Global IEE Annex A_Template for Environmental Capability Statement.pdf

USAID ASHA FY 2019-2023 GLOBAL IEE – ANNEX A 1

ANNEX A: TEMPLATE FOR ENVIRONMENTAL CAPABILITY STATEMENT

Applicants must complete all questions below and submit to ASHA with the application.

Application Name: [INSERT NAME]

Commodities or/+ Construction? [SELECT]

1. Site Selection: Will the project be located in or near sensitive ecosystems and-or hazard-prone areas? (Yes/No): _______ Please describe corrective actions:________

2. Toxics: Will toxic construction materials be involved (e.g., asbestos)? (Yes/No/Not Applicable): _______

3. Pesticides: Will the project need to address pest control and (if relevant) procure and or use pesticides? (Yes/No): _______ Are any pesticides that are needed already described in the USAID ASHA Construction Pesticide Evaluation and Safe Use Action Plan or PERSUAP? (Yes/No): _______

4. Water Supply: Will the project ensure adequate water quality assurance (e.g., fecal coliforms, arsenic) to meet projected demand, and considering climate projections?

(Yes/No): _______. Please describe.________________

5. Solid Waste: How will the project dispose of solid waste (construction waste, electronic waste etc.) generated by its activities?

6. Sanitary Waste: How will the project dispose of sanitary waste streams generated by its activities?

7. Medical Waste: Will medical waste be generated? (Yes/No/Not Applicable):

_____Please describe the disposal mechanisms for medical waste generated.________________

8. Energy: Will the project employ energy efficiency measures and/or non-fossil fuel energy sources (e.g., hydropower, wind and solar panels)? (Yes/No): _______ Please describe.

9. Climate Risks and Opportunities: How will the project consider climate risk on all issues listed above, particularly site selection, water supply, and construction design?