment that are safe for the environment.

• Settlement Scale Sanitation System: Developing communal septic tanks, sludge

management, MCK ++ (Bath, Laundry and Toilet Central) including digesters and bio-gas

distribution, installing hand-washing stations, water pipe laying, and de-sludge management.

• Individual Sanitation System: Improving septic tanks, latrines, and sludge management.



EVALUATION OF ACTIVITIES FOR ENVIRONMENTAL IMPACT POTENTIAL RECOMMENDED

THRESHOLD DECISIONS AND MITIGATION ACTIONS (INCLUDING MONITORING AND

EVALUATION)

1. All activities that are recommended for categorical exclusion are within the scope of the

approved IEE referenced as Asia 15-061 Indonesia IEE & ETD USAID IUWASH PLUS Project

and will not be repeated in this document.

2. USAID IUWASH PLUS activities involving field studies and other actions that directly effecting

the physical or natural environment, including small-scale water and sanitation improvement

and/or construction are expected to have some negative impacts on the natural or physical

environment and are therefore recommended for a Negative Determination with condition

under 22 CFR 216.3(a)(2)(iii). The related Environmental Monitoring and Mitigation Plan

is attached to this IEE.

RECOMMENDED ENVIRONMENTAL ACTION

Recommended IEE Determination

A Negative Determination with Condition under 22 CFR 216.3(a)(2)(iii) is recommended for small-scale

water and sanitation improvement and/or construction work, field studies or other actions that are

determined to have a direct impact on the natural or physical environment. The Environmental

Monitoring and Mitigation Plan for such activities is described in the attachment.

The Contractor will refer also to host country (Indonesia) environmental regulations (UU 32/2009

covering Environmental Management) unless otherwise directed in writing by USAID. In case of conflict

between host country and USAID regulations, the latter shall govern. A summary of the host country

environmental policies and procedures is described below.

National Environmental Policies and Procedures

GOI environmental mitigation and management requirements are principally set forth in: 1) Minister of

Environment Regulation No. 05 of 2012 regarding when Environmental Impact Analyses (“EIA” or

Analisis Mengenai Dampak Lingkungan Hidup, “AMDAL”) are required; and 2) Minister of Environment

Regulation No. 13 of 2010 regarding environmental management (Upaya Pengelolaan Lingkungan or

“UKL”), environmental monitoring (Upaya Pemantauan Lingkungan or “UPL”) and environmental

management capacity (as reflected in the Surat Pernyataan Pengelolaan Lingkungan or “SPPL”).

Broadly speaking, GOI regulations require that any plan which is foreseen to bring about significant

adverse impacts to the environment must be accompanied by an environmental analysis. Significant

adverse impact is determined by the size of population affected, size of the area disturbed, duration of

impact, intensity of impact and reversibility and irreversibility of the impact. A preliminary

environmental assessment is required for activities involving: modification of soil features and natural

environment; exploitation of natural resources; a process that affects natural or cultural reserves;

introduction of new species; or technological applications foreseen to have considerable potential to

affect the environment.

In each USAID IUWASH PLUS region, the project works closely with officials from various

departments to achieve the USAID IUWASH PLUS Project targets. Experts or specialists in related

disciplines from the local provincial or district government and/or technical consultants from local



universities are involved in the planning and evaluation of project activities as well as training of staff

beneficiaries. This ensures that all Indonesian environmental policies and procedures are followed.



ANNEX

ANNEX 1: INSTRUCTIONS FOR USING THE USAID IUWASH PLUS PROJECT

ENVIRONMENTAL REVIEW FORM

Who must submit the Environmental Review Form (ERF)? All Implementing Partners seeking

to implement activities under the USAID IUWASH PLUS Project must complete, sign and submit the

ERF to USAID IUWASH PLUSTOCOR.

Authority: Use of the ERF for these activities is mandated by the governing Initial Environmental

Examination (IEE) for the USAID IUWASH PLUS Project.

No implementation without an approved ERF. The proposed activities cannot be implemented

and no "irreversible commitment of resources" for these activities can be made until the ERF (including

Environmental Review Report, if required, see Step 4, below) is cleared by the TOCOR, the Mission

Environmental Officer (MEO) and the Regional Environmental Advisor (REA).

NOTE: USAID may deny clearance to the ERF, or may require modification and re-submission for

clearance.

Environmental management requirements resulting from the ERF. If the ERF requires

preparation of an Environmental Mitigation and Monitoring Review (EMMR) report (see Step 4, below),

any environmental mitigation measures specified in the approved EMMR must be implemented.

Situations in which additional environmental review is required. If the ERF finds that one of

more of the proposed activities has the potential to cause significant adverse environmental

impacts, the activities must be redesigned or an IEE or full Environmental Assessment must be

conducted and approved prior to implementation. If USAID determines that the proposed activities are

outside the scope of activities for which use of this form is authorized, the activities must be redesigned

or an IEE or IEE Amendment will be required. In either situation, USAID will confer with the partner to

determine next steps.

Note: If an IEE or EA is required, all environmental management measures specified in the IEE or EA

must then be implemented.

Step 1. Provide requested "Applicant information"(Section A of the ERF)

Step 2. List all proposed activities. In Section B of the form, list all proposed activities.

Activities are a desired accomplishment or output: e.g. seedling production, road rehabilitation, school

construction. Each activity has entailed actions-for example, road rehabilitation includes survey, grading,

culvert construction, compaction, etc. Be aware of these entailed actions, but do NOT list them.

Provide detailed descriptions for each activity. For example, "training" is not a sufficient activity listing.

The listing must specify WHO is being trained, and in WHAT.



Step 3a. Screening to identify low-risk and high-risk activities. For each

activity you have listed in Section B of the form, refer to the list below to determine whether it is a

listed low-risk or high-risk activity. If an activity is specifically identified as "very low risk" or "high risk"

in the list below, indicate this in the "screening result'' column in Section B of the form.

Very low-risk activities (Activities with low potential for adverse biophysical or health impacts; including §216.2(c)(2))

High-risk activities (Activities with high potential for adverse biophysical or health impacts; including §216.2(d)(1))

• Provision of education, technical assistance, or training. (Note that activities directly affecting the

environment. do not qualify.) • Community awareness initiatives. • Controlled agricultural experimentation exclusively

for the purpose of research and field evaluation confined to small areas (normally under 4 ha./10 acres). This must be carefully monitored and no

protected or other sensitive environmental areas may be affected).

• Technical studies and analyses and other

information generation activities not involving intrusive sampling of endangered species or critical habitats.

• Document or information transfers. • Nutrition, health care or family planning, EXCEPT

when (a) some included activities could directly

affect the environment (construction, water supply systems, etc.) or (b) biohazardous (esp. HIV/AIDS) waste is handled or blood is tested.

• Small-scale construction. Construction or repair of

facilities if total surface area to be disturbed is under 10,000 sq. ft. (approx. 1,000 sq. m.) (and when no protected or other sensitive

environmental areas could be affected).

• River basin development • New lands development

• Planned resettlement of human populations. • Penetration road building, or rehabilitation of roads

(primary, secondary, some tertiary) over 10 km

length, and any roads which may pass through or near relatively undegraded forest lands or other sensitive ecological areas

• Substantial piped water supply and sewerage construction.

• Major bore hole or water point construction.

• Large-scale irrigation; Water management structures such as dams and impoundments

• Drainage of wetlands or other permanently flooded

areas. • Large-scale agricultural mechanization. • Agricultural land leveling.

• Procurement or use of restricted-use pesticides, or wide-area application in non-emergency conditions under non-supervised conditions. (Consult MEO.)

• Light industrial plant production or processing (e.g.,

sawmill operation, agro-industrial processing of forestry products, tanneries, cloth-dying operations).

• Intermediate credit. Support for intermediate credit arrangements (when no significant biophysical

environmental impact can reasonably be expected). • Maternal and child feeding conducted under Title II

of Public Law 480.

• Title II Activities. Food for development programs under Title III of P.L. 480, when no on-the-ground biophysical interventions are likely.

• Capacity for development. Studies or programs intended to develop the capability of recipients to engage in development planning. (Does NOT

include activities directly affecting the environment) • Small-scale Natural Resource Management activities

for which the answer to ALL SUPPLEMENTAL

SCREENING QUESTIONS (see Natural Resources supplement) is “NO.”



High-risk and typically not funded by USAID

Actions affecting protected areas and species. Actions determined likely to: (1) significantly degrade protected areas, such as introduction of exotic plants or animal, and (2) jeopardize threatened and endangered species or adversely modify their habitat (esp. wetlands, tropical forests)

Activities in forests, including:

• Conversion of forest lands to rearing of livestock • Planned colonization of forest lands

• Procurement or use of timber harvesting equipment • Commercial extraction of timber • Construction of dams or other water control structures that flood relatively undegraded forest lands

• Construction, upgrading or maintenance of roads that pass through relatively non-degraded forest lands. (Includes temporary haul roads for logging or other extractive industries

(This list of activities is taken from the text of 22 CFR 216 and other applicable laws, regulations and

directives)

Step 3b. Identifying activities of unknown or moderate risk. All activities

NOT identified as “very low risk” or “very high risk” are considered to be of “unknown or moderate

risk.” Common examples of moderate-risk activities are given in the table below. Check “moderate or

unknown risk” under screening results in Section B of the form for ALL such activities.

Common examples of moderate-risk activities

CAUTION: If ANY of the activities listed in this table may adversely impact (1) protected areas, (2)

other sensitive environmental areas, or (3) threatened and endangered species and their habitat,

THEY ARE NOT MODERATE RISK. All such activities are HIGH RISK ACTIVITIES.

Small-scale agriculture, NRM, sanitation, etc.

(You may wish to define what “small scale” means

for each activity)

Agricultural experimentation. Controlled and

carefully monitored agricultural experimentation

exclusively for the purpose of research and field

evaluation of MORE than 4 ha.

NOTE Biotechnology/GMOs: No biotechnology

testing or release of any kind are to take place within

an assisted country until the host countries

involved have drafted and approved a regulatory

framework governing biotechnology and biosafety.

All USAID-funded interventions which involve

biotechnologies are to be informed by the ADS 211

series governing "Biosafety Procedures for Genetic

Sampling. Technical studies and analyses or

similar activities that could involve intrusive

sampling, of endangered species or critical

habitats. (Includes aerial sampling.)

Water provision/storage. Construction or

rehabilitation of small-scale water points or

water storage devices for domestic or non-

domestic use. Water points must be located

where no protected or other sensitive

environmental areas could be affected.

NOTE: USAID guidance on water quality

requires testing for arsenic, nitrates, nitrites

and coliform bacteria.



Common examples of moderate-risk activities

CAUTION: If ANY of the activities listed in this table may adversely impact (1) protected areas, (2)

other sensitive environmental areas, or (3) threatened and endangered species and their habitat,

THEY ARE NOT MODERATE RISK. All such activities are HIGH RISK ACTIVITIES.

Engineering Research". In particular, this guidance

details the required written approval procedures

needed before transferring or releasing GE

products to the field.

Medium-scale construction. Construction or

rehabilitation of facilities or structures in which the

surface area to be disturbed exceeds 10,000 sq. ft

(1000 sq. meters) but funding level is $200,000 or

less. (E.g. small warehouses, farm packing sheds,

agricultural trading posts, produce market centers,

and community training centers.)

Rural roads. Construction or rehabilitation of

rural roads meeting the following criteria:

• Length of road work is less than ~10 km

• No change in alignment or right of way

• Ecologically sensitive areas are at least 100 m

away from the road and not affected by

construction or changes in drainage.

• No protected areas or relatively un-degraded

forest are within 5 km of the road.

Title II & III Small-Scale Infrastructure. Food

for Development programs under Title II or III,

involving small-scale infrastructure with the known

potential to cause environmental harm (e.g., roads,

bore holes).

Quantity imports of commodities such as fertilizers

Support for intermediate credit

institutions when indirect environmental

harm conceivably could result.

Institutional support grants to

NGOs/PVOs when the activities of the

organizations are known and may reasonably

have adverse environmental impact.

Pesticides. Small-scale use of USEPA-

registered, least-toxic general-use pesticides.

Use must be limited to NGO-supervised use

by farmers, demonstration, training and

education, or emergency assistance.

NOTE: Environmental review (see step 5)

must be carried out consistent with USAID

Pesticide Procedures as required in Reg. 16 [22

CFR 216.3(b)(1)].

Nutrition, health care or family planning,

if (a) some included activities could directly

affect the environment (e.g., construction,

supply systems, etc.) or (b) bio-hazardous

healthcare waste (esp. HIV/AIDS) is produced,

syringes are used, or blood is tested.

Step 4. Determine if you must write an Environmental Review Report.

Examine the “screening results” as you have entered them in Table 1 of the form.

i. If ALL the activities are “very low risk,” then no further review is necessary. In Section C of

the form, check the box labeled “very low risk activities.” Skip to Step 8 of these instructions.

ii. If ANY activities are “unknown or moderate risk,” you MUST complete an

ENVIRONMENTAL REVIEW REPORT addressing these activities. Proceed to Step 5.

iii. If ANY activities are “high risk,” note that USAID’s regulations usually require a full

environmental assessment study (EA). Because these activities are assumed to have a high

probability of causing significant, adverse environmental impacts, they are closely scrutinized.



Any proposed high-risk activity should be discussed in advance with USAID. Activity re-design

is often indicated.

In some cases, it is possible that reasonable, achievable mitigation and monitoring can reduce or

eliminate likely impacts so that a full EA will not be required. If the applicant believes this to be the case,

the Environmental Review Report must argue this case

The Environmental Review Report follows the outline below. Alternate outlines are acceptable, so long

as all required information is covered.

A. Summary of Proposal. Very briefly summarize background, rationale and outputs/results

expected. (Reference proposal, if appropriate)

B.Description of Activities. For all moderate and high-risk activities listed in Section B of the

ERF, succinctly describe location, siting, surroundings (include a map, even a sketch map). Provide both

quantitative and qualitative information about actions needed during all project phases and who will

undertake them. (All of this information can be provided in a table). If various alternatives have been

considered and rejected because the proposed activity is considered more environmentally sound,

explain these.

C.Site-specific Environmental Situation & Host Country Requirements. Describe the

environmental characteristics of the site(s) where the proposed activities will take place. Focus on site

characteristics of concern—e.g., natural ecosystems, animal habitats, steep slopes, etc. With regard to

these critical characteristics, is the environmental situation at the site degrading, improving, or stable?

Also note applicable host country environmental regulations and/or policies. (For example, does the

project require host country environmental review or permitting? Building approval? Etc.)

NOTE: provide site-specific information in this section, NOT country-level information.

D. Environmental Issues, Mitigation Actions, and Findings. For ALL proposed activities

i. Briefly note the potential environmental impacts or concerns presented by the proposed

activities (if any). For guidance, refer to Africa Bureau’s Environmental Guidelines for Small-Scale

Activities; available at www.encapafrica.org/egssaa.htm.

As per the Small-Scale Guidelines, consider direct, indirect and cumulative impacts across the activity

lifecycle (i.e. impacts of site selection, construction, and operation, as well as any problems that might

arise with abandoning, restoring or reusing the site at the end of the anticipated life of the facility or

activity). Note that “environment” includes air, water, geology, soils, vegetation, wildlife, aquatic

resources, historic, archaeological or other cultural resources, people and their communities, land use,

traffic, waste disposal, water supply, energy, etc.)

ii. Assess the extent to which these potential impacts and concerns are significant in the context

of the specific activity design and site.

iii. Set out the mitigation actions to be employed to address these issues.

Mitigation actions are means taken to avoid, reduce or compensate for impacts. Mitigation measures

must be reasonable and implementable by field staff. They should be consistent with the good practice

guidance provided in Africa Bureau’s Environmental Guidelines for Small-Scale Activities;

(www.encapafrica.org/egssaa.htm.) Cite this or other guidance used for mitigation design.

http://www.encapafrica.org/egssaa.htm

http://www.encapafrica.org/egssaa.htm



iv. Reach one of three findings regarding the potential impacts:

a. Significant adverse impacts are very unlikely. Of its nature, the activity in question is very

unlikely to result in significant, adverse environmental impacts. Special mitigation or monitoring is not

required.

Note: this conclusion is rarely appropriate for high-risk activities.

b. With implementation of the specified mitigation and monitoring, significant adverse impacts are very

unlikely.

c. Significant adverse impacts are possible. That is, it is not possible to rule out significant adverse

environmental impacts even given reasonable, attainable mitigation and monitoring.

In this case, USAID and the partner will consult regarding next steps. If the activity is to go forward in

its current form, additional analysis in the form of an IEE or EA will be required.

Format and structure of this section. Choose a format and structure that presents the necessary

information clearly and succinctly.

Table formats can be used. In the example below, the proposed activity was construction of an

institutional facility on a 7500m3 plot bisected by a seasonal stream providing drainage to the local area.

One potential impact of the activity was reduction of or alteration to the drainage eco-service provided

by the seasonal stream.

Issue or cause for

concern Analysis Finding and conditions/mitigation actions

The seasonal stream

running through the plot

drains an area of at least 2

km2 to the WNW.

Diminution or alteration

to this drainage “service”

could result in increased

upstream pooling &

flooding during the rainy

season, with associated

property damage and

increased breeding habitat

for disease vectors.

As indicated at left, this

impact only arises if the

drainage “service”

provided by the seasonal

stream is diminished or

altered in some adverse

manner.

So long as compound

design maintains the

existing service level and

construction is managed

without disruption to

stream flow, actual

adverse impact will be

negligible or zero.

Per analysis at left, this potential impact is not

significant, so long as the following mitigations are

implemented:

1. Total stream capacity cannot be diminished by the

development of the compound. (Stream channel on

average is 3m x 1m.)

2. The stream must remain substantially in the same

channel and cannot, e.g., be re-routed around the

property.

3. If construction will result in an interruption to

stream flow, provision must be made to provide a

temporary bypass. Temporary damming of stream

flow is not permissible.

4. Post-construction, the stream bed within the

property, including point-of-entry (e.g. via culvert

under perimeter wall) must be maintained free of

obstructions to flow.

E. Environmental Mitigation and Monitoring Plan (EMMP). Set out how compliance with

mitigation actions will be monitored and verified. This includes specifying WHO will be responsible



for the various mitigation actions, and HOW implementation of the mitigation actions will be

tracked/verified.

Also specify how you will report to USAID on the implementation of mitigation actions. (You are

REQUIRED to provide your COTR with sufficient information on the status of mitigation

implementation for USAID to effectively fulfill its oversight and performance monitoring role.)

Again, choose a format and structure that presents the necessary information clearly and succinctly.

EMMPs are typically in table format, and often include a compliance log or “monitoring record” section

that records implementation status of the various mitigation actions. The EMMP with current

monitoring log can then simply be submitted to the C/AOTR with the quarterly or 6-month project

report, satisfying the environmental compliance reporting requirement.

The most basic EMMP format is:

Mitigation action Responsible Party Monitoring/Verification

Method

Monitoring Record

(date, result,

corrective actions

taken, if any)

For additional EMMP formats and examples, see the ENCAP EMMP factsheet, available via

www.encapafrica.org/meoEntry.htm

F.Other Information. Where possible and as appropriate, include photos of the site and

surroundings; maps; and list the names of any reference materials or individuals consulted.

(Pictures and maps of the site can substantially reduce the written description required in parts B & C)

Step 6. Transcribe findings from the Environmental Review Report to

the ERF. For each high-risk or unknown/moderate-risk activity, transcribe your finding from the

environmental review report to the last column of Section B of the ERF.

Step 7. Sign certifications (Section C of former.)

Step 8. Submit form to USAID COTR. Be sure to attach the Environmental Review

Report, if any.

http://www.encapafrica.org/meoEntry.htm



ANNEX 2: ENVIRONMENTAL REVIEW FORM (ERF) FOR USAID IUWASH PLUS

PROJECT SUB-CONTRACTS/SUB-GRANTS

Follow, but do not submit, the attached instructions.

A. Applicant information

Organization Parent grant or

project

Individual contact

and title

Address, phone &

email (if available)

Proposed

subproject

/subgrant

(brief description)

Amount of funding

requested

Period of

performance

Location(s) of

proposed activities

B. Activities, screening results, and findings

Screening result

(Step 3 of instructions)

Findings

(Step 6 of instructions. Complete

for all moderate/unknown and

high-risk activities ONLY)

Proposed activities

(Provide DESCRIPTIVE listing.

Continue on additional page if necessary)

Very

Low

Ris

k

Modera

te o

r

unknow

n r

isk*

Hig

h-R

isk*

sig

nific

ant

advers

e im

pacts

are

very

unlik

ely

With s

pecifie

d

mitig

ation,

sig

nific

ant

advers

e im

pacts

are

very

unlik

ely

S

ignific

ant

Advers

e im

pacts

are

possib

le

1.

2.

3.

4.

5.



6.

7.

8.

*These screening results require completion of an Environmental Review Report

C. Certification:

I, the undersigned, certify that:

1. The information on this form and accompanying environmental review report (if any) is correct and

complete.

2. Implementation of these activities will not go forward until specific approval is received from the

COR.

3. All mitigation and monitoring measures specified in the Environmental Review Report will be

implemented in their entirety, and that staff charged with this implementation will have the

authority, capacity and knowledge for successful implementation.

(Signature)(Date)

(Print name)(Title)

Note: if screening results for any activity are “high risk” or “moderate or

unknown risk,” this form is not complete unless accompanied by an

environmental review report.

BELOW THIS LINE FOR USAID USE ONLY

Notes:

1. For clearance to be granted, the activity MUST be within the scope of the activities for which use of

the ERF is authorized in the governing IEE. Review IEE before signature. If activities are outside this

scope, deny clearance and provide explanation in comments section. The Partner, C/AOTR, MEO and

REA must then confer regarding next steps: activity re-design, an IEE or EA.

2. Clearing an ERF containing one or more findings that significant adverse impacts are possible

indicates agreement with the analysis and findings. It does NOT authorize activities for which

“significant adverse impacts are possible” to go forward. It DOES authorize other activities to go



forward. The Partner, C/AOTR, MEO and REA must then confer regarding next steps: activity re-

design, an IEE or EA.

Clearance record

C/AOR

Clearance given

Clearance denied

(print name) (signature) (date)

USAID/Indonesia MEO

Clearance given

Clearance denied


Regional Env. Advisor

(REA)*

Clearance given

Clearance denied


Bureau Env. Officer (BEO)*

Clearance given

Clearance denied


C/AOR and MEO clearance is required. REA and BEO clearance is required for all “high risk” screening

results and for findings of “significant adverse impacts possible. The BEO may review.

Note: if clearance is denied, comments must be provided to applicant

(use space below & attach sheets if necessary)



ANNEX 3: ENVIRONMENTAL REVIEW REPORT FOR IDENTIFYING POTENTIAL

ENVIRONMENTAL IMPACTS OF PROJECT ACTIVITIES AND PROCESSES

Implemented under: USAID IUWASH PLUS Project

DCN: Asia 15-036

Prepared by: DAI Global LLC

The Environmental Review Report for Identifying Potential Environmental Impacts of Project Activities

and Processes (ERR) is intended for use mainly by implementing partners to: assess activity-specific

baseline conditions, including applicable environmental requirements; identify potential adverse

environmental effects associated with planned activity(s) and processes; and develop environmental

mitigation and monitoring plans (EMMPs) that can effectively avoid or adequately minimize the identified

effects. If implementing partners are in doubt about whether a planned activity requires the preparation

of an ERR, they should contact the Project COR for clarification. (When preparing the checklist, please

indicate "not applicable" for items that have no bearing on the activity.)

A. Activity and Site Information

Project Name: (as stated ill the triggering IEE)

Indonesia Urban Water, Sanitation, and Hygiene -

Penyehatan Lingkungan Untuk Semua(USAID IUWASH PLUS) Project

Mission/Country USAID/Indonesia

DCN of Triggering IEE Asia 15-036

Activity/Site Name

Type of Activity

Name of Reviewer and Summary of Professional Qualifications

Date of Review

B. Activity Description

1. Activity purpose and need

2. Location of activity

3. Beneficiaries, e.g., size of community, number of school children, etc.

4. Number of employees and annual revenue, if this is a business

5. Implementation timeframe and schedule

6. Detailed description of activity and site, e.g., size of the facility or hectares of land; steps that

will be taken to accomplish the activity



7. Existing or planned certifications, e.g., lSO 1400 I EMS, ISO 9000, HCCP, SA 8000, Global Gap,

Environmental Product Declarations, Eco Flower, EcoLogo, Cradle to Cradle, UL Environment,

GREENGUARD, Fair Trade, Green Seal, LEED, or various Forest Certifications

8. Site map, e.g., provide an image from Google Earth of the location

9. Photos of site (when available)

C. Activity-Specific Baseline Environmental Conditions

1. Population characteristics

2. Geography

3. Natural resources, e.g., nearby forest/protected areas, ground and surface water

resources

4. Current land use

5. Proximity to public facilities, e.g. schools, hospitals, etc.

6. Other relevant description of current environmental conditions in proximity to the

activity

D. Legal, Regulatory, and Permitting Requirements

1. National environmental impact assessment requirements for this activity

2. Applicable National or local permits for this activity, responsible party, and schedule for

obtaining them:

Permit Type Responsible Party Schedule

Zoning

Building Construction

Source Material Extraction

Waste Disposal

Wastewater

Storm Water Management

Air Quality

Water Use

Historical or Cultural Preservation

Wetlands or Water Bodies

Threatened or Endangered Species

Other

3. Additional national or other international environmental laws, conventions, standards with

which the activity might be required to comply

a. Air emission standards

b. Water discharge standards

c. Solid waste disposal or storage regulations



d. Hazardous waste storage and disposal

e. Historical or cultural preservation

f.Other

E. Engineering Safety and Integrity (for Sections E. and F., provide a discussion for any of the listed

issues that are likely to have bearing on this activity)

1. Will the activity be required to adhere to formal engineering designs/plans? Have these been or

will they be developed by a qualified engineer?

2. Do designs/plans effectively and comprehensively address:

a. Management of storm water runoff and its effects?

b. Reuse, recycling, and disposal of construction debris and by-products?

c. Energy efficiency and/or preference for renewable energy sources?

d. Pollution prevention and cleaner production measures?

e. Maximum reliance on green building or green land-use approaches?

f. Emergency response planning?

g. Mitigation or avoidance of occupational safety and health hazards?

h. Environmental management of mobilization and de-mobilization?

i. Capacity of the host country recipient organization to sustain the environmental

management aspects of the activity after closure and handover?

3. Are there known geological hazards, e.g., faults, landslides, or unstable soil structure, which

could affect the activity? lf so, how will the project ensure structural integrity?

4. Will the site require grading, trenching, or excavation? Will the activity generate borrow pits? If

so, how wilI these be managed during implementation and closure?

5. Will the activity cause interference with the current drainage systems or conditions? Will it

increase the risk of flooding?

6. Will the activity interfere with above- or below-ground utility transmission lines, e.g.,

communications, water, sewer, or natural gas?

7. Will the activity potentially interfere with vehicle or pedestrian traffic?

8. Does the activity increase the risk of fire, explosion, or hazardous chemical releases?



9. Does the activity require disposal or retrofitting of polychlorinated biphenyl-containing

equipment, e.g., transformers or florescent light ballasts?

F. Environment, Health, and Safety Consequences

1. Potential impacts to public health and well-being

a. Will the activity require temporary or permanent property land taking?

b. Will activities require temporary or permanent human resettlement?

c. Will area residents and/or workers be exposed to pesticides, fertilizer, or other toxic

substances, e.g., as a result of farming or manufacturing? If so, how will the project:

i. Ensure that these chemicals do not contaminate ground or surface water?

ii. Ensure that workers use protective clothing and equipment to prevent

exposure?

iii. Control releases of these substances to air, water, and land?

iv. Restrict access to the site to reduce the potential for human exposure?

d. Will the activity generate pesticide, chemical, or industrial wastes? Could these wastes potentially

contaminate soil, groundwater or surface water?

e. Will chemical containers be stored at the site?

f.Does the activity remove asbestos-containing materials or use of building materials that may contain

asbestos, formaldehyde, or other toxic materials? Can the project certify that building materials are

non-toxic? If so, how will these wastes be disposed of?

g.Will the activity generate other solid or hazardous wastes such as construction debris, dry or wet cell

batteries, florescent tubes, aerosol cans, paint, solvents, etc.? If so, how will this waste be disposed of?

h.Will the activity generate nontoxic, nonhazardous solid wastes (subsequently requiring land resources

for disposal)?

i.Will the activity pose the need to handle and dispose of medical wastes? If so, describe measures of

ensuring occupational and public health and safety, both onsite and offsite.

j.Does the activity provide a new source of drinking water for a community? If so, how will the project

monitor water quality in accordance with health standards?

k.Will the activity potentially disturb soil contaminated with toxic or hazardous materials?

l.Will activities, e.g., construction, refurbishment, demolition, or blasting, result in increased noise or

light pollution, which could adversely affect the natural or human environment?

2. Atmospheric and air quality impacts

a. Will the activity result in increased emission of air pollutants from a

vent or as fugitive releases, e.g., soot, sulfur dioxide, oxides of nitrogen,

volatile organic compounds, methane, etc.?

b. Will the activity involve burning of wood or biomass?



c. Will the activity install, operate, maintain, or decommission systems

containing ozone depleting substances, e.g., Freon or other refrigerants?

d. Will the activity generate an increase in carbon emissions?

e. Will the activity increase odor and/or noise?

3. Water quality changes and impacts

a. How far is the site located from the nearest river, stream, or lake?

b. Will the activity disturb wetland, lacustrine, or riparian areas?

c. What is the depth to groundwater at the site?

d. Will the activity result in increased ground or surface water extraction?

lf so, what are the volumes? Permit requirements?

e. Will the activity discharge domestic or industrial sewage to surface,

ground water, or publicly-owned treatment facility?

f. Does the activity result in increased volumes of storm water run-off

and/or is there potential for discharges of potentially contaminated

(including suspended solids) storm water?

g. Will the activity result in the runoff of pesticides, fertilizers, or toxic

chemicals into surface water or groundwater?

h. Will the activity result in discharge of livestock wastes such as manure

or blood into surface water?

i. Does the site require excavation, placing of fill, or substrate removal

(e.g., gravel) from a river, stream or lake?

4. Land use changes and impacts

a.Will the activity convert fallow land to agricultural land?

b.Will the activity convert forest land to agricultural land?

c.Will the activity convert agricultural land to commercial, industrial, or residential uses?

d.Will the activity require onsite storage of liquid fuels or hazardous materials in bulk quantities?

e.Will the activity result in natural resource extraction, e.g., granite, limestone, coal, lignite, oil, or gas?

f.Will the activity alter the view shed of area residents or others?

5. Impacts to forestry, biodiversity, protected areas and endangered species

a. Is the site located adjacent to a protected area, national park, nature preserve, or wildlife refuge?

b.Is the site located in or near threatened or endangered (T &E) species habitat? Is there a plan for

identifying T&E species during activity implementation? If T&E species are identified during

implementation, is there a formal process for halting work, avoiding impacts, and notifying authorities?

c.Is the site located in a migratory bird flight or other animal migratory pathway?

d.Will the activity involve harvesting of non-timber forest products, e.g., mushrooms, medicinal and

aromatic plants (MAPs), herbs, or woody debris?



e.Will the activity involve tree removal or logging? If so, please describe.

6. Historic or cultural resources

a.Are there cultural or historic sites located at or near the site? If so, what is the distance from these?

What is the plan for avoiding disturbance or notifying authorities?

b.Are there unique ethnic or traditional cultures or values present in the site? If so, what is the

applicable preservation plan?

G. Further Analysis of Recommended Actions. On the basis of the analysis, guided by the

questions above, choose one of the following actions:



Categorical Exclusion: The activity is not likely to have an effect on the natural or physical

environment. No further environmental review is required.

Negative Determination with Conditions: The activity does not have potentially significant

adverse environmental, health, or safety effects, but may contribute to minor impacts that can be eliminated or adequately minimized by appropriate mitigation measures. EMMPs shall be developed, approved by the COR/AOR, in consultation with the MEO, prior to beginning the

activity, incorporated into workplans, and then implemented.

Positive Determination: The activity has potentially significant adverse environmental effects and requires further analysis of alternatives, solicitation of stakeholder input, and incorporation of environmental considerations into activity design. A Scoping Statement must be prepared and be

submitted to the BEO for approval. Following BEO approval an Environmental Assessment (EA) will be conducted. The activity may not be implemented until the BEO clears the final EA. For activities related to the procurement, use, or training related to pesticides, a PERUSAP will be

prepared for BEO approval.

Activity Cancellation: The activity poses significant and unmitigable adverse environmental

effects. Adequate EMMPs cannot be developed to eliminate these effects and alternatives are not feasible. The project is not recommended for funding.

H. EMMPs (Using the format provided below, or its equivalent, list the processes that comprise the

activity, then for each, identify impacts requiring further consideration, and for each impact describe

the mitigation and monitoring measures that will be implemented to avoid or adequately minimize

the impacts. All environment, health, and safety impacts requiring further consideration, which were

identified in Sections E. and F., should be addressed.)

1. Activity-specific environmental mitigation plan (Upon request, the COR/AOR

may be able to provide your project with example EMMPs that are specific to

your activity.)

Process

Identified

Environmental Impact

Do the Impacts

Require Further Consideration?

Mitigation Measures Monitoring Indicators

List all the processes that

comprise the

A single process

may have several

potential impacts- provide a separate

For each impact, indicate Yes or No;

if No, provide justification, e.g.:

For each impact

requiring further consideration,

describe the mitigation measures

Specify indicators

to (1) determine if mitigation is in

*Note regarding applicability related to Pesticides (216.2( e): The exemptions of §2 I 6.2(b)(I) and the

categorical exclusions of §216.2( c )(2) such as technical assistance, education , and training are not

applicable to assistance for the procurement or use of pesticides.



activity(s). A line

should be included

for each process

line for each

impact

(/) There are no

applicable legal

requirements including permits or

reporting and

(2) There is no

relevant community concern and

(3) Pollution prevention is not feasible or practical

and

(4) Does not pose a risk because of low

severity, frequency, or duration.

that will avoid or

adequately minimize the impact. (If mitigation measures

are well-specified in the IEE, quote

directly from IEE.)

place and (2)

successful.

For example, visual

inspections for seepage around pit latrine,

sedimentation at stream crossings, etc.)

2. Activity-specific monitoring plan

Monitoring Indicators Monitoring and Reporting

Frequency Responsible Parties Records Generated

Specify indicators to (1) determine if mitigation is in p lace and (2)

successful (for example by visual inspections.)

For example: “Monitoring weekly and report in quarterly reports”

Separate parties responsible for mitigation from those

responsible for reporting if possible

If appropriate, describe the type of records generated by the

mitigation, monitoring and reporting process.

I. Environmental Review Report Clearances:

Preparer:

__________________________________________



[Name]

_____________________

Date

Clearance:

___________________________________________

[Name], Mission Environmental Officer

_____________________

Date

Clearance:

___________________________________________

[Name], COR

_____________________

Date

Distribution:

COR Project File

MEO Files



ANNEX 4: ENVIRONMENTAL MITIGATION AND MONITORING REPORT (EMMR)

EMMR PART 1 OF 4: ENVIRONMENTAL VERIFICATION FORM

USAID/Indonesia AWARD Name

Indonesia Urban Water, Sanitation, and Hygiene - Penyehatan Lingkungan Untuk Semua (USAID IUWASH PLUS) Project

Date of Screening

Name of Prime Implementing Organization

DAI Global LLC

Funding Period for this Award

Name of Sub-Awardee/Contractor (if this EMMR is for a Sub)

Funding Period for this Award

Current FY Resource Levels Date of Previous EMMR for this Organization

Report Prepared By

Name: Date:

Key Elements of Program/Activities Implemented

(See Initial Environmental screening of USAID IUWASH PLUS activities)



EMMR PART 2 OF 4: MITIGATION PLAN

Category of Activity from

of DO3 IEE

Describe specific

environmental

threats of your

organization’s

activities (based

on analysis in

DO3 IEE)

Description of Mitigation Measures for

these activities as required in Section 4 of

DO3 IEE

Who is

responsible for

monitoring

Monitoring

Indicator

Monitoring

Method

Frequency of

Monitoring



EMMR PART 3 OF 4: REPORTING FORM

List each Mitigation Measure from column

3 in the EMMR Mitigation Plan (EMMR Part

2 of 3)

Status of Mitigation Measures List any outstanding issues relating

to required conditions Remarks



EMMR PART 4 OF 4: REPORTING FORM

List each Mitigation Measure from column

3 in the EMMR Mitigation Plan (EMMR Part

2 of 3)

Status of Mitigation Measures List any outstanding issues relating

to required conditions Remarks



ANNEX 5: SUPPLEMENT TO THE ENVIRONMENTAL REVIEW FORM ADDITIONAL

SCREENING CRITERIA FOR NATURAL RESOURCE ACTIVITIES UNDER

USAID IUWASH PLUS

Purpose: This is a supplement to the “Instructions for environmental review of USAID IUWASH

PLUS activities.” It is to be used for natural resources-based activities, including:

Community-Based Natural Resource Management (CBNRM)

Ecotourism

Natural resources-based enterprise development with micro- and small enterprises

This supplement provides additional questions to ascertain whether these proposed activities should be

categorized as “very low risk:”

If the answers to ALL the questions that follow are “NO,” then the proposed natural resource-

based activity is considered “very low risk.”

If the answer to ANY question is “YES,” the activity CANNOT be considered “very low risk.”

Screening criteria

Will the activities… YES NO

Natural Resources

Accelerate erosion by water or wind?

Reduce soil fertility and/or permeability?

Alter existing stream flow, reduce seasonal availability of water resources?

Potentially contaminate surface water and groundwater supplies?

Involve the extraction of renewable natural resources?

Lead to unsustainable use of renewable natural resources such as forest products?

Involve the extraction of non-renewable natural resources?

Restrict customary access to natural resources?

Reduce local air quality through generating dust, burning of wastes or using fossil

fuels and other materials in improperly ventilated areas?

Affect dry-season grazing areas and/or lead to restricted access to a common

resource?

Lead to unsustainable or unnecessarily high water extraction and/or wasteful use?

Ecosystems and Biodiversity

Drain wetlands, or be sited on floodplains?

Harvest wetland plant materials or utilize sediments of bodies of water?



Will the activities… YES NO

Lead to the clearing of forestlands for agriculture, the over-harvesting of valuable

forest species?

Promote in-forest bee keeping?

Lead to increased hunting, or the collection of animals or plant materials?

Increase the risks to endangered or threatened species?

Introduce new exotic species of plants or animals to the area?

Lead to road construction or rehabilitation, or otherwise facilitate access to fragile

areas (natural woodlands, wetlands, erosion-prone areas)?

Cause disruption of wildlife migratory routes?

Agricultural and Forestry Production

Have an impact on existing or traditional agricultural production systems by reducing

seed availability or reallocating land for other purposes?

Lead to forest plantation harvesting without replanting, the burning of pastureland, or

a reduction in fallow periods?

Affect existing food storage capacities by reducing food inventories or encouraging

the incidence of pests?

Affect domestic livestock by reducing grazing areas, or creating conditions where

livestock disease problems could be exacerbated?

Involve the use of insecticides, herbicides and/or other pesticides?

Community and Social Issues

Have a negative impact on potable water supplies?

Encourage domestic animal migration through natural areas?

Change the existing land tenure system?

Have a negative impact on culturally important sites in the community?

Increase in-migration to the area?

Create conditions that lead to a reduction in community health standards?

Lead to the generation of non-biodegradable waste?

Involve the relocation of the local community?

Potentially cause or aggravate land-use conflicts?