Environmental Screening Form and EMMP Template USAID West Africa Regional Regulation 216 Workshop: Ghana USAID/GEMS JANUARY, 2017

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Environmental Screening Form and EMMP Template USAID West Africa Regional Regulation 216 Workshop: Ghana USAID/GEMS JANUARY, 2017 This document contains two tools to be used for an exercise in which workshop participants will practice performing site-specific environmental impact analysis and the design of a corresponding EMMP. These tools are: 1. The Environmental Screening Form (ESF), 2. The Environmental and Monitoring Plan (EMMP) Template. 1 The project sites to be visited during this workshop are not USAID-financed, and therefore there are no governing IEE/EAs for participants to consult, and no officially assigned environmental threshold determinations for activities. For this reason, it will be important for participants to classify the potential environmental risk threshold of the distinct activities at each site, so that they may correctly identify which activities require environmental mitigation and monitoring. ENVIRONMENTAL SCREENING FORM Commented [MS1]: This will have to be updating according to the context in Ghana The Environmental Screening Form (ESF) contains information relevant to the potential environmental effects over the life of the intervention with regard to natural resources, the environment, and human health. If items in Column A of the Environmental Screening Form are checked YES, then items for monitoring and mitigation are to be specified in the Environmental Plan (Table 1) of the EMMP Template. The Environmental Plan simply outlines the plan of action for mitigation of potential environmental effects. If all Column A is checked NO, then EMMP Tables 1 and 2 are not required to be completed and the intervention can begin. However, this should not be the case for the project sites to be visited during the USAID/West Africa Regulation 216 Workshop. Risk Classification Different interventions under an award can have varying levels of risk for environmental effects and therefore require different courses of action. No-risk interventions, classified under column B do not require the development of an Environmental Plan (Table 1) or an Environmental Monitoring and Evaluation Report (Table 2) and could be covered under a Categorical Exclusion (22 CFR 216.2(c)). Interventions identified as Medium-risk under column C require the IP to develop a plan to mitigate them. High-risk interventions under column C include interventions that have irrevocable change and/or cannot be mitigated by the implementation of industry standards, best management practices, or 1 The ESF has been adapted from the USAID/LAC EMMP Guidelines, and the EMMP Template has been adapted from the USAID Title II FY16 RFA-IEE.

design-specific implementation standards and, therefore, are considered to have significant environmental effects that will require an EA (22 CFR216.2 (d)). Name of intervention: Implementing Partner: Award Number: Date: Relevant IEE/ETD# INFRASTRUCTURE (Buildings, roads, WASH, etc.) 1 Will the intervention involve construction and/or reconstruction/rehabilitation of any type of building? For new construction, if less than 1,000 m2 = medium risk, if greater than 1,000 m2 = high risk. 2 2 Will the intervention involve building penetrating roads, road rehabilitation and maintenance or other road related infrastructure (drainage, bridges, etc.)? If penetrating road construction/rerouting = high risk 3, if repair/rehabilitation (improving drainage, resurfacing of existing roads) = medium risk. 3 Will the intervention involve construction or rehabilitation of water and sanitation infrastructure (irrigation systems, potable water, water harvesting, septic systems etc.). Potable water systems require testing for bacteria, arsenic and other heavy metals. 4 Will the intervention involve construction or rehabilitation of any other infrastructure such as landfills, incinerators, energy infrastructure, etc. 5 Will the infrastructure intervention cost more than US $500,000 4? If YES, approval of a USAID Engineer is required as mitigation measures in Table 2. Additionally, compliance with FAA 611 is required (please consult with the mission legal advisor). 6 Does the intervention require adherence to national building code or other national regulatory standard? measures in Table 2. 7 Does the intervention require local planning permissions (i.e. zoning, building permits, etc.) Column A Yes Column B No Column C If answered yes to Column A, Is it a high risk or medium risk High Risk Medium- Risk BIOPHYSICAL 9 Will the intervention involve changes in water quality (pollution, sedimentation, stagnation, salinization, temperature change, etc.) 10 Will the intervention affect surface or groundwater quantity 11 Will the intervention involve training and/or implementation of agricultural practices/production including animal husbandry? 2 Construction interventions need to be reviewed for scale, planned use, building code needs and maintenance. New construction having a footprint larger than 1000 meters 2 or 10,000 feet 2 is considered large scale and high risk. Some small construction interventions, such as building an entrance sign to a park, may require simple mitigation measures whereas larger buildings will require more extensive review and monitoring. 3 New construction of roads is considered high risk and will require a full environmental assessment of the planned construction, i.e. a Positive Determination. Any reroutes of a road or trail longer than 100 meters is considered a high risk. Reroutes within a protected area, nearby a water source/wetlands, and/or archaeological site are considered a high risk. 4 Pursuant to FAA, section 611, Completion of Plans and Cost Estimates.

12 Will the intervention involve aquaculture systems? 13 Will the intervention involve the use or disposal of hazardous materials (used engine oil, paint, varnish, lead-based products, fluorescent light bulbs/mercury, batteries, asbestos or other hazardous or special management waste)? Consider effects to both the biophysical environment and human health. 14 Will the intervention involve implementation of timber management 5, extraction of forest products, clearing of forest cover, and/or conversion of forest land by cutting of trees >20cm diameter at base height (DBH)? 15 Is the intervention in or near (within 50m) 6 any sensitive terrestrial or aquatic areas including protected areas, wetlands, critical wildlife habitat (including nesting areas), and threatened or endangered species? 16 Will the interventions proposed generate airborne particulates (dust), liquids, or solids (i.e. discharge pollutants) or potentially violate local air standards? 17 Will the intervention create objectionable odors? 18 Will the intervention occur on steep slopes (greater than 15%)? 19 Will the intervention contribute to erosion? 20 Will the intervention change existing land use in the vicinity? 21 Is the proposed intervention incompatible with land type (i.e., annual crops on steep slopes, infrastructure on poorly drained soils)? 22 Will the intervention affect unique geologic or physical features? 23 Will the intervention have potential effects to inhabitants, natural landscapes, or flora/fauna downstream from the intervention site? 24 Will the intervention have a direct or indirect effect, or include actions with mangroves, coral reefs and other marine/coastal ecosystems? GLOBAL CLIMATE CHANGE 25 Are interventions or outcomes vulnerable to changes in the weather or climate such as changes in precipitation patterns, increased temperatures or sea level rise? 26 Does the intervention exacerbate climate change vulnerabilities (i.e., drought, flooding, decrease water supply)? 27 Will the intervention create greenhouse gas emissions from decomposing waste, burning of organic matter, or use of fossil fuels etc. (consider duration and scale) SOCIO ECONOMIC 28 Will the intervention contribute to displacement of people, housing or businesses? 29 Will the intervention affect indigenous peoples and/or unique cultural or historical features? 30 Will the intervention expose people or property to flooding? ENVIRONMENT & HEALTH 31 Will the intervention create conditions encouraging an increase in illness, diseases, or disease vectors (waterborne, STDs or other)? 32 Will the intervention generate hazards or barriers for pedestrians, 5 Any interventions that involve the commercial harvesting of trees or converting forests is considered high risk and will require a full environmental assessment of the intervention (i.e. Positive Determination). The reference to cutting trees of greater than 20cm dbh is for actions related to forest management and commercial forest products and not for individual trees being cut for construction or non-commercial purpose. 6 Less than 50 meters is based on best practices from US Federal and State regulations.

motorists or persons with disabilities? 33 Will the intervention involve the use, storage, handling or disposal of syringes, gauzes, gloves and other biohazard medical waste? 34 Will the intervention expose workers to occupational hazards? 35 Will the intervention increase existing noise levels? GENDER 7 36 Does the intervention inhibit the equal involvement of men and women? 37 Do the intervention results disproportionately benefit/impact men and women? OTHER 38 Does the intervention/activity involve a sub-award component? 8 39 Is an operations and maintenance plan required? (for all type of infrastructure, equipment, road rehabilitation, or water and sanitation action = Yes) Reference: February 8, 2007; L. Poitevien (USAID/Haiti), M. Donald (USAID/Dominican Republic), E. Clesceri (USAID/Washington). Guidelines for Implementing Partners on the USAID Haiti Environmental Report. 7 A positive response to gender questions require follow up only when there are other positive responses on questions, and an EMMP is developed. 8 If the intervention includes a sub-award component, each sub-awardee shall be required to prepare an EMMP prior to implementation of the sub-award.

ENVIRONMENTAL MITIGATION AND MONITORING PLAN (EMMP) TEMPLATE The following two template tables can be filled out in the development of the EMMP during this Regulation 216 workshop exercises. Table 1: Environmental Plan Activity Description of Impact Prescribed Measure Measure # Table 2: Environmental Monitoring and Evaluation Report # Prescribed Measure Responsible Party for Measure Implementation Monitoring Methods Indicators Methods Frequency Estimated Cost of Implementing and Monitoring Dates Monitored Results Problems Encountered Effectiveness Recommended Adjustments