World Bank Document

E2960 v2 The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) -EMP Environment Management Plan

Public Disclosure Authorized

The World Bank Funded Chongqing Urban- Rural Integration Project Phase II (CURIP II)

Public Disclosure Authorized Environment Management Plan

Public Disclosure Authorized

Feb. 2012

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) -EMP

Contents

1 GENERAL ...... 34

1.1 BACKGROUND OF CURIP II...... 34 1.2 FACILITIES FOR WASTEWATER TREATMENT AND SOLID WASTE DISPOSAL ...... 1 2 LAWS, REGULATIONS, STANDARDS AND SAFEGUARD POLICIES OF THE WORLD BANK, ENVIRONMENT SCREENING AND EA PROCESSING...... 5

2.1 LAWS , R EGULATIONS , S TANDARDS AND SAFEGUARD POLICIES OF THE WORLD BANK ...... 5 2.1.1 National Laws, Regulations and Relevant Documents ...... 5 2.1.2 Sector Policies ...... 5 2.1.3 Guidelines and Regulations on the EIA Technology ...... 6 2.1.4 Local Regulations and Documents ...... 7 2.1.5 Main Planning Documents ...... 7 2.1.6 Project Relevant Documents...... 7 2.1.7 Assessment Standards ...... 8 2.2 SAFEGUARD POLICIES OF THE WORLD BANK AND THE GUIDELINE OF EHS...... 8 2.3 EA C LASSIFICATION ...... 8 3 ENVIRONMENTAL IMPACTS AND MITIGATION MEASURES ...... 9 3.1 ANALYSIS OF POTENTIAL NEGATIVE ENVIRONMENTAL IMPACTS OF CURIPII...... 9 3.2 MEDICAL WASTEWATER TREATMENT DURING OPERATION PERIOD OF CURIP ...... 12 3.3 ENGINEERING MEASURES FOR DISPOSAL OF MEDICAL SOLID WASTE AND CONTROL OF NOISE AND EXHAUST GAS EMISSION ...... 16 3.3.1 Medical Solid Waste Disposal during Operation Stage ...... 16 3.3.2 Engineering Measures for Medical Solid Waste Disposal during Operation Period...... 17 3.3.3 Engineering Measures for Control of Noise and Exhaust Emission during Operation Period ...... 17 4 ENVIRONMENT MANAGEMENT PLAN EMP ...... 22

4.1 PURPOSE OF EMP ...... 22 4.2 ENVIRONMENT MANAGEMENT ORGANIZATIONS AND DUTIES ...... 22 4.2.1 Management Organization ...... 24 4.2.2 Supervision Organization ...... 25 4.2.3 Agencies Responsible of Implementation, Executing and Monitoring...... 27 4.3 CODE OF GOOD PRACTICE FOR ENVIRONMENTAL MANAGEMENT ...... 27 4.4 ENVIRONMENT MONITORING PLAN ...... 50 4.5 CAPACITY BUILDING ...... 58 4.5.1 Training Program ...... 58 4.5.2 Equipment (Material) Procurement Plan...... 59 4.6 PUBLIC COMPLAINT AND FEEDBACK MECHANISM ...... 60 4.6.1 Public Complaint ...... 60 4.6.2 Feedback Mechanism ...... 61 4.7 REPORT MECHANISM ...... 61 4.8 EMERGENCY PROCEDURE FOR MAJOR ENVIRONMENT IMPACT DURING CONSTRUCTION PERIOD ...... 62 4.9 IMPLEMENTATION PLAN ...... 62 4.10 EMP C OST ESTIMATE ...... 68 4.11 MEDICAL WASTE MANAGEMENT PLAN ...... 79 4.11.1 Implement the Provisions of Medical Waste Management in Chongqing...... 79 4.11.2 Development of Medical Wastes Management Plan...... 80 4.11.3 Implementation of Mitigation Measures for Disposal of Medical Solid Wastes...... 86 4.12 EMP P ERFORMANCE INDICATORS FOR CURIP II...... 89

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) -EMP

1 General

1.1 Background of CURIP II

Following on the Chongqing Urban-rural Integration project I (CURIP I), the main objective of the proposed project is to improve medical service system in the selected districts/counties of Chongqing. Compared with the other public service industry, the district/county level medical service system is still a very weak sector in Chongqing. Since the district/county level medical treatment institutions are key points in three level health service network (including rural health service agencies and township community medical service centre) and will play a leading role in the improvement of medical service, so the implementation of CURIP II is conducive to shorten the gap between urban and rural areas in Chongqing, improve the accessibility of public service ability and public service resources in district/county level.

One of the goals of the national 12 th Five Year Plan for economic and social development in Chongqing is: to construct "13 3A-grade hospitals in districts/counties, complete the task to reconstruct and upgrade the district/county level hospitals as the key projects for Health Chongqing of the “12 th Five Year Plan”. Therefore, the implementation of the CURIP is very necessary and timely.

Please see Fig. 1-1 for distribution of project hospitals in districts and counties.

Fig. 1-1 Distribution of Project in Districts and Counties under CURIP II

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) -EMP

Chengkou County

Wushan County

Wanzhou District

Tongnan County Dianjiang County

Fuling District Qianjiang District

Youyang County

Project hospital

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) -EMP Table 1－－－1 Summary of CURIPⅡⅡⅡ SN / District or Size Infectious Main Construction Contents Service Construction Site Location and PIU / Construction County / project Disease People Investment Floor Area Period hospital Department RMB 10,000 Building area 22,583m2, None Construct main building with increase of 273 beds, ground -7F~10F, underground - 1.1566 PIU: Fuling District relocate of 227 beds from 8F, water, power, air million in People’s Hospital original inpatient building to conditional and other public Fuling Expected Construction the new one, with 500 beds utilities; removal of original District Period: 12 months in total; no additional medical wastewater treatment The original inpatient departments founded, while facilities with capacity of building and office 1 Fuling District allocation of the rooms for 250m3/d in the north-east side Construct inside 10162 building in the hospital People’s Hospital each department in the new of the site, and construct the hospital, No.6 (including will be demolished for Inpatient building; increase of 60 wastewater treatment station Minkang Street, environment the construction of Comprehensive staffs beside existing 365 with capacity of 270m3/d Fuling District; protection central plaza; while the Building staffs (enhanced primary treatment) floor area 6,317 investment of original dead house, (expansion in the in the north-east side of the m2. 204) outpatient building, original site) new building; arrange 30m2 administrative building, temporary medical solid waste boiler house, staff storage site in -2F, stop the canteen, boiled water service of the existing one; house, laundry room and construct central air conditional staff apartment will be system, 115 parking spaces kept. (ground park 47, underground park 68) Total building area With individual Construct main building with 0.9352 15000m2, 150 beds, design fever outpatient ground 5F, underground -1F, million in Located in D6-4 outpatient capacity 250 department water, power, air conditional Tongnan 6750 Land, Jiangbei person-time/d, with 150 and other public utilities; County PIU: Tongnan M&C (including 2 Tongnan M&C New Development fixed staffs. construct medical wastewater Health Care Hospital environment Health Care Area, Tongnan treatment station with capacity Relocation Project protection Hospital County; land area of 130m3/d (secondary Expected Construction investment of 13,333 m2. anaerobic treatment) in the Period: 16 months 158) south-west side of the site; arrange temporary medical solid waste storage sites in

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) -EMP SN / District or Size Infectious Main Construction Contents Service Construction Site Location and PIU / Construction County / project Disease People Investment Floor Area Period hospital Department RMB 10,000 north-west side of 2F skirt building and east side of 5F tower building respectively. Total building area 30,000 With individual Construct outpatient & m2, 300 beds, designed fever outpatient inpatient comprehensive 1.7332 outpatient and emergency department building with ground 15F, million in capacity 1450 person- underground -2F, including Wanzhou time/d, with 1000 fixed outpatient and emergency District Located in the 2nd staffs (average 500 department, medical & community, persons/d in the hospital) technical department, inpatient 3 Wanzhou Xinglong Village, department, as well as water, District People’s Gaofeng Town, power, air conditional system, 13500 Hospital Economic Wanzhou District oxygen supply, heating supply (including PIU: Wanzhou District Development Area (Gaofeng and other public utilities; environment People’s Hospital Branch Outpatient expanding area of construct underground parking protection Expected Construction & Inpatient Wanzhou garage with 200 paring site in - investment of Period: 18 months Comprehensive Economic 1F and -2F; construct medical 523) Building Development wastewater treatment station Area); land area with capacity of 500m3/d in the 66,667 m2. south-east side of the hospital; arrange temporary medical solid waste storage site in south-east of the hospital, close to the wastewater treatment station. Located in the Total building area None Construct one internal middle between 26,000m2, increase of 240 medicine building and 0.9637 4 Dianjiang 11700 north side of beds, outpatient capacity supporting facilities (parking million in County TCM (including PIU: Dianjiang TCM Dianjiang TCM can reach 600 person- site and canteen) with ground Dianjiang Hospital Internal environment Hospital Hospital and time/d. 11F (underground -2F), County Medicine protection Expected Construction Diajiang Health including outpatient and Comprehensive investment of Period: 22 months School; land area emergency department, Building 129) 6,215 m2. inpatient department, 111 ground parks; construct

front part and back part, is storage site in -1F of framework structure with inpatient building; ground 3F & underground -1F Expected Construction and building area 2,796.1 m2; Period: 12 months inpatient building is framework (The second phase: structure with ground 5F and construction of 2# building area 6,691 m2; service domestic wastewater building is framework structure treatment station with with ground 2F & underground capacity of 100 m3/d and -3F and building area 1,961.2 100m3 emergency

The second phase includes the construction of staff living area and administration & logistic building, with ground 2F and total building area of 1,099.28 m2, which is not included in the WB project. Building area about None Construct inpatient 1630m2 27,000m2, 300 beds, comprehensive building with 0.2465 6 12150 PIU: Chengkou County Located at No.14 outpatient capacity about ground 20F, underground -2F, million in Chengkou County (including People’s Hospital Wenhua Road, 420 person-time/d, with 350 water, power, air conditional Chengkou People’s Hospital environment Expansion in the original Gecheng Street fixed staffs and other public utilities County Inpatient protection site Office, Chengkou construct medical wastewater Comprehensive investment of Expected Construction County; land area treatment station with capacity Building 130) Period: 20 months 1,630 m2. of 300m3/d, arrange temporary solid waste storage site in -2F. Total building area 32,000 None Construct main building with m2, 350 beds, with 500 ground 16F, water, power, air 0.536 medical care and service conditional and other public million in 7 Qianjiang Located in staffs for all-time service. utilities; construct medical Qianjing 14400 District Central Tongping PIU: Qianjiang District wastewater treatment station District (including Hospital Community, Central Hospital with capacity of 200 m3/d environment Zhengyang Branch Zhengyang Street New Construction (secondary treatment) in the protection Inpatient Office, Qianjiang Expected Construction north outside of the building; investment of Comprehensive District; land area Period: 24 months arrange temporary medical 200) Building 6.719 m2. solid waste storage site in 3F, close to parking garage; ground park 36. 8 Located at No. 117 Total building area about With individual Construct main building with 9000 PIU: Youyang County Youyang County Middle 20,000 m2, increase of 60 fever outpatient 13F, including underground - 0.8359 (including People’s Hospital; People’s Hospital Taohuayuan Road, beds, with 638 beds in total, department 2F, water, power, air million in environment Removal of original Outpatient & Zhongduo Town, with 558 f ixed medical care conditional and other public Youyang protection medical wastewater

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) -EMP

1.2 Facilities for Wastewater Treatment and Solid Waste Disposal

The project owners and contractors should strictly implement the mitigation measures as described in the EMP during construction period and operation period. Additionally, the wastewater and solid waste produced in the construction and operation period could be further treated or disposed of by the existing infrastructure in the project districts/counties.

The name, location, capacity, distance (from the hospital site) and transportation roads of the domestic waste landfill site, construction waste residue site and hazardous waste disposal site for each hospital in District/County, see Table 1 - 2

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) -EMP Table 1-2 Situation of the wastewater disposal facilities for each hospital District/County Name Location Volume/Capacity Distance, transportation roads management department km Fuling District Spoil deposit site of Group 2 million m3 8 Renmixi road →Binjiang The construction and Jiangdongmopangou, Fuling 1,Quntuozi Road →Wujiang bridge →Fuqin environment office of community, Road →Pengle Road Jiangdong Sub-District Jiangdong Sub- Office, Fuling District District Office, Fuling domestic waste landfill site Group 2, Minxie 30 million m3 10.5 Renminxi Road →Liminbei Municipal devices of of Fuling village, Lizhi Road →Taijida Road →Fuhao Road Fuling District Sub-District Office, Fuling Municipal wastewater Group 7, Chaqi 0.14 million m3/d 8 Admit into: Yangzi River The Fuling drainage treatment plant village, limited liability company Jiangdong Sub- of District Office, Fuling three gorges Water Authorities ； Solid waste disposal center Group 5, Tuanjie Incineration 3t/d 12 Renminxi Road →Liminbei The environment ： of Fuling village, Lizhi Additions Road →Taijida Road →Fuhao Road protection agency of Office, Fuling steaming and Fuling District boiling 5t/d ； Tongnan County Group 6, Construction waste residue 30 million m3 2 Jintian Sub-District Office Majawan, Jintian field Sub-District Office domestic waste landfill site Qingyan Hamlet, 1.48 million m3 13 Construction committee of Dongsheng Tongnan County Village, Zitong Sub-District Office Municipal sewage treatment Guanyin village, 20 thousand m3/d 3 Admit into: Fujiang River Dewatering company of plant Guilin Sub- Tongnan County District Office

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) -EMP District/County Name Location Volume/Capacity Distance, transportation roads management department km Treatment facility of Shuangshi town Incineration 15t/d 130 Chongqing Zhongming medical wastes industry area, Environmental Yongchuan management Co., LTD District

Wanzhou District Construction waste residue site slag field of / 5 field economic and development area building waste landfill site Group 5, Qianjia 500t/d 30 Environment and village, Changlin sanitation station of town Wanzhou District Sewage treatment plant of Group 6, 800m3/d 1 Gaofeng Town Xinglong Village, Giafeng Town Treatment field of medical Group 5, Qianjia steaming and 30 wastes village, Changlin boiling ： 8t/d town Dianjiang County Construction waste residue Framentary Designated by field place construction committee domestic waste landfill field Nanyinsi,Xinmin 190t Capacity 10 Guixidadao passed by 102 Bianmin Sanitation town 1,930,000 provincial road to Xinmin town development Co., LTD m3;190t/d Dianjiang County

municipal sewage treatment Zoujiaba, Recent capacity 30 3 Admit into: Guixi River plant Shiling village, thousand Guixi town m3/d ； Future capacity 60 thousand m3/d

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) -EMP District/County Name Location Volume/Capacity Distance, transportation roads management department km Specified hazardous waste Group 5, Tuanjie burning 3t/d ； 108 Yuyi High Environmental Protection disposal treatment field village, Lizhi new way →Fuling/Changshou →Changfu Bureau of Fuling District Sub-District construction :5t/d ； High way →319 National Office, Fuling road →Wujiang road →Gongyuan road →Guangchang road →Guangchanghuan road →Wutai road Wushan County Spoil deposit field Group capacity 1.3 17.5 From 103 provincial road to Huiqin Environmental 2,Hongmiao million t Miaowan health Co., LTD hamlet, Longjin domestic waste treatment village, Wushan field county Medical hazardous waste Group 5, Qianjia Decatizing 150 Mainly rely on Hurong High way Wanzhou District disposal field village, Changlin process ： 8t/d town, Wanzhou District Chengkou County Construction waste Spoil Xiejiaopo 55 thousand m3 South Bureau of Urban Utilities deposit field west 2 S 202 Provincial road and Landscaping of Chengkou County Domestic waste treatment Xiejiaopo 28 thousand m3 South Bureau of Urban Utilities field west 2 S 202 road and Landscaping of Chengkou County Municipal sewage treatment Group 5000t/d Length Discharge into Renhe river plant 2,Guanzhangzi of Pipe hamlet, Longtian network Village 3.6km Medical hazardous waste Group 5, Qianjia Decatizing 130 S102,KaiCounty, S102,Wankai Wanzhou District disposal field village, Changlin process ： 8t/d High way town, Wanzhou District Qianjiang District Construction waste residue Liangjiawan, Total Volume 8 Banpo —Chuchanggou— Environmental protection field Fenshuiling, 180 万m3 ， 200t/d Fenshuiling bureau of Qianjiang Domestic waste treatment Nanjia office, District field Chengnan 3

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) -EMP District/County Name Location Volume/Capacity Distance, transportation roads management department km Xincheng Municipal sewage Phrase I 30 10 Discharge into: Apeng river (Local name treatment plant thousand m3/d; Liangqiao) total capacity of 90 Tuanjie thousand m3/d neighborhood committee, Zhengyang street

Medical hazardous waste Group7,Nanjia Decatizing3t/d ； 8.5 Environmental protection disposal field neighborhood bureau of Qianjiang committee, District Chengnan Sub- District Office, Qianjiang District Youyang County Construction waste residue Banxi 0.2 million m3 20 Huancheng road →Youyang to Municipal field Town,Youyang Banxi segment 319 national road devices of Youyang County County

Domestic waste treatment Longdong 1.07millionm3, 40 Huancheng road →Youyang to Municipal devices of field village, Longtan Service life 15 Banxi segment 319 national road Youyang County town, Youyang Years County Municipal sewage treatment Shanshuwan, 20 thousand m3/d 5 Admit into: Youyang River plant Hejiaba village, Huayuan town Medical hazardous waste Group7,Nanjia Decatizing3t/d ； 90 Environmental protection disposal field neighborhood bureau of Qianjiang committee, District Chengnan Sub- District Office, Qianjiang District

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report

2 Laws, Regulations, Standards and Safeguard Policies of the World Bank, Environment Screening and EA Processing

2.1 Laws, Regulations, Standards and Safeguard Policies of the World Bank

2.1.1 National Laws, Regulations and Relevant Documents

1) Environmental Protection Law of the PRC (1989); 2) Law of the PRC on Environmental Impact Assessment (2002); 3) Law of the PRC on the Prevention and Control of Atmospheric Pollution (29 April 2000); 4) Law of the PRC on Prevention and Control of Water Pollution (Feb.2008); 5) Law of the PRC on the Prevention and Control of Pollution by Solid Waste (2005); 6) Law of the PRC on the Prevention and Control of Environmental Noise Pollution (1997); 7) Law of the PRC on Soil Conservation (25 Dec. 2010); 8) Law of the PRC on the Land Management (28 Aug. 2004) 9) Law of the PRC on Urban Planning; 10) Law of the PRC on the Infectious Diseases (Revised on 28 Aug. 2004) 11) Opinions of the State Council on Promoting Chongqing Urban-rural Integration Reform and Development (GF [2009] No.3); 12) Law of the People’s Republic of China on the Prevention and Control of Atmospheric Pollution (8 May 1991); 13) Law of the People's Republic of China on Prevention and Control of Water Pollution (20 Mar. 2000); 14) Decree of the State Council of the PRC [1998] No. 253: Regulations on the Administration of Construction Project Environmental Protection; 15) Regulations on the Protection of Basic Farmland; 16) Regulations on the Hospital Waste Management (2003) 17) Regulations on the Environmental Protection and Inspection Management for the Construction Project (27 Dec. 2001) 18) Environmental Protection Classification Management List for the Construction Project (2 Sep. 2008) 19) Provisions of Strengthening EIA Management of Construction Projects Financed by International Financial Organizations ([1993] No. 324issued by the State Environmental Protection Administration of the PRC) 20) Decisions on Some Issues about the Environmental Protection of the Sate Council (16 Aug. 1996) 21) Decisions on Strengthening the Environment Protection with the Scientifically Views of the State Council (GF [2005] No.39) 22) Regulations on the Hospital Waste (GF 2003-380)

2.1.2 Sector Policies

1) National Inventory of Hazardous Waste (Decree of the Ministry of Environmental Protection of the PRC and National Development and Reform Commission [2008] No. 1);

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report 2) Policies on the Prevention Technology for the Hazardous Waste (HF2001 No. 199) 3) Classification List for the Medical Waste (WYF2003 No.287) 4) Technical Requirements on the Transferring Vehicles for the Medical Waste (Trial) （ GB 19217—2003 ） 5) Hospital Waste Management Regulations for the Health and Medical Care Institutions (Decree of the Health Department 2003 No. 36) 6) Design Standards of the Hospital Wastewater Treatment （ CECS 07 -2004 ） 7) Guidelines on the Hospital Wastewater Treatment Technology (HF 2003 No.197) 8) Discharging Standards for the Water Pollutant from the Hospital Institutions(GB 18466—2005 ） 9) Notice of Technical Requirements on the Establishment of the Automatic Monitoring System for the Residual Chlorine in the Discharged Hospital Wastewater (Temporary, HB letter 2003 No. 283) 10) Technical Codes of Hospital Waste Centralized Disposal (HF [2003] No. 206) 11) Measures on the Management of Duplicated Form for Transfer of Hazardous Waste (Decree of the State Environmental Protection Administration of the PRC [1999] No. 5); 12) Standard of Packaging Bags, Containers and Warning Symbols Specific to Medical Waste (HJ/T 421-2008); 13) Technical Standards for Medical Waste Incinerator (GB19218-2003); 14) Standards for Pollution Control on Hazardous Waste Storage (GB18597-2001) 15) Notice to Strengthen the Management of the Medical Solid Waste by Law issued by the Health Department in June 2004

2.1.3 Guidelines and Regulations on the EIA Technology

1) Technical Guidelines for Environmental Impact Assessment - General Principals (HJ/T 2.1-2011); 2) Technical Guidelines for Environmental Impact Assessment - Atmospheric Environment (HJ/T 2.2-2008); 3) Technical Guidelines for Environmental Impact Assessment- Ground Water Environment (HJ/T 2.3-93); 4) Notice on the Quality Assessment Methods for the Ground Water Environment Issued by the Environmental Protection Department (Trial 9 Mar. 2011) 5) Technical Guidelines for Environmental Impact Assessment - Acoustical Environment (HJ/T 2.4-2009); 6) Technical Guidelines for Environmental Impact Assessment - Ecological Environment (HJ19 -2011); 7) Technical Guidelines for Environmental Impact Assessment - Underground Water Environment (HJ610 -2011); 8) Technical Guidelines for Project Environmental Risk Assessment (HJ/T 169- 2004). 9) Temporary Methods on the Public Participation in the EIA (HF2006 No. 28) 10) Technical Standards on the Water and Soil Conservation for the Construction Project （－）GB50433 2008 11) Technical Standards on the Applicable Area Classification of the Environmental Noise in the Urban Areas GB/T 15190 94 12) Letter from the State’s Environmental Protection Head Bureau (HB Letter 2005 No. 713)

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report 2.1.4 Local Regulations and Documents

1) Environmental Protection Regulations of Chongqing Municipality (1 Sept 2007) 2) Regulations on the Water Pollutant in the Yangtze Three Gorges Water Reservoir Areas and Valleys (29 July 2011) 3) Improvement Programmes on the Standardization of the Discharging Outfall (YHF2001 No.556) 4) Chongqing Environmental Noise Pollution Prevention Methods (Chongqing Gov. Decree No. 126) 5) Methods to Implement the State’s Water and Soil Preservation Law in Chongqing (28 Nov. 1997) 6) Regulations on the Functional Zone Classification of the Chongqing Environmental Air Quality (YFF 2008 No.135) 7) Regulations on the Applicable Function Category Classification of the Ground Water Area in Chongqing (YFF 1998 No. 89) 8) Notice to Adjust the Functional Category of the Ground Water Area Issued by the Chongqing Environmental Protection Bureau (YHF 2009 No.110) 9) Notice about the Adjustment Programme of the Applicable Area Classification for the Noise Environmental Quality Standard Issued by the Chongqing Environmental Protection Bureau (YHF 2007 No. 39) 10) Notice to Modify the Adjustment Programme of the Applicable Area Classification for the Noise Environmental Quality Standard Issued by the Chongqing Environmental Protection Bureau (YHF 2007 No. 78) 11) Modification on the Chongqing Ecology Functional Zone Classification 2008 12) Notice about the Collective Treatment of the Medical Solid Waste in the Urban Areas (YH2004 No. 88) 13) Notice to Further Strengthen the Medical Solid Waste Management Issued by the Chongqing Municipal Gov. (YFF2007 No.71) 14) Opinions to Speed up the Key Works for the Health Improvement in 2011 Issued by the Chongqing Municipal Government (YFF No.16 2011) 15) Programmes to Implement the Chongqing Urban and Rural Integration Environmental Protection Works issued by the Chongqing Municipal Government (YFF2009 No. 45)

2.1.5 Main Planning Documents

1) Planning on the Water Pollution Prevention in Three Gorges Reservoir Areas and the Up-stream Areas of (Revision) (YHF2008 No.16) 2) General Planning on the Chongqing Urban and Rural Integration (2007- 2020) 3) The 12th Five-year Planning about the National Economical and Social Development in Chongqing 4) Health Action Plan for the “Health Chongqing” (2008-2012) 5) The 12th Five-year Planning about the County and District Health Industry Development Planning in the Chongqing Ecological Functional Zone Classification (Revision)

2.1.6 Project Relevant Documents

1) FSR of the project 2) Social Assessment Reports of the Projects 3) Memo of the World Bank Project Identification Mission for the CURIP II (10 to 19 July 2011) 7

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report 4) Memo (final version) of the World Bank Preparation Mission for the CURIP II in China (4 Nov. to 31 Oct. 2011)

2.1.7 Assessment Standards

The assessment standards include the environmental quality standards and the discharging standards for the pollutant and the environmentally functional classifications for the proposed projects issued by the Chongqing Environmental Protection Bureau and the relevant county / district-level environmental protection bureaus.

The environmental quality standards and the discharging standards are shown in Appendix A.

2.2 Safeguard Policies of the World Bank and the Guideline of EHS

World Bank OP4.01: Environmental Impact Assessment

World Bank OP4.12: Involuntary Resettlement

General Guidelines of the International Financing Company for the Environment, Health and Safety

Guidelines of the International Financing Company for the Environment, Health and Safety of the Health Service Institutions

Among the 10 basic safeguard policies of the World Bank, the OP4.01 is the most basically requirement and is one of the main basis for compilation of the environmental assessment report for the project. Through the data collection about the environmental impact assessment for the hospitals and site investigation, the Table 1-2 shows the items relating to the safeguards policies and procedures of the World Bank. No cultural heritage has been found in the locations of the proposed hospitals and nearby areas (the Cultural Heritage Protection Management Bureaus of the project counties and districts have issued the confirmation letters, see Attachment D). Hence, the project hospitals have nothing relating to the World Bank’s safeguards policies regarding cultural heritage.

Table 2-1Items of the CURIP II relating the WB’s safeguard policies

No. WB’s safeguard policies and procedures CURIP

1 OP 4.01 Environmental Assessment Relating

6 OP 4.12 Involuntary Resettlement Relating

2.3 EA Classification

Because the project are scattered in the big region, according to the field survey of the Bank’ EIA experts and CPMO together with EIA team, the project is generally located in urban 8

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report built-up areas or planning zones for urban development, where the environment vulnerable areas, such as ecological sensitive impact that require special protection and social concern are not existent. In addition, the impact in terms of scale and range caused by medical waste water and medical waste, if they are well managed is not serious, and can be minimized or mitigated to an acceptable level. At the same time, the treated effluent from the proposed medical wastewater treatment stations and the medical waste to be generated from the project hospitals can be further treated or disposed by local facilities. The project has been classified into Category B of the World Bank.

3 Environmental Impacts and Mitigation Measures

3.1 Analysis of Potential Negative Environmental Impacts of CURIPII

Analysis of major environmental impacts of CURIP are listed in Table 3-1.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report

Table 3-1 Analysis of environmental impacts of CURIP

Location of impact Period Impact factors Source and process of impacts Main pollution factors Level of impact Features source

Low impact for Ecological expanded Small scale environment Earthwork ,construction Construction ,land acquisition Proposed hospital site hospital, high vegetation damage solid waste, soil erosion impact for new and soil erosion

hospital

Low impact for Low and scattered Along the earthwork Transportation vehicle, new hospital, impact for new Traffic noise and mechanic and material Sound environment construction equipment ,blasting high impact for hospital, high noise transportation line works expanded impact for and construction site hospital. expanded hospital, Construction Peirod Surface source , Transportation , stored materials, TSP 、PM 、NO 、 Along transportation Small sphere of exhaust of construction 10 2 Ambient air line and construction Heavy TSP influence equipment, construction of And CO site structure of hospital

Domestic wastewater, garbage Water environment SS 、COD Construction camp Low A Little dispersed and construction solid waste

Immigrant relocation and resettlement, land and resource use, Along transportation Short-term, partial Social environment occupation of road, traffic jam and medical services of the line and construction Significant impact expanded hospital will be influenced within short time , site

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report

Location of impact Period Impact factors Source and process of impacts Main pollution factors Level of impact Features source

Due to the increase of the number of beds and Sound Vehicle entrance and Low impact and outpatient, the traffic Operation Period Vehicle noise out area of the within small Long-term impact volume will be increased, environment hospital scope so the traffic noise will be increased on a certain basis.

Peculiar smell from Slight impact and Peculiar smell of ammonia, Medical wastewater Air Environment medical wastewater within small Long-term impact hydrogen sulfide, odor etc. treatment station treatment station scope

Surface water Number of fecal coliform Slight impact and Medical wastewater Medical wastewater within small Long-term impact treatment station 、、COD BOD 5、、SS NH 3N scope

Guided discharge of Reduce soil surface runoff of the Ecological erosion, restore Long-term hospital, enhancement of environment Surrounding area of the damaged beneficial effects flood control measures in Soil erosion and vegetation the hospital vegetation the surrounding area, slope

protection and ecological

restoration

Improvement of the resettled immigrants’ life; improvement of medical services of the project hospitals related hospital, ease the problem of “difficult and expensive to see a doctor," be Direct and indirect Long-term Social Environment conducive to achieving "Healthy Chongqing" objective in the Significant impacted area bbeneficial effects project districts/counties. Building of green hospital will help to improve doctor-patient relationship and the social environment will be stable and harmonious.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report

Location of impact Period Impact factors Source and process of impacts Main pollution factors Level of impact Features source

Implicative impact As the quality of medical services improved, the number of The hospital entrance of outpatient and hospital bed utilization rate will be increased , the transportation and the adjacent road Significant in a people hospitalized and accompanying person will result in the Environment certain time beneficial effects increase of the traffic volume, therefore , road traffic near the

hospital may be pro-resistance

Construction of hospitals of district and county-level and the improvement of medical service capability will be good to the Long-term Resident health in Areas covered by healthy development of hospitals of district and county-level, the beneficial effects districts and three-level medical Significant health of residents in districts/counties will be secured; the counties system situation of disorderly disposal of medical waste will be improved.

Some accidents may occur Small probability Social and in medical wastes The place where events, preventive Medical wastes High ecological collection, storage or accident occurred measures and transportation. emergency plans

3.2 Medical Wastewater Treatment during Operation Period of CURIP

For treatment of medical wastewater from project hospitals during operation period, medical wastewater treatment stations will be constructed. For some medical wastewater treatment stations where the effluent will be discharged to the existing WWTP for further treatment, the Pre-treatment Standard of Discharge Standard for Liquid Pollutants from Medical Institutions will be implemented. For those medical wastewater treatment stations where the effluent could not be discharged to the existing WWTP for further treatment, the Discharge Standard as specified in Discharge Standard for Liquid Pollutants from Medical Institutions will be implemented. The details for it are shown in Table 3-2.

Table 3-2 Medical Wastewater Quality and Volume of Project Hospitals

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report

Fuling 265.4 Before 398 106 153 15 / 10 Biological Permit (after contact meet the pre- After 180 70 60 3.8 / 1.1 oxidation treatment process 290m3 standard) /d

Tongnan 122.4 Before 300 150 120 30 1.6×108 / Secondary Permit (after anaerobic meet the pre- After 250 100 60 25 5000 / treatment and treatment disinfection standard) process 130m3 /d

Wanzhou 257 Before 300 150 120 30 1.6×108 / Secondary Permit to anaerobic discharge into After 60 20 20 15 500 / treatment and the Yangtze disinfection (after meet the process 257 discharge m3/d standard)

Dianjiang 104 Before 400 200 / 50 1.6×108 / Enhanced Permit (after primary meet the pre- After 250 100 / 35 5000 / treatment and treatment disinfection standard) process120m3/d

Wushan 134.86 Before 300 150 120 30 1.6×108 / secondary before treatment before Jiangdong

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report

County Waste Before /After Waste Water Quality mg/L Fecal Corliform number/L Proposed Waste Permit to Enter Water Treatment Water the Waste Volume COD BOD5 SS NH3N Fecal Animal/Plant Treatment Water m3/d Corliform Oil Process and Treatment Capacity Plant or not treatment before Jiangdong After 60 20 20 15 500 / the completion Sewage Plant of Jiangdong completion, After 200 100 60 25 5000 / Sewage Plant; discharge into and class 1 Daning River; treatment after After the completion completion, of the follow the pre- plant 200m3/d treatment standard

Chengkou 285.5 Before 300 150 120 30 1.6×108 / Enhanced Permit (after primary meet the pre- After 250 100 50 20 5000 / treatment and treatment disinfection standard) process 300m3/d

Qianjiang 180.2 Before 300 150 120 30 1.6×108 / Secondary Permit (after anaerobic meet the pre- After 250 100 60 25 5000 / treatment and treatment disinfection standard) process 200m3/d

Youyang 370.16 Before 300 150 120 30 1.6×108 / Biological Permit (after contact meet the pre- After 250 100 60 25 5000 / oxidation treatment process 400m3 standard) /d

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report

Note 1: Water disinfectant: chlorine dioxide (site preparation) (Dianjiang County TCM Hospital plans to use sodium hypochlorite for disinfection); Disinfectants for sludge: lime

Note 2: Pre-treatment standard in the Table refers to the pre-treatment standard in the Medical Institution Water Pollutants Discharge Standard GB18466-2005

Note 3: In the short term, the Jiangdong Branch of Wushan TCM Hospital adopts the aerobic biological contact oxidation and disinfection process, and follows the pre-treatment standard in the Medical Institution Water Pollutants Discharge Standard; in the long term, it will adopt the secondary anaerobic treatment and disinfection process, and follows the pre-treatment standard in the Medical Institution Water Pollutants Discharge Standard.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report

3.3 Engineering Measures for Disposal of Medical Solid Waste and Control of Noise and Exhaust Gas Emission

3.3.1 Medical Solid Waste Disposal during Operation Stage

Domestic solid waste disposal sites and construction waste disposal sites in each project district/county are shown in Table 3-3.

Table 3-3 Construction solid waste statistical information District/Cou Excavation Filling Spoil Construction Domestic Sludge nty 0.01Millio 0.01Million 0.01Milli waste t waste t n m3 m3 on m3 Fuling 2.2 0.9 1.3 5545/5500 7.3 2t District Tongnan 3.0 0.6 2.4 32.7 4.8 County Wanzhou 10.0 10.0 0 107.2 11 County Dianjiang 0.7 0.1 0.6 192 13.2 County Wushan 27.0 0 27.0 68.9 10.8 County Chengkou 3.53 1.93 1.6 451/400 12 About0.5t County Qianjiang 1.3 1.0 0.3 （ Balla 83.8 7.3 District st filling ） Youyang 3.0 / 3.0 2800/2715 4.4 About0.5t County 50.73X 10 4 14.53 X 36.2 X 9280.6/8615 70.8 Dangerous m3/71.022 10 4 10 4 waste Total X 10 4t m3/20.342 m3/50.68 about 3t X 10 4t X 10 4t 516151 Dangerous Total discard ，t waste about3t Note 1: Above / is the total amount for construction waste, under / is the waste of old building dismantle; The bulk specific weight of earth and stone is 1.4 t/m 3. Note 2: The sludge is produced from dismantling the original medical wastes disposal station, and the 2t of sludge from Fuling Hospital includes about 0.4t of old asbestos heat preservation material from dismantling the original boiler.

The construction spoil will be transported by trucks to domestic waste landfill site in each district/county to be used as covering soil. The surplus rocks and construction garbage will be transported to construction garbage disposal site in each district/county. The domestic solid waste will be collected by public sanitation department and transported to the domestic solid waste disposal site. To implement EMP, maintain the environmental quality in construction sites to meet the requirements for function zones. Special attention should be paid to soil preservation and ecological protection on slopes, spoil disposal sites and other temporarily occupied sites.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report 3.3.2 Engineering Measures for Medical Solid Waste Disposal during Operation Period

The amount of medical solid wastes produced by hospitals of CURIP II during operation period and their collection, temporary storage, transportation and disposal are shown in following Table 3-4.

3.3.3 Engineering Measures for Control of Noise and Exhaust Emission during Operation Period

When the hospitals of CURIP II are put into operation, the noise is mainly from the blowers of cooling tower of air condition system, the ventilation blowers of the underground garage and pumps in the wastewater treatment station. The low noise equipment will be used, and engineering measures such as sound barrier and vibration reducing facilities will be adopted so as to meet the site noise standard. The odor from the wastewater treatment stations will be collected and discharged after being adsorbed by active carbon. Clean energy including electricity or natural gas will be used in canteen and exhaust will be emitted after treatment.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report

Table 3-4 the amount of medical waste generation in CURIP district/county, and its collection, temporary storage and transportation

Project Medical Collection and temporary storage Transportation and treatment District/Counties waste ，，，t/a

240.9 Collection : The waste is removed for centralized treatment in an anti-leak, sealed, safe and sanitary manner by special Fuling District Plus 4.2(sludge) Separate collection of waste in both bags and boxes vehicles of the solid waste treatment center of Fuling district in Chongqing. Temporary storage :

Medical waste after disinfection treatment is packed in solid, impermeable and moist-proof airtight containers with adequate tensile strength and clear The proposed temporary storage spot is 12 km away color logos. The medical waste is temporarily stored in the second floor of from Fuling medical waste treatment center. The the basement in the proposed inpatient complex. This floor, covering an transport route is as follow: the hospital → Renming area of 30m 2, is big enough to accommodate three days’ waste, and is far West Road → Liming North Road → Liming South from both the medical district and the patients’ recreational area. Storage Road → Taiji Avenue → Fuhao Road → the solid facilities for medical garbage and living garbage are separated, with the waste treatment center wastewater from the temporary storage floor directly channeled, through pipes, to the medical waste water treatment station.

Medical waste can be transferred from the temporary storage floor to lower floors through the nearest elevators for medical waste, and then directly to the medical waste transfer vehicles through the waste channels on the west. The whole transferring route will not pass such sensitive areas as wards so as to avoid the risks of cross infection.

In accordance with the regulation, preventive measures will be adopted in this new medical waste temporary storage spot. Brick walls and baffles will be built; Bold notice board will be set up; The spot will be cleaned and disinfected on a regular basis.

Medical Waste Management Regulation shall be strictly implemented, with professionally trained stuff dealing with the daily collection and

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report

Project Medical Collection and temporary storage Transportation and treatment District/Counties waste ，，，t/a transference of the waste under a strict registration system.

Tongnan District 33.58 plus The two medical waste temporary storage spots will be located at the Yongchaun district-located Chongqing Mingzhi 4(sludge) northwest corner of the second floor and the east side of the fifth floor Environmental management Co. Ltd. is responsible respectively, both far away from the medical district, food processing for the transference and treatment. The distance district and the patient’s recreational area. Storage facilities for medical between the hospital and this company’s centralized garbage and living garbage are separated, with the wastewater from the treatment site is 90km. The fine road condition and temporary storage floor directly channeled, through pipes, to the medical convenient transportation facilitate the transference waste water treatment station. Medical waste can be transferred from the process, mainly relying on Provincial Road 205, temporary storage floor to lower floors through the nearest elevators for Chongqing Suining Expressway, and Chengdu medical waste, and then directly to the medical waste transfer vehicles Chongqing Expressway. through the waste channels in the northeast corner. The whole transferring route will not pass such sensitive areas as wards so as to avoid the risks of cross infection.

Wanzhou District 76.3 plus 20 Medical waste is transferred to the storage spot by special hand trucks or The distance between the proposed spot and (sludge) trailers which will be rinsed and disinfected on a regular basis. The medical Yongchuan district’s centralized treatment site is 20 waste temporary storage spot under this project is located at the southeast km. The fine road condition and convenient corner of the hospital (near the sewage treatment station), separated from transportation facilitate the transference process, the living garbage storage facility and equipped with rainproof devices. It is mainly relying on Wanzhong Road, Changjiang in the waste concentration area, far from the medical district, food Bridge, Wanzhou Avenue, Wanzhou Lichuan processing district, and populated areas. There are special entrances and National Road 318. exits around, making it convenient for the loading and unloading of medical waste and the staff’s and transfer vehicles’ in and out. In accordance with the policy requirements, the medical waste storage spot will have little impact on the surroundings. With hardened ground, the seepage-proof medical waste storage room avoids direct sunshine and is separated from the food preparation and supply area and the garage. Beside it is locked to prevent random in and out. Only the cleaning staff and vehicles with permission are allowed in for transference and cleaning purposes. Measures are also adopted to prevent the rodents and insects. The existing water resource will be used for cleaning and disinfection. The

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report

Project Medical Collection and temporary storage Transportation and treatment District/Counties waste ，，，t/a drainage system within is linked with the sewage treatment station. Besides, the room is equipped with lighting, ventilation, protective clothing, standby bags and vessels.

Dianjiang County 56.9 plus 8(sludge) To strictly implement the medical waste management regulations, the Chongqing Fuling District Medical Treatment medical waste will be treated after classified collection. A new medical Center, 108km away from the proposed spot under waste temporary storage room of 4m 2 will be built in the southwest corner this project will be responsible for the waste of the hospital complex. Clear signposts will be put up. Efforts will be removal. The detailed route is as follow: Dianjiang→ taken to ensure that the room is airtight and anti-leak, and that the Chongqing Yibin Highway → Fuling/Changshou → proliferation of pathogenic bacteria is prevented by means of daily Changshou Fuling Highway → National Road 319 disinfection and sterilization. Special attention will also be paid to the → Wujiang Road → Park Road →Square Road → management work of the temporary storage, transference and treatment of Square Ring Road →Wutai Road → Fuling the medical waste. District ；

Wushan County 47.82 plus Each floor in all buildings of the hospital has a medical waste collection The distance between the hospital and Wanzhou 35(sludge) room and the inpatient department is equipped with medical waste Medical Waste Centralized Treatment Center is 150 channels. These wastes, after classified collection, are temporarily stored in km. The fine road condition and convenient the first floor of the basement from where this waste is removed and treated transportation facilitate the transference process, by a qualified medical waste treatment company (Wanzhou Senhao Co. mainly relying on the Shanghai Chengdu Ltd.). Expressway.

Chengkou County 88.56 plus 7.29 The medical waste temporary storage spot is located at the basement storey The distance between the proposed spot and (sludge) 2 of the proposed project, far away from the medical district, patients’ Wanzhou Medical Waste Centralized Treatment recreational area, facilitating the in and out of the staff and transfer Center is 130 km. The route is as follow: Chengkou vehicles. The disinfectant and fluid, used after the daily removal of medical County (Provincial Road S202) → Kaixian waste, can be channeled into the sewage treatment station. (Provincial Road S102 and Wanzhou Kaixian Highway) →Wanzhou (G318) →Changling Town

Qianjiang District 67.71 plus The waste temporary storage spot is located at the southern part of the The medical wastes are dealt with by Qianjiang 1.0(sludge) Zhengyang District, covering an area of 112 m2, far away from the medical Medical Waste Centralized Treatment Facilities, district, food processing district and the patients’ recreational area. Storage which covers a distance of 8.5 km, mainly through facilities for medical garbage and living garbage are separated, with the the Zhengzhou Road, to offer on -site collection and

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report

Project Medical Collection and temporary storage Transportation and treatment District/Counties waste ，，，t/a wastewater from the temporary storage floor directly channeled, through removal service. pipes, to the medical wastewater treatment station. Medical waste can be transferred directly to the transfer vehicles without passing such sensitive areas as wards so as to avoid the risks of cross infection.

Youyang County After the extension, the medical waste temporary storage spot will be The medical wastes are dealt with by Qianjiang located at the basement storey of the emergency complex, with clear Medical Waste Centralized Treatment Facilities. The 43.8 plus 4.2 signposts. Preventive measures will be adopted. Medical Waste transportation distance is 50km, mainly relying on (sludge) Management Regulation shall be strictly implemented, with professionally the National Road 319. The road condition is fine, trained stuff dealing with the daily collection and transference of the waste and the transportation is convenient. under a strict registration system. Medical wastes, amounting to 100kg daily can be transferred from the temporary storage floor to the basement storey through the nearest elevators for medical waste, and then directly to the medical waste transfer vehicles. The whole transferring route will not pass such sensitive areas as wards so as to avoid the risks of cross infection. Sub-contractors will deal with the centralized treatment of these wastes. The waste water from the temporary storage spot will be channeled, through pipes, directly to the medical wastewater treatment station. The living garbage will be put in barrels and kept in rain-proof and anti-leak areas until the sanitation department staff come to remove them and get them treated on a regular basis.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

4 Environment Management Plan （（（）（ EMP）））

CURIP II Environment Management Plan for construction and operation period consists of proposed mitigation measures, environment monitoring, reporting requirement, emergency response procedures, institutional arrangement, capacity building & training, cost estimate and performance indicators.

EMP will be part of project management work. Project management offices at municipal, district/county level have appointed special staff to supervise EMP implementation status. Requirements in EMP must be incorporated into contractual document: 1) to ensure that the bid winner understands exactly their duties during construction; 2) to be a basis of enforcement and reporting once substandard measures taken due to breach of contract. Besides, the major mitigation measures and completion status of monitoring assignment could be linked with disbursement condition of the contract.

4.1 Purpose of EMP

The purpose to prepare EMP is to improve activities of project screening, location selection, planning, design and implementation by establishment of practical and feasible measures to mitigate or compensate adverse impact and enhance favorable impact. In conclusion, measures required in EMP is to be taken to mitigate adverse impact and will be evaluated by environment monitoring plan, then the further mitigation measures will be proposed based on the monitoring result.

EMP includes mitigation, monitoring and institutional building measures in period of project design, construction and operation, which will be applied to mitigate or compensate adverse environment impact to an acceptable level and meet the requirement of related state and local environmental protection standard.

4.2 Environment Management Organizations and Duties

Environment protection management organization and its duties are shown in Figure 6-1. EMP organization consists of management agency, supervision agency, implementation agency and monitoring agency.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Environmental management agencies involved at design and construction stages

Chongqing Development and Supreme Supervision Agency Ministry of Environmental Protection of PRC; Reform Committee (CDRC) The Bank World Bank Ministry of Health of PRC Enviro nment Management Organization during Safeguard inspection design and construction Chongqing Environmental Protection Bureau; The Chongqing World Bank Project Chongqing Health Bureau Management Office (CPMO) Top daily Executive departments of the Supervising organization Chongqing environment Implementation agency Fuling EPB; Health Bureau of Fuling; protection bureau, Chongqing Development & Reform at construction stage: Tongnan EPB; Health Bureau of Tongnan; communication bureau, Committee and PMO at Project Implementation Unit contractor Wanzhou EPB; Health Bureau of Wanzhou; Chongqing Health Bureau etc. district/county level; (PIU) Dianjiang EPB; Health Bureau of Dianjiang; (Participating hospitals) Wushan EPB; Health Bureau of Wushan; Chengkou EPB; Health Bureau of Chengkou; Qianjiang EPB; Health Bureau of Qianjiang; Liuyang EPB; Health Bureau of Liuyang; Environment Communication Bureau of Fuling; Contractor Construction Design Environment assessment units monitoring units Communication Bureau of Tongnan; supervising units unit s Executive departments at Communication Bureau of Wanzhou; district/county level: environment Communication Bureau of Dianjiang; protection bureau, communication Communication Daily Bureau supervision of Wushan; agency bureau, health bureau etc. Communication Bureau of Chengkou; Communication Bureau of Qianjiang; Communication Bureau of Liuyang’ Project Implementation Unit (PIU) Environment (participating hospitals) monitoring units

Environmental management agency

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Implementation agency Monitoring agency Environment supervising organization 4.2.1 Management Organization Fig. 4-1 Environment Management and Sup ervising Organization of CURIP II Environmental protection management organization and its duties are presented in Table 4-1.

Table 4-1 Environment protection management organization and its main duties

Organization Duties Remarks

1 daily environmental protection expert at On behalf of Chongqing Municipal Government and Chongqing least. Environment supervisor (engineer) Chongqing World Bank Development and Reform Committee, CPMO will coordinate and manage is planned during construction, who is to Project Management for CURIP, be responsible for making the environmental protection supervise the environmental protection Office (CPMO) meeting requirement of WB safeguard policy. measure as required in EMP and bidding document.

Instruct construction unit to execute the state’s environment protection Chongqing laws and regulations; be responsible for or supervise domestic approval of Responsible for approval of EA report of Environmental EA documents of sub-components, supervise implementation of major sub-components Protection Bureau environment protection measures; be responsible in total for checking and acceptance of environment protection.

Be responsible of Chongqing health project design, capacity building & Responsible for approval of EA report of major sub- Chongqing Health components training, supervision and management of health facilities at construction Bureau and operation stages.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

On behalf of government and Development and Reform Committee at Integrate and coordinate local health DRC at district / county district/county level, it will coordinate and manage for CURIP in their bureau, EMP, communication bureau to level own jurisdiction, be responsible for making the environmental protection advance project. meeting requirement of WB safeguard policy.

Health bureau at district To be the health policy guidance of local Supervising and managing of participating hospitals & county level hospitals

Communication bureau To coordinate for a smooth city Traffic management of participating hospitals at construction and at district & county transportation network at construction operation stages level and operation stages

Supervising and managing of environmental protection measures within Responsible for approval and registering EPB at district & county their jurisdiction at construction and operation stages; Responsible for EA for supplementary EA report of sub- level approval & recording, and check and acceptance of environment components protection of EA.

4.2.2 Supervision Organization

Environment protection supervising organization and its main duties are described in Table 4-2

Table 4-2 Environment supervisiion organization and its main duties

Organization Duties Remarks

Responsible for check and confirmation of EA files of projects. Administrative EP department of Chongqing Environmental Supervising and management to the environment protection of Chongqing City Protection Bureau the construction; organize and coordinate relating structures to serve for the environment protection; supervising

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

implementation of EMP; responsible for final acceptance of environment protection facilities of the project; Confirm the environment laws and regulations the project should abide with; instruct environment protection bureau of areas and counties to supervise and manage the environment during construction and operation; accept, investigate and coordinate public complaints about the environment , supervising improvement of environment protection facilities and measures.

Accept guidance from Chongqing Environmental Protection Bureau, 3 EPBs at district level: Wanzhou, detailed supervise the construction unit to implement EMP, execute Fuling, Qianjiang; concerning environmental management laws, regulations; coordinate the 8 EPBs at district / county level departments to perform environmental works; responsible for 5 EPBs at county level: Tongnan, construction, completion, check-up of operation conditions, supervision Dianjiang , Wushan, Chengkou, Liuyang and management of the environmental facilities for sub-items inbound; accept, investigate and coordinate environmental complaints from public, supervise environmental facilities and improve measures.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

4.2.3 Agencies Responsible of Implementation, Executing and Monitoring

8 hospitals under CURIPII are executing agencies for EMP which is an incorporated part of bidding document. Contractors, being the implementing agencies for EMP, will take contractual measures as requested in EMP and carry out internal environment monitoring. Chongqing Environment Monitoring Center and district/county level environment monitoring stations whose environment monitoring qualification have been certified by the State, will perform the individual and objective monitoring according to contractual agreement with executive or implementing agencies.

4.3 Code of Good Practice for Environmental Management

The codes of good practice for environmental management are presented in Table 4-3.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Table 4-3 Codes of Good Practice for Environmental Management

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan)

A. Design period /

1.Location Comprehensive analyzing and comparison of hospital sizing and location in aspect of Design CPMO, Health selection & environmental protection, social demand, technology, economy and engineering; institute, EA Bureau, DRC at dimension unit, social district/county The determined sizing and location shall be approved by related departments of governments at assessment level municipal, district/county level, as well as PIUs. unit

2.Ecological The location selection and general layout shall respect the principle of occupying fertile land Design CPMO, DRC & protection and quality forest land as little as possible. institute, EA EPB at measures unit, social district/county In order to mitigate acoustic environment impact, the green belt (sound filter) and bounding assessment level, Chongqing wall with plant attached will be planned in the adjacent area between proposed hospital and unit EPB, Forestry planned road or city road. Bureau etc.

The layout of plant shall be highlighted in waiting area and in-patient building.

3.Traffic noise Optimize hospital flow design and general layout to mitigate impact of traffic noise during Design EPB at operation period. institute, EA district/county unit level The hospital location shall be easy accessible for patient and the beyond the noise reachable area.

4.Surface water Expansion of hospital at the existing location shall make fully use of domestic wastewater Design EPB at pollution treatment facilities in good operation. district/county institute, EA level, Water The appropriate process for medical wastewater treatment shall take advantage of current unit Resource Bureau infrastructure facilities with consideration of operation status for domestic wastewater

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan) treatment plants of participating districts/counties (or town, economic development zone). The process shall meet the pre-treatment (WWTP in operation) or discharge (no WWTP).

Subcomponent located in the catchment area of drinking water, the diversion and drainage system for rain water must be designed in detail as well as wastewater treatment.

Under the precondition of process requirement, location for medical wastewater treatment station shall make full use of wing area, take fully consideration of green area at aiming of raising land utilization rate. Gravity flow is more preferred in water treatment process for the sake of energy saving. In addition, design capacity of medical wastewater treatment station shall consider development as well as risk.

5.Atmospheric The deodorization treatment for waste gas from medical wastewater treatment station shall be Design EPB at pollution in good design; optimization of layout of self-supplied diesel generator and noise control district/county design; optimization of ventilation design of underground parking lot; institute, EA level unit Optimization of layout of eatery and boiler room, and design of oil fume removal and vent system.

6. Medical waste General layout for temporary storage point of medical waste requires prevention of rat, fly and Design EPB at cockroach; district/county institute, EA level Water – sewage separation design is required in medical waste collection and transportation. unit

Rinsing, drainage and diversion design for temporary storage point and waste collection trunk/barrel.

Seepage control design for temporary storage point;

7.Lighting, natural Natural lighting and ventilation shall be well used in design. Design CPMO, DRC and ventilation, and EPB at

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan) natural scenery district/county The hospital design shall take advantage of local natural scenery. institute, EA level unit

8.Radiation The general layout and prevention of radiation room shall meet the national code. Design Chongqing EPB, prevention EPB at The layout of radiation room must meet the requirement stated in “Standard for Radiological institute, EA district/county Protection in Medical X-Ray Diagnosis (GBZ130-2002)”: the placement of X-Ray diagnosis unit level, Health room shall fully consider the prevention and safety issues in the surroundings. Bureau

9.Risk control Based on the emergency response plan in relation to accidents of hazardous chemistry Design CPMO,DRC at transportation or medical waste collection and transpiration. district/county institute, EA level Design optimization: Clo2 disinfection room in WWTP, raw material (on-site preparation of unit clo2) storage room; ventilation facilities be put in place to strengthen ventilation; the smooth evacuation is the key point in designing of disinfection room where needs to be equipped by automatic alarm system for clo2 leakage.

10.Cultural relics The existence of cultural relics shall be investigated in the area where subcomponent located. Design CPMO institute, cultural heritage department

11. Water & soil The design needs to be optimized in: earthwork balance, dumping site, location of temporary Design CPMO, EPB at conservation piling point for surface soil. district/county institution, A level If the dumping site is built by subcomponent itself, the approvals from local Land & unit Resource Bureau and EPB are required and the water & soil conservation measure needs to be taken: retaining wall and intercepting ditch to be built respectively in downstream and upstream of dumping site, drainage ditch at both sides, outlet of drainage ditch needs to be

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan) connected with sediment tank; leveling and forestation are required once dumping site completed.

The temporary piling area for surface soil (used as an overlay) shall be designed with interception ditch and sediment tank, the color stripped cloth shall be atop on surface soil.

12 ． Construction Construction camp shall be located in the existing village or nearby, instead of closing to the Design CPMO, DRC and camp / access road environmental sensitive points. EPB at to construction institute, EA district/county site Access road to construction site shall make full use of existing road or to be built inside land unit level occupying area under the subcomponent; Access road for temporary use shall 1) be built on the village road with avoid area with large-scale residential point, school, hospital and natural vegetation in good condition,

Construction camp not built in the existing village shall equipped by septic tank or urine directing toilet

13.Traffic effect The proposed hospitals will be located in the built-up or planning area and are adjacent to Design CPMO, DRC and municipal road. To prevent traffic jam in construction and operation period, the design shall be EPB at optimized in hospital inside & outside layout, exit & entrance, parking lot. institute, EA district/county unit level, Communication Bureau

14. Earthquake The level of anti-seismic capacity of the hospitals should be at least one level more than the Design CPMO, DRC and Has been ordinary civil structures in the project area. institute, EA EPB at included in the unit district/county main structure level, Health cost Bureau,

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan)

B. Construction refer to period chapter6.9

Interruption to The contractor should separate the construction area from the hospital medical services, set Contractor, CPMO, DRC and routine operation aside or build new secure channel for medical services and patients, specially assign full-time EPB at of Fuling District staff to ensure the clear access to the ambulance; district/county Hospital, level, Health Chengkou County The hospital should set up the flowers or fish tank in the hospital outpatient waiting area for Bureau, Forestry Hospital and viewing , to adjust the waiting crowd psychology, in particular, to strengthen the setting of Bureau Youyang County fixed and mobile medical advisory services; Hospital and impact on the Construction in night is prohibited. Optimization of medical care processes, shorten the waiting surrounding area time for the type-B ultrasonic, endoscope and other examinations. During the noon, operation of equipment with high noise should be banned.

Hospital inpatient building adjacent to the construction site side, the windows and balconies should be closed properly.

Contact the urban management department, to rectify unlicensed vendors and people occupied the road or places to do business in front of the hospital.

The construction sites should be fenced with steel plates or wall with height more than 2.5 m and more than 3 m in sensitive sections. Open space should be established between the construction sites and the hospital buildings with warning signs set up near the site. Full-time staff should be signed by constrictors to guide people avoid the construction sites.

Safety nets should be installed at site to protect the people near the site.

Separate entrance and exit should be established exclusively for construction vehicles and workers.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan)

Preparation should be done before the commencement of construction covering survey of local roads, power supply and communication. The contractor should develop construction plan with relevant authorities; emergency plan should be included in the construction plan to ensure the normal activities of the residents.

Contractor should cooperate with traffic department and police bureau in guiding the traffic flow where necessary, and information on traffic management near the hospitals should be disseminated to the public via radio, TV or newspaper.

Bulletin board should be set up at the construction site informing the construction schedule and the hotline number for complaints.

The contractor should contact the relevant departments for development of water supply and water supply. In the area where the power capacity is low, the power supply line should be established for the construction site prior to the commencement of the construction.

Access roads should be provided for pedestrians on the sensitive sections where hospitals, schools, residential blocks and commercial areas are located.

Construction in night should be banned; where construction in night is necessary, permit should be obtained from local environmental department and the construction plan for night construction should be disseminated to the public near the construction site.

Traffic flow of pedestrians and the construction fleet should be separated;

Local me trials are preferred for procurement so as to reduce the transportation distance. Bus should be used for workers to travel between the camp and the construction sites.

Mitigation to noise impact on surrounding area:

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan)

Noise control measures should be used and the location of equipment should be far from sensitive areas.

Equipment with low noise level should be used and well maintained.

Construction should be carefully scheduled on the section near sensitive areas.

Travel speed of construction vehicles should be reduced when entering the area sensitive to noise.

Equipment should be well maintained to reduce noise.

Operation staff of equipment should be shifted to reduce the exposure to the noise; the worker near the noise source should be equipped with ear plugs.

Transportation route of materials should be far from noise sensitive areas, i.e. schools.

Equipment with strong noise and vibration should be banned from operating on noon.

The road sections near the construction sites should be frequently sprayed with water.

Before the construction, the site should be enclosed, the ground for construction and entrance should be hardened, vehicle washing devices should be provided on site.

Construction site should be sprayed with water in excavation work; during the backfilling the site should also be spayed with water.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan)

Stockpile yard for materials should be covered or sprayed with water. Spoil and construction waste should be collected and cleaned in timely manner.

Overloading of vehicles should be avoided and the transportation vehicles should be covered. The transportation route for materials should be planned to avoid the area where traffic is intense. On the sections where traffic control is implemented, transportation in night should be carefully planned; the dust leaked during transportation should be cleaned.

Before construction is started, the contractor should develop earth balance plan; spoil should be reused where possible, if not, the spoil should be transported to the deposit sites or landfill sites designated by municipal department.

The solid waste should be collected and transported on daily basis to the landfill sites designated by municipal sanitation department.

The earth and spoil should be piled and compacted, the pile should be covered.

The area beside the roads should be prohibited from stockpiling of materials.

Permit should be obtained for transportation of construction solid waste;

Burning of construction solid waste should be banned.

Management of wastewater

The wastewater from construction sites should be treated in settling tanks before discharging into municipal sewers. Direct discharge of construction wastewater into surface waters should be banned.

Education on surface water protection should be provided to the contractors.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan)

Full-time staff should be assigned by contractors to supervise the collection and transportation of spoil. Direct dumping of spoil into surface streams should be banned.

1.Ecological Before construction kickoff, public bulletin board shall be set up around the job site for the Contractor, CPMO, DRC and 4.8 protection protection of wildlife and natural vegetation. And promotion and education for ecological supervision EPB at measures protection shall be conducted to the contractors; company district/county level, Health As soon as the construction staff enter the jobsite, ecological protection education shall be Bureau, Forestry conducted immediately, and relevant knowledge, laws and regulations regarding ecological and Bureau environmental protection shall be promoted;

Full time staff from the supervision company and contractor shall temporarily undertake the supervision job on ecological and environmental protection. In the manner of patrol supervision, the execution of eco-protection measures and the staff’s protective behaviors shall be inspected;

Issues regarding construction sites, camp sites, and access roads, etc. shall be coordinated with the local forestry administration before hand, so as to reduce the destruction to the uttermost upon the soils and vegetation around the jobsites;

While temporarily using the farming land or forest land, the surface 30-40 cm soils on the land shall be scooped off, piled up or collected and preserved, and shall be reclaimed as soon as the construction is finished;

Strengthen the management during construction period. Capturing and killing wildlife by construction staff, and abuse in cutting and slashing forest are strictly forbidden;

The unidentifiable plants within the lands of the project shall be identified by the technicians from the local forestry administration station. If belonging to the protection by the nation, the plant shall be marked and transplanted to a safe location before construction kickoff;

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan)

For the hospitals in expansion, the principle of “protection on the spot” shall be applied to all the existing trees along both sides of the subgrade, the original ecological resources shall be preserved as far as possible.

The civil work shall be arranged in non-rainy season so as to 1)improve effective load and transportation efficiency of vehicle;2)keep city clean by reducing water loss, making the air pollution by cyclone dust under control.

Earthwork excavation in the project area shall be planned scientifically with the principle of “the earthwork transported and backfilled shall be as much as excavated” to avoid water pollution by water & soil erosion resulting from unnecessary piling and spoil earthwork.

Side ditch and intercepting/flood discharge ditch shall be built before construction start to avoid the loose earth being flushed into river, pond, culvert or farm land by runoff.

Earthwork in large scale shall not be arranged in rain season; earthwork in rain season shall be in a consecutive process of excavation, transportation, filling, compacting to avoid water & soil erosion; the temporary piling site shall be placed with simple bar, flood interceptor and simple sediment tank; the piling earthwork needs to be covered and compacted when storm comes

Wushan County TCM Hospital Jiangdong Branch to be built under the sharp gradient geological condition is required to design with interceptor on the upper slope to discharge runoff.

2.Construction Keep the construction machines and vehicles in good working condition, reduce the Contractor, CPMO, DRC and 9.9 noise simultaneous working time of noisy equipments; supervision EPB at company district/county Properly choose and arrange construction machines, strive to use low noise equipment and level, Health place high noise equipment far away from noise sensitive areas; Bureau

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan)

Strive to avoid sensitive areas such as dense residential area, school and hospital in selection of transportation route; The climbing slope shall be avoided as much as possible; vehicle shall be at a slower speed and reduce whilst as much as possible.

Strive to adjust construction time, and avoid affecting environmental sensitive locations such as hospital, school etc;

When constructing around sensitive locations, adopt temporary noise reducing measures, such as assembled baffle plate around the construction area, pile up soil Bank as temporary noise reducing walls with excavated and compacted soil that was to be disposed.

For continuous operation such as construction casting etc that require night noisy operation close to residential area, or day time noisy operation around schools, 3 days before the continuous construction, the construction company must apply to the local protection bureau following the application and approve procedure regulated in “Administrative Measures of Chongqing municipality on Prevention and Control of Environmental Noise Pollution”. After approval, a “Temporary Permit of Pollutant Discharge” will be issued; the construction company must keep the “Temporary Permit of Pollutant Discharge” on the construction site for reference before the continuous construction work begins, and announce it to the public in the form of bulletin board to try to prevent the noise from affecting the public population.

Within 15 days before the college entrance exam and senior high school entrance exam, construction work at night that causes noise pollution is forbidden (excluding emergency repair)

Construction machines such as pile driver and excavator must stop working at night (22:00— 6:00)

Exit & entrance for construction vehicle for Fuling, Liuyang and Chengkou, the instruction from traffic management department is advisable to control or whilst forbid whilst

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan) and no whilst at night with the purpose of mitigate noise impact to the surrounding resident, school etc.

3. Surface water Construction material, such as asphalt, oil, paint etc must not be placed close to rivers, fish Contractor, CPMO, DRC and 7.8 pollution pond or drinking water well etc, there must be sufficient canvas for cover to prevent the supervision EPB at material from entering water body on rainy days. company district/county level Farmland irrigation, might be affected by construction, shall be equipped with temporary ditch or water transmission pipeline to restoration or reconstruction permanent irrigation and water drainage system.

When constructing close to water body, the water side of construction site must set up temporary retaining walls, to prevent earth and rocks from clogging up rivers, ditches, or irrigation & draining system, avoid affecting the water body or animal and plant in the water;

To strengthen construction machinery management; the regular site for car washing and facilities for oil separation and sediment shall be put in place.

Rainfall in construction will bring surface runoff with high content of SS and oil, the diverted drainage ditch and oil separation sediment tank are required on the construction site. The initial rain water through process of oil separation and sediment will be used to control dust or rinsing of construction machinery. The rain water in extra will be leached through land for discharging with reduced impact to surface water.

Do not set up construction camp close to environmental sensitive point but the existing house can be used.

To ensure the good health condition in construction site.

To ensure the safety of drinking water.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan)

To strive for using municipal wastewater pipeline to domestic wastewater discharge; construction camp not equipped with septic tank or urine directing toilet, the waste shall be mixed with soil and used for materials for greening or agriculture after construction completed.

The temporary material piling site shall be at a hidden place instead of riverside, occupying farmland and place with beautiful scenery.

The greening work or ground consolidation shall be completed as soon as possible after construction finished to reduce impact to surface water caused by rain water flushing.

4.Atmospheric It is suggested that asphalt mixing station use enclosed stirring device with dust-removal Contractor, CPMO, DRC and 6.6 pollution device; soil and concrete mixing station use enclosed stirring method; supervision EPB at company district/county Set up vehicle washing facilities and simple sand traps at the exit of construction sites; the level surface of the roads leading in and out of the stock ground and borrow site, dumping place etc must be kept wet and pave bamboo fence or grass mat etc to reduce the dust when vehicles pass by, or windy times. Soil transported with existing roads must not have high water content, or else mud will drip along the way, affect the tidiness of road, and produce secondary dust.

In dry, rain-less and windy weather, the construction company must equip or rent certain numbers of street sprinkler to sprinkle water on unpaved temporary road, construction road and stock ground, twice a day (once each morning and afternoon) to reduce dust pollution. For sensitive locations such as school, hospital, residential area etc, sprinkle times should be increased in dry and windy weather.

For stock ground that easily get sprinkled with fine powder substance, the location of the ground should be chosen downwind to sensitive locations, wind prevention and covering measures should also be taken to reduce dust;

For the transportation of bulk concrete, sand and lime, covering measures must be taken to

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan) reduce dust;

Strengthen the maintenance of construction transportation machines and reduce exhaust gas discharge

5. Solid waste In the Fuling, Youyang, Chengkou and Tongnan county hospital projects, the sludge generated 3.0 during the demolishment of old medical wastewater treatment station should be limed on sites. Then the naturally dewatered sludge should be sealed and transported to hazardous waste disposal plant located in adjacent counties ( Fuling, Wanzhou and Yongchuan districts). Before civil works construction or transfer, the original sludge pond sites should be limed and stabilized. The asbestos as heat insulation material of old boiler room in Fuling people’s hospital should also be sealed and transported to Fuling hazardous waste disposal plant.

The construction solid waste generated by demolishment of old building and construction shall be disposed in the slag disposal pit appointed by relative district/county construction commission.

The extra rock and soil can be taken as covering soil in landfill or transported to construction waste disposal sites.

The domestic solid waste collected by rain prevention litterbin should also be disposed in the appointed site.

For works with large volume of soil, rock and solid waste transportation, as Wushan county sub project, spillage prevention measurement must be addressed during the transportation to avoid impact on urban environment and dust problem.

6. Cultural relics During the construction, once possible cultural relic is founded, the construction must be Contractor, CPMO, DRC and 1.8 stopped immediately. supervision EPB at company district/county The contractor shall protect the site and informing the relative cultural relic department at the level, cultural

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan) same time. heritage management Construction can’t continue until confirmation from relative department obtained. department

7. Traffic impact Feasible construction plan and transportation impact mitigation plan should be included in the 27.9 bidding document:

Logical arrangement of transportation timing and routes to avoid traffic jam;

Setting up bulletin board on construction transportation road intersection to remind the social vehicles to detour.

Construction material should be tided up and setting up fences in the construction sites adjacent road;

If possible, extra size material, such as steel, and machines should be arranged in holiday or 20:00 to 22:00 with low traffic load. Specific staff should be designated to introduce vehicles to avoid destruction on municipal public facilities and adjacent buildings. Unless reported and approved, previous actions can’t be arranged during the night. Unloading noise mitigation measures and no-whilst measure should be adapted.

Reduction of unloading vehicle lagging time on site to avoid traffic jam.

During the construction period, the municipal water supply, sewer, natural gas pipes and electricity & communication line should be protected to avoid possible traffic jam cause by accident settlement.

Applying for supporting from traffic patrol platform for following aspects;

1) No parking in the access road of hospital construction sites;

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan)

2) In the specific time and road section, non-construction or non-patient vehicles should detour.

3) Optimization of traffic signal in construction affected area;

4) Traffic control in the construction area and adjacent roads on vehicles and pedestrian;

5) Remote informing and diverting to passing big vehicles to alleviate traffic load;

8.Public Transportation of bulk material should not pass the township trade road or on the market Contractor, CPMO, DRC & 4.8 disturbance trading day. supervision EPB at company district/county Transportation at night shall at the slower speed and no hooking. level

The construction activities should not ruin public service facilities at neighborhood.

The municipal approval for temporary occupying sidewalk in construction is required; besides, the temporary access road for pedestrian shall be built. Seeped materials at construction site or splash by transportation vehicle to pedestrian shall take drainage measures timely; the vehicle for construction transportation must in slow driving in water gathered section.

Fuling hospital, Chengkou hospital and Liuyang hospital: if the construction has to occupy overhead space of sidewalk, the solid platfond, rail and breast wall must be set, as well as lighting facilities.

To easy contact with related agencies when complaints caused by noise, air pollution and other impact, billboard must be placed in a striking place on each construction site with information related to name of constructor, supervision company, hotline of local EPB, contact name.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan)

9.Health and Provide epidemic disease prevention information to construction workers; Contractor and CPMO, 3.6 safety supervision district/county Provide sufficient labor protection equipment to construction workers; company level DRC/EPB/Healt Provide safety prevention information to public population around the construction site; h Bureau

Set up warning sign for danger at the construction site, forbid public population from entering the construction site or any other dangerous location;

Strictly handle dynamic and explosive operation

Interruption of The construction sites for the hospital of Fuling, Chengkou and Youyang should be fenced and Contractor Supervision - Hospital operation the entrance and exit of the site should be guarded by full-time staff assigned by the company, PMO contractors;

During hoisting materials in the site, full-time staff of contractors should warn the people and guide them to avoid the proximity of the site;

Material transportation vehicles should lower speed when entering the construction sites;

The entrance and exit of the hospital should be guided

Construction activity should be banned from 22:00 pm to 8:00 am;

Lower noise equipment should be preferred and used on site.

10.Disease and Timber for construction (wood package for equipment included) from other areas must pass the local forest district/county 1.8 pest prevention inspection at local Forest Prevention Stations. prevention level forestry stations bureau

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan) subtotal 72 training in EP training shall be provided to each contractor and 2 supervisors from supervision company CPMO CPMO, EPB 19.8 construction (senior leader included) before construction. period EMP and other EP document must be incorporated into special conditions of bidding document for making EP as a legal responsibility to contractor.

C、、、 Operation RMB 10 4/year

1.Traffic Traffic management inside of hospital to improve operation efficiency: to avoid traffic jam participating Chongqing EPB, 64.8 environment causing by vehicle lining up to hospital; to establish guiding system in the underground parking hospital, EPB at effect lot; to introduce a charge mode of paying parking fee in advance to avoid traffic block at exit. related liner district/county (to be covered departments level, Health by operation Optimization of external traffic organization to improve vehicle distribution condition: bureau, cost, 2 persons establishment of striking guiding system and sign board; consulting with municipal district/county for each management and communication departments to adjust, widen and channel part of roads level subcomponent) outside hospital. management department of Applying to municipal traffic management departments for taking administrative measures to municipal road at strengthening traffic management at exit and entrance of hospital.

1) ”No parking” board will be placed nearby exit and entrance of hospital; taxi temporary stop will be set in the principle of proximity.

2) Improvement of public traffic facilities around hospital, as well as walking environment.

3) Rectification of occupying space by vendor to avoid traffic jam caused by people.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan)

2.Medical Medical wastewater treatment facilities for each hospital is in good operation, outgoing participating 17 wastewater wastewater can meet the national standard (pre-treatment standard for discharge standard); hospital Chongqing EPB, To make fully use of domestic wastewater treatment plant in each participating district/county: EPB at accepting hospital treated water which has met the pre-treatment standard. district/county level, Health The special wastewater in small amount needs to be pre-treated or individual treatment. Bureau

Medical wastewater needs to be disinfected before discharge.

The flat grate outlet will be placed at the road outside Wanzhou Hospital to collect rain water from road, sidewalk and house roof. The rainy water collection tank will have disinfection treatment on the initial rain water after a long period of drought. The rain water pipe to be built (0.5km in length) will divert the runoff to the downstream river of Gaofeng Reservoir with purpose of ensuing water quality of Gaofeng Reservoir.

3.Medial waste The classified collection trunk (barrel) shall be adopted for medical waste. participating Chongqing EPB, 198.5 hospital, EPB at The medical temporary storage point shall be placed with established prevention measures of medical waste district/county rat, fly and cockroach, leakage and raining water. treatment unit level, Health bureau Sorting collection barrel and temporary storage point shall have striking logo (signs) with different color; the cleaning and disinfection at a regular time basis is required.

“Administrative Rules of Medical Waste” must be strictly followed with a routine procedure of collection & transportation by the appointed person in every day and filling up the shifting registration.

Medical waste shall be transported by turnover box or small noise free rubber tire vehicle as much as possible.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan)

The vehicle transporting hazardous substance and medical waste shall certified by three licenses (Business License, Business Permit to collect and handle dangerous waste, Business Permit to Transport for dangerous waste); The special purpose vehicle is required to transportation of hazardous waste and medical waste.

The medical waste transfer system shall be respected.

After transportation of medical waste piled at temporary storage point, the corridor passing through, elevator shall be in process of disinfection and sterilization.

The emergency response team for handling leakage accident of hazardous goods and medical waste shall be established in each involved district/county; the emergency plan shall be developed too.

4.Radiation Standards for radiological protection in medical diagnostic X-ray （ GB8279-87 ） shall be participating Chongqing EPB, （ to be listed respected in procurement and installation of medical facilities. hospital EPB at under operation district/county cost ） The external exposure of radiation room shall meet the national standard. level, Health bureau The safety and prevention measures shall be taken to the working staff of radiation and examinee.

Primary measures: radiation protection wall, protection door, lead glass to be put in place; strengthening management and training of technician in x-ray department; establishment of emergency response plan.

5. Solid waste The waste activated carbon in medical wastewater treatment station will be recycled and treated participating Chongqing EPB, 26.5 by qualified unit. hospital EPB at district/county Sludge (screenings included) in medical wastewater treatment station will be 1) in a sealed level package before lime disinfection and natural evaporation dehydration; 2) transported and

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan) package before lime disinfection and natural evaporation dehydration; 2) transported and disposed by medical waste disposal site.

Domestic waste will be collected and transported by the nearby waste collection station.

6. Waste gas Waste gas collected by medical wastewater treatment station will be in process of activated participating EPB at 58 carbon absorption to meet the “Discharge standard of water pollutants for medical organization hospital district/county (deodorization); (GB18466-2005)”before discharging on the rooftop through special pipeline. level

The material used in the boiler room shall be the clean fuel such as natural gas. 84 （ to be listed Gas & smoke discharge facilities shall be placed in the eatery. under operation cost ）

7. Noise Diesel generator, ventilator, air compressor (main source of noise) etc, shall be placed participating EPB at 44.1 basement or special equipment chamber. hospital district/county level （ to be listed Roof cooling tower: mitigation measures include vibration absorption, water muffler, external under operation blinds; cost ）

Track monitoring on external acoustic effect: Lianhuadong Road side of Tongnan Hospital; Wanzhong Road side of Wanzhou Hospital; Provincial highway S103 side of Wushan Hospital, eastern planning road of Wushan Hospital; Zhengzhou Road side of Qianjiang Hospital.

The comprehensive noise control will be taken, together with track monitoring; if beyond 2 nd grade of acoustic environment standard, further management measures will be taken.

8.Disease Physical check for the staff working in medical wastewater treatment station and being participating Health bureau at （ to be listed prevention responsible of classified collection; hospital district/county under operation level cost ）

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Stage Code of Practice Implemented Supervised by Budget by (RMB10 4yuan) level cost ） Staff in medical wastewater treatment station and being responsible of classified collection and staff engaging in classified collection shall be equipped with labor protection supplies, as well as rinsing & disinfection facilities. subtotal 300 /year

Training in Dissemination of medical waste classified collection to hospital staff: to understand the participating district/county 8.4 operation period meaning of different color labeled on the classified collection bag (red: contagious waste; hospital level PMOs, EPB yellow: infectious waste; green: damage waste)

D. Monitoring Environment monitoring at a regular time basis, refer to monitoring plan. district/county EPB at level district/county environment level monitoring agency

Note: RMB 1.929mil yuan/year in operation period will be covered by operation cost; the medical wastewater treatment station and diesel generator will be included in engineering cost and is not presented in the table above.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

4.4 Environment Monitoring Plan

CURIP II monitoring plan is presented in Table 4-4.

Table 4-4 CURIP II Monitoring Plan

Item Parameter Location Duration & Monitoring unit Supervision & Budget Frequency management unit (RMB, 10 4)

Construction refer to Chapter period 6.9

Domestic Name of Internal domestic Contractor, PIU, PIU 1.6 wastewater on site wastewater monitoring: all of wastewater outlet and commissioned treatment construction sites, at a random check monitoring unit facilities, status all of domestic (in operation or wastewater outlet not), effect, discharged to

pH 、NH 3- External twice/year, once Chongqing EPB at 6.4 N、BOD 5、 monitoring: for dry and rainy environment district/county COD 、、Oil fecal selected season, 1 sample / monitoring center, level coli form construction sites each time or district/county environment monitoring stations

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Item Parameter Location Duration & Monitoring unit Supervision & Budget Frequency management unit (RMB, 10 4)

Construction pH 、、SS Oil Internal non-polluted Contractor, PIU, PIU 1.0 wastewater monitoring: all of industrial and commissioned construction sites wastewater outlet monitoring unit at a random check

External Twice/year, 1 Chongqing EPB at 2.0 monitoring: sample /each time environment district/county selected monitoring center, level construction sites or district/county environment monitoring stations

Ambient air TSP 、SO 2、NO 2 external Once at the peak Chongqing EPB at 6.2 monitoring: of construction environment district/county environmental every year; monitoring center, level sensitive points at sampling or district/county school and requirement: 8h of environment residential areas daytime for monitoring close to consecutive 5days stations construction site for each point (1 point) every time

Acoustic Leq(dBA) Internal random inspection Contractor, PIU, PIU 1.0 environment monitoring: but at least once and commissioned construction site every month, 1 monitoring unit

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Item Parameter Location Duration & Monitoring unit Supervision & Budget Frequency management unit (RMB, 10 4) construction site every month, 1 monitoring unit boundary and day for each time adjacent (day and night) residential building (2 points)

External once at the peak of Chongqing EPB at 4.0 monitoring: construction every environment district/county environmental season, 1day for monitoring center, level sensitive points each time(day & or district/county close to school & night) environment residential area monitoring stations

Traffic Traffic Internal random inspection Contractor, PIU PIU 2.0 environment smoothness of monitoring: roads related township close to road construction site

Water & soil Top soil storage, Internal random Contractor, PIU, PIU 1.0 conservation detention pond, monitoring: inspection, at least and commissioned intercepting ditch, construction site once for rainy monitoring unit flood discharge and all of season of every ditch, retaining dumping sites of year wall etc. spoiled earthwork

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Item Parameter Location Duration & Monitoring unit Supervision & Budget Frequency management unit (RMB, 10 4)

Disease Clean water Internal random inspection Contractor, PIU, PIU, Health 1.0 prevention supply, medical monitoring: and commissioned bureau consultation etc. construction monitoring unit camp, construction site subtotal 26.2

Operation period RMB, 10 4/year

Medical pH 、NH 3- External Twice/year, 1 Chongqing EPB at 7.2 wastewater N、BOD 5、 monitoring: sample /each time; environment district/county COD 、、oil fecal external outlet of monitoring center, level, health coliform medical One time/quarter, or district/county bureau wastewater 3 samples/each environment treatment plants time for Wanzhou monitoring for participating and Wushan stations hospitals Hospitals

Domestic External once/year, 1 Chongqing EPB at 1.6 wastewater monitoring: sample /each time environment district/county external outlet of monitoring center, level medical or district/county wastewater environment treatment plants monitoring

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Item Parameter Location Duration & Monitoring unit Supervision & Budget Frequency management unit (RMB, 10 4) for participating stations hospitals

Medical waste collection Internal Twice/year participating EPB at 1.8 facilities, monitoring: hospital district/county temporary storage collection points, level, health facilities, temporary storage bureau pollutant-cleaning points; collection distributary, – temporary operation record, storage point;; handling loading temporary storage & unloading, point – loading duplicate forms site; for transfer of hazardous waste

Radiation effect radiation Internal Twice/year participating EPB at 1.8 prevention monitoring: inside hospital district/county measures; safety & outside of level, health measures for radiation room bureau working staff and examinee

ionizing radiation External Once/year qualified EPB at 2.0 monitoring environment district/county monitoring station level, health

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Item Parameter Location Duration & Monitoring unit Supervision & Budget Frequency management unit (RMB, 10 4) monitoring station bureau

Solid waste waste activated Internal Twice/year participating EPB at 1.8 carbon, sludge monitoring: hospital district/county from medical medical level wastewater wastewater treatment station; treatment station, domestic waste collection and temporary storage points for domestic waste

Waste gas NH 3； Internal Random participating EPB at 1.0 monitoring: inspection, at least hospital district/county neighborhood of twice /year level, medical wastewater treatment station

External Twice/year Chongqing EPB at 1.6 monitoring: in the environment district/county area of 10m monitoring center, level, outside perimeter or district/county of medical environment wastewater monitoring

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Item Parameter Location Duration & Monitoring unit Supervision & Budget Frequency management unit (RMB, 10 4) treatment station stations

Noise Leq (dBA) the Internal Twice/year, 1 day Contractor, PIU, PIU 1.0 public disturbed monitoring: in- for each time (day and commissioned by the noise? Or patient building, and night) monitoring unit Leq (dBA) medical room, residential building outside hospital or school

Leq(dBA) External Twice/year, day Chongqing EPB at 3.0 monitoring: for each time (day environment district/county environmental and night) monitoring center, level, sensitive points or district/county inside and outside environment hospital (2 points) monitoring stations

Traffic Traffic in Internal Twice/year Contractor, PIU, PIU 1.0 environment smoothness monitoring: exit & and commissioned entrance of monitoring unit hospital, municipal roads close to the hospital

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Item Parameter Location Duration & Monitoring unit Supervision & Budget Frequency management unit (RMB, 10 4)

Disease Labor safety Internal Twice/year Contractor, PIU, PIU 1.0 prevention monitoring: and commissioned wastewater monitoring unit treatment station for hospital and household; waste collection and temporary storage points for hospital and household; subtotal 24.8

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

4.5 Capacity Building

4.5.1 Training Program

To ensure effective implementation of EMP, the PIUs and monitoring agencies must be competent. Given the extensive coverage of mitigation measures and monitoring, the EMP training will be provided to PIUs and district/county PMOs in purpose of distinguishing their own duties so as to seek the agreement in object, methodology and detailed measures of environment management. Contractor, being the important trainee of training, is supposed to carry out mitigation measures required in EMP during construction period, be responsible for environmental safety of construction, and ensure the construction activities is within environment capacity.

EMP training at construction period will be covered by project budget, while EMP training in operation period will be covered by operation & maintenance cost. Refer to table 6-5 for capacity building and training plan.

Table 4-5 Capacity building and training plan

Items Trainee Content Frequency Day/ Person/ Budget, 10 4Yuan time time

Construction period

Environmental PMOs at 1.EP laws & 9 0.5 4 4.5 protection district/county regulations regulations & level policies 2.EP policy & plan 9 0.5 5 PIU 3.WB environment 9 0.5 5 Contractor management

EMP Contractor 1.EP responsibility 9 0.5 4 13.5 implementation in construction PIU 2.Main task of EP 9 0.5 4 in construction

3.Main content of 9 0.5 5 EP in construction

4.Reports required 9 0.5 5 in EMP

5.Improvement or 9 0.5 4 revision of EMP

6.Internal 9 0.5 5 monitoring method, data collection & processing

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan Crisis PIU crisis management 9 0.5 4 1.8 management measure Contractor subtotal 45 19.8 operation period

Environment PIU EP facilities, 9 0.5 4 3.6 monitoring ecological inspection, restoration, reporting inspection of soil & water conservation, environment quality monitoring, report preparation

Environmental PIU 1.Research & 9 0.5 5 4.8 protection management of facilities & medical wastewater measures discharge

2.Medial waste: 9 0.5 5 collection, temporary storage and final disposal management

3.Environment 9 0.5 5 safety regulations & policy, procedure

4.Emergency 9 0.5 5 response plan subtotal 24 8.4 total 69 28.2

4.5.2 Equipment (Material) Procurement Plan

CURIP II will carry out environment-friendly procurement plan. The environment-friendly principle could be extended to contract management, disbursement via procurement document, which requires contractual party to take mitigation measures and perform environment monitoring as requested in EMP.

As high-cost of environment protection activities are classified into engineering measures, such as soil & water conservation, ecological restoration, medical wastewater treatment station, medical waste storing point etc, the corresponding materials and facilities have been included in engineering procurement plan. The corresponding procurement plan will be provided by contractor and operation units with fund being covered by project cost.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan Procurement plan for EMP equipment (materials) will focus on requirement of procurement procedure.

In the implementation of EMP (mitigation measure) and monitoring process, the procured raw material and equipment supplier have to be certified by local EP executive department via environment acceptance procedure, while the kind of equipment & materials with lower cost but being unfriendly to environment and resource/energy wasting should be refused.

Environment monitoring unit shall make commitment that: 1) no damage to vegetation, no garbage left on site; 2) wastewater and gas generated by monitoring or analyzing shall be treated to discharge standard.

The procurement for compact equipment of medical wastewater treatment plant, such as pump, boosting pump, ClO2 disinfection facilities shall: 1) meet the requirement in terms of process demand, capacity and standard; 2) meet the requirement of EP regulations in relation to noise, waste gas leakage/discharge.

The grass and sapling suitable to local soil and climate or being planted in an adjacent area shall be preferred in vegetation restoration, which will prevent the alien organism invasion.

In conclusion, the raw materials and equipment to be procured shall meet 1) the requirement of process demand, treatment capacity; 2) the environment friendly requirement in terms of low environment load, energy saving, long service life, easy recycling and treatment, convenient to disassemble.

As for NBF procured material and equipment, it’s still a part of CURIP II. The alternative procurement procedure is allowed but the quality has to be satisfactory, matching with others, timely delivery, environment friendly and cost effective.

In addition, liquor, cigarette and other hazardous substance are non-environmental friendly and it’s inappropriate to be procured.

4.6 Public Complaint and Feedback Mechanism

4.6.1 Public Complaint

During environment impact assessment period, the public could 1) express their opinions via forum or filling up questionnaire sent by EA units; 2) put forward their comments or suggestions by sending a letter, email, fax, making a call to the contractor or EA units; 3) make complaint to district/county level EPB, local petition office.

During construction or operation period, the public could 1) put forward their comments or suggestions by sending a letter, email, fax, making a call to the contractor or PIU; 2) make complaint to district/county level EPB, local petition office.

In receipt of complaint from EP departments or rectification notice from administrative agency and the EA units, the contractor and PIU, together with related agencies, shall organize the site-visiting, investigation, publicize the rectification plan to solve EP dispute.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan 4.6.2 Feedback Mechanism

Based on the environment monitoring report and inspection by supervision agencies, the mitigation measures in EMP will be adjusted accordingly and the environment management activities will be further improved.

If major deviation from EMP found during inspection, or huge adverse environment impact caused by project variation, or the number of affected people by adverse environment increased a lot, CPMO will consult with the Consultant immediately. Meanwhile, WB will organize EA team to conduct additional assessment. The public consultation will be carried out, if necessary. The revised EIA with EMP inclusive must be submitted to WB after approved by EPB. The revised EMP shall be informed to PIU and contractor to perform accordingly.

4.7 Report Mechanism

EMP implementation report schedule for CURIP II (Health Project) is shown as Table 4-6. The reports shall also include record (in form of picture and writing) of recording, handling and response of public complaint.

Table 4-6 EMP Implementation Report Schedule Stage and Name To be Prepared To be received by Frequency Report Type by Construction Stage Internal Internal Contractor Project Hospital twice each Monitoring Monitoring half year and Inspection Report Internal Project Hospital District/county EPB, 1 each half Monitoring District/county PMO, year Report CPMO External Each external contractor or District/county As per monitoring monitoring qualified EPB,District/county monitoring and inspection report environmental PMO, CPMO plan monitoring station Report to WB Semiannual CPMO WB 2 each year progress report Operation stage External Trial contractor or District/county once monitoring operation qualified EPB,District/county acceptance environmental PMO report monitoring station Internal Internal Project Hospital District/county EPB, 1 each year Monitoring Monitoring District/county PMO Report

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan 4.8 Emergency Procedure for Major Environment Impact during Construction Period

During construction period, if major environmental impact incident happens (i.e. serious traffic jam or other cause which leads or could lead to suspension of hospital daily operation), contractor should take the following emergency procedure:

Make the following analysis: whether the onsite equipment, material storage layout and route of transportation traffic is reasonable; whether the hydrological/climate condition is abnormal; whether any significant factor is interfering with construction and transportation; whether the supply of water, electricity, fuel and communication is normal; whether the staff from contractor strictly follow the construction procedure/rules, etc.

Whether the environmental mitigation measures have been strictly followed during construction

After excluding external factors, improvement suggestion on mitigation measures should be proposed or emergency plan to mitigate negative impact should be implemented, and supplementary environmental monitoring should be conducted following implementation of improvement suggestion or emergency plan

The process/result of implementation of improvement suggestion or emergency plan shall be included in contractor’s internal monitoring report If, following investigation, construction and transportation factor are ruled out, measures should be taken to curb the spread of the negative impact, and report should be made to related government administration and PIU. 4.9 Implementation Plan

The implementation plan of EMP is shown in Table 4-7.

Table 4-7 Implementation of EMP （、、、Q1 Q2 Q3 Q4 refers to Quarter 1～Quarter 4） Year One 2012 Items Q1 Q2 Q3 Q4 To open to the public in the To revise EMP, revise and project affected areas the detail mitigation measures, environmental protection check environment measures in accordance standards and environmental with EMP. Complete Mitigation measures function zones, stipulate approval procedures for format for various reports, spoil disposal sites, soil evaluate variations and reservation in construction update mitigation measures. camp and ecological protection

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan To prepare specifications and bidding documents for independent external monitoring, the format of monitoring report and requirements for semi- Procure independent annual external monitoring environment monitoring Monitoring report. To formulate units through competitive environmental indicators for bidding for PIUs. monthly supervision report and reporting format of environmental indicator in monthly supervision report.

To form EMP implementing agencies and make clear their responsibilities. District/county PMOs and EPBs responsible for regulation, PIUs responsible for implementation of EMP, and contractors responsible for implementation of Each contractor should mitigation measures for specially assign one full- construction period, PIUs time or part-time Institutional Strengthening responsible for environment management implementation of person to work with mitigation measures for environment supervisor and operation period, PIU. independent external monitoring agency responsible for environmental monitoring, preparation of monitoring reports and evaluation reports.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan To implement the environment management training plan. Each contractor should propagandize To prepare the environment environmental protection, management training plan animals and plants Training for PIUs, contractors and preservation and soil district/county PMOs. preservation to their staff,

especially the mitigation measures, and enhance the medical information to prevent infectious diseases.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Year Two 2013 Items Q1 Q2 Q3 Q4 To implement To implement To implement EMP, EMP, EMP, maintain maintain the maintain the the To implement environmental environmental environmental EMP, maintain quality in quality in quality in the construction construction construction environmental sites to meet sites to meet sites to meet quality in the the the construction sites requirements requirements requirements to meet the for function for function for function requirements for zones. Special zones. Special zones. Special function zones. attention attention Mitigation attention Special attention should be should be measures should be paid should be paid to paid to soil paid to soil to soil soil preservation preservation preservation preservation and ecological and and and ecological protection on ecological ecological protection on slopes, spoil protection on protection on slopes, spoil disposal sites and slopes, spoil slopes, spoil disposal sites other temporarily disposal sites disposal sites and other occupied sites. and other and other temporarily temporarily temporarily occupied sites. occupied occupied sites. sites.

To authorize monitoring To authorize units and monitoring units To authorize To authorize prepare and prepare monitoring monitoring monitoring monitoring units and units and reports. To reports. To Monitoring prepare prepare prepare semi- prepare semi- monitoring monitoring annual annual external reports reports external monitoring monitoring report report

Institutional ／／ / / Strengthening

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Training ／／ / /

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Year Three 2014 Items Q1 Q2 Q3 Q4 To implement EMP, maintain the environmental quality in construction To implement sites to meet EMP, the According to maintain the requirements EMP To implement environmental for function requirements, EMP, maintain the quality in zones. Special the land environmental construction attention (spoil site, quality in sites to meet should be etc.) construction sites the paid to soil temporarily to meet the requirements preservation occupied requirements for for function and should be function zones. zones. Special ecological returned to Special attention attention protection on cultivation Mitigation should be paid to should be slopes, spoil and measures soil preservation paid to soil disposal sites vegetation and ecological preservation and other recovery just protection on and temporarily after slopes, spoil ecological occupied construction disposal sites and protection on sites. completion, other temporarily slopes, spoil To do well including occupied sites. disposal sites the surface soil and other landscaping backfill, temporarily during the vegetation occupied final sate of reinstatement. sites. construction,. Local types of plant preferred to reinstate and compensate vegetation.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan To authorize To authorize monitoring monitoring units and units and To authorize prepare prepare To authorize monitoring monitoring monitoring monitoring units units and reports. To reports. To Monitoring and prepare prepare prepare semi- prepare semi- monitoring reports monitoring annual annual reports external external

monitoring monitoring report report

Institutional / / / / Strengthening

Training ／／ / /

4.10 EMP Cost Estimate

Costly environmental protection activities for CURIP II (i.e. water/soil conservation, ecological recovery, medical wastewater treatment and medical waste temporary storage facility) are all structural measures and their cost have been incorporated into engineering cost, which will be listed in the bid for the project. Cost listed in EMP is mainly for environmental management during construction and operation period, which covers mainly mitigation measures, environmental monitoring and training with the total amount being RMB 4.512 mil.

Cost estimate for environmental protection works of CURIP II is summarized in Table 4-8 and 4-9.

Table 4-8 CURIP II Environmental Protection Cost Estimate

Project Environ- Investment Discharge mental Pollutant Prevention Measure Source Hospital Impact (10 4 yuan)

Fuling After collection, to be District Odor deodorized and Gas WWT Station discharged through 4 Pollution special pipe leading to housetop

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Project Environ- Investment Discharge mental Pollutant Prevention Measure Source Hospital Impact (10 4 yuan)

To be conveyed by 3 included in Diesel oil engine SO 、flue special pipe and 2 engineering (temporary use) gas 、NO 、 CO discharged high above X cost roof

162 included COD 、BOD To be treated by newly 5 in built WWT Station Hospital engineering SS 、NH -N (270m3/d, Enhanced wastewater 3 cost Water Primary Pollution Fecal coliform Treatment+disinfection)

Heavy metal, Clinical To be collected and acid, laboratory disposed of by external 3 wastewater qualified organization Alkaline

Medical waste / To be temporarily stored in allocated room before disposed of by sludge / qualified external organization 25

Solid Waste Recovered by qualified Used active / organization before carbon reuse

To be collected by Domestic garbage / sanitary service and 2 sent to landfill

Proper layout, vibration Noise 5 included in mitigation, noise Equipment noise Noise engineering elimination, building as cost noise barrier

Subtotal RMB 0.34 mil listed in mitigation cost in operation period 204

Tongnan After collection, to be County deodorized and discharged through air Pollution WWT Station Odor special pipe leading to 5 housetop

To be conveyed by 5 included in Diesel oil engine SO 、flue special pipe and 2 engineering (temporary use) gas 、NO 、 CO discharged high above X cost roof

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Project Environ- Investment Discharge mental Pollutant Prevention Measure Source Hospital Impact (10 4 yuan)

Oil smoke purifier, to 10 included Kitchen oil be conveyed by special in Oil smoke smoke pipe and discharged engineering high above roof cost

To be treated by newly COD 、BOD 5 built WWT Station 100 included Hospital (130m 3/d, two stage in SS 、NH -N wastewater 3 anaerobic+disinfection), engineering Water a canteen oil screening cost Fecal coliform Pollution tank to be built

Clinical To be collected and Heavy metal, laboratory disposed of by external 3.0 acid, alkaline wastewater qualified organization

To be temporarily stored in allocated room Medical waste / before disposed of by 9.0 qualified external organization

Disinfected/water absorbed by lime and Sludge / 1.0 sent to medical waste disposal site Solid Waste Recovered by qualified Used active / organization before / carbon reuse

To be collected by Domestic garbage / sanitary service and 2.0 sent to landfill

To be cleared and Kitchen garbage / disposed of by qualified organization

Proper layout, vibration 3 included in mitigation, noise Noise Equipment noise noise engineering elimination, building as cost noise barrier

other EIA, Environmental acceptance, environmental monitoring 20

RMB 0.20 mil to be included in operation period mitigation Subtotal 158 measure

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Project Environ- Investment Discharge mental Pollutant Prevention Measure Source Hospital Impact (10 4 yuan)

Wanzhou After collection, to be District deodorized, disinfected and then conveyed WWT Station Odor 12 through special shaft to be discharged high above roof

Mechanical smoke discharge system/ transmission system to Air 20 included be set up for gas fired Pollutant in Boiler SO 、NO 、CO boiler, smoke to be 2 X engineering conveyed and cost discharged above rooftop of in-patient building

To be conveyed by 8 included in SO 、flue special pipe and Diesel oil engine 2 engineering gas 、NO 、 CO discharged high above X cost roof

A 500m3/d medical wastewater treatment station will be built;

Clinical laboratory COD 、BOD wastewater (containing 250 Water 5 heavy metal ) to be Pollutant Hospital SS 、NH -N collected and disposed included in wastewater 3 of by qualified engineering

Fecal coliform organization; cost

sewage network to rehabilitated and incorporated into municipal network.

Solid waste Medical waste / Temporary storage 80 room for medical waste

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Project Environ- Investment Discharge mental Pollutant Prevention Measure Source Hospital Impact (10 4 yuan) room for medical waste

to be set up, designated handcart/trailer and lift to be used; after being collected by type, to be sent (by Wanzhou Senhao Waste Sludge / Treatment Company) to Wanzhou Medical Waste Disposal Site to be treated in high temperature boiling workshop/ incineration workshop.

Recovered by qualified Used active / organization before carbon reuse

Stored in designated room to be sent by Domestic garbage / sanitary service to 10 Wanzhou Changling Landfill

Proper layout, vibration 10 included Noise mitigation, noise in Equipment noise noise elimination, building as engineering

noise barrier cost

Temporary enclosure structural measures, plastic clothing fencing, Water/soil temporary drainage, conservation and 100 sand sedimentation others greening facility, permanent drainage ditch, landscaping

EIA, Environmental acceptance, environmental monitoring 33

RMB 1.20 mil to be included in operation period mitigation subtotal 523 measure

Dianjiang 20.0 to be County Dust control, noise control, wastewater treatment, construction listed Construction noise, construction waste clearing, spoil removal, water/soil separately Period conservation measure

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Project Environ- Investment Discharge mental Pollutant Prevention Measure Source Hospital Impact (10 4 yuan)

Medical To be deodorized by Waste gas wastewater Odor Granular Activated 11 station Carbon

38 included Medical 120.0m 3/d WWT in Waste water Fecal coliform wastewater Station engineering cost

10 included Noise separation/ Central air- in Noise Noise elimination treatment conditioner engineering for air cooling tower cost

Medical waste: a 4m 2 room for temporary storage; collected by type and disposed by Chongqing Fuling Medical Waste Treatment Center; to build a new medical waste temporary 20 storage room (enclosed and antiseepage); to be disinfected and sterilized every day to prevent pathogen spread; medical waste to be cleared daily

Sludge from wastewater treatment system (medical waste): to be treated by Chongqing Fuling Medical Waste Treatment 5 Solid waste Center

Used active carbon (hazardous waste) :Recovered by qualified

organization before reuse

Common waste(domestic waste): to add a 2m 2 solid waste 3 collection room

Hogwash oil from oil screening tank: to be collected and treated

by organization authorized by EP and Health Administration

1800 m2 greening area 2 Other Regular monitoring by EP and Health Service; 1 online 20 monitoring facility at wastewater discharge point

RMB 0.39 mil to be included in operation period mitigation Subtotal 129 measure

Wushan Collected and County deodorized by granular activated carbon and Air Pollutant WWT Station Odor conveyed through 5 special shaft to be discharged above rooftop

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Project Environ- Investment Discharge mental Pollutant Prevention Measure Source Hospital Impact (10 4 yuan)

To be conveyed by 5 included in Boiler, Diesel SO 、flue special pipe and 2 engineering Engine gas 、NO 、 CO discharged high above X cost roof

Oil smoke purifier, to 10 included Kitchen oil be conveyed by special in Oil smoke smoke pipe and discharged engineering high above roof cost

2 WWT Station and 1 Oil Screening Tank to be built to treat medical COD 、BOD 5 wastewater and 200 domestic wastewater Hospital SS 、NH -N with capacity at included in Wastewater 3 200m 3/d and 100m 3/d engineering Fecal coliform respectively, emergency cost tank at the same capacity will also be Water built Pollutant Clinical To be collected and Heavy metal, laboratory disposed of by external 3.0 acid, alkaline wastewater qualified organization

Collected separately and dried and put into Dentistry Heavy metal grind mouth bottles, to 2.0 wastewater be recycled by manufacturer

Medical waste / To be temporarily stored in allocated room 20 before disposed of by sludge / qualified organization

Recovered by qualified Used active / organization before Solid waste carbon reuse

To be collected by Domestic garbage / sanitary service and 2.0 sent to landfill

To be cleared and Kitchen garbage / disposed by qualified organization

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Project Environ- Investment Discharge mental Pollutant Prevention Measure Source Hospital Impact (10 4 yuan)

3.0 included Noise Proper layout, vibration in Equipment noise Noise mitigation, noise engineering elimination, building as cost

others EIA, Environmental acceptance, environmental monitoring 30

RMB 0.32 mil to be included in operation period mitigation Total 280 measure

Chengkou Spread water to reduce County dust, enclosure, harden 4 to be Site Dust the road at listed exit/entrance, flush separately vehicle/tyres

Wastewater from construction equipment maintenance to be used SS for dust control 1.2 to be Construction following oil screening oil listed wastewater sedimentation; separately wastewater from COD personnel to be treated Construction by existing biochemical Period tank

Construction debris and Spoil, spoil to be sent to construction Xiejiaopo Construction 6.7 to be Construction debris and Debris Landfill; listed debris domestic domestic garbage to be separately garbage disposed of by local sanitary service

Temporary noise 5 to be Construction insulation wall to be set Noise listed noise up between site and separately original hospital, etc.

6 included Mechanical ventilation/ in Garage NO THC X airing engineering cost Waste gas

Collected by blower and treated by activated WWT Station odor carbon before discharge 11 above rooftop through special duct

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Project Environ- Investment Discharge mental Pollutant Prevention Measure Source Hospital Impact (10 4 yuan)

To discharged to municipal sewage network following meeting pretreatment COD 、BOD 5 standard after treatment 42 included Medical with secondary in SS 、NH -N wastewater 3 anaerobic process in engineering Wastewater 300m 3/d medical cost Fecal coliform wastewater station (enhanced primary treatment + disinfection)

Included in Clinical Heavy metal to be disposed of as solid waste laboratory and organic hazardous waste by treatment wastewater chemical, etc qualified organization cost

Collected by type and then packaged, sent to Medical waste, Chongqing Wanzhou / 8.5 medical sludge Senhao Waste Treatment Company for Solid waste innocuous treatment

Garbage from medical area must be disinfected Domestic garbage / and sent by sanitary 3.5 service to designated landfill

Foundation noise 5.1 Traffic and reduction/ underground included in Noise Noise equipment building noise engineering insulation cost

Landscaping, topography and vegetation recovery, Others water/soil conservation cost; EA, environmental 37 monitoring etc.

RMB 0.23 mil to be included in operation period mitigation subtotal 130 measure

Qianjiang Collected and absorbed Odor by activated carbon Waste gas WWT Station then to be discharged 5 above rooftop through special duct

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Project Environ- Investment Discharge mental Pollutant Prevention Measure Source Hospital Impact (10 4 yuan)

To be conveyed by Diesel 5 included in SO 、flue special pipe and Engine(temporary 2 engineering gas 、NO 、 CO discharged high above use) X cost roof

Oil smoke purifier, to 10 included Kitchen oil be conveyed by special in Oil smoke smoke pipe to be discharged engineering high above roof cost

To be treated by newly COD 、BOD 5 built WWT Station 162 included Hospital (200m 3/d, two stage in SS 、NH -N Wastewater 3 anaerobic+disinfection), engineering Waste water a canteen oil screening cost Fecal coliform tank to be built

Clinical To be collected and Heavy metal, laboratory disposed of by external 3.0 acid, alkaline wastewater qualified organization

Medical waste / To be temporarily stored in allocated room then to be disposed of 10 sludge / by qualified external organization

Recovered by qualified Used active Solid waste / organization before carbon reuse

To be collected by Domestic garbage / sanitary service and 2.0 sent to landfill

To be cleared and Kitchen garbage / disposed by qualified organization

Proper layout, vibration 3.0 included mitigation, noise in Noise Equipment noise noise elimination, building as engineering noise barrier cost

RMB 0.20 mil to be included in operation period mitigation subtotal 200 measure

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Project Environ- Investment Discharge mental Pollutant Prevention Measure Source Hospital Impact (10 4 yuan)

Youyang After collection, to be deodorized, then Odor conveyed through WWT Station 5 special shaft to be

discharged high above Waste Gas roof

To be conveyed by Diesel oil SO 、flue gas 2 included in 2 special pipe to be engine(temporary engineering discharged high above use) NO 、CO cost X roof

COD 、BOD 5 To be treated by newly 200 included Medical built WWT Station in SS 、NH -N wastewater 3 (400m 3/d, two stage engineering anaerobic+disinfection) cost Waste water Fecal coliform

Clinical To be collected and Heavy metal, laboratory disposed of by external 3 acid, alkaline wastewater qualified organization

Medical waste / To be temporarily stored in allocated room and then to be disposed 20 sludge / of by qualified external organization Solid waste Recovered by qualified Used active / organization before carbon reuse

To be collected by Domestic garbage / sanitary service and 2 sent to landfill

Proper layout, vibration 5 included in mitigation, noise Noise Equipment noise Noise engineering elimination, building as cost noise barrier

Environmental others 5 monitoring

RMB 0.30 mil to be included in operation period mitigation Total 242 measure

CURIP Of which: medical waste water station: RMB 11.54 mil included in engineering cost; Total 1866 Total operation period mitigation measure cost: RMB 3 mil (including medical waste RMB 1.985 mil)

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

In Table 4-8, for Wanzhou, Dianjiang and Chengkou hospitals, the construction period mitigation measure cost and cost in “others” column listed in EA were not adopted due to huge difference among the project hospitals (total RMB 2.839 mil); Cost for diesel engine noise control and canteen oil smoke control (total RMB 1.281 mil) was listed in engineering cost; Cost for medical wastewater station (RMB 11.54 mil) was listed in engineering cost; Therefore cost for operation period mitigation measures are RMB 3 mil (including medical waste RMB 1.985 mil). If the following cost are to be included:

• construction period mitigation measure (RMB 0.72 mil, as Table 4-3);

• environmental monitoring cost in construction period (RMB 0.262 mil) and operation period (RMB 0.248 mil) (as Table 4-4);

• capacity building training (RMB 0.282 mil),

The total environmental protection cost estimate for CURIP II is around RMB 4.512 mil, summarized in Table 4-9.

Table 4-9 CURIP II Environmental Protection Cost Estimate

Training Mitigation measure ( Monitoring cost RMB 10 4 yuan ) ( RMB 10 4 yuan ) ( RMB 10 4 yuan )

Period Construction Operation Construction Operation Construction Operation period period period period period period

Amount 19.8 8.4 72 300 26.2 24.8

Subtotal 28.2 372 51

Total 451.2

Note: Medical wastewater station RMB 11.54 mil was listed in engineering cost; Noise control cost for air-conditioner and stand-by diesel engine, and canteen oil smoke control cost were listed in operation cost.

4.11 Medical Waste Management Plan

4.11.1 Implement the Provisions of Medical Waste Management in Chongqing

Strictly implement the notice on further strengthening medical waste management issued by Chongqing Municipal People's Government (CQ Gov.[2007] No. 71) during the operation period of CURIP . .

To develop regulations and emergency plans for safe disposal of medical waste and equipped with appropriate facilities and equipment, set part-time or full time personnel responsible for the implementation, inspection, supervision and management of medical

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan waste. To provide training to the staff involving medical waste collection, transportation, storage and disposal on relevant laws, regulations, professional and technical.

Medical waste generated should be collected separately and stored temporarily. The final collection, transportation and disposal will be done by the organization which has hazardous waste (medical waste) operating permit. The disposal fee should be paid to the disposal company. a) Medical waste generating units should enter a waste disposal agreement by a unified, standardized format with medical waste disposal unit before the end of each year. b) Packaging of medical waste should meet the requirement of “The Regulations on Special Packaging for Medical Waste, Containers and Warning Signs ”. c) Medical waste generating units should use the special facilities and equipment to temporarily store the medical waste. Medical waste shall not be openly stored and the time for temporary storage will not be more than 2 days; d) Medical waste generating units should accurately measure the quantity of medical waste transferred, strictly implement the relevant provisions for registration and keep the records for future reference.

Implementation licensing systems and the transfer record system for transfer of hazardous waste . a) The project hospital should fill out “The medical waste transfer registration form for medical and health institutions in Chongqing " and "Chongqing hazardous waste transfer form (medical waste only)"; b) The project hospital should go to the local EPA to apply for medical waste transfer license for the next year and get the "Registration Form" and "Medical waste sheet" by 30 December each year. c) When the medical waste is transferred to the disposal company, the project hospital should fill in the “registration form" and the form should be checked and signed by both parties. Each unit from where the medical wastes comes from should prepare a monthly summary of the quantity of medical waste and fill in the sheet based on "Registration Form" and give to the disposal company.

Prohibitions The following actions are prohibited: transfer, buying and sale of medical waste, throw the medical waste during transportation drop and scatter; storage the medical waste in a non- storage place or medical waste mixed with garbage or other waste. Company without license or permit is not allowed to do medical waste collection, storage, transportation and disposal activities or the company with license or permit is not allowed to do medical waste collection, storage, and transportation and disposal activities not in accordance with the license. 4.11.2 Development of Medical Wastes Management Plan

4.11.2.1 Medical Wastes Management Medical Wastes management responsibility system should be established in project hospitals, and the hospital legal representative is the first person in charge of fulfilling responsibility

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan earnestly, so as to avoid the infectious disease transmission and environmental pollution accidents resulting from medical Wastes.

The project hospitals should formulate the rules and regulations related to safety disposal of medical Wastes and the emergency action plan. Monitoring department or full-time (part- time) personnel responsible for the examination, supervision, and implementation of medical Wastes management work should be provided to prevent the behavior in violation of national Medical Wastes Management Regulation occurs.

The project hospitals should provide trainings in connection with related laws and professional skills, safety protection and emergency treatment for the staff who are engaged in collection, transport, storage, disposal of medical Wastes.

The project hospitals should take effective professional health protection measures for the staff who are engaged in collection, transport, storage, disposal of medical Wastes, such as providing necessary protective equipments and providing regular physical examinations; When necessary, provide immunization to the related personnel to prevent health damage.

The project hospitals should carry out the medical Wastes transfer manifest system according to the provisions of Law of the People''s Republic of China on the Prevention and Control of Environmental Pollution by Solid Wastes and Announcement on Further Strengthening the Medical Wastes Management issued by Chongqing Municipal Government (Yufufa [2007] No. 71).

The project hospitals should register the medical Wastes, the items to be registered include: the source of medical Wastes, types, weight or quantity, handover time, disposal method, final destination and signature of responsible person. The register material should be kept for at least three years.

The project hospitals should take effective measures to prevent the loss, leakage and spread of medical Wastes.

Any units and individual are forbidden to transfer, buy and sell medical Wastes.

Medical Wastes are forbidden to be thrown away in the process of delivery, to be dumped, piled up in the non-storage site or mixed with other Wastes and life rubbish.

Medical Wastes are forbidden to be posted.

Medical Wastes are forbidden to be transported by railway, waterway and air.

For the medical Wastes management organization and their responsibilities of the project hospitals, please see the Table 4-10 and Fig 4-2

Table 4-10 The project hospital medical Wastes management organization and their responsibilities

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan Wastes Structure Responsibility Monitoring on Management Management Parameter Organization Hospital leader Hospital director and Set up Wastes management leader be assigned team, specify HWO, arrange funds and manpower, ensure the implementation of monitoring measures, ensure the key personnel to be trained. Medical Section leader, Control the collection of Analysis of the Wastes Wastes infection control internal Wastes, ensure correct discharge amount management personnel, hospital storage, coordinate disposal according to the member/team logistics, operation, and supervise classification of Wastes (HWO) management Wastes transport, liaison with producer's structure per personnel, director director of section office to month; check the material of the hospital ensure the trainings, monitor balance sheet, reduce the pharmacy the production, disposal, cost Wastes; cost accounting department, radiation of Wastes and its impact to for training, collection, management public. temporary storage and personnel transportation & disposal; The most important task of analysis of the accident HWO: coordination and causes of each section in centralized management of the Wastes disposal.. Wastes and operation of Wastes management system in accordance with actual situation.

Hospital Leader

HWO

Medical Department Nursing Department Administrative Inspection Nurse Department Clinic Nursing Aid, etc Administration Pharmacy, etc Logistics, etc 82

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

Fig 4-2 Medical Wastes management organization system chart

The key points of Wastes management in project hospitals are: the of leadership’s attention, setting up Wastes management team (organization), good management plan, compliance with the laws and regulations, appropriate funding support, trainings for qualified personnel, the whole staff participation and management in whole process.

4.11.2.2 The Collection and Temporary Storage of Hospital Solid Wastes Hospital solid Wastes should be disposed cost effectively and quantity decreasingly by project hospitals according to related national laws.

Hospital solid Wastes from project hospitals should be collected by themselves, as well as sorted and stored in the special package or airtight container, which is leakage proof and sharp tool penetrate proof.

Hospital solid Wastes temporary storage facilities and equipments should be arranged for project hospitals. Hospital solid Wastes should not be stored in the open air, and the storage period cannot be more than two days.

Hospital solid Wastes temporary storage facilities and equipments should be far away from medical service area, food process area, people active area and domestic solid wastes storage site. Obvious warning sign and safety measures for leakage proof, mouse proof, mosquito & fly proof, black beetle proof, theft proof and child contact proof, should be prepared.

Hospital solid Wastes temporary storage facilities and equipments should be disinfected and cleaned regularly.

Hospital solid Wastes should be collected and transferred to temporary storage site by project hospitals through special vehicles, which are leakage proof and scatter proof, according to the confirmed internal transfer time and route of hospital solid Wastes.

Transfer vehicles should be disinfested and cleaned in the appointed sites of the project hospitals after utilization.

Based on the principle of centralized disposal nearby, hospital solid Wastes should be sent to hospital solid Wastes centralized disposal center for treatment in time.

High hazardous solid Wastes, such as culture medium, specimen and bacteria colony of pathogen, and storage liquid of poisonous colony, etc., should be disinfected on site before being transferred to hospital solid Wastes centralized disposal center.

Medical wastewater from project hospitals, as well as excretion from epidemical patients or dubitable epidemical patients, should be disinfected strictly according to related national 83

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan requirements by project hospitals, which can only be discharged into wastewater treatment system after reaching the national discharge standard.

4.11.2.3 The Training Plan on Hospital Solid Wastes Management The knowledge promulgation about the harm of hospital solid Wastes and pollution prevention, as well as training on accident disposal should be conducted by project hospitals, to ensure that the staffs can reach the requirements, and know their character and duties on the management of hospital solid Wastes.

The training plans on the management and control of hospital solid Wastes should be prepared.

4.11.2.4 The Management and Control of Hospital Solid Wastes Accident Actions for management and control of hospital solid Wastes accident include: preparing the emergency prevention plan on hospital solid Wastes leakage and pollution accidents during the collection, temporary storage and management of hospital solid Wastes; preparing operation process for the safety collection and storage of hospital solid wastes; preparing emergency disposal process, and arranging related training and exercise.

Once accident occurs, it should be investigated and recorded; the related accident records on hospital solid Wastes should be investigated and reviewed; health service administration department should be contacted, etc.. The emergency disposal process of hospital solid Wastes for project hospitals is shown in Table 4-11..

Table 4-11 Emergency Disposal Process of Hospital Solid Wastes for Project Hospitals

Cleaning Process of Instant Treatment of Report of Emergency Extravasations Exposed Body Accidents Confirm the property of the If skin problem, use soap and All emergency accidents and extravasations; evacuate the water to wash the wound; if nearly leakage event should be inhabitants from the affected mucous membrane problem, use reported as following process: areas of extravasations; inform flow water to wash the wound; description of accident, the appointed staffs to control use of antibiotic (no evidence); occurrence time and place, and collect the extravasations press for flood immediately; concerning people, other related with the protection facilities topical application of drug and details, which should be (including protection cloths) topical injection of antibiotic are reported and recorded. mentioned in the emergency not recommended. plan; provide initial assistance and clean the affected areas; seek for necessary measures to clean eyes and skins. 4.11.2.5 PDCA Cycle in Medical Solid Wastes Management It is suggested in the comprehensive assessment report that the PDCA Cycle should be implemented in the medical solid Wastes management in the project hospitals. The PDCA Cycle includes four stages, they are:

Plan stage: to identify and confirm contents;

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan Do stage: to implement the plan and realize the objectives;

Check stage: to conclude the results through evaluation and find out the weak points;

Action stage: to summarize the experiences obtained and the lessons learnt for a continuous improvement.

The preliminary plan for implementation of PDCA Cycle in medical solid wastes management in project hospitals is shown in the Table 4-12.

Table 4-12 Implementation of PDCA Cycle in Medical Solid Wastes Management in Project Hospitals

Plan Do Check Action Contents Current To analyze the medical Wastes First to To find out To adjust situation producing flow and its quantity, and implement weak management investigation plan how to dispose it. Based on the it in pilot points aiming to and analysis locations of facilities to store the wards, then through eliminate weak of Wastes Wastes to determine the collection extend it to evaluation points and for a disposal flow and establish the relevant whole and continuous process organizations, various principles, hospital; analysis; improvement. requirements and detailed timetable, emergency hazard to detailed transportation routes, action, human maintenance and cleaning plans. accident being, report. economic Establishment To provide various solutions, evaluate risks; of detailed options selected and determine the hazard to measures detailed measures. environme Establishment To establish record system: nt and of record public To record (whole process, to protect system health. himself, government requirements); Records keeping (records should be kept for three years, for control and monitoring, and as evidence); Record types (records of transportation, disposal, processing, training, instruction, harm and accident record, auditing report). Contents recorded (Wastes producer and location, date of production, type of Wastes, collection and disposal unit, signature of person to deal with it).

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan Estimation of To estimate the costs according to the relevant costs types of medical Wastes, facilities for collection, transportation and disposal, manpower, time, etc. Training and The target groups of training, training monitoring contents, items to be monitored and monitoring frequency.

4.11.3 Implementation of Mitigation Measures for Disposal of Medical Solid Wastes

After implementing the mitigation measures for disposal of medical solid wastes as mentioned in Section 4.2.4 and when the planned hospitals for all the project hospitals are completed and put into operation, it is estimated that around 777.06 t/a (including sludge 121.49 t/a) medical waste will be produced, which will be centrally disposed of in medical waste (hazardous waste) sites in Fuling District, Yongchuan District and Qianjiang District respectively.

Given that medical waste is highly hazardous, certain risk exists in collection, storage and transportation of medical waste in this project. To ensure effective treatment of medical waste, minimize the involved risks and avoid negative impact on the environment, the following specific preventive measures are proposed:

（）1 separation/collection by type for medical

Table 4-13 listed the measures for separation/collection

Table 4-13 Measure for Medical Waste Separation/Collection

No. Type Separation

Contagious waste, pathological waste

Including waste which may contain Yellow or red pathogen(such as bacteria, virus, parasitic or bag/container, with marks epiphyte), or the pathogen concentration or of “infectious” and amount can cause disease for vulnerable host. international infection 1 Also including pathological and anatomy symbol. High strength material(such as tissue, organ, body part, human antiseepage plastic bag or fetus, animal body, blood and other bodily container which can sustain liquid), cloths, dressing, equipment/instrument pressured steam will be and other material which contacted infectious used. stuff

Yellow or red, with marks of “sharp stuff”. Hard, Sharp stuff: including needle, scalpel, razor, impermeable, water tight 2 transfusion set, saw, broken glass and nail, etc. container with cover (such as steel or hard plastic) will be used. Container for sharp stiff should be put

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan into sealed yellow bag, with tag marking “infectious waste”

Waste medicine: including medicine that passed shelf life, unused, decayed and contaminated Brown bag/container. medical, vaccine and useless blood serum, 3 Antiseepage plastic bag or including vessel and other material which may container. have been contaminated (such as small medicine bottle, test tube)

Chemical waste: whether the waste is hazardous depends on its toxicity, corrosiveness, combustibility, reaction and genetic toxicity. Chemical waste, which may take the form of solid, liquid and gas, are Brown bag/container. produced by using chemical during water tight, bags or 4 diagnosis/test, cleaning, internal housekeeping containers with and disinfection. The chemical include anticorrosion for chemical formaldehyde, photographic chemical, halogenated and non-halogenated solvent, organic and inorganic chemical (such as acid and alkaline) used for cleaning/disinfection.

Waste containing heavy Waste containing large amount of heavy metal: metal should be separated 5 battery, broken thermometer, blood pressure from general medical meter(containing Hg, Cr) waste.

Pressure container: including container/air Pressure container should 6 injection/cylinder containing nitrogen oxide, be separated from general oxygen, ethylene oxide, CO2, pressured air medical waste

Black bag/container. Halogenated plastic (e.g. PVC) should be separated General medical waste (including food waste, from general medical waste 7 paper, plastic, card board) to avoid hazardous gas emission (such as dioxin) during incineration treatment.

（2） Medical Waste Collection/Temporary Storage Measure

Medical waste collection/temporary storage measure is listed in Table 4-14.

Table 4-14 Medical Waste Collection/Temporary Storage Measure

NO. Type Collection/Temporary Storage Measure

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan

When the quantity reaches around 3/4, the bag/container should be sealed and replaced. Bag/container should be replaced immediately if full. Collection and 1 Bag/container should be identified and tagged before removing. Storage Designated hand cart/trailer should be used for transferring waste to storage area. The hand cart/trailer should be cleaned and disinfected regularly.

Medical waste storage room should be separated from domestic waste storage space and should have rain-preventing facility.

It should be far away from food processing area and intensive human activity area, but should be in waste central area. Special exit/entrance should be set up at a close distance to facilitate loading/unloading of waste, access of workers and transportation vehicle.

Foundation level should be high enough to ensure that facility will not be flooded or submerged; strict enclosure measures must be taken and superintendence must be conducted by designated person to avoid non-staff access and to prevent rats/mosquito/cockroach, burglary and children’s contact;

The floor and 1.0 m high dado must be properly treated in respect of 2 Waste storage area antiseepage. Floor should be well drained, easy to clean and disinfect.

Wastewater produced should be directly transferred to nearby WWT Station through pipe. Direct discharge to outside environment should be banned.

It is advisable that tap water faucet be installed outside the storage room as water source for cleaning.

Direct sunshine on interior storage room should be avoided and the room should be well lighted and ventilated.

Inside the storage room warning sign of “No Smoking, No Food Eating” should be put up. Warning sign showing the existence of Hazardous Waste and Medical Waste should be erected in eye- catching place outside the storage room.

Strong odor due to decaying of medical waste which is stored in temporary storage room or designated cabinet should be avoided. It is advisable that waste should be cleared daily. If daily clearing 3 Storage time practice cannot be adopted and local maximum temperature is above 25 , waste should be stored in low temperature condition (below 20 ) and maximum storage time should be within 48 hours.

Mercury (Hg) should be placed in sealed and impermeable container and stored separately in safe place; 4 other Cytotoxic waste should be separated from other waste and stored separately in safe place.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Environmental Management Plan By establishment of medical waste management rule, the whole-process management of medical waste will be strictly adopted. Recycling/reuse of medical waste is banned to prevent medical waste from being illegally processed and reused, which will, to large extent, curb the spread of medical waste, disease and contamination, and is also one of the most important measures to mitigate medical waste’s impact. Collection/separation by type is the basic guarantee for contamination elimination and innocuous treatment. By strict enforcement of related rules on medical waste storage and transportation, and medical waste transfer sheet joint-signature rule, the whole waste transportation process will be under strict control; hence damage to surface water and ecological environment along waste transportation routes will be prevented.

4.12 EMP Performance Indicators for CURIP II

Based on the guideline that the performance indicators should be relevant, economical, measurable, sufficient and clear, the EMP performance indicators for CURIP II are tentatively proposed (as shown in Table 4-10).

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report

Table 4-10 EMP Performance Indicators for CURIP II Design Objectives Performance Indicators Data Source/ Report Assumptions/ Risks Mechanism Goal/Impact Reduce Since the first year in operation, the negative Routine monitoring data in Assumption: discharge of environmental impact will be reduced. For project district/county EPB Associated environmental protection waste gas, waste the environmental air in project’s EPB trial operation facility will be designed, constructed water and lower surrounding area, NH3 will meet “Medical acceptance report. and put into operation concurrently with noise; medical Organization Water Pollutant Discharge External monitoring report major project facility; The waste collected Standard” (GB18466-2005). during operation period. environmental zoning plan and by type and PM10 、、NO2 SO2 in the env ironmental air environmental protection standard index disposed of by and COD 、、BOD5 NH3-N, oil, fecal coliform of EPM remain unchanged. qualified in environmental air and environmental noise CURIP II is completed in accordance organization to monitoring data will all be within the limit with design quality level and schedule reduce specified in Function Zoning Plan. and operation is normal. environmental Risks: potential leakage danger exist for contamination. activated carbon absorption facility, chlorine dioxide disinfection facility and its raw material storage facility for medical waste treatment station, and these above dangers have not been effectively and timely eliminated. Purpose/Result To improve the By 2015, CURIP II project district/county Operation report for Assumption: 8 project hospital waste water treatment capacity to be project hospitals CURIP is completed in accordance with districts/counties increased by 1280m3/d in total, BOD5, COD, design quality level and schedule and medical waste NH3 －N, oil and coliform discharged from EPB data from project operation is normal. water treatment medical WWT Station to meet “Medical district/county EPB Risk ： level Organization Water Pollutant Discharge Extreme climate or geological disaster Standard” （ GB18466 -2005 ） . Environmental monitoring may affect disposal of medical By 2015, for the 8 project districts/counties, report from project wastewater and waste. 100% of the medical waste and sludge from district/county medical WWT Station will be sent to medical ； waste (hazardous waste) disposal site. Building Assessment Standard”. Outputs Mitigation Contractor will implement mitigation PIU’s monthly report Assumption: Contractor, Operator, PIU

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report

Design Objectives Performance Indicators Data Source/ Report Assumptions/ Risks Mechanism measures in measures during construction period to during construction period. and monitoring organization implement construction ensure: site particle disorganized emission Internal monitoring report EMP in accordance with contracts and period be concentration ＜1mg/m3 ; site noise meets External schedule; properly Construction Site Noise Standard monitoring/appraisal report Risk: Despite verbal promise, established and （－）GB12523 90 ; production wastewater Contractor, Operator and PIU fail to related SS ＜70mg/L following sedimentation and be strictly follow mitigation measures; monitoring is in reused as far as possible for site spraying and Construction acceptance Environmental protection facility only place. equipment cleaning; 100% of domestic report approved by EPB serves as a means to pass acceptance Environmental garbage from site working camp will be sent but is not put into stable operation; protection, to local domestic waste disposal site. External monitoring organization delay water/soil From the first year of operation, hospital submission of monitoring/appraisal conservation wastewater treatment facility will be in report more than 2 weeks or report, facility normal operation, and water discharged will though timely submitted, contains associated with meet the pretreatment or discharge standard mistakes such as wrong sampling place CURIP II be specified by “Medical Organization Water or monitoring parameter. completed Pollutant Discharge Standard” （ GB18466- concurrently 2005 ） ; the landscaping area which can be with major restored in the project area and affected area project facility will be 100% reinstated. Environmental management and pollution prevention rules will be established/perfected. ； Rules for chlorine dioxide disinfection facility and storage facility for raw material (hydrochloric acid, sodium perchlorate) is in place; environmental risk emergency plan is established. Work program and target at various stage: Input ： In Jan 2012, EMP to be prepared and submitted to WB for appraisal. The EMP , following WB’s approval, will For construction period: be adjusted/improved based on monitoring/inspection results during project implementation. CURIP II hospital medical WWT Before or during construction of the 8 hospitals in districts/county, EMP implementation technique training to Station engineering cost is RMB 11.54 be delivered to 100 persons. mil, medical waste temporary storage facility is listed in engineering cost;

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report

Design Objectives Performance Indicators Data Source/ Report Assumptions/ Risks Mechanism For each hospital, information on construction commencement will be notified to local community before mitigation measure of negative impact construction starts. Implementation of EMP and monitoring results will be publicized to residents within project is RMB 0.72 mil; capacity building and area. training is RMB 0.198 mil; Contractor and PIU to implement mitigation measures as specified in EMP; External monitoring organization Environmental monitoring cost is RMB will conduct independent monitoring/inspection and submit report; 0.262 mil. Environment related indicator to be established for Construction Progress Report in view of internal/external For operation period monitoring in order to obtain the implementation information, effectiveness and improvement suggestion of Mitigation measure cost is RMB 3 mil/a mitigation measures during construction period; (including medical waste mitigation Semiannual report to be submitted to WB since the year of construction commencement; measure RMB 1.985 mil); capacity Operator and PIU to put into operation the completed project major facility and environmental protection building and training RMB 0.084mil; facility in operation period; equipment noise(diesel power generator, etc) control and canteen oil smoke control cost RMB 1.281 is listed in engineering cost; daily operation cost for medical WWT Station is listed in hospital operation cost; environmental monitoring cost is RMB 0.208 mil.

The Bank World Bank Funded Chongqing Urban-Rural Integration Project Phase II (CURIP II) - Summary of EIA Report