Initial Environmental Examination

December 2018

Proposed Multitranche Financing Facility : Improving Access to Health Services for Disadvantaged Groups (Tranche 1)

Prepared by the Municipality of for the Asian Development Bank. CURRENCY EQUIVALENTS (as of 2 December 2018)

Currency unit – togrog (MNT) MNT1.00 = $ 0.000383656 $1.00 = MNT2,606.500 ABBREVIATIONS AP – Affected Person/People ACM – Asbestos Containing Materials ADB – Asian Development Bank ADF – Asian Development Fund ASI – Agency for Specialized Inspection C- SEMP – Contractor’s Site-specific Environmental Management Plan CDC – Community Development Council CWWTP – Central wastewater treatment plant DPR – Detailed Project Report DSC – Design supervision consultants EA – Executing Agency EARF – Environment Assessment and Review Framework EIA – Environmental Impact Assessment EIC – Information, Education, and Communication EMoP – Environmental Monitoring Plan EMP – Environmental Management Plan EMR – Environmental Monitoring Report ESM – Environmental and Social Management System ERP – Emergency Reponse Plan FAM – Facility Administration Manual FHC – Family Health Clinic GASI – General Agency for Specialized Inspection GoM – Government of Mongolia GRM – Grievance Redress Mechanism IA – Implementing Agency IEE – Initial Environmental Examination LAR – Land Acquisition and Resettlement M&E – Monitoring and Evaluation MET – Ministry of Environment and Tourism MFF – Multi-tranche Financing Facility MoF – Ministry of Finance MOH – Ministry of Health NGOs – Nongovernment Organizations PC – Public Consultation PHC – Primary Health Care PIU – Project Implementation Unit PPTA – Project Preparatory Technical Assistance REA – Rapid Environmental Assessment RRP – Report and Recommendation of he President to the Board SGHP – Shallow-ground Heat Pump SHC – Soum Health Center SME – Small and Medium-Sized Enterprise SPA – Specially Protected Area SPS – Safeguard Policy Statement USUG – Ulaanbaatar Water Supply and Sewerage Authority VOC – Volatile Organic Compound WHO – World Health Organization

WEIGHTS AND MEASURES

1 Cusec – Measure of flow rate (28.317 liters per second) 1 ha. (hectare) – 10,000 sq m 1 km (kilometer) – 1,000 m 1 kV – kilovolt (1,000 volts) 1 kW – kilowatt (1,000 watts) 1 kWh – 1 kilowatt-hour = 1000 watts

GLOSSARY Aimag – Province Soum – Smallest administrative unit of Aimag Bagh – Smallest administrative unit of Soum District – Smallest administrative unit of Ulaanbaatar city Khoroo – Smallest administrative unit of District Ger area – Area in the cities which residents use traditional dwellings like as herders’ tent (sometimes called as “yurt”) Khashaa Plot – Fencing around Ger owned by households Construction Drawings – Technical and detailed drawing for construction of building For the Purposes of this – Individual Family health clinics (FHC)/ Soum IEE Sub-Project health center (SHC)/Hospitals selected and included in the project for new construction

NOTE

In this report, "$" refers to US dollars.

This initial environmental examination is a document of the borrower. The views expressed herein do not necessarily represent those of ADB's Board of Directors, Management, or staff, and may be preliminary in nature. Your attention is directed to the “terms of use” section on ADB’s website.

In preparing any country program or strategy, financing any project, or by making any designation of or reference to a particular territory or geographic area in this document, the Asian Development Bank does not intend to make any judgments as to the legal or other status of any territory or area.

TABLE OF CONTENTS

GLOSSARY iii

NOTE iii

TABLE OF CONTENTS i

List of Tables vii

List of Figures xi

Executive Summary i

I. INTRODUCTION 1 A. Background 1 B. Outcome and impact. 1 C. Tranche 1: Multi Tranche Financing Facility 2 D. Proposed Financing Plans 3 E. Implementation Arrangements 3 F. Scope of Work and Methodology Adopted 3

II. POLICY, LEGAL AND ADMINISTRATIVE FRAMEWORK 5 A. ADB’s Safeguard Policy Statement (SPS 2009) 5 1. Environmental Impact Assessment Requirements of ADB 5 2. ADB SPS Requirements (SR1): Environment Policy 6 3. Standards, guidelines and good practice in ADB SPS 6 B. National Mongolian Legislation 7 1. Mongolia’s Environmental Policy 7 2. Relevant Mongolian Government Acts, Rules, Strategies and Guidelines. 8 3. Mongolian Environmental, Health and Safety Standards 12 4. Mongolian Health Care Waste Standards 13 5. Environmental Assessment Requirements of Mongolia 14 6. Environment Compliances Relevant to the Project and time frames 18 7. Mongolia FHC/SHC/Hospital building Environmental Infrastructure 21 8. Green Building Concept 21 C. International Treaties 23 D. Equivalence of International Best Policies in Infrastructure Development 24

III. DESCRIPTION OF THE PROJECT 26 A. Overview 26 B. Project Components 26 C. Scale and Magnitude of Sub‐Projects (Scope of Civil Works) 27 D. Existing Infrastructure at Subproject Locations 29

1. Health Center Status 29 2. Plot Size on Land available 32 3. Distance from Various Receptors 32 4. Distance from Reserve Forest/Protected Areas/National Park/Sanctuary 35 5. Ulaanbaatar city: Infrastructure development condition 36 6. : Infrastructure development condition 42 7. 5 Soum health centers: Infrastructure development condition 46 E. Proposed Environmental infrastructure for sub‐projects 49 1. Hospital/FHC/SHC/Buildings 50 2. Design of buildings 51 3. Equipment: 53 4. Water, Wastewater, Solid Waste, Sewage infrastructure 53 5. Health Care Waste Management 55 6. Operational procedures 56

IV. DESCRIPTION OF ENVIRONMENT (Baseline Data) 57 A. Environment of Mongolia 57 1. Topography 57 2. Climate 57 3. Ecosystems 58 4. Water Resources 59 5. Natural disasters 59 6. Seismology 59 7. Biodiversity 60 8. Protected areas in Mongolia 62 9. Cultural heritage 65 B. Environment at Tranche‐1 subproject areas 66 C. Topography 68 1. Topography of Ulaanbaatar city 68 2. Topography of Khovd City 70 3. Topography of Erdenemandal Soum 70 4. Topography of Tarialan Soum 71 5. Topography of Bayan‐Undur Soum 72 6. Topography of Erdene Soum 73 7. Topography of Soum 74 8. Topography of 75 D. Climate 76 1. Climate Condition in Ulaanbaatar City 76 2. Climate condition in Khovd city 80 3. Climate condition in Erdenemandal Soum 84 4. Climate condition in Tarialan Soum 85 5. Climate condition in Bayan‐Undur Soum 87 6. Climate condition in Erdene Soum 88 7. Climate condition in Dashinchilen Soum 89 8. Climate condition in Ulaangom city 91 E. Air Quality (AQ) 92 1. Air quality condition in Ulaanbaatar city 93 2. Air Quality in Khovd city 96 3. Air quality condition in the 5 Soums 98 4. Air quality condition in Ulaangom city 100

F. Noise Condition 100 G. Soil, Geology and Seismology 103 1. Soil, Geology and Seismology in Ulaanbaatar City 103 2. Soil, geology and seismology in Khovd city 105 3. Soil, geology and seismology in Erdenemandal Soum 107 4. Soil, geology and seismology in Tarialan Soum 108 5. Soil, geology and seismology in Bayan‐Undur Soum 108 6. Soil, geology and seismology in Erdene Soum 109 7. Soil, geology and seismology in Dashinchilen Soum 110 8. Soil, geology and seismology in Ulaangom 111 H. Surface Water Resources and Quality 112 1. Surface water resources in Ulaanbaatar city 112 2. Surface water resources in Khovd city 115 3. Surface water resources in Erdenemandal Soum 118 4. Surface water resources in Tarialan Soum 118 5. Surface water resources in Bayan‐Undur Soum 119 6. Surface water resources in Erdene Soum 120 7. Surface water resources in Dashinchilen Soum 120 8. Surface water resources in Ulaangom city 121 I. Groundwater Resources and Quality 122 1. Ground water resources in Ulaanbaatar 123 2. Ground water resources in Khovd area 129 3. Ground water resources in the 5 Soums 131 J. Biodiversity 136 1. Biodiversity in Ulaanbaatar area 136 2. Biodiversity in Khovd area 140 3. Biodiversity in the 5 Soums 143 4. Biodiversity in Ulaangom area 145 K. Protected Areas 146 1. Protected areas around Ulaanbaatar city 146 2. Protected areas around Khovd city 149 3. Protected areas around the 5 Soums 150 4. Protected areas around Ulaangom city 151 L. Socio‐Economic Condition 152 1. Economic Development 152 2. Demography 154 3. Ethnic minorities 155 4. Education 156 5. Health Service in Mongolia 157 6. Employment and Poverty 157 7. Land Use Pattern 159 8. Cultural Heritage 162 9. Climate Change in Mongolia 163

V. ANTICIPATED ENVIRONMENTAL IMPACTS AND MITIGATION MEASURES 165 A. Impacts and Mitigation Measures During Project Location and Design 165 B. Impacts and Mitigation Measures During Pre‐Construction Stage 167 1. Land acquisition 167 2. Temporary Use of Land 167

3. Banned substances – Asbestos 168 4. Demolition 168 5. Volatile Organic Compounds 169 6. Equipment replacement ‐ X‐rays etc. 169 7. Shallow‐ground heat pump pilot project 169 C. Impacts and Mitigation Measures During Construction Stage 170 1. Impact on Physical Resources 171 2. Impact on Environmental Resources 172 3. Impact on Ecological Resources 178 4. Impact on Terrestrial Ecology 178 5. Human Environment 180 6. Socio Economics 185 7. Waste Disposal 186 D. Impacts and Mitigation Measures During Operational Stage 187 1. Hospital / Health Center Environment 187 2. Disadvantaged Patients/children 188 3. Increased demand of utilities‐electricity, heating, sewage and drinking water 188 4. Health Care Waste (HCW) Management 188 5. Emergency response during operations 190 6. Occupational Health and safety (OHS) during operations 190 7. Electric Shock 191 8. Noise Generation 191 E. Cumulative Impact Analysis of subprojects 191 1. Densification of area 192 2. Influence zone of each FHC/SHC/Hospital 192 3. Noise Amplification 192 4. Greenhouse Gas emissions 192 F. Summary of Impacts 193 1. Impacts on key environmental parameters (Air, water, soil and Noise) 194

VI. ANALYSIS OF ALTERNATIVES 196 A. MOH Approach for Planning of a subproject 196 B. Alternatives for Subproject Components 196 1. No “Build” Alternative 196 2. To “Build” Alternative 196 C. Methodology for sub‐project site selection: environmental view 196 1. Development of Alternate Access Route 198

VII. INFORMATION DISCLOSURE, CONSULTATION, AND PARTICIPATION 200 A. Consultation Process 200 B. Consultation Details 200 1. Locations and participants 204 C. Information Disclosure 205

VIII. GRIEVANCE REDRESS MECHANISM 206 A. Grievance Channels (Framework) 206 B. Time Frame 206

C. The Grievance Redress Mechanism 206

IX. ENVIRONMENTAL MANAGEMENT PLAN 210 A. Critical Environmental Review Criteria 210 1. Loss of irreplaceable resources 210 2. Accelerated use of resources for short‐term gains 210 3. Endangering of species 210 4. Promoting undesirable rural‐to urban migration 210 5. Increase in affluent/poor income gap 210 B. Emergency Response, Disaster Management, Health and Safety 210 1. Emergency 210 2. Disaster Management 211 3. Health and Safety Issues Management 211 C. Training Programs 212 D. Magnitude of Environmental Impacts 213 E. Environmental Management Plan 220 F. Environmental Monitoring Plan (EMoP) 221 G. Development of Site‐specific Construction Environmental Management Plan (SEMP) 222 H. Monitoring and Reporting 223 I. Monitoring and Reporting 223 1. Responsibilities 223 2. Construction Contracts 223 3. Monitoring of Site‐specific EMPs 223 4. Performance indicators 225 5. External Monitoring 226 6. Reporting 226 J. Environmental Management Plan Budget Costs 226 K. Institutional Arrangements 231 1. Project Implementation Organizations: Roles and Responsibilities 231 2. Project Organizational Structure 232 3. EMP implementation arrangements. 232 L. Implementation Plan 235

X. CONCLUSION AND RECOMMENDATION 237

ANNEXURES 240 Annexure – 1: Environmental quality and health and safety standards relevant to the subprojects under the program during construction and operation 240 Annexure – 2: General Environmental, Health and safety Guidelines‐ IFC‐EHS 247 Annexure – 3: Inventory of FHC/SHC/Hospital 252 Annexure ‐ 3b: Google Earth Images of FHC/SHC/Hospital Identified 263 Annexure – 4: Environment Management Plan (EMP) 275 Annexure – 5: Environment Monitoring Plan (Environmental Parameters) 286 5a. Environmental Safeguard Clauses for Civil Works Contracts 289

5b. Environmental Site Inspection and Monitoring Checklist 291 Annexure ‐ 6: Sample Environment Monitoring Report 293 Annexure ‐ 7: Details of Public Consultation (Environment) 295 Annexure – 8: Grievance Registration Form 341 A. Plant species around Ulaanbaatar area 343 Annexure – 10: Specialized Inspection Agency 354

List of Tables TABLE 0.1: SUMMARY IMPACTS ON KEY ENVIRONMENT PARAMETERS I TABLE 0.2: KEY FEATURES AND ENVIRONMENTAL ISSUES FOR EACH SUB‐PROJECT II TABLE I.1: INDICATIVE FINANCING PLAN 3 TABLE I.2: INDICATIVE IMPLEMENTATION ARRANGEMENTS 3 TABLE II.1: ENVIRONMENT SAFEGUARDS CATEGORIZATION: DEFINITION 5 TABLE II.2: RELEVANT ENVIRONMENTAL, HEALTH AND SAFETY LAWS IN MONGOLIA 8 TABLE II.3: CLASSIFICATION OF PROJECTS FOR WHICH GEIA IS LEGALLY MANDATORY 15 TABLE II.4: DETAILS OF GEIA AND DEAI REQUIREMENTS FOR TRANCHE 1 18 TABLE II.5: SUMMARY OF ENVIRONMENTAL COMPLIANCE REQUIREMENTS FOR EARF CONSIDERATION FOR TRANCHE‐1 COMPONENTS 19 TABLE II.6: NECESSARY PERMISSION AND DOCUMENTS RECOMMENDED FOR CONSIDERATION FOR DETAILED PROJECT IMPLEMENTATION PLAN BY PIU 19 TABLE II.7: CRITERIA OF THE MGBC’S GREEN BUILDING RATING SYSTEM 22 TABLE II.8: RELEVANT INTERNATIONAL ENVIRONMENTAL CONVENTIONS 23 TABLE III.1: SUB‐PROJECT COMPONENTS AND THEIR KEY FEATURES 27 TABLE III.2: DOCTORS, NURSES AND PATIENTS FOR THE SUBPROJECT IN ULAANBAATAR CITY 31 TABLE III.3: SUMMARY OF APPROXIMATE DISTANCE OF SUBPROJECTS FROM MAJOR RECEPTORS 33 TABLE III.4: DISTANCE FROM PROTECTED AREAS (NATIONAL PARKS, SANCTUARIES AND FOREST RESERVES) FOR ALL SUBPROJECTS 35 TABLE III.5: INFRASTRUCTURE CONDITION FOR TRANCHE‐1 SUBPROJECT IN ULAANBAATAR CITY 38 TABLE III.6: INFRASTRUCTURE CONDITION FOR THE SOUM HEALTH CENTERS 48 TABLE III.7: EXISTING AND SUGGESTED INFRASTRUCTURES AT EACH SUB‐PROJECT SITE 55 TABLE IV.1: LIST OF PROTECTED AREAS OF MONGOLIA 63 TABLE IV.2: NUMBER OF HERITAGE, CULTURAL AND RELIGIOUS SITES IN MONGOLIA 65 TABLE IV.3: SUBPROJECT LOCATIONS FOR TRANCHE‐1 66 TABLE IV.4: MONTHLY MEAN AIR TEMPERATURE IN ULAANBAATAR CITY, 2003‐2017, °C 77 TABLE IV.5: MONTHLY MAX AIR TEMPERATURE IN ULAANBAATAR CITY, 2010‐2017, °C 77 TABLE IV.6: MONTHLY MIN AIR TEMPERATURE IN ULAANBAATAR CITY, 2003‐2017, °C 78 TABLE IV.7: MONTHLY PRECIPITATION LEVEL IN ULAANBAATAR CITY, 2003‐2017 78 TABLE IV.8: MONTHLY AVERAGE WIND SPEED, M/SEC 79 TABLE IV.9: MONTHLY MAX. WIND SPEED, M/SEC 79 TABLE IV.10: MONTHLY MEAN AIR TEMPERATURE, KHOVD CITY, °C 80

TABLE IV.11: MONTHLY MAXIMUM AIR TEMPERATURE, KHOVD CITY, °C 81 TABLE IV.12: MONTHLY MINIMUM AIR TEMPERATURE, KHOVD CITY °C 81 TABLE IV.13: MONTHLY PRECIPITATION LEVEL, KHOVD CITY MM 82 TABLE IV.14: AVERAGE WIND SPEED BY MONTHS, M/SEC 83 TABLE IV.15: MAXIMUM WIND SPEED BY MONTH, KHOVD CITY, M/SEC 83 TABLE IV.16: MEAN AIR TEMPERATURE BY MONTHS, 2013‐2017, 0C 84 TABLE IV.17: MAXIMUM AIR TEMPERATURE BY MONTHS, 2013‐2017, 0C 84 TABLE IV.18: MINIMUM AIR TEMPERATURE BY MONTH, 2010‐2017, 0C 84 TABLE IV.19: MONTHLY TOTAL PRECIPITATION, MM, 2013‐2017 85 TABLE IV.20: AVERAGE WIND SPEED IN EACH MONTH, M/SEC 85 TABLE IV.21: MAXIMUM WIND SPEED IN EACH MONTH, M/SEC 85 TABLE IV.22: MEAN AIR TEMPERATURE BY MONTH, 2013‐2017, 0C 85 TABLE IV.23: MAXIMUM AIR TEMPERATURE BY MONTH, 2013‐2017, 0C 86 TABLE IV.24: MINIMUM AIR TEMPERATURE BY MONTH, 2013‐2017, 0C 86 TABLE IV.25: MONTHLY TOTAL PRECIPITATION, MM, 2010‐2017 86 TABLE IV.26: AVERAGE WIND SPEED IN EACH MONTH, M/SEC 86 TABLE IV.27: MAXIMUM WIND SPEED IN EACH MONTH, M/SEC 87 TABLE IV.28: MEAN AIR TEMPERATURE BY MONTH, 2013‐2017, 0C 87 TABLE IV.29: MAXIMUM AIR TEMPERATURE BY MONTH, 2013‐2017, 0C 87 TABLE IV.30: MINIMUM AIR TEMPERATURE BY MONTH, 2010‐2017, 0C 87 TABLE IV.31: MONTHLY TOTAL PRECIPITATION, MM, 2013‐2017 88 TABLE IV.32: AVERAGE WIND SPEED IN EACH MONTH, M/SEC 88 TABLE IV.33: MEAN AIR TEMPERATURE BY MONTH, 2013‐2017, 0C 88 TABLE IV.34: MAXIMUM AIR TEMPERATURE BY MONTH, 2013‐20170C 88 TABLE IV.35: MINIMUM AIR TEMPERATURE BY MONTH, 2013‐20170C 89 TABLE IV.36: MONTHLY TOTAL PRECIPITATION, MM, 2013‐2017 89 TABLE IV.37: AVERAGE WIND SPEED IN EACH MONTH, M/SEC 89 TABLE IV.38: MAXIMUM WIND SPEED IN EACH MONTH, M/SEC 89 TABLE IV.39: MONTHLY AVERAGE AIR TEMPERATURE IN DASHINCHILEN, 2013‐2017, 0C 90 TABLE IV.40: MONTHLY MAXIMUM AIR TEMPERATURE IN DASHINCHILEN, 2013‐2017, 0C 90 TABLE IV.41: MONTHLY MINIMUM AIR TEMPERATURE IN DASHINCHILEN, 2013‐2017, 0C 90 TABLE IV.42: PRECIPITATION LEVEL BY MONTHS, 2013‐2017, MM 90

TABLE IV.43: MONTHLY AVERAGE WIND SPEED, M/SEC 91 TABLE IV.44: MONTHLY MEAN AIR TEMPERATURES, 2013‐2017,0C 91 TABLE IV.45: MONTHLY MAXIMUM AIR TEMPERATURES, 2013‐2017,0C 91 TABLE IV.46: MONTHLY MINIMUM AIR TEMPERATURES, 2013‐2017,0C 91 TABLE IV.47: TOTAL MONTHLY PRECIPITATION LEVEL IN ULAANGOM, 2013‐2017, MM 92 TABLE IV.48: MONTHLY AVERAGE WIND SPEED, M/SEC 92 TABLE IV.49: MONTHLY AVERAGE VALUES OF SULPHUR DIOXIDE, MG/M³ 94 TABLE IV.50: MONTHLY AVERAGE VALUES OF NITROGEN DIOXIDE, MG/M³ 95 TABLE IV.51: MONTHLY AVERAGE DUST CONCENTRATION PM10, MG/M³ 95

TABLE IV.52: MONTHLY AVERAGE DUST CONCENTRATION LEVEL PM2.5 MG/M³ 96 TABLE IV.53: AIR QUALITY, NOISE MEASUREMENT AND SAMPLING ANALYSIS RESULTS 96 TABLE IV.54: MONTHLY AVERAGE VALUE OF SULPHUR DIOXIDE, MG/M³ 97 TABLE IV.55: MONTHLY AVERAGE VALUE OF NITROGEN DIOXIDE, MG/M³ 97 TABLE IV.56: DUST CONCENTRATION LEVEL BY MONTHLY AVERAGE VALUE, MG/M³ 98 TABLE IV.57: AIR QUALITY MEASUREMENT DEVICES 98 TABLE IV.58: AIR QUALITY MEASUREMENT RESULTS AT ERDENEMANDAL SOUM HOSPITAL 99 TABLE IV.59: AIR QUALITY MEASUREMENT RESULTS IN TARIALAN SOUM CENTER 99 TABLE IV.60: AIR QUALITY MEASUREMENT RESULTS AT BAYAN‐UNDUR SOUM HOSPITAL 99 TABLE IV.61: AIR QUALITY MEASUREMENT RESULTS AT ERDENE SOUM HOSPITAL 100 TABLE IV.62: AIR QUALITY MEASUREMENT RESULTS AT DASHINCHILEN SOUM HOSPITAL 100 TABLE IV.63: AIR QUALITY MEASUREMENT RESULTS AT UVS HOSPITAL 100 TABLE IV.64: MEASUREMENT OF DAYTIME NOISE LEVEL AT SUBPROJECTS IN ULAANBAATAR CITY, APRIL, 2018 102 TABLE IV.65: NOISE MEASUREMENTS IN KHOVD AND UVS HOSPITALS 102 TABLE IV.66: MEASUREMED DAYTIME NOISE LEVELS IN THE 5 SOUMS 103 TABLE IV.67: HEAVY METALS CONTAMINATION LABORATORY TEST RESULTS, MG/KG 103 TABLE IV.68: HEAVY METAL CONTENTS IN SOIL SAMPLES (MG/KG) 106 TABLE IV.69: SOIL CHEMICAL ANALYSIS 107 TABLE IV.70: SOIL CONTAMINATION ANALYSIS 107 TABLE IV.71: CHEMICAL CONTENTS IN THE SOIL SAMPLE 108 TABLE IV.72: SOIL CONTAMINATION ANALYSIS 108 TABLE IV.73: CHEMICAL ANALYSIS RESULTS 109 TABLE IV.74: SOIL CONTAMINATION ANALYSIS 109

TABLE IV.75: SOIL CHEMICAL ANALYSIS 110 TABLE IV.76: SOIL CONTAMINATION ANALYSIS 110 TABLE IV.77: CHEMICAL ANALYSIS RESULTS 110 TABLE IV.78: SOIL CONTAMINATION ANALYSIS 111 TABLE IV.79: CHEMICAL ANALYSIS RESULTS 111 TABLE IV.80: SOIL CONTAMINATION ANALYSIS 112 TABLE IV.81: LONG‐TERM MEAN RUNOFF DATA OF ALTANBULAG RIVER STATION, THE 112 TABLE IV.82: LONG TERM MEAN RUNOFF OF THE TUUL RIVER AT ULAANBAATAR – ZAISAN STATION 113 TABLE IV.83: AVERAGE WATER QUALITY IN THE TUUL RIVER IN ULAANBAATAR CITY (2007‐2017) 114 TABLE IV.84: HEAVY METALS IN TUUL RIVER WATER AND AROUND TUUL RIVER AREA 115 TABLE IV.85: MONTHLY MEAN WATER FLOW DATA FOR BUYANT RIVER 116 TABLE IV.86: BUYANT RIVER WATER QUALITY (GAUGING STATION NORTH OF KHOVD CITY) 117 TABLE IV.87: BUYANT RIVER WATER QUALITY (GAUGING STATION SOUTH OF KHOVD CITY) 117 TABLE IV.88: TUUL BASIN ALLUVIAL GROUND WATER DEPOSITS NEAR ULAANBAATAR CITY 123 TABLE IV.89: NEWLY DISCOVERED GROUND WATER DEPOSITS AROUND ULAANBAATAR CITY 124 TABLE IV.90: LABORATORY RESULTS FOR WATER SAMPLES, CENTRAL WATER SUPPLY SYSTEM 125 TABLE IV.91: LABORATORY RESULTS FOR WATER SAMPLES AT WELL USED BY FHC IN 14TH KHOROO OF KHAN‐ UUL DISTRICT 125 TABLE IV.92: LABORATORY RESULTS FOR WATER SAMPLES AT WELL TAKEN FROM THE GER AREA WATER DISTRIBUTION SYSTEM, USED FHC IN 10TH KHOROO OF KHAN‐UUL DISTRICT 126 TABLE IV.93: LABORATORY RESULTS FOR WATER SAMPLES AT WELL TAKEN FROM THE GER AREA WATER DISTRIBUTION SYSTEM, USED FHC IN 19TH KHOROO IN CHINGELTEI DISTRICT 126 TABLE IV.94: LABORATORY RESULTS FOR WATER SAMPLES AT WELL WATER USED BY KHAN‐UUL DISTRICT HOSPITAL 126 TABLE IV.95: GROUNDWATER RESOURCES IN THE PROJECT AREA 131 TABLE IV.96: LABORATORY TEST RESULTS FOR GROUNDWATER SAMPLE 131 TABLE IV.97: TOTAL RENEWABLE GROUNDWATER RESERVES FOR THE 5 SOUMS 132 TABLE IV.98: GROUND WATER WELL LABORATORY TEST RESULTS, ERDENEMANDAL SOUM 132 TABLE IV.99: GROUND WATER WELL LABORATORY TEST RESULTS, TARIALAN SOUM 132 TABLE IV.100: GROUND WATER WELL LABORATORY TEST RESULTS, BAYAN‐UNDUR SOUM 133 TABLE IV.101: GROUND WATER WELL LABORATORY TEST RESULTS, ERDENE SOUM 133 TABLE IV.102: GROUND WATER WELL LABORATORY TEST RESULTS, DASHINCHILEN SOUM 134 TABLE IV.103: GROUNDWATER DEPOSITS IN UVS LAKE BASIN 135 TABLE IV.104: GROUND WATER WELL LABORATORY TEST RESULTS, ULAANGOM 136

TABLE IV.105: TREES PLANTED WITHIN THE YARDS OF THE 5 SOUM HEALTH CENTERS 144 TABLE IV.106: SPECIAL PROTECTED AREAS IN THE VICINITY OF ULAANBAATAR CITY 147 TABLE IV.107: SPA’S AROUND 5 SOUM CENTERS 151 TABLE IV.108: MONTHLY AVERAGE INCOME PER HOUSEHOLD 158 TABLE IV.109: CLASSIFICATION OF LAND USE OF MONGOLIA 160 TABLE V.1: TEMPORARY USE OF LAND AT HOSPITALS/FHC/SHC 167 TABLE V.2: CONSTRUCTION MACHINERY NOISE 174 TABLE V.3: POTENTIAL NOISE SCREEN LOCATIONS 175 TABLE V.4: SUMMARY ANALYSIS OF POSITIVE AND ADVERSE IMPACTS 193 TABLE V.5: SUMMARY ANALYSIS OF POSITIVE AND ADVERSE IMPACTS 194 TABLE VI.1: LOCATIONS OF PROPOSED FHC/SHC/HOSPITALS IN ULAANBAATAR/OTHER PROVINCES AND LAND STATUS 197 TABLE VII.1: SUMMARY FINDINGS OF PUBLIC CONSULTATIONS 201 TABLE VII.2: SUMMARY OF RECOMMENDATIONS BY THE CONSULTEES 203 TABLE VII.3: LOCATION AND NUMBER OF PARTICIPANTS OF CONSULTATIONS 204 TABLE VIII.1: CONSTITUTION OF GRIEVANCE REDRESS COMMITTEE 206 TABLE IX.1: SAFETY IMPLICATION AND MITIGATION 211 TABLE IX.2: TRAINING PROGRAMME ‐ SUMMARY OF TRAINING NEEDS 212 TABLE IX.3: MAGNITUDE OF ENVIRONMENTAL IMPACTS ‐ MATRIX 215 TABLE IX.4: CONSTRUCTION PHASE MONITORING 224 TABLE IX.5: OPERATIONS PHASE MONITORING 224 TABLE IX.6: PERFORMANCE INDICATORS OF ENVIRONMENTAL MANAGEMENT PRIOR TO CONSTRUCTION.225 TABLE IX.7: ESTIMATED COSTS FOR IMPLEMENTING EMP FOR THREE TRANCHES 228 TABLE IX.8: DETAILS OF EMP COSTS FOR THREE TRANCHES 229 TABLE IX.9: INSTITUTIONAL ROLES AND RESPONSIBILITIES FOR EMP IMPLEMENTATION ACTIVITIES 235 TABLE IX.10: OVERALL PROJECT IMPLEMENTATION SCHEDULE 236

List of Figures FIGURE II.1: ENVIRONMENTAL IMPACT ASSESSMENT PROCESS IN MONGOLIA 17 FIGURE III.1: MAP OF MONGOLIA AND LOCATION OF SUB‐PROJECT IMPLEMENTING AIMAGS 26 FIGURE III.2: LOCATION OF PROJECT SITES IN ULAANBAATAR CITY 27 FIGURE III.3: SOLID WASTE COLLECTION POINT 39

FIGURE III.4: MEDICAL WASTE COLLECTION ROOM AT KHAN‐UUL HOSPITAL. 40 FIGURE III.5: DISINFECTION UNIT AT THE MEDICAL WASTE FACILITY OF ELEMENT LLC 41 FIGURE III.6: LANDFILL POINT AT THE MEDICAL WASTE FACILITY OF ELEMENT LLC 41 FIGURE III.7: MEDICAL WASTE TRANSPORT TRUCK OF ELEMENT LLC 42 FIGURE III.8: SOLID WASTE COLLECTION POINT AT KHOVD HOSPITAL 43 FIGURE III.9: SOLID WASTE COLLECTION PLACE AT UVS HOSPITAL 43 FIGURE III.10: MEDICAL WASTE COLLECTION FACILITY AT KHOVD HOSPITAL 43 FIGURE III.11: MEDICAL WASTE COLLECTION FACILITY AT UVS HOSPITAL 44 FIGURE III.12: MEDICAL WASTE TRANSPORT VEHICLES 44 FIGURE III.13: MEDICAL WASTE TRANSPORT VEHICLES OF UVS HOSPITAL 45 FIGURE III.14: WASTE LANDFILL SITE FOR KHOVD HOSPITAL 45 FIGURE III.15: LABELLED MEDICAL AND NON‐MEDICAL WASTE BINS AT UVS HOSPITAL 46 FIGURE III.16: MEDICAL WASTE COLLECTION HOUSE, ERDENE SOUM HEALTH CENTER 49 FIGURE III.17: SEPTIC TANK AT ERDENE SOUM HEALTH CENTER 49 FIGURE III.18: ARCHITECTURAL PLANNING DESIGN APPROVAL 50 FIGURE IV.1: EARTHQUAKE RISK IN MONGOLIA: MODIFIED MERCALLI SCALE 60 FIGURE IV.2: VEGETATION ZONE MAP OF MONGOLIA SHOWING FOREST AREAS 62 FIGURE IV.3: LOCATION OF TRANCHE‐1 COMPONENTS IN MONGOLIA 67 FIGURE IV.4: LOCATION MAP OF TRANCHE‐1 COMPONENTS IN ULAANBAATAR CITY 68 FIGURE IV.5: TOPOGRAPHY MAP OF ULAANBAATAR CITY 69 FIGURE IV.6. TOPOGRAPHICAL MAP OF KHOVD 70 FIGURE IV.7. TOPOGRAPHICAL MAP OF ERDENEMANDAL SOUM 71 FIGURE IV.8. TOPOGRAPHICAL MAP OF TARIALAN SOUM 72 FIGURE IV.9: TOPOGRAPHICAL MAP BAYAN‐UNDUR SOUM CENTER 73 FIGURE IV.10. TOPOGRAPHICAL MAP OF ERDENE SOUM 74 FIGURE IV.11. TOPOGRAPHICAL MAP OF DASHINCHILEN 75 FIGURE IV.12. TOPOGRAPHICAL MAP OF ULAANGOM CITY 76 FIGURE IV.13. AIR QUALITY AND NOISE CONTROL STATIONS IN UB CITY 93 FIGURE IV.14: NOISE POLLUTION ESTIMATION OF ULAANBAATAR CITY 101 FIGURE IV.15: EARTHQUAKE ZONES MAP ULAANBAATAR AND SUBPROJECT LOCATIONS 105 FIGURE IV.16: SOIL SAMPLING LOCATION IN THE ERDENEMANDAL SOUM HOSPITAL 107 FIGURE IV.17: SOIL SAMPLING LOCATION 108

FIGURE IV.18: SOIL SAMPLING LOCATION 109 FIGURE IV.19: SOIL SAMPLING LOCATION AT THE SOUM HOSPITAL 110 FIGURE IV.20: FLOOD PRONE AREAS OF ULAANBAATAR 114 FIGURE IV.21: LOCATION OF THE KHOVD AIMAG HOSPITAL AND THE BUYANT RIVER 116 FIGURE IV.22: SURFACE WATER NETWORK MAP OF ERDENEMANDAL SOUM 118 FIGURE IV.23: SURFACE WATER NETWORK MAP OF TARIALAN SOUM 119 FIGURE IV.24: SURFACE NETWORK MAP OF BAYAN‐UNDUR SOUM 120 FIGURE IV.25: SURFACE WATER MAP OF DASHINCHILEN SOUM 121 FIGURE IV.26: SURFACE WATER MAP OF ULAANGOM CITY 122 FIGURE IV.27: DISTRIBUTION OF PERMAFROST IN THE AREA OF ULAANBAATAR 128 FIGURE IV.28: PERMAFROST MAP, KHOVD 130 FIGURE IV.29: RENEWABLE GROUNDWATER RESERVE MAP OF MONGOLIA 135 FIGURE IV.30: VEGETATION ZONES OF MONGOLIA 137 FIGURE IV.31: POPULUS TREES AND BUSHES AT THE EMERGENCY CALL CENTER 137 FIGURE IV.32: POPULUS TREES AT THE PROPOSED CONSTRUCTION SITE THAT NEED TO BE RE‐PLANTED AT KHAN‐UUL DISTRICT HOSPITAL 138 FIGURE IV.33: POPULUS AND PINE TREES AND BUSHES AT THE PROPOSED CONSTRUCTION SITE THAT NEED TO BE RE‐PLANTED. FHC IN 10TH KHOROO OF KHAN‐UUL. 138 FIGURE IV.34: WILDLIFE ZONES IN MONGOLIA (A.G. BANNIKOV) 139 FIGURE IV.35: POPULUS TREES AT THE PROPOSED CONSTRUCTION SITE THAT NEED TO BE RE‐PLANTED. KHOVD HOSPITAL. 141 FIGURE IV.36: LOCATION OF ALTAI‐SAYAN ECO‐REGION 141 FIGURE IV.37: PLANT‐GEOGRAPHICAL MAP OF MONGOLIA 143 FIGURE IV.38: TREES IN THE YARD OF TARIALAN SOUM HEALTH CENTER THAT NEED TO BE REMOVED 144 FIGURE IV.39: WILDLIFE‐GEOGRAPHICAL ZONES OF MONGOLIA (A.G. BANNIKOV) 145 FIGURE IV.40: LOCATION OF SPA’S AND SUBPROJECT COMPONENTS 147 FIGURE IV.41: MOUNT SPA AND ITS BUFFER ZONE 148 FIGURE IV.42: SPECIAL PROTECTED AREAS AROUND THE KHOVD CITY AND LOCATION OF SUBPROJECT 149 FIGURE IV.43: SPA LOCATION MAP OF MONGOLIA 151 FIGURE IV.44: PROTECTED AREAS AROUND ULAANGOM CITY 152 FIGURE IV.45: LAND USE PATTERN IN ULAANBAATAR 161 FIGURE VI.1: ALTERNATE ACCESS ROUTE FOR FHC 199 FIGURE VIII.1: FLOW CHART SHOWING GRIEVANCE REDRESS MECHANISM FOR ENVIRONMENT 208

FIGURE IX.1: PROJECT ORGANIZATION STRUCTURE 232

EXECUTIVE SUMMARY

1. The project will help to sustain the health status of Mongolian people, through better quality and inclusiveness of healthcare services and enhanced system for healthcare financing, improved. The investment program will deliver four major outputs to address the key constraints identified above. The project will Urban and rural primary healthcare strengthened; (ii) District and Aimag hospital services improved, (iii) Strategic purchasing model strengthened; (iv) Ministry of Health capacity in procurement and financial management for sector development strengthened. The project is expected to be implemented from September 2019 to June 2029. Components and Summary Environmental Issues 2. The IEE report comprises of baseline data on the existing condition of the physical and biological environment, the anticipated environmental impacts, proposed mitigation measures, monitoring frameworks, grievance procedure and public consultations. The consultant team undertook field surveys to sub-project sites to assess the physical and biological environment – factors such as site ecology, management of construction, sanitation, use of equipment and machineries, environmental health and safety, occupational hazard etc. The environment management and monitoring plan have been dealt with in detail in the respective sections of the report. A Tranche-1 environment management plan has been attached separately. However, a summary list of key impacts on environment parameters are briefly enumerated in Table 1 below: Table 0.1: Summary Impacts on key environment parameters

# Environmental Type of Reason Proposed Mitigation Measures Parameter Impact 1 Air Quality Medium Significant air emission Sprinkling of water, proper handling from the construction of excavated soil, construction activity during material, banned substances/VOCs stacking/storage of soil, etc. construction material at site 2 Water Quality Low The project will require The required water will be sourced small quantity of water for from tankers by the construction construction. No hazardous company. effluent is envisaged to be Domestic effluent shall be discharged during discharged in holding tanks which construction will be cleaned regularly and waste is safely stored, transported and disposed at urban body’s solid waste management site. 3 Soil Quality Low Land is available. Construction company to ensure FHC/SHC/Hospital has proper housekeeping, sanitation open/vacant areas within and cleanliness at work site. the premises for ii

# Environmental Type of Reason Proposed Mitigation Measures Parameter Impact construction of additional buidling1 and government land for new FHC/SHC/Hospital. 4 Noise Quality Low The construction activity Noise monitoring will be done at may lead to noise pollution regular intervals. If any night during concreting –steel construction activity that is noise cutting, bending, casting intensive is undertaken, staff and using vibrators, operation of neighbourhood must be consulted mechanised equipment and to determine suitable timings. drills etc. that will affect the patients, residents of the area. 5 Hazardous Minimal The sub-projects will not Sections of buildings, if they contain Substance – eg. impact the main buildings any hazardous material will not be Asbestos, VOCs of the selected for improvement actions. FHC/SHC/Hospital/Health Center 6 Terrestrial Low No ecologically sensitive Tree replantation/transplantation to Ecology place (protected be carried out inside premises if area/reserved any trees are cut by the forest/Important flora and construction company fauna species) within 5 km radius from each sub- project site

3. Table 2 below gives key features, including environmental issues (if any) for the sub- projects: Table 0.2: Key features and environmental issues for each Sub-project No Compon Location Key features of sub-project Key Environmental Issues ents component A Tranche 1 FHC/SHC/Hospital 1 Khan-Uul Khan Uul Connected to centralized heating, water, Location within the SPA buffer zone, Hospital District, sewage and electricity systems, no land replanting of 59 Populus trees, emission Yarmag acquisition or resettlement issues for of dust and noise, traffic safety new building precaution required, waste generation during both construction and operation period 2 Khovd, Khovd Connected to centralized heating, water, Replanting of 7-8 Populus trees, Hospital Province, sewage and electricity systems, medical emission of dust and noise, traffic safety Jargalant waste collection site needs to be precaution required, waste generation Soum replaced with closed bins and concrete/ during both construction and operation lined flooring, no land acquisition or period resettlement issues for new building. 3 Uvs Ulaango Connected to centralized heating, water, Emission of dust and noise, traffic safety hospital m city sewage and electricity systems, medical during construction, waste generation

1 Construction of additional buildings to expand services. iii

No Compon Location Key features of sub-project Key Environmental Issues ents component waste collection disposal site needs to during both construction and operation be replaced with closed bins and period. There are kindergartens and concrete/lined flooring. 1200m2 middle schools (in 150-350m distance) additional building will be built inside surrounding the hospital. boundary of Hospital land. 4 Emergen Sukhbaat Connected to centralized heating, water, Replanting of 23 trees and bushes, cy Health ar sewage and electricity systems. The emission of dust and noise, traffic safety Center district,1 Specialised Agency for Inspection has precaution required during construction, st Khoroo confirmed there is no asbestos present waste generation during both in the building built in 1970. There is an construction and operation period. office building and a private house right next to the proposed construction site, no land acquisition or resettlement issues for construction of new building. 5 FHC 10th Connected to centralized heating, water, Replanting of 28 trees and bushes, Khoroo in sewage and electricity systems, potential relocation of heating pipeline to Khan-Uul demolish existing 119m2 building built in nearby kindergarten, emission of dust district 2000, there is kindergarten locating and noise, traffic safety precaution nearby the construction site, no land required during construction, waste acquisition or resettlement issues for generation during both construction and new building. operation period. 6 FHC 14th Not connected to any centralized Relocation of water supply pipeline for Khoroo in network except for electricity, has own the kindergarten, make an alternate Khan-Uul water well and septic tank, electric access road for the kindergarten, district heating, land permission to be obtained emission of dust and noise, traffic safety in May 2018, no land acquisition and during construction, waste generation resettlement issues for new building, during both construction and operation there is kindergarten located nearby the period. construction site. 7 FHC 19th Not connected to any centralized Emission of dust and noise, traffic safety Khoroo in network except for electricity, has own during construction, waste generation Chingelte septic tank, heating from own HOB during both construction and operation i district using coal, flood channel nearby period. For the purposes of the IEE, the construction site, no land acquisition water well samples were tested and and resettlement issues for new meets national drinking water standard building. of Mongolia. 8 FHC 17th Connected to centralized water and Emission of dust and noise, traffic safety Khoroo in electricity systems, has own septic tank, during construction, waste generation Bayanzur heating from own HOB, demolish during both construction and operation kh district existing 203 m2 building built in 2001, no period. land acquisition and resettlement issues for new building. 9 SHC Erdenem Not connected to any centralized The proposed construction site is andal network except for electricity, has own currently a parking space for the Soum Soum septic tank, heating from own HOB, a health center, thus a new parking space new additional building (800m2) inside and entrance point shall be planned, an the boundary of the hospital land will be old heating pipeline is very close to the built. proposed construction site (it will not be used for this facility). Emission of dust and noise, traffic safety during construction, waste generation during both construction and operation period. 10 SHC Tarialan Connected to centralized water, heating Emission of dust and noise, traffic safety Soum and electricity networks, has own septic during construction, waste generation

iv

No Compon Location Key features of sub-project Key Environmental Issues ents component tank, new additional building (800m2) during both construction and operation inside the boundary of the hospital land period, 44 trees in the hospital premise will be built, a small wooden house (with needs to be removed and re-planted, 4 size 3m x 4m) needs to be demolished. households are located at 40-60m distance from the construction site on the southern side that will be affected. 11 SHC Bayan- Connected to centralized heating and Emission of dust and noise, traffic safety Undur electricity networks, deliver water from during construction, waste generation Soum nearby water well in the Soum center, during both construction and operation has own septic tank, new additional period, a middle school is located at building (800m2) inside the boundary of 150m distance from the construction site the hospital land will be built. on the northern side. 12 SHC Erdene Connected to centralized water, heating Emission of dust and noise, traffic safety Soum and electricity networks, will be during construction, waste generation connected to centralized sewage during both construction and operation pipeline later this year, new additional period. Waste collection point in the building (800m2) inside the boundary of hospital yard needs to be replaced with the hospital land will be built. closed lid bins with proper concrete/lined flooring. The Soum health center currently does not have fencing around it. 13 SHC Dashinchi Not connected to any centralized Emission of dust and noise, traffic safety len Soum pipelines: heating, electricity and water. during construction, waste generation Domestic use is supplied from its own during both construction and operation well and drinking water is transported period. The closest ger area is only from the well in the Soum center. Has 100m from the construction site. own septic tank, new additional building (800m2) inside the boundary of the hospital land will be built.

4. Potential impacts are mostly temporary, predictable, and reversible, and can be mitigated through adherence to national2 and international standards3, design criteria, and/or implementation of Environment Management Plan (EMP). FHC/SHC/Hospital are proposed on government land and the location of FHC/SHC/Hospital avoided any sanctuary/protected areas or any other environmentally-sensitive areas. Utilization of the best available technology and best management practices are built-in to the project design and listed through the Environment Management Plan (EMP) and more specifically through the site specific EMPs to be developed by the Construction company. 5. The Khan-Uul District hospital is located about 1.4 km distance from Bogdkhan Mount Special Protection Area (SPA) buffer zone. Bogd khan Mount SPA where the Khan-Uul hospital is located is a settlement area having built-up apartments etc. and is not a biodiversity site. The construction and rehabilitation will take place inside the existing land area of Khan-Uul Hospital. Construction activities are not prohibited within the SPA buffer zone but it needs to have DEIA and EMP approved by MET. Draft domestic DEIA reports for Khan-Uul and Khovd hospitals are already made by a local professional firm and available

2 Relevant Mongolian Standards mentioned in Section 2 later 3 World Bank/IFC Environment Health and Safety Guidelines 2007 v

now. However, approval process of the domestic DEIA reports by Ministry of Environment requires the project to have approved detailed design. 6. IEE including EMP has been prepared to mitigate the potential adverse impacts of construction. The new FHC/SHC/Hospitals are proposed only on land owned by the Government and therefore acquisition of land will not be required from the surrounding communities. The proposed additional buildings4 of FHC/SHC/Hospitals will be located on existing government lands or those lands that are allotted to MOH by Government of Mongolia. All proposed new FHC/SHC/Hospitals have been identified to have possession of vacant land area; whereas the FHC/SHC/Hospitals where construction is to be done in their existing land, there is no need to acquire land. 7. Current facilities for two FHCs and NECC will be shifted to temporarily to properties on rent nearby for continuous functioning during construction therefore minimising nuisance to the patients and staff. All other facilities do not require closure during operations as these are separate buildings or new buildings. 8. Modern state of the art buildings with equipment and building infrastructure fitted with firefighting and alarm systems, electric shockproof designs, seismic resilience, storm and flooding resilient structures are being designed by architects. Buildings will be designed having provisions for energy efficiency and green design. Demolition of two FHC’s comprising of 119 m² each (10th Khoroo of Khan-Uul, 17th Khoroo of Bayanzurkh). The mortuary and kitchen at Khan-Uul District hospital will also be demolished. No asbestos is involved in all of the 2 of FHC buildings and Khan-Uul hospital that will be demolished. The 2 storied NECC building measuring 816 m2 will be demolished. Specialized Inspection Agency of the Municipality Authority of Ulaanbaatar city has confirmed that there is no asbestos present in the National Emergency Health Call Center Building by issuing a certificate no 02- 03/4170 dated 31 October 2018 (attached as Annexure 10). The detailed “asbestos inspection” at the National Emergency Health Call Center was conducted in June 2018. Asbestos containing material (ACM) will not be used as a new material in rehabilitation works or new buildings. 9. During site visits, the hospital managements have assured no hazardous materials would be involved in demolition and disposal of debris to designated waste sites planned. Specialized Inspection Agency of the Municipality Authority of Ulaanbaatar city has confirmed that there is no asbestos (or asbestos containing materials [ACM]) present in the National Emergency Health Call Center Building by issuing a certificate no 02-03/4170 dated 31 October 2018 (attached as Annexure 10). The detailed “asbestos inspection” at the National Emergency Health Call Center was conducted in June 2018. For all other facilities, existence of any hazardous materials, such as asbestos shall be determined prior to development of design. If renovation or refurbishment for any component requires removal of asbestos containing materials (ACM), the particular activity will be dropped from funding.

4 Construction of additional buildings to expand services.

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10. At existing hospital areas, no hydrology will change. FHC at 19th Khoroo in Chingeltei is located nearby a flood channel. The digging and drilling (if required) must be done to understand the depth of rock from top or presence of any permafrost. 11. For most of the proposed new FHC/SHC/Hospital, the construction drawings (technical reports) will be finalized after conducting detailed physical survey of the land through architect firms engaged by the EA under the project. The construction of additional buildings5 will be done avoiding existing apartment/housing, other buildings, trees or any other existing settlement directly related with the livelihood of people. As assessed, the project benefits outweigh the negative impacts. 12. The negative environmental impacts that are likely to be associated with construction activities of the FHC/SHC/Hospitals include - noise and dust during construction, transportation of construction material to site, disposal of waste soil, and inconvenience to neighbouring communities due to increased traffic due to new building construction activities. Constant movement of vehicles that transport construction materials will cause increased level of dust and noise during the construction period. There will be a minor increase of traffic during the construction activities. The impact will be negligible as sprinkling of water, proper handling of excavated soil, and proper construction material storage would be done at the sub-project sites. Effective traffic management and accident management plan will be prepared by Construction Company under guidance of PIU. 13. Construction activities may require a camp for construction staff and/or machinery parking area and additional space for heavy machinery movement; in this regard the hospital and clinic administrations will be required to host the camps and to provide additional space for machinery movement. Most workers will be local residents at the project sites in Ulaanbaatar city. But for construction of Khovd hospital, Uvs hospital and SHC’s, some of the workers might come from other regions. Most workers may stay in nearby accommodation planned by the construction company. The construction company to develop occupation health and safety plan for those workers from other regions as per EMP. 14. Spoil accumulation points and disposal to be identified – inert material to go to waste fill site, other clinical/ medical waste will go to medical waste site during operations. Any hazardous material will be handled as per national Mongolian environmental laws. At existing hospital areas, the drainage plans will be prepared and disclosed by Construction Company which will be approved by the city/province level specialized agency before construction. 15. During the site visits, the officials and consultants made numerous observations and held discussions with FHC/FHC/SHC/Hospital managements concerned to assist in proper design of new FHC/SHC/Hospital with respect to the following: (i) location of proper access roads, laydown area for materials to be used by the construction companies to use without disturbing the working and minimizing utilization of public and playground areas, (ii) avoidance of underground existing pipes for water, heating, sewage etc. at these proposed work sites, (iii) right of way for construction vehicles and provide traffic safety during construction to local residents living adjoining these FHC/SHC/Hospital, (iv) traffic caused by

5 Construction of additional buildings to expand services. vii

construction of new buildings by use of concrete, dump trucks etc. transporting materials inside FHC/SHC/Hospital premises; traffic safety for patients during operations of FHC/SHC/Hospital in normal work hours; (vi) lack of safety equipment such as smoke alarms in most old buildings and the need for adequate firefighting extinguishers and imparting evacuation drills and emergency response procedures training, (vii) distances of these FHC/SHC/Hospital from non-sensitive biodiversity areas and cultural heritage sites to ensure no impact, (viii) dust and noise emissions from the construction subprojects and their impacts on patients and apartment dwellers adjoining the FHC/SHC/Hospital area, (ix) noises from any surroundings areas during construction and operations, (x) avoid any shadow projection onto adjoining buildings due to new structures to be constructed as part of this project, (xi) any banned substances generated as part of any construction project such as asbestos etc., (xii) emissions from coal based heating and water boilers (some cases), (xiii) if insulation works are required in FHC/SHC/Hospital to ensure energy efficiency, i.e. loss of heat due to old walls, (xiv) check presence of any associated or linked facilities, and (xv) determine potential climate change impacts of project activities, if any. 16. The team along with district officials and FHC/SHC/Hospital managements conducted group consultation and discussions with the apartment dwellers/public residing in these sub-project areas to sensitize them about project activities, their impacts and get their suggestions. 17. Very small numbers of trees exist in the sites selected for subprojects. There are about 59 Populus trees at Khan-Uul District hospital site, about 7-8 Populus trees at Khovd hospital site, 10 Populus trees at National Emergency Health Call Center (NECC), and about 25 trees and bushes at the FHC in 10th Khoroo of Khan-Uul district that need to be removed and re-planted. Populus tree does not have any protected status both domestically and internationally. 18. No endangered or protected species of flora or fauna are reported at any of the subproject sites. Locational orientation of the FHC/SHC/Hospital will be finalized in a manner so as to avoid or minimize the shadow falling on adjoining structures. Before start of construction, the construction company shall procure all requisite regulatory approvals from all concerned authorities. Adequate provisions have been made for the environmental mitigation and monitoring of predicted impacts, along with their associated costs in the IEE. Adverse impacts if noticed during implementation will be mitigated using appropriate design and management measures as per the EMP by the construction company. 19. Before start of construction, the construction company shall prepare a construction site specific EMP and procure all requisite regulatory approvals from all concerned authorities. Adequate provisions have been made for the environmental mitigation and monitoring of predicted impacts, along with their associated costs in the IEE. Adverse impacts if noticed during implementation will be mitigated using appropriate design and management measures as per the EMP by the construction company. 20. Some risks expected during construction (for hospital personnel, patients and nearby residents), but can be addressed through sound construction site management such as sound proofing noise, construction yard protection fencing, proper traffic management during construction material movements. The Construction Company and

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Hospital/FHC/SHC/National Emergency Health Call Center (NECC) sites will plan and implement disaster management plan, emergency site accident remedial measures and information disclosure etc. 21. Hospitals, FHC’s, SHC’s and NECC will generate hazardous, infectious and chemical waste during its operation that can be managed properly following to EMP. No other significant risks are anticipated during operation. An Emergency Response Program (ERP) will be prepared by Contraction Company in consultation with Environment safeguard specialist of the PIUs. ERP training will be provided to all stakeholders in the project construction and operations stages. 22. For some FHC/SHC/Hospital sub-projects, the construction drawings development is underway. The data regarding soil, topography, contour, land cutting and filling required, distance from water body and distance from major roads, details of trees can be affected; land details will be collected by engineering firms. If sites are changed other than those indicated in the IEE, supplementary information will be supplied for each of new location for these subprojects by MOH to ADB for prior approval before finalizing detailed design. IEE/EMP will be updated once the detailed design is approved by EA. This updated IEE/EMP will be reviewed and disclosed as per procedure detailed in the EARF. 23. According to the MET regulation requires development of a Tranche-1 Environment Impact Assessment (EIA). According to Government of Mongolia’s (GoM) EIA Notification, projects are not listed as environmental sensitive projects and hence no clearance is required from Ministry of Environment and Tourism (MET); however, clearance from General Agency for Specialized Inspection (GASI) and urban bodies is would be taken by the EA at advanced stages of project preparation. 24. Since the project does not involve activities that have significant adverse impacts and no banned substances are present, an IEE has been developed comprising development of an environmental management plan and monitoring plan as per ADB’s Safeguard Policy Statement (SPS) 2009. The IEE report conforms to national environmental regulations and is also consistent with ADB SPS 2009. Accordingly, the environmental classification for the project is “Category B” as per ADB SPS 2009.

I. INTRODUCTION

A. Background 25. The current population of Ulaanbaatar is about 1.38 million (2016), of which, around 60% reside in poorer ger (traditional tent) areas with limited access to basic socioeconomic services (e.g., water supply and wastewater treatment, roads and transportation, heating, roads, primary health clinics (PHC)/family health clinics (FHC)/Hospitals, primary schools and kindergartens. Further exacerbating the situation is the sharp decline of the gross domestic product (GDP) growth from 17.3% in 2011 to 1% in 2016, increasing levels of air pollution, and rising poverty levels nationwide. People’s access and utilization of healthcare in Mongolia remain inequitable. Since 1997, the Asian Development Bank (ADB) has been a major player in the health sector supporting reforms and investing in primary and hospital care, health insurance, access to pharmaceuticals, health human resources development, and sector governance. On-going health reforms are targeted at increasing the availability and access to health services in urban and rural areas, maintaining high health insurance coverage and expanding the health insurance benefit package. 26. The infrastructure situation of district hospitals in Ulaanbaatar is poor. Most district hospitals were not designed as hospitals, providing a narrow range of services; often poorly maintained; and faced with severe deficiencies in waterproofing, electrical installations and heating, ventilation, and air conditioning systems. District hospitals with a larger range of services, as mandated by the revised health law 2011, have not been established due to lack of technical capacity and funding shortages.6 A limited number of private hospitals are operational, though unaffordable for most of the population. MOH capacity to effectively govern, manage, and supervise health service delivery requires improvements; a conducive environment for private sector investment in health needs to emerge, combined with safety nets for the disadvantaged; and cooperation with nongovernment entities needs to be mainstreamed. 27. Strategic context. The proposed investment program is in line with ADB’s country partnership strategy for Mongolia, 2017–2020 and ADB’s Operational Plan for Health, 2015– 2020, which both underscore the importance of improving the quality of health services, the efficiency of health systems, and the reduction of health-related expenditures.7

B. Outcome and impact. 28. These solutions will result in the following outcome: access to affordable quality primary and secondary health services in Khovd Aimag (province), Ulaanbaatar ger areas, and other selected Aimags improved. The investment program will be aligned with the following impact: the health status of Mongolians, through better quality and inclusiveness of healthcare

6 ADB has been supporting the development of a new district general hospital with a comprehensive set of services in Songinokhairkhan. (ADB. 2012. Report and Recommendation of the President to the Board of Directors: Pro- posed Loan to Mongolia for the Fourth Health Sector Development Project – Additional Financing. Manila.) 7 ADB. 2017. Country Partnership Strategy: Mongolia, 2017–2020—Sustaining Inclusive Growth in a Period of Economic Difficulty. Manila; ADB. 2015. Operational Plan for Health, 2015–2020: Health in Asia and the Pacific— A Focused Approach to Address the Health Needs of ADB Developing Member Countries. Manila. 2

services and enhanced system for healthcare financing, improved. The investment program will deliver four major outputs to address the key constraints identified above:  Urban and rural primary healthcare strengthened.  District and Aimag hospital services improved.  Strategic purchasing model strengthened.  Ministry of Health capacity in procurement and financial management for sector development strengthened. 29. Innovations. The investment program includes the following key innovations: (i) PPP models for hospital maintenance will be tested to address the severe neglect of facilities and equipment maintenance; (ii) expanded and integrated services, including information and communication technology, of FHCs (e.g., laboratory facility, rehabilitation) and district hospitals (e.g., surgery, obstetrics and maternity, linking outpatient and inpatient departments) will be designed and implemented; and (iii) a strategic purchasing model will be designed and carried out to shift state funding for health from financing budget lines to purchasing services.

C. Tranche 1: Multi Tranche Financing Facility 30. These solutions are best delivered by a program of investments under an MFF to achieve the outcome. The policy framework is clearly stated and requires sustained investments and policy dialogue through a long-term commitment and partnership. A project implementation unit with strong capacity to transfer evidence-based practices to subsequent tranche processing and implementation will be established to (i) achieve the expected reforms spanning over several tranches (e.g., strategic purchasing for improved health delivery), (ii) implement major health infrastructure development benefiting from previous tranche design and implementation (district and provincial general hospitals), and (iii) pilot PPP for maintenance and integrated service models that will be upscaled throughout subsequent tranches. The investment program will be implemented from January 2019 to June 2029, project 1 from 2019 to 2024, project 2 from 2022 to 2026, and project 3 from 2025 to 2029. 31. The scope of project 1 (Tranche 1) includes the same four outputs as the MFF. Output 1 will design and construct six FHCs with expanded services and five client-friendly SHCs, pilot an integrated primary and secondary care model, reform PHC financing and contracting, introduce an electronic health record system for PHC, introduce low-carbon technology, and strengthen UCHD’s planning and management capacity. Output 2 will expand hospital in Khan-Uul district and in Khovd and Uvs Aimags, strengthen hospital autonomy, and introduce low-carbon technology in hospital building construction. Output 3 will design and initiate reforms of the strategic purchasing systems. Output 4 will assess needs and implement a capacity building program for MOH’s procurement, financial, and risk management, which will continue during the entire duration of the program. 3

D. Proposed Financing Plans 32. The MFF is estimated to cost $161.6 million equivalent. A loan of $160 million equivalent from ADB’s ordinary capital resources, Mongolia country and regional allocations, is proposed, consisting of three tranches amounting to $60 million, $40 million, and $40 million, respectively. Table I.1: Indicative Financing Plan

MFF amount Tranche 1 Share of Total Source ($ million) ($ million) (%) Asian Development Bank Ordinary capital resources (Regular loan) 160.0 80.0 99.0 Government 1.6 0.8 1.0 Total 161.6 80.8 100.0 Source: Asian Development Bank estimates.

E. Implementation Arrangements Table I.2: Indicative Implementation Arrangements

Aspects Arrangements Indicative Tranche 1 period January 2019–January 2024

Management (i) Executing agency MOH MOH for policy-related indicators of outputs 1, 2, 3, and 4 and the (ii) Key implementing agencies investments in Khovd and other Aimags; and Ulaanbaatar City Mayor’s Office for investments in Ulaanbaatar MFF = multi-tranche financing facility, MOH = Ministry of Health. Source: Asian Development Bank.

33. The Ministry of Health (MOH) will be the project executing agency. The implementing agencies will be MOH. It was also agreed that a project implementation unit will be established by MOH to manage day-to-day activities of the project. The project will be implemented from September 2019 to June 2029.

F. Scope of Work and Methodology Adopted 34. The broad scope of the Environmental Assessment study is:  To conduct field visits to collect data relevant to the study area and also collect secondary data so as to establish the baseline environmental status of the study area;  To assess the impacts on environmental attributes due to the location, design, construction and operation of the proposed project;  To prepare a mitigation plan outlining the measures for protecting the environment including institutional arrangement and environmental monitoring;

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 To identify critical environmental attributes required to be monitored subsequent to the implementation of the proposed project;  To carry out consultation with local people to identify the public perception of the project; and  To establish the Environment Monitoring Plan (EMoP) for the MOH to submit environmental monitoring reports to ADB at regular intervals. 35. Each proposed FHC/SHC/Hospital on the list was further examined for conformance to ADB’s safeguards and technical due diligence confirmed for support before the design of the project is finalized in June 2018. Accordingly, transect walks and field surveys were undertaken to assess physical and biological environment in April/October 2018. However, the exact physical location within the site for some FHC/SHC/Hospitals may vary after the exact demarcation of locations by the Architects preparing construction technical drawings and General Agency for Specialised Inspection (GASI) requirements. 36. The IEE report comprises baseline data on existing condition of physical, ecological, economic, and social information, together with the anticipated environmental impacts and proposed mitigation measures. This report is prepared on the basis of preliminary survey, field study and consultations with the help of available secondary data of different sites, articles and report. 37. Detailed assessment of secondary source baseline environmental data for Ulaanbaatar and concerned Aimags/Soums was done to support the findings of the field survey by consultants. Public consultations were held with affected persons such as apartment dwellers, other stakeholders, and government officers of the project area. Annexure 7 gives details of places and persons who attended these consultations. The field studies were supported by data collected from secondary sources such as internet, forest atlas, published data from GoM documents, population census statistics data, as well as documents from MOH and documents from other government departments etc. 5

II. POLICY, LEGAL AND ADMINISTRATIVE FRAMEWORK

38. The Tranches, Projects and components pertaining to this IEE are subject to both ADB and National environmental safeguard policies and legislation. This section specifies the ADB requirements and those set out in Mongolian law, which prescribe the principles governing the implementation of all components.

A. ADB’s Safeguard Policy Statement (SPS 2009) 1. Environmental Impact Assessment Requirements of ADB 39. The safeguard policies are operational policies that seek to avoid, minimize or mitigate the adverse environmental and social impacts of projects including protecting the rights of those people likely to be affected or marginalized by the development process. ADB’s safeguard policy framework in the SPS consists of three operational policies on the environment, indigenous people and involuntary resettlement. ADB has developed Operational Procedures to be followed in relation to the SPS policies and these are included in the ADB Operations Manual. 40. The ADB’s Safeguard Policy Statement (SPS), 2009 is applicable to all projects. These projects can be categorized as A, B, C or FI. Table II-1 below provides a list of categorization of the activities related to Environment, Safeguards, as per ADB’s Safeguard Policy Statement 2009 requirements: Table II.1: Environment Safeguards Categorization: Definition

Category Environment Type of reporting required. A — Significant Projects that anticipate significant adverse environmental An environmental impact impacts that are irreversible, diverse, or unprecedented. assessment (EIA) is required to These impacts may affect an area larger than the sites or address significant impacts. facilities subject to physical works. B — Less Significant Projects with potential adverse impacts that are site- An initial environmental specific, few if any of them are irreversible, and in most examination (IEE) is required to cases mitigation measures can be more readily designed determine whether or not than for Category A investments. significant environmental impacts. C — Minimal or impact Projects that have minimal or no adverse environmental Environmental due diligence impacts. report or any other document that reviews environmental implications is required, FI — Financial Projects of ADB funds through financial intermediaries (FI) An environmental and social Intermediation management system (ESMS) report is required.

41. At an initial stage of identifying project activities, the ADB's Prohibited Investment Activities List (described in Asian Development Bank’s Safeguards Policy Statement 2009.) will apply.

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If the investment involves any prohibited activity, EA will not consider the investment. However, in this project, there are no prohibited activities being undertaken. 8 2. ADB SPS Requirements (SR1): Environment Policy 42. ADB’s SPS sets out the policy objectives, scope and triggers, and principles for the environmental safeguards. To achieve the policy objectives and deliver the policy principles, ADB carries out the actions described in the Policy Delivery Process (subsection B of the SPS). To help borrowers/clients and their projects achieve the desired outcomes, ADB adopts a set of specific safeguard requirements that borrowers/clients are required to meet in addressing environmental and social impacts and risks. ADB staff, through their due diligence, review, and supervision, will ensure that borrowers/clients comply with these requirements during project preparation and implementation. 43. The objective of ADB’s due diligence for the Project loan is that EA ensures the environmental soundness and sustainability of projects and to support the integration of environmental considerations into the project decision-making process. 44. Environmental safeguards are triggered if a project is likely to have potential environmental risks and impacts. For the MFF, Project 1 has been evaluated as a Category B Project, requiring an IEE. Guidelines on the ADB’s requirements for environment due diligence in are in accordance to the Safeguard Policy Statement (June 2009). 3. Standards, guidelines and good practice in ADB SPS 45. The Appendix 1 of the ADB SPS Policy Statement 2009 (SPS) states, "During the design, construction, and operation of the project, the borrower/client will apply pollution prevention and control technologies and practices consistent with international good practice, as reflected in internationally recognized standards such as the World Bank Group’s Environment, Health and Safety Guidelines. These standards contain performance levels and measures that are normally acceptable and applicable to projects. When the host country regulations differ from these levels and measures, the borrower/client will achieve whichever is more stringent. If less stringent levels or measures are appropriate in view of specific project circumstances, the borrower/client will provide full and detailed justification for any proposed alternatives that ae consistent with the requirements presented in the SPS 2009.” 46. For this purpose, IFC EHS guidelines are recommended. The Environmental, Health, and Safety (EHS) General Guideline9 (April 30, 2007) will be applicable for this Project. The Section 4 on Construction and Demolition of the guidelines are important for consideration. These standards are listed in Annexure 2 for reference.

8 No production of, trade in, or use of unbonded asbestos fibers 9 These standards contain performance levels and measures that are normally acceptable and applicable to pro- jects. When host country regulations differ from these levels and measures, the borrower/client will achieve whichever is more stringent. If less stringent levels or measures are appropriate in view of specific project cir- cumstances, the borrower/client will provide full and detailed justification for any proposed alternatives that are consistent with the requirements presented in this document. 7

47. The following IFC/World Bank guidelines will also be used for guidance for development of health care facilities: - Environmental, Health, and Safety Guidelines for Waste Management Facilities. - Environmental, Health, And Safety Guidelines for Water and Sanitation. - Environmental, Health, And Safety Guidelines for Health Care Facilities.

B. National Mongolian Legislation 1. Mongolia’s Environmental Policy 48. Mongolia has enacted a comprehensive policy and legal framework for environmental assessment and management. It has policies, legislation and strategies in place to manage the protected areas such as national parks, to satisfy its international obligations, and to protect the quality of the environment for the health and well-being of its citizens. The hierarchy of policies and legislative provisions for environmental management in Mongolia comprises the Constitution, international treaties and environment and resource protection laws.10 49. The main policy documents are the National Biodiversity Program 2015-2025 and a set of environmental laws that were amended in May 2012 including the Law on EIA. The Government of Mongolia has adopted Green Development Policy in 2014 which amis to advance Mongolia’s national development in an environmentally sustainable manner, building the conditions for future generations to benefit and gain in the long term and to ensure environmental sustainabilitythrough creation of growth based on green development concepts and through citizen’s participation and inclusiveness. It seeks to ensure green development for Mongolia through achieving six main objectives: (i) Promote resource efficient, low carbon production and consumption with emphasis on waste reduction. (ii) Maintain ecosystem balance and reduce environmental degradation while intensifying reclamation activities and environmental protection. (iii) Promote investment in environmental protection, human development and clean technology and leverage tax, credit and incentive mechanisms to finance green economy. (iv) Promote green jobs, reduce poverty and promote green lifestyle. (v) Make education, science and technology and innovation accelerators of green development by promoting environmentally adapted style and cultural values. (vi) Plan and implement human settlement adapted to climate change, and natural resources carrying capacity. 50. The main principles of the Green Development Policy are: (i) harmony between sectoral policies and planning are consistent with green development concepts, (ii) support for clean advanced technologies, (iii) citizens’ participation and inclusiveness in green growth, (iv) environmentally friendly attitudes, habits and competencies,

10 UNDP. 2008. Institutional Structures for Environmental Management in Mongolia. Ulaanbaatar and Wellington.

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(v) transparency, accountability and liability and (vi) efficient, effective and rational use of resources. 51. A fundamental principle of the Mongolian state environmental policy is that economic development must be in harmony with the extraction and utilization of natural resources and that air, water and soil pollution will be controlled. In April 1996, Mongolia’s National Council for Sustainable Development was established to manage and organize activities related to sustainable development in the country. The country’s strategy is designed for environmentally friendly, economically stable and socially wealthy development, which emphasizes people as the determining factor for long-term sustainable development. 52. The health of Mongolia's natural ecosystems and populations of wild species is of both national and global importance. The country forms an important part of the global ecosystem where the eco-regions of the Siberian taiga, the Central Asian steppe, the high Altai Sayan, and the Gobi Desert converge. The Project area is in the Altai Sayan ecoregion. 2. Relevant Mongolian Government Acts, Rules, Strategies and Guidelines. 53. The implementation of various components of Improving Access to Health Services for Disadvantaged Groups Project will be governed by Government of Mongolia (GoM) laws and regulations related to environmental considerations. Major Mongolian environmental laws and regulations relevant to the project are listed in Table below. Table II.2: Relevant Environmental, Health and Safety Laws in Mongolia

Law Enacted and Responsible Agency Brief Description Amended Law on Enacted in - State specialized inspection To ensure safe environment, have Environmental 1995 and agency ecologically balanced social and Protection amended - Environmental departments of economic development, and for the 2017 district, province and Soum protection of the environment for authorities present and future generations, the proper use of natural resources and - Department of Environment of the restoration of available MUB resources”. Its Article 7 requires the conduct of natural resource assessment and environmental impact assessment to preserve the natural state of the environment, and Article 10, the conduct of environmental monitoring on the state and changes of the environment. Law on Enacted in - Ministry of Environment and Regulates “relations concerning Environmental January Tourism (MET) protection of the environment, Impact 1998 and last - State specialized inspection prevention of ecological imbalance, Assessment amended in agency the use of natural resources, 2012. - Environmental departments of assessment of the environmental impact and decision-making on the district authority start of a project”. It sets out the - Legal entity/Project general requirements and procedures implementing entity for project screening and conduct of - Mongolian Academy of Sciences environmental assessment and review. 9

Law Enacted and Responsible Agency Brief Description Amended Law on Land Enacted in - Ministry of Road, Transportation, Regulates the possession & use of (revised) 2003 and Construction and Urban land by a citizen, entity & amended Development (MRTCUD); organization, & other related issues. 2018 - Administration of Land Affairs, Articles 42/43 provide guide on Geodesy and Cartography removing possessed land & granting of compensation relative to removing. (ALAGac); - Administration of State Registry of Titles (ASRT) - State Protected Area Administration of the MET Law on Special Enacted in - Special protected areas Regulates relations concerning the Protected Areas 1994 and administration department of the use & taking of areas under special amended in MET protection (strictly protected areas, 2015 - Protected area administrations national parks, natural reserves & - River basin administrations/ national monument areas, local recently these administrations protected areas) are declined due to lack of funding/ - Local government authority Law on Plant Enacted in - Ministry of Environment and Regulates the inhibition, protection, Protection 1996 and Tourism (MET) inspection of pasturelands & plants amended in - State specialized inspection 2017 agency - Environmental departments of district authority - Mongolian Academy of sciences Law on Natural Enacted in - Ministry of Environment and Regulates the protection, proper use, Plants 1995 and Tourism (MET) & restoration of natural plants other amended in - State specialized inspection than forest & cultivated plants. 2015 agency - Environmental departments of district authority - Mongolian Academy of sciences Law on Buffer Enacted in - Special protected areas Regulates the determination of Zones 1997 and administration department of the special protected area’s buffer zones amended in MET & activities. Article 9 requires 2015 - Protected area administrations conducting detailed environmental - River basin administrations/ assessment for the establishment of water reservoirs or construction of recently these administrations floodwalls or dams in buffer zones for are declined due to lack of special protected areas. funding/Local government authority Law on Forest Enacted in - Special protected areas Regulates relations for protection, (revised) 2012 and administration department of the possession, sustainable use & amended in MET reproduction of the forest in Mongolia. 2017 - Protected area administrations Defines prohibited activities in protected forest zones & their

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Law Enacted and Responsible Agency Brief Description Amended - River basin administrations/ regimes & conditions when recently these administrations undertaking allowed activities in the are declined due to lack of utilization zone forests & their regimes. funding/Local government authority - State Specialized Inspection Agency Law on Protection Enacted in - MET Regulates the collection, registration, of Cultural 2014 and - Cultural heritage department of research, classification, evaluation, Heritage amended in the Ministry of Education Culture preservation, protection, promotion, 2016. and Science restoration, possession and usage of - Mongolian Academy of sciences cultural heritage including tangible and intangible heritage. (MAS) Archaeological and Paleontological departments Law on Subsoil Enacted in - Mineral resource authority of the Regulates relations concerning the 1988 and implementing agency of use & protection of subsoil in the amended in Mongolian Government interests of present and future 2015 - MET generations. - Local citizens representative meeting committee - Mining companies Law on Soil Enacted in - MET – including national Regulates matters related to protection and 2012 and programs protection of soil deterioration, prevention from amended in - MAS – mainly laboratories exclamation, and prevention from desertification 2015 - State specialized inspection desertification agency - Local (Municipality, district and Khoroo levels) government authority, including environmental departments Law on Water Enacted in - MET – Land management and Regulates relations pertaining to the (revised) 2012 and water policy management effective use, protection & restoration amended in department of water resources. Specifies regular 2017 - River basin administrations monitoring of the levels of water - Meteorological institute resources, quality & pollution. Provides safeguards against water - “Mongol Us” Government pollution. Organization USUG - MAS laboratories - Ministry of Energy – mainly on hydro- power stations - State Specialized inspection agency Law on Air Enacted in - Meteorological institute Regulates the protection of the (revised) 2012 and - MOH atmosphere to provide environmental amended in - Clean Air program balance & for the sake of present & 2018 - Clean Air fund future generations. Allows government to set standard limits to 11

Law Enacted and Responsible Agency Brief Description Amended - EIA companies emissions from all sources. Regulates - MET regular monitoring of air pollution, - Air pollution mitigation projects hazardous impacts & changes in small air components such as ozone - MAS – laboratories and hydrogen. - The National Committee for Reducing - Air Pollution (NCRAP) Law on Hygiene Enacted in State specialized inspection Governs relationships concerning 2016 and agency maintenance of sanitary conditions, amended in Laboratories defining the general requirements for 2017 sanitation in order to ensure the right of an individual to healthy & safe working & living conditions, ensuring normal sanitary conditions, & defining the rights & duties of individuals, economic entities & organizations with this respect. Law on Waste Enacted in State specialized agency Governs the collection, transportation, 2017 MOH - District level infrastructure storage, & depositing in landfills of landscaping service departments household & industrial waste, re- using waste as a source of raw Infrastructure landscaping service materials to eliminate hazardous companies impacts of household and industrial MET waste on public health & the environment. Undertakings that generate significant amount of wastes must dispose of the wastes in designated landfills that meet prescribed standards. Law on Disaster Enacted in - MET Regulates matters relating to the Protection 2003 and - NEMA – National Emergency principles & full powers of disaster amended in Management Agency protection organizations & agencies, 2012 and - State disaster protection their organization & activities, as well 2017 services as the rights & duties of the State, local authorities, enterprises, entities - State emergency commission & individuals in relation to disaster - MOH and local level emergency protection. management departments and divisions - State specialized inspection agency Law on Fauna Enacted in - MET Regulates protection of animals, 2012 and - MAS growth and development, breeding, amended in - State specialized rational use of its resources. 2017 inspectionagency Law on Health Enacted in MOH This law defines roles and 2011 and responsibilities of health institutions amended in and their staffs and state policies and 2018. general principles for health services

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Law Enacted and Responsible Agency Brief Description Amended Law on Labour Enacted in MOL This law aims to ensure equality in 1999 and labour relations between employees amended in and employers by defining roles, 2017. responsibilities and rights of them, work condition and terms of employment. Law on Labour Enacted in MOH This law defines state policy and Safety and 2008 and control on work condition, Hygiene amended in requirements on occupational health 2018. and safety conditions and aims to ensure provision of safe labour condition for employees. Law on Fire Safety Enacted in Ulaanbaatar (Municipality of This regulates affairs regarding fire 2015 Ulaanbaatar) safety and defines roles of organizations, entities and individuals to ensure fire safety at all places.

3. Mongolian Environmental, Health and Safety Standards 54. At present there are “Mongolian National Standards”- MNS in effect in Mongolia. The standards prescribe effluent/wastewater standard, ambient air, noise, water quality, soil quality, industrial effluent discharge, boiler emission etc. 55. Key standards applied for this project include the following: (i) Water quality general requirement (MNS 4586:1998); (ii) Air quality. General technical requirements (MNS 4585:2016); (iii) Drinking water. Hygiene requirements, evaluation of quality and safety (MNS 0900:2018), (iv) Waste water quality supplied to sanitation network (MNS 6561-2015), (v) Determining disposal location of waste water (MNS 6230-2010), (vi) Occupational hygiene and work condition (MNS 4990-2015), (vii) General Requirements on personal protective equipment (MNS 4931-2000), (viii) General requirement on fire safety (MNS 4244-1994), (ix) General requirement on transportation of domestic waste (MNS 5344-2011), (x) Planning of public utility facilities and distance from green areas (MNS 5973-2009), (xi) General requirement for parking space (MNS 5342-2007) and the WHO Guidelines for Drinking-water Quality, Fourth Edition (2011); (xii) Soil Quality, Soil Pollutant Elements and Substances Standard (MNS 5850:2008); (xiii) Ambient Noise Standard (MNS 4585:2016); and (xiv) Labour safety and hygiene. General requirement for noise level and occupational safety (MNS 5002:2000). The standards for air, water, noise and soils pollution as per Mongolian Standards are listed in Annexure 1 for reference. 56. These standards are compared with World Bank EHS guidelines as listed in Annexure 2. Any standards that are found to be better/stringent will be followed. The ADB SPS 2009 guideline in this regard is mentioned in the section later. Any sector specific guidelines take precedence over general EHS guidelines; for example, the prescribed wastewater to surface water limits (standards) from EHS guideline on health facilities standards take precedence over standards in general EHS guidelines. 13

4. Mongolian Health Care Waste Standards 57. Order of the Minister of Health No.293, 2009. “Strategy for Improving Healthcare Waste Management in Mongolia”: It provides strategies to improve waste management practices of health service centers in the country and 2009-2013 action plan to improve waste manage- ment of health service centers. 58. Order of the Minister of Health No: 505, 2017. " Regulation on classifying, collecting, storing, transporting, recycling and disposing of hazardous medical waste": It imposes several im- portant guidelines and requirements on medical waste management activities of the health service centers, including: - Annexure 1. Guidelines on classifying and collecting of medical waste. - Annexure 2. Guidelines on storing of medical waste - Annexure 3. Guidelines on transporting of medical waste - Annexure 4. Guidelines on processing and disposing of medical waste - Annexure 5. Requirements on medical waste landfill facility - Annexure 6. Requirements on necessary devices and equipment for handling medical waste - Annexure 7. General requirement on medical waste training - Annexure 8. Template for medical waste record sheet 59. Order of the Minister of Health No: 459, 2015. "Methodology on calculating medical waste fees for health service centers": provides methods and norms to calculate medical waste fees paid by health service centers to licensed agency contracted for disposing of medical waste. Currently, the only licensed agency for medical waste in Mongolia has been Element LLC. 6 project components in UB city have contracted with this company. Asbetos 60. The Millennium Challenge Corporation’s (MCC)11 Environmental and Social Assessment unit worked closely with the government to develop and implement Hazardous Materials and Waste Management Guidelines, which resulted in the proper handling, transportation, storage, and disposal of asbestos, lead-based paint and other hazardous wastes during the rehabilitation of project sites. Subsequently, in 2010 the Mongolian government banned the use of asbestos in construction materials. However, till date, these is no Mongolian law that that has been enacted in this regard. Since the host country does not have its own Asbestos

11 The Millennium Challenge Corporation (MCC) and the Government of Mongolia signed a five-year, $284.9 mil- lion compact in October 2007, designed to increase the country’s economic growth and reduce poverty, by in- vesting in five project areas-property rights, health, vocational education, energy and environment, and transpor- tation. https://www.mcc.gov/where-we-work/program/mongolia-compact

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handling requirements, internationally recognized procedures (defined later in the document) will be used for any internationally funded projects12. Occupational Health and Safety 61. Occupational health and safety standard (MNS 5002:2000). Article 16 of the National Constitution of Mongolia states that every employee has the right to ‘suitable conditions of work’. The government adopted a National Program for Occupational Safety and Health Improvement in 2001 and national standards are also adopted such as the National Standard on Occupational Health and Safety (OHS) MNS 5002:2000 which support the Occupational Safety and Health Law 2008 which sets out policies, rules and regulations on occupational safety and health, and the most common requirements for workplace safety. 62. Mongolia ratified in 1998 ILO Convention No. 144 - Concerning Tripartite Consultations to Promote the Implementation of International Labour Standards. As stipulated in Article 138 of the Labour Law of Mongolia, the National Tripartite Committee on Labour and Social Consensus—composed of representatives of the Government, employers’ and workers’ organizations—was established as the highest national level regulatory mechanism for social dialogue. Mongolia ratified the Occupational Safety and Health Convention (No.155) of ILO in 1999. In 2001, the government adopted the National Programme for Occupational Safety and Health Improvement. 63. The following laws and statutes deal with OSH issues:  Labour Law of Mongolia.  Social Insurance Act.  Law on benefits provided by the Social Insurance Fund against Industrial Accidents and Occupational Diseases.  Law on Pensions and Benefits for Military personnel.  Law of Mongolia on State Auditing.  Law on Administrative Supervision.  2003 General Statute of the State Inspection Agency (SIA) approved by Government Resolution No. 37.  Other laws and regulations. 5. Environmental Assessment Requirements of Mongolia 64. The EIA requirements of Mongolia are regulated by the Law on EIA (13 enacted 2012). The terms of the law apply to all new projects, as well as rehabilitation and expansion of existing industrial, service or construction activities and projects that use natural resources. law revised in 2012 and brought into force in 2013, implemented through a new Environmental Impact Assessment Regulation.14 The 2012 revision introduces a requirement for Strategic

12 Mongolia Employment Support Project (P159215) of World Bank document no. DSFG2708 dated Nov 30, 2016 prepared for Ministry of Labor and Social Protection, Mongilia. 13 Law of Mongolia on Environmental Impact Assessments (1998, amended in 2002). Unofficial translation available from http://cdm-mongolia.com. 14 The new EIA Regulation revokes 2 Regulations and 1 Guideline document which do not meet the requirements of the EIA Law. The revoked legislation is: Regulation on the Environmental Impact Assessment Committee (2006); Guidelines on Formulating EPPs and EMPs (2000); and Regulation on Detailed EIA Appraisal (2006). These reg- ulations are superseded by the EIA Law. 15

Environmental Assessment for policy documents, and increases emphasis on public participation during a general EIA. 65. The purpose of the EIA law is environmental protection, the prevention of ecological imbalance, the regulation of natural resource use, the assessment of environmental impacts of projects and procedures for decision-making regarding the implementation of projects. The EIA process in Mongolia is summarized in Figure II-1. 66. There are two types of EIAs defined under the Law on Environmental Impact Assessment (2012), as follows: 1) General EIA (GEIA). To initiate a GEIA, the project proponent submits to the MET or Aimag government a brief description of the project, including feasibility study, technical details, drawings, baseline description of the project environment, and a written opinion of the Soum governor. These documents form the basis of the GEIA and MET’s assessment, which will have one of three conclusions: (a) project is rejected due to non- conformity with national laws and/or the severity of impacts; (b) project may proceed, subject to specific conditions, and (iii) a detailed EIA (DEIA) is necessary. Assessment by MET generally takes 14 working days. 2) Detailed EIA. The scope of the DEIA is defined in MET’s response for the GEIA. The DEIA is prepared by an accredited national entity. The DEIA is submitted by the project proponent to MET and Aimag government. The reviewer(s) of the GEIA also review the DEIA, generally within 18 working days, and present the findings to the MET. Based on the content of the DEIA, reviewer conclusions, and any additional comments by MET departments, MET issues a decision on whether to approve or reject the project. 67. Table II.3 lists all classes of projects that require GEIA according to the Mongolian law. Table II.3: Classification of Projects for which GEIA is Legally Mandatory

No Project type Executor Central Government Authority for The Governors offices of Nature and Environment Provinces and the Capital city 1. Mining Exploration of all kind of minerals Exploration of common minerals to be used within local area 2. Heavy industry All types - 3. Light and Food Big industries owned by Government Local SMEs industry 4. Agriculture - Water reservoir Other industries and services - Irrigation system - Plantation of fallow 5. Infrastructure - Energy production more than 1 MW - Energy production up to 1 MW capacity capacity - Electricity transmission line more than - Electricity transmission line up to 5 kV voltage 5 KV voltage - Heat distribution pipes - Heat distribution pipes local - Hydro station - Road and communication local - Railway

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No Project type Executor Central Government Authority for The Governors offices of Nature and Environment Provinces and the Capital city - Airport - Road international and inter cities - Communication international and inter cities 6. Service - Hotel, resort, sanatorium and other Hotel, resort, sanatorium and other service organizations with capacity service organizations with capacity more than 50 bed day up to 50 bed day - Tourism 7. Other projects: - Water supply, water treatment and - Water supply, water treatment - Town planning solid waste disposal in urban areas solid waste disposal in urban - Defensive and with more than 10000 inhabitants areas with up to 10,000 civil protection - State owned facilities for defence and inhabitants - Water supply civil protection - Local facilities for defence and system civil protection - Water treatment plant - Solid waste disposal and others 8. Bio diversity - Fisheries (big size) Hunting and forestry, tribe - Population, use and other activities Fishery for local market relative to animal and plants, 9. Chemicals, Treatment, use, storage, transport and radioactive disposal of chemicals, radioactive substances and substances and hazardous wastes hazardous wastes 10. Activities to be Activities to be conducted in boundaries Activities to be conducted at locally conducted at of special protected areas protected areas. special protected areas

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Projects Requiring GEIA Screening - New projects, renovation/expansion of industrial, service & construction activities, projects using natural resources

Project Implementer submits documents to MET or aimag - Project description, Feasibility Study, design approved by eligible authority and other related documents

MET or aimag expert - Conducts General EIA (screening) within 14 days Makes 1 of 3 decisions

Decision 1 - Project Can Not Progress Project is rejected because of non-conformity or impacts

Decision 2 - Project Can Progress DEIA is not required With specific conditions

Decision 3 - Project implementer - selects Li- DEIA is required censed Company for Detailed EIA

Figure II.1: Environmental Impact Assessment Process in Mongolia Source: Adapted from Vol. 1 (2001) Compendium of Laws: A Mongolian Citizens Reference Book.

68. In compliance with Mongolia’s environmental safeguard policy, the Project is subject to General Environmental Impact Assessment (GEIA) - or environmental screening - by the Ministry of Environment and Tourism (MET). A professional environmental consulting firm S.E.C is contracted with ADB and has been conducting the domestic standard Baseline Environmental Survey Report which needs to be submitted to MET together with approved preliminary design before obtaining GEIA. GEIA is expected to be obtained from the MET in Q4 of 2018. According to Mongolian Law on EIA, DEIA report will be approved by MET only after Design works for the new buildings are approved by Construction Development Center. 69. Broadly, the GEIA conclusion has stipulated the following items to be included in the DEIA report; a. engagement of a MET-registered entity to conduct/prepare the DEIA; b. investigations to be conducted relative to issues concerning, identification of impacts of Subproject activity on, definition of mitigation measures and costs to monitor the quality of and impact on --- ground- and surface water, soil, air, weather, forest plant and animals; c. determination of the concentration of wastewater generated, monitoring and associated costs; d. development of EMP; e. identification of potential impacts on physical cultural resources, recommend management measures for affected ones and obtaining conclusion from a professional

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organization on this matter; f. assessment of potential risks due to natural hazards and defining of mitigation measures; g. documentation of public consultations; h. risk assessment of hazardous materials used in the Subproject activity according to the new procedures and rules developed in 2013, and recommendations for their safe storage, use and transport; and i. submission of DEIA to MET for review and approval after the design of the new buildings for hospitals and FHC are finalized and approved by Construction Development Center.

70. The DEIA procedure guidelines the following method approved by the Minister’s order A-117 of MET in April 2014 and it is required to contain the following chapters: (i) environmental baseline data; (ii) analysis of extent and distribution of adverse impacts; (iii) measures to minimize, mitigate, and/or avoid impacts; (iv) alternative methods and technology; (v) risk assessment; (vi) environmental management plan (EMP); and (vii) stakeholder consultations, including potentially affected communities. 71. According to the law, the rule approved by the Minister’s order A-05 effective from January 2013, the PIU shall submit EMP performance report to the MET within twelve months from the start of the year as well as getting approval for the next year’s plan and associated budget. Table II.4 lists the requirements of DEIA and GEIA for the Program (Tranche 1).

Table II.4: Details of GEIA and DEAI requirements for Tranche 1 If DEIA required (a decision by No. Subprojects GEIA MET or Aimag Environment Dept) Tranche-1 1 Khan-Uul District Hospital required likely to be required 2 Khovd Hospital required likely to be required 3 Uvs Hospital required likely to be required 4 Emergency Call Center required not likely to be required 5 FHC in 10th khoroo of Khan-Uul required not likely to be required 6 FHC in 14th khoroo of Khan-Uul required not likely to be required 7 FHC in 17th khoroo of Bayanzurkh required not likely to be required 8 FHC in 19th khoroo of Chingeltei required not likely to be required 9 SHC in Dashinchilen soum required not likely to be required 10 SHC in Erdenemandal soum required not likely to be required 11 SHC in Bayan-Undur soum required not likely to be required 12 SHC in Tarialan soum required not likely to be required 13 SHC in Erdene soum required not likely to be required

6. Environment Compliances Relevant to the Project and time frames 72. A summary of government environmental compliance requirements applicable to the tranche 1 is presented in Table II.5. 19

Table II.5: Summary of Environmental Compliance Requirements for EARF Consideration for Tranche-1 components

Permissions and documents Responsible Agency Expected Current Status required for the Project Time (as of Nov 01, Frame 2018) Project preparation phase Land ownership documents: land Land management division of 2018 Q2 Complete certificate, land use agreement and related district or soum cadastrial map Conceptual design drawing Developed by the contracted firm 2018 Q2 Near Complete M4H. (pending conceptual design for Uvs hospital) Initial Environmental Examination and IEE/EMP development by 2018 Q4 Draft IEE and EMP (ADB standard) international and national EMP are ready environment consultants Climate Change assessment prepared Development by international and 2018 Q4 Draft Climate for each tranche national environment consultants change report ready Public Consultation Organized by national 2018 Q2- Complete environmental consultant in Q4 conjunction with the related local authorities and hospitals/FHC/SHC Baseline Environmental Assessment Licenced professional firm 2018 Q3 Complete report contracted to conduct the survey. Social, gender, resettlement and land Social, gender and resettlement 2018 Q2 Complete acquisition survey consultant General Environmental Impact Issued by the Ministry of 2018 Q4 Expected to Assessment Environment and Tourism after the obtained by preliminary design drawing is December 30, approved *. 2018 * Draft domestic DEIA reports for Khan-Uul and Khovd hospitals are already made by a local professional firm and available now. However, approval process of the domestic DEIA reports by Ministry of Environment requires the project to have approved detailed design.

73. Project approval by ADB is expected in Q4 of 2018 while the expected date for Loan Agreement is Q1 of 2019. Once the Loan Agreement between Government of Mongolia and ADB is signed, MOH will establish Project Implementation Unit who will be reponsible for developing the Detailed Project Implementation Plan and managing all project related tasks during the pre-construction, construction and operation phases of the Project. The PIU shall include following permissions and documents when developing the Detailed Project Implementation Plan. Table II.6: Necessary permission and documents recommended for consideration for Detailed Project Implementation Plan by PIU

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Permissions and documents Responsible Agency related to construction Design development phase Develop detailed design (blue A professional licensed firm will be selected by MOH to print) develop the detailed design Geo-technical survey The firm who will be selected to develop detailed design (engineer-geological survey) sub-contracts with a professional company to executes the survey. Expertise conclusion on the Construction Development Center (an agency under the detailed design Ministry of Construction) Approval of DEIA reports for the Professional EIA Committee of MET required Tranche-1 subprojects Pre-construction phase Heating supply technical Issued by Municipal Heating Networking Compa specification ny (Government owned entity) Electrical technical specifications Issued by Municipal Energy Distribution Networking (Government owned entity) Water supply and waste water Issues by USUG – Water Supply Network Administration technical specifications Agency (A Government Agency) Approval on demolish existing old Issued by related district or Soum authority buildings Determined location of construction Specified by the Authorities15 within the permission to start waste disposal point construction works granted by the Construction Client Unit Solid waste removal agreement Every district or Soum has a state-owned agency who offer with local service entities contractual services on removal and demolishing of solid waste generated by each entity in their respective district/Soum. Permission for construction of a Granted by Ministry of Construction, Construction Client new buildings Unit Permission to start of construction Granted by Ministry of Construction, Construction Client works Unit after the contractor is selected. Contractor will prepare site specific Construction EMP (SEMP), occupational health and safety risk assessment and plans and develop emergency response plan. Construction phase Monthly construction progress Supervision Cosultant Firm who will be contracted with reports MOH Environmental monitoring report Civil Work Contractor with support of authenticated local (twice a year) laboratories

15 The location is specified for disposal of waste with the permission as per Mongolian regulations. 21

Permissions and documents Responsible Agency related to construction Periodic inspection of construction General Agency for Specialized Inspection (A government work institute) Fire Safety certificate General Agency for Emergency (A government institute) Acceptance Letter for the newly State Committeee comprises of General Agency for constructed buildings Specialized Inspection and MOH staffs Operation phase Fire Safety plan for building General Agency for Emergency (A government institute) evacuation in case of fire. Solid waste management plan Developed and implemented by Hospital/FHC/SHC, supervised by General Agency of Specialized Inspection Waste water management plan (for Developed and implemented by FHC/SHC, supervised by subprojects that are not connected General Agency of Specialized Inspection to central sanitation network) Medical waste management plan Developed and implemented by Hospital/FHC/SHC, supervised by General Agency of Specialized Inspection

7. Mongolia FHC/SHC/Hospital building Environmental Infrastructure 74. The consultants reviewed environmental issues related to development of infrastructure at FHC/SHC/Hospital in Mongolia. The project preparation technical assistance would ensure that project design proposes measures to address constraints in carrying out safe construction of FHC/SHC/Hospital buildings as per national and international norms. 75. The project design must include development of overall environmental infrastructure, a systematic technological evaluation of appropriate, cost-effective and sustainable solutions to Hospital care waste management, waste water, connections to centralized sewerage systems, effective solid waste management, connected water supply and energy efficient heating system infrastructure at FHC/SHC/Hospital facilities in urban and rural settings. 76. Most FHC/SHC’s in Ulaanbaatar are served by central water supply, wastewater collection and treatment facilities, centralized drainage systems, centralized heating systems and available electrical supply. However, regional environmental infrastructure systems are somewhat lacking in many cases, especially in Ger areas of Ulaanbaatar and outside, in rural areas. Additional Financing is also being made to FHC/SHC/Hospital in Provinces where many of the problems outlined above are more serious in other parts of Mongolia. 8. Green Building Concept16 77. A preliminary draft of a green building rating system was developed by Mongolia Green Building Council (MGBC) in 2014 by order of the Ministry of Environment and Tourism of

16 Source of information Design and Technology Options - Analysis for a Green Public Kindergarten in Mongolia February 2016 Prepared by Mongolian Green Building Council and Building Technologies LLC for Global Green Growth Institute and Ministry of Environment.

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Mongolia (MET). The draft system consists of ten main and 26 sub- criteria, covering the four thematic areas of energy, water, environment, and innovation (as shown in Table II.7). Table II.7: Criteria of the MGBC’s Green Building Rating System

Energy Implementation of the requirements of standard criteria of the A, B, C heating/thermal categories specified in BND 23-02-09 - Mongolian Building Standard Usage of energy efficient equipment Usage of interior and exterior lighting of the building Usage of renewable energy sources Water saving Water saving equipment installation Reuse of grey water futures Reuse of rain water Environmental Location: aspects External planning, playground, car parking, bike parking and greenery should be designed according to BND Connectivity to the public transport Building: Usage of resource saving building material Usage of Green marked building material Interior air quality: Internal air temperature, humidity and noise level according to BND Usage of green labelled material in Interior design. Environmental management: Usage of environmental management program and environmental monitoring plan during construction. Construction company or client has ISO 14001 environmental management standard. Maximum natural lighting in design. Innovation Usage of innovative technology, idea and material not directly related to green building rating system, but incorporated into GBRS (Source: Mongolia Green Building Council, 2014, report)

78. The criteria of the draft rating systems helped inform the choice of green design and technology options for the green public kindergarten in Mongolia. The design concept of the green public kindergarten (developed by Green Technology Center-Korea (GTCK)) examined design and technology options across five areas, as follows: 1. Building materials: Insulation, Interior: LED, others 2. Energy: - Energy efficiency of building: Insulation of building for heat loss prevention; - Heating: Four types of electrical and renewable heating systems - Electric floor heating, night heat saver, power saving heating and usage of hybrid systems. 3. Water and sanitation: - Drinking Water: Solar panel to work the bore-well for drinking water; - Wastewater: Biological treatment systems for wastewater. 23

4. Exterior: Landscaping etc. 5. Other: Septic Tank for Solid waste.

C. International Treaties 79. Mongolia is a party of an international environmental conventions and protocols. It has passes state laws that implement the terms of these international conventions, with provision that: “If an international treaty to which Mongolia is a party is inconsistent with this law then the provisions of the international treaty shall prevail”. 80. In recognition of its global responsibilities, Mongolia has acceded to a number of international environmental conventions. Each of these conventions places obligations on signatory governments ranging from the provision of a legislative basis for implementation, to adherence to the requirements and conditions of each convention, to monitoring implementation performance on a regular basis, to reporting on a regular basis to the conference of parties. Some of the key ones are shown in the following Table II.8. Table II.8: Relevant International Environmental Conventions

Year of Convention Accession World Heritage Convention 1990 Convention on Biological Diversity (CBD) 1993 UN Framework Convention on Climate Change (UNFCCC) 1994 UN Convention on Combating Desertification (UNCCD) 1996 Vienna Convention for the Protection of the Ozone Layer 1996 Montreal Protocol (regulating substances that deplete the ozone layer) 1996 Convention on International Trade in Endangered Species of Fauna and Flora 1996 (CITES) Convention on the Transboundary Movement of Hazardous Waste (Basel) 1997 Convention on the Protection of Wetlands of International Importance (Ramsar) 1998 Kyoto Protocol 1999 Rotterdam Convention on the Prior Informed Consent Procedure for Certain 2000 Hazardous Chemicals and Pesticides in International Trade Stockholm Convention on Persistent Organic Pollutants (POPs) 2004 Minimata Convention on Mercury 2013 Note: (a) accession; (e) entry into force; (r) ratification

81. Each of these conventions places obligations on signatory governments ranging from the provision of a legislative basis for implementation, to adhere to requirements and conditions of each convention, to monitor implementation performance on a regular basis, to report on a regular basis to the conference of parties. 82. Special Protected Areas. A further indication of the global significance of the Mongolian environment is the fact that 11 sites in Mongolia have been declared as wetlands of

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international importance under the Ramsar Convention, making a total of almost 1.5 million hectares. However, any of the project sites do not fall under the jurisdiction of any of the protected or sensitive or special areas in Mongolia. 83. The Protected Areas which were established in accordance with the Law on Protected Areas fall into five different categories, subject to their protection and management arrangements. 14 areas of altogether 12.4 million hectares were designated by the Parliament as Strictly Protected Areas (SPAs). These are areas “that represent unique features and characteristics of natural zones, have preserved their original conditions, and are of a special scientific and cultural significance.” Under the current legal framework both SPAs and NPs fall under the jurisdiction of the National government, i.e. MET, and are thus designated by the Central Parliament, financed through the State budget and managed through Protected Area Administrations (PAA). 84. Asbestos Containing Material (ACM). The International Labor Organization (ILO) established an Asbestos Convention (C162) in 1986 to promote national laws and regulations for the “prevention and control of, and protection of workers against, health hazards due to occupational exposure to asbestos. The convention outlines aspects of best practice: Scope and Definitions, General Principles, Protective and Preventive Measures, Surveillance of the Working Environment, and Workers’ Health. As of March 4, 2008, 31 countries had ratified the Convention; 17 of them have banned asbestos17. The World Bank Group’s (WBG’s) EHS Guidelines specify that the use of ACM should be avoided in new buildings and construction or as a new material in remodeling or renovation activities. Repair or removal and disposal of existing ACM in buildings should be performed only by specially trained personnel18 following host country requirements or, if the country does not have its own requirements, internationally recognized procedures.19

D. Equivalence of International Best Policies in Infrastructure Development 85. The Project is required to meet the ADB SPS guidelines as well as international standards of the IFC, which is part of the World Bank Group. The international environmental and social safeguard policies of these organizations are outlined below. - World Bank Group’s Environment, Health and Safety (EHS) Guidelines, 2007. - IFC (2007) guidelines for asbestos-containing materials (ACM):20 - Environmental, Health, and Safety Guidelines for Waste Management Facilities. - Environmental, Health, and Safety Guidelines for Water and Sanitation.

17 Mongolia is not a signatory to this convention. 18 Training of specialized personnel and the maintenance and removal methods applied should be equivalent to those required under applicable regulations in the United States and Europe (examples of North American training standards are available at: http://www.osha.gov/SLTC/asbestos/training.html) 19 Examples include the ASTM International E1368 Standard Practice for Visual Inspection of Asbestos Abatement Projects; E2356 Standard Practice for Comprehensive Building Asbestos Surveys; and E2394 Standard Prac- tice for Maintenance, Renovation and Repair of Installed‐ Asbestos Cement Products. 20 International Finance‐ Corporation. Environmental, Health, and Safety Guidelines, 2007. ‐ https://www.ifc.org/wps/wcm/connect/Topics_Ext_Content/IFC_External_Corporate_Site/Sustainability-At- IFC/Policies-Standards/EHS-Guidelines

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- Environmental, Health, and Safety Guidelines for Health Care Facilities. - General EHS Guidelines: Occupational Health and Safety - World Bank. 2009. “Good Practice Note: Asbestos—Occupational and Community Health Issues.” World Bank, Washington, DC. - WHO guidelines on incinerators and asbestos management - ADB’s Environmental Safeguards: A Good Practice Sourcebook-Draft Working Document (November 2012). - ILO Core Labour Standards.  Internationally-recognized Standard Practice for Maintenance, Renovation and Repair of Installed Asbestos Cement Products (American Society for Testing and Materials [ASTM] E 2394).21

21 ASTM International. ASTM E2394-11, Standard Practice for Maintenance, Renovation and Repair of Installed Asbestos Cement Products. West Conshohocken, PA, 2011. http://www.astm.org/Standards/E2394.htm. This standard describes work practices that protect worker and community health within the resources available in de- veloping and industrialized countries. As much as possible it relies on readily-available tools, equipment, and sup- plies, and techniques that require careful and diligent workmanship but not the services of highly-skilled trades- men. The standard is written for construction workers and tradesmen, for those involved in the preparation of con- tracts and tenders, and for government officials involved in developing regulations to protect worker and communi- ty health.

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III. DESCRIPTION OF THE PROJECT

A. Overview 86. The project will help improving the health status of Mongolian people, through better quality and inclusiveness of healthcare services and enhanced systems for healthcare financing. The project is expected to be implemented from January 2019 to June 2029. About 4 FHC’s, 3 Hospitals and 5 Soum health centers will be newly constructed/expanded and 1 National Emergency Health Call Center.

B. Project Components 87. Figure III.1 provides the detailed map of Mongolia; Figure III.2 shows the location of ADB- funded sub-projects in Ulaanbaatar city; Annexure 3b shows the location of the sub-projects on the compound of the Khovd, Uvs Aimags, National Emergency Health Call Center, and five Soums respectively.

Figure III.1: Map of Mongolia and Location of sub-project implementing Aimags 27

Figure III.2: Location of Project Sites in Ulaanbaatar City

C. Scale and Magnitude of Sub-Projects (Scope of Civil Works) 88. Table III-1 shows sub-projects and their associated key features under funded by ADB. Table III.1: Sub-project components and their key features No Compon Location Key features of sub-project Key Environmental Issues ents component A Tranche 1 FHC/SHC/Hospital 1 Khan-Uul Khan Uul Connected to centralized heating, water, Location within the SPA buffer zone, Hospital District, sewage and electricity systems, no land replanting of 59 Populus trees, emission Yarmag acquisition or resettlement issues for of dust and noise, traffic safety new building precaution required, waste generation during both construction and operation period 2 Khovd, Khovd Connected to centralized heating, water, Replanting of 7-8 Populus trees, Hospital Province, sewage and electricity systems, medical emission of dust and noise, traffic safety Jargalant waste collection site needs to be precaution required, waste generation Soum replaced with closed bins and concrete/ during both construction and operation lined flooring, no land acquisition or period resettlement issues for new building. 3 Uvs Ulaango Connected to centralized heating, water, Emission of dust and noise, traffic safety hospital m city sewage and electricity systems, medical during construction, waste generation waste collection disposal site needs to during both construction and operation be replaced with closed bins and period. There are kindergartens and concrete/lined flooring. 1200m2 middle schools (in 150-350m distance) additional building will be built inside surrounding the hospital. boundary of Hospital land.

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No Compon Location Key features of sub-project Key Environmental Issues ents component 4 Emergen Sukhbaat Connected to centralized heating, water, Replanting of 23 trees and bushes, cy Health ar sewage and electricity systems. The emission of dust and noise, traffic safety Center district,1 Specialised Agency for Inspection has precaution required during construction, st Khoroo confirmed there is no asbestos present waste generation during both in the building built in 1970. There is an construction and operation period. office building and a private house right next to the proposed construction site, no land acquisition or resettlement issues for construction of new building. 5 FHC 10th Connected to centralized heating, water, Replanting of 28 trees and bushes, Khoroo in sewage and electricity systems, potential relocation of heating pipeline to Khan-Uul demolish existing 119m2 building built in nearby kindergarten, emission of dust district 2000, there is kindergarten locating and noise, traffic safety precaution nearby the construction site, no land required during construction, waste acquisition or resettlement issues for generation during both construction and new building. operation period. 6 FHC 14th Not connected to any centralized Relocation of water supply pipeline for Khoroo in network except for electricity, has own the kindergarten, make an alternate Khan-Uul water well and septic tank, electric access road for the kindergarten, district heating, land permission to be obtained emission of dust and noise, traffic safety in May 2018, no land acquisition and during construction, waste generation resettlement issues for new building, during both construction and operation there is kindergarten located nearby the period. construction site. 7 FHC 19th Not connected to any centralized Emission of dust and noise, traffic safety Khoroo in network except for electricity, has own during construction, waste generation Chingelte septic tank, heating from own HOB during both construction and operation i district using coal, flood channel nearby period. For the purposes of the IEE, the construction site, no land acquisition water well samples were tested and and resettlement issues for new meets national drinking water standard building. of Mongolia. 8 FHC 17th Connected to centralized water and Emission of dust and noise, traffic safety Khoroo in electricity systems, has own septic tank, during construction, waste generation Bayanzur heating from own HOB, demolish during both construction and operation kh district existing 203 m2 building built in 2001, no period. land acquisition and resettlement issues for new building. 9 SHC Erdenem Not connected to any centralized The proposed construction site is andal network except for electricity, has own currently a parking space for the Soum Soum septic tank, heating from own HOB, a health center, thus a new parking space new additional building (800m2) inside and entrance point shall be planned, an the boundary of the hospital land will be old heating pipeline is very close to the built. proposed construction site (it will not be used for this facility). Emission of dust and noise, traffic safety during construction, waste generation during both construction and operation period. 10 SHC Tarialan Connected to centralized water, heating Emission of dust and noise, traffic safety Soum and electricity networks, has own septic during construction, waste generation tank, new additional building (800m2) during both construction and operation inside the boundary of the hospital land period, 44 trees in the hospital premise will be built, a small wooden house (with needs to be removed and re-planted, 4 size 3m x 4m) needs to be demolished. households are located at 40-60m distance from the construction site on the 29

No Compon Location Key features of sub-project Key Environmental Issues ents component southern side that will be affected. 11 SHC Bayan- Connected to centralized heating and Emission of dust and noise, traffic safety Undur electricity networks, deliver water from during construction, waste generation Soum nearby water well in the Soum center, during both construction and operation has own septic tank, new additional period, a middle school is located at building (800m2) inside the boundary of 150m distance from the construction site the hospital land will be built. on the northern side. 12 SHC Erdene Connected to centralized water, heating Emission of dust and noise, traffic safety Soum and electricity networks, will be during construction, waste generation connected to centralized sewage during both construction and operation pipeline later this year, new additional period. Waste collection point in the building (800m2) inside the boundary of hospital yard needs to be replaced with the hospital land will be built. closed lid bins with proper concrete/lined flooring. The Soum health center currently does not have fencing around it. 13 SHC Dashinchi Not connected to any centralized Emission of dust and noise, traffic safety len Soum pipelines: heating, electricity and water. during construction, waste generation Domestic use is supplied from its own during both construction and operation well and drinking water is transported period. The closest ger area is only from the well in the Soum center. Has 100m from the construction site. own septic tank, new additional building (800m2) inside the boundary of the hospital land will be built.

89. For some of the FHC/SHC/Hospital sub-projects, location specific construction drawing maps are under development through accredited architects in Mongolia. The data regarding soil, topography, contour, land cutting and filling required, distance from any water body and distance from major roads, fruit/non-fruit trees that can be affected, land details are listed in Annexure 3 and also confirmed by engineering firms during the design stage. However, if sites are changed other than those indicated here in the IEE, supplementary information will be supplied for each of new location for subprojects proposed by MOH to ADB for prior to approval before finalizing design drawings.

D. Existing Infrastructure at Subproject Locations 1. Health Center Status i. Health service in Ulaanbaatar city There 133 FHC’s operate in Ulaanbaatar city that have 633 doctors, 586 nurses and offered health services to 4.2 million patients in 2016. There are 12 district and emergency hospitals in the city that have 883 doctors, 889 nurses and offered health services to 2.38 million patients in Health condition in of Khovd city. Number of doctors, nurses and patients for the subproject in Ulaanbaatar city are shown in below in

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90. Table III.2.

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Table III.2: Doctors, nurses and patients for the subproject in Ulaanbaatar city

No. Name of hospital/FHC # of doctors # of nurses # of patients per month 1 Khan-Uul district hospital 44 50 780 2 Emergency Center 161 28 28,450 3 FHC in 10th Khoroo of Khan-Uul 5 5 3,588 4 FHC in 14th Khoroo of Khan-Uul 2 2 3,130 5 FHC in 19th Khoroo of Chingeltei 6 5 3,485 6 FHC in 17th Khoroo of Bayazurkh 5 6 1,542 ii. Health service in Khovd and Uvs Aimags 91. The hospital has a total of 387 employees which includes 97 doctors, 143 nurses and 50 technical and service workers. It capacity is 258 beds for in-patients. It offers health services to 11,600 patients per month. The hospital operates with 3 main facilities: The main hospital, the infectious disease treatment center that serves around 1,200 patients per year; and the birth clinic that serves around 2200 clients per year. 92. The hospital has a total of 336 employees which includes 70 doctors, 180 nurses and over 80 technical and service workers. Its capacity is 250 beds for in-patients. It offers health services to 110,000 patients each year. iii. Health service in the 5 Soums 93. The Erdenemandal Soum health center not just serves Erdenemandal Soum residents. In addition, it offers health services to 17,000 residents of neighbouring 3 Soums: Khairkhan, Jargalant and Tsetsrleg. The Soum health center has 8 doctors, 7 nurses and 15 other employees. It serves around 10,000 people per year. In-patient department of the Soum health center has 22 beds and serves 1,100 people per year. The main disease types in the project area are injury, digestive system diseases and cardiovascular system diseases. 94. Besides the Soum health center, there are 1 private health center and 3 other pharmacies are operating at the Soum center. The Soum health center has 6 doctors and 22 other staffs. It serves 700-800 people each month. In-patient department of the Soum health center has 20 beds and serves 30-40 people per month. 17 infectious disease cases and 1555 non- infectious disease cases were registered in the Soum in 2017. 95. Bayan-Undur Soum health center has 3 doctors, 11 nurses and 7 other employees. It serves 300-600 people per month. In-patient department of the Soum health center has 15 beds and serves 20-30 persons per month. 8 cases of infectious disease and 505 cases of non- infectious disease were registered in the Soum in 2017. 96. Erdene Soum health center has 12 doctors and nurses and serves all Soum residents as well as soldiers of nearby border military bases. In-patient department of the Soum health center has 7 beds and has served 217 persons in 2017. Infectious disease rate in the Soum is 11.8 cases per 10,000 persons. 658 non-infectious disease cases and 210 injury cases were registered in the Soum in 2017.

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97. Dashinchilen Soum health center has 5 doctors and 4 nurses. In-patient department of the Soum health center has 7 beds and has served 8000 persons in 2017. 2. Plot Size on Land available 98. The construction drawings (technical drawings) will be developed by the FHC/SHC/Hospitals through accredited architects in Mongolia. The plot size for each FHC/SHC/Hospitals will vary depending upon the size, location, orientation of land, access road, and its suitability for new building construction design. Normally, a FHC/SHC/Hospital plot size would vary between 640-12,000 square meters (i.e. 32 m x 20 m for FHC and 1200 m2 each for Khovd and Uvs hospitals and 12,000m2 for Khan-Uul hospital). Annexure 3b provides details about the plans of plots (use google earth) for all project sites. 3. Distance from Various Receptors 99. Summary distances from major receptors is given in Table III.3 below. Annexure 3 contains complete details about all locational details, setback distances, including distances from waterbodies, hospitals, schools, utilities etc. in Tables A3.1-A3.3. These details were collected by the consultant team during the site visits, public consultations and recorded in Annexure 7. 33

Table III.3: Summary of approximate distance of subprojects from major receptors Sub-Project Components

) km (

) verage Distance of verage Distance ffected km No. No. A A ( Number of Trees Number FHC/SHC/Hospitals FHC/SHC/Hospitals from District HQ (Km) from Minimum distance any or apartments of constructed buildings area (km) other from Distance in FHC/SHC/Hospital the area Distance from water (km) body Distance from Railway Line (km) Distance from Two lane (km) Roads Distance from Airport (km) Distance f- waste water (km) treatment facility Distance from Power (km) Plant/substation Distance from utilities – supply heating, water Distance from urban urban from Distance landfill site (km) Distance from Fire station (km) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 1 Khan Uul District 5.65 0.15 0.54 59 1.2km Tuul 4.42 0.28 5.5 6.4 3 0.3 11.8 5.6 Populus river 2 Khovd Province 0.37 0.16 1.1 7-8 320m none 0.12 4.5 3.5 1.4km 0 3.71 0.62 Populus Buyant river 3 Uvs Hospital 0.6 0.1 0.1 None 3km none 1 5 2 2.5 0 4.5 0.9 Gashuunii river 4 National Emergency 1.3 0.01 0.13 5 450m 0.9 0.02 14 12.8 5+ 0 6.7 1.6 Health Call Center Populus, Selbe river 18 bush 5 FHC 10th Khoroo in 10.8 0.03 2.2 5 1.8km Tuul 5.3 0.23 0.68 4.5 3.5 0.01 6.5 0.5 Khan-Uul district Populus, river 23 bush 6 FHC 14th Khoroo in 18.5 0.2 8.8 None 1.2km 12.7 0.54 7.9 12.9 5+ 7.9 4.7 11.5 Khan-Uul district Turgen river 7 FHC 19th Khoroo in 8.2 0.15 3.2 None 520m 9.7 0.05 20 16.2 5+ 6.7 6.5 1.9 Chingeltei district Selbe river 8 FHC 17th Khoroo in 3.17 0.05 0.75 None 750m 2.9 0.06 20.1 18.5 5+ 1.5 3.4 1.5 Bayanzurkh district river 9 SHC Erdenemandal none 587m 450 km 0.02 450 0.35 0 0.6 Soum Hanui river 10 SHC Tarialan Soum 0.03 44 trees 9.2km 195 km 1.2 195 0.32 0 0.35 Har buh river 34

Sub-Project Components

) km (

) ffected verage Distance of verage Distance km Distance from water (km) body Distance from Railway Line (km) Distance from Two lane (km) Roads Distance from Airport (km) Distance f- waste water (km) treatment facility Distance from Power (km) Plant/substation Distance from utilities – supply heating, water FHC/SHC/Hospitals FHC/SHC/Hospitals from District HQ (Km) from Minimum distance any or apartments of constructed buildings area (km) other from Distance in FHC/SHC/Hospital the area Distance from urban urban from Distance landfill site (km) Distance from Fire station (km) ( A No. No. A Number of Trees Number 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 11 SHC Bayan-Undur none 2.1km 350 km 0.015 370km 0.015 0 0.3 Soum Nergui lake 12 SHC Erdene Soum 0.1 none none none 2km 0.2 100 0.4 0 0.5 13 Dashinchilen SHC 0.3 0.1 None None 9km Khar None 0.02 None none 0.32 none 3.4 buh river 0.3

NAV: Not available as detailed survey not completed by MOH; Trees Affected– Lopped or cut as detailed survey will be done by construction company; N/A – Not applicable 35

100. For some of the FHC/SHC/Hospitals sub-projects, the construction drawings development is underway. The data regarding soil, topography, contour, land cutting and filling required, distance from water body and distance from major roads, fruit/non-fruit trees can be affected, land details will be collected by Construction Company. If sites are changed other than those indicated here, supplementary information will be supplied for each of these subprojects by MOH to ADB for prior approval before contract award. 4. Distance from Reserve Forest/Protected Areas/National Park/Sanctuary 101. The distance from the FHC/SHC/Hospital to the national parks/protected areas/reserve forests are given in the Table III.4. Table III.4: Distance from Protected Areas (National Parks, Sanctuaries and Forest reserves) for all subprojects No Sub-Projects Location Distance from Protected Areas (km) 1 2 3 4 1 Khan-Uul Hospital Khan Uul District Bogd Khan SPA is 1.4 km 2 Khovd, Hospital Khovd Province 19 km distance from the Depression of Great Lakes SPA and in 33 km distance from Huh Serh Mountain Range SPA 3 Uvs hospital Ulaangom city 24km from Uvs lake SPA 4 National Emergency Sukhbaatar district Bogd Khan SPA is 3.1 km Health Call Center 5 FHC 10th Khoroo in Khan-Uul district Bogd Khan SPA is 2.7 km 6 FHC 14th Khoroo in Khan-Uul district Bogd Khan SPA is 6.38 km 7 FHC 19th Khoroo in Chingeltei district Bogd Khan SPA is 12 km 8 FHC 17th Khoroo in Bayanzurkh district Bogd Khan SPA is 4.5 km 9 SHC Erdenemandal Soum Demchig monastery/tombs is 27km 10 SHC Tarialan Soum Namnan Uul SPA is 15 km 11 SHC Bayan-Undur Soum Local SPA is 20 km 12 SHC Erdene Soum Burdene bulag sand SPA is 38km 13 SHC Dashinchilen Soum 31km from Hugnu-Tarna mount SPA

102. The Khan-Uul District hospital is located about 1.4 km distance from Bogd khan Mount Special Protection Area22 buffer zone. This area is already a housing area and does not

22 According to the Mongolian Law on Special Protected Areas and Law on Buffer Zones Article 7. Strictly Protected Areas. Strictly Protected Areas shall consist of those territories taken under state spe- cial protection, upon consideration of the preservation status of the original conditions and features of natural zones, in order to represent specific traits of the zones and scientific importance, and to ensure environmental balance. Article 27. Plenary Rights of the State Administrative Central Organization in charge of Special Protected Areas. The State Administrative Central Organization in charge of Special Protected Areas shall exercise the following plenary rights

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contain any biodiversity. The construction will take place inside the existing land area of Khan-Uul Hospital. Bogd khan Mount SPA buffer zone where the Khan-Uul hospital is located is a settlement area with apartments etc. Construction activities are not prohibited within the SPA buffer zone but it needs to have DEIA and EMP approved by MET. According to Mongolian Law on EIA, DEIA report will be approved by MET only after design works for the new buildings are approved by Construction Development Center. Secondly, the hospital has a GEIA obtained from the MET in 2013 that says “the hospital may operate, no need of a DEIA”. Draft domestic DEIA reports for Khan-Uul and Khovd hospitals are already made by a local professional firm and available. However, approval process of the domestic DEIA reports by Ministry of Environment requires the project to have approved detailed design. Mongolian Law on DEIA states that “The project owner must submit detailed design approved by relevent domestic authorities together with the DEIA report to Ministry of Environment and tourism to start the approval process for DEIA (Clause 7.3)”. 103. There are no SPA’s in the vicinity of other FHCs, hospitals and the Soum health centers that could be affected by construction activities. 5. Ulaanbaatar city: Infrastructure development condition 104. Ulaanbaatar city the biggest city and national capital of Mongolia. It is the main hub for Mongolia’s railroad, sealed road, communication and fiber optic cable networks. Mongolia’s railway line which connects and is 1,110 km long and passes through the Ulaanbaatar city. 105. Ulaanbaatar city has 3 main sealed road gates. Songinokhairkhan Tuv is the western gate which connects northern and western province of Mongolia to the city. It is located at 22km distance from the city center. Bayanzurkh gate is the eastern gate which connects eastern and south-eastern provinces to the city. It is located at 17 km distance from the city. Aitsiin Davaa is the southern gate which connects Umnugobi, Dundgobi and Tuv provinces to the city. It is located at 25 km distance from the city center. 106. An international airport called Chinggis Khaan airport connects Ulaanbaatar with Beijing, Moscow, Seoul, Tokyo, Berlin, Hong Kong, Singapore and other destinations. 107. Electrical power is supplied by the Central Electricity System (CES), which produces around 2.66 billion kilowatt hours (1998) of power. Five coal-fired power stations provide almost 85 percent of the total, with the balance imported from Russia. During the 1990s, attempts were made to renovate the CES with international aid and to build small hydroelectric and wind-powered stations. Power interruptions are common, and some remote areas remain without electricity, where diesel oil, wood, and dried horse and camel dung is used as fuel.

7/ set out travel and tourism routes, directions and procedures; 8/ in cooperation with the relevant State Administrative Central Organizations, review and approve overall planning for settled area in the authorized zones of the Special Protected Areas and the location and proposals for creating a new tourist, holiday and treatment camps;……

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108. The Ulaanbaatar city has centralized water supply and sewage networks that cover central parts of the city. The city supplies its water consumption from ground water boreholes in Tuul river valley. Waste water generated by dwellings in the city has been collected by centralized pipelines which are connected to the Central Waste Water Treatment Plant which located in western part of the city. i. Electricity network. 109. All 6 Tranche-1 subprojects in the Ulaanbaatar city are connected to the centralized electricity network. ii. Sewage network 110. Among the 6 Tranche-1 subprojects in Ulaanbaatar city, only 1 subproject (National Emergency Health Call Center) is connected to the centralized sewage networks while other 6 subprojects collect their waste water in designated holding tanks. They have contracted with sewage transportation agencies that send its sewage trucks on a weekly basis to the hospitals and FHC’s. All the waste water/septage/sludge removed from all the sub-project sites is delivered to the Central Waste Water Treatment Plant. Khan-Uul district hospital is planning to be connected to the central sewage network in 2018. The frequency of removal of waste water is dependent on the amount of wastewater generated at site. However, the hospitals can increase the capacity of the holding tanks based on the detailed design prepared by Construction company. iii. Heating network 111. 3 Tranche-1 subprojects in Ulaanbaatar city, namely Khan-Uul district hospital, Emergency Center and FHC in 10th Khoroo of Khan-Uul are connected to the central heating networks of the city. The FHC in 14th Khoroo of Khan-Uul district uses electric heating system while the other 2 FHC’s (19th Khoroo of Chingeltei and 17th Khoroo of Bayanzurkh) supply heating from their own heat only boiler (HOB). All HOB’s must adhere to the Mongolian standards - MNS 5457- 2005 “Maximum acceptable level and measuring method of toxic elements (CO, SO2, NOx, ash) in the exhaust gases contents of heating boilers and home stoves”. The same is attached in Annexure 1 Table A1.8. The coal is usually purchased in bags and stored at closed area outside the boiler house. The ash and the bottom ash are stored by the Hospital/FHC/SHC to the solid waste management truck. iv. Water supply network 112. The three FHC’s in UB city are located in the 19th khoroo of Chingeltei district, 17th khoroo of Bayanzurkh district and the 14th khoroo of Khan-Uul district. 113. Only two subprojects (National Emergency Health Call Center and FHC in 17th Khoroo of Bayanzurkh district) are connected to the centralized water supply network of Ulaanbaatar city. Khan-Uul district hospital is planning to be connected to the centralized water supply network in 2018. 2 subprojects (Khan-Uul hospital and FHC in 14th Khoroo of Khan-Uul) supply water from their own water wells while other 2 subprojects (10th Khoroo of Khan-Uul and 19th Khoroo of Chingeltei) supply their water needs from transported water reserved in their own reservoir. Currently, 2 FHC’s in UB city use ger are water distribution system (19 khoroo of Chingeltei and 10th khoroo) and FHC in 14th khoroo of Khan-Uul and Khan-Uul

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hospital use their own water well. Of these 4 components, 2 of them (Khan-Uul district hospital and FHC in 10th khoroo of Khan-Uul) will be connected to centralized water supply systems in the near future because centralized water pipelines have com close their hospital sites. Thus, in the future, FHC in 19 khoroo of Chingeltei will still be using Ger Area Water Development Scheme (GAWDS) and FHC in 14th khoroo of Khan-Uul will still be using drinking water well (DWW) because of the remote location. DWW in 14th khoroo of Khan-Uul is owned by local government while water is supplied to FHC in 19 khoroo of Chingeltei via GAWDS comes from centralized water wells owned by the city government. Both water wells have enough capacity to meet increased water demand by the FHC’s in the future. Both water well samples were tested during the IEE baseline development and meet national drinking water standard of Mongolia. Table III.5: Infrastructure condition for Tranche-1 subproject in Ulaanbaatar city

Name of Sewage water Heating supply Water supply hospital/FHC management facility Connected Septic Connecte Heating Electric From From From to central tank d to from an heating central own transported Sewage central own water water water reserved heating HOB supply well in own water system system reservoir. Khan-Uul district No Yes Yes No Yes hospital Emergency Health Center in Yes Yes Yes Ulaanbaatar city FHC at 10th Khoroo in Khan- No Yes Yes No Yes Uul FHC at 14th Khoroo in Khan- No Yes No Yes No Yes Uul FHC at 19th Khoroo in No Yes No Yes No Yes Chingeltei FHC at 17th Khoroo in No Yes No Yes Yes Bayanzurkh v. Waste management in Ulaanbaatar city 114. Current solid waste management system of Ulaanbaatar city comprises the following:  All entities and residential towns are responsible for having a designated solid waste collection point in their premises.  All districts have specialized urban service agencies who are responsible for collect waste generated by entities and residential areas in their respective districts and 39

transport the waste to central dumpsites of the city. These agencies have their own waste transport vehicles.  There are 3 central dumpsite locations around Ulaanbaatar: Narangiin Enger dumpsite is located on northwestern side, Ulaanchuluut is located on northeastern side and Moringiin Davaa on southwestern side of the city respectively. These are all engineered waste sites being managed by city government.  All hospitals and FHC’s in Ulaanbaatar have solid waste collection point within their premises. For Khan-Uul hospital, it is a small brick house with 15 m3 capacity where non- hazardous solid waste is collected before being removed to the central dumpsite of the Ulaanbaatar city. The hospitals and FHC’s signed a long-term contract with a waste transportation agency who sends their waste transport trucks twice a week.

Figure III.3: Solid waste collection point 115. 4 Tranche-1 FHC’s collect their solid waste at a designated point outside their building. Medical waste management system in Ulaanbaatar comprises of following components:  All hospitals and FHC’s are responsible for having a designated place to collect waste they generate. This solid waste collection will be new closed lid bins ad concrete/lined flooring during the detailed design by Construction Company. 116. A specialized agency – Element LLC who is licensed by the MOH, is contracted with all hospitals and FHC’s and responsible for transporting medical waste to their own designated landfill facility within the Narangiin Enger central dumpsite. Element LLC employs 55 staff and operates 10 specialized trucks and collects medical waste from every hospital 2-3 times a week. Their medical waste landfill facility at Narangiin Enger comprises of 3 building: office

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building, autoclave and incineration building and material warehouse building. This facility is being run in PPP mode based on international model23. 117. The medical waste landfill site operated by Element LLC is not an engineered one too. However, Element LLC is the only medical waste handling agency in Mongolia with special license by MOH. MOH requires all hospitals and FHC’s in UB city to contract with Element LLC to remove the medical waste. Inert spoil will not be mixed with medical waste. Every district of UB city and every soum in Mongolia has its own government owned waste handling agency who are responsible for transporting and landfilling of the waste generated at the hospitals during both construction and operation. 118. The medical waste is collected in boxes and bins which is picked by Element LLC on regular basis. Modern signage on the boxes is needed to ensure proper segregation and disposal.

Figure III.4: Medical waste collection room at Khan-Uul hospital. vi. Waste water management 119. Only 1 sub-project in Ulaanbaatar city (Emergency Center) is connected to the central sewage network. Waste water management for the 5 other subproject in Ulaanbaatar city is as follows:  All hospitals and FHC’s have septic tanks landfilled underneath outside of their current buildings where the waste water is collected temporarily. These septic tanks have capacity of 2-3 metric tons.  A specialized waste water transportation agency – Tenuun Bilegt Khangai LLC (private entity) is responsible for sending its truck every week to draw waste water collected in the septic tanks and transport it to the Central Waste Water Treatment Plant of Ulaanbaatar city (a state-owned enterprise). This company operates transport trucks that have waste water tanks with capacity of 8-10 metric tons.

23 The land belongs to UB Government while equipment etc belongs to Element LLC. It has collection facility and autoclave unit for disinfection. After autoclave disinfection the staff disposes the waste using a land filling method which is scientific in nature.

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Figure III.5: Disinfection Unit at the Medical Waste Facility of Element LLC

Figure III.6: Landfill point at the Medical Waste Facility of Element LLC

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Figure III.7: Medical Waste Transport Truck of Element LLC 6. Khovd: Infrastructure development condition 120. Khovd city is located at 1450 km distance from Ulaanbaatar. Khovd city is been connected to Chinese border with 350 km paved road recently. The Millennium Road which will connect Khovd city to Ulaanbaatar is under construction. The city has an airport called Baatarkhairkhan airport which connects it to Ulaanbaatar city and other provincial centers such as Ulgii, Ulaangom and Murun. 121. Khovd city has a coal burning power plant which supplies heating and electricity for the city. Waste water treatment plant of the Khovd city is located on the north-eastern side of the city. Most of the entities in central part of the Khovd city are connected to centralized water supply and waste water pipelines. The Khovd hospital has good infrastructure condition. It has connected to centralized electricity, heating, water supply and sewage networks of the Khovd city. i. Waste management in Khovd and Uvs Aimags 122. Current solid waste management for Khovd and Uvs hospitals comprises the following:  There are waste collection points are located within the hospital’s premises. However, the detailed design should include provision for replacing them with closed bin storage with concrete/lined flooring.  The hospitals are contracted with local firms who are responsible for sending its trucks to the hospitals twice a week to transport the solid waste to the central dumpsite of Khovd and Ulaangom cities. None of the Aimages and Soums have engineered sanitary landfills.  Local Soum governments are responsible for daily operation of the central dumpsite. 43

Figure III.8: Solid waste collection point at Khovd Hospital

Figure III.9: Solid waste collection place at Uvs Hospital

Figure III.10: Medical waste collection facility at Khovd Hospital

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Figure III.11: Medical waste collection facility at Uvs Hospital

Figure III.12: Medical waste transport vehicles 123. It is recommended that an improved occupational health and safety (OHS) for this collection system must be developed and implemented at Khovd and Uvs hospitals. Hospital staff must attend trainings sessions identified (later section IX.2) on waste management are attended.

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Figure III.13: Medical waste transport vehicles of Uvs hospital

Figure III.14: Waste landfill site for Khovd hospital

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Figure III.15: Labelled Medical and Non-medical waste bins at Uvs Hospital

124. Medical waste management procedure for Khovd and Uvs hospitals is as follows:  The hospital was provided with autoclave to treat syringes with funding by an ADB funded project back in 2013. The autoclave is not working currently. It is proposed to replace the autoclave equipment.  They have designated medical waste collection house made of bricks within hospitals premises.  The hospitals have their own waste removal trucks that transport the medical waste collected in the designated houses to landfilling sites nearby the central dumpsites of the Khovd and Ulaangom cities. Uvs and Khovd hospitals have their own landfill pits with permission by the respective area governments. The hospitals have obtained permission to use the spots as medical waste landfilling site from their respective Soum governments: Jargalant and Ulaangom Soums. The detailed design must develop new landfill pits that are fully engineered in desing and also necessary equipments (such as autoclave) and disinfecting facilities. 7. 5 Soum health centers: Infrastructure development condition 125. Erdenemandal Soum is located at 465 km distance from UB city in western direction. Erdenemandal Soum is connected to the central power grid of Mongolia but not connected to the sealed road network yet. The Soum hospital is connected to the Soum center’s water 47

supply and sewage pipeline networks. The Soum hospital has its own heat only boiler24. The Soum center is connected to fiber optic cable and mobile phone networks. 126. Tarialan Soum is located at 637km distance from UB city in northwestern direction. The Soum is connected to sealed road network and central power grid of Mongolia. All entities in the Soum center including the Soum health center are connected to centralized heating and water supply pipelines. The Soum health center has its own septic tank within its yard. It is drawn and removed by sewage truck to central dumpsite of the Soum center at frequency specified by the FHC/SHC management. 127. Bayan-Undur Soum is located at 320km distance from UB city in southwestern direction. Bayan-Undur Soum center is already connected to central power transmission line. In the Soum center, drinking water is supplied from 2 ground water wells25 and distributed to offices, entities by centralized water supply pipelines. There are 2 heat only boilers in the Soum center that supply heating to all entities in the Soum center through pipelines. The Soum is not connected to the paved road network of Mongolia. However, it connected to fiber optic cable and mobile phone networks. 128. Erdene Soum is located at 600km distance from the UB city in southern Gobi Desert of Mongolia. It neighbours with China on its southern border. Erdene Soum has already connected centralized power transmission line. All offices, school, kindergartens and the hospital are connected to centralized heating pipelines by 2017. UB-Zamyn Uud paved road and trans-Mongolian railway lines traverse through Erdene Soum territory. The Soum’s drinking water is supplied from a ground water well which is located at 18km distance from the Soum center. There are 2 water reservoirs at the Soum center with each having capacity of 250m3. The Soum health center is connected to the centralized water supply pipeline of the Soum center. Erdene Soum center is connected to fiber optic cable and mobile phone networks of Mongolia. 129. Dashinchilen Soum is located at 227 km distance from UB city in western direction. Dashinchilen Soum center is already connected to central power transmission line. In the Soum center, drinking water is supplied from a ground water well26 and distributed to offices, entities by centralized water supply pipelines. Dashinchilen SHC is not connected to centralized sewage and heating pipelines. The Soum is connected to the paved road network of Mongolia and fiber optic cable and mobile phone networks.

24 All HOB’s must adhere to the Mongolian standards - MNS 5457- 2005 “Maximum acceptable level and measuring method of toxic elements (CO, SO2, NOx, ash) in the exhaust gases contents of heating boilers and home stoves”. The same is attached in Annexure 1 Table A1.8. 25 Construction Company to ensure that detailed design for the new facility would adhere to all national and interna- tional drinking water standards (which ever are more stringent). 26 Construction Company to ensure that detailed design for the new facility would adhere to all national and interna- tional drinking water standards (which ever are more stringent).

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Table III.6: Infrastructure condition for the Soum health centers

Name of SHC’s Sewage water Heating supply Water supply management facility Connected Septic Connect Heating Electric From From From to central tank ed to from an heating central own transported Sewage central own water water water heating HOB supply well reserved in system system own water reservoir. Erdenemandal No No Yes Yes Soum Tarialan Soum No Yes Yes Yes Bayan-Undur No Yes Yes Yes Soum Erdene Soum Yes Yes Yes Yes Dashinchilen No Yes No Yes No Yes Yes Soum ii. Waste management in the 5 Soums 130. The 5 Soum health centers have the same waste management system. Each Soum health center has a waste collection point within its yard. Civil service agencies in the Soum centers remove the collected solid waste to the central dumpsites of the respective Soum centers on a weekly basis. Every district of every soum in Mongolia has its own government owned waste handling agency who are responsible for transporting and landfilling of the waste generated at the hospitals during both construction and operation. 131. The Soum health centers collect their medical waste in a designated small brick houses within the hospital yard. Collected medical waste are transported to the each Soum health center has its own designated landfill spot within the central dumpsite of the Soum center to where the collected medical waste are transported, treated and landfilled on monthly basis. However, medical waste/sanitary landfill site for both Khovd and Uvs Soums are not engineered sanitary or hazardous waste disposal sites. The detailed design must develop new landfill pits that are fully engineered in design (covered, has concrete/line flooring etc.) and also necessary equipments (such as autoclave) and disinfecting facilities. 49

Figure III.16: Medical waste collection house, Erdene Soum health center 132. Each Soum health center has septic tanks where the wastewater is collected. Once the septic tank is full, civil service agencies of their respective Soum center draws the collected waste water and remove to central dumpsite of the Soum center.

Figure III.17: Septic tank at Erdene Soum health center27

E. Proposed Environmental infrastructure for sub-projects 133. Keeping in view the funding status, several aspects for construction were discussed and Architectural Planning – Concept Design was approved by MOH on 28 August 2018 for the facilities under the project shown in Figure III.18.

27 Figure depicts a septic tank / a holding tank to be emptied using a tanker at regular intervals.

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Figure III.18: Architectural planning design approval 1. Hospital/FHC/SHC/Buildings 134. The Diagnostics & Treatment (D&T) Building proposed for construction at the Khan Uul District Hospital/Khovd Hospital/Uvs Hospital will consist of the following departments. The ground level includes the emergency department, imaging, laboratory, central sterilization and laundry. The second level contains the surgical department, labor and delivery (obstetrics) and critical care. The D&T block provides the basic requirements in support of basic inpatient facilities of up to 150 beds. all patient beds will be housed in new construction for 150 inpatient beds. The 4 storey tall patient building (long portion of the 'T') contains a central core containing vertical transportation and support functions (elevators, stairs, support rooms). 135. Patient Tower (at Khan Uul Hospital) - A new entrance to the facility is intended between the existing patient (future sub-acute) building and the new patient building. This will provide a sheltered area for patient and visitor drop-off. This node will allow access to the outpatient clinics, inpatient elevators, diagnostics center and sub-acute patient building. 51

136. Family Health Centers- This facility is intended to provide basic outpatient healthcare services to the general population. Each center has a capacity of 3-5 practitioners and can accommodate the following disciplines:  Internal Medicine  Pediatrics  Obstetrics and Gynecology  Dentistry  Infectious Diseases 137. The main entrance serves all visitors. It is large and wide to allow for adequate traffic. A double doorway with a vestibule provides a thermal weather barrier. Upon entry, a reception desk, cloak room and central waiting area is provided. The layout provides for common services of pharmacy, physiotherapy, rehabilitation and phlebotomy in closest proximity to the waiting area. Beyond these areas are the adult services wing, including examination, treatment, administrative and social service rooms. To the left of the waiting area is the women's and children's' wing, providing pediatric, obstetric, gynecological and vaccine exam and consult rooms. Support services, staff entrance and emergency exits are distributed throughout. 138. Soum Health Centers- These facilities will be centralized amongst multiple small towns and villages in order to distribute accessible basic healthcare services within reasonable travel distances. These facilities will service populations of varying sizes and will be located with a focus on geographic distribution, more than population census. Each center has a capacity of multiple practitioners- doctors, nurses, population health and other specialists (both full time and rotating). They will accommodate all basic health disciplines including:  Internal Medicine  Vaccinations  Pediatrics  Preventive Health  Obstetrics and Gynecology  Trauma / Urgent Care  Dentistry  Inpatient Observation  Infectious Diseases

139. National Emergency Medical Services Coordination Center - the existing (old) building of the National Emergency Medical Services (EMS) Call and Coordination Center will be replaced by a new building following modern standards of Emergency Medical Services 2. Design of buildings Energy Sources

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140. Use of energy efficient systems, including heat recovery and ground heat pumps. Designers shall investigate the introduction of sustainable infrastructure, using best international design practices, in the form of:

 Solar energy - at a minimum, this should be used in support of passive hot water production. Potential for solar charged storage cells should be considered for closed systems (e.g. site lighting, signage, etc.).  Wind energy - to be investigated as a source of electricity for each facility.  Ground source heat pumps - depending upon site and availability, the possibility of geothermal resources for passive heating, terrain and cost permitting. This technology requires significant land, but can be installed beneath adjacent public space (parks, streets and neighboring buildings.  Geothermal heat sources - depending upon zone and access to thermal fields, this is an excellent green energy source.  Available emergency power and primary energy sources, clearwater sources and sewage processing must be investigated for every potential site. Natural light and air  Maximize available daylight and solar powered site lighting.  Utilize LED lighting, where appropriate.  Design toward passive (wind) cooling,  Locate passive exhaust to support passive dispersion of laboratory, kitchen and laundry exhaust air. Consider wind direction related to residential and public surroundings.  Introduction of a 4 storey atrium in the core will support passive cooling through a "chimney effect". While not included in the planning diagrams, this is accounted for in the costs (200 square meters per floor) and should be included by the designers. Interior finishes and materials  Utilize reclaimed or recycled materials as standard non-medical furnishings and finishes.  Use non-toxic and non-polluting products. An increasing variety of safe and chemical- free products is available, from organic, hypoallergenic paint to fibers and woods that haven't been treated with pesticides.  Avoid toxic adhesives, materials and products. Exterior envelope design  All exterior surfaces shall utilize high R-value materials, ensuring appropriate insulation.  For all elements of the building envelope, true "R-values" of each assembly components must comply with the following insulation target values: o R-5 windows and doors, o R-10 under slabs and for any below-grade foundation walls, o R-20 for above-grade foundation walls and sLaboratory perimeter, 53

o R-40 for above-ground walls, o R-60 for roofs/attics.  Introduction of glass along all exterior walls, as well as in skylights will increase natural light for both healing and sustainability.  Operable windows and focus on cross ventilation to promote passive cooling and fresh air circulation.  Local materials, typical/standard building components and local labor should be utilized to reduce negative environmental impacts.  Standardization of all facilities, modularity of components and concurrent design efforts will reduce program costs and negative environmental impact. 3. Equipment: 141. Besides the above, some equipment is also proposed to funded as part of the project. 4. Water, Wastewater, Solid Waste, Sewage infrastructure 142. Total of 13 sites including 4 FHC, 5 SHCs and 4 Hospitals suggested are supported by the project. Currently, from the 13 project sites, 4 sites require New Construction (NC), 9 sites to be built in Separate Buildings (SB), 0 sites require Additional Floor (AF) construction. Out of them, 8 sites have connected to Central Heating (CH), 4 sites have individual Heat Only Boiler (HOB) and 1 site has Electric Heating (EH), 6 sites have connected to Central Water Supply System (CWSS), 3 sites have individual Deep Water Well (DWW) for water supply and 4 sites have connected to Ger Area Water Distribution System (GAWDS), and 0 site have transporting water from other area. In total 3 sites have connected to Central Sewage System (CSS), 10 sites have individual Holding Tank (HT), 0 site has no sewage facility and uses a pit for grey water disposing. Basing on current situation of infrastructure and possibilities to be connected service infrastruc- tures of project sites, the project future solution would be suggested as in Table 6.4 that 9 sites which have the possibilities have to be connected to Central Heating (CH), 4 sites will have indi- vidual Heat Only Boiler (HOB) or Electric Heating (EH), 8 sites will be connected to Central Wa- ter Supply System (CWSS), 3 sites must have Deep Water Wells (DWW) for water supply and 2 sites will have connection to Ger Area Water Distribution System (GAWDS), and 6 sites will be connected to Central Sewage System (CSS), 7 sites can have individual Septic Tank (ST)28 and 0 sites which have no enough space for installing ST can be have Holding Tank (HT) for dispos- ing waste water.

28 Per EHS Health Care Facilities guidelines: In cases where wastewater is not discharged to sanitary sewage sys- tems, FHC/SHC/Hospital operators should ensure that wastewater receives on-site primary and secondary treat- ment, in addition to chlorine disinfection. Septic tanks are only suitable for sanitary sewage.

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143. Table III.7 lists all current vs suggested infrastructure solutions for each sub-project site.

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Table III.7: Existing and suggested infrastructures at each sub-project site No Sub-Project Location Type of Current/Future situation of infrastructure or components projected Utilities construction NC/SB/ Capac Heating Water Supply Waste water AF ity /m2 Current Futur Current Future Curren Future e t 1 2 3 4 5 6 7 8 9 10 11 1 Khan-Uul Khan Uul District SB 12,000 CH CH DWW CWS ST CSS Hospital 2 Khovd, Khovd Province SB 1,200 CH CH CWS CWS CSS CSS Hospital 3 Uvs hospital Ulaangom city SB 1,200 CH CH CWS CWS CSS CSS 4 Emergency Sukhbaatar district SB n/a CH CH CWS CWS CSS CSS health Center 5 FHC 10th Khoroo in Khan- NC 640 CH CH GAWDS CWS ST CSS Uul district 6 FHC 14th Khoroo in Khan- NC 640 ET* HOB DWW* DWW ST* ST Uul district* ** 7 FHC 19th Khoroo in NC 640 HOB* HOB GAWDS* GAWDS ST* ST Chingeltei district * ** 8 FHC 17th Khoroo in NC 640 HOB HOB CWS CWS ST ST Bayanzurkh district ** 9 SHC Erdenemandal SB 800 HOB CH DWW DWW ST ST Soum 10 SHC Tarialan Soum SB 800 CH CH CWS CWS ST ST 11 SHC Bayan-Undur SB 800 CH CH GAWDS DWW ST ST Soum 12 SHC Erdene Soum SB 800 CH CH CWS CWS ST CSS 13 SHC Dashinchilen Soum SB 800 HOB HOB GAWDS GAWDS ST ST ** Remark: NC-New Construction, SB-Separate Building, AF-Additional Floor, CH-Central Heating, CWS-Central Water Supply, CSS-Central Sewage System, DWW-Deep Water Well, HOB-Heat Only Boiler, ET-Electric Heating, GAWDS- Ger Area Water Distribution System and HT-Holding Tank, ST-Septic Tank. *2 FHC’s (Khan-Uul 14th Khoroo and Chingeltei 19th Khoroo) does not have their own building now. They locate in their respective Khoroo administration complex buildings. Thus, the heating, water supply and sewage systems show current condition of the Khoroo administration buildings. ** To replace HOB heating with electic heating if possible at the locations proposed. 5. Health Care Waste Management 144. Based on site observations and information from FHC/SHCs/Hospitals and district administration, the following actions to implement proper health care waste management at the hospitals / health centers concerned:  Availability of drinking water for FHCs/SHCs – must be connected to central water supply system as transportation of drinking water29 requires intensive utilization, and FHCs/SHCs should have a safe and secure water source;  All FHCs/SHCs need to connect to the sewage system or install septic tank or holding tank due to the absence of central wastewater treatment systems in the districts.

29 Construction Company to ensure that detailed design for the new facility would adhere to all national and interna- tional drinking water standards (which ever are more stringent).

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 The Construction Company would design the facilities in a way encourage managments to replace the proposed HOB based heating with Electric Floor heating to remove coal handling, ash and other pollution load;  All hazardous waste such as needles, syringes, bandages, waste medical vials etc. must be handled in properly marked containers to be pickup by the designated agency. Health care waste collection facilities need to be improved in SHCs and storage facilities should be covered. Burning (if any) should be prohibited; 6. Operational procedures 145. Implement protocols which promote sustainable operations, including:  Waste management should be controlled to allow for recycling of non-bio or medical materials.  Removal and re-use of packaging and recyclable materials, through distributors. In-clude proper onsite breakdown and storage of all materials.  Since the bio hazardous matter is collected by centralized regional agency, the project should provide training and on-site bins for appropriate separation and storage of materials.  Energy conservation - design switching protocols and procedures to assure proper shut-downs of equipment during off-hours.

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IV. DESCRIPTION OF ENVIRONMENT (BASELINE DATA)

146. The FHC/SHC/Hospitals subprojects funded under the Tranche 1 are situated in districts of Ulaanbaatar city and Khovd province. This chapter focuses on the present environmental conditions of the sub-project areas in Ulaanbaatar and other provinces. Most sub-project activities will have minimal impacts to the environment, and will not be influenced by current environment conditions. Thus, the main emphasis of this chapter is the description of physical, biological, and socioeconomic conditions in Ulaanbaatar, Khovd, Uvs and 5 Soum centers, and more specifically the environment at the FHC/SHC/Hospitals.

A. Environment of Mongolia 1. Topography 147. Although most of the country is flat, with rolling hills, there are several significant mountain ranges, notably the Altai, Khangai, Knentii and Khuvsgul. About half of the land is at an altitude of about 1,400 m or more above mean sea level. The altitudes range from 560 m (above sea level) at the lowest point of Khokh Nuur in the eastern steppes, to the highest of 4,374 m (above sea level) at Khuiten peak in the Altai Mountains. 2. Climate 148. Mongolia lies between the boreal forests of Siberia and the Gobi Desert, spanning the southernmost border of the permafrost and the northernmost deserts of Central Asia. Large distances and high mountain chains separate the country from the oceans. It has an extreme continental climate with marked differences in seasonal and diurnal temperatures and low precipitation. Mean annual observed precipitation ranges from 38.4 mm at Ekhiin gol in Bayanhongor Aimag (province) to 389.3 mm at Dadal in Hentii Aimag. Most of the rainfall occurs in summer, between June and August. Mean monthly temperatures for the last thirty years range from -11.8°C (January) to 25.20C (July) at Ekhiin gol, the warmest place, and from -32°C (January) to 12.8°C (July) at Rinchinlumbe, the coldest place in Mongolia. 149. Mongolia has a severe continental climate. Ulaanbaatar is the coldest national capital in the world, with temperatures ranging from approximately -37°C to +25°C. The country is also prone to severe winters, known as zud which means any condition that stops livestock getting to pasture. The winters of 1999, 2000, 2001 and 2010 were zud years, which resulted in the deaths of more than 25% of the livestock population. Ulaanbaatar is located at 1,350m altitude in the valley of four mountain ranges which rise to 1,650 to 1,949m altitude. Due to its location, the city experiences many temperature inversions. At least 80% of these inversions occur from October to April when air temperatures are from 7.50 to 11.7°C and land temperatures are from minus 210 to minus 39°C. The average depth of the inversions is 650 to 920 m. 150. Precipitation. The country averages 257 cloudless days a year, and it is usually at the center of a region of high atmospheric pressure. Precipitation is highest in the north, including Ulaanbaatar (average of 200 to 350 mm per year) and lowest in the south, which receives 100 to 200 mm annually. In Ulaanbaatar, 95-97 percent of precipitation falls during the warm season, including 75-80 percent in the summer. In winter, the precipitation ranges

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from 1 to 3 mm, whereas in July it ranges from 100 to 120 mm. At an average, it rains 40-70 days a year, snow falls on 25-30 days, and land is covered with snow for 140-170 days. 151. Wind. The dry environment exacerbates the frequent dust storms occurring in Mongolia each year. Wind erosion of soil is a dynamic process of soil degradation in which the share stress applied on the ground surface by wind exceeds the ability of the soil particles to resist separation and transportation. The wind erosion depends on the climatic factors, soil properties, landscape characteristics and availability of vegetation. In Ulaanbaatar, wind blows mostly from the north and northwest and average wind velocities are usually lower than in other parts of Mongolia. Monthly wind velocities average 1.6 – 4.4 m/s, with an average of 7 to 9 days per year where wind velocities exceed 10 m/s. 3. Ecosystems 152. Mongolia’s position, size and topography have resulted in a unique assembly of ecosystems or natural zones. Studies of the flora and fauna of the country, together with climatic and geographic data, have resulted in the classification of Mongolia into six broad ecological regions, 16 provinces and 47 bio-geographical zones. Mongolia also has been divided into six broad vegetation zones (Alpine, Taiga, Forest-Steppe, Steppe, Desert- Steppe and Desert). Ecosystems are fragile and extremely vulnerable to many forms of economic exploitation. 153. Alpine. High mountains rising above the tree line occur in the Altai, Khangai, Khentii and Khuvsgul ranges. The tops of these mountains are relatively flat, with few sharp peaks. Vegetation consists of low shrubs and herbs, sedges, mosses, algae and lichens, and there are few birds and mammals living at this altitude. 154. Taiga. Mountain taiga forest covers areas of the Khuvsgul and , the area north of the Tarbagatai Mountains, the upper reaches of the Orhon river, and the Khan Khokhii range. It is the southern edge of the Siberian taiga that has the largest continuous forest system in the world. 155. Forest-Steppe. This zone lies between the steppe and the taiga, in the Khnagai and Altai mountain chains, including parts of Orhon and Selenge river basins and Khyangan Mountains of eastern Mongolia. Coniferous forests are found on the northern slopes, while the southern slopes are covered with open steppe vegetation. 156. Steppe. The steppe zone extends from the western Great Lakes depression past Khangai and the middle Khalkha highlands to the steppes of Khentii, Dornogobi and Dornod. It is characterized by flat plains and rolling hills covered in feather grass and shrubs. 157. Desert-Steppe. Mongolia’s desert-steppe or semi-desert is characterized by a dry climate with mean annual precipitation of 100-125 mm and vegetation dominated by low grasses and shrubs. Many of Central Asia’s endemic plants occur in this zone. 158. Desert. Desert occurs predominantly in the south. The Mongolian desert is extremely dry, with mean annual rainfall lower than 100 mm, and some areas remain without rain for several years at a time. High winds and dust storms are frequent in spring and summer. There are oases with poplar, but for the most part the desert consists of bare sandy plains and rocky mountains. 59

4. Water Resources 159. Mongolia straddles a major continental watershed aligned east-west across the country. North of the divide, drainage is to the Arctic Ocean via the Lena River and Lake Baikal, and to the Pacific Ocean via the Amur and Yenisei rivers. South of the divide drainage terminates in dry lakes and salt pans with no outlet to the sea. 160. There are more than 3,800 rivers and streams with regular run-off in Mongolia. The total length of the river network is about 6,500 km. There are 186 glaciers of a total volume of 62.5 km³ and 3,500 lakes covering total surface area of 15,600 km² with a total volume of 500 km3 and 8,000 river lets. There are three major drainage basins: rivers in the west drain to the enclosed Basin of Central Asia; rivers in the north drain to Arctic Ocean Basin; and rivers in the east drain to Pacific Ocean Basin. 161. The potential water resources of the country are estimated to be about 36.4 km³. Of this, the surface water resources are 22.0 km³ and the usable groundwater resources are 12.6 km³. About 78% of the river run-off is formed on 36% of the territory in northern, western, and north-eastern mountainous areas and 22 per cent is formed on 64 % of the territory in the south of the country. On an average, the annual amount of water resources per capita is 17,300 m³. However, it ranges from 4,500 m³ per capita in the Gobi area to 46,000 m³ per capita in northern and central areas. 162. Permafrost. Two thirds of the population of Mongolia lives in the region with permafrost distribution. With the increasing activity of infrastructure networks, knowledge about the distribution patterns of mountain permafrost helps reducing installation costs, and improves life safety of people in such area. A map of seasonally frozen ground and permafrost distribution of Mongolia at a scale of 1:1,500,000 is available. This map was compiled by the results of Russian – Mongolian geocryological expedition in 1967 – 1971. 5. Natural disasters 163. Natural disasters in Mongolia are mainly caused by forest fires, floods, extreme cold, snow storms and disease outbreaks. Forest fires accounted for 49% of the disaster events during the period 1990-2000. During this period, floods, disease outbreaks and extreme cold and snow storms accounted for 11%, 13% and 5%, respectively.30 Floods and earthquakes are the natural disasters of potential relevance to the project and thus further discussed below. 6. Seismology 164. Mongolia has experienced four major earthquakes (Msk>8) and many more moderate earthquakes (MSK 5.3-7.5) in the last century. The seismic activity in Mongolia is related to its location between the compressive structures associated with the collision of the Indian- Australian plate with the Eurasian plate on the one hand and the extensional structure associated with the Baykal rift system on the other. The historical records (1903 onward) of the seismicity in Mongolia show a high concentration of seismic activity along the Mongolian-

30 Source: National Center for Emergency, 2002.

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Altay and Gobi-Altay ranges and the north-western border with Russia and around east of Hangay mountain. The multi-organizational Global Seismic Hazard Assessment Program classifies Ulaanbaatar as “low” to “moderate” earthquake risk areas shown in Figure IV.1.

Earthquake Intensity Risk Zones This map shows earthquake intensity zones in accordance with the 1956 version of the Modified Mercalli Scale (MM), describing the effects of an earthquake on the surface of the earth and integrating numerous parameters such as ground acceleration, duration of an earthquake, and subsoil effects. It also includes historical earthquake reports. The Zones indicate where there is a probability of 20 percent that degrees of intensity shown on the map will be exceeded in 50 years. This probability figure varies with time; i.e., it is lower for shorter periods and higher for longer periods.

I. Instrumental VII. Very Strong II. Feeble VIII. Destructive

III. Slight IX. Ruinous

IV. Moderate X. Disastrous V. Rather Strong XI. Very Disastrous VI. Strong XII. Catastrophic

Source: http://www.preventionweb.net/files/15692_mngearthquakeriskv1100816.pdf Figure IV.1: Earthquake Risk in Mongolia: Modified Mercalli Scale 7. Biodiversity 165. Animals: Mongolian fauna is relatively rich in animal species which inhabit different habitats of the country’s variable natural zones, such as forests, steppes, deserts, and high mountains. The Mongolian fauna includes many species which are common in Siberian 61

Taiga, European forests, or West Asian and Triennia deserts. But there are also species which are endemic to the steppe and deserts of Central Asia, and are common in Mongolia. In addition, Mongolia is one of the richest countries in the world by prehistoric remains of various animal species. 166. Mammals. Altogether 138 mammalian species belonging to 73 genera, 22 families, and 8 orders, out of which, 13 are insectivoruos, 12 chiropters, 6 lagomorphs, 69 rodents, 24 carnivores, 2 perissodectyls, 1 tylopods and 11 artiodactyls, exist in Mongolia. 167. Birds. 449 species belonging to 193 genera, 56 families and 17 orders have been recorded so far in Mongolia. More than 330 species from this total are migratory, and the remaining 119 species inhabit Mongolia year-round. 322 species nest in spring in Mongolia, and more than 10 species, nesting in the Tundra and in Arctic Ocean coasts, stay over winter in Mongolia. Approximately, 50 species migrate through Mongolia and 20 species are observed occasionally. 168. Plants. Detailed plant collections have still not been made for some regions so it is likely that there are over 3,000 species of flowering plants in Mongolia. There are 845 species of medicinal plants, 68 species of soil-binding plants, and 120 species of important food plants in Mongolia. The factors threatening the Mongolian biological diversity are climate change, desertification, forest insects and disease; pasture harmful insects and unsustainable human activities. 169. Forest. The recorded forest resources of Mongolia accounts for about 11.6% of its land area. Area actually under closed forest is only about 8.1% equal to about 12.9 million hectares which is a substantial resource compared to that in many countries. The natural regeneration of Mongolian forests is slow, and fires and insects often damage the forests. Mongolia’s forest resources consist of more than 140 species of trees and shrubs and bushes, and 81.2% of the forest area is covered by natural coniferous forest, 15.8 % by saxauls (Haloxylon ammodendron), and 3.0% by shrubs and bushes. Of the total forest land of Mongolia, 91.2 % or 16.68 million hectares is forest area, and 8.8 % or 1.60 million hectares is non-forest area. Of the total forest resources of 1,379.2 million m3 in Mongolia, 58.8 % is Siberian larch, 5.2 % is pine, 7.7% is cedar, 8.8 is Siberian spruce and fir, and 16.0% is saxaul. Other species like birch, poplar and willow and shrubs are spread in small quantities.

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Source: UNDP, UN+Redd Program, June 2011. Figure IV.2: Vegetation zone map of Mongolia showing forest areas

8. Protected areas in Mongolia 170. Mongolia was probably one of the first countries in the world to recognize the importance of conservation. In 1778, the Bogd Khan Mountain, which is located outside Mongolia’s capital, was officially designated by the State. The values and the knowledge leading to the establishment of Protected Areas (PAs) have varied throughout the years with the on-going development of scientific knowledge and increasing involvement of stakeholders. To date, Mongolia’s PA network consists of 89 Protected Areas covering 17.4% (27.2 million hectares) of the Mongolian territory. The number of PAs has increased drastically over the past two decades following the National Programme on Protected Areas adopted by the Mongolian Parliament (1998) that set the goal of establishing a system of PAs that would cover 30% of the territory before 2015. The number of SPAs, for instance, has increased from 71 to 89, which constitutes an increase of 4.5 million hectares just within the last two years. Simultaneously, it is, however, critical to improve the representativeness of ecosystems within the national PA system. 171. The Protected Areas which were established in accordance with the Law on Protected Areas fall into five different categories, subject to their protection and management arrangements. 14 areas of altogether 12.4 million hectares were designated by the Parliament as Strictly Protected Areas (SPAs). These are areas “that represent unique features and characteristics of natural zones, have preserved their original conditions, and are of a special scientific and cultural significance.” The second category, National Parks (NPs), includes 30 areas of altogether 11.9 million hectares. These are areas “whose natural original condition is relatively preserved and which have historical, cultural, scientific and ecological importance”. Under the current legal framework both SPAs and NPs fall under the jurisdiction of the National government, i.e. MET, and are thus designated by the Central 63

Parliament, financed through the State budget and managed through Protected Area Administrations (PAA). 172. The third category is Nature Reserves (NRs). To date 31 areas covering 2.8 million hectares of land are designated to “create conditions for protecting, preserving and restoring specific natural features as well as one of any natural resources and wealth”. 173. The fourth category, Natural, Cultural and Historical Monuments (NCHMs), encompasses 14 areas covering 125,000 hectares. These are areas of unique natural formations and areas designated to protect historical and cultural monuments. Although designated by the National Parliament, Nature Reserves and Natural, Cultural and Historical Monuments are supposed to be managed and financed by the local governments (Aimags). In light of limited public finance for environmental conservation, especially at the local level, the management of these types of PAs tends to be kept at a bare minimum, unless the areas have attracted international projects and programs. 174. The fifth category of protection includes Local Protected Areas (LPAs) which can be designated by the Aimag or Soum level Citizens Khural (local Parliament) for protection and conservation purposes independently from the Central Government’s administrative body. To date Soum and Aimag Citizens’ Khurals have designed some 937 Local Protected Areas in the last decade – covering nearly 17 million hectares – or over 10% of Mongolia’s territory. 175. The first four categories are State PA, designated by the National Parliament, whereas category 5 is a Local PA, designated by Aimag or Soum Parliament. Management responsibility is with the 29 State Administrations for SPA (cat.1) and NP (cat.2) but given to Aimag and Soum not only for the Local PA (cat.5), but also for Nature Reserves (cat 3) and Monuments (cat.4). However, Aimag and Soum often lack capacities and resources for proper management of NRs and NCHMs. Therefore, their management is sometimes supported by international donors, NGOs or the State Administration (especially if they are in proximity to SPAs and NPs). 176. In accordance with the Law on Protected Areas, all Special Protected Areas may have a Buffer Zone (BZ). The establishment and management of Buffer Zones are regulated by a separate Law on Buffer Zones of Protected Areas. It aims to reduce, mitigate and prevent the actual and/or potential adverse impacts experienced in their respective PA by way of (i) increasing local communities’ participation in the conservation of protected sites, by (ii) providing livelihood means to local communities and (iii) by ensuring the appropriate use of natural resources. Currently the Government actively advocates the establishment of Buffer Zones around SPAs and NPs. If properly managed the LPAs will in principal offer a good protection and they will also provide for an expansion zone of the Protected Areas. Table IV.1 lists all protected areas in Mongolia. Table IV.1: List of Protected Areas of Mongolia

№ Names of PA Province name Classific Size Total size ation (hectares) 1 Gobi Ikh/B/ Baynkhongor SPA 927111.8222 963834.9905 2 Alag Khairkhan Gobi-Altai NP 36723.16831 3 Gobi Ikh /A/ Gobi-Altai, Baynkhongor SPA 4633299.775 4656395.739

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№ Names of PA Province name Classific Size Total size ation (hectares) 4 Eej Khairkhan Gobi-Altai NM 23095.9647 5 Khukh Serkhi Nuruu Bayan-Ulgii, Khovd SPA 75749.75203 242940.3987 6 ChiGertein river valley Bayan-Ulgii NP 167190.6466 7 Bogdkhan mountain Tuv SPA 41322.27316 41322.27316 8 Khasagt Khairkhan Gobi-Altai SPA 26760.57436 298073.9928 9 Mongol Els Gobi-Altai NP 271313.4184 10 Numrug Dornod SPA 320982.1815 320982.1815 11 Dornod Mongol Dornod SPA 589905.6506 1453809.886 12 Mongol Daguur // SPA 92880.45414 13 Mongol Daguur /B/ SPA 15273.1854 14 Yahi Lake NR 251217.9575 15 Ugtam NR 46022.85092 16 Toson Khulstai Dornod, Khentii NR 458509.7875 17 Uvs lake Uvs SPA 441223.2166 597234.8923 18 Tsagaan Shuwuut SPA 25537.7004 19 Turgen mountain SPA 130473.9754 20 Tes river NR 21 Khan Khukhii Uvs NP 221598.2789 713144.2672 22 Hyargas lake NP 341301.7869 23 Altan els SPA 150244.2014 24 OtgontenGer mountain Zankhan SPA 90498.66441 349902.0528 25 Ulaagchin Khar lake Zankhan NP 259403.3884 26 Tsambagarav Bayan-Ulgii NP 113749.2134 928352.2948 27 Altai Tavan Bogd NP 656106.3865 28 Siilhem Nuruu // NP 69935.4433 29 Siilhem Nuruu /B/ NP 77942.5287 30 Devel aral NR 10618.72285 31 Khangain nuruu Arkhangai, Baynkhongor NP 906604.5447 1040155.534 32 Khorgo-Terkh Arkhangai NP 76893.00337 Tsagaan lake 33 Noyon Khangai NP 56657.98638 34 Onon-Balj // Khentii NP 294079.7835 400466.775 35 Onon-Balj /B/ NP 106386.9926 36 Khugnu Tarna , Uvurkhangai NP 84143.05686 84143.05686 37 Dariganga Sukhbaatar NP 64547.60536 88788.83834 38 Shiliin Bogd NM 18136.91995 39 Khorgiin khundii NM 6104.313042 40 Khustain nuruu Tuv NP 48400.56794 48400.56794 41 Gobi Gurvan Saikhan Umnugobi NP 2697170.845 2697170.845 42 Khan Khentii Tuv , Selenge, Khentii SPA 1748103.891 1762660.811 43 Undurkhaan uul Khentii NP 8820.0 44 Binderya uul NM 5736.92 45 nuur NM 3913.0 46 Gorhi-Terelj Tuv NP 291838.556 47 Nagalkhaan mountain NR 1860.721221 48 Khar us lake Khovd NP 852997.2452 935804.6195 49 Mankhan NR 82807.37429 50 Tarvagatain nuruu Zankhan NP 547629.8987 547629.8987 51 Little Gobi // Umnugobi SPA 1147812.066 1830429.418 52 Little Gobi /B/ Dornogobi, Umnugobi SPA 682617.3514 65

№ Names of PA Province name Classific Size Total size ation (hectares) 53 Ikh bogd mountain Baynkhongor NP 262855.8119 379164.3547 54 Zag Baidgar river NP 116308.5428 55 Tujiin nars Selenge NP 70804.71976 70804.71976 56 valley Arkhangai, Uvurkhangai NP 92717.98585 103867.05 57 Khuisiin naiman lake Arkhangai NM 11149.06413 58 Ikh gazar chuluu Dundgobi NR 175906.1387 175906.1387 59 Khuvsgul Khuvgul NP 1175602.174 1206879.379 60 Dayan deerkhi cave NM 31277.20524 61 Ulaan taiga Khuvgul SPA 431694.4634 1534077.778 62 Khoridol Saridag SPA 226672.0417 63 Tengis-Shishged NP 875711.2729 64 Zed-Khantai-Buteeliin- Bulgan SPA 604265.563 604265.563 nuruu 65 Myangan Ugalzat Khovd NP 303775.0681 303775.0681 66 Bulgan river- Ikh Khovd NP 92743.66388 598840.3653 Ongog 67 Munkhkhairkhan NP 506096.7014 mountain Uyench 68 Ikh Nart Dornogobi NR 66752.0 66752.0 69 Khar Ymaat Dornod NR 50691.0 50691.0

9. Cultural heritage 177. A total of 460 historical, archeological and cultural sites are registered and protected by the Government of Mongolia. Of which, 285 are protected by the local governments. Below Table IV.2 shows number of protected cultural sites by each province. Table IV.2: Number of Heritage, Cultural and Religious Sites in Mongolia

# Name of Number of heritage, cultural and Number of heritages, cultural and Provinces religious sites religious sites in/nearby project sites Under State Under Provincial Under State Under provincial protection protection protection protection 1 Arkhangai 14 24 - - 2 Bayn-Ulgii 16 13 - - 3 Baynkhongor 10 10 None None 4 Bulgan 10 25 None None 5 Gobi-Altai 8 29 None None 6 Gobisumber 0 2 None None 7 Uul 3 2 None None 8 Dornogobi 5 8 None None 9 Dornod 3 8 None None 10 Dundgobi 7 16 - - 11 Zavkhan 6 5 - -

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# Name of Number of heritage, cultural and Number of heritages, cultural and Provinces religious sites religious sites in/nearby project sites Under State Under Provincial Under State Under provincial protection protection protection protection 12 Orkhon 0 1 None None 13 Uvurkhangai 9 26 None None 14 Umnugobi 8 15 - - 15 Sukhbaatar 8 4 - - 16 Selenge 2 5 None None 17 Tuv 15 6 - - 18 Uvs 5 8 - - 19 Khovd 9 8 - - 20 Khuvsgul 9 26 - - 21 Khentee 13 23 - - 22 Ulaanbaatar 15 11 None None TOTAL 175 285 Source: “Guideline for registration of cultural heritages” by MOH and Centre for Cultural Heritages of Mongolia, 2014.

B. Environment at Tranche-1 subproject areas 178. There are 13 subprojects in the Tranche-1 phase of the project. Locations of the Trache- 1 subprojects are shown in below Table IV.3. Table IV.3: Subproject locations for Tranche-1 № Tranche-1 components Location City Coordinates 1 Khan-Uul district hospital Ulaanbaatar city 106°49'57.80"E 47°52'5.40"N 2 Khovd province hospital Khovd city 91°37'59.51"E 48° 0'13.58"N 3 Uvs province hospital Ulaangom city 103° 11' 05"E 46° 39' 58.5"N 4 Emergency Center 106° 55' 25.63" 47° 54' 55.16" 5 FHC at Khan-Uul 10th Khoroo 106°45'38.99"E 47°51'30.04"N 6 FHC at Khan-Uul 14th Khoroo Ulaanbaatar city 106°42'31.52"E 47°47'25.00"N 7 FHC at Chingeltei 19th Khoroo 106°55'17.40"E 47°59'41.31"N 8 FHC at Bayanzurkh 17th Khoroo 107° 0'14.68"E 47°55'41.85"N 9 SHC in Erdenemandal Soum 101°22'29.95"E 48°31'45.35"N 10 SHC in Tarialan Soum Khuvsgul province 101°59'18.13"E 49°36'53.52"N 11 SHC in Bayan-Undur Soum Uvurkhangai province 104° 7'7.53"E 67

№ Tranche-1 components Location City Coordinates 46°29'51.06"N 12 SHC in Erdene Soum Dornogobi province 111° 5'14.6"E 44°26'38.4"N 13 SHC in Dashinchilen Soum Bulgan province 104° 2'32.30"E 47°51'0.35"N

Figure IV.3: Location of Tranche-1 Components in Mongolia

179. 6 of the 13 Tranche-1 subprojects are located within the Ulaanbaatar (UB) city as shown in below Figure IV.4.

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Figure IV.4: Location map of Tranche-1 Components in Ulaanbaatar city 180. Following sections of this chapter provides baseline environmental descriptions for the subproject areas and locations. 13 Tranche-1 subprojects are located in 8 different areas: i) Ulaanbaatar city within which 6 subprojects are located ii) Khovd city iii) Erdenemandal Soum iv) Tarialan Soum v) Bayan-Undur Soum vi) Erdene Soum vii) Dashinchilen Soum viii) Ulaangom city. Baseline environmental condition for all 8 project areas are described in following sections.

C. Topography 1. Topography of Ulaanbaatar city 181. By physical geographical divisions of Mongolia, Ulaanbaatar and its surrounding area is located in the southwestern edge of Khentii Mountain, in particular, the Tuul River flood plain and terrace, expanding up to 2.5-4 kilometers (km) in width. Geographically, it is in forest- steppe region which is surrounded by Bogdkhan, Songinokhairkhan, Chingeltei and Bayanzurkh Mountains, elevated 1950-2268 meters (m) above sea level. 69

Figure IV.5: Topography Map of Ulaanbaatar City 182. Bogdkhan is a mountain chain that stretches 40 km from east to west. The highest peak is Tsetsee Gun, elevated 2268 m above sea level. An ancient flat surface that is 2000 m above sea level is dominant in the mountain. Northwest of the city there are two major mountains, the 1831 m high Tolgoit Mountain and 1800 m high Chingeltei Mountain. The summit of the mountains are rounded and mountainsides lower gradually, turning to hills such as Maanit, Tasgany Ovoo and Naran edging the Tuul River valley. 183. There is tectonically originated Songinokhairkhan Mountain in the west whose absolute height is 1652 m and Bayanzurkh Mountain in the east whose absolute height is 1527 m. Those mountains have relatively steep sides, pointed tops and ravines. Difference of relative elevation of those mountains and valleys between the mountains is generally 400-500 m and sometimes reaches 700-920 m. 184. The elevation of the Tuul River Basin is 1250-1345 m and river width reaches 1.2-4.0 km. Absolute height of the small mountains such as Tolgoit, Bayankhoshuu, Bayantsogt, Khoid Bayan and Tsagduult is 1515-1831 m, while their sides or slope is usually 15-20 degrees and reach sometimes 30-35 degrees. A number of dry riverbeds and ravines are found crossing the sides and downhill of the mountains. 185. The majority of buildings in Ulaanbaatar were built in the Tuul River Basin, downstream area of Selbe River and terraces of Zuun Naran, Baruun Naran and Tsagaan Khuaran. State buildings or objects of special purpose are located within the protected zones of Ikh Tenger and Baga Tenger, in the southern edge of the Tuul River Valley. Additionally, there are small private housing complexes, summer houses and ger districts in Selbe, Khul and Belkh River

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valleys, Khar Usan Tokhoi of Tuul River, Mogoin Denj, Ikh Khuandai, downstream of Uliastai and Gachuurt Rivers, and Zuun Salaa and Baruun Salaa of Tolgoit River. 2. Topography of Khovd City 186. The project area is located within the Altai Sayan Eco-Region that includes Mongolia, China, Russia and Kazakhstan. The Altai Mountains in Mongolia’s Western Region stretch approximately 1,500 km. The average altitude of Khovd province is 2,230 m with the lowest point at 1,350 m in Bayannuur Soum, and the highest being the peak of the Altai Tavan Bogd Mountain at 4,650 m. The topographic features dry steppe and steppe, as well as high mountain areas running in north-west direction. The landscape surrounding Khovd is primarily meadow landscape on saline soils with sedges on river valley bottom. area includes extensive rolling ranges, medium rolling ranges and mountains, slight rolling ranges of sloped structure, mountainous ravines, semi-level surfaces of mountain skirts, glacial valleys, mountains with sharp ridged peaks, alluvial lake valleys, delluvial—prolluvial and mountain river valleys.

Figure IV.6. Topographical map of Khovd 3. Topography of Erdenemandal Soum 187. Erdenemandal Soum center is located at 460 km distance from Ulaanbaatar city in the western direction. It is the northern most Soum in the Arkhangain province. Erdenemandal Soum center is located within the stepped forest sub-zone in the Hanui river basin on the northern edge of the Khangai mountain range. There are a number of highly elevated mountains of the Khangai range on both eastern and western sides of low land of the Hanui river valley where the Soum center is located. 71

Figure IV.7. Topographical map of Erdenemandal Soum 4. Topography of Tarialan Soum 188. Tarialan Soum of Khuvsgul province is located in the northern Mongolian steppe-forest zone in the Selenge river basin. The valley in which the Tarailan Soum center is located is a plain steppe surrounded with small mountains with scattered forest. The Soum center is located at 521 km distance from Ulaanbaatar city in northwest direction.

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Figure IV.8. Topographical map of Tarialan Soum 5. Topography of Bayan-Undur Soum 189. Bayan-Undur Soum center is located at 340 km distance from Ulaanbaatar city in the south-western direction. It is located within the central Mongolian steppe zone on the eastern edge of the Khangai mountain range. Landscape in the Soum is shaped by dry and plain steppes surrounded with mountains. 73

n Figure IV.9: Topographical map Bayan-Undur Soum center 6. Topography of Erdene Soum 190. Erdene Soum is located at 600 km distance from Ulaanbaatar city in south-eastern direction nearby China-Mongolia border. Trans-Mongolian railway line and Ulaanbaatar- Zamyn-Uud highway (a part of the Asian Highway No.2) traverse through the Erdene Soum territory. It is located in the midst of the central Asian Gobi Desert. Landscape of the Soum is shaped by arid and plain steppes with scattered vegetation and sand dunes in the southern part.

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Figure IV.10. Topographical map of Erdene Soum

7. Topography of Dashinchilen Soum 191. Geographically, Dashinchilen Soum center is located within the central Mongolian steppes natural zone. It is located in the Khar buh river basin in southern part of Bulgan province. Landscape of the project area is shaped by valleys between small hills and mountains on the south and meadowland of Khar Bukh river on the north.

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Figure IV.11. Topographical map of Dashinchilen

8. Topography of Ulaangom 192. Geographically, the Ulaangom city is located in the Great Lake Depression in western Mongolia with altitude of 939m above sea level. In terms of natural zonation, it falls in the semi-arid steppe-desert. The city is located on plain steppes surrounded by Harhiraa, Turgen and Han-Huhii mountains on its west, south and northwest and depression of Uvs lake on its northeast. Its landscape is shaped by highly elevated mountains of Harhiraa and

76

Han Huhii mountain ranges, sharp slopes on the mountains foots on south and west, valleys between small hills with average slopes on its north and east.

Figure IV.12. Topographical map of Ulaangom city

D. Climate 1. Climate Condition in Ulaanbaatar City 193. Six of Tranche-1 components such as Khan-Uul and Chingeltei district hospitals, Emergency Health Center and 4 family health centers are located within the Ulaanbaatar city which has extreme continental climate and falls in the and semi-arid climate zone of the eastern Central Asia. In terms of natural zonation of Mongolia, Ulaanbaatar city falls in the steppe-forest zone of northern Mongolia. It has 4 seasons which comprises of short and warm summer (June to August), dry and cool autumn (September to October), long, harsh, cold winter (November to February) and dry and windy spring (March to May). 77

194. Air temperature. Ulaanbaatar is the coldest capital city in the world where the air temperature in winter is as low as 39.8°. The mean annual air temperature is 0.3°, while average temperature in January which is the coldest month of year is -21.5°. Monthly mean, maximum and minimum air temperatures for the last 15 years are shown in below tables. Table IV.4: Monthly Mean Air Temperature in Ulaanbaatar City, 2003-2017, °C

Months Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2003 -20.6 -15.1 -7.5 3.1 9.5 17.0 18.8 14.2 10.3 0.3 -12.7 -21.2 2004 -21.3 -14.7 -10.0 4.4 9.6 18.0 19.0 16.3 9.8 1.5 -10.1 -17.2 2005 -22.0 -24.4 -8.2 1.9 9.0 16.1 20.5 18.3 9.9 2.6 -8.5 -19.4 2006 -20.4 -17.3 -6.3 -0.5 8.0 15.2 18.0 17.6 11.0 2.3 -8.4 -16.1 2007 -18.7 -10.7 -9.0 3.6 11.8 18.7 21.9 18.3 13.2 0.2 -9.0 -16.8 2008 -23.6 -17.7 -2.4 5.2 8.2 17.4 20.2 17.8 10.9 1.5 -7.1 -19.1 2009 -20.5 -17.3 -7.5 7.2 12.3 16.8 19.3 16.8 10.1 1.2 -13.5 -20.9 2010 -23.6 -20.8 -11.5 -2.2 12.1 19.4 21.7 15.6 12.2 1.6 -8.9 -19.2 2011 -23.8 -15.6 -9.6 4.2 8.2 17.3 17.4 18.4 8.0 3.7 -10.4 -22.1 2012 -25.5 -20.2 -8.0 2.7 11.5 15.2 18.0 15.9 11.6 0.2 -12.3 -22.4 2013 -20.8 -19.4 -6.3 0.2 11.6 15.8 17.9 15.5 9.3 1.0 -8.0 -15.9 2014 -18.5 -18.4 -4.7 6.9 8.2 15.4 17.9 16.3 9.9 3.7 -8.2 -16.6 2015 -15.6 -12.9 -6.2 4.1 9.0 16.7 19.9 18.8 10.7 2.9 -10.9 -15.7 2016 -23.9 -16.3 -4.7 3.5 9.1 15.6 20.7 17.6 10.6 -1.7 -13.7 -16.5 2017 -20.0 -13.7 -4.2 5.0 12.7 19.3 21.0 15.8 9.7 0.7 -12.2 -16.7

195. Construction season in Ulaanbaatar is relatively short and lasts between mid-April and mid-October only when the monthly mean air temperature is above 0°C. Table IV.5: Monthly max air temperature in Ulaanbaatar city, 2010-2017, °C

Months Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2010 -6.2 -4.6 8.2 22.3 29.5 38.3 37.4 30.0 31.5 21.6 8.1 -3.0 2011 -9.6 2.0 12.6 24.4 27.2 32.5 30.0 33.0 25.2 22.0 10.5 -9.0 2012 -9.4 -4.3 14.4 22.4 30.0 32.7 29.4 31.4 27.4 19.0 9.6 -9.5 2013 -7.1 -2.5 9.6 19.5 28.7 29.0 30.0 27.4 26.5 20.2 9.1 -3.1 2014 -3.7 2.1 12.1 23.2 32.6 29.6 32.5 29.0 31.7 17.1 9.2 -6.3 2015 -3.6 2.7 17.5 26.7 28.3 31.1 33.7 33.7 27.3 20.2 10.3 -6.9 2016 -12.3 -1.2 12.7 18.7 28.0 29.4 34.6 36.7 22.8 18.8 6.7 -4.3 2017 -4.8 -0.8 13.1 23.1 31.4 34.5 36.9 29.0 26.1 17.7 9.4 -1.5

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Table IV.6: Monthly min air temperature in Ulaanbaatar city, 2003-2017, °C

Months Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2003 -34.0 -31.5 -24.4 -10.9 -1.5 3.6 7.3 3.1 -0.3 -11.5 -24.9 -34.5 2004 -31.6 -28.0 -27.1 -14.9 -7.6 2.5 5.4 2.3 -7.4 -17.9 -24.6 -33.3 2005 -33.2 -35.0 -28.2 -14.0 -8.4 2.1 9.0 3.0 -3.3 -7.9 -17.4 -30.1 2006 -31.1 -36.9 -21.5 -15.8 -6.1 2.0 6.7 5.2 -3.2 -12.8 -25.7 -27.3 2007 -26.8 -22.6 -26.7 -12.6 -1.8 0.5 8.0 8.7 -3.4 -15.6 -20.9 -26.6 2008 -33.8 -31.6 -18.1 -10.2 -5.3 1.8 9.2 2.2 -3.6 -14.0 -20.0 -31.8 2009 -32.9 -33.3 -25.7 -8.1 -4.0 1.8 10.2 4.2 -4.4 -12.7 -25.5 -33.6 2010 -35.7 -33.1 -29.1 -17.0 -1.5 3.3 7.3 3.2 -5.3 -9.8 -23.9 -33.2 2013 -33.2 -29.9 -20.8 -14.8 -1.1 1.8 7.3 3.3 -4.2 -12.7 -21.4 -28.7 2014 -31.6 -29.5 -22.2 -8.1 -8.0 1.0 8.4 4.6 -8.8 -8.7 -23.8 -26.7 2015 -26.7 -24.8 -22.4 -16.7 -5.4 2.8 10.1 7.8 -2.6 -8.9 -30.2 -30.4 2016 -32.0 -26.8 -24.4 -8.9 -7.3 6.8 8.6 2.2 -4.1 -19.2 -31.5 -26.9 2017 -31.4 -25.6 -15.9 -8.2 -6.0 4.0 9.0 2.4 -6.1 -10.8 -26.7 -25.5

196. Precipitation. In terms of precipitation, Ulaanbaatar city belongs to the Arctic ocean watershed. The annual precipitation level in the city is about 262mm. Average annual moisture level is around 0.36% with highest moisture level (75-80%) occurring in January and lowest in May (45-50%). 87% of the total precipitation which equals to 180 mm falls during the summer season between June and August. It has snow cover for about 130 days a year (multi-year average) between November 10 and March 20. Below table shows the monthly precipitation level recorded during the last 15 years between 2003 and 2017. Table IV.7: Monthly Precipitation Level in Ulaanbaatar City, 2003-2017

Months Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2003 1.4 6.2 1.3 3.3 51.4 22.3 75.3 46.3 51.6 2.9 19.2 6.8 2004 2.3 8.9 7 16.5 25.6 85.8 48.6 16.8 34.6 3.5 5.6 5.5 2005 4.4 4.6 4.8 10.5 13.6 24.4 59.9 41.8 23.9 1.5 1.7 2.2 2006 5.1 1.1 3.5 5.6 70.1 26.3 86.4 26.2 18.4 10.2 3.1 1.8 2007 4.4 6.7 11.5 4.5 18.6 23.2 35.5 72.6 0.8 1.8 2.1 4 2008 2.2 0.9 2.3 1.4 12.4 67.2 69.1 41.3 14 10.8 0.7 6.2 2009 0.9 2.8 3.8 2 39 31.1 118 47.3 13.8 8.1 1.8 5.5 2010 2.3 4.4 7.2 1.1 25.7 23.3 79.6 65.8 8.9 12.6 7.6 1.2 2011 1.4 8.2 0.4 11 27.4 77.3 58.3 43.9 7.6 10.5 11.7 2.1 2012 0.7 1.4 0.9 6.5 9 70.1 106.8 56.7 17.5 3.8 7.8 6.2 79

Months Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2013 1.4 1.8 11.2 13.6 26.8 36.8 37.2 75.4 15.8 34.5 3.8 1.4 2014 0.9 1.9 2 6.8 40 62.4 100.4 55.2 19.1 1.5 0.9 3.1 2015 1.3 0.8 20.5 22.6 12.7 9.2 125.5 30.8 22.6 14.2 5.1 4.5 2016 1.2 1.4 10.9 3.2 33.2 68.4 80.5 45.2 24.5 13.7 18.4 1.1 2017 0.8 0.2 1.9 2.6 11 70.4 28.1 94.6 48.1 16.1 11.2 2.4

197. Wind regime. The predominant wind directions in Ulaanbaatar city are north-to-south and northwest to southeast. Average annual wind speed is 2.2 m/sec. Wind speed is at its lowest during the winter season due to anti-cyclone centered in western Mongolia while during the spring, the most windy season of year, it reaches up to 15-20 m/sec in April and May. Below tables show monthly average and maximum wind speed recorded during the last 15 years between 2003 and 2017. Table IV.8: Monthly average wind speed, m/sec

Months Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2003 0.9 1.4 1.6 2.3 2.4 2.3 1.9 2.1 1.8 1.2 1.3 0.6 2004 0.9 1.2 1.8 2.1 2.5 2.3 2.0 1.7 2.0 1.3 1.3 1.0 2005 1.1 1.0 1.9 3.3 3.4 2.9 2.9 2.7 2.8 2.4 1.8 1.5 2006 1.0 1.5 2.0 2.7 2.5 2.0 1.5 2.4 2.2 2.2 1.3 1.0 2007 0.9 1.3 1.5 2.3 2.7 2.7 2.1 2.1 2.0 1.7 1.3 0.8 2008 0.9 1.1 2.0 3.1 3.3 3.1 2.9 2.8 2.8 2.5 1.9 1.6 2009 1.4 2.2 2.6 3.0 3.5 3.5 3.1 2.9 3.0 2.4 1.8 1.8 2010 1.9 2.1 2.8 2.9 3.6 3.2 3.1 2.8 2.7 2.1 1.9 1.7 2011 1.3 1.7 2.3 3.1 3.2 3.0 2.8 2.7 2.6 2.2 2.0 1.2 2012 1.1 1.8 2.4 3.2 3.4 2.7 2.2 2.8 2.5 2.2 2.1 1.6 2013 1.2 1.6 2.4 2.6 3.2 3.1 2.1 2.3 2.5 2.3 1.4 1.0 2014 1.3 1.7 2.3 2.7 3.0 2.9 2.6 2.7 2.5 2.0 1.7 0.8 2015 1.0 1.2 1.6 2.2 2.7 2.2 2.3 2.0 2.0 1.6 1.2 0.6 2016 0.6 0.9 1.2 2.1 2.2 1.7 2.4 2.2 2.1 2.2 1.6 0.9 2017 1.2 1.5 1.8 2.2 2.8 2.3 1.5 2.1 2.5 1.7 1.3 1.0

Table IV.9: Monthly max. Wind Speed, m/sec

Months Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2003 20 12 12 16 20 14 12 12 16 16 18 12

80

Months Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2004 12 14 16 18 16 16 14 14 14 10 10 12 2005 10 12 12 24 21 20 22 24 21 17 14 10 2006 5 12 14 20 20 17 20 20 21 18 17 10 2007 15 12 17 14 14 18 17 18 16 13 10 9 2008 7 8 14 21 20 30 21 24 16 16 14 17 2009 14 19 18 20 19 21 20 17 20 16 15 18 2010 13 22 19 19 22 25 17 22 14 14 20 13 2011 10 11 20 19 23 20 18 18 19 16 13 9 2012 10 13 17 20 19 20 17 20 20 14 13 13 2013 12 14 18 15 22 18 15 15 16 19 14 15 2014 12 12 18 24 19 23 22 20 21 17 17 12 2015 12.0 14.0 14.0 20.0 19.0 19.0 21.0 22.0 18.0 19.0 13.0 12.0 2016 11.0 14.0 20.0 18.0 21.0 15.0 20.0 14.0 13.0 23.0 12.0 11.0 2017 16.0 14.0 12.0 16.0 20.0 23.0 18.0 20.0 14.0 16.0 14.0 10.0

2. Climate condition in Khovd city 198. The project area – Khovd city has a continental dry climate. It has a short summer where the maximum air temperature reaches as high as 37° and a long harsh winter where the minimum air temperature reaches as low as -43°. Mean annual air temperature is 1.5° in the city. The coldest month is January where the average monthly temperature is around - 23.5° while July is the hottest month where the average monthly temperature is around 20.9°. Below tables show monthly mean, maximum and minimum air temperatures recorded during the last 15-year period between 2003 and 2017. Table IV.10: Monthly Mean Air Temperature, Khovd City, °C

Months Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2003 -21.5 -19.2 -7.6 2.7 11.8 19.4 18.6 14.8 12.0 2.0 -10.5 -19.5 2004 -23.2 -11.6 -4.1 8.1 13.6 18.2 21.1 17.2 10.9 2.0 -10.1 -16.0 2005 -31.3 -30.6 -9.3 6.5 11.4 18.1 21.4 17.6 12.1 3.5 -8.0 -23.9 2006 -19.4 -12.5 -3.3 5.6 10.8 17.7 20.3 18.3 11.8 4.6 -6.2 -16.7 2007 -22.0 -12.8 -4.6 6.9 14.5 19.5 22.5 18.9 12.9 1.1 -8.0 -19.7 2008 -26.8 -21.9 -1.6 6.4 14.0 19.0 20.6 19.3 12.1 3.9 -6.5 -18.0 2009 -24.2 -14.9 -3.2 8.6 13.6 17.2 19.9 17.6 11.0 4.4 -13.9 -22.8 2010 -25.0 -24.3 -8.9 1.3 11.4 19.1 20.9 16.5 11.7 3.0 -5.1 -15.0 81

Months Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2011 -30.9 -19.9 -9.1 7.7 11.4 18.8 19.5 19.3 10.2 3.8 -8.1 -20.7 2012 -28.3 -23.4 -7.1 6.3 12.7 20.5 20.8 17.5 12.4 2.4 -8.1 -18.6 2013 -20.2 -16.2 2.2 7.0 12.2 17.2 20.0 18.6 11.2 3.3 -9.6 -19.8 2014 -20.4 -21.5 -4.6 7.4 11.5 17.7 20.8 18.4 10.9 5.9 -8.1 -19.4 2015 -15.9 -13.6 -4.3 7.2 13.1 17.3 22.1 19.8 10.5 3.6 -7.6 -14.7 2016 -25.1 -22.7 -3.0 7.8 10.4 18.9 21.7 18.3 13.9 1.0 -7.9 -12.9 2017 -18.4 -11.7 -2.9 8.6 15.3 20.9 22.9 17.9 12.4 1.9 -7.2 -18.7 Source: Weather station at Khovd city

199. Based on the climate in the area, it can be said that duration of construction season relatively short, between mid-April and mid-October, when air temperature is above °0C. Table IV.11: Monthly Maximum Air Temperature, Khovd City, °C

Months Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2003 -4.5 2.3 16.9 28.0 27.0 32.0 30.6 27.0 28.5 21.0 8.2 -4.1 2004 -7.4 10.2 13.8 24.2 29.9 31.0 37.0 32.0 27.5 20.0 11.2 6.8 2005 -15.5 -17.5 11.0 24.9 25.0 34.3 32.4 30.0 28.5 17.5 10.0 -5.9 2006 2.0 6.0 18.4 28.3 25.4 31.8 34.0 31.7 28.3 19.2 16.2 -0.5 2007 -7.8 7.7 11.0 22.8 29.6 33.5 36.0 32.5 28.2 17.0 9.2 -2.0 2008 -14.4 1.4 13.5 22.6 27.3 33.0 31.0 35.5 24.7 18.6 12.8 8.0 2009 1.6 6.5 15.2 23.5 28.2 31.4 32.0 31.0 24.1 20.8 16.5 -0.6 2010 1.3 4.2 16.5 23.1 27.8 33.7 31.8 31.8 28.1 23.3 11.8 12.2 2011 -14.4 -4.5 12.8 24.5 26.2 28.3 35.6 30.4 25.0 20.9 6.9 -7.6 2012 -12.5 -5.7 12.8 20.8 26.5 33.5 30.6 31.0 29.0 17.0 7.7 -4.6 2013 4.0 2.2 17.9 24.3 25.5 31.9 30.1 28.9 27.8 25.3 9.6 -1.1 2014 2.7 1.7 14.2 22.3 28.4 28.7 33.3 34.0 32.4 19.3 7.4 -2.8 2015 4.9 7.3 16.5 25.2 27.4 31.1 37.0 35.4 29.0 21.0 12.0 2.8 2016 -4.5 -4 16.3 21 26.9 33.3 32.1 30.5 28.5 19.9 17.9 2.3 2017 -0.3 6.3 15.5 22.3 30.7 32.7 34.9 31.4 29 17.8 10.2 -4.2 Source: Weather station at Khovd city

Table IV.12: Monthly minimum Air Temperature, Khovd City °C

Months Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2003 -32.0 -36.0 -22.2 -15.6 -1.5 7.8 9.0 2.6 -4.6 -14.5 -24.2 -29.8

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Months Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2004 -32.3 -31.4 -18.4 -7.0 -6.4 1.5 9.5 3.4 -9.3 -11.5 -23.0 -41.1 2005 -42.3 -43.0 -31.5 -12.4 -6.3 2.5 10.0 4.9 -3.0 -10.4 -24.5 -33.1 2006 -32.4 -25.1 -21.9 -10.8 -4.9 -0.9 7.3 6.9 -1.0 -9.4 -22.3 -25.4 2007 -30.6 -25.2 -21.4 -13.9 -0.1 1.8 11.6 7.1 -4.4 -13.2 -20.3 -30.9 2008 -37.5 -37.2 -17.0 -9.9 -6.5 5.0 7.6 2.8 -5.1 -9.6 -19.8 -33.9 2009 -35.0 -27.1 -23.2 -4.4 -2.4 3.4 8.0 5.7 -3.0 -9.6 -27.4 -32.8 2010 -36.9 -41.0 -28.2 -20.6 -2.1 4.4 7.5 3.7 -0.8 -9.9 -24.7 -30.0 2011 -40.8 -32.9 -26.7 -8.6 -2.7 7.5 5.3 3.5 -3.2 -11.6 -19.0 -30.2 2012 -37.8 -35.6 -24.5 -9.3 -2.8 9.1 10.7 4.6 -2.3 -15.1 -23.7 -30.9 2013 -32.7 -28.8 -16.5 -12.7 -1.4 5.7 9.0 5.2 -5.5 -10.4 -25.0 -30.5 2014 -31.3 -34.7 -22.0 -7.6 -1.4 2.3 6.6 5.8 -4.1 -14.1 -26.1 -29.7 2015 -28.6 -28.5 -25.0 -10.6 -2.1 2.4 6.4 5.6 -5.4 -13.2 -22.0 -25.6 2016 -39.7 -36.6 -21.2 -6.4 -4.3 8.5 11.3 4.5 0.1 -21.6 -27.1 -23.9 2017 -30.9 -27.2 -16.4 -5.8 -10.9 6.2 10.6 4.1 -4.8 -12.7 -22.1 -27.9 Source: Weather station at Khovd city

200. Precipitation. Total annual precipitation in the Khovd city is 130.1mm. Two thirds of the total precipitation which equals to 82.3 mm falls during the summer period between June and August. Monthly precipitation levels recorded during the last 15 years are shown in below table. Table IV.13: Monthly precipitation level, Khovd City mm

Months Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2003 1.3 5.9 8.2 1.7 27.1 21.6 46.9 101.6 1.9 2.6 2.7 1.9 2004 2.7 1 1.1 22.6 18.3 22.9 12.7 13.9 0.9 5.8 2005 0 0.4 1.4 13.9 45.2 7.2 62.6 0.9 0.6 2.5 1.1 2006 0.2 2.5 5.6 17.1 27.1 11.1 11.5 8.3 0 0.8 2007 2.3 1.2 6.7 3.5 6 28.8 24.1 5.4 5.7 0.5 2.5 2008 0.9 2.5 15.4 0.9 11.5 11.6 33.2 4.6 15 1.3 0.2 6.9 2009 0 2.5 5.8 3.8 6.1 16.2 27.2 17 4.3 10 4 4.2 2010 3.6 0.9 1.5 13.9 22.6 46.1 10.9 39.5 24.3 0.3 8.9 0.5 2011 2.7 0.6 5.9 11.3 10.3 55 23.1 7.8 8.5 2.2 1.9 2012 0.9 0.2 10.1 12.8 17.8 56.2 36.5 6.5 15.2 2.7 1 2013 1.2 4.2 5.1 0.2 51 53.2 25.5 22.4 8.4 3.6 0.3 2014 0 2.9 1.8 4.8 51.1 30 16.1 24.2 0.6 7.6 1.1 2015 4.4 1.8 0.9 3.1 60.1 4.7 17.9 3.3 5.1 2.8 0 2016 6.6 1.7 9.4 31.6 23.6 39.9 22.4 6.6 4.1 11.6 0.4 0.3 2017 1.9 10.7 6.5 4.1 5.9 5.4 21 14.2 1 0 3.3 83

Source: Weather station at Khovd city

201. Wind regime. The predominant wind direction the project area is west-to-east and northwest-to-southeast. Annual mean wind speed is 1.8 m/sec while the maximum wind speed is around 14 m/sec. Spring months (March, April and May) are considered to be the most windy period of year where maximum wind speed reaches 21 m/sec occasionally. Table IV.14: Average Wind Speed by Months, m/sec

Months Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2003 0.5 0.6 0.8 1.8 0.8 1 0.9 0.7 1.3 1.1 0.9 0.2 2004 0.1 0.8 2 1.4 1.7 1.4 1.6 1.3 2.1 1.1 2 1.4 2005 1 1.3 1.9 3.6 3.1 3.1 1.4 1.1 1.5 1.2 1.2 0.7 2006 1.3 1.5 1.9 3.4 2.9 1.7 1.6 1.9 1.4 1.7 0.8 0.4 2007 0.6 1.5 2.1 1.9 3.6 2.1 1.5 1.5 1.6 1.6 1 0.7 2008 0.2 1.1 1.1 3.4 3.4 2.7 2.5 2.8 2.7 1.9 1.2 1 2009 0.7 1.3 1.8 2.7 3.2 3.3 2.6 2.3 2.2 2.5 1.6 1.2 2010 1.3 1.5 3.1 2.5 3.5 2.5 2.5 2.2 2.2 1.8 2.3 2 2011 1.1 1.3 2.1 2.4 3.2 2.6 2.5 2.4 2.2 1.9 1.6 0.9 2012 1 1.3 2.1 2.7 3 2.5 2 1.6 1.2 1.3 1.5 0.5 2013 0.6 1.2 1.6 2 3.1 2.2 1.7 1.5 1.6 1.5 0.8 0.8 2014 1.3 0.8 1.1 1.9 2.5 1.7 1.8 1.4 2 3 2.2 1.4 2015 1.7 1.7 2.5 3.2 3.1 2.5 3.2 2.5 2.7 2.5 1.7 1.4 2016 1 1.2 2 3 3.3 2.6 2.5 2.6 2 2.2 2.2 1.5 2017 1.3 1.6 1.7 2.7 3.4 2.6 2.6 2.3 3 2.2 1.6 1.1 Source: Weather station at Khovd city

Table IV.15: Maximum Wind Speed by Month, Khovd City, m/sec

Months Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2003 6 14 12 16 12 12 10 9 10 16 12 10 2004 4 14 16 16 12 14 12 14 12 9 14 14 2005 3 5 12 26 18 22 12 10 20 14 16 19 2006 26 26 26 27 27 10 12 28 14 20 14 8 2007 2 20 24 16 20 16 14 14 14 20 20 12 2008 4 14 24 25 20 20 18 24 19 21 17 18 2009 14 16 28 17 23 20 18 18 21 24 22 16 2010 15 17 29 22 32 18 23 20 16 19 30 24 2011 3 7 22 24 22 19 21 20 18 17 23 17 2012 4 7 16 23 28 17 16 18 14 14 20 10 2013 20 24 24 16 22 18 14 14 16 16 12 8

84

Months Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2014 16 10 12 18 18 14 22 14 14 19 22 15 2015 17 20 17 21 19 17 19 16 20 22 19 16 2016 5 6 17 17 27 16 16 16 20 30 18 20 2017 10 16 12 20 22 19 20 18 34 18 16 16 Source: Weather station at Khovd city

3. Climate condition in Erdenemandal Soum 202. Erdenemandal Soum of Arkhangai province has cold continental climate due to its location in relatively elevated region of eastern Khangai mountain range. 203. Air temperature. Mean annual air temperature is 0.80 Celsius degree. January is the coldest month with average air temperature of 18-200 while July is the hottest month with average air temperature of 18-190. Table IV.16: Mean air temperature by months, 2013-2017, 0C Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 -18.6 -18.3 -2.7 1.9 9.5 13.6 15.8 14.0 7.7 0.7 -5.9 -12.9 2014 -13.5 -16.2 -4.3 5.2 7.9 13.4 16.6 14.1 7.3 2.6 -8.4 -15.5 2015 -13.0 -12.7 -6.3 3.9 8.0 14.5 17.9 16.1 7.5 2.0 -11.1 -12.3 2016 -22.9 -13.5 -3.3 3.5 7.9 13.5 18.4 15.1 9.9 -3.9 -10.4 -13.7 2017 -18.2 -13.2 -4.7 4.9 11.8 17.0 19.0 14.5 8.8 -0.8 -6.9 -11.3

Table IV.17: Maximum air temperature by months, 2013-2017, 0C Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 -0.3 -2.0 12.0 22.0 27.0 28.6 28.0 23.5 24.0 19.8 12.5 2.8 2014 4.3 5.9 14.0 21.5 31.0 27.3 31.4 29.0 29.5 18.5 12.3 -0.2 2015 6.0 9.0 18.0 26.1 27.3 30.5 32.0 33.3 25.1 20.8 14.6 -0.9 2016 -3.9 5.7 14.6 17.4 25.0 26.5 32.8 32.3 23.8 16.3 10.5 2.7 2017 -3.1 0.1 14.2 22.0 30.4 33.3 34.4 29.6 26.3 20.7 15.2 1.4

Table IV.18: Minimum air temperature by month, 2010-2017, 0C Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 -32.9 -34.5 -20.2 -15.3 -5.9 -1.5 4.2 4.5 -6.0 -14.9 -21.7 -30.0 2014 -28.5 -30.0 -22.0 -9.2 -6.5 -1.7 4.2 0.3 -9.5 -11.3 -26.2 -28.5 2015 -28.3 -29.2 -24.5 -21.2 -7.9 -0.8 4.2 4.0 -8.9 -14.7 -33.4 -26.6 2016 -34.1 -28.3 -24.4 -12.0 -4.7 3.0 7.5 2.4 -1.9 -19.8 -34.5 -25.0 2017 -31.1 -26.5 -17.2 -8.0 -6.0 1.3 5.8 -0.6 -7.7 -16.2 -21.7 -24.6

204. Precipitation. Mean annual precipitation in Erdenemandal Soum is around 200mm. About 80% of total annual precipitation fall during summer months of May, June, July and August. Below table shows monthly precipitation recorded during the last 5 years. 85

Table IV.19: Monthly total precipitation, mm, 2013-2017 Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 0.0 2.2 0.0 4.8 26.6 46.6 30.7 69.5 10.0 2.4 0.0 4.1 2014 0.0 0.0 1.4 13.7 19.2 21.4 34.2 54.8 15.7 7.9 2.6 0.0 2015 0.0 4.0 0.0 2.9 17.4 9.0 36.3 36.9 12.7 0.0 2.1 1.1 2016 2.4 0.0 3.9 33.1 21.3 52.8 64.7 30.5 24.2 17.5 3.8 2.9 2017 0.0 1.1 0.0 4.0 9.8 16.1 32.5 68.4 7.9 8.8 0.0 0.0

205. Wind regime. The predominant wind direction is from northwest to southeast. Mean annual wind speed is 3-4 m/sec. Wind speed increases during spring months between March and May and decreases during the autumn and winter months. Below tables show average and maximum wind speed in each month during the last 5 years. Table IV.20: Average wind speed in each month, m/sec Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 1.8 2.1 3.3 2.8 3.0 2.3 1.3 1.6 2.2 2.5 2.5 1.9 2014 1.7 1.8 2.3 2.5 3.0 2.0 2.2 2.0 2.5 3.1 2.9 2.1 2015 2.4 2.7 2.9 4.1 3.7 3.2 2.9 3.1 3.0 3.7 3.0 4.1 2016 3.2 4.0 4.5 4.9 5.3 3.4 3.3 3.3 3.3 3.5 4.0 3.9 2017 3.4 3.7 3.8 4.3 5.2 4.1 4.0 4.2 4.1 4.2 5.0 4.0

Table IV.21: Maximum wind speed in each month, m/sec Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 4.9 6.7 9.1 8.1 7.4 6.1 3.9 4.8 6.8 6.1 6.6 5.2 2014 5.8 6.1 8.0 6.5 8.3 8.1 8.9 8.3 8.2 9.6 8.7 6.0 2015 6.7 8.1 8.8 11.1 10.0 9.0 9.3 8.6 8.7 8.4 7.8 8.2 2016 5.7 9.2 9.9 13.2 12.4 10.3 9.2 8.3 7.7 8.3 9.2 7.4 2017 6.7 7.4 7.5 11.5 14.3 12.6 11.8 11.7 12.3 9.1 11.1 10.5

4. Climate condition in Tarialan Soum 206. The Tarialan Soum has cold continental climate. In terms of natural zonation, it falls in the steppe-forest zone. It has harsh and cold winter and a short warm summer. 207. Air temperature. The mean annual air temperature is -0.80 in Tarialan Soum. The mean air temperature in January - the coldest month is -230 while mean air temperature of July - the hottest month is 200. Monthly mean, maximum and minimum temperatures in the last 5 years are shown in below tables. Table IV.22: Mean air temperature by month, 2013-2017, 0C Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 -22.4 -19.5 -4.2 2.6 10.7 14.7 17.0 15.5 8.3 0.6 -8.3 -17.5 2014 -18.9 -17.9 -4.2 6.5 9.3 15.3 17.2 15.1 8.2 2.0 -9.6 -19.1 2015 -17.4 -14.3 -5.7 5.2 9.4 16.6 20.0 17.9 8.6 2.1 -11.5 -14.8 2016 -23.3 -15.0 -2.8 4.2 9.0 15.1 19.7 15.8 11.1 -2.9 -13.6 -17.4 2017 -20.6 -15.6 -4.4 5.9 13.0 18.9 20.2 15.6 9.1 -0.3 -8.2 -13.5

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Table IV.23: Maximum air temperature by month, 2013-2017, 0C Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 -3.0 0.6 12.2 21.0 27.7 28.9 28.4 25.3 24.5 17.4 9.2 -0.8 2014 -1.7 1.6 15.4 22.6 31.8 29.3 30.0 30.2 29.4 15.0 8.4 -7.6 2015 -2.1 0.0 16.5 26.5 28.4 32.6 33.1 36.3 25.1 21.0 10.9 -2.6 2016 -11.5 4.0 14.8 19.6 26.0 27.4 31.8 32.8 24.2 17.9 8.1 -3.0 2017 -8.2 1.7 13.4 24.6 32.6 34.9 33.9 30.6 26.3 17.0 10.9 -0.3

Table IV.24: Minimum air temperature by month, 2013-2017, 0C Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 -35.8 -30.8 -19.9 -13.7 -4.3 1.6 7.6 6.6 -5.7 -15.3 -22.0 -30.3 2014 -32.9 -29.1 -22.7 -7.7 -6.8 1.7 6.5 2.1 -9.2 -13.7 -28.4 -27.9 2015 -31.1 -27.7 -22.8 -15.4 -7.3 1.1 6.7 7.3 -5.3 -12.7 -26.8 -27.2 2016 -33.0 -29.1 -23.2 -9.1 -6.7 4.3 9.6 3.4 -1.7 -19.6 -31.6 -28.0 2017 -32.9 -26.3 -15.7 -6.9 -5.2 4.7 8.4 2.4 -7.3 -12.5 -21.0 -25.1

208. Precipitation. The multi-year average annual precipitation level is 306.3mm in Tarialan Soum. Below table shows precipitation level in each month of the last 5 years in the Soum. 90% of total annual precipitation falls during the summer months between May and September. Table IV.25: Monthly total precipitation, mm, 2010-2017 Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 0.0 2.3 1.8 10.6 24.7 48.9 35.8 49.2 17.8 4.1 10.3 3.3 2014 0.0 0.0 6.9 23.1 12.2 45.3 28.4 29.2 13.0 15.9 2.1 10.2 2015 0.0 0.0 1.3 1.2 6.6 21.0 43.7 18.8 18.2 6.9 0.0 0.0 2016 0.0 2.4 3.3 14.4 17.9 60.7 14.0 33.4 5.1 16.2 8.8 0.0 2017 1.5 0.0 7.2 5.5 7.7 10.5 18.3 61.5 14.0 3.6 0.0 2.6

209. Wind regime. Wind speed is relatively low (1.8-2.7 m/sec) in Tarialan Soum because it is located within the northern-Mongolian steppe-forest zone. Wind speed increases during spring months, especially in April and comes down to moderate level during autumn and winter months. The pre-dominant wind direction is from north to south. Below tables show average and maximum wind speed in each month of the last 5 years. Table IV.26: Average wind speed in each month, m/sec Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 2.4 3.3 3.8 3.9 3.7 3.1 2.7 2.9 3.3 3.2 3.1 2.8 2014 3.3 3.2 3.5 3.6 4.0 3.2 3.0 2.5 3.2 3.1 2.8 2.7 2015 2.9 2.9 3.4 4.2 4.1 3.5 3.4 3.1 3.1 3.3 2.3 2.5 2016 2.5 2.8 3.4 3.9 4.0 3.4 3.1 2.6 3.3 2.9 2.5 2.3 2017 2.4 2.5 3.2 3.6 4.2 3.4 3.6 3.0 2.6 2.6 2.4 2.2

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Table IV.27: Maximum wind speed in each month, m/sec Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 6.0 8.0 9.9 10.6 10.3 8.7 8.2 7.3 6.7 8.2 7.1 7.4 2014 8.5 8.6 9.7 10.9 12.0 10.1 8.2 7.0 7.4 8.2 8.5 6.5 2015 7.1 8.4 9.2 13.1 12.4 9.6 9.1 8.7 7.8 8.3 5.7 5.9 2016 5.8 6.5 8.6 11.5 13.6 9.8 8.1 7.3 7.4 6.9 5.8 5.4 2017 6.0 5.7 6.9 9.5 11.5 11.4 10.8 8.1 7.0 6.4 6.6 5.2

5. Climate condition in Bayan-Undur Soum 210. Bayan-undur Soum has semi-arid and cold continental climate. In terms of natural zonation, it is located in the semi-arid steppes of Central Mongolia. 211. Air temperature. The mean annual air temperature in the Bayan-Undur Soum is around 00 to -20c. Table IV.28: Mean air temperature by month, 2013-2017, 0C Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 -25.5 -21.9 -5.0 3.0 14.0 18.6 19.8 17.4 10.5 1.7 -5.7 -15.4 2014 -19.6 -18.0 -2.9 8.9 11.6 18.2 21.0 19.2 10.2 3.3 -8.0 -17.4 2015 -17.7 -14.2 -4.3 6.7 12.7 19.6 22.6 20.0 10.9 3.8 -15.1 -19.3 2016 -26.6 -17.1 -3.9 6.3 12.5 17.9 22.4 19.1 12.7 -1.3 -12.7 -18.3 2017 -24.3 -17.5 -3.2 8.4 16.7 21.8 24.3 18.0 11.4 0.8 -12.4 -16.5

Table IV.29: Maximum air temperature by month, 2013-2017, 0C Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 -7.0 1.8 13.8 23.7 30.5 31.5 30.9 29.5 28.7 22.4 11.0 4.0 2014 4.0 2.5 15.6 25.5 33.0 31.0 33.5 33.0 33.2 21.5 13.0 -0.2 2015 5.0 7.0 21.0 31.0 33.2 38.9 35.9 35.7 30.2 24.1 11.0 -1.4 2016 -11.1 4.1 17.5 23.5 28.8 31.6 34.0 38.4 26.5 22.5 12.3 -0.3 2017 -5.5 3.8 17.3 26.0 34.7 37.4 38.3 33.5 28.3 21.1 15.9 -0.1

Table IV.30: Minimum air temperature by month, 2010-2017, 0C Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 -39.9 -35.3 -29.3 -15.2 0.5 1.5 9.9 4.8 -4.5 -12.4 -26.2 -32.9 2014 -34.3 -31.4 -23.2 -6.7 -5.5 2.6 9.6 5.0 -8.0 -9.9 -22.0 -30.9 2015 -30.5 -27.6 -23.6 -20.0 -6.5 3.3 10.7 11.2 -4.9 -11.6 -37.2 -32.7 2016 -36.5 -35.4 -29.1 -9.7 -4.0 6.9 11.2 1.8 -2.4 -19.0 -37.1 -31.2 2017 -31.1 -26.5 -17.2 -8.0 -6.0 1.3 5.8 -0.6 -7.7 -16.2 -21.7 -24.6

212. Precipitation. Mean annual precipitation is around 250-300mm.80-90% of total annual precipitation falls during the summer months between June and August. Below table shows monthly total precipitation during the last 5 years. 213.

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Table IV.31: Monthly total precipitation, mm, 2013-2017 Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 0.0 8.9 0.0 14.3 14.3 13.0 21.0 46.8 17.2 10.6 9.3 4.1 2014 2.4 2.2 0.0 12.2 20.4 11.2 39.3 11.8 28.7 9.8 0.0 5.4 2015 1.2 2.6 1.2 10.5 9.5 11.7 18.2 29.3 13.7 5.2 11.4 1.1 2016 0.0 2.7 9.1 13.0 13.5 31.4 35.6 28.0 24.8 1.2 8.1 1.6 2017 1.3 2.7 2.3 3.9 6.3 10.3 32.1 40.0 31.1 1.9 11.0 2.1

214. Wind regime. The predominant wind direction is from northwest to southeast. Mean annual wind speed is 3-4 m/sec. Table IV.32: Average wind speed in each month, m/sec Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 1.0 1.5 2.8 2.7 3.0 2.8 2.3 1.8 2.1 1.7 1.7 1.1 2014 1.1 2.5 2.4 2.8 3.1 2.6 2.9 2.4 2.1 2.4 2.1 2.3 2015 1.7 2.0 2.3 3.5 3.1 3.5 3.2 2.2 2.5 2.9 1.7 1.2 2016 0.7 1.7 2.7 3.8 4.5 3.1 2.7 2.8 2.5 2.7 2.0 1.6 2017 1.5 2.2 2.4 3.1 4.0 3.7 3.3 2.9 2.8 2.4 2.2 1.9 6. Climate condition in Erdene Soum 215. Erdene Soum is located in the Gobi Desert which has dry continental climate. 216. Air temperature. Mean annual air temperature in the Soum is 5.50. July is the hottest month with average air temperature 23.1-24.00 while January is the coldest month with average air temperature of -15.30. Number of days where air temperature is above 50 is around 165-185 days a year. Table IV.33: Mean air temperature by month, 2013-2017, 0C Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 -18.9 -15.0 -2.0 4.7 17.4 21.5 24.6 21.9 15.0 5.8 -4.7 -13.2 2014 -12.5 -11.8 0.2 10.8 14.0 20.4 25.0 21.9 15.1 7.3 -3.8 -14.0 2015 -12.6 -9.2 -1.8 7.6 13.2 19.2 23.8 22.0 15.3 6.1 -8.1 -15.7 2016 -23.6 -13.7 -1.5 7.8 13.5 19.8 25.2 24.4 14.9 3.8 -7.0 -11.5 2017 -15.6 -9.7 -2.3 8.6 16.9 22.7 26.2 20.7 15.3 5.0 -8.0 -14.0

Table IV.34: Maximum air temperature by month, 2013-20170C Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 2.9 7.0 22.3 23.9 33.1 35.7 38.5 36.0 34.8 27.4 12.6 2.7 2014 4.9 10.4 18.1 27.6 35.4 31.0 39.7 40.0 31.9 24.5 8.0 -1.5 2015 0.7 8.3 18.7 29.5 37.2 32.2 37.4 35.4 27.6 25.6 15.7 -2.0 2016 -6.7 4.2 20.3 27.5 32.4 31.8 36.5 38.9 31.8 21.4 14.2 4.4 2017 4.1 6.8 13.7 25.0 35.6 38.4 39.5 32.7 31.6 23.8 12.4 -0.8

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Table IV.35: Minimum air temperature by month, 2013-20170C Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 -34.9 -30.2 -20.9 -14.6 2.7 5.4 13.6 6.6 -0.4 -13.4 -21.8 -24.7 2014 -26.4 -27.6 -19.2 -6.0 -3.2 9.9 11.3 7.8 -3.6 -7.3 -17.3 -24.5 2015 -25.1 -21.6 -20.3 -11.0 -4.8 5.8 12.0 11.2 1.0 -9.7 -30.8 -27.8 2016 -39.3 -29.7 -22.3 -7.5 -1.8 7.6 12.1 7.8 -2.2 -15.3 -24.0 -25.3 2017 -28.4 -25.7 -19.4 -7.0 -4.2 6.2 12.8 4.2 -3.6 -11.6 -22.7 -25.9

217. Precipitation. Multi-year average total annual precipitation level is at 128.7mm in Erdene Soum. About 88-92% of the total annual precipitation fall during the summer months. Below table shows total monthly precipitation level during the last 5 years. Table IV.36: Monthly total precipitation, mm, 2013-2017 Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 0.0 0.0 0.0 8.6 8.1 14.0 23.2 7.8 1.4 3.9 0.0 0.0 2014 0.0 0.0 0.0 2.3 14.4 17.8 9.7 9.5 9.1 19.6 0.0 0.0 2015 1.9 0.0 0.0 8.9 1.8 19.3 19.3 13.7 17.6 1.2 3.4 0.0 2016 1.8 0.0 0.0 0.0 11.2 17.4 22.1 2.4 5.2 10.6 0.0 0.0 2017 0.0 1.0 10.2 4.6 0.0 2.2 10.9 12.1 12.5 0.0 1.4 0.0

218. Wind regime. The Gobi region has relatively high wind speed and is prone dust and sand storms during the spring months of March, April and May. Mean annual wind speed is around 3.1-4.3 m/sec and it reaches 13-14 m/sec during the spring months. The predominant wind direction is from northwest to southeast. Table IV.37: Average wind speed in each month, m/sec Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 1.9 2.8 3.5 3.8 5.8 4.7 3.8 4.1 4.3 4.3 3.9 2.7 2014 3.1 2.8 3.4 4.5 5.4 3.6 4.2 3.0 4.2 3.5 3.7 3.0 2015 2.2 3.0 3.9 4.5 5.0 3.9 3.3 4.1 4.5 5.4 3.5 3.4 2016 3.2 4.4 5.2 6.2 7.0 4.9 4.1 4.2 3.6 3.7 4.3 2.8 2017 2.7 2.6 3.1 3.7 4.6 3.5 3.2 2.5 4.5 3.6 4.5 4.5

Table IV.38: Maximum wind speed in each month, m/sec Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 5.3 8.0 11.8 10.9 14.0 12.2 14.6 12.5 11.7 11.3 11.7 8.9 2014 10.3 7.8 11.1 13.7 15.5 12.0 13.2 12.5 11.2 11.5 12.6 11.0 2015 9.6 10.2 13.3 14.0 15.1 11.1 10.5 10.5 8.9 9.9 6.9 7.5 2016 7.3 8.8 10.7 14.0 14.5 10.9 8.2 8.6 7.9 7.8 9.5 6.2 2017 6.1 6.2 7.0 8.1 9.9 7.7 6.8 6.4 10.1 7.6 9.2 8.8 7. Climate condition in Dashinchilen Soum 219. In terms of Koppen climate classification system, Dashinchilen Soum falls in the cold semi- arid climate zone (BSk) where the climate is characterized by long, snowy and harsh winter (between November to early March), windy and dry spring (early March to early June), short

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and warm summer (early June to late August) and cool autumn (from late August to early November). 220. Baseline climate condition in the project region is described using the last 5 years climate data from weather stations in Dashinchilen Soum center. 221. Air temperature. The mean annual air temperature in Dashinchilen is around 00-200. Average air temperature in January which is the coldest month of the year is -240C while in July, the hottest month of the yea, the average temperature is +220C. Table IV.39: Monthly average air temperature in Dashinchilen, 2013-2017, 0C Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 -25.5 -21.9 -5.0 3.0 14.0 18.6 19.8 17.4 10.5 1.7 -5.7 -15.4 2014 -19.6 -18.0 -2.9 8.9 11.6 18.2 21.0 19.2 10.2 3.3 -8.0 -17.4 2015 -17.7 -14.2 -4.3 6.7 12.7 19.6 22.6 20.0 10.9 3.8 -15.1 -19.3 2016 -26.6 -17.1 -3.9 6.3 12.5 17.9 22.4 19.1 12.7 -1.3 -12.7 -18.3 2017 -24.3 -17.5 -3.2 8.4 16.7 21.8 24.3 18.0 11.4 0.8 -12.4 -16.5

Table IV.40: Monthly maximum air temperature in Dashinchilen, 2013-2017, 0C Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 -7.0 1.8 13.8 23.7 30.5 31.5 30.9 29.5 28.7 22.4 11.0 4.0 2014 4.0 2.5 15.6 25.5 33.0 31.0 33.5 33.0 33.2 21.5 13.0 -0.2 2015 5.0 7.0 21.0 31.0 33.2 38.9 35.9 35.7 30.2 24.1 11.0 -1.4 2016 -11.1 4.1 17.5 23.5 28.8 31.6 34.0 38.4 26.5 22.5 12.3 -0.3 2017 -5.5 3.8 17.3 26.0 34.7 37.4 38.3 33.5 28.3 21.1 15.9 -0.1

Table IV.41: Monthly minimum air temperature in Dashinchilen, 2013-2017, 0C Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 -39.9 -35.3 -29.3 -15.2 0.5 1.5 9.9 4.8 -4.5 -12.4 -26.2 -32.9 2014 -34.3 -31.4 -23.2 -6.7 -5.5 2.6 9.6 5.0 -8.0 -9.9 -22.0 -30.9 2015 -30.5 -27.6 -23.6 -20.0 -6.5 3.3 10.7 11.2 -4.9 -11.6 -37.2 -32.7 2016 -36.5 -35.4 -29.1 -9.7 -4.0 6.9 11.2 1.8 -2.4 -19.0 -37.1 -31.2 2017 -31.1 -26.5 -17.2 -8.0 -6.0 1.3 5.8 -0.6 -7.7 -16.2 -21.7 -24.6

222. Precipitation. Total annual precipitation in Dashinchilen is around 250-300mm. 90% of total precipitation falls during the warm period between June and September. Table IV.42: Precipitation level by months, 2013-2017, mm Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 0.0 8.9 0.0 14.3 14.3 13.0 21.0 46.8 17.2 10.6 9.3 4.1 2014 2.4 2.2 0.0 12.2 20.4 11.2 39.3 11.8 28.7 9.8 0.0 5.4 2015 1.2 2.6 1.2 10.5 9.5 11.7 18.2 29.3 13.7 5.2 11.4 1.1 2016 0.0 2.7 9.1 13.0 13.5 31.4 35.6 28.0 24.8 1.2 8.1 1.6 2017 1.3 2.7 2.3 3.9 6.3 10.3 32.1 40.0 31.1 1.9 11.0 2.1

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223. Wind regime. Average wind speed in Dashinchilen is 2.4m/sec. It reaches as high as 20- 30m/sec during windy days in April and May. The predominant wind direction northwest to southeast. Table IV.43: Monthly average wind speed, m/sec Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 1.0 1.5 2.8 2.7 3.0 2.8 2.3 1.8 2.1 1.7 1.7 1.1 2014 1.1 2.5 2.4 2.8 3.1 2.6 2.9 2.4 2.1 2.4 2.1 2.3 2015 1.7 2.0 2.3 3.5 3.1 3.5 3.2 2.2 2.5 2.9 1.7 1.2 2016 0.7 1.7 2.7 3.8 4.5 3.1 2.7 2.8 2.5 2.7 2.0 1.6 2017 1.5 2.2 2.4 3.1 4.0 3.7 3.3 2.9 2.8 2.4 2.2 1.9

8. Climate condition in Ulaangom city 224. In terms of Koppen climate classification system, Ulaangom city falls in the cold semi-arid climate zone (BSk) where the climate is characterized by long, snowy and harsh winter (between November to early March), windy and dry spring (early March to early June), short and warm summer (early June to late August) and cool autumn (from late August to early November). Baseline climate condition in the project region is described using the last 5 years climate data from weather stations in Ulaangom city. 225. Air temperature. The mean annual air temperature in Dashinchilen is around -1.3-20C. Average air temperature in January which is the coldest month of the year is -300C while in July, the hottest month of the year, the average temperature is +21.50C. Table IV.44: Monthly mean air temperatures, 2013-2017,0C Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 -30.9 -27.6 -9.4 5.2 10.5 16.9 20.3 18.1 8.9 0.8 -5.9 -17.5 2014 -29.7 -30.3 -16 2.9 11.2 17.4 21.3 18.7 9.8 3.3 -7.3 -24.1 2015 -28.5 -25.6 -12.8 5.5 12.5 19.3 21.8 19.7 10.3 2.6 -9.8 -20.0 2016 -32.4 -29.7 -14.1 3.1 10.5 19.2 22.9 16.9 13.3 -0.3 -13.7 -24.1 2017 -29.2 -27.2 -13.8 6.5 13.8 21.2 21.2 17.9 10.5 -0.6 -9.6 -23.2

Table IV.45: Monthly maximum air temperatures, 2013-2017,0C Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 -24.8 -20.4 -3.9 11.7 18.2 23.9 27.3 24.6 16.2 6.5 -1.7 -14.6 2014 -22.9 -22.5 -9.5 9.2 18.2 24.6 28.6 26.5 17.8 10.3 -2.2 -18.9 2015 -21.5 -17.9 -5.9 12.3 19.5 26.0 29.3 27.1 17.2 10.1 -5.8 -16.8 2016 -26.9 -23.2 -8.5 8.1 17.8 26.2 29.6 23.1 20.6 4.8 -8.7 -19.3 2017 -22.7 -19.9 -6.9 13.2 21.5 28.8 28.5 24.9 17.4 7.4 -4.3 -19.1

Table IV.46: Monthly minimum air temperatures, 2013-2017,0C Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 -35.7 -34.3 -14.4 -1.5 2.0 9.1 12.9 11.7 2.2 -4.7 -10.1 -21.3 2014 -34.6 -36.5 -22.0 -28.0 3.4 9.6 13.0 10.7 1.9 -2.9 12.5 -29.5

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Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2015 -33.7 -32.2 -19.5 -15.0 4.4 10.8 13.8 11.8 3.4 -4.2 -14.5 -23.7 2016 -37.7 -35.9 -19.5 -16.0 27.0 11.5 15.6 11.0 6.7 -4.8 -19.7 -29.5 2017 -34.5 -33.8 -19.9 -0.1 5.0 12.2 13.4 10.7 3.9 -5.3 -15.1 -28.3

226. Precipitation. Total annual precipitation level in Ulaangom city is 139.8mm. 80% of total precipitation falls in July and August. Table IV.47: Total monthly precipitation level in Ulaangom, 2013-2017, mm Months Year Yearly total 1 2 3 4 5 6 7 8 9 10 11 12 2013 1.7 5 1.7 1.1 1.9 18.1 21 71.1 11.4 7.6 7.5 5.3 153.4 2014 4.4 1.4 5.3 12.3 16.7 27.7 10.6 7.1 4.2 10.9 1.3 1.8 103.7 2015 1.5 1.5 1.6 15.2 23.3 15.9 13.1 4.0 12.2 10.4 16.3 3.8 118.8 2016 3.4 1.9 11.8 7.5 9.0 14.9 7.2 94.5 31.4 15.9 11.5 6.9 215.9 2017 2.8 0.2 9.3 3.1 5.1 4.6 7.5 7.6 20.5 3.1 10.0 7.0 80.8

227. Wind regime. The predominant wind direction is northwest to southeast. Yearly average wind speed in Ulaangom is 1.4m/sec. It reaches as high as 18-20m/sec during windy months of April and May.

Table IV.48: Monthly average wind speed, m/sec Months Year 1 2 3 4 5 6 7 8 9 10 11 12 2013 1.0 1.2 1.8 2.7 3.4 3.2 2.7 2.5 2.6 2.1 3.6 1.5 2014 1.3 1.1 1.4 2.6 3.4 2.8 2.8 2.7 2.8 2.4 2.6 1.3 2015 1.4 1.5 1.6 3.2 3.0 2.8 3.2 2.9 2.9 3.0 1.6 0.9 2016 1.4 1.5 1.6 3.2 3.0 2.8 3.2 2.9 2.9 3.0 1.6 0.9

2017 0.7 0.8 1.6 2.4 3.2 3.0 2.6 2.7 2.9 2.2 2.2 1.4

E. Air Quality (AQ) 228. This section details all baseline air quality measurement stations in UB, Khovd and Uvs. Table below shows air quality monitoring and noise monitoring locations in UB city. 93

Figure IV.13. Air Quality and Noise Control stations in UB city

229. The monthly average values of air quality testing are taken from air quality stations at UB, Khovd and Uvs and these values are compared to national standards. The average air quality (AQ) values already exceeded the maximum allowed levels in winter months, thus it can be concluded that air quality of UB, Khovd and Uvs is very polluted in winter months and therefore the maximum values not required. Definitely, if monthly average values already exceed the standard levels, 24-hour maximum values definitely will exceed it. As for 5 soum centers, air quality was measured with 1-hour average by the Institute of Meteorology in the respective province. In 5 soum centers, it can be concluded there is no air pollution. These also include all air quality emissions currently in the area including any on-going incineration at any of these SHCs. The following section provides baseline AQ tables. 230. According to the National Air quality standard MNS4585:2016, the air quality

measurement data (NO2, SO2 and TSP) show 24-hour average value over 30 day period. 1. Air quality condition in Ulaanbaatar city 231. Air pollution in the capital Ulaanbaatar surpasses standard levels with the adverse effect on the population’s health and well-being as well as environmental balance. A World Bank study states that Particulate Matter (PM) is the largest and relatively most severe air pollution problem in the City. In terms of PM, Ulaanbaatar is ‘‘among the most polluted cities in the

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world. Primary sources of air pollution in Ulaanbaatar are three thermal power plants, about 200 small and medium sized heating boilers, about 160,000 traditional Gers and wooden houses, and over 40,000 automobiles. 232. Topography and meteorology exacerbated ambient air quality conditions in the country, and particularly in Ulaanbaatar. Mountains surround Ulaanbaatar up to 2,250 meters in height inhibited dispersion of pollutants. To compound the situation, a stable atmospheric inversion forms during the winter season. As a result, ambient pollutant concentrations often remained for days or weeks at a time to exceed Mongolian and other international ambient air quality standards. Burning of coal and woods in the households in urban cities has been identified as major sources of air pollution, which affects ambient air quality and human health. 233. Based on the air quality measurement data obtained from the air quality stations in the

Ulaanbaatar city, concentrates of the key air pollution parameters such as SO2, NO2 and dust are described in following sections.

234. Sulphur Dioxide, SO2. Looking at the measurement results of 2015-2017, average annual value of the Sulphur dioxide was 0.014 mg/m3 which is within the maximum allowed level (0.02 mg/m3) specified in the national standard of MNS 4585:2016. However, monthly average values in winter months of November, December, January and February have exceeded the maximum allowed level. Table IV.49: Monthly average values of Sulphur dioxide, mg/m³

Months 2015 2016 2017 Max allowed level January 0.031 0.035 0.029 February 0.022 0.040 0.022 March 0.012 0.010 0.011 April 0.009 0.006 0.009 May 0.009 0.005 0.005 June 0.009 0.008 0.005 July 0.012 0.009 0.02 August 0.013 0.005 0.003 September 0.005 0.004 0.001 October 0.013 0.009 0.004 November 0.029 0.019 0.008 December 0.032 0.033 0.012 Year average 0.016 0.015 0.010

235. Nitrogen dioxide, NO2. All of the measured monthly average values of nitrogen dioxide between 2015-2017 was within the maximum allowed level of 0.04 mg/m3 specified in the national standard MNS 4585:2016.

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Table IV.50: Monthly Average Values of Nitrogen Dioxide, mg/m³

Months 2015 2016 2017 Max allowed level January 0.033 0.024 0.035 February 0.024 0.023 0.032 March 0.017 0.016 0.018 April 0.014 0.009 0.014 May 0.011 0.012 0.011 June 0.009 0.009 0.011 0.04 July 0.010 0.010 August 0.009 0.008 0.009 September 0.013 0.010 0.009 October 0.018 0.013 0.012 November 0.027 0.025 0.020 December 0.031 0.038 0.025

236. Dust concentration, level PM10. The monthly average level of dust concentration PM 10 has exceeded the standard level of 0.05 mg/m3 specified in national standard MNS 4585:2016 in nearly every month of measurement. Table IV.51: Monthly Average Dust Concentration PM10, mg/m³

Months 2015 2016 2017 Max allowed level January 0.147 0.155 0.175 February 0.158 0.119 0.119 March 0.115 0.074 0.094 April 0.154 0.121 0.163 May 0.150 0.091 0.126 June 0.151 0.058 0.102 0.05 July 0.062 0.075 August 0.097 0.045 0.041 September 0.094 0.064 0.060 October 0.165 0.100 0.123 November 0.142 0.151 0.124 December 0.152 0.158 0.157

237. Dust concentration level, PM2.5. The monthly average level of dust concentration PM2.5 has exceeded the standard level of 0.025 mg/m³ specified in national standard MNS 4585:2016 in nearly every month of measurement.

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Table IV.52: Monthly Average Dust Concentration Level PM2.5 mg/m³

Months 2015 2016 2017 Max allowed level January 0.127 0.147 0.164 February 0.093 0.098 0.105 March 0.058 0.047 0.051 April 0.046 0.034 0.044 May 0.035 0.022 0.025 June 0.031 0.020 0.022 0.025 July 0.018 0.035 August 0.023 0.012 0.013 September 0.023 0.026 0.020 October 0.052 0.046 0.057 November 0.099 0.118 0.097 December 0.141 0.148 0.146

238. The following table shows the total amount of dust (TSP), sulfuric gas (SO2), nitrogen

dioxide (NO2) and current noise levels measure at 6 points in Ulaanbaatar city in April 2018. Measured levels of sulphur dioxide and dust particulate exceeded the maximum allowed level at every point of measurement. Overall, the air quality in the city is in a bad condition. Table IV.53: Air quality, noise measurement and sampling analysis results

№ Sampli Location Sampl Sulphur Nitrogen Total particulate matter Nois ng e date dioxide SO2, dioxide NO2, (TSP), PM10, mg / m³ e point mg / m³ mg / m³ DBA 1 Air-1 N47053’34.4”, 0.030 0.032 0.652 62 E106050’31.3” 2 Air-2 N47053’44.0”, 0.014 0.027 0.468 48 E106051’28.8” 3 Air-3 N47053’27.8”, 0.034 0.038 0.492 60 E106048’52.7” 2018.0 4 Air-4 N47053’31.4”, 4.16 0.050 0.029 0.444 46 E106046’18.3” 5 Air-5 N47053’48.9”, 0.022 0.025 0.048 38 E106045’08.8” 6 Air-6 N47054’3.6”, 0.25 0.031 0.468 52 E106045’25.2” Air Quality Standards MNS 4585: 0.02 0.04 0.05 60 2016 Source: Test results of Meteorological and Environmental Monitoring Agency, Center for Meteorology and Metrology. 2. Air Quality in Khovd city 239. In Khovd city, the main reason to decrease air quality is the smoke emitting from traditional heating stoves, improved stoves and boilers with capacity of up to 10 kW used by 97

for households in Ger area and enterprises which are not connected with the Central Heating System in winter season. Based on the air quality measurement data between year 2008- 2017 obtained from the Meteorology Institute of Khovd province, key air pollution parameters such as Sulphur dioxide, nitrogen dioxide and dust concentration level are described in below sections.

240. Sulphur dioxide, SO2. Sulphur dioxide level exceeded maximum allowed level in January 2013, January and February of 2014 and February of 2016. In other months of measurement, the monthly average level was within the standard level. Table IV.54: Monthly Average Value of Sulphur dioxide, mg/m³

Year Months Max allowed I II III IV V VI VII VIII IX X XI XII level 2008 0.012 0.011 0.004 0.001 0.000 0.000 0.000 0.001 0.002 0.005 0.004 0.008 2009 0.004 0.004 0.003 0.001 0.001 0.001 0.001 0.000 0.001 0.001 0.003 0.004

2010 0.006 0.011 0.006 0.003 0.001 0.000 0.000 0.000 0.001 0.003 0.004 0.004

2011 0.011 0.013 0.005 0.003 0.001 0.000 0.000 0.000 0.001 0.002 0.004 0.005 0.02 2012 0.018 0.020 0.009 0.007 0.004 0.002 0.002 0.002 0.004 0.012 0.012 0.006 2013 0.023 0.010 0.005 0.006 0.006 0.001 0.001 0.002 0.003 0.005 0.009 0.016 2014 0.033 0.026 0.007 0.007 0.005 0.002 0.001 0.002 0.003 0.003 0.006 0.025 2015 0.013 0.015 0.007 0.005 0.004 0.001 0.001 0.001 0.003 0.004 0.008 0.009 2016 0.019 0.031 0.015 0.008 0.006 0.002 0.001 0.001 0.002 0.004 0.007 0.011 2017 0.017 0.018 0.018 0.01 0.003 0.001 0.001 0.002 0.003 0.004 0.009 0.021

241. Nitrogen dioxide, NO2. Monthly average value of nitrogen dioxide is usually higher than the standard level in winter months, especially between December and March. Table IV.55: Monthly Average Value of Nitrogen dioxide, mg/m³

Year Months Max allowe I II III IV V VI VII VIII IX X XI XII d level 2008 0.060 0.059 0.052 0.035 0.022 0.020 0.018 0.023 0.030 0.023 0.023 0.059 0.04 2009 0.022 0.017 0.015 0.013 0.010 0.010 0.010 0.011 0.011 0.010 0.012 0.022 2010 0.017 0.020 0.016 0.016 0.017 0.014 0.010 0.014 0.014 0.015 0.018 0.022 2011 0.029 0.026 0.019 0.015 0.012 0.009 0.010 0.010 0.011 0.011 0.012 0.021 2012 0.035 0.044 0.026 0.028 0.027 0.016 0.020 0.017 0.023 0.034 0.026 0.017 2013 0.047 0.042 0.024 0.030 0.027 0.014 0.015 0.016 0.018 0.019 0.030 0.042 2014 0.071 0.062 0.032 0.026 0.022 0.020 0.019 0.019 0.019 0.019 0.023 0.060 2015 0.057 0.060 0.041 0.025 0.018 0.020 0.016 0.018 0.018 0.019 0.021 0.029 2016 0.047 0.068 0.039 0.034 0.026 0.019 0.018 0.017 0.019 0.019 0.025 0.044

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Year Months Max ll 2017 0.057 0.062 0.054 0.028 0.018 0.013 0.016 0.018 0.018 0.02 0.028 0.046

242. Dust concentration. Total suspended particulate PM10 level exceeds the maximum allowed level during winter months between December and March. Table IV.56: Dust concentration level by monthly average value, mg/m³

Year Months Max allowed I II III IV V VI VII VIII IX X XI XII level 2010 0.26 0.23 0.13 0.08 0.02 0.01 0.02 0.02 0.03 0.10 0.30 0.28 0.05 2011 1.85 1.45 0.54 0.36 0.26 0.17 0.10 0.16 0.30 0.57 0.79 1.40

2012 2.03 2.11 0.34 0.39 0.35 0.92 2013 1.46 0.51 0.29 0.29 0.23 0.06 0.05 0.07 0.07 0.42 0.83 1.88 2014 1.72 1.03 0.61 0.41 0.20 0.13 0.09 0.12 0.19 0.30 0.79 1.95 2015 1.01 0.84 0.60 0.25 0.40 0.36 0.33 0.32 0.37 0.50 0.64 1.03 2016 0.34 0.36 0.20 0.06 0.05 0.04 0.03 0.05 0.07 0.07 0.18 0.63 2017 0.652 0.294 0.14 0.05 0.039 0.027 0.049 0.054 0.066 0.061 0.081 0.827

3. Air quality condition in the 5 Soums 243. The consultant team has conducted air quality measurement at the 5 Soum health centers between May and September, 2018 using below devices. Table IV.57: Air quality measurement devices Measurement Relevant Description of device № parameters standard

1 TSP PM2.5 MNS 4048:1988 Dust track II 8530

MNS 2 NO2 SKC AirChek 2000 Pump 17.2.5.11:1988

MNS 3 SO2 SKC AirChek 2000 Pump 17.2.5.12:1988

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Measurement Relevant Description of device № parameters standard

MNS 0012-9- Benetech Digital Datalogging 4 Noise 015:1987 Sound Level Meter GM1356

i. Erdenemandal Soum 244. The air quality measurement results in Erdenemandal Soum are shown in below table. (Coordinates N-44026’39.6” E-111005’18.1) Table IV.58: Air quality measurement results at Erdenemandal Soum hospital

3 3 3 TSP -2.5, mg/m 30 Noise Item SO2, mg/m NO2, mg/m minute average decibel Measurement results 0.004 0.008 0.03 33.1 MNS 4585:2016 0.450 0.200 0.05 60 ii. Tarialan Soum 245. The Meteorology institute of Khuvsgul province conducts air quality measurement at the Tarialan Soum center once a year. The most recent measurement took place in November 2017 at the air quality monitoring spot (Coordinates: N-49036’46.8” E-101059’34.8). The air quality measurement results are shown in below table. Table IV.59: Air quality measurement results in Tarialan Soum center

Dust TSP PM2.5 Noise 3 3 3 Item SO2, mg/m NO2, mg/m mg/m decibel Average Max Min Measurement results 0.006 0.022 0.215 29.5 0.061 31.8 Max allowed level 0.500 0.450 0.085 60 MNS 585:2007 /30 min average/ iii. Bayan-Undur Soum

246. SO2 and NO2 was measured with 20-minute average value while TSP was measured with 30-minute average value. The measurement results are shown in below table. Table IV.60: Air quality measurement results at Bayan-Undur Soum hospital

3 3 3 TSP 2.5, mg/m Noise Item SO2, mg/m NO2, mg/m 30 minute average decibel Measurement results 0.002 0.035 0.062 39 MNS 4585:2016 0.450 0.200 0.05 60 iv. Erdene Soum 247. The consultant team has conducted air quality measurement at the Erdene Soum hospital premise (coordination N-44026’39.6” E-111005’18.1) on May 23, 2018. The measurement results are shown in below table.

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Table IV.61: Air quality measurement results at Erdene Soum hospital

3 3 3 TSP -2.5, mg/m 30 Item SO2, mg/m NO2, mg/m Noise decibel minute average Measurement results 0.003 0.032 0.025 28.4 MNS 4585:2016 0.450 0.200 0.05 60 v. Dashinchilen Soum

248. SO2 and NO2 was measured with 20-minute average value while TSP was measured with 30-minute average value. The measurement results are shown in below table. Table IV.62: Air quality measurement results at Dashinchilen Soum hospital

3 3 3 TSP 2.5, mg/m Noise Item SO2, mg/m NO2, mg/m 30 minute average decibel Measurement results 0.018 0.022 0.140 47.5 MNS 4585:2016 0.450 0.200 0.05 60

4. Air quality condition in Ulaangom city 249. Professional laboratory under the Institute of Meteorology of Uvs province has conducted

air quality measurement at the hospital premise on October 16, 2018. SO2 and NO2 was measured with 20-minute average value while TSP was measured with 30-minute average value. The measurement results are shown in below table. Table IV.63: Air quality measurement results at Uvs hospital

3 3 3 TSP -10, mg/m Noise Item SO2, mg/m NO2, mg/m 30 minute average decibel Measurement results 0.002 0.023 0.156 52.3 MNS 4585:2016 0.450 0.200 0.05 60

F. Noise Condition 250. WHO31 states that guidelines on community noise (not industrial work place noise, therefore including traffic) should be based on the following:  Indoor sound levels, thresholds for guidelines should be based on a combination of values of 30 dB (average equivalent over 8 hours LAeq) and 45 dB (maximum for an individual noise event);  Outdoor sound levels should not exceed 50 dB LAeq to protect the majority of people from being moderately annoyed during the daytime. Most countries in Europe have adopted 40 dB LAeq as the maximum allowable level for new developments;  Hospital patients have less ability to cope with stress, the equivalent noise level should not exceed 35 dB LAeq in most rooms in which patients are being treated or observed; and for

31 World Health Organisation (1999) Guidelines on Community Noise. 101

 FHC/SHC/Hospitals the background sound pressure level should not exceed 35 dB LAeq during teaching sessions. 251. It is clear from the noise measurements in Ulaanbaatar that in the majority of locations, ambient noise exceeds the WHO recommendations for community noise outside. However, with regards to the noise within sensitive receptors such as households, FHC/SHC and hospitals, the data are of limited value as the distance from the source is not given and measurements are not taken within buildings. 252. In project sites out of Ulaanbaatar city, in provinces there is no estimation about noise measurement. Allowable level of vibration caused by noise according to the “Standard of Mongolia MNS 5002-2000” which was renewed in 2000 was normalized and set at the factory levels. At all other sectors, the standard are set as being in compliance with the standard of its technological safety procedure. Noise pollution estimation of Ulaanbaatar city has been done according to the complex assessment of urban development in 2000 (Figure IV.14). 253. According to the National air quality32 standard, noise level data show 16 hour average value during daytime (7:00am and 22:00pm) over 30 day period

Source: Journal published by Eurasian Union of Scientists, “International Conference on Science and Practice” March 2016. Figure IV.14: Noise Pollution Estimation of Ulaanbaatar City

32 In Mongolia, both noise and air quality parameters are together included in Air Quality Standard MNS4585:2016. There is no separate standard for noise.

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254. According to the research work done by Eurasian Union of Scientists, construction area of the center of Ulaanbaatar city has extreme noise, 41.8 percent of all settled area has too much or great noise, 36.9 percent has an average noise and 21.3 percent has low estimation. Moreover, there is an estimation that it was 81.5-85.9 db(A) or unsuitable in the distance up to 300 m from the railway, 68.55-72.6 db(A) or limited suitable in the distance of 300-500 m, 56.3 db(A) or suitable in 500-600 m distance. 255. But, it has been estimated that 64 db(A) or limited suitable was in the distance up to 100 m from the central highway of the city and 45.7-58.3 db(A) or suitable was in 100-500 m distance. As described in the urban planning and construction norm, it has been determined that settled zone will be planned in the distance not less than 100 m from railway and further, it is required to plan to be in distance not less than 300 m from railway and 100 m from highway. 256. Measured daytime noise levels in April 2018 exceeded the maximum allowed level indicated in the national standard at 2 hospitals: Emergency Center and FHC in 17th Khoroo of Bayanzurkh. Table IV.64: Measurement of daytime noise level at subprojects in Ulaanbaatar city, April, 2018

No. Monitoring point 1-hour average (db(A)) 1 Emergency Center 63.7 2 Khan-Uul district hospital 46.5 3 FHC 10th Khoroo Khan-Uul 51.2 4 FHC 14th Khoroo Khan-Uul 41.3 5 FHC 17th Khoroo Bayanzurkh 74.2 6 FHC 19th Khoroo Chingeltei 33.6 Mongolian National Noise Standards: MNS 4585: 2016 allowable limits: daytime is 60 dBA, night is 45 dBA. Night is 10pm-6am according to the Act on Labor. Remark: 1. based on 1 hour average. Source: ADB Consultant, 2018.

257. Measured daytime noise level in April 2018 exceeded the maximum allowed level indicated in the national standard at the parking area of Khovd hospital. Table IV.65: Noise Measurements in Khovd and Uvs hospitals

No. Monitoring point 1-hour average (db(A)) 1 Parking area of the Khovd hospital 73.7 2 Proposed construction spot in the Khovd hospital yard 37.1 3 Proposed construction spot in the Uvs hospital yard 41.3 Mongolian National Noise Standards: MNS MNS 4585: 2016 allowable limits: daytime is 60 dBA, night is 45 dBA. Night is 10pm-6am according to the Act on Labor.

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Table IV.66: Measuremed daytime noise levels in the 5 Soums Item/Soums Erdenemandal Tarialan Bayan- Erdene Dashinchilen Undur Measured noise level 33.1 31.8 39 28.4 35.6 /decibel/ Mongolian National Noise Standards: MNS MNS 4585: 2016 allowable limits: daytime is 60 dBA, night is 45 dBA. Night is 10pm-6am according to the Act on Labor.

G. Soil, Geology and Seismology 1. Soil, Geology and Seismology in Ulaanbaatar City 258. Ulaanbaatar city is located within the Khentii mountain range and Tuul river basin and in steppe-forest natural zone. In terms of soil-geographical zonation system of Mongolia, Ulaanbaatar city belongs to the mountain dark brown soil zone. The main types of soil distributed within the Ulaanbaatar city are alluvial dark brown soil and grassland dark brown soil. 259. In terms of geological age, following soil types were identified in Ulaanbaatar and its surrounding area:  Technogenic topsoil  Contemporary proluvial gravel soil  Contemporary alluvial soil  Contemporary diluvial-proluvial upper soil  Middle-upper quaternary alluvial-proluvial soil  Eluvial-diluvual gravel soil  Neogene lacustrine-alluvial-proluvial clay soil  Carbonaceous sedimentary rock soil 260. Soil pollution has become a serious issue in Ulaanbaatar city in recent years. Especially in ger areas, the soil polluted due to pit latrines and improper waste disposals. Specialized Inspection Agency of Ulaanbaatar city conducts soil tests twice a year in densely populated areas. According to the Laboratory test results of the survey in 2017, 32 percent of Ulaanbaatar has been affected by soil contamination. 261. SEC LLC experts carried out heavy metal’s pollution analysis at the subproject locations in Ulaanbaatar city in April 2018. Below table shows results of the Laboratory test analysis. Table IV.67: Heavy Metals Contamination Laboratory Test Results, mg/kg

Subproject locations Depth, Heavy metal contents, mg/kg cm Ni / Cd / Pb / Zn / Cr / Cu / Nickel Cadmium Plumbu Zinc Cromium Copper m Khan-Uul District Hospital 0-10 7.60 0.00 0.00 68.8 0.00 35.1 FHC at 14th Khoroo of Khan- 0-10 60.7 0.00 30.7 39.7 51.8 40.9 Uul FHC at 10th Khoroo of Khan- 0-10 15.6 0.00 62.5 48.1 0.00 13.4

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Subproject locations Depth, Heavy metal contents, mg/kg cm Ni / Cd / Pb / Zn / Cr / Cu / Nickel Cadmium Plumbu Zinc Cromium Copper m Uul FHC at 17th Khoroo of 0-10 30.9 0.00 20.4 50.9 55.4 40.4 Bayanzurkh FHC at 19th Khoroo of 0-10 27.8 0.00 19.7 52.7 33.1 81.5 Chingeltei Maximum allowed level (MNS 5850: 150.0 3.0 100.0 300.0 150.0 100.0 2008) Harmful level (MNS 5850: 2008) 1000.0 10.0 500.0 600.0 400.0 500.0

262. Environmental baseline standards for air, water, soil and noise are attached as Annexure 4. A regular monitoring of all above parameters during construction, operation, and maintenance phase will further describe the pollutants loads in the ambient environmental conditions. This tracking will lead to an effective use of Environment Management plan and Environment Monitoring Plan in ensuring compliance with design parameters. 263. Geology. Geologically the Ulaanbaatar region belongs to the Khentii geosynclinals depression. Ulaanbaatar city is mainly underlain by cambrian, devonian, and carboniferous sandstone and mudstone. Ulaanbaatar City is located on an alluvial plain. MNET confirmed that in the city, soil is low in permeability and gullying and erosion is visible on steep slopes in the Ger areas to the north of the city. 264. Seismology. Territory of Ulaanbaatar city falls within the earthquake magnitude scale ranges between 6.0 and 8.0 degrees in Mercalli scale. According to the recent study of faults in Bogd and Bulnai, big faults move in a frequency of thousands of years and velocity of their transition changes by very few millimeters per joule. Small faults are of medium strength ( 6-7); frequency of quake may be longer (Ochirbat Fund). 105

Figure IV.15: Earthquake Zones Map Ulaanbaatar and Subproject Locations

2. Soil, geology and seismology in Khovd city 265. In terms of physical geographic region, Khovd city falls in Altay mountain range, Khovd river basin. In terms of natural zonation, it is located within the mountain-steppe zone. In terms of soil-geographical zonation, Khovd city belongs to the mountain-dark soil region. 266. Soil. Soil characteristics vary within the project area with the following types present:  High mountain steppe-raw humic soils are widespread in high altitudes sections around Khovd and high mountain tundra occur largely in northern part of Khovd.  Gobi brown soil dominates near Khovd and Olgii. 267. SEC LLC experts carried out heavy metals’ contamination analysis for the Khovd hospital in April 2018. Soil samples were taken at the waste collection point within the hospital yard and at the medical waste landfill site nearby the central dumpsite of Khovd city. Laboratory test analysis were made at the authenticated laboratory of Engineer-Geodesy LLC in Ulaanbaatar. Below table shows results of the heavy metals contamination analysis.

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Table IV.68: Heavy Metal Contents in Soil Samples (mg/kg)

Sampling points Depth, sm Heavy metal contents, mg/kg Cr Pb Cd Ni Zn Cu Medical waste landfilling 0-10 79.6 60.7 0.19 58.7 97.6 80.7 point Waste collection point in the 0-10 88.1 52.6 0.0067 46.8 101.6 79.4 hospital yard Maximum allowed level (MNS 5850: 2008) 150.0 100.0 3.0 150.0 300.0 100.0 Harmful level (MNS 5850: 2008) 400.0 500.0 10.0 1000.0 600.0 500.0

268. Geology. The project area is situated in the Mongol Altai high mountainous area which began to form in the Cambrian Period, when the rocks were folded and faulted. According to the geo-morphological map of Mongolia, the terrain in the project area includes extensive rolling ranges, medium rolling ranges and mountains, slight rolling ranges of sloped structure, mountainous ravines, semi-level surfaces of mountain skirts, glacial valleys, mountains with sharp ridged peaks, alluvial lake valleys, delluvial—prolluvial and mountain river valleys.33 269. Seismology. The Research Center of Astronomy and Geophysics of the Mongolian Academy of Sciences (RCAG) has partnered with the French organization ‘Department Analyse, Surveillance, Environment’ (DASE) in order to assess the seismic hazard in Mongolia and Ulaanbaatar (on-going). The results of the RCAG and DASE assessment34 were derived through a full review of Mongolia’s seismic activity, and attenuation laws were redefined. The results so far show previously unknown active faults around Ulaanbaatar. 270. Figure IV.1 illustrates seismic hazard in terms of macro-seismic intensity35, using the Modified Mercalli Scale which is an alternative hazard metric to the older peak ground acceleration measure. Intensity is a generic bounded damage scale used to relate observed (or expected / forecasted) damage to the earth and built environment directly to earthquake magnitude. Macro-seismic intensity is a subjective scale requiring a personal interpretation of damage experienced by buildings after an earthquake, and is largely based on post- earthquake field surveys of building and site damage. Khovd city lies in zone of intensity VII hazard signifying light structural building damage in buildings of good design and

33 Geo-morphological map of Mongolia, Government of Mongolia. 2007. 34 http://www-dase.cea.fr/public/dossiers_thematiques/evaluation_de_l_alea_sismique/description_en.html 35 Intensity may be related directly to peak ground acceleration and peak ground velocity through empirical relation- ships. The former measure is an international standard hazard metric currently adopted by many countries for presenting national seismic hazard assessments; ground velocity however is often considered a more repre- sentative measure of a location’s ground motion hazard than ground acceleration. Peak ground velocity is closely related to the energy flux between ground and building. Seismic hazard may be forecast using ground velocity as an alternative measure to intensity, such that intensity may be determined as a function of peak ground velocity. Earthquake damage statistics often give a much closer correlation with peak ground velocity than with peak ground acceleration, particularly at higher intensity values. Both however are more meaningful than using magni- tude in isolation when specifying engineering seismic loading design criteria. Source: Dr J Bayliss, Independent Advisor, UK. Pers. Comm. December 2012. 107

construction, slight to moderate structural damage in ordinarily built structures, and considerable damage in poorly built or badly designed structures. 271. The Khovd hospital lies in the Mongol Altai zone for seismic activity and this zone includes the Mongol Altai mountain range. The largest recorded earthquake in this zone occurred near the Munhhairhan Mountain in 1931 with a magnitude of over 8.0. Since then, no earthquake with a Magnitude of 7.0 or greater has been recorded in this zone. 3. Soil, geology and seismology in Erdenemandal Soum 272. In terms of natural zonation, Erdenemandal Soum is located steppe-forest zone of Khangai mountain range and in terms of soil characteristics zonation, it is located within the dark brown soil zone. Dark brown soil of river valley and wetland is distributed around the Soum center. The consultant team has taken soil sample at the proposed construction site within the Soum hospital yard. The Soil sample was tested at the laboratory of Engineer- Geodesy. Laboratory test results are shown in below table. Figure IV.16: Soil sampling location in the Erdenemandal Soum hospital

Table IV.69: Soil chemical analysis Content of base Variable

Sampling Depth, Е25 Humus Salt chemicals, elements NO3 CO2 No. sm Ds/m % % mg equi/100gr mg/100 Ca+Mg Ca 03 0-50 7.7 0.110 0.29 0.04 1.61 0.16 13.1 8.9 4.2 0.6 8 03 0-30 7.8 0.099 0.36 0.03 0.69 - 14.4 10.7 3.7 0.5 11 Table IV.70: Soil contamination analysis Content of heavy metals, mg/kg Sampling No. Depth, sm Ni Cd Pb Zn Cr Cu 03 0-50 15.4 0.00 49.7 37.0 4.82 10.5 Maximum allowed level (MNS 5850: 2008) 150.0 3.0 100.0 300.0 150.0 100.0

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4. Soil, geology and seismology in Tarialan Soum 273. In terms of natural zonation, the Soum belong to steppe forest zone of northern Mongolia and in terms of soil characteristics zonation it is located within the dark-brown soil of small mountains and hills. Forest brown soil type is distributed around the Soum center. The consultant team has taken soil sample at the proposed construction site within the Soum hospital yard. The soil sample was tested at the laboratory of Engineer-Geodesy. Laboratory test results are shown in below table.

Figure IV.17: Soil sampling location Table IV.71: Chemical contents in the soil sample Content of base Variable Sampling Depth, Е25 Humus Salt chemicals, elements NO3 CO2 No. sm Ds/m % % mg equi/100gr mg/100 Ca+Mg Ca Mg P2O5 K2O 0-10 7.7 0.535 3.11 0.03 6.7 - 26.5 18.2 8.3 2.5 18 01 10-30 8.1 0.069 2.53 0.04 5.3 0.3 25.2 15.8 9.4 1.9 12 Table IV.72: Soil contamination analysis Content of heavy metals, mg/kg Sampling No. Depth, sm Ni Cd Pb Zn Cr Cu 01 0-15 0.00 0.00 5.97 7.59 13.9 16.2 Maximum allowed level (MNS 5850: 2008) 150.0 3.0 100.0 300.0 150.0 100.0

5. Soil, geology and seismology in Bayan-Undur Soum 274. In terms of natural zonation, Bayan-Undur Soum is located within the semi-arid steppe zone of central Mongolia and in terms of soil characteristics zonation, it is located within the steppe brown soil zone. Rocky brown and grey brown soil types are distributed around the Soum center. The consultant team has taken soil sample at the proposed construction site within the Soum hospital yard. The Soil sample was tested at the laboratory of Engineer- Geodesy. Laboratory test results are shown in below table. 109

Figure IV.18: Soil sampling location Table IV.73: Chemical analysis results Content of base Variable

Sampling Depth, Е25 Humus Salt chemicals, elements NO3 CO2 No. sm Ds/m % % mg equi/100gr mg/100 Ca+Mg Ca P2O5 K2O 02 0-20 7.5 0.142 0.62 0.07 3.55 0.66 15.0 9.1 5.9 0.5 9

Table IV.74: Soil contamination analysis Content of heavy metals, mg/kg Sampling No. Depth, sm Ni Cd Pb Zn Cr Cu 02 0-20 16.2 0.00 30.6 87.6 3.44 15.3 Maximum allowed level (MNS 5850: 2008) 150.0 3.0 100.0 300.0 150.0 100.0

6. Soil, geology and seismology in Erdene Soum 275. In terms of soil characteristics zonation, Erdene Soum is located semi-desert grey brown soil zone. Grey-brown soil of arid steppes and semi-desert is distributed around the Soum center. The consultant team has taken soil sample at the proposed construction site within the Soum hospital yard. The Soil sample was tested at the laboratory of Engineer-Geodesy. Laboratory test results are shown in below table.

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Figure IV.19: Soil sampling location at the Soum hospital Table IV.75: Soil chemical analysis Content of base Variable Sampling Depth, Е25 Humus Salt chemicals, elements NO3 CO2 No. sm Ds/m % % mg equi/100gr mg/100 Ca+Mg Ca Mg P2O5 K2O 04 0-20 8.7 0.990 0.25 0.47 0.69 1.32 15.1 9.8 5.3 0.7 8 Table IV.76: Soil contamination analysis Content of heavy metals, mg/kg Sampling No. Depth, sm Ni Cd Pb Zn Cr Cu 04 0-20 13.9 0.0011 64.8 5.49 11.1 26.7 Maximum allowed level (MNS 5850: 2008) 150.0 3.0 100.0 300.0 150.0 100.0

7. Soil, geology and seismology in Dashinchilen Soum 276. In terms of soil-geography, Dashinchilen falls in the Greater Khangai Mountain dark- brown soil zone. The predominant soil types distributed in the project area includes:  sandy dark-brown soil of central Mongolian steppes region;  dark-brown soil of low hills and mountains; and  alluvial salty dark-brown soil of meadowland. Table IV.77: Chemical analysis results Content of base Variable

Sampling Depth, Е25 Humus Salt chemicals, elements NO3 CO2 No. sm Ds/m % % mg equi/100gr mg/100 Ca+Mg Ca P2O5 K2O 0-20 7.6 0.072 0.16 0.03 0.37 0.00 10.9 6.2 4.7 0.1 4

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Table IV.78: Soil contamination analysis Content of heavy metals, mg/kg Sampling No. Depth, sm Ni Cd Pb Zn Cr Cu 02 0-20 10.5 0.00 15.9 37.2 5.22 7.07 Maximum allowed level (MNS 5850: 2008) 150.0 3.0 100.0 300.0 150.0 100.0

8. Soil, geology and seismology in Ulaangom 277. Ulaangom city is surroundedbya diverse natural zones that range from elevated mountains to meadowland to semi-arid deserts. Soiltypes distributed in the region reflects the diverse feature of its ecosystem. The predominant soil types distributed around the Ulaangom city include:  Dark brown soil: is distributed at the Harhiraa mountain range in the southwest and Khan Huhii mountain range in the southeast of the city. Such types of mountain dark brown soil of fertile layer with 30-40sm of depth with 3.5-4.5% humus content.  Grey brown soil: is distributed at the mountain foots and narrow valley between mountains with average slope. Such type of soil has fertile layer of 20-30sm depth with 2-2.5% humus content.  Desert brown soil: is mainly distributed in Uvs lake basin.  Salty brown soil: is mainly distributed along the coastal lines of the Uvs lake.  Alluvial meadowland dark brown soil: distributed ain the depressions and meadowlands surrounding the Uvs lake and its tributary river basins. Such type of soil contains high grade of mud and humus level fluctuates between 5-18%. 278. In terms of permafrost division, the project region falls in the scattered occurrence zone. Relatively high altitude (1650-1900m above sea level) and minus value of mean annual temperature and long and cold winter in the project region are the main factors to permafrost occurrence. 279. In Modified Mercalli Scale earthquake risk classification, Ulaangom city falls in the zone VII which is defined as very strong risk of earthquake. Table IV.79: Chemical analysis results Content of base Variable

Sampling Depth, Е25 Humus Salt chemicals, elements NO3 CO2 No. sm Ds/m % % mg equi/100gr mg/100 Ca+Mg Ca P2O5 K2O 08 0-20 7.5 0.10 0.23 0.06 1.63 0.14 12.2 8.2 4.0 0.5 7.8

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Table IV.80: Soil contamination analysis Content of heavy metals, mg/kg Sampling No. Depth, sm Ni Cd Pb Zn Cr Cu 02 0-20 0.00 0.1 23.3 233.3 0.0 23.7 Maximum allowed level (MNS 5850: 2008) 150.0 3.0 100.0 300.0 150.0 100.0

Seismology of the 5 Soum health centers

280. Earthquake intensity risk zonation map is shown below. In terms of earthquake intensity risk, Tarialan, Dashinchilen and Bayan-Undur Soum centers fall within the Modified Mercalli Scale degree VI zone (strong risk), Erdene Soum center lies within degree I-V zone (slight to moderate risk) while Erdenemandal Soum lies within the degree VII zone (very strong risk).

H. Surface Water Resources and Quality 1. Surface water resources in Ulaanbaatar city 281. Ulaanbaatar is located in the Tuul River basin. The Tuul River is 704 km long and drains an area 49,840 square km. The width of the Tuul River is 35-75 meters in normal situation, depth 0.8-3.5 m and water flow is 0.50-1.50 m / sec. One of the specific peculiarities of the runoff source of the Tuul River is the relatively low portion of groundwater contribution. It was estimated that about 69% of the annual runoff forms from rainfall, 6% from snow melting and 25% from groundwater source. This indicates that according to the flow regime classification the Tuul River belongs to the rivers with spring snow melting and rainfall floods. 282. Water levels are very unstable during the warm season because the main factors contributing to river runoff are summer rainfall. There is observed spring floods at the end of April and early May, but the duration and runoff will be less than rainfall. After the spring flood a short warm season low flow is observed. During July to September the rainfall flood is observed with several flow peaks. The maximum discharge of the rainfall flood exceeds the spring flood amount by 1.5-2 times. After the rainfall flood, the water level recedes until the beginning of the ice phenomena. River ice phenomena begin from last 10 days of October and are it is fully be glaciated from 2nd 10 days of November until end of the April with an average of 149 days. Table IV.81: Long-term mean runoff data of Altanbulag River Station, the Tuul River

Years Months 1 2 3 4 5 6 7 8 9 10 2002 '' 0.023399 0.174994 0.714 14.71097 10.77067 23.43226 6.55 3.864333 1.419355 2003 '' '' 0.25 4.37 17 10.5 19.9 27.8 14.1 6.61 2004 " 0.374005 2.759801 15.78167 18 13.012 31.1871 20.52581 19.36333 18.1129 2005 " " 0.45 3.935367 9.83 27.86333 13.5871 14.63484 14.223 14.42903 2006 '' '' 0.13 2.35 12.2 26.2 29.9 10.7 8.67 8.04 2007 " " 0.169444 2.805 5.223871 6 14.50194 13.96161 9.045 5.9 113

Years Months 1 2 3 4 5 6 7 8 9 10 2008 0.091613 0.064828 0.343871 2.243333 2.595484 19.20733 27.76129 7.755484 11.388 6.989677 2009 0.056129 0.087857 0.722258 5.217667 10.03613 10.14867 18.43871 16.50742 14.46667 7.514839 2010 0.047677 0.159357 0.707742 2.597667 16.98677 11.609 5.363226 13.2771 6.192 5.122903 2011 0.049 0.12125 2.029032 5.377333 17.40161 20.07833 24.28903 18.22516 14.27333 2.962903 2012 0.033871 0.067241 0.627419 6.742 17.38065 20.677 61.61032 60.65355 23.57567 14.53935 2013 0.027852 0.119071 0.673871 2.946667 20.28419 26.20433 36.66258 62.00161 47.74533 14.36871 2014 0.018226 0.107143 0.796774 4.468 28.92387 27.922 59.56258 32.11935 17.12867 13.50645 2015 0.018226 0.107143 0.677097 3.202667 4.504839 4.155 12.68581 25.03161 11.162 7.454516

Table IV.82: Long term mean runoff of the Tuul River at Ulaanbaatar – Zaisan Station

Months Years 1 2 3 4 5 6 7 8 9 10 11 12 2001 0.00 0.00 0.58 4.55 44.99 26.48 26.18 42.50 31.19 13.57 2.54 0.18 2002 0.00 0.00 0.15 0.87 34.97 23.93 40.60 13.10 11.33 7.33 1.34 0.04 2003 0.00 0.00 0.03 2.66 28.60 16.90 32.40 41.70 22.60 8.95 2.05 0.35 2004 0.00 0.00 0.07 13.56 24.82 18.07 44.59 25.51 23.76 18.35 4.92 0.52 2005 0.00 0.00 0.02 3.70 14.75 52.05 22.80 25.64 31.42 17.82 2.72 0.05 2006 0.00 0.00 0.14 3.66 20.33 48.45 48.10 18.71 11.10 8.65 1.65 0.08 2007 0.00 0.00 0.16 2.25 15.40 10.50 26.20 25.30 17.70 9.32 0.94 0.03 2008 0.00 0.00 0.04 1.97 3.62 38.30 78.90 20.10 38.10 15.50 4.44 0.33 2009 0.01 0.00 0.13 8.68 11.22 23.24 44.58 33.66 21.36 10.45 1.58 0.31 2010 0.01 0.00 0.00 1.67 22.30 14.00 11.30 24.50 12.40 6.53 1.50 0.02 2011 0.00 0.00 0.00 3.96 31.00 33.50 40.85 16.39 11.28 6.45 2.00 0.13 2012 0.00 0.00 0.00 0.72 23.80 26.00 77.60 71.50 38.70 17.50 3.52 0.27 2013 0.00 0.00 0.00 1.96 12.10 34.60 49.30 80.20 54.50 16.00 3.44 0.36 2014 0.01 0.00 0.01 2.21 41.00 41.70 91.30 36.90 19.70 11.20 3.25 0.69 2015 0.06 0.00 0.13 12.00 7.61 8.06 12.50 30.40 13.50 8.72 2.48 0.39

283. Flooding. Localized flooding can be observed in many areas of the country, especially in built-up areas after heavy rain because of poor water drainage. This flooding is ephemeral and the water subsides rapidly. More than 75% of precipitation in Ulaanbaatar occurs in July and August. Serious floods, mainly caused by the Tuul River, occurred in 1915, 1939, 1959, 1966, 1967, 1971, 1973, 1982 and 2003. In 1966, the Tuul water level reached 3.2 meters with a flow of 1500-1800 cubic meters per second and the flood killed over 100 people.

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Source: Emergency Management Department of Ulaanbaatar Municipality Figure IV.20: Flood prone areas of Ulaanbaatar 284. Surface water quality. There are total of 13 water quality hydrological gauging stations operating in Ulaanbaatar. Of these, Selbe-Sanzai guards do not operate. In determining the water quality and composition of the Tuul and its tributaries, data of June 2013- 2017 provided by Central Environmental Laboratory of the Institute of Meteorology and Hydrology was used for presenting the long-term average rate. The Institute of Meteorology and Hydrology also summarizes he results of the water quality monitoring reports and assesses the water pollution index at each monitoring point. Data of The Tuul and its tributary rivers, and the monitoring results for drinking water quality and safety for the capital city and the Soums carried out by the General Agency for Specialized Inspection. Table below provides average water quality in Tuul river of the Ulaanbaatar city. Table IV.83: Average Water Quality in the Tuul river in Ulaanbaatar City (2007-2017)

Summary DO BOD5 COD NH4+ NO2- NO3- PO4-3 [mg/l] [mg/l] [mg/l] [mg/l] [mg/l] [mg/l] [mg/l] Mean 8.68 4.59 5.42 1.47 0.060 0.65 0.12 Min 6.87 1.79 2.96 0.11 0.003 0.15 0.01 Max 9.40 15.79 9.34 6.47 0.220 1.77 0.50 Standard 0.81 4.37 2.22 2.18 0.079 0.51 0.17 Source: Data provided by Environmental monitoring laboratory of MNET

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285. Heavy metals. The result of heavy metals analysis of the samples taken by SEC LLC in August 2017 is shown in Table below. The table shows that there is no indication of surface water exceeded 2nd grade of the Surface Water Quality Standard (SWQS) which was classified as clean. Most of the heavy metals tend to increase along the downstream. Table IV.84: Heavy metals in Tuul River Water and Around Tuul River Area

№ Laboratory Samples Content mg / l No. Ni / nickel Cd / Pb / lead Zn / Cr / Cu / cadmium zinc chromium copper 1 3230 Tuul+Songino 0,00 0,00 0,00 1,87 0,00 0,67 2 3231 Tuul River 0,00 0,00 0,00 0,59 0,0056 0,33 3 3235 Tuul/Zaisan/ 0,00 0,00 0,00 0,67 0,00 0,16

2. Surface water resources in Khovd city 286. Surface water resources in the project area include rivers, streams, springs and lakes. The project area is located within the Central Asian Internal Drainage basin and is on the far western edge of the Great Lakes Depression36. Unlike water hydrological regimes in the North and East of Mongolia which drain to the ocean, the project area is in an internal drainage basin where surface waters drain to inland terminal locations where the water evaporates or seeps into the ground. Specifically, the project area is in the Khar lake-Khovd river basin, a sub-basin of the Great Lakes’ Depression and is considered unique not only in Mongolia, but also in the world with its high mountains distributed by glaciers and permanent snow cover, canyons, valleys, and ecological zones such as forest steppe, steppe, Gobi and desert regions. 287. The basin area is 86,120.8 sq. km and is divided into three water balance units: Khovd river, Buyant river and Khar Us-Durgun lake basins according to the hydrological network. 288. Buyant River. The Buyant River is 171 km long, originating in the Mongol–Altai Mountains and Huh Serkhiyn Mountain and runs through the northern part of Khovd town. It is a tributary of the Khovd River, which flows into the Khar Us Lake. When the discharge of the river is less than 6 m3/s, the river’s waters will not reach Khovd River. The proposed construction site is located at 290m distance from the Buyant river. According the Law on Water, protection zone for any surface water covers 200m area on both sides of the river bank. Thus, the construction site does not fall within the water protected zone and there is no restriction for any construction activity.

36 Batnasan N., (2003). Freshwater issues in Mongolia, Proceedings of the National Seminar on IRBM in Mongolia, 24–25 Sept. 2003, Ulaanbaatar, p. 53–61.

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Figure IV.21: Location of the Khovd Aimag Hospital and the Buyant River Table IV.85: Monthly mean water flow data for Buyant river

Normal flow rate Average flow rate Minimum flow rate No % Q 5о /м3/ек/ % Q 75 /м3/ек/ % Q 95/м3/ек/ 1 2.25 1.44 2.32 1.40 0.85 0.324 2 1.98 1.28 1.33 0.806 0.90 0.343 3 2.73 1.75 2.86 1.73 0.77 0.294 4 3.10 1.98 7.74 4.69 6.92 2.64 5 8.86 5.68 13.8 8.36 13.1 4.99 6 16.8 10.71 17.0 10.3 17.4 6.63 7 23.7 15.2 15.2 9.12 18.6 7.09 8 14.6 9.35 12.4 7.51 12.9 4.92 9 9.04 5.79 9.80 5.94 10.2 3.89 10 7.59 4.86 8.87 5.37 10.5 4.00 11 5.34 3.42 5.25 3.18 6.47 2.47 12 3.92 2.51 3.26 1.97 1.62 0.618 117

Normal flow rate Average flow rate Minimum flow rate No % Q 5о /м3/ек/ % Q 75 /м3/ек/ % Q 95/м3/ек/ 100.0 5.34 100.0 5.05 100.0 3.18

289. Seasonal Flooding. The rivers in the project area flow from the Altai Mountains. Spring floods in these rivers generally start in the middle of April, with peak flow occurring in late June and continuing for 110–150 days. The spring flood flow is 60–90% of total annual flow of Altai Mountain Rivers and the main source of water is from melting snow and glaciers. Summer flow is significant because rainfall run off combines with the spring flood waters from the Altai Mountain Rivers. Surface water quality in Khovd Table IV.86: Buyant River Water Quality (Gauging Station North of Khovd City)

Date pH EC O2 BOD NH4 2016.9.29 7.41 205.0 10.21 3.0 0.24 2016.10.28 7.27 189.0 9.15 1.8 0.15 2016.11.22 7.34 185.0 9.86 2.5 0.16 2017.4.28 7.27 223.0 9.68 2.8 0.37 2017.5.31 7.41 219.0 9.33 2.3 0.28 2017.6.30 7.56 195.8 8.62 2.3 0.21 2017.7.31 7.18 223.0 7.10 2.7 0.20 2017.8.29 7.22 201.0 7.60 2.7 0.16 2017.9.29 7.14 209.0 7.94 2.5 0.27 2017.10.31 7.57 197.0 8.11 2.2 0.32 2017.11.30 7.25 161.0 8.79 2.7 0.20 2018.4.30 7.65 273.0 9.30 2.4 0.44

Table IV.87: Buyant River Water Quality (Gauging Station South of Khovd City)

Date pH EC O2 BOD NH4 2016.9.29 7.26 189.0 10.74 3.2 0.22 2016.10.28 7.21 197.0 8.80 1.9 0.13 2016.11.22 7.29 207.0 10.38 2.6 0.19 2017.4.28 7.35 207.0 10.21 2.6 0.35 2017.5.31 7.53 207.0 9.86 1.9 0.36 2017.6.30 7.32 224.0 8.80 2.1 0.18 2017.7.31 7.05 201.0 7.60 2.9 0.17 2017.8.29 7.13 187.0 8.28 3.0 0.09 2017.9.29 7.36 194.3 8.62 2.7 0.24

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Date pH EC O2 BOD NH4 2017.10.31 7.63 179.0 8.45 2.0 0.28 2017.11.30 7.17 177.0 9.13 2.9 0.23 2018.4.30 7.42 209.0 9.80 2.2 0.37

3. Surface water resources in Erdenemandal Soum 290. Erdenemandal Soum is located the Hanui river valley which belongs to Selenge river basin. Hanui river starts at the Khan-Undur mount in the Khangai range and flows 421 km distance toward the Selenge river in northeastern direction. Hanui river has a catchment area of 14,620 km2 and a width of 5-35m at its upper section and 40-110m at its lower section. Average depth of river is 0.5-2.2m. Water flow of the Hanui river is between 0.5 m/sec to 3.5 m/sec, varies depending on the surface slope.

Figure IV.22: Surface water network map of Erdenemandal Soum

4. Surface water resources in Tarialan Soum 291. The Soum center is located at 25km distance from the Selenge river which is the biggest river in Mongolia and biggest tributary for the lake Baikal. More than 40% of all rivers in Mongolia tribute to Selenge river which starts at the confluence point of Ider river and Delger river in Khuvsgul province and flows 1024km to the lake Baikal. Selenge river flows 615 km 119

through the territory of Mongolia. Its basin (including all its tributary rivers) occupies 447,000 km2 of area in northern Mongolia.

292. At the upper section, Selenge river is 60-70m wide and 0.5-3.0 deep. At its lower section, Selenge river is 100-250m wide and 1.0-5.0 deep.

Figure IV.23: Surface water network map of Tarialan Soum 5. Surface water resources in Bayan-Undur Soum 293. There are no surface water resources with permanent flow nearby the Bayan-Undur Soum center. However, in terms of surface water network of Mongolia, the Soum belongs to the Ongiin River basin zone. Ongiin river flows in 108 km distance from the Soum center. Surface water map of the Bayan-Undur Soum is shown below.

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Figure IV.24: Surface network map of Bayan-Undur Soum

6. Surface water resources in Erdene Soum 294. There is no surface water resource registered in Erdene Soum because it is located in the midst of the Gobi Desert. 7. Surface water resources in Dashinchilen Soum 295. Dashinchilen Soum is located within the Tuul river basin. Khar Bukh river which is one of the main tributaries for Tuul river, flows in 9km distance from the Soum center on northwestern side. Other major surface water bodies in the project area are Ikh Tsagaan and Tsagaan lakes that locate in 18km and 20km distance from the Dashinchilen Soum center on eastern side, respectively. Surface water bodies around Dashinchilen Soum is shown in below map.

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Figure IV.25: Surface water map of Dashinchilen Soum

8. Surface water resources in Ulaangom city 296. The main surface water bodies in the project region includes Uvs lake (in 25km distance) and its tributary rivers such as Gashuunii river (3km on southeast), Harhiraa river (12km on south) and Sagil river (in 23km on north). Uvs lake is the biggest lake in Mongolia by surface area, covering 3350 km2. Main tributaries for Uvs lake is Tes river, Harhiraa river, Sagil river and Borshoo river. No river is stemming from the lake which makes it a highly saline lake. Average altitude of the Uvs lake area is 750m above sea level. Main surface bodies around Ulaangom town is shown in below map.

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Figure IV.26: Surface water map of Ulaangom city

I. Groundwater Resources and Quality 297. Out of the 13 T1 components, 6 components are already connected to centralized water supply system of their respective areas. 3 components use deep water well (Khan-Uul hospital, FHC in 14th khoroo of Khan-Uul and SHC in Erdenemandal soum) and 4 components use GAWDS (FHC’s in 10th khoroo of Khan-Uul, 19th khoroo of Chingeltei and SHC’s in Bayan-Undur and Dashinchilen soums). Water supply through GAWDS comes from a government owned central water well. The current water sources have enough supply to serve the project. 123

298. All key parameters tested meet the requirements of the Drinking Water standard of Mongolia MNS0900:2018. Thus, it can be concluded the tested water samples for all components are not polluted and can be used for human drinking purposes. 1. Ground water resources in Ulaanbaatar 299. Groundwater exists in unconfined aquifers (alluvial sediments of late quaternary to recent period) at depths between 4 - 30 m. The static water level in the Tuul River valley is from 2 - 6 m in winter and 0.5-5 m in summer, if there are no wells in operation. However, extraction of groundwater can cause the static water level to drop from 10 - 13 m in winter and from 15 - 19 m in summer. 300. There were spread two main types of aquifers of porous water bearing complex and fractures zone within the Tuul river basin and there can be found springs or spas (Ulaanbaatar, Ar Janchivlin, Ovor Janchivlin, etc) containing natural carbon dioxide gas in the porous and fracture water. The porous water bearing complex contained in the lower Cretaceous, Neogene and quaternary deposits, however the fractured zone was found in the intrusive rocks of Cambrium, Devonium, Jurassic and Triassic periods and in the sedimentary and metamorphic deposits of Carbonic period. 301. Geological ages and lithologic compositions of the aquifers found in the Tuul river basin were generalized and divided into 6 porous aquifers and 2 fractured zones based on results of previous studies and groundwater movement as well as classification made considering dominant characteristics either porosity or fractured level. i. Exploitable ground water reserve for the Ulaanbaatar city 302. As of 2007, the central water supply grid for Ulaanbaatar city had 96 wells, of which the wells #1-9 and #12-27 were opened between 1961-1974 and the wells #40-46, #48-63 were opened between 1980-1984. In 1980, following ground water deposits and their reserve were approved by the Government of Mongolia. Since then, 4 new ground water deposits, such as Yarmag-Sonsgolon, Buyant Ukhaa, Uvur Gorkhi and Terelj-Tuul, were newly discovered. Table IV.88: Tuul Basin Alluvial Ground Water Deposits Near Ulaanbaatar City

Name of deposits Reserve, Type of consumption thousand m3/day +B C1 Tuv 90.3 34.8 Drinking water and industrial Upper 89.7 - Drinking water and industrial Industrial 30.3 - Drinking water and industrial Meat Processing Plant 8.6 - Drinking water and industrial CHP-1 3.5 - Technical CHP-2 4.92.5 - Technical CHP-3 41.4 - Technical CHP-4 7.2 - Technical Others 35.8 Technical

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Name of deposits Reserve, Type of consumption thousand m3/day Total 278.4 70.6

Table IV.89: Newly discovered ground water deposits around Ulaanbaatar city

Name of deposit Reserve, m3/day Yarmag Sonsgolon (2011) 26201 Buyant Ukhaa new district (2010) 22550 Uvur Gorkhi (2003) 11750 Terelj-Tuul (2007) 40062 Khui Doloon Hudag (2007) 3845 Total 104,408

303. Ulaanbaatar city has seen a sharp increase in ground water consumption in recent years due to rapid growth of its population. According to a survey in 2010 by the city government, there were around 800 water wells are being used by the city residents and entities that exploit 339.7 thousand m3 ground water per annum (Jadambaa, 2009). 304. The central water supply grid of the Ulaanbaatar city comprises of 3 main water supply sources: namely Central source, Industrial source and Meat Processing Plant. Besides of the 3 main sources, there are 3 other supply sources, namely Upper, CHP-3 and CHP-4, that consists of 218 boreholes. The total ground water reserve of these main sources is 278.4 thousand m3/day. Ground water exploitation amount from these sources equal to 261.6 thousand m3/day and from other 576 individual water wells in the city equal to 78.1 thousand m3/day. The total ground water exploitation amount is currently at 339.7 thousand m3/day. ii. Groundwater Quality in Ulaanbaatar city 305. Along the Tuul river valley, quality of the groundwater supply resources of Ulaanbaatar is satisfactory. Water in the Tuul river valley found in alluvium deposit and it is very clear and soft, and its chemical composition belongs to the first grade of calcium group of the hydrocarbonate class. However, the water quality and chemical composition of wells and boreholes drilled in other areas and zones other than Tuul river valley vary a lot. According to the results of previous studies and analyses made in the water samples taken from wells located in the vicinity of Ulaanbaatar city, especially some water points on its north-west, north and east have mineralized water, most well water is hard, chemical composition is of hydrocarbonate class and belongs to the calcium group water. But the water of the sedimentary rocks in the Tuul river valley has low mineralization and chemical composition is of hydrocarbonate class and calcium group. This water is clear and soft and it is of the types of 1 and 2. 306. In order to identify ground water pollution, water samples were taken from the wells that are being used for the Ulaanbaatar city central water supply system. In order to determine changes in water quality over years, we have used water quality survey results made in 125

2009, 2010, 2013 and 2014. All survey results were compared to the Mongolian Standard on Drinking water MNS 900:2005. 2010, 2013 and 2014 water quality surveys were conducted within the hydrogeological exploration works and water quality testing was made at the Laboratory of the Geo-Ecological Institute. Below table shows Laboratory test results for water samples taken from the wells # 1, 6, 8, 9, 21, 29, 31, 47, 53, 54 of central water supply system during surveys in 2009 and 2014. Table IV.90: Laboratory Results for Water Samples, Central Water Supply System Well# Date of pH TDS Na+ К+ Ca2+ Mg2+ NH4+ Cl- SO42- HCO3 sampling (ppm) 1 2009 6.9 51.0 2.7 27.1 6.7 4.3 4.1 6.6 44.8 2014.09.23 7.4 60.0 10.6 12.0 1.2 0 7.1 5.0 51.9 Average 7.0 67.8 7.9 17.0 3.2 1.4 6.1 3.9 52.6 6 2009 6.8 58.0 3.8 25.7 11.7 2.0 6.7 9.5 46.4 2014.09.23 7.2 42.0 7.7 12.0 1.2 0 5.3 4.0 48.8 Average 7.0 50.0 5.7 18.8 6.4 1.0 6.0 6.7 47.6 8 2009 7.2 44.0 5.5 18.3 16.8 0.4 7.7 6.2 42.2 2014.09.23 7.2 52.0 2.9 16.0 1.2 0 3.6 6.0 48.8 Average 7.2 61.8 6.0 15.8 6.5 0.1 5.9 4.1 50.3 9 2009 6.9 62.0 0.2 19.5 12.3 10.0 8.8 5.7 45.9 2014.09.23 7.2 82.0 6.0 22.0 2.4 0 5.3 15.0 67.1 Average 7.0 78.6 5.1 17.8 5.7 3.3 7.1 6.9 58.0 21 2009.06.30 7.2 42.0 7.9 24.0 9.5 0 7.9 5.4 43.1 2014.09.23 7.1 36.0 7.7 10.0 1.2 0 5.3 4.0 42.7 Average 7.2 39.0 7.8 17.0 5.3 0 6.6 4.7 42.9 29 2009 6.4 58.0 0.3 23.9 13.6 4.4 5.3 8.2 47.9 2014.09.23 7.7 70.0 6.6 22.0 1.2 0 3.6 4.0 79.3 Average 7.1 64.0 3.4 22.9 7.4 2.2 4.4 6.1 63.6 31 2009 6.9 65.0 2.0 23.7 13.5 3.1 8.7 20.3 30.3 2014.09.23 7.2 50.0 8.1 14.0 1.2 0 5.3 5.0 54.9 Average 7.1 57.5 5.1 18.9 7.4 1.5 7.0 12.7 42.6 47 2009 6.9 47.0 1.6 21.4 15.3 3.5 5.4 8.3 46.4 2014.09.23 7.3 50.0 9.4 12.0 1.2 0 7.1 5.0 48.8 Average 7.1 48.5 5.5 16.7 8.3 1.7 6.2 6.7 47.6 53 2009 6.7 57.0 10.9 21.0 6.5 3.0 6.0 12.9 36.5 2014.09.23 7.1 43.0 4.3 10.0 4.9 0 5.3 4.0 51.9 Average 6.9 50.0 7.6 15.5 5.7 1.5 5.7 8.5 44.2 54 2009 6.5 43.0 9.3 21.7 6.7 3.3 8.3 6.6 39.8 2014.09.23 7.2 50.0 8.9 14.0 1.2 0 3.6 4.0 61.0 Average 6.9 46.5 9.1 17.8 3.9 1.7 5.9 5.3 50.4 MNS 900:2005 6.5-8.5 100 30 1.5 350 500

Table IV.91: Laboratory Results for Water Samples at well used by FHC in 14th khoroo of Khan-Uul district Parameter Measuring unit Test Results Drinking water standard of Mongolia MNS 0900:2018 Turbidity 0.00 - Hardness mg-eqv/l 4.10 7 pH 7.31 6.5-8.5 Na+ + K+ mg/l 337.06 400 Ca2' mg/l 57.31 100 Mg2- mg/l 15.08 30

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Parameter Measuring unit Test Results Drinking water standard of Mongolia MNS 0900:2018 2 SO4 mg/l 0.29 500 HCO3 mg/l 256.28 - 2 CO3 mg/l 0.00 - Cl mg/l 19.17 350 Total sus- g/l 0.65 1 pended solids NH4 mg/l 0.7 1.5 NO3 mg/l 4.99 50 Table IV.92: Laboratory Results for Water Samples at well taken from the ger area water distribution system, used FHC in 10th khoroo of Khan-Uul district Parameter Measuring unit Test Results Drinking water standard of Mongolia MNS 0900:2018 Turbidity 0.00 - Hardness mg-eqv/l 3.99 7 pH 7.34 6.5-8.5 Na+ + K+ mg/l 158.49 400 Ca2' mg/l 61.12 100 Mg2- mg/l 11.43 30 2 SO4 mg/l 0.1 500 HCO3 mg/l 329.51 - 2 CO3 mg/l 0.00 - Cl mg/l 26.98 350 Total sus- g/l 0.56 1 pended solids NH4 mg/l 0.7 1.5 NO3 mg/l 5.04 50 Table IV.93: Laboratory Results for Water Samples at well taken from the ger area water distribution system, used FHC in 19th khoroo in Chingeltei district Parameter Measuring unit Test Results Drinking water standard of Mongolia MNS 0900:2018 Turbidity 0.00 - Hardness mg-eqv/l 0.9 7 pH 7.24 6.5-8.5 Na+ + K+ mg/l 369.37 400 Ca2' mg/l 12.63 100 Mg2- mg/l 3.28 30 2 SO4 mg/l 0.31 500 HCO3 mg/l 85.43 - 2 CO3 mg/l 0.00 - Cl mg/l 26.27 350 Total sus- g/l 0.57 1 pended solids NH4 mg/l 0.7 1.5 NO3 mg/l 6.05 50 Table IV.94: Laboratory Results for Water Samples at well water used by Khan-Uul district hospital Parameter Measuring unit Test Results Drinking water standard of Mongolia MNS 0900:2018 Turbidity 0.00 - Hardness mg-eqv/l 2.60 7 pH 7.56 6.5-8.5 Na+ + K+ mg/l 185.06 400 127

Parameter Measuring unit Test Results Drinking water standard of Mongolia MNS 0900:2018 Ca2' mg/l 38.08 100 Mg2- mg/l 8.51 30 2 SO4 mg/l 0.12 500 HCO3 mg/l 244.08 - 2 CO3 mg/l 0.00 - Cl mg/l 26.98 350 Total sus- g/l 0.32 1 pended solids NH4 mg/l 1.00 1.5 NO3 mg/l 5.05 50

307. Permafrost in Ulaanbaatar area. Ulaanbaatar lies in a discontinuous permafrost region of Mongolia. Boundary and suites of the permafrost, found over the central and northern parts around Nogoon Nuur and Ikh Toirog, were determined during development of the map of Ulaanbaatar at scale 1:10000 on the basis of the previous research materials and drilling and geophysical survey undertaken during the research. This research registered that upper edge of the permafrost starts at 2.5-2.7 m and maximum thickness reaches 35 m. Drilling and temperature measurement, undertaken in 2002, did not find any permafrost up to 8 m and thickness of permafrost does not exceed 20 m. Permafrost of the study area is stable in high temperature which fluctuates between 0.1˚C and 0.3˚C. The research found that the permafrost process around Nogoon Nuur was relatively active or intensive (Tavan Undes LLC, 2003, page 12). 308. On the territory of Ulaanbaatar, annual and seasonal permafrost soil is spread in relation to land surface formation and climate feature. The annual permafrost intermittently and patchily spread here (Tumurbaatar, 1995). The annual permafrost spreads on relatively small area in intermittently through average high mountains near Tolgoit, Selbe, Uliastai and Gachuurt river outfalls in north part of the Ulaanbaatar. But above-mentioned rivers valleys and outfalls of Baruun Salaa and Zuun Salaa rivers in Tolgoit, Belkh and Selkh rivers, Sharga Morit and Khandgait rivers in Selbe river, Zuun gol and Baruun gol, Urd Bayn gol rivers in Uliastain river, Shijir, Shavart and Bugat rivers in Gachuurt river valley, the long- term permafrost spreads patchily. In other parts along or in low parts of land surface, medium bare mountain slopes and low hills relic soil spreads in seasonal permafrost. The annual permafrost spreads mostly in valley bottom and back side of mountains, humid sandy and argillaceous debris. Here phenomenon of cold salient, seasonal and annual cold fraction and overflow is commonly occurred by impact of the permafrost process. Furthermore, various micro types from the permafrost are derived in hollows and convexes. The most occurred phenomenon of the permafrost is the overflow “toshin”. It is related to seasonal freezing and formed in river, stream and sprig beds, and sometimes it occupies even side areas. When it gets warm in spring its ice melts and breaks valley bottom in some extent. 309. Annual absolute thickness of the permafrost is 15-40 m in thick river beds, hollow and convex regions, 25-120 m on top of high mountains and their back slopes and average thickness is 30-100 m. Seasonal freezing of relic soil in natural normal condition of annual permafrost and its melting is 2.7- 3.4 m in alluvia gravel, gravelly sand and sandy soil or in river beds, 4.0- 5.6 m in sandy soil with broken rocks of mountain slopes, 2.8- 3.1 m in

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mountain back slope soil and 5.1- 5.4 m in mountain top soil and sediment (Sharkhuu S., 2002). 310. Annual mean temperature of the relic soil freezes from zero degrees and its seasonal freezing and melting depth size decreases, when its loamy, fatty and humid feature is increased. In coherent to it, the relic soil seasonal melting average depth does not exceed over 2m in marsh area of river beds and mountain flat slope and reaches at 3-4 m on valley slope dry area. Dominant average freezing of the relic soil seasonally is 2.5-3.5 m deep in average, but it does not exceed over 1.5-2.0 m in argillaceous debris enriched by humidity and reaches at 4-5 m in broken sandy debris lack of humidity in annual and seasonal permafrost process and phenomenon spongy debris spread is the most common in bottom of valleys and hollows regarding humidity and less distributed to mountain side slope, even in south slope. 311. For the last year’s depth of permafrost relic soil is presumably to decline and annual permafrost to be changed in south line of the relic soil due to natural and human activities, which was mentioned by researchers of Institute of Geography. It is clearly observed in patchily spread areas, where the permafrost depth declined, marshes along rivers dried up and seasonal permafrost is decayed. Due to loss of the permafrost relic soil forestation and reproduction is stagnated and stretches from forest landscape to steppe landscape that affects loss of plant cover and chases wildlife away from its habitat. Therefore, the annual and seasonal permafrost relic soil and its process influence specifically on natural and socio- economic condition of this area. Currently, there is no detailed research on permafrost of the Ulaanbaatar available and it is not possible to define changes made on its phenomenon, proves and relic soil freezing and melting in depth. Figure IV.27 shows the regional distribution of permafrost near Ulaanbaatar.

Figure IV.27: Distribution of Permafrost in the Area of Ulaanbaatar

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2. Ground water resources in Khovd area 312. Groundwater resources are limited and its distribution uneven in the Khar lake-Khovd river basin. Within the basin, groundwater generally accumulates close to tributaries of rivers and around lake depressions. A groundwater deposit in alluvial sediments of Buyant river valley has been exploited as the main water supply source for the City of Khovd. The groundwater deposit is distributed in an 70.8 km² area along the Buyant river and its potential exploitable reserve is estimated as 11.2 million m³/year. If to include a wider area of where water bearing rocks and alluvial sediments exist for the estimation, total potential groundwater reserve could be up to 1,409 million m³/year. According to more detailed groundwater exploration surveys in recent years, the verified exploitable reserve for the Buyan valley deposit is 16,070 m³/day of which 3,900 m³/day or 24.3% of the reserve is already exploited during the last 40 years. 313. Permafrost. Permafrost is characterized by negative temperatures of soils/rocks and occurrence or possible occurrence of underground ice. An active layer is subject to seasonal thawing/freezing, beneath which is permanently frozen ground. Global warming and anthropogenic impacts intensify permafrost warming and thawing. Permafrost degradation can cause substantial change in water hydrology, damage infrastructure and affect ecosystems. In the Altai Mountain region, where permafrost is divided into five zones that depend on altitude: (i) continuous, (ii) discontinuous, (iii) widespread island, (iv) rare spread island, and (v) sporadic: 314. Continuous permafrost lies predominantly in mountain areas with altitude of more than 3,000 m above sea level. The temperature of the permafrost ranges between -1.5 ° and - 2.5 ° and its thickness is between 80 and 150 m. The minimum temperature of the permafrost drops to -4 °, and in some locations, permafrost thickness reaches 200–500 m. Discontinuous permafrost is widespread in the Western part of the Mongol–Altai Range and in some upper reaches of the Khovd River. The temperature of the permafrost ranges between -0.8 and -1.5°, with a thickness of 40 to 80 m. The maximum thickness of permafrost is 200 m.

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Figure IV.28: Permafrost Map, Khovd Source: Administration of Land Affairs. Geodesy and Cartography. 2004. Geographic Atlas of Mongolia. Ulaanbaatar. 315. Widespread island permafrost is located in areas with elevations between 2,500 and 2,800 m above sea level. The temperature of the permafrost is between -0.2 ° and -0.8 ° with a thickness ranging from 15 to 40 m. The maximum thickness of the permafrost is 100 m. Rare spread island permafrost occurs throughout valleys of rivers and lakes with elevations of 2,000 - 2,500 m above sea level. The temperature of the permafrost is between -0.1 and -0.2° and the thickness between 5 and 15 m. Sporadic permafrost occurs in the muddy soil of springs. The average temperature of the permafrost is between -0.0 ° and - 0.1 ° with an average thickness between 0.5 m and 5.0 m. 131

316. Around Khovd city continuous, discontinuous, widespread island, and rare spread permafrost have been reported. 317. Groundwater quality. Groundwater in the Altai mountainous region is known to exhibit mineralization and hardness characteristics of 640 mg/l and 4.8 mg-eqv/l respectively, and the water for the region is salty and fluorinated.37 Groundwater resources in the project area are shown in table below. Table IV.95: Groundwater Resources in the Project Area

Khovd river basin Buyant river basin Volume million m3 786 139 Ground water use as % of total by 2021 0.67% 2.9% Source: Integrated Water Resource Management Plan for Khar Lake–Khovd River Basin (2011).

318. SEC LLC experts carried out groundwater quality testing in Khovd city in April 2018. A sample taken from the central water supply distribution grid was tested at the laboratory of Institute of Meteorology in Khovd city. The test results show the groundwater sample meets drinking water standard of Mongolia (MNS 0900:2005). Table IV.96: Laboratory Test Results for Groundwater Sample

№ Parameters Test results Measuring MNS 900:2005 unit 1 Turbidity / 1.5 2 Hardness 1.84 // 7 3 Total dissolved solids (TDS) 12.8 / - 4 Cl 10.6 / 350 5 SO4 19.2 / 500 6 Ca 5.7 / 100 7 Mg 0.47 / 30 8 NH4 0.19 / 1.5 3. Ground water resources in the 5 Soums 319. Mongolia has relatively scarce groundwater resources especially in the southern and western parts of the country. Precipitation is the main source of groundwater recharge. However, due to relatively low precipitation level and high evaporation level during the summer, such recharge rates are slight to moderate. There are groundwater reserves at all of the 5 Soum centers that are being exploited by human drinking. Total exploitable reserve and resumable reserves for the each Soum center are shown in below tables.

37 Source: National Center for Emergency, 2002.

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Table IV.97: Total renewable groundwater reserves for the 5 Soums Total resumable Catchment Recharge Water Basin Project areas/Soums reserve, million № area, km2 rate, mm m3/year 1 central and eastern part of 28613.00 5.000 143.000 Uvurkhangai province Ongiin Gol (including Bayan-Undur Soum) 2 Hanui river Erdenemandal Soum 1890.00 40.000 90.000 Galba-Uush 3 Erdene Soum 229.00 100.000 23.000 Dolood Gobi 4 Selenge Tarialan Soum 3950.00 80.000 250.000 5 Tuul river Dashinchilen Soum 2859.00 75.000 214.000

Groundwater quality in the 5 Soums 320. Results of water quality test analysis made at the Laboratory of Engineer Geodesy LLC show that all water samples tested meet drinking water standard of Mongolia. Table IV.98: Ground water well Laboratory test results, Erdenemandal Soum Parameters Content (mg-equivalent/l) Max allowed level (mg/l) MNS900:2005 TSS 0.53 1000 Hardness 2.5 7.0 Turbidity 0 pH 7.14 CI- 21.3 350

-- SO4 0.01 500

- NO3 6.00 50.0

- NO2 1.50 1.0

2- CO3 0.00

- HCO3 292.9 Na++K+ 75.5

+ NH4 0.7 1.5 Ca2+ 14.03 Mg2+ 21.89 30.0 Fe 1.00

Table IV.99: Ground water well Laboratory test results, Tarialan Soum Parameters Content (mg-equivalent/l) Max allowed level (mg/l) MNS900:2005 TSS 0.89 1000 Hardness 5.08 7.0 Turbidity 0 pH 7.45 133

Parameters Content (mg-equivalent/l) Max allowed level (mg/l) MNS900:2005 CI- 18.46 350

-- SO4 0.23 500

- NO3 4.64 50.0

- NO2 1.50 1.0

2- CO3 0.00

- HCO3 414.94 Na++K+ 302.17

+ NH4 0.70 1.5 Ca2+ 78.16 Mg2+ 14.35 30.0 Fe 1.50

Table IV.100: Ground water well Laboratory test results, Bayan-Undur Soum Parameters Content (mg-equivalent/l) Max allowed level (mg/l) MNS900:2005 TSS 0.52 1000 Hardness 2.97 7.0 Turbidity 0 pH 7.11 CI- 26.27 350

-- SO4 0.18 500

- NO3 5.66 50.0

- NO2 1.50 1.0

2- CO3 0.00

- HCO3 329.51 Na++K+ 275.93

+ NH4 0.70 1.5 Ca2+ 51.10 Mg2+ 5.11 30.0 Fe 0.05

Table IV.101: Ground water well Laboratory test results, Erdene Soum Parameters Content (mg-equivalent/l) Max allowed level (mg/l) MNS900:2005 TSS 0.57 1000 Hardness 3.51 7.0 Turbidity 0 pH 7.16

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Parameters Content (mg-equivalent/l) Max allowed level (mg/l) MNS900:2005 CI- 109.34 350

-- SO4 0.01 500

- NO3 8.05 50.0

- NO2 1.50 1.0

2- CO3 0.00

- HCO3 427.14 Na++K+ 161.16

+ NH4 0.70 1.5 Ca2+ 48.30 Mg2+ 13.38 30.0 Fe 1.50

Table IV.102: Ground water well Laboratory test results, Dashinchilen Soum Parameters Content (mg-equivalent/l) Max allowed level (mg/l) MNS900:2005 TSS 0.66 1000 Hardness 2.46 7.0 Turbidity 0 pH 7.21 CI- 38.34 350

-- SO4 0.16 500

- NO3 6.02 50.0

- NO2 1.5 1.0

2- CO3 0.00

- HCO3 414.94 Na++K+ 306.75

+ NH4 0.7 1.5 Ca2+ 40.48 Mg2+ 5.47 30.0 Fe 1.5

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Figure IV.29: Renewable groundwater reserve map of Mongolia

4. Ground water resources in Ulaangom area

321. Ulaangom city is located within the Uvs lake-Tes river water basin. The basin is rich in ground water resources with 10 deposits discovered. The total renewable ground water reserve for Uvs lake basin is estimated at 1622 million m3/year. Following table shows ground water deposits in the region. Table IV.103: Groundwater deposits in Uvs lake basin № Ground water deposits Catchment Recharge Renewable groundwater in Uvs lake basin area, km2 rate, mm reserve, million m3/year 1 Deposit 1 2797.00 220.000 615.000 2 Deposit 2 1207.00 200.000 241.000 3 Deposit 3 1198.00 160.000 192.000 4 Deposit 4 1730.00 70.000 121.000 5 Deposit 5 770.00 60.000 46.000 6 Deposit 6 576.00 75.000 43.000 7 Deposit 7 2508.00 35.000 88.000 8 Deposit 8 4264.00 15.000 64.000 9 Deposit 9 7981.00 8.000 60.000 10 Deposit 10 30479.00 5.000 152.000

322. In order to determine ground water quality in Ulaangom, a water sample was taken at the deep water well which is the main for Ulaangom city’s centralized water supply system. Laboratory test results provided in below table show the water sample meets drinking water standard of Mongolia.

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Table IV.104: Ground water well Laboratory test results, Ulaangom Parameters Content (mg-equivalent/l) Max allowed level (mg/l) MNS900:2005 TSS 4.0 1000 Hardness 2.78 7.0 pH 7 CI- 5.0 350

-- SO4 43.9 500

- NO3 2.89 50.0

- NO2 0.005 1.0

2- CO3

- HCO3 140.3 Na++K+ 14.5

+ NH4 0.05 1.5 Ca2+ 40.8 Mg2+ 9.0 30.0 Fe 0.09

PO4 0.007 3.5 F 0.16 0.7-1.5

J. Biodiversity 1. Biodiversity in Ulaanbaatar area i. Vegetation 323. Ulaanbaatar area is encompassed by Khentii Mountain Taiga (northeastern part) and Mongol Daurian Forest-Steppe (central and northwestern parts) Districts out of 16 flora and geographical . North and north-eastern parts of Ulaanbaatar city belong to Khentii mountain taiga zone. 63 vascular species pertaining to 34 genera and 21 families have been listed in the proposed project site. There are many species of Artemisia and Chenopodium. Endemic, restricted range, rare, endangered and Mongolian Red Book-listed species have not been registered herein. Degradation indicator weeds and annual plants occupy more than half of the area, due to the previous earthworks and its location in a settlement. 137

Figure IV.30: Vegetation Zones of Mongolia 324. There are 12 species each of Asteraceae and Poaceae, followed by 6 species Fabaceae Lindl. As for other families, there are 1-3 species of them. The study found that one species family are predominant. List of plant species registered around Ulaanbaatar city has provided in Annexure 9. 325. There are about 59 Populustrees at Khan-Uul district hospital site, 5 Populus trees and 18 various types of bushes at Emergency Health Center, and 5 Populus trees, 23 various types of bushes at the FHC in 10th Khoroo of Khan-Uul that need to be removed and re- planted. These Populus trees and bushes can be re-planted at the proposed green areas planned within the project design. Populus tree does not have any protection status both domestically and internationally.

Figure IV.31: Populus Trees and Bushes at the Emergency Call Center

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Figure IV.32: Populus trees at the proposed construction site that need to be re-planted at Khan-Uul District Hospital

Figure IV.33: Populus and Pine trees and bushes at the proposed construction site that need to be re-planted. FHC in 10th Khoroo of Khan-Uul. 326. Fauna. In terms of mammal zonation of Mongolia, Ulaanbaatar city belongs to the of Steppe – Forest steppe sub zone in the Khentii Mount Range Zone. Forty mammal species belonging to 26 genera, 12 families of 5 orders inhabit Bogd Mountain, located in vast valley of the Tuul River and its tributaries, resting in Khangai and Khentii Mountain district, in particular, southwestern edge of Khentii Mountain district according to Mongolian physical geographical divisioning. Rodentia lead among regional mammals by number, distribution, spatial location, occupancy, density, reproduction, ecosystem structure and biogeocenosis impact, while Carnivora lead by farming importance, followed by Ungulates and Lagomorpha. 327. Regionally, taiga species are dominant; 29 percent is forest taiga mammals, 26 percent is forest-steppe mammals, 18 percent is steppe mammals and 10 percent is mammal species inhabiting rocks or cliffs. 17 percent is accounted for by Rodentia and Lagomorpha, that mix soils by digging holes and fertilize surrounding area by excrement. They have an important role to ensure ecological balance. 328. 15% of total regional mammals is rare and very rare animals protected to a certain degree under Mongolian and international laws and regulations. Mongolian Redbook-listed red deer, Siberian musk deer and daurian hedgehog inhabit Bogd Mountain located in Tuul River Basin. Mongolian marmot has been very rare due to excessive hunting for hides and meat and has been listed as critically endangered in IUCN (E.L. Clark & Munkhbat. 2007. 139

Mongolian Red List of Mammals. Pp. 23; Ed. E.L. Clark, Munkhbat, S. Dulamtseren et all. 2007. Summary Conservation Action Plans for Mongolian Mammals). Red squirrel, daurian hedgehog and sable have been listed as rare. Grey wolf, mountain cat, manul cat are listed in Appendix II, Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES).

1. Khuvsgul 6. Northwestern Mongolia 2. Kehntii mount zone 7. Northern Gobi 3. Western Hyangan 8. Gobi-Altay zone 4. Mongol-Daurian 9. Southern Gobi 5. Khangain mount zone 10. Western Gobi zone Figure IV.34: Wildlife zones in Mongolia (A.G. Bannikov) 329. Occurrence of 50 percent of the mammals in the region is normally abundant and 35 percent is hunting species, including red deer, roe deer, marmot, mountain hare and Tolai hare that are valuable by rich meat and hides, and grey wolf, fox, lynx, Asian badger, Mustel erminea, Least weasel, that are valuable by fur. Daurian pika, Tolai hare, grey wolf, fox, Vulpes vulpes, Vulpes corsac and Eversmann's polecat were registered during the field survey on proposed project site are considered as “abundantly” distributed species. Conservation status of mammals in Bogd Mountain is shown in Annexure 9. 330. Bird species. Birds are the species that always move or migrate seasonally during all lifetime. Most birds migrate to warm regions as soon as autumn chill sets for winterization and come back in spring for nesting, breeding, laying eggs and gaining obesity and go back in autumn to warm countries with their offspring. It is called a migration. 67 percent of 205 bird species that inhabit Bodkhan Mountain SPA is migratory species. Migratory form of living is dependent directly on availability of feed, in addition to air temperature. 331. Sedentary birds also change their habitat seasonally in small range. Thus, more than half of the birds inhabiting the SPA is migratory, while the rest is sedentary species that change habitat seasonally. 205 bird species belonging to 65 genera, 25 families and 8 orders have been registered in Bogdkhan Mountain SPA. 67 percent of 205 bird species that inhabit

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Bogdkhan Mountain is migratory. They arrive in spring for nesting, breeding and laying eggs and migrate to warm region for winterization. 33 percent or 68 species are sedentary birds that inhabit the mountain. 20 percent or 42 bird species that inhabit Bogdkhan Mountain are rare species that are listed in Mongolian and international laws and regulations (Annexure 9). 332. The birds were included in the field survey scope. When its result is integrated with previous study materials, 20 bird species belonging to 9 orders inhabit the area. Of them, 2 (10.5%) are migratory, 17 (89.5%) are sedentary birds. As for habitat of the birds, there are 2 high mountain species (10.5%), 2 species that inhabit the woods and bushes (10.5%), 9 species that inhabit steppe (47.3%), 3 species that inhabit rocks and cliffs (15.7%) and 2 species that inhabit everywhere (10.5%). High mountain species are vulture and rudd. Pie and raven are the species inhabiting woods and bushes. 9 species that inhabit steppe are Long-legged Buzzard, Steppe Eagle, Saker Falcon, Common Kestrel, Demoiselle Crane, Horned Lark, Rook, Northern Wheater, Isabelline Wheater and Eurasian Tree Sparrow. Black kite, Rock dove, Pie, Raven and House Sparrow are bird species that inhabit settlements. 333. Amphibians and reptiles. According to the oral study undertaken during the field survey, there are 3 cold-blooded reptile species (Sunwatcher oadhead agama, Mongolia Racerunner and Halys pit viper) in the area. Out of invertebrates, insects are important for cold-blooded reptiles’ feed. There are abundant insect species pertaining to Coleoptera, Lepidoptera, Diptera and Orthoptera in the area. Mongolia has forest, taiga, high mountains, steppe and desert landscapes from north to south. 334. Although these landscapes are geographical perception, they serve as integrated factors which influence on various animals’ life. There are few or limited amphibian and reptile species in Tuul River Basin. Out of amphibians in the area, Bufo raddei and Elaphe dione are listed in Mongolian amphibians and reptiles’ list. Bufo raddei It is most common species in Mongolia. It is found in wetlands such as rivers, lakes and oases of desert, steppe and forest-steppe zones. Its population may have decreased because of habitat deterioration, water pollution, mining and shrinkage of wetlands. Nevertheless, it has not been listed rare. 335. Elaphe dione is found in vast area of various ecological zones from desert in south to forest taiga in north at 600-3000 m above sea level. Reason of rarity is varied because it lives in various biotopes. Feed scarcity related to winter coldness, drought and deficient crop yield and carnivores such as fox, steppe fox and birds of prey negatively impact on the number of Elaphe dione. Anthropogenic factors, such as settlements and infrastructure facilities including roads and hydro power plants, exploration and extraction of natural resources has deteriorated and shrunk habitat of Elaphe dione. 2. Biodiversity in Khovd area 336. The project area of Khovd comprises high mountain, mountain steppe, dry steppe, desert-steppe, stepped desert, grasses—undershrub desert, undershrub and shrub desert, and hammad vegetation38. Annexure 9 presents the registered plant species around the

38 Vegetation tolerant of high temperatures and saline conditions. 141

Khovd city. Over 80 species of plants listed in the Mongolian Red Book can be found in Khovd Aimag. However, field surveys and consultations with experts result in the conclusion that no Red Book species are located within the road alignment corridor. 337. There are 7-8 Populus trees at the proposed construction site at the Khovd hospital that needs to be removed and re-planted. These Populus trees can be re-planted at the proposed green areas planned within the project design.

Figure IV.35: Populus trees at the proposed construction site that need to be re-planted. Khovd hospital. 338. Fauna in Khovd city. The project area is located within the Altai–Sayan Eco-region, shown in Figure IV-32. The eco-region is characterized by rich faunal biodiversity ranging from mountain tundra of Mongolian Altai to Gobi Desert. Within the eco-region there are 360 species of vertebrates, including 90 species of mammals, more than 250 species of birds, 11 species of reptiles, 8 species of fishes, and 1 species of amphibian.39

Figure IV.36: Location of Altai-Sayan Eco-region

39 WWF. 2001. Altai-Sayan Ecoregion: Ecoregion Climate Change Biodiversity Decline.

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Source: WWF.

339. The Mongolian Altai–Sayan contains rare and endangered mammals such as Snow Leopard (Uncia uncia), Argali Wild Sheep (Ovis ammon), Siberian Ibex (Capra sibirica), Mongolian Saiga (Saiga tatarica mongolica), Musk Deer (Moschus moschiferus) Pallas’ cat (Felis manul) or Manul, Black Tailed Gazelle (Gazelle subgutturosa), Wild Boar (Sus scrofa nigipes), Stone Martin (Martes foina), Marbeled Polecat (Vormela peregusna), 340. Elk (Cervus elaphus) or Red Deer. It is also a habitat for steppe and semi-desert fauna such as wolves, foxes, martens, weasels, marmots, corsac foxes, manul cats, and marbled polecat. There are 44 species of small mammals, including mice, squirrels, hamsters, voles, shrews, jerboas, rabbits, and badgers that are distributed throughout the Altai–Sayan Eco- region, depending on the type of habitat present. 341. Amphibia and Reptiles. Four families and six species of reptiles including Toad-headed Agama (Phrynocephalus versicolor), Mongolian Agama (Laudakia stoliczkana), Multi- cellated Racerunner (Eremias multiocellata), Gobi Racerunner (Eremias przewalskii), Pallas’s Coluber (Elephe dione), and Central Asian Viper (Aqkistrodon halys) have been reported in the Mongolian Altai-Sayan eco-region. In 1987, sand lizards (Lacerta agilis) were first discovered in Bayangol of the Altai Mountain range in Khovd Aimag.40 342. Birds. There are 258 bird species found in the western region. The majority of these birds are migratory and few are local inhabitants. There are a number of rare and endangered species of birds, including Snowcock (Tetraogallus altaicus) or Altain ular, Cenereous Vulture (Aegypius monachus), Golden Eagle (Aquila chrysaetos), Lammergeyer (Gypaetus barbatus), Spoonbills (Platalea Leucorodia), Dalmatian Pelican (Pelecanus crispus), Great White Egrets (Egretta alba), Whooper Swans (Cygnus cygnus), Greet Blackheaded Gulls (Larus ichthyatus), Black Storks (Ciconia nigra) and Swan Goose (Anser cygnoides). 343. Fish. Seventy-six native fish species are reliably recorded in Mongolia, of which five are new to science and unnamed.41 The project area is located on the edge of the Great Lakes watershed formed from a number of closed inland depressions. Ten fish species are reported to inhabit the water bodies and courses of the watershed including endemic genus Oreoleuciscus (O.potanini, O.humilis, O.angusticephalus, O.dsapchynensis,42 Mongolian and Siberian grayling (Thymallus brevirostris and arcticus), and Stone loach (Barbatula toni). 344. Insects. The dominant species are steppe and semi-dessert insects of Orthoptera orders (includes grasshoppers and crickets) and Coleoptera orders (beetles). 345. Rare and Endangered Species and Habitat Fragmentation. The Mongolian Red Book (1997) lists 30 species of mammals, 30 species of birds, 5 species of reptiles, 4 species of amphibians, 6 species of fish, 19 insects, 2 crustaceans, and 4 mollusc species as endangered, vulnerable, or rare. A number of rare and endangered species occur in the

40 Government of Mongolia. 2007. EIA. Ulaanbaatar 41 Government of Mongolia. 2007. EIA. Ulaanbaatar 42 Government of Mongolia. 2007. EIA. Ulaanbaatar 143

Mongolian Altai–Sayan Eco-region and in the Bayan-Olgii and Khovd Aimags. In 2011, the Government of Mongolia approved a National Program for very rare and rare wildlife. The program aims to protect and restore critical habitats for species such as the Mongolian Saiga and Argali sheep. The IUCN listing for Mongolian Saiga gives its Red List Category as ‘Critically Endangered.43 Within Mongolia, IUCN’s range/distribution map confirms the Mongolian Saiga is not present in the Tranche 2 project area. The IUCN listing for Argali sheep gives its Red List Category as ‘Near Endangered’. Within Mongolia, Argali are distributed widely, but patchily across a large portion of the country. With the exception of the Argali sheep, within the project area there are no habitats where rare or very rare species of mammals, birds and reptiles have been reported. 3. Biodiversity in the 5 Soums 346. Plant geographic zonation map and location of the 5 Soums of the project are shown in below map. Erdenemandal and Tarialan Soum are located within the steppe-forest zone of Khangai mountain range, Bayan-Undur and Dashinchilen Soums are located within the Central Khalkha plain steppe zone, while the Erdene Soum is located within the southern Gobi Desert zone.

Figure IV.37: Plant-geographical map of Mongolia Plant zones shown in the map: 1- Khuvsgul range, 2- Khentii range, 3- Steppe-forest of Khangai range, 4- Mongol-Daguur steppe, 5- Hyangan range, 6- Mongol Altai range, 7-Central Khalkha palin steppes, 8- eastern Mongolia, 9- Great Lakes Depression, 10- Lake basins, 11- Northern gobi semi- desert, 12- Southern gobi desert, 13- Gobi-Altai range, 14- Zuungar gobi desert, 15- South of Altai gobi desert, 16- Alshaa gobi

43 http://www.iucnredlist.org/details/19832/0

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347. Predominant plant species in the plant-geographical zones (steppe-forest zone of Khangai mountain range, Central Khalkha plain steppe zone and southern Gobi Desert zone) within which the project sites located are shown in tables in Appendix 9. 348. There a number of Populus trees and bushes planted within the yards of the Soum hospitals. 44 trees in the Tarialan Soum health center yard will be affected or need to be removed and replaced during the construction of new facilities. Below table shows total number of trees and number of affected trees at each project site. Table IV.105: Trees planted within the yards of the 5 Soum health centers No. Soum hospitals Total number of trees Potential impact on the trees planted 1 Tarialan Soum hospital 44 trees Need to be removed 2 Erdenemandal Soum None hospital 3 Erdene Soum hospital 30 elm trees Not be affected by construction 4 Bayan-Undur Soum None hospital 5 Dashinchilen SHC None

Figure IV.38: Trees in the yard of Tarialan Soum health center that need to be removed

Fauna species in the 5 Soums 349. Mongolia is divided into 10 wildlife-geographical zones. Below map shows the wildlife- geographical zones of Mongolia and location of 5 Soum health centers. Tarialan, Dashinchilen and Erdenemendal Soums belong to Khangai range zone, Bayan-Undur Soum 145

belongs to Mongol-Daguur zone while Erdene Soum lies in the northern Gobi districts respectively.

1. Khuvsgul zone 6. Northwestern Mongolia zone 2. Khentii zone 7. Northern Gobi zone 3. Western Hyangan zone 8. Gobi-Altai zone 4. Mongol-Daguur zone 9. Gobi south of Altai zone 5. Khangai zone 10. Western Gobi zone Figure IV.39: Wildlife-geographical zones of Mongolia (A.G. Bannikov)

350. Predominant wildlife species in the Khangai range zone, Mongol-Daguur zone and Northern Gobi zone within which the Soum health centers located are provided in the tables in Appendix 9. 351. Since the Soum health centers are located in the midst of Soum centers – settlement areas, no wildlife species inhabit nearby nor will be affected by construction activities. 4. Biodiversity in Ulaangom area Vegetation in Ulaangom 352. In terms of vegetation-geographic division, Ulaangom city falls in the Vegetation zone of Depression of the Great Lakes in western Mongolia. Further within the zone, Ulaangom city is located within the semi-arid steppe-desert sub-zone. 353. Over 430 plant species are distirbuted in the wider project region which includes 67 medicinal species, 24 vegetable species, 12 protected species and 10 species listed in the Redbook of Mongolia. 354. There are no trees at the proposed construction site within the hospital premise. Aforementioned rare and protected plant species are mainly distributed in the Uvs lake basin in 20-25km distance from the project site.

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Fauna in Ulaangom 355. In terms of zoo-geographic division, the Ulaangom city falls in the western Mongolia steppe-desert zone. Since the hospital premises is located within the major settlement area, there are no wildlife species in its vicinity. In the wider project region, over 80 mammal species, 240 bird species and 5 fish species are registered in the Uvs lake SPA. This includes 8 species listed in the Redbook of Mongolia, 9 species listed in the CITES. 356. Most notable mammal species inhabit in the Harhiraa-Turgen mountain and Uvs lake SPA’s that have protection status are described as below:  Argali wild sheep (ovis ammon): inhabits at Harhiraa-Turgen and Tsagaan Shuvuut SPA’s (about 29 km from the project site respectively). Estimated population of argali sheep is around 180 head in the Tsagaan Shuvuut SPA and 550-600 head throughout the territory of Uvs province. Internationally, argali sheep is classified as “near threatened with decreasing population”.  Ibex: inhabits at Harhiraa-Turgen and Tsagaan Shuvuut SPA’s with estimated population of 1013 heads at Tsagaan Shuvuut SPA and 1496 heads at the Turgen SPA.  Snow leopard: inhabits at Harhiraa-Turgen and Tsagaan Shuvuut SPA’s. WWF is implemented a program on snow leopard protection in the region between 1997 and 2002.  Birds: According to the fish survey by Russian ikhtyologist V.I. Zabelin, there are 359 bird species inhabit in the Uvs lake SPA. Out of which, 8 bird species dwell permannently while 82 species are migratory. Marsh lands around Uvs lake SPA was registered at RAMSAR convention list in 2004. 357. Ecological resources of the potentially impacted environment are defined to include the area’s flora and fauna, and specially protected areas. The sub-project sites include areas which have very little vegetation or exposed ground which may form habitats for fauna. However, there are a limited number of bird species observable in the Ulaanbaatar and Khovd cities, such as crows and sparrows, common to many urban environments. There are no rare, threatened, or endangered species within the construction boundaries of the sub- projects.

K. Protected Areas 1. Protected areas around Ulaanbaatar city 358. The Law on Special Protected Areas of Mongolia came into effect on the basis of the Constitution, the Land Law, the Border Law, the Law on Buffer Zones, and other legal acts. The purpose of this law is to regulate relations concerning utilization of and taking areas under special protection, preservation and protection of natural landscape in order to keep particular features of natural zones and belts, their peculiar formation, forms of rare and rarest fauna and flora, historical and cultural sites and natural sightseeing as well as studying and identifying their evolution. 359. Strictly Protected Areas are divided into following three zones: These include: (i) Core zone; (ii) Buffer zone; and (iii) Transition; 147

360. National Conservation Parks divided into three zones. These include: (i) Special zone; (ii) Tourism zone; and (iii) Protected area; 361. Each of these Zones has appropriate security procedures stated on the Law of Protected Areas. There are 2 Special protected areas in the vicinity of Ulaanbaatar city that include one strictly protected area and one natural reserve area. Below table shows the special protected. Table IV.106: Special Protected Areas in the Vicinity of Ulaanbaatar City

№ Special protected areas Area size, Distance from the subproject locations hectares 1 Bogdhan mountain strictly 42,192 1.4 km from the Khan-Uul district hospital protected area 2 Chingeltei khairhan mountain 4,385 At least 5 km away from all subproject biosphere reserve locations Total 46,577

Figure IV.40: Location of SPA’s and subproject components i. Bogdkhan Mountain Special protected area. 362. The strictly protected area includes the areas of Khan-Uul district, Bayanzurkh district of Ulaanbaatar city and Sergelen Soum of Tuv Aimag and size of the protected area is 42192.36 ha. Bogdhan mountain is one of the oldest protected area locally as well as worldwide. Mongolians protected Bogdhan Mountain since II-III century, the Hereid Tribe Chieftain Van Han worshipped it as sacred mountain and named it to Han Uul.Bogd Mountain was protected officially from the year 1778. In the year 1957, following People congress’s resolution number 31 the mountain was named and the mountain

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became strictly protected area. In the year 1974, old name of Bogd mountain was changed back and the mountain became strictly protected area. Following resolution #26 of Parliament in 1995, the mountain was classified as strictly protected area accordance with Law on special protected areas.

Figure IV.41: Bogd khan Mount SPA and its buffer zone 363. The highest peak of the strictly protected mountain is Tsetsee gun which is 2268 m above sea level. There are several springs in the Bogd Khan Mountain for medical treatment. Several species of trees dominate in different areas and this pattern show that biosphere is diverse. For example: In some areas spruce trees are common, north and north west areas pine trees, south and north east areas larch tree. Total 588 species from 256 genuses, 70 families of plants grow in the Bogd Khan Mountain. The plant families belong to 18 genus and 80 percent is mountain taiga, 72 percent is steppe plants. The Bogdkhan mountain is the northern border of Hentii taiga animal distribution. The Bogdkhan mountain is the habitat to the animals of 54 species, 36 genus, 17 families and 6 orders. 1660 insect species from 270 genus of 174 families, 259 species of mesofauna, 96 species of micro fauna and 194 bird species from 36 families of 25 orders were registered in the Bogdhan mountain. ii. Chingeltei Khairhan Mount biosphere reserve 364. The mountain biosphere reserve area is located in Chingeltei district of Ulaanbaatar. The parliament introduced the resolution number 56 in May 22, 2012 that taking Chingeltei hairhan mountain as reserved area. Chingeltei Hairhan is sacred mountain that located north of the Ulaanbaatar city. Peak height of the Chingeltei Hairhan is 1,831m above the sea level. Chingeltei Hairhan is the part of the Hentii mountain range and slopes are steep on the front and back of the mountain is less steep. 149

365. Chingeltei Mountain is seasonal permafrost. On the west side of the mountain runs Zuun and Baruun Salaa River and on the east side of the mountain runs Selbe River. On the back of the mountain slope is covered with fertile dark brown, forest soils. It is rich in vegetation of forest steppe and mountain steppe plants. It has birch, cedar and larch forest. The ancient legend of the Chingeltei mountain is that mountain speaks to a monk teachers and the monks use to meditate and research wrote books. The Dambadarjaalin monastery located in the Chingeltei Mountain is burial place for 2nd Bogd Javzandamba and historically significant architecture. There are many historical sites exist. Because of increased household settlement ecological balance is disturbed by wood logging, increase in livestock and settlement.

Figure IV.42: Special Protected Areas around the Khovd city and location of subproject 2. Protected areas around Khovd city 366. There are 2 special protected areas around the Khovd city that includes one strictly protected area (Khuh Serkh Mountain Range) and one natural reserve area (Depression of

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Great Lakes). As shown in below picture, the Khovd hospital is located at 19km distance from the Depression of Great Lakes and in 33 km distance from Khuh Serkh Mountain Range. i. Khuh Serkh Mountain Range – Strictly Protected Area 367. Khuh Serkh Mountain Range became a strictly protected area in 1977 within the purpose of conservation of biodiversity in area. The SPA has a number protected and rare wildlife species such as ibex, argali sheep, falcon and snow leopard. 39 mammal species, 57 bird species and over 100 species of plants are registered in the SPA. The total size of the SPA covers 24,800 hectares of land. ii. Khar Us Lake – Natural Reserve Area (Depression of Great Lakes) 368. The Parliament of Mongolia has adopted Resolution No.47 in 1997 with which the Depression of Great Lakes received the status of natural reserve area. The main purpose of the protection status are:  Depression of great lakes are a home to over 200 migratory and permanent-dwelling bird species that includes internationally protected and rare bird species. Thus, this area is nationally recognized as critical habitat for birds.  The lakes are surrounded by a huge area of wetland thus registered in the list of important wetlands in the RAMSAR convention in 1999.  The SPA comprises of 3 lakes connected with each other: Khar Us lake, Khar Lake and Durgun lake. Surface size of the lakes are: 1859.2 km2 for the Khar Us lake, 574.8 km² for Khar lake and 305 km² for Durgun lake. Over 40 mammal species habitat in the SPA including saiga, argali sheep, ibex, snow leopard, goitered gazelle and wild boar. 3. Protected areas around the 5 Soums 369. There are about 90 specially protected areas throughout Mongolia. Of which, 14 are strictly protected, 29 are natural complex areas, 32 are natural reserves and 15 are cultural heritage sites. Location of SPA’s in Mongolia and location of 5 Soum health centers are shown in below map. 151

Figure IV.43: SPA location map of Mongolia 370. There are no SPA’s in the vicinity of the Soum health centers that could be affected by construction activities. However, in a wide region, there are some SPA’s. Description of the closest locating special protected areas to the 5 Soum health centers are provided in below table. Table IV.107: SPA’s around 5 Soum centers No. Soum health Name of the closest Location of SPA and its distance from project centers locating SPA site 1 Bayan-Undur Hugnu-Tarna Natural Locates in Gurvanbulag Soum of Bulgan province Soum Complex in 71 km distance from the project site 2 Erdenemandal Horgo-Terhiin Tsagaan 100 km from the health center Soum Lake Natural Reserve Area 3 Erdene Soum Burdene Bulag Natural Locates in Erdene Soum in 22 km distance from Reserve Area the project site 4 Tarialan Soum Namnan Uul Natural Locates in Tarialan Soum in 15.8 km distance Reserve Area from the project site 5 Dashinchilen Khugnu-Tarna Mount Locates in 31 km distance from the Dashinchilen Soum SPA SHC. 4. Protected areas around Ulaangom city 371. The closest protected areas to the project site are: Uvs lake SPA and Harhiraa-Turgen mountain SPA. Uvs lake is the biggest lake in Mongolia with surface area of 3,300km2 and is a home to numerous birds, fish and mammal species. Harhiraa-Turgen mountain range has several glaciers and is a home to a number of internationally protected animals such as argali wild sheep, ibex and snow leopard. 372. The project will have no impact on the SPA’s because of its location at the center of Ulaangom city.

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Figure IV.44: Protected areas around Ulaangom city

L. Socio-Economic Condition 1. Economic Development i. Ulaanbaatar 373. Ulaanbaatar city is the political, economic and business center for Mongolia. Nearly all of the biggest business entities, international organizations and the national government institutes are located in the city. Gross domestic production of Ulaanbaatar City accounts for around 56% of the National gross domestic production (GDP). Manufacturing includes production of electricity and heating, metals (such as copper and steel foundries) as well as woolen products such as cashmere and carpets, food, furniture, clothes, construction materials and leather processing. There are 47,000 state and private business operate in the city which includes 1030 entities with more than 50 employees. 153 ii. Khovd 374. The Khovd city is the key development center in western regions of Mongolia. There are 1966 registered state and private entities in the Khovd province which includes 46 entities with more than 50 employees. Manufacturing output in Khovd province totaled 65 billion MNT (27 million USD) in 2017. Key industrial outputs include production of electricity and heating, wool and leather processing, coal mining and construction materials. 4028 people work in the manufacturing and mining entities in the province. The biggest mining project in the western regions of Mongolia is Khushuut Coking Coal Mine which is located in Tsetseg Soum of Khovd province in about 190km distance from the Khovd city. Khovd province is also known for its crop planting industry, especially planting of vegetables, watermelons and other fruits. iii. FIve Soums 375. The economy of the Erdenemandal Soum and its residents rely mainly on animal husbandry. Main economic sectors of the Soum includes animal husbandry (84%), service sector (10%), light industry (5%) and crop planting (1%). Light industry outputs include wool and cashmere products and food products. 376. The main economic sectors in Tarialan Soum is agriculture which includes crop planting and animal husbandry which mainly consists of cow breeding. The main contributors to the Soum economy are: agricultural sector 80%, light industry 11% and service sector 11%. 377. Main economic sector of the Bayan-Undur Soum is animal husbandry and service sectors. The Soum ranks third in Uvurkhangai province in heads of livestock. As of 2017 end, the Soum has 412,000 heads of livestock. According 2017 statistics, key contributing sectors to the Soum economy are service sector (53%), animal husbandry (37%) and light industry (10%). Light industries in the Soum has produced output worth of 186 million MNT in 2017 which mainly consists of diary product, food production, meat processing, cashmere and wool production. 378. Agricultural sector which includes livestock breeding and crop planting are the main economic sector in Dashinchilen. Agricultural sector constitutes 87% of the Soum GDP while light industry contributes 7% and service sectors contributes 4%. The Soum has 226,000 heads of livestock and wheat and other vegetables are planted at 1150 hectares of field. There are 4 business entities who are engaged in wheat planting in the Soum. Muku LLC has its own flour plant at the Soum center. There are 38 business entities are operating the Dashinchilen who combined to produce output worth 4.8 billion MNT in 2017. iv. Uvs province 379. Uvs province is one of the relatively well-developed provinces in Mongolia with GDP of 130 million USD. The main economic sectors in Uvs province are livestock breeding, crop planting, light industry, service sector and mining. In 2017, Uvs had 3.13 million heads of livestock and planted wheat, vegetables and seabuckthorn at 9,235 hectares of field. There are 3 coal mines,1 gold mine, 3 salt mines and 3 common mineral mines are operating in the province. Light industry in the province includes flour mills, food production, wool processing and power production. Production of seabuckthorn products are the key brands of Uvs

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province. It produces 60% of total seabuckthorn harvest in the nation with around 550 entities are engaging in seabuckthorn plantation. They produce seabuckthorn juice, crème and several other products at 13 processing plants and export to 4 foreign countries. 140 biggest business entities in Uvs province produced a total of 13.6 billion MNT output in 2017. 2. Demography i. Demography of Ulaanbaatar city 380. The population of Ulaanbaatar, the capital city of Mongolia, has been increasing rapidly from 0.78 million (Mongolia: 2.40 million) in 2000 to 1.417 million (Mongolia: 3.2 million) in 2018 with an average annual growth rate of 2.9%. There are 380,800 households live in the city. 381. This rapid increase of population is chiefly due to a rapid migration from rural area to urban area. The average number of population migrated in the past 10 years is estimated at around 20,000 per year which cause the expansion of Ger area surrounding the apartment area of Ulaanbaatar. At present Ulaanbaatar accounts for 46% of the total population of Mongolia. 382. In terms of age groups, 30.7% of population is under age 15, 63.1% is aged between 16- 59 and 6.2% is aged above 60. Overall, 64.3% of Ulaanbaatar city population is under the age of 35. Average life expectance in Ulaanbaatar city is 71.8 (Mongolia: 71.24) while the figure is 66.5 for males and 75.3 for females. There are 33,700 disabled people live in the city. ii. Demography of Khovd city 383. The Khovd province population was 87,363 at the end of 2017 of which 49.9% is male while 50.1% is female. The Khovd population is increased by 2.3% comparing to the previous year (2016). Khovd city, provincial center, has a population of 29,800 people (32.8% of the total population of the province) of which 14,582 are male and 15,218 are female. 384. There are 1,377 people who are aged above 60 in the Khovd province while there are 2,727 disabled people living in the province. Average life expectancy in Khovd province is 71.71 and the figure is 68.27 for males and 75.55 females. iii. Demography of the 5 Soums 385. Erdenemandal Soum population is 5,677 persons of 1,683 households. 52% of population resides at the Soum center. 28% of its population is aged under 14 years, 61.7% is aged between 15-60 years. Vulnerable social groups in the Soum include 147 households with single mothers and 252 disabled persons. Average life expectance in Arkhangai province is at 71.81 years. 386. Tarialan Soum has population of 6,096 persons of 1,730 households. Of which, 51.3% is male and 48.7% is female residents. Roughly a half of the Soum population (49.5%) resides within the Soum center. The vulnerable social groups of the Soum includes 278 households with single mothers and 330 disabled persons. The average life expectancy in Khuvsgul province is 66.18 years. 155

387. Bayan-Undur Soum population is 3,816, of which 50.02% is female and 49.97% is male residents. Around 20% of the Soum population is living in the Soum center. Vulnerable groups in the Soum includes 127 households with single mothers, 107 old aged people and 146 disabled persons. Average life expectancy in Uvurkhangai province is 69.85 years (67.31 years for males and 72.65 years for females). 388. Erdene Soum population is 2378 at the end of 2017. Of which, 1,223 persons are male and 1,155 persons are female. 59.25% of the Soum population reside within the Soum center. 29.7% of the Soum population is aged under 14 years, 61.3% is aged between 15-60 years and 8.9% is aged over 60 years. Vulnerable group in the Soum includes 98 household with single mothers and 124 disabled persons. The average life expectancy in Dornogobi province is 70.6 which is 0.71 years higher than national average. 389. Dashinchilen Soum has 3,037 residents belonging to 891 households in the 4 bag units. Out of which, 50% are male and 49.3% are female residents. In terms of age group, 29.7% of total residents are under age of 15, 60.5% is aged between 15-60 years and 9.8% is aged over 60 years. Annual population growth was between 2.6% - 3.7% between 2012-2017. There are 359 (41.7% of total households in the Soum) herder households. Population of the Soum center is 980 which equals to 32.2% of total Soum population. Vulnerable social groups in the Soum includes 26 orphan children, 122 households led by single mothers and 130 disabled persons. Average life expectancy in Bulgan province is 73.3 years which is nearly 4 years higher than the national average. The figure is 68.3 years for males and 78.6 years for female residents. iv. Demography of Uvs province 390. As of 2017year end, Uvs province had population of 82,600 people belonging to 21,800 households. Uvs province is divided into 19 Soum and 93 bag administration. Provincial center Ulaangom city has 30,900 residents. Average life expectancy in Uvs province is at 68.84 years which is 1 year lower than the national average. The figure is 63.93 years for male residents and 72.87 years for female residents. Uvs province population has remained the same for the last 10 years despite a big migration of herder households to central parts of Mongolia due to harsh winter condition. 3. Ethnic minorities 391. Ethnic account for about 85% of the population and consist of Khalkha and other groups, all distinguished primarily by dialects of the Mongol language. The Khalkha make up 90% of the ethnic Mongol population. The remaining 10% include , Durbet Mongols and others in the north and in the east. Turkic peoples (Kazakhs, , and (Uzbek) constitute 7% of Mongolia's population, and the rest are Tungusic peoples, Chinese, and Russians. Most but not all Russians left the country following the withdrawal of economic aid and dissolution of the Soviet Union in 1991. 392. In Khovd city, one of the subproject areas, there are about 3,000 ethnic Kazakh minorities reside. Khovd province itself, has 4 Soums (Khovd, Bulgan, Jargalant and Buyant) that have a total of 8,000 – 10,000 ethnic Kazakh minorities.

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4. Education i. Ulaanbaatar 393. Mongolia is ranked 117th in human development index among 177 countries. Literacy rate in Mongolia is at 97.8% where male literacy is at 98% while female literacy is at 97.5%. The education institutes consist of pre-school education (kindergarten), mid-level education (primary, middle and high schools) and university education (universities, colleges and TVET’s). In the city, there are 661 kindergartens that have 113,521 children 11,812 teachers and 241 middle schools that have 247,960 pupils and 11,281 teachers. 89 of the 96 universities operating in Mongolia are located in Ulaanbaatar city. Total number of university students residing the Ulaanbaatar city is 144,000 which equals to 92.8% of the total students in Mongolia. ii. Khovd 394. In Khovd province, there are 42 kindergartens that have 9,000 children and 25 middle schools that have 18,472 pupils and 1,020 teachers. The Technical and Vocational Education College of Khovd city was founded in 1966 which operates with 3 main facilities: Construction College, Agricultural College and Manufacturing College. Khovd University which is located in the city has 2,355 students and the only university in the western regions of Mongolia. Most of high school graduates go to Ulaanbaatar city for university education though. iii. The 5 Soum centers 395. The middle school at the Soum center has 1,121 pupils and 108 teachers and other employees. The kindergarten at the Soum center has 290 children and 33 teachers. 396. The only middle school at the Soum center has 1,181 pupils and 104 employees which includes 61 teachers. The only kindergarten in the Soum center has 358 children and 13 teachers. There are no other educational institutions in the Soum. 397. The middle school at the Bayan-Undur Soum center has 638 pupils and 60 employees which includes 34 teachers. The kindergarten at the Soum center has 123 children and 15 teachers. There are no other educational institutes in the Soum. 398. There is 1 school and 2 kindergartens operating at the Erdene Soum center. The middle school (which is inclusive of primary and high schools within it) has 310 pupils and 38 teachers. In total, the 2 kindergartens have 141 children and 6 teachers. 399. The only kindergarten in Dashinchilen Soum is called Narlag which has 165 children and 18 teachers. There is one middle school in the Soum which has 510 pupils and 31 teachers. iv. Ulaangom 400. There are 10 kindergartens in Ulaangom city that have 2,233 children and 61 teachers. 7 middle schools in Ulaangom employ 412 teachers who teach a total of 7,691 pupils. There are 2 colleges in Ulaangom city: Uvs TVET and a branch of Labour College of Mongolia. In total, the two colleges have 1531 students and 81 teachers. 157

5. Health Service in Mongolia 401. During the Socialist Period, health services were publicly funded, but despite achievements in facilities and improved health status, the system was inefficient. In the mid- 1990s, the health sector reform focused on improving primary health care and disease prevention. This, along with economic development, contributed to improvements in health status over the last 15 years. Health service system of Mongolia consists of 3 levels: 402. Level 1: Primary health centers (often called Family Health Centers) are based in each Khoroo (smallest administration unit) level and offers primary health services. FHC’s are administered by their respective district and Soum governments. 4 such FHC’s are involved in Tranche-1 phase of the project (please see section 4.2 for more details). 403. Level 2: District, Soum and Aimag hospitals operate within their respective areas and offers wide range of health services. Level 2 hospitals are administered by their respective district, Aimag and Soum governments. 3 such hospitals are involved in Tranche-1 phase of the project. 404. Level 3: Central Clinical Centers based in Ulaanbaatar city offers all types of health services to both urban and rural population and also act as the medical science development centers. There are 4 such hospitals that are governed directly by the Ministry of Health. 405. The leading causes of mortality are non-communicable diseases (cardiovascular diseases and neoplasms) and external causes (injuries and poisonings). Respiratory and digestive system diseases are the main causes of morbidity, along with external causes (injuries and poisonings) in urban areas and urinary tract diseases in rural settings. 6. Employment and Poverty i. Unemployment 406. According to the Mongolian Statistical Yearbook 2009, the ‘Registered Unemployment Rate’ for Ulaanbaatar is 1.6%. However, this is the rate of people that are officially registered unemployed. The book also provides an ‘unemployment rate’ which is 14% for the Ulaanbaatar City, derived from a new methodology of calculation based on the results of a Labor Force Survey. Total workforce in Khovd province is 39,668 persons which includes 34,313 employed and 5,355 unemployed people. Unemployment rate in Khovd province is 13.5%. By age groups, 46.5% of the unemployed people in Khovd are aged between 18-24, 31.4% are aged between 25-34. Total workforce in Uvs province is 49,100 persons which includes 3177 unemployed persons. Labor participation rate is at 77.2% and unemployment rate in Uvs province is at 8.4%. 407. Unemployment rate in Erdenemandal Soum is at 5.4% at the end of 2017 which was a 0.2% increase comparing through the previous year. 408. Unemployment rate is Tarialan Soum is at 3.2% as of 2017 end. In 2017, 132 new jobs were created due to the state’s investment of 3.6 billion MNT. 409. Unemployment rate in Bayan-Undur Soum is 7.6% in 2017 which 1.3% lower compared to the previous year.

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410. 1,097 persons out of 1513 persons of labor age in Erdene Soum are employed. Of which, 510 are herders. As of May 2018, unemployment rate in the Soum is 39.9%. 411. There were 251 unemployed persons in Dashinchilen Soum as of August 2018. Out of which 108 are female residents. Unemployment rate in Dashinchilen is at 12%. ii. Poverty 412. The Mongolian Statistical Yearbook 2016 provides background data on poverty levels within the City. The Poverty Headcount Index is a widely-used poverty measure, giving the percentage of the population whose consumption is below the poverty line. For Ulaanbaatar, this rate is 36.7% in 2009, which compares to 38.7% nationally. This increases to over 49% in rural areas, showing that relatively speaking, Ulaanbaatar is wealthier than the rural areas. The analysis of the first Living Standard Measurement Survey (LSMS) provided a profile of the poor and identified the most vulnerable groups in the country. More than 800,000 people or 36 % of the population were reported as poor. The assessment showed that female- headed households had a higher incidence of poverty as do unemployed and rural households owning less than 15 animals. Urban poverty is marginally higher than rural poverty particularly in provincial capitals that have been hard hit by the closing of state enterprises. These observations are most probably still valid, although no new data exist. Income comes from different sources and varies according to location as shown in Table below. Table IV.108: Monthly Average Income per Household

Types of income National Ulaanbaatar Aimag Soum Rural average (%) (%) centers (%) centers (%) areas (%) Income Total 100.0 100.0 100.0 100.0 100.0 Monetary Income Total 91.5 97.0 94.6 89.4 70.9 Wages and salaries 48.5 57.0 52.5 49.3 13.8 Pensions. allowances and 20.0 18.3 22.2 20.5 22.1 compensation* Income from livestock products 5.3 0.2 1.9 5.7 26.6 Income from crop products 0.5 0.0 0.3 2.4 0.8 Income from non-agricultural 10.7 14.0 11.2 5.9 3.4 production and services Other income 6.5 7.5 6.5 5.6 4.2 Food and non-food products 3.1 2.8 2.9 1.4 5.7 received from others free of charge Food consumption from own 5.4 0.2 2.5 9.2 23.4 business (Source: National Statistics Book, 2016)

413. Private transfers by family members living in the capital or abroad provide a significant source of income in poor households accounting for nearly 20 % of total income. Without these private transfers the poverty rate would increase to 46 % of the population. 159

414. The survey found that there was a strong correlation between unemployment and poverty with 58 % of the unemployed being poor. Unemployment was a particularly difficult problem in both the urban and rural areas. In addition to the 100,000 already unemployed the civil service reform will create another 30,000-unemployed former public service employees. In addition, over 25,000 people enter the labour market annually finishing their education. Among the rural poor 35 % of the very poor and 14 % of the poor were unemployed. Among the urban poor, the situation was even worse with 55 % of the very poor and 34 % of the poor being unemployed. 7. Land Use Pattern The land use pattern map of Ulaanbaatar is shown below in Figure IV.45 which shows the new land use classification and zoning scheme of Ulaanbaatar and

415. Table IV.109 gives the details of Control of building use by Land Use Zones. With its territory of 156.412 million ha, Mongolia occupies 17th place by the size of territory and first place by per capita land resources (65 ha) in the world. Per capita agricultural land in Mongolia (53.8 ha) accounts for 20 times over the world's average. 416. The land, except that given to the citizens of Mongolia for private ownership, as well as the subsoil with its mineral resources, forests, water resources and wildfowl shall be the property of the State. The State may give for private ownership plots of land, except pasturage and land under public utilization and special use, only to the citizens of Mongolia. This provision shall not apply to the ownership of the subsoil thereof. Citizens shall be prohibited to transfer the land in their ownership to foreign citizens and stateless persons by way of selling, bartering, donating or pledging as well as from transferring it to others for their possession and use without permission from competent State authorities. The state shall have the right to hold landowners responsible for the land, to exchange or take it over with compensation on the grounds of special public need, or confiscate the land if it is used in a manner adverse to the health of the population, the interests of environmental protection or national security. The State may allow foreign citizens, legal persons and stateless persons to lease land for a specified period of time under conditions and procedures as provided for by law. Also, in provision 16.2 of the Constitution was indicated that the citizens of Mongolia are guaranteed to enjoy the following rights and freedoms: the right to a healthy and safe environment, and to be protected against environmental pollution and ecological imbalance. 417. In the provision 17.2 it was indicated that “1). Citizens of Mongolia, while upholding justice and humanity, shall fulfil in good faith the following basic duties: 2) to respect dignity, reputation, rights and legitimate interests of others;” and in the provision 19.1 “The State shall be responsible to the citizens for the creation of economic, social, legal and other guarantees ensuring human rights and freedoms, to fight against violations of human rights and freedoms and to restore infringed rights.” 418. As per the Provision 10 of Law on Land of Mongolia, land is classified in six categories as stated below in Table below.

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Table IV.109: Classification of Land Use of Mongolia

No Classification of Land Use 2013 2014 Changes I Agricultural land 115361.4 115008.6 -352.8 1 Pasture land 111026.1 110646.7 -379.4 2 Hay making area 1712.3 1717.6 5.3 3 Crop land 986.8 1012.8 26.0 4 Abandoned land 304.9 304.9 0.0 5 Land under Agricultural building and facilities 71.4 76.8 5.4 6 Land unsuitable for agricultural use 1259.7 1259.7 0.0 II Urban Land 699.6 712.1 12.5 7 Land for Construction and facilities 73.1 75.3 2.2 8 Public land/area 330.1 330.3 0.2 9 Industrial area 40.4 41.1 0.7 10 Mining land 200.9 206.2 5.3 11 Ger area 54.5 59.3 4.8 III Roads and Communication Land 437.3 454.8 17.5 12 Road 319.7 329.7 10.0 13 Railway 27.8 29.9 2.1 14 Land for air transport 8.8 8.9 0.1 15 Communication land 80.8 86.2 5.4 16 Land for port of water transport 0.0 0.0 0.0 IV Forest Land 14295.4 14320.5 25.1 17 Forest covered area 12138.6 12181.3 42.7 18 Logged area 142.4 142.0 -0.4 19 Land for forest nursery 46.5 50.9 4.4 20 Forest restoration area 744.0 743.6 -0.4 21 Other land area of forest 1223.7 1202.7 -21.0 V Water Land 686.8 686.7 -0.1 22 Rivers 228.5 228.5 0.0 23 Lakes and founds 444.7 444.3 -0.4 24 Creek and springs 12.4 12.4 0.0 25 Glaciers and 1.1 1.6 0.5 VI Land for State Special Needs 24931.1 25228.9 297.8 26 Protected Areas 20948.3 21140.9 192.6 27 Border zone area 3111.9 3111.9 0.0 161

No Classification of Land Use 2013 2014 Changes 28 Land for National Defense 124.1 124.1 0.0 29 Land for International Diplomatic Consulates 0.0 0.0 0.0 30 Land for Scientific experiment and meteorological 22.9 22.9 0.0 observation and monitoring 31 Inter-Aimags reserve pastureland 586.2 691.4 105.2 32 Hay making area of State Forage Foundation 110.9 110.9 0.0 33 Oil and petroleum contracted land 24.4 24.4 0.0 34 Land for economic free zone 2.1 2.1 0.0 GRAND TOTAL 56411.5 56411.5 0.0 Source: Report on Mongolian Environmental status in 2013-2014.

Source: Gantulga Gombodorj and Chinbat Badamdorj. Urban land use classification and functional zoning of Ulaanbaatar city, Mongolia, 2010. Figure IV.45: Land use pattern in Ulaanbaatar 419. All subprojects have their own land certificates and fall in the category II shown in above Figure.

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8. Cultural Heritage i. Cultural heritage in Ulaanbaatar city 420. Ulaanbaatar is rich in physical cultural resources. The list of important heritage, cultural and religious sites of Mongolia and its provinces revised in 1994, 1998 and 2008. In this list, total of 460 objects were registered and out of them 175 have to be under State protection and 285 have to be under provincial protection. 421. There are no heritage, cultural and religious sites in or close to the subproject sites in Ulaanbaatar city. ii. Cultural heritage in Khovd city 422. There are no heritage, cultural and religious sites in or close to the subproject site in Khovd city. 423. The key cultural resources in the Khovd city is Sangiin Kherem Manchu wall which is located at 48° 0'42.57"N, 91°38'28.40"E in 500m-600m distance from the Khovd hospital. The wall was built around 1762 by the Manchu Qing dynasty warlords. The walled compound once contained temples and homes but a partial wall is all that remains. The site is to the north of the town, adjacent to the main existing route through the town. iii. Cultural heritage in the 5 Soums 424. Following historical or cultural physical heritages exist in a wider project region. None of them locate in the immediate vicinity of the project sites, thus will not be impacted. iiia. Bayan-Undur Soum, Uvurhangai province:  Historical Sculpture at Baga Ereen, Harhorin Soum, Uvurkhangai province  Buural statue, Bayan-Undur Soum  Hunnic tombs in in Zuil Soum  Yesun Zuil Suvarga – religious site, Zuil Soum iiib. Erdenemandal Soum of Arkhangai province  Stone sculpture of Bumbugur Mount, Erdenemandal Soum  Ih Jargalant historical remaining, Erdenemandal Soum  Stone sculpture at Urtiin am  Hunui river sculpture, Erdenemandal Soum  Remnants of ancient city of Har Hul Khan, Erdenemandal Soum  Turkic scripts on rocks of Ih Hanui Mount, Erdenemandal Soum iiic. Erdene Soum of Dornogobi province 425. Eternity Spring. There is a spring called Eternity spring at the Adramag Mount in about 38km distance from the project site. This place has been named as one of the 9 natural wonders of Dornogobi province. iiid. Dashinchilen Soum 426. There are several places with cultural and historical importance in Dashinchilen Soum. These include: 163

 Khar buhiin balgas (9km from project site)  Chin Tolgoin balgas (18km from project site)  Tsogtiin tsagaan balgas (28km from project site)  Erdene hambiin hiid (33km from project site)  Hugnu Khanii hiid (37km from project site) 427. The former three are remainings of ancient settlements while the latter two are buddhist temples built in medieval period. iv. Cultural heritage in Uvs province 428. Cultural heritages around Ulaangom city includes:  Ancient tombs at Chandmani mountain  Doloodoin turkic scripts at Uvs museum  Doloodoi statue Uighur scripts at Uvs museum  Harlag Beis Temple

 Stone sculptures at Delger Murun, Turgen Soum

9. Climate Change in Mongolia 429. In order to address the issue of global climate change and its effects on people and the economy, Mongolia affirmed the United Nations Framework Convention on Climate Change (UNFCCC) in 1993 and the Kyoto Protocol in 1999. The Government of Mongolia has taken considerable steps toward the implementation of the UNFCCC, by accomplishing the re- quired commitments such as the Initial National Communication, Technology Needs As- sessment and the National Action Plan on Climate Change to address climate change and other legal commitments. Mongolian government is a very active member of Green Climate Fund of the United Nations. The Board of GCF has approved abundance funds to Mongolian projects including concessional loan and grant.

430. In 2007, Mongolia was ranked 96th in the list of CO2 emitting countries, contributing around 0.04% to the global emission. UNEP states that in Mongolia, the energy sector (in- cluding stationary energy, transportation and fugitive emissions) was the largest source of greenhouse gas (GHG) emissions comprising 65.4% of total emissions. The second largest source of GHG emissions was the agricultural sector (41.4%). The report also states that to-

tal CO2 removal was more than total CO2 emissions in 2006 due to an increase in the area of abandoned lands and a reduction in newly cultivated land. However, by 2020, it is predicted that Mongolia’s GHG emissions will be more than 5 times that of 2006. According to a pre- liminary GHG emission reduction evaluation conduct by the PPTA mission, the project activi-

ties (output 1 and output 2) of this project will eventually reduce 4,800 tonne eTCO2 per year.

431. Climate modelling for Mongolia is projecting changes which include increased air tem- peratures, increased precipitation in some areas and a reduction of water resources in other areas. Potential evapo-transpiration increase would be higher than precipitation amount in-

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crease. Future climate changes are expected to negatively impact Mongolia, mostly in the agricultural and livestock sectors. This in turn will affect the society and economy, meaning climate change adaptation is a significant issue for the country. The PPTA mission has con- duct a climate change risk screening in September, 2018. The risk rating was identified to be medium, and no significant impacts on the project are expected. The screening identified (i) More frequent extreme low temperature events (e.g. dzuds days) in the future as a major risk affecting project design, construction, maintenance and performance. Low temperature and annual temperature difference, which will cause structure deformation and low cement solidification. (ii) More frequent flooding and heavy rainfall as a major risk (iii) More frequent lack of precipitation/drought as a minor risk. Mitigation measures to address various climate change related vulnerabilities will be considered during the detailed design stage. 165

V. ANTICIPATED ENVIRONMENTAL IMPACTS AND MITIGATION MEASURES

432. In the following chapter, impacts and mitigation measures are described. They have been divided into pre-construction phases (location specific and design phases), construction phase, and operation phase impacts. The chapter is structured according to activities.

A. Impacts and Mitigation Measures During Project Location and Design 433. All buildings shall be designed in compliance with relevant the Government of Mongolia’s design standards and codes for energy-efficient, safe buildings, including but not limited to: Mongolian national standards (MNS) 3838: 2008 and Construction standard package # 91.040. World Bank’s EHS guidelines 2007 standards will apply in-case where the Mongolian standards are less stringent. 434. The Khan-Uul District hospital is located about 1.4 km distance from Bogdkhan Mount Strictly Protection Area. This area is already a housing area and not a biodiversity site. The construction will take place inside the existing land area of Khan-Uul Hospital. The Khan-Uul hospital is located within the buffer zone of Bogdkhan Mount Special Protected Area. Bogdkhan Mount SPA where the Khan-Uul hospital is located is a settlement area with apartments etc. It is not a special area of protecting biodiversity near project site. The proposed construction site is already in the midst of a residential area. Construction activities are not prohibited within the SPA buffer zone but it needs to have DEIA and EMP approved by MET. According to Mongolian Law on EIA, DEIA report will be approved by MET only after Design works for the new buildings are approved by Construction Development Center. Secondly, the hospital has a GEIA obtained from the MET in July 2011 that says “the hospital may operate, no need of a DEIA”. Draft domestic DEIA reports for Khan-Uul and Khovd hospitals are already made by a local professional firm and available. However, approval process of the domestic DEIA reports by Ministry of Environment requires the project to have approved detailed design. 435. Potential adverse environment impacts associated with FHC/SHC/Hospital has been avoided or minimized through careful location selection. Subproject location sites have avoided geologically unstable areas, which can also pose foundation related problems. No land acquisition is required for FHC/SHC/Hospital as the government public or existing FHC/SHC/Hospital land is available. Shrubs and trees may be uprooted and transported to locations inside the premises. All proposed new FHC/SHC/Hospitals have been identified to have possession of vacant land area; whereas the FHC/SHC/Hospitals where construction is to be done in their existing land, there is no need to acquire land. 436. Current facilities for two FHCs and NECC will be shifted temporarily to properties on rent nearby for continuous functioning during construction therefore minimising nuisance to the patients and staff. All other facilities do not require closure during operations as these are separate buildings or new buildings. 437. Green Building and Energy Efficiency: The building design must include green building and energy efficiency features as listed in Section 4. Use of more energy efficient smokeless heat only boilers (HOBs) may have to be mandated in bidding documents.

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Alternatively, the design must include alternatives to HOBs such as electric floor heating that can be controlled using heating control regulators. 438. Type and scale of insulation to be installed in the building will be designed by the Construction Company as per norms followed in Mongolia. The design must lead to introduction of other energy efficiency elements (heat meters; heat insulation that meets the requirements on Mongolian Energy Efficiency Regulations; LED lighting; triple glazed windows) etc. 439. Linked facilities: The PIU must confirm from concerned authorities of various linked facilities such as landfills to accept solid waste, and power, heating, water, wastewater facilities to each of the FHC/SHC/Hospitals on their ability to deliver required services and without interruptions. Any underground utilities such as heating pipes, sewage drainage, water pipeline etc. if disconnected to the premises will be restored. 440. Rehabilitation of old buildings: lays out details of infrastructure that requires rehabilitation such as installation/provision of modern fire control systems/firewalls, smoke alarms, building insulation, possible plumbing and/or electric heating systems instead of coal based heat only boilers. The PIU and the construction company must ensure proper design be implemented for the FHC/SHC/Hospital so that the infrastructure become coherent, and complies to national and international health and safety norms. 441. Ambient Air Quality: Given the low ambient air quality (noticeable in Section 4), it is proposed to introduce Air conditioners, air purifiers inside the FHC/SHC/Hospital to provide safe ambient air quality inside the buildings. High Efficiency Particulate Air (HEPA) purifier, Anion Air Purifier etc. can be used. HEPA filters, as defined by the USA Department of Energy (DOE) standard adopted by most American industries, remove at least 99.97% of airborne particles 0.3 micrometers (µm) in diameter. The operation and maintenance costs of HEPA purifier which includes replace of filters periodically which would need to be borne by FHC/SHC/Hospital’s from their own funds. 442. Sanitation Systems: The design improvements in the project require construction of sanitation facilities where access to the municipal sanitation system is not possible, septic systems are to be installed to reduce the requirement for vacuum truck clearance to a minimum. A “septic tank system” is a small-scale sewage treatment system common in areas that lack connection to main sewage pipes provided by local governments or private corporations. The term "septic" refers to the anaerobic bacterial environment that develops in the tank which decomposes or mineralizes the waste discharged into the tank. Septic tanks can be coupled with other onsite wastewater treatment units such as bio filters or aerobic systems involving artificially forced aeration. Periodic preventive maintenance is required to remove solids that remain and gradually fill the tank, reducing its efficiency. 443. Several FHCs/SHC/Hospitals are using holding tanks due to physical limitations. “Holding tanks” are used exclusively for those areas where shallow ground water and saturated soil represent a real threaten and vehicle for pollutants migration from pits. In fact, the Ger Districts of Ulaanbaatar are characterized by areas environmentally not suitable for human settlements but due to lack of protection zones or law enforcement many of these areas are densely populated resulting in an environmental and public health threat due to 167

migration of pollutants from pit latrines directly into water sources or via saturated soil. The low-cost facility does not allow the use of holding tanks installed for grey water disposal. 444. Restoration: Associated impacts on any public area and play area outside each FHC/SHC/Hospital building that could be used for storage and workmen office will be restricted to the construction phase and will be temporary in nature. After construction is complete, the playground or any other play areas within the premises will be repaired and can be used again. 445. Climate Change: All facilities shall be properly sited to minimize the risk of scouring that may result from increase intensity of precipitation as a result of climate change.

B. Impacts and Mitigation Measures During Pre-Construction Stage 1. Land acquisition 446. The proposed project site in the FHC/SHC/Hospital premises doesn’t require any relocation of homestead since the project activities would be implemented at the FHC/SHC/Hospital’s own vacant land. None of the projects are located in ecological important and has no natural habitat and is not immediately adjacent to watercourses. Annexure 3 lists all sub-project site features regarding land and location. The detailed design should ensure that following measures will be taken prior to the project activities:  Ensure existing drainage facilities are located at a distance from the site.  Plan for protecting /preserving topsoil from foundations etc. for reinstatment after construction is complete, and  Detailed design to include planning for repair /reinstatement of any damaged play areas, access roads, or public facilities etc. after construction is completed. 2. Temporary Use of Land Impact 447. The mobilization of construction equipment and construction materials will require space for storage and parking of construction vehicles and equipment, construction material storage yards, disposal sites, and labor camps for human resource to avoid environmental impact and public inconvenience. Table V.1: Temporary use of Land at Hospitals/FHC/SHC No Component Location Land for building Land for temporary use s 1 Khan-Uul Khan Uul District, Within the hospital Within the hospital boundary Hospital Yarmag boundary 2 Khovd, Khovd Province, Within the hospital Within the hospital boundary Hospital Jargalant Soum boundary 3 Uvs hospital Ulaangom city Within the hospital Within the hospital boundary boundary 4 Emergency Sukhbaatar Within the hospital Within the hospital boundary and infront Health district,1 st Khoroo boundary of existing building to be demolished Center later (the Center will shift temporarily to new rented property nearby) 5 FHC 10th Khoroo in Within the hospital boun Within the FHC boundary and infront of

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No Component Location Land for building Land for temporary use s Khan-Uul district Within the FHC boundary existing building to be demolished dary 6 FHC 14th Khoroo in Within the FHC boundary Within the FHC boundary Khan-Uul district 7 FHC 19th Khoroo in Within the FHC boundary Within the FHC boundary Chingeltei district 8 FHC 17th Khoroo in Within the FHC boundary Within the FHC boundary and infront of Bayanzurkh district existing building to be demolished 9 SHC Erdenemandal Within the SHC boundary Within the SHC boundary Soum 10 SHC Tarialan Soum Within the SHC boundary Within the SHC boundary 11 SHC Bayan-Undur Soum Within the SHC boundary Within the SHC boundary 12 SHC Erdene Soum Within the SHC boundary Within the SHC boundary 13 SHC Dashinchilen Soum Within the SHC boundary Within the SHC boundary

Mitigation 448. These locations must comply with the local laws and regulations and need approval from authorities to utilize these facilities (access roads, telecommunication, and pipe borne water supply). It is important that selection of temporary lands does not infringe upon adjoining residential areas, water bodies, natural flow paths, and access roads to garages, FHC/SHC/Hospital and other amenities in the area. Removal of trees should be minimized during preparation of construction area, access road and other facilities. 3. Banned substances – Asbestos 449. Mongolia recently banned the use of asbestos building products, but the management of asbestos containing materials (ACM) remains fairly poor. Presence of asbestos-cement roofing materials on some existing buildings is an issue as most buildings are old. Construction workers can be exposed to asbestos fibers during roofing modification, repair, or replacement. The old building repair and/or demolition raises doubts about buildings with asbestos containing materials and therefore repair/removal/disposal of such material which is carcinogenic in nature is really hazardous for the workers and the like. During site visits, the hospital managements have assured there are no hazardous materials involved in demolition and disposal of debris to designated waste sites. If renovation or refurbishment for any component requires removal of asbestos containing materials (ACM), the particular activity will be dropped from funding. Specialized Inspection Agency of the Municipality Authority of Ulaanbaatar city has confirmed that there is no asbestos present in the National Emergency Health Call Center Building by issuing a certificate no. 02-03/4170 dated 31 October 2018 (attached as Annexure 10). The detailed “asbestos inspection” at the National Emergency Health Call Center was conducted in June 2018. 4. Demolition 450. Dust and noise generation from earth works and construction material storage and other construction activities during the construction period. Demolition of two FHC comprises of 119 m2 each (10th of Khan-Uul, 17th Khoroos of Bayanzurkh). The mortuary and kitchen at Khan-Uul District hospital will also be demolished. No asbestos is involved in all of the 2 of 169

FHC buildings that will be demolished. The 2 storied National Emergency Health Call Center building measuring 816 m2 will be demolished. Specialized Inspection Agency of the Municipality Authority of Ulaanbaatar city has confirmed that there is no asbestos present in the National Emergency Health Call Center Building by issuing a certificate no 02-03/4170 dated 31 October 2018 (attached as Annexure 10). The detailed “asbestos inspection” at the National Emergency Health Call Center was conducted in June 2018. 5. Volatile Organic Compounds 451. Only low or no volatile organic compound (VOC) emitting materials shall be used (including paints, coatings, adhesives, carpet and furniture’s) to ensure high indoor air quality. Water-based nontoxic, no allergenic paint for drywall or plaster surfaces shall be preferred to latex or oil-based paints. 6. Equipment replacement - X-rays etc. 452. The hospitals in Mongolia confirmed they do not use any radioactive materials in X-ray and other imaging devices. The current X-ray devices at the hospitals have digital lamps that generate x-ray. Any x-ray devices to be provided to FHC’s and SHC’s within the project should have digital lamps. The equipment supplier shall be responsible for all Occupational Health and Safety training as part supply, commissioning and training. 7. Shallow-ground heat pump pilot project 453. A SGHP systems consist of a heat pump system (heat pump units and ancillary equip- ment such as pumps, heat exchangers, pipes etc.) and a ground heat exchanger. Shallow- ground heat exchangers can be divided into two main types – shallow (1.0–2.5 m) horizontal heat exchangers and deep (15–175+ m) vertical systems. Deep vertical systems are divided into closed loop systems, which use a mixture of anti-freeze (e.g. propylene glycol) and wa- ter as a heating media, and open loop systems which use natural groundwater as a heating media. 454. The pilot subproject will demonstrate performance and enable to gain experience in de- sign, installation, operation and maintenance of a Shallow-ground heat pump systems for fu- ture scaling-up. This component will install thermal of Shallow-ground heat pump capacity on a pilot basis under a separate grant. 455. Recenty “Report of specified environmental assessment” of Heat Pump using a Shallow- ground project was preparedfor a project to be built in territory Takhilt Bahg, Jargalant soum44. The SGHP study determined that the preferred ground heat exchanger type in Khovd is a deep vertical closed loop heat exchanger, as the ground freezing level in Khovd is deeper than 3.2 meters, beyond the typical installation depth of horizontal heat exchang- ers, and test bore holes did not encounter sufficient groundwater resources for an open loop system.

44 Source: IEE for Project Number: 50088-002: Upscaling Renewable Energy Sector Project June 2018 Mongolia prepared by the Ministry of Energy for ADB

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456. Safety issues including the test borings must be secured by consultations with driling experts. Preconstruction would require for precautions needed to ensure there are minimal impacts due to its installation and operation include: - Construction Impacts. The above study would be useful in providing most design param- eters. However, based on physical requirement the project would require digging to lay the pipes for shallow (1.0–2.5 m) horizontal heat exchangers and or vertical heat ex- changers that are deep (15–175+ m). Normally such exchangers would not put up in rocky soil as that would make the digging difficult. Proper mitigation measures for digging and disposing of excess soil from the site will be exercised regarding noise, air quality, disposal, protection from drainage etc. - Potential Operation impacts. The Khovd GSHP will utilize a closed loop. The heat ex- changer will circulate the liquid (water and antifreeze) in a closed loop system of pipes buried underground. The heat exchanger will transfer the heat between the refrigerant in the heat pump and the antifreeze solution circulated through the pipe. There will be no utilization of ground water or risk of water loss in adjacent wells, and operation of the sys- tem will not generate any pollutants. The heat pump merely removes or adds heat to the ground. Further, as the system will not be utilized for cooling in the summer, there will be no risk of the creation of a thermal plume. To avoid potential groundwater contamination the wells will be sealed with a thermally conductive bentonite grout. In addition, Mono- propylene glycol will be used as the antifreeze. It is a viscous colorless liquid which is nearly odorless. Due to its low toxicity it is used in a range of products including food- stocks and e-cigarettes. It is the only allowed anti-freeze allowed in GSHPs in an increas- ing number of European countries

C. Impacts and Mitigation Measures During Construction Stage 457. The project activities during construction phase will involve construction of FHC/SHC/Hospital buildings, which will involve excavation for building and equipment foundations, concreting, civil works and erection of equipment, clearing of area including transplanting trees wherever required, and restoring top soil in all playground areas within the FHC/SHC/Hospital premises. During the operation phase, most of the construction phase impacts will get stabilized and the impacts will be restricted only to the operation and maintenance of the FHC/SHC/Hospital building. 458. The impacts on the environment from various activities of the project can be categorized as follows: i. Impact on Physical Resources - Impact on Topography - Impact on Climate - Impact on Environmental Resources - Impact on Air Quality - Impact on Noise Levels - Impact on surface Water Quality - Impact on ground Water Quality - Impact on Soils and Geology 171

ii. Impact on Ecological Resources - Terrestrial Ecology - Wild Life - Aquatic Ecology iii. Impact on Human Environment - Health and Safety - Agriculture - Socio-economics - Resettlement and Rehabilitation - Cultural sites - Traffic and Transport iv. Interference with other utilities and traffic - Waste Disposal - Solid waste disposal - Liquid waste disposal - Hazardous waste disposal 459. The impact of project activities on various environmental attributes are discussed in subsequent sections. 1. Impact on Physical Resources i. Topography Impact 460. During the construction of the FHC/SHC/Hospitals, the most prominent impact on the surface topography will be due to the excavation for foundations, removing of the trees (if any) and erection of buildings. The impact will be irreversible as the present feature of the site as well as the land use will change due to construction of new buildings for the FHC/SHC/Hospitals. 461. The construction phase involves site preparation, clearing of existing vegetation and some earthworks for levelling the surface. These activities may cause some negative impacts such as:  Change in Landscape;  Emission of Dust;  Associated noise; and  Improper management of construction debris and solid waste may pose risk to the neighbours. Mitigation 462. Proper EMP measures will be implemented by the Contractor. Further sections discuss the above impacts in greater detail. ii. Climate Impact

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463. Design and construction of FHC/SHC/Hospital buildings should consider ‘climate proofing design’ for subproject facilities. Alternative solutions and final designs should be subject to expert and community consultation and must analyse flood risk and drainage design to accommodate surface water runoff to greenfield rate at least 1 in100 yr flood plus climate change allowance if feasible. Mitigation 464. All facilities shall be properly sited to minimize the risk of scouring that may result from increase intensity of precipitation as a result of climate change. However, the overall impact on the climate conditions from the proposed sub-projects both during operation phases will not be significant. 2. Impact on Environmental Resources i. Air Quality Impact 465. During the construction phase, the activity would involve excavation for the erection, movement of transporting vehicles carrying the construction materials etc. along the access road. All these activities would give rise to emission of dust particles thereby affecting air quality marginally at the site which although will be transitory in nature. Though the emissions are temporary and not expected to contribute significantly to the ambient air quality and will be within prescribed limits for industrial regions by national ambient air quality standards, necessary measures are to be taken. 466. The air quality in the project area may slightly deteriorate45 for the time being during construction mostly due to dust emission. Dust produced will potentially negatively affect the following:  patients, staff and general public; and  Adjoining apartment dwellers and other buildings in the vicinity  Community areas – playgrounds, parking areas etc.  Construction workers; 467. Unlike for other countries in Asia, this is the most fragile issue for majory infrastructure projects in semi-dry regions like Mongolia. Most complaints from citizens are related to dust from construction and heavy machinery working on sites. Even though planned, the dust suppression is very rarely done by contractors. The Contractor has to ensure all complaints are addressed on this issue. Mitigation 468. Regular sprinkling of water on open surface and dust emitting46 grounds should be done regularly until paving is done during dry season and keeping all soil, sand, and aggregate

45 If air quality (AQ) is already exceeded at a location (for example at UB the air quality is very bad in winters), then the construction company shall try to ensure the AQ does not become worse due to the construction methodology utlised at site. 173

piles covered (whether on the site, or on trucks) to minimize the air pollution during the construction stage. If there is any complain of dust emission from patients, staff and neighbours, should be given proper attention. Detailed design47 must incporporate measures such as siting any stockpiles furthest from properties, hoardings etc.

469. The construction company shall ensure proper dust management/assessment is done to reduce impact due to site construction dust. The Construction company shall evaluate the volume of earthworks, the proximity of houses/hospital buildings and must monitor the dust within 500m using appropriate equipment as specified in Annexure 5. The training on air quality to be developed by PIU as listed in Table IX.2. Please ensure comprehensive dust mitigation plan developed given arid area, recognition complaints relate to dust, and that water sprinkling can help but cannot solve the entire problem, refer to qualitative dust assessment guidance ii. Noise Levels Impact 470. During the construction phase, the major sources of noise pollution are movement of vehicles transporting the construction material and equipment within and outside the construction site. Most of the access roads along the location are wide enough and can be used to bring construction material without obstructing the neighborhood roads. The major work of the construction is expected to be carried out during the day time however the movement of trucks and concreting may happen in the night to avoid congestion in the area in the day time. There residents living nearby will be exposed to noise generated during day and night during the construction phase. 471. Construction works may cause objectionable noise nuisance to workers, patients or staff. FHC/SHC/Hospital authority and patients must be notified in writing on the date of commencement of construction work at least one month in advance. Following measures will help to keep noise and vibration in acceptable level during construction phase: Mitigation 472. Contractor shall equip their heavy construction equipment and plants with exhaust silencers to limit the engine noise not to exceed 75 db(A) (compacters/rollers, loaders and cranes) and regularly maintain all construction vehicles and machinery that should meet the Mongolian national standards for noise emission. Annexure 3 lists all receptors adjoing the construction area. 473. Contractor shall preferably limit working time for activities that create noise within normal waking hours of the public except for construction site near public sensitive receptors. There will be no constructin work allowed in during night. Construction related activities closer to sensitive receptors have to be scheduled in coordination with the residents and relevant authorities.

46 Refer to qualitative dust assessment guidance in EHS guidelines to ensure construction company will prepare comprehensive dust mitigation plan given arid area and recognition of complaints that relate to dust. 47 As per EHS Guidelines for Construction and Demolition.

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474. Contractor and its suppliers of construction materials should strictly implement noise control regulations stipulated for Noise pollution for all construction vehicles and equipment. All machines will be fitted with noise reduction devices. Ulaanbaatar has many construction sites, some of which operate 24 hours a day. Mongolian standards currently establish a maximum environmental noise goal for residential receptors of 60 decibels (A-weighted) (dB(A)) during the daytime and 45dB(A) during the night time, with night being defined as between 22:00-06:00 hours. Depending on noise attenuation and proximity to the construction works, 24 hour a day construction may breach the National Standard for Noise (MNS 4585:2007). World Bank EHS Guidelines 2007 for noise limits will apply as they are more stringent than the Mongolian noise standards. The corresponding level of noise parameter for daytime is 55 dBA. During the night, it is necessary to prohibit noisy activities if properties within 500m and the noise levels cannot exceed 45dBA. 475. For managing noise nuisance, construction works should be limited to daytime hours and all employees likely to be exposed to ear noise must use ear protectors. However, the noise impacts will be local limited to the premises and very short term. Loud noise may disturb the local resident apartment dwellers during normal hours of waking as well. Due consideration must be given by the Construction Company in consultation with local residents. Noise barriers may be installed by the Construction Company to ensure residents are not inconvenienced. 476. The Construction company will install noise barriers during construction if the residents complain of higher noise incidence from construction activities. Magnitude of noise spread around a construction area was calculated for the main types of construction machineries in relation to distance from the construction site are shown in below table. The maximum allowed daytime noise level in urban areas is 60 decibel in accordance with Mongolian standard MNS4585:2016. Table V.2: Construction Machinery Noise

Distance to Machinery Machine Type 5 m 10 m 20 m 40 m 60 m 80 m 100 m 150 m 200 m 300 m Loader 90 84 78 72 68.5 66 64 60.5 58 54.5 Vibratory Road 86 80 74 68 64.5 62 60 56.5 54 50.5 Roller Bulldozer 86 80 74 68 64.5 62 60 56.5 54 50.5 Land Scraper 90 84 78 72 68.5 66 64 60.5 58 54.5 Excavator 84 78 72 66 62.5 60 58 54.5 52 48.8 Roller 87 81 75 69 65.5 63 61 57.5 55 51.5 Mixing Equip- 87 81 75 69 65.5 63 61 57.5 55 51.5 ment Source: Government of Mongolia. 2011. IEE for the Regional Logistics Development Project. 477. As seen above, the magnitude of noise level from construction machineries exceed the standard level of 60 decibel within 100m distance of the construction site. Thus, all potential receptors within 100m distance from the construction site need to be protected with noise barrier walls. A detailed analysis on potential noise receptors is provided in below table.

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Table V.3: Potential Noise screen locations

No Hospital/FHC Setback and type of buildings/distance in meters Noise barrier walls name North South East West recommended on 1 Khan-Uul hospital Current existing Empty space Apartments Settlements /ger North and west sides hospital building under con- area/ of the construction in 30m struction 150m 50m site 2 Khovd province Infectious dis- Current existing Auto garages Warehouse South side of the hospital ease center in hospital building construction site 250m in 33m 3 FHC at 10th kho- Underground Ger area in 60m Office building Kindergarten in Southwest, south and roo in Khan-Uul garage in 50m 30m on south- east sides of the west construction site 4 FHC at 14th kho- Public road in Old empty build- Dirt road Middle school in Northwest side of the roo in Khan-Uul 400m ing 80m on north- construction site west 5 FHC at 19th kho- Ger area in 60m Ger area in 80m Empty space Local khoroo West, south and north roo in Chingeltei administration sides of the construc- building in 20m tion site 6 FHC at 17th kho- Settlements /ger Office building, Parking space, Settlements /ger South, north and west roo in Bayanzurkh area/ in 30m service centers in dirt road area/ in 30m sides of the construc- 20m tion site 7 Emergency Health Private house in Office building in Apartment in Parking space South, north and east Center in UB city 20m 10m 100m sides of the construc- tion site 8 SHC in Ger area in 200 A private hospital Current SHC Empty space East side of the con- Erdenemandal in 200m building in 30m struction site soum 9 SHC in Tarialan Current SHC Ger area beyong Ger area be- Empty space South, north and east soum building in 30m in 40m yong in 50m sides of the construc- tion site 10 SHC in Bayan- Empty space and Old building and Empty space Ger area be- None Undur soum road earth track yong an empty space 11 SHC in Erdene Current SHC Main public road Parking space Earth track North side of the soum building in 80m construction site 12 Dashinchilen SHC Current SHC Empty space Ger area in Public road North and east sides building in 30m 60m of the construction empty space site 13 Uvs hospital Empty space Main hospital Infectious Private hospital South, northwest and building 20m disease center in 40m on east sides of the in 60m northwest construction site iii. Surface Water Quality Impact 478. The construction and operation of the FHC/SHC/Hospital will not have any major impact on the surface and ground water quality in the area. Contamination of water bodies, if any in that area, may result due to spilling of construction materials and surface runoff from the construction site adjoining the water body. There may be increase in the turbidity levels temporarily where the surface runoff during construction meets the drainage of the area. This can be avoided by careful selection of the raw material and waste material storage at the construction site. 479. Proposed activities will create temporary impacts to the existing drainage system in the area including in earthen and line drains. Thus, it will create temporary inundation closer to

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the above locations during rainy season. Stagnation of water will create direct impact on public health.

480. Please add following EHSs guidelines on C&D - the measures proposed here are superficial, need to also consider exposure of earthworks, sedimentation ponds etc. Is this necessary for any of the sites? So what does away mean - 500m? Mitigation 481. Incorporation of following measures will minimize anticipated impact due to obstruction of natural flow paths and existing drainage:  Provisions of temporary drainage facilities to the particular locations if existing drains are obstructed due to construction activities.  Maintenance of all drainage paths by avoiding blockages at all times.  Contractor should minimize excavation of drainage systems in the project affected area.  If any FHC/SHC/Hospital is situated in immediate vicinity of the water body/river, adequate reinforcement of embankment will be done to ensure no surface runoff gets discharged into the water body/river. 482. Care shall be taken to locate the temporary construction sheds away from the drainage/water bodies. Adequate drinking water facilities, sanitary facilities and drainage in the temporary sheds of the construction workers should be provided to avoid the surface water pollution. Provision of adequate washing and toilet facilities should be made obligatory. This should from an integral component in the planning stage before commencement of construction activity. iv. Ground Water Quality Impact 483. Ground water pollution can take place, if chemical substances and oily waste get leached by precipitation of water and percolate to the ground water table. For FHC/SHC/Hospitals construction activity, no chemical substance or oil is used hence there is no impact on ground water quality. The silt discharge from the earth work around water bodies, oil, grease and fuel release from the construction vehicles / equipment and spoil from construction and other construction related activities such as raw sewerage from worker accommodation sites will mix with runoff water. This situation will increase during the rainy season and have a critical impact on surface and ground water. Mitigation 484. The construction company must ensure that drinking water procured from ground water wells must meet national drinking water standards and must be regularly tested in conformance to the Annexure 5. 177

485. Since most of the labor in UB city will stay at their homes, there is no construction labor camp. Also, in all Soum areas, the construction site will be based inside the SHC boundary and will use sanitary facilities48 of the SHC. 486. The construction company must develop pollution prevention plan to ensure that all fuel, oil, chemical is stored in 110% bundled area with impermeable floor, everything correctly labelled etc. They must refuel vehicles (if any) only in designated areas and must have spill kits on site to clean any spills at once and remove contaminated soil49 etc. to avoid contamination of ground water. 487. Following measures will be required in order to prevent deterioration of water from the construction and construction related activities:  All construction vehicles and equipment should be maintained in proper conditions without any leakages,  Contractors shall use silt traps and erosion control measures where the construction is carried out in close proximity to the water bodies to avoid entering of cement particles, rock, rubbles and waste water to the surrounding drains,  Construction activities requiring digging should be preferably done in the dry season,  Waste oil should be collected properly and disposed to the approved location. v. Soil and Geology Impact 488. Project activities including excavation, cut and fill operations, removal of trees and green cover vegetation etc. will enhance the soil erosion during the rainy season. The excavation activity and land clearance in the erosion prone areas have been minimized. Levelling and stabilization of construction sites will be done after completion of construction activity. Also, increased acceleration of surface runoff will damage the topsoil. 489. Construction company must develop a drainage and earthwork management plan to to limit erosion, runoff etc. pursuant to Mongolian standards and/or best international practices depending on whichever is more stringent. Mitigation 490. The impacts associated with excessive erosion and other civil works can be avoided or minimized by following mitigation measures:  Effort should be taken to minimize removal of trees and green cover vegetation.  Minimize obstruction or destruction to natural drainage pattern of the surrounding area.  Proper treatment of clearing and filling areas against flow acceleration.  Contractors shall restrict cut and fill operation around sharp/deep slope areas.  Top soil which are removed during construction must be stored separately for future utilization.

48 Construction Company to use EBRD/IFC guideline on worker accommodation for no. of toilets etc 49 Refer to EHS guidelines on Construction and Demolition

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3. Impact on Ecological Resources 491. Since FHC/SHC/Hospitals are constructed in government lands, there is no displacement of people or animals. It is also not causing any disturbance to the life of people and local animals and birds’ movement. There is no national wildlife park, bird sanctuary, wetland in the location of the proposed FHC/SHC/Hospitals. The ecological impacts are briefly described in the following sections. i. Effect on Flora and Fauna Impact 492. Noise, vibration and emission from construction vehicles, equipment may occur during construction and pre-construction stages in temporary manner which may affect the local flora and fauna. Mitigation 493. None of the declared environmentally sensitive areas is located within the project area. It is not expected that any flora and fauna that are rare, endangered, endemic or threatened will be affected - no migratory paths of small mammals and reptiles may be affected due to construction activities. The impacts related to above activities are temporary and can be mitigated through following measures:  Strict attention on worker force regarding disturbance to surrounding areas.  Selection of approved locations for material storage yards and camps away from the environmental sensitive or populated areas. Avoid any camps outside the site boundary as well as establishing camps in the buffer zone of specially protected area.  Avoid entering of construction waste (cement particles, rock, rubbles and waste water) and sanitary waste to the surrounding water bodies. ii. Aquatic Ecology 494. There are no major rivers or tributaries in the location of subprojects. No significant impacts on aquatic ecology of the river are envisaged and will not have any impact due to subproject activities. 4. Impact on Terrestrial Ecology 495. There is no sensitive ecological area / protected forest area such as national wildlife park, bird sanctuary crossing the proposed sub-project locations. The removal of herbaceous vegetation from the soil and loosening of the top soil generally causes soil erosion. However, such impacts would be primarily confined to the project site during initial periods of the construction phase and would be minimized through adoption of mitigation measures like paving and surface treatment and water sprinkling. 179 i. Wild Life 496. For selected the sub-project locations, no wild life locations have been included as far as possible during the field visits. National Park or Nature Protection Areas50 near Ulaanbaatar and other provinces which are around 7-80 km away from the nearest project FHC/SHC/Hospital. ii. Removal of Trees Impact 497. Very small number of trees exist in the sites selected for most subprojects. There are about 59 Populus trees at Khan-Uul District hospital site, about 7-8 Populus trees at Khovd hospital site, 10 Populus trees at National Emergency Health Call Center (NECC), and about 25 trees and bushes at the FHC in 10th Khoroo of Khan-Uul district that need to be removed and re-planted. Populus tree does not have any protected status both domestically and internationally. Mitigation 498. The exact number of trees affected will be known during the detailed design by the construction company. This will be an irreversible impact. However, any tree that will be cut may be transplanted depending on its type and its suitability for transplantation within the premises. This will minimize the tree loss. 499. The construction company develop a transplantation plan with respective FHC/SHC/Hospital managementsto implement a tree replanting programme which should be undertaken in 1:2 ratio (e.g. where two trees will be planted when a single tree is cut). The construction company would be responsible for replantation of trees cut from the construction area within the planned green areas of the FHC/SHC/Hospital premises. iii. Effect on Local Road Network This suggestion was supported by FHC/SHC/Hospital managements, Ulaanbaatar city and Khovd Provincial Governments Impact 500. Iron bars, concrete materials, digging equipment, etc. will be transported through the local road network to the project site. Transporting of large quantities of materials using heavy vehicles could exceed the carrying capacity of the road51. This would lead to physical damages to local road network. Thus, it will be necessary to obtain consent from the road/highway authorities to use local/national highway roads prior to transportation. The construction company will conduct a pre-reconnissance survey of road condition to ensure that no structure would be damaged by vibrations etc to avoid future claims from the road department. The construction company must develop traffic management plan to minimise road safety risks, as hospitals need to consider how sick, elderly, disabled will be able to safely enter / egress site as part of the design process.

50 These national parks, sanctuaries or nature protection areas only support biodiversity and are not necessarily deemed to be Specially Protected Areas mentioned earlier which can be use for camps, residential etc. defined in Section 2. 51 Estimates of number of trucks can only done by the construction company during detailed design.

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Mitigation 501. The Construction Company should properly maintain all road sections, install road signs warning of patients, pedestrian crossing etc. which will be utilized for the construction related activities. In presence of multiple FHC/SHC/Hospital sites in the vicinity of construction area, the Construction company will ensure free and safe access roads to each FHC/SHC/Hospital and install appropriate road safety signs as necessary in the area. iv. Effect on Visual Aesthetics 502. The proposed project site has some grass and scrub vegetation that will be affected due to the land development. But with completion of the FHC/SHC/Hospital building and replanting of new vegetation and trees around the building, the FHC/SHC/Hospital building site should built to fit into locsl context as well as recover the visual aesthetics. Disposal of Debris Impact 503. As a result of construction related activities, spoil and debris will be generated during the construction stage. Improper disposal of the debris will have an impact on the surrounding ecology, public health and scenic beauty. Mitigation 504. Following measures will minimize the impacts associated with disposal of debris:  Spoil materials (soil, sand, rock etc.) generated from construction activities shall be used wherever possible for site levelling, back-filling etc. Any dismantled and demolished structural materials, if any, should be dumped in accordance to government norms or international best practises whichever are more stringent.  Preparation of Disposal Management Plan for the project and selection of the disposal site by excluding locations, which are closer to residential, commercial and public sensitive areas, is necessary by the construction company. Prior approval should be obtained for linked facilities such dumping grounds / land fill sites from relevant local authorities if currently all existing sanitary landfill sites are to be used. However, if new sites are proposed, they would need to be identified.  Dumped materials may interfere with the drainage pattern of the area, any water bodies, agricultural lands, marshlands and down slope or any environmental sensitive areas if not planned properly. Therefore, care must be taken that proper silt traps are developed at the site to ensure no dumped material flows into the drains.  During operation phase, there is no requirement for disposal of debris. 5. Human Environment i. Traffic and Transport Impact 505. During the construction phase, traffic disturbance needs to be minimized by avoiding heavy traffic hours, ensuring proper access roads and avoiding road blockage. Increase in vehicular traffic in the area is likely to be experience during construction phase of the 181

FHC/SHC/Hospital building because of trucks ferrying in off construction material and carrying waste material from site. Following are the impacts likely to occur due to increased traffic:  Slightly more congestion near the main entrance to the FHC/SHC/Hospital.  Increased number of vehicles on local roads will result in increased wear and tear of local roads thus reducing lifespan of affected roads.  Pedestrians and cyclists using local roads will have to exercise more care with increase of vehicular traffic on the said roads.  There will be an increase of exhaust emission from vehicles, which will pollute local atmospheric air. Constant movement of vehicles that transport construction materials will cause increased level of dust and noise during the construction period. Mitigation 506. Effective traffic management and accident management plan by Contractor needs to be prepared. Slightly more congestion near the main entrance to the Hospital / Health Center could exist at the gates due to limited entry available at the site until entire construction is complete. The Contractor will post traffic managers at all access roads at of the FHC/SHC/Hospital sites and will ensure parking places are not encroached by placing any construction/waste material or parking of construction vehicles. 507. The Construction Company may have to carry the construction material into the site at night or during least congestion period. So, the traffic related congestion and air pollution would be least affected in this case. ii. Worker and Community Health and Safety - Construction Impact 508. Health and safety impacts will be in terms of risk of accidents and exposure to electric shock at the construction site. In addition, when construction work takes place in a public environment, safety measures are often lacking to protect the public. Project activities may create accidental damage to general public and the construction workers. Mitigation 509. The Construction company will undertake Health and safety risk assessment that would include measures of EHS Guidelines on occupational health and safety (OHS) and community health and safety (CHS) to avoid, minimise, mitigate for residual risk. Necessary training regarding safety aspects to the personnel working at the FHC/SHC/Hospital will be provided by the construction company. The workers should wear PPE (Personal Protective Equipment), safety goggles, and other necessaries during construction period and during the maintenance work. First aid facilities will be made available with the labour gangs and doctors called in from nearby towns when necessary. Article 16 of the National Constitution of Mongolia states that every employee has the right to ‘suitable conditions of work’. The government adopted a National Program for Occupational Safety and Health Improvement in 2001 and national standards are also adopted such as the National Standard on Occupational Health and Safety (MNS 5002:2000).

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510. Therefore, Construction Company should take necessary action to enhance personal safety during the construction through following measures:  Organize awareness programmes relevant to personal safety of the workers and general public in the area;  Installation of warning signs to particular locations such as transverse points of local road network by FHC/SHC/Hospital;  Provide protective safety belts, footwear, helmets, goggles, eye-shields and clothes to workers depending on their duty; and  Arrangement of proper first aid unit and transport facilities to take injured people to the hospitals.  Health and safety issues due to construction activities will be an issue for workers, patients, staff and others. Accident can happen occur during earth cutting, casting, construction works and installation of heavy machinery if care is not taken in their operation. Any near miss, minor, lost time, fatal incident to be reported within 24 hr of incident with corrective action plan to avoid repeat accidents.  The whole work site will have to be fenced off and marked, so as to prevent the access of FHC/SHC/Hospital patient and neighbours to the construction site. When land clearing is complete, the work area is finished, and facilities are in place, all of the above impacts and risks will be neutralized 511. During construction, the EA and the PIU through the Construction Company will engage in public consultations and EMP trainings (listed in Table 7.2) to improve worker and community members’ knowledge, attitudes and practices on health and safety. iii. Community Health 512. The construction company will ensure to adopt internationally and nationally adopted safety regulations during the construction of various sub-project near schools, houses, neighbouring community etc.:  Health and safety issues due to construction activities will be an issue for workers, community, patients and others. Accident can occur during earth cutting, casting, construction works and installation of heavy machinery if care is not taken in their operation.  The whole work site will have to be fenced off and marked, so as to prevent the access of local community, in particular residents and children in the vicinity of construction sites. When land clearing is complete, the work area is finished, and facilities are in place, all of the above impacts and risks will be neutralized 513. Risks to community health and safety (CHS) and occupational health and safety (OHS) are highest during the construction stage as project activities can affect various environmental, social and behavioural determinants of health. Risks to CHS and OHS can be inter-related, as interactions between construction workers and local community members are unavoidable. 514. The increase in construction traffic, especially of heavy goods vehicles, along the road local networks will affect road safety and the risk of road traffic accidents and injuries. This 183

risk is higher for pedestrians and near vulnerable receptors such as schools and other social services. The construction company must focus the traffic safety awareness campaigns to communities that lives and communes along transportation corridors, imposing speed limitations with zero tolerance clauses in the worker codes of conduct for non-compliance, traffic signs on entry and exit points of the construction site, signs of caution about movement of transportation machinery. 515. Construction traffic and construction works on the various sites will generate noise. Construction-related day-time noise, as well as annoyance and other health effects in the general population around the various construction sites. Night-time noise associated with night-time construction traffic and offloading can cause sleep disturbance and therefore will be limited and as per agreement with local community. Mitigation measures can address community health and safety risks and impacts associate with increased air pollution, noise and traffic during the construction phase. iv. Occupational health and Safety Impact 516. The objective of occupational health and safety is to provide workers with safe and healthy working conditions and prevent accidents, injuries, and disease. It also covers the establishment of preventive and emergency preparedness and response measures to avoid, and where avoidance is not possible, to minimize, adverse impacts and risks to the health and safety of local communities. It is therefore a combination of occupational health and safety of staff/workers at the subproject facilities and community health and safety of people living nearby or potentially affected by failures or poor operation of facilities. Mitigation 517. The contractors will also implement precautions to protect the health and safety of construction workers. The occupational health and safety risks will be managed by applying measures in the following order of preference: avoiding, controlling, minimizing hazards, and providing adequate protective equipment. All workers will undergo a site induction/orientation that will highlight expectations on minimizing impacts to the physical and social environment. There will be an on-site and off-site code of conduct established that will outline roles, responsibilities and consequences for non-compliance. Prior to construction, the site-specific Environmental Management Plan will be finalized to include the following components: a. Public Health Management Plan b. Waste and Hazardous Material Management c. Worker accommodation Management (if there are workers’ camps) d. Traffic Safety Management component during construction e. Dust, Noise and Vibration Management f. Occupational Health and Safety Management

518. In addition, each contractor’s Site-Specific Construction Environmental Management Plan will include measures for health and safety for personnel. Contractor should be required to employ at least one dedicated Health and Safety (H&S) supervisor per site. The plan will be

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submitted to the PIU/PMO for review and appraisal and will include the following provisions for health and safety: 519. Personal protection. Provide personal protection equipment (PPE) appropriate to the job, such as safety boots, helmets, gloves, protective clothing, goggles, and ear protection, in accordance with relevant health and safety regulations, for workers. 520. Worker Accommodation Plan. which will conform to International worker accommodation standards52 to prevent health, safety, security and environmental risks to workers and community members alike. 521. Emergency Preparedness and Response. An emergency response plan to take actions on accidents and emergencies, including environmental and public health emergencies associated with hazardous material spills and similar events will be prepared, and submitted to the PIU for review and appraisal. A fully equipped first-aid base in each construction site will be provided. 522. Records Management. A Records Management System will be established to document occupational accidents, diseases, and incidents, that: (a) includes a tracking system to ensure that incidents are followed-up; (b) can easily retrieve records; and (c) can be used during compliance monitoring and audits. The system will be backed up on at least one external hard drive to protect records against loss or damage. 523. Safety communication. Ensure that safety, rescue and industrial health matters are given a high degree of publicity to all persons regularly or occasionally on the site. Posters drawing attention to site safety, rescue and industrial health regulations will be made or obtained from the appropriate sources and will be displayed prominently in relevant areas of the site. 524. Training, awareness and competence. Train all construction workers in basic sanitation and health care issues, general health and safety matters, and on the specific hazards of their work. The Contractor must have no tolerance policy on workers on following H&S requirements and must incentivize workers for maintaining good H&S record. v. Sanitation Hazard & Drinking Water Impact 525. The health of the project personnel, construction workers and laborer at the site could be impacted if arrangement of sanitation and drinking water is not ensured adequately and properly. The project activities shall make higher demand on the local utilities and service facilities particularly construction and drinking water, health and sanitary facilities. Mitigation 526. Most workers will be local residents at the project sites but some of the workers might come from other regions and may stay in nearby accommodation planned by the Contractor. Regular testing of drinking water as specified in the EMoP in Annexure 5 is compulsory. The

52 In accordance to EBRD/IFC worker accommodation guidelines. 185

Contractor to develop occupation health and safety plan for those workers from other regions as per EMP. According to domestic standard MNS0900:2018, these are the all parameters tested for ground water quality testing. To determine full suite as per EHS Guidelines could be performed by construction company during construction. vi. Temporary Outage of the Electricity Impact 527. Temporary disconnection of power supply may occur during the construction activities. Thus, general public and the apartment dwellers, who live in the vicinity of the sub-project area, could face inconvenience for short periods of time such as from few hours to half a day during daytime hours. Mitigation 528. Following measures will have to be taken for mitigation:  Advance notice to the public about the time and the duration of the utility disruption, and  Restore the utilities immediately to overcome public inconvenience. vii. Emergency Response during construction 529. The Construction Company must train its project personnel, construction workers and labourers, and staff to have knowledge of sufficient emergency response systems put in place. Fire safety management training and mock drill should be practiced periodically and emergency equipment and facilities like fire extinguisher/water hose, first aid etc. must be available to manage fire hazard or any medical emergency. 6. Socio Economics i. Agriculture 530. There will not be any land acquisition for the FHC/SHC/Hospital projects as all land used for the project as government lands and free from encroachments. ii. Local Employment 531. Construction of FHC/SHC/Hospitals will generate local employment, as number of unskilled labourers (both men and women) will be required at the time of construction activities. Local employment during this period will increase socio-economic standards. iii. Resettlement and Rehabilitation 532. For the construction of FHC/SHC/Hospitals, no land acquisition is required, hence there is no resettlement and rehabilitation involved in the project. iv. Cultural sites 533. There are no archaeological, historical or cultural important sites along the location; hence the impacts on these sites are not envisaged.

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7. Waste Disposal i. Solid Waste Disposal Impact 534. The solid waste generation will be at the location of the construction site which will include metal scraps, wooden packing material etc. Mitigation 535. Wooden waste and metal scrap will be collected and disposed of in compliance with applicable regulations and rules. ii. Sanitary Waste Disposal at Construction Sites and Labor Camps Impact 536. Those places where most labor will be staying will be near apartments which may use some community or FHC/SHC/Hospital facilities for solid waste, water and sanitation. There could be few gers of storage etc. at the site of construction which would be of temporary nature. Adequate drinking water facilities, sanitary facilities and drainage in the temporary sheds of the construction workers should be provided to avoid the surface water pollution. 537. There should be proper solid waste disposal procedure to enhance sanitation of workers who stay in Hopsital/FHC/SHC campus. Any possibilities of infecting water borne diseases or vector borne diseases (Parasitic infections) will be eliminated by adopting proper solid waste disposal procedure. Ssolid waste disposal practices such as open dumping of solid waste and poor sanitation facilities would not be allowed as they would lead to pollution of surrounding environment, contamination of water bodies and increase adverse impact to the general public inhabited in the area. Improper dumping of spoil materials and solid wastes may cause environmental degradation of the FHC/SHC/Hospital area and patients, staff and neighboring people will face problems like: bad smell, aesthetically unpleasant environment, diseases etc. Mitigation 538. Thus, following measures are needed to protect and enhance the quality of environment during the construction stage:  A better way to overcome garbage disposal as mentioned above by reducing or avoiding the construction of gers for labour, thus the selection of majority of skilled and unskilled workers from the project influence area will be a proper measure in this regard.  Proper sanitation system should be provided and at the same time, regular, proper and safe disposal of human waste at each Hospital/FHC/SHC should be ensured. Contractors and workers should obey appropriate means of waste removal and sanitation measures. Adequate number of toilets and bathrooms should be made for the workers, and proper disposal system (septic tank) of sewage waste should be implemented for sanitation purpose and the workers should be aware to use those facilities. Contractor should provide adequate facilities to manage its wastes in accordance with the guidance given by the Mongolian law on solid waste and law on construction, and related regulations. 187

 Contractor should develop a proper waste management plan for handling and managing waste generated from the construction labor work area without contamination to natural environment and it will reduce risk to general public who stay close to sites. Also, Construction Company should be responsible to enhance the quality of environment.  Adequate supply of water should be provided to the urinals, toilets and wash rooms of the workers’ accommodation  Contractor should provide garbage bins to all worker’s accommodation and construction sites, for dumping wastes regularly in a hygienic manner in the area. iii. Liquid Waste Disposal 539. The construction company must develop pollution prevention plan to ensure that all fuel, oil, chemical is stored in 110% bundled area with impermeable floor. If there is any generation of liquid waste, the construction company shall arrange to handle it as per Mongolian law or best practice international practices (whichever is more stringent). iv. Hazardous Waste Disposal Impact 540. During the Hospitals / Health Centers construction generation of any hazardous waste generation is not expected. Although today asbestos is hardly used in construction materials other than asbestos cement products, it may still be found in older buildings in the form of friable surfacing materials, thermal system insulation, non friable flooring materials, and ‐ other applications. ‐ Mitigation 541. Inert (non-infectious) Hazardous waste material such as batteries, and solar panels (if used) would need to be disposed of as per Mongolian law. The contractor will transfer and dispose of the such hazardous waste to a suitable place to Mongolia, then the Contractor will dispose it to such a location. Otherwise, this lined site will be refilled with waste and used until it is completely filled. Once it is filled, the pit shall be sealed to protect leakage (leaching through pores in concrete to the ground) of the contaminant. For any infectious medical waste, it will be handled by suitable government nominated private agencies (such as Element LLC) for its disposal. 542. However, there is no corresponding law or regulation regarding asbestos and asbestos containing mateials handling and disposal. Therefore, for this tranche, if renovation or refurbishment for any component requires removal of asbestos containing materials (ACM), the particular activity will be dropped from funding.

D. Impacts and Mitigation Measures During Operational Stage 1. Hospital / Health Center Environment Impact 543. During operations, the FHC/SHC/Hospital building must ensure a better quality of FHC / SHC / Hospital infrastructure for patients (both interior and outside) besides better quality of

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health care facilities. Improper heating, washrooms, suffocation problem etc. are possible adverse impacts that will eventually lead to a poor FHC/SHC/Hospital environment. Mitigation 544. The building would be designed to ensure the suitable heating, water, lighting, storage areas, proper ventilation, sufficient toilets & washrooms and support infrastructure. There are no topographical changes envisaged during the operation phase of the Hospitals / Health Centers. 2. Disadvantaged Patients/children Impact 545. The disadvantages patients and children might be at a disadvantage in the existing Hospital/health centers due to physical limitations. Mitigation 546. The new FHC/SHC/Hospitals would incorporate certain design improvements required for the disadvantaged patients including children. These would include: (i) disabled access, sanitation and signage (wheelchair access ramps to be included above ground level if deemed appropriate by MOH; wheelchair access to one toilet cubicle per sanitation block (male and female) to be included; Dual handrails on stairs for small children and adults; Brightly colored and braille signage to be included). The construction company will ensure proper design and access to all facilities within the hospital and outside the building to ensure that these are free from any encumbrances, obstruction and defect free in their installation. 3. Increased demand of utilities-electricity, heating, sewage and drinking water Impact 547. The new buildings will require services (notably sewage, water, heating and electricity), which could cause additional demand during periods of low water availability and load- shedding on utilities. The proposed building design features that address water and energy conservation would help considerably in this regard. Mitigation 548. The FHC/SHC/Hospitals must design a management procedure in coordination with PIU to maintain the septic tanks, individual heat only boiler, water heater, electricity generators (if any) on the premises. They also need to ensure proper funds are available for regular upkeep and maintenance of these facilities. 4. Health Care Waste (HCW) Management Impact 549. According to WHO53, around 15% of HCW is considered hazardous material that may be infectious, toxic or radioactive. Inadequate HCW management can cause environmental

53 Health Care Waste Management in Mongolia, 2013 by WHO.

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pollution, growth and multiplication of vectors like insects, rodents and worms and may lead to the transmission of diseases like typhoid, cholera, hepatitis and AIDS through injuries from syringes and needles contaminated with human waste. 550. Solid Waste. Operation of the FHC/SHC/Hospital building will result in production of solid waste, which will require careful storage, separation and handling. 551. Disposal of Medical Solid Waste. Hospitals, FHC’s and NECC will generate hazardous, infectious and chemical waste during their operations that can be managed properly following to EMP. 552. Non-medical Wastewater. The FHC/SHC/Hospital building will create non-medical wastewater discharge that will be mainly water used for domestic and toilet uses. 553. Medical/Chemical wastewater. New FHC/SHC/Hospital may have chemicals and they will manage chemical wastes according to the “Guideline on Methodology and Technology to Dispose, Storage, Transportation, Collection of Chemical Wastes; (2009). Mitigation 554. Solid Waste. Properly marked waste containers should be available at each floor and outside the building. All solid waste will be segregated properly, disposed to the safe places carefully. The PIU, the City Public Service Company and the Construction Company will provide training on solid waste management to both staff/patients to segregate waste by placing separate containers stating waste type before being collected by the City Public Service Company. 555. Sweeping and washing should be done to provide patients a waste free healthy environment. It is important that solid waste and sewage from the FHC/SHC/Hospital building should not be nuisance to the community. 556. Disposal of Medical Solid Waste. Medical waste such as syringes, bandages, etc. are collected on regular intervals by Element LLC is the sole licensee having obtained special license on handling medical waste from the Ministry of Health. to collect medical waste in Mongolia. They have a medical waste facility at Ulaanbaatar city’s central dumpsite called Narangiin Enger. 557. Non-medical Wastewater. The domestic liquid waste will be disposed through a septic tank. The project will have planned drainage system to discharge the surface runoff. 558. Medical/Chemical wastewater. The medical wastewater is collected and disposed of as per GOM guidelines. Currently, all FHC/SHC/Hospital collect and keep chemicals used for chemical classes which is disposed of by the District Branch of Emergency Management Agency. The Specialized Inspection Agency monitors this procedure regularly and also registers all chemicals used by FHC/SHC/Hospital. 559. If any capital investment for health care waste management works outside the premises of the hospital/FHC/SCH is required for developing capacity of the Aimag/Soum local agen-

http://www.wpro.who.int/mongolia/publications/health_waste_management.pdf

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cies (such as transportation equipment for waste, liquids, development of engineering land- fills etc.), it will be budgeted separately from the EMP and the project – either by the Mongo- lian Government or through alternate sources. Mostly all landfill in Mongolia are non- engineered landfills and project cannot make huge investments in Aimag/Soum facilities. 5. Emergency response during operations Mitigation 560. The Hospital management will have sufficient emergency response systems in place. The stairs of the building will be well designed and adequate for easy passage of the occupants. Fire safety management training and mock drill should be practiced periodically and emergency equipment and facilities like fire extinguisher/water hose, first aid etc. must be available to manage fire hazard or any medical emergency. Emergency electricity generators of sizing dependent on Hospital/FHC/SHC size are installed at each facility that conform to MET guidelines on emissions. 561. All big hospitals are required to have backup generator. Size of generators at the various hospitals are as follows: - SHC’s: small petrol motors with connection to 220V, - Khovd and Uvs hospitals: 110kw diesel generator with capacity of 400l fuel bank. - Khan-Uul hospital: 140kw diesel generator with 450l fuel bank connected with 380V. - FHC’s: All 4 FHC’s do not have back-up generators even though they are required to have. 562. The Mongolian national emission standard MNS5014:2009 applies to vehicles and cars only, there is no specific requirement for diesel generators. 563. Some risks expected during construction (for hospital personnel, patients and nearby residents), but can be addressed through sound construction site management such as sound proofing noise, construction yard protection fencing, proper traffic management during construction material movements. The construction company and Hospital/FHC/NECC sites will plan and implement disaster management plan, emergency site accident remedial measures and information disclosure etc. 6. Occupational Health and safety (OHS) 54during operations Mitigation 564. Need to ensure life and fire safety design per EHS guidelines on health facilities and CHS are addressed at design stage for implementation during the operations stage.

565. The hospital/FHC/SHC health care facilities would have staff operating them, the patients and visitors in the premises on daily basis. The EA must ensure that the OHS needs are adhered by

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providing budget, staff and equipment55. equally needs to be considered - see EHS guidelines on HCF for issues to consider 7. Electric Shock Impact 566. This may lead to death or injury to the hospital staffs, patients and public in the area if facilities are not constructed properly. Mitigation 567. This can be minimized or avoided by providing security enclosures, establishment of warning signs, and careful design using appropriate technologies to minimize hazards. 8. Noise Generation 568. During construction phase, there is no concurrent construction in two adjoining FHC/SHC/Hospitals so there will be no amplification of noise to the neighbourhood. However, during operations, the noise from operations of hospitals would be related electricity generators (that conform to Mongolian noise and emission standards), traffic that gets built up near the hospital gates or from machinery that transports wastes –solid wastes (including medical waste) and liquid wastes (including any chemicals) including the residents during the consultations have assured that they would not be inconvenienced on that account. 569. During the operation phase of the project, the ambient noise level meets the World Bank EHS Guidelines for residential areas (55 dB(A) during daytime and 45 dB(A) during night time). During normal work hours, noise from construction may also disturb some residents, but they have been consulted prior to the start of construction. The generator set that will be installed will be of design that is noiseless.

E. Cumulative Impact Analysis of subprojects 570. The Cumulative Impacts56 are defined as the combination of multiple impacts from existing projects, the proposed project, and anticipated future projects that may result in significant adverse and/or beneficial impacts that cannot be expected in the case of a stand- alone project. The Induced Impacts are the adverse and/or beneficial impacts on areas and communities from unintended but predictable developments caused by a project, which may occur later or at a different location. 571. The potentially affected environment in the project area is defined principally in regard to two factors: (i) the nature and scale of the proposed action; and (ii) the sensitivity and circumstances of the environment in which the proposed action will occur or issues of special concern (such as induced and cumulative impacts, etc.). The project’s area of influence regarding potential impacts associated with noise and traffic congestion during construction will extend to areas around the construction zones.

55 Refer EHS guidelines on Health Care Facilities for design 56 Environment Safeguards- A Good Practice Sourcebook on Draft Working Document (December 2012).

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1. Densification of area 572. The FHC/SHC/Hospitals have sufficient vacant pieces of land required for construction in the current premises that was not used as a playground. Therefore, the issue of densification of construction in the area does not arise. 2. Influence zone of each FHC/SHC/Hospital 573. In some areas, where the other FHC/SHC/Hospital are located in vicinity (about 100m distance), the detailed design by the construction company must ensure proper setback distances between new building and existing facility is maintained as per Mongolian norms. Figures in Annexure 3b provide details about the affected area for each FHC/SHC/Hospital. The effective area of influence taken for each FHC/SHC/Hospital is a 100 m radius for all impacts – noise, dust, and traffic. 574. There are no physical-geological and hydro-dynamically difficult conditions that may adversely impact the construction. No environmentally sensitive areas were observed near the sites as all infrastructure improvements are located in Ulaanbaatar City, Khovd and Uvs provinces. There are no cultural heritage sites in the project areas. 3. Noise Amplification 575. During construction phase, there is no concurrent construction in two adjoining FHC/SHC/Hospitals so there will be no amplification of noise to the neighbourhood. However, in UB there may be some areas where many concurrent construction sites for commercial buildings are under construction day and night which may lead amplification of noise. 4. Greenhouse Gas emissions 576. The project would install about 4 heat only boilers (using coal) in locations (FHC’s in 19th Khoroo of Chingeltei, 14th Khoroo of Khan-Uul and 17th Khoroo of Bayanzurkh and SHC in Dashinchilen Soum) where the district heating is not available (Ger areas). Given that the hours of operation would be for 24 hours for 210 days (1 October to 1 May) at the emission rate of 2500g/s for 3 boilers would lead to 5.4 tonnes/annum (Calculated using data from Table A1.8.2 in Annexure 1). The EHS guideline which states that GHG emission limit for project should not exceed 25,00057 tonnes/annum is well within limits58. However, the discussions were held with MOH to install electric floor heating and electric boiler for hot water in these FHC/SHC/Hospital to avoid handling of coal, ash and its related impacts of using Heat only Boiler. However, most houses/apartments, schools etc. all have Heat only boiler if they are not connected to central heating facility. In that case, the cumulative GHG emissions will increase but not significantly on account of these health facilities constructed/repaired as part of the project.

57 EHS Guideline, Guidance Note 3 Resource Efficiency and Pollution Prevention, 2012 58 * Small Combustible facilities Emission Guidelines (3 MWth-50 MWth) - for Boilers using solid fuel (Annexure 1, Table A1.6). 193

F. Summary of Impacts 577. Potential environmental impacts (both positive and negative) associated with all project phases were identified in this section is illustrated by the following Table. Most of the minor, temporary adverse environmental impacts relate to the building construction process, and can be relatively easily mitigated with standard best practices that are increasingly being required of the construction industry. Table below provides a summary analysis of positive and adverse impacts of the sub-projects. Table V.4: Summary Analysis of Positive and Adverse Impacts

1 Project Activities Positive Impacts (Type) A Pre-Construction i Increasing local Local business will be enhanced due to the construction activities in the businesses area. Local construction companies will be contracted. (Temporary) B Construction i Employment Employment opportunity to local population. (Temporary) C Operation i Socio -economic Development of health facilities will help nomadic population in the country impact to access health facilities and thereby provide better quality of life to society and neighbourhood. (Permanent) ii State of Art new Most FHC/SHC/Hospital building are between 32-30-year-old buildings facilities having inefficient heating, electricity, rusted water and inadequate sanitation. (Permanent) 2 Project Activities Adverse Impacts (Type) A Pre-Construction i Site Access Loss of access to the site for public spaces/play area. (Temporary) ii Site preparation, Clearing of vegetation, trees; land development may create problems in clearing and local drainage pattern; emission of dust, Improper management of earthworks construction debris and solid waste may pose risk to the Patients and others; construction noise (Temporary). Reduction in visual aesthetics at site, access road, truck traffic, construction equipment and permanent building (Permanent). B Construction i Influx of workers Health & safety of workers at site may pose risks; concentration of labor force creates un-hygienic condition and sanitation hazard (Temporary). ii Construction Equipment installations may create noise; carrying of construction materials equipment / materials may create traffic congestion; cutting/filling, stockpiling of construction material and traffic movement may create dust emission, improper management of construction debris and solid waste may pose risk to the workers, Patients and residents (Temporary). iii Vehicle and pedestrian More congestion near the main entrance to the hospital; increased number traffic of vehicles on local roads will result in increased wear and tear of local roads thus reducing lifespan of affected roads; pedestrians to exercise care with increase of vehicular traffic on the adjacent roads and increase of exhaust emission from vehicles (Temporary).

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C Operation i Vehicle and pedestrian Slightly more congestion near the main entrance to the Hospital; traffic adjacent to Pedestrians to exercise more care with increase of vehicular traffic at Hospital building hospital gates for drop-pickup of patients; increase of exhaust emission from vehicles, which will pollute local atmospheric air (Temporary). ii Generation of Improper solid waste management, sanitation hazard. (Temporary) consumables iii Increased demand on Increased risk of water shortages and electricity load shedding. (Permanent) local services iv Extreme climate Mongolia is earthquake prone area. Fire hazard or any medical emergency events, disasters and may arise during operation of the Hospitals. (Permanent) emergency

1. Impacts on key environmental parameters (Air, water, soil and Noise) 578. Table below lists impacts on environment parameters of the sub-project areas where the project will be implemented. Table V.5: Summary Analysis of Positive and Adverse Impacts

# Environmental Type of Reason Proposed Mitigation Measures Parameter Impact 1 Air Quality Medium Significant air emission Sprinkling of water, proper handling from the construction of excavated soil, construction activity during material, banned substances/VOCs stacking/storage of soil, etc. construction material at site 2 Water Quality Low The project will require The required water will be sourced small quantity of water for from tankers by the construction construction. No hazardous company. effluent is envisaged to be Domestic effluent shall be discharged during discharged in holding tanks which construction will be cleaned regularly and waste is safely stored, transported and disposed at urban body’s solid waste management site. 3 Soil Quality Low Land is available. Construction company to ensure FHC/SHC/Hospital has proper housekeeping, sanitation open/vacant areas within and cleanliness at work site. the premises for additional buildings59 and government land for new FHC/SHC/Hospital. 4 Noise Quality Low The construction activity Noise monitoring will be done at may lead to noise pollution regular intervals. If any night during concreting –steel construction activity that is noise cutting, bending, casting intensive is undertaken, staff and using vibrators, operation of neighbourhood must be consulted

59 Construction of additional buildings to expand services. 195

# Environmental Type of Reason Proposed Mitigation Measures Parameter Impact mechanised equipment and to determine suitable timings. drills etc. that will affect the patients, residents of the area. 5 Hazardous Minimal The sub-projects will not Sections of buildings, if they contain Substance – eg. impact the main buildings any hazardous material will not be Asbestos, VOCs of the selected for improvement actions. FHC/SHC/Hospital/Health Center 6 Terrestrial Low No ecologically sensitive Tree replantation/transplantation to Ecology place (protected be carried out inside premises if area/reserved any trees are cut by the forest/Important flora and construction company fauna species) within 5 km radius from each sub- project site

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VI. ANALYSIS OF ALTERNATIVES

A. MOH Approach for Planning of a subproject 579. At the planning stage itself, one of the factors that govern the establishment of the FHC/SHC/Hospitals is the availability of scarce land available in the cities concerned. Preliminary location selection is done by MOH based on the interpretation and walk over survey.

B. Alternatives for Subproject Components 1. No “Build” Alternative 580. The ‘No Build’ alternative in the present case would mean there would be shortage of health care facilities at proposed FHC/SHC/Hospitals and hence, the development of health sector in Mongolia will be hampered. Hence, the 'No build' alternative is unacceptable, and the potential socioeconomic benefits of implementation of such a project far outweigh the adverse impacts, all of which can be controlled and minimized to an acceptable level. 581. Health Sector Development. New building construction for FHC/SHC/Hospitals will ensure more access of health care to patients and availability of such facilities at affordable prices. Thus, it will help in development of health sector in Mongolia and will contribute in building of a healthier nation. 2. To “Build” Alternative 582. The project has been designed to provide extra space to hospitals at its own vacant space adjacent to existing FHC/SHC/Hospital building, thus involved no resettlement issues. So, there is no logic to find alternative site for the project since it is in the existing FHC/SHC/Hospital premises.

C. Methodology for sub-project site selection: environmental view 583. Site selection among alternatives consider requirements of environmental parameters, availability of logistic support during construction, operation and maintenance of FHC/SHC/Hospital and specific feasible locations that were identified based on the relevant site maps and walkover surveys. For selection of appropriate site for FHC/SHC/Hospitals, the following points are taken into consideration: i. Site selection should consider seismicity and geography of the local area; the area should not be prone to landslide or be unstable. ii. Construction activities do not adversely affect the population living near the proposed FHC/SHC/Hospital and does not create any threat to the survival of any community with special reference to tribal (herder) community etc. iii. The location of FHC/SHC/Hospitals does not affect any monument of cultural or historical importance. iv. No resettlement of households by the FHC/SHC/Hospitals site, no loss of livelihoods, siting of FHC/SHC/Hospital away from sensitive receptors with due consultation with the community and local government units concerned. 197

v. Construction techniques and machinery selection shall be made with a view to minimize ground disturbance. vi. While planning for FHC/SHC/Hospital, all underground infrastructure – drainage, sewage heating etc. shall be marked and to avoid seepage/leakages and pollution of water sources. vii. Construction Company to ensure that noise will not be a nuisance to neighbouring properties. Provision of noise barriers near FHC/SHC/Hospitals sites will be made if required. viii. Security fences will be erected around FHC/SHC/Hospital construction sites. Warning signs shall be displayed at site and road signs to be installed at appropriate locations. ix. MOH shall ensure that construction company must incorporate the best technical practices to deal with environmental issues in its working. x. Design of FHC/SHC/Hospital shall be made so as to include modern fire control systems/firewalls. Provision of fire-fighting equipment would be made at locations easily accessible etc. xi. The location of FHC/SHC/Hospitals does not affect any public utility services like power, heating and gas lines, sewage and drainage pipes other underground structures such as hydrocarbon pipelines and unstable ground feature (permafrost etc.). etc. xii. Minimum cutting of trees and safety of people and property and favourable ground profile. xiii. Avoidance of reserved forest, archaeological and other sensitive areas, animal / bird sanctuaries xiv. Avoidance of rocky stretches and areas reserved for planned and future development, marshy low-lying areas, river beds and earth slip zones. xv. The construction drawings for design each facility must ensure no shadow of the proposed new buildings should fall on to adjoining buildings in keeping with building bye- laws of the Mongolia. 584. Keeping above in mind, various sub-projects proposed by MOH officials for funding were taken up for initial assessment of environmental impacts. Similarly, MOH has selected available government lands that are available in the area which are nearly barren for FHC/SHC/Hospital at Ulaanbaatar and other provinces. Table VI-1 provides locational details about FHC/SHC/Hospital proposed in Ulaanbaatar and other provinces. Table VI.1: Locations of proposed FHC/SHC/Hospitals in Ulaanbaatar/other provinces and Land status No Sub-Projects Location Latitude Longitude Altitude Land Area Status (m) 1 2 3 4 5 6 7 1 Khan-Uul Khan Uul District 47°52'5.40 106°49'57. 1320 Land certificated issued Hospital "N 80"E 2 Khovd, Hospital Khovd Province 48°0'13.58 91°37'59.5 1400 Land certificated issued "N 1"E 3 Emergency Sukhbaatar district 47°54' 106° 55' 1330 Land certificated issued health Center 55.16"N 25.63" 4 Uvs hospital Ulaangom city 46° 39' 103° 11' 969 Land certificated issued 58.5"N 05"E

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No Sub-Projects Location Latitude Longitude Altitude Land Area Status (m) 1 2 3 4 5 6 7 5 FHC 10th Khoroo in Khan- 47°51'30. 106°45'38 1310 Land certificated issued Uul district 04"N .99"E 6 FHC 14th Khoroo in Khan- 47°47'25.0 106°42'31. 1320 Land certificated issued Uul district 0"N 52"E 7 FHC 19th Khoroo in 47°59'41.3 106°55'17. 1390 FHC applied to MUB for Chingeltei district 1"N 40"E land certificated 8 FHC 17th Khoroo in 47°55'41.8 107° 1370 Land certificated issued Bayanzurkh district 5"N 0'14.68"E 9 SHC Erdenemandal Soum 48°31'45.3 101°22'29. 1507 Land certificated issued 5"N 95"E 10 SHC Tarialan Soum 49°36'53.5 101°59'18. 1233 Land certificated issued 2"N 13"E 11 SHC Bayan-Undur Soum 46°29'51.0 104° 1618 Land certificated issued 6"N 7'7.53"E 12 SHC Erdene Soum 44°26'38.4 111° 992 Land certificated issued "N 5'14.6"E 13 SHC Dashinchilen Soum 47°51'0.35 104° 1109 Land certificated issued "N 2'32.30"E

1. Development of Alternate Access Route 585. To provide access to the FHC in 10th khoroo of Khan-Uul district two options were considered: Option 1. Length of the access route is shorter but it uses a narrow access road in- between apartment buildings and goes through a parking space. The main concerns are traffic safety and blocking of a parking space. Option 2. The access route goes through dirt track which has much less traffic which means less concern for traffic safety. It will cause dust emission but it can be minimized through regular water spray. 586. Given the above traffic safety concerns and impact on surrounding community, it was recommended to use option 2 access road during the construction period. The construction contractor shall develop a site-specific EMP and traffic safety plan in order to ensure traffic safety concerns and impact on surrounding community are managed.

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Figure VI.1: Alternate Access Route for FHC

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VII. INFORMATION DISCLOSURE, CONSULTATION, AND PARTICIPATION

A. Consultation Process 587. During the project formulation stage, MOH has conducted a project scoping exercise and reconnaissance survey of the existing system. Accordingly, during public consultation sessions, considerable dialogue had been held between MOH representatives, individuals, and groups from the community to make them aware of the proposed project. 588. The project-affected community residing beside the proposed FHC/SHC/Hospitals has already gained a reasonable knowledge about the potential grievances, which may arise in the future. The community were also informed about the Grievance Redressal Mechanism (GRM), which will be followed by MOH as per ADB SPS 2009 guidelines.

B. Consultation Details 589. During the site visits, the officials and consultants made numerous observations and held discussions with FHC/SHC/Hospital managements concerned which would be helpful for project design: (i) location of proper access roads, laydown area for materials to be used by the construction companies to use without disturbing the FHC/SHC/Hospital working and minimizing utilization of public/playground areas, (ii) avoidance of underground existing pipes for water, heating, sewage etc. at these proposed work sites, (iii) right of way for construction vehicles and provide traffic safety during construction to local residents living adjoining these FHC/SHC/Hospital, (iv) traffic caused by construction of new buildings by use of concrete, dump trucks etc. transporting materials inside FHC/SHC/Hospital premises; traffic safety for patients during operations of FHC/SHC/Hospital in normal work hours, (vi) lack of safety equipment such as smoke alarms in most old buildings and the need for adequate firefighting extinguishers and imparting evacuation drills and emergency response procedures training, (vii) distances of these FHC/SHC/Hospital from non-sensitive biodiversity areas and cultural heritage sites to ensure no impact, (viii) dust and noise emissions from the construction subprojects and their impacts on patients and apartment dwellers adjoining the hospital area, (ix) noises from any surroundings areas during construction and operations, (x) avoid any shadow projection onto adjoining buildings due to new structures to be constructed as part of this project, (xi) any banned substances generated as part of any construction project such as asbestos etc., (xii) emissions from coal based heating and water boilers (some cases), (xiii) if insulation works are required in FHC/SHC/Hospital to ensure energy efficiency, i.e. Loss of heat due to old walls (xiv) if any linked or associated facilities are present, and (xv) check climate change vulnerability of the location. 590. The team along with district officials and FHC/SHC/Hospital conducted group discussions with the public residing in these subproject areas to sensitize them about project activities, their impacts and get their suggestions for FHC/hospitals between May 17 and May 30, 2018 and for SHC’s between June 20 and October 16, 2018. Annexure 7 indicates a summary of public consultations conducted during the field survey along with socio economic profile in the project affected area. 201

591. Consultations were carried out with various stakeholders such as MOH officials, Government of Mongolia officials, relevant land departments of the project area. As part of the assessment, approximately 1,046 representatives from surrounding households, entities, apartments/buildings have been surveyed/interviewed to collect the data during the months of April/October 2018. These discussions were carried out at almost at nearby apartments/buildings that were situated in the vicinity of FHC/SHC/Hospital. 592. The resident community consulted was requested to air their opinions freely, on the project, its impact, and suggestions for mitigating adverse impacts. People participated in voluntary public consultation sessions to express their view about the proposed project. No major environmental issues were raised during the consultation process. 593. Table VII.1 provides summary of public consultations. Table VII.2 below summarizes some follow-up actions recommended by the consultees. Table VII.1: Summary Findings of Public Consultations # Issues Discussed Summary Responses and Suggestions from the Participants 1 Do you support for the construction at Nearly all participants (99% or 1,036 out of 1,046 people) FHC/SHC/Hospital? are supportive of construction at FHC/SHC/Hospital. 2 515 (49.2%) participants says currently they don’t have Do you have sufficient access to health sufficient access to health service while only 509 (48.7%) services in your community now? participants replied current access to health service is sufficient for them. 3 Will this construction at 935 respondents (89.4%) answered that construction at FHC/SHC/Hospital give any negative FHC/hospital will not exert any negative impact for their impact to your apartment complex? apartment complex60. 4 45% of participants expect improved access to health What benefits do you perceive from this service for them while 47.5% expect better equipment or construction? increased capacity for the FHC/hospital. 5 Would you have any problem with 85.6% of participants said they don’t have problem with FHC/SHC/Hospital if construction construction company makes access road in their parking company makes access road in your area or dig pipeline while 11% says it might cause a parking area, dig any pipeline etc. for problem. 3.5% of participants did not respond. repair for diversion? 6 Would you be having trouble if 822 (78.6%) participants replied dust emission caused by construction causes some dust during construction is not an issue for them while 195 (18.6%) digging and storing in the participants said it might cause a trouble. FHC/SHC/Hospital premises? 7 Will you have a problem if the 904 participants (86.4%) said that construction works during construction company required to work night time is not a problem for them while 109 people during the night to bringing construction (10.4%) said it’s problematic. material and have earthworks that would cause noise? 8 Will you have a problem if the 83.2% of participants replied vibration and noise during the construction activity generates extreme construction will not be a problem for them while 94 people vibration and noise such as concreting, (9%) replied it will be a problem. cutting, digging etc.? 9 Are you concerned about Health & 34.8% of participants (364 people) said they will have Safety of patients, children, residents concerns about health and safety of patients, residents and

60 Most of the apartment dwellers in UB city are less than 500 m distance.

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# Issues Discussed Summary Responses and Suggestions from the Participants and staff during the construction? staffs during the construction, while 56.5% (591 people) said they don’t worry about this. 10 Would you like to participate in safety 674 (64.4%) of participants would be interested in monitoring and controlling activities? participating safety monitoring activities for forming a And Would you be willing to form a committee. Committee to help to FHC/SHC/Hospital during the construction period? 11 Any other critical environment related 68.5% of participants think there will not be any critical issue and concern by the residents for environment related issue during the construction while 118 the during construction and operation people (11.3%) think there will be issues such as dust and stage? noise. 12 If you have any problem caused by this If they encounter any problem regarding construction, 391 FHC/SHC/Hospital construction, whom people (37.4%) will contact their Soum/Khoroo/district would you like to contact? administration while 407 people (38.9%) will contact (Construction company, FHC/hospital management and 82 people (7.8%) will FHC/SHC/Hospital, urban department directly contact the construction company. 180 people etc.) (17.2%) have no idea about whom to contact. 13 48.5.4% of participants (506 people) expect a bigger What would you expect to improve at building with increased capacity while 220 people expect current building (such as changing coal better and modern equipment and devices and 219 people heating to electric heating etc.) expect connection to centralized heating and water supply networks. 14 Any shops/commercial establishments 88% (920 people) of participants think that construction will and industrial activity disturbed by this not disturb any shops/commercial establishments or construction? industrial activity. 15 What other organizations of 789 people (75.4%) responded there no such type of NGO’s environment & nature conservation in their area of living while 163 people (15.6%) said yes (NGOs/CBOs/ Civil Society) active in there are. the area? Name of these organizations 16 Following additional comments are raised during public consultation:

FHC at 10th Khoroo of Khan-Uul: Construction company shall pay attention to traffic safety; Construction of new FHC should not be delayed because there is a lot of need among community; New FHC building shall have garage.

FHC at 14th Khoroo of Khan-Uul: New FHC shall have in-patient department; Quality of the new building is important. Any other issues or comments?

FHC at 19th Khoroo of Chingeltei: Since the planned construction site is currently a parking space for Khoroo building, a new parking space shall be included in the design.

Khan-Uul district hospital: Number of beds for in-patient department of the hospital must be increased tremendously.

Emergency Center: There will be disturbance on staffs and patients of the 203

# Issues Discussed Summary Responses and Suggestions from the Participants neighbouring Lux Med hospital (a private hospital in the next building).

Khovd hospital: Khovd hospitalise will be provided with medical equipment within another project funded by Belgium government. ADB need to make sure it won’t provide the same equipment or repeat.

Uvs hospital: Availability of entrance for disabled people, Occupational safety during the construction, Quality of the new extension building.

FHC at 17th Khoroo of Bayanzurkh: Green area shall be planned for new FHC; Traffic safety is important.

SHC in Erdenemandal Soum Construction safety management is very important; Provide modern and new equipment for the new SHC; We need X-ray device in the Soum.

SHC in Tarialan Soum In-patient department shall have at least 22 beds in accordance with MOH standard; Dental clinic is needed for the Soum; 2 storey building is needed for us.

SHC in Bayan-Undur Soum Quality of new building is important; Need the new facility as soon as possible; Construction safety is important.

SHC in Erdene Soum Pay attention to safety during construction; SHC capacity must be increased.

SHC in Dashinchilen Soum Safety management is very important; Engage local workforce in construction; Quality of the new building is important; Enhance capability of doctors and nurses.

Table VII.2: Summary of Recommendations by the Consultees # Issue Responsible Party 1 Introducing of EMP back to communities surrounding the Civil works contractors and sites for improving their knowledge about their responsibilities FHC/SHC/Hospital using and participation in monitoring is important Advertising budget of EMP. 2 Traffic Management Civil works contractors adhere to  The Construction Company to ensure proper road safety EMP. for residents, patients during construction.  To conduct transportation using a dedicated road in order to ensure safety of the citizens;  To park the vehicles in the dedicated parking space

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# Issue Responsible Party  If Ger area street road must be used for transportation, the least populated street shall be used 3 Noise Civil works contractors to adhere to No construction work during night time EMP and also to citizen council requirements. Erect a wall with noise barrier where current existing hospital buildings are very close to the construction site (Khan-Uul and Khovd hospitals and National Emergency Health Call Center) 4 A Committee of citizens, FHC/SHC/Hospital and MOH for MOH and FHC/SHC/Hospital inspecting the quality of the construction and process of Management to form citizen following safety procedures during construction. council. 5  New building of the FHC/SHC/Hospital must meet the Architect, MOH and Civil works standards and use quality construction materials. contractors.  Ventilation, heating and plumbing system should be taken into serious consideration.  Complete external landscaping and maintenance must be done e.g. fence, road, parking space, green area, street lighting and play ground and equipment  In order to reflect current needs of the hospitals/FHC’s, design team needs to collect and reflect suggestions from the management of the FHC/hospital at the early stage of design

594. The EA and the construction company shall review the above recommendations and shall conduct additional consultations every six months during construction period to incorporate suggestions in their design and construction practices. 1. Locations and participants 595. Consultation meetings were held at 13 sites in total out of them 4 sites will be under new construction where the administrations, directors of the existing FHC/SHC/Hospitals assisted the team. 596. Annexure 7 gives the names of all participants of the public consultation conducted by the team. Consultation details for the 13 sites is also attached. Table VII.3 provides a summary of location and number of participants for the consultations. Table VII.3: Location and Number of Participants of Consultations No Sub-Project Location Number of Participants at Number of components Consultations Meetings people filled in Total Male Female questionnaire 1 2 3 4 5 6 1 Khan-Uul Hospital Khan Uul District 69 13 56 38 2 Khovd, Hospital Khovd Province 57 15 42 43 3 Uvs, Hospital Ulaangom, Uvs province 78 19 59 75 4 National Emergency Sukhbaatar district 29 16 13 29 Health Call Center 5 FHC 10th Khoroo in Khan-Uul 79 33 46 121 district 6 FHC 14th Khoroo in Khan-Uul 70 22 48 61 district 205

No Sub-Project Location Number of Participants at Number of components Consultations Meetings people filled in Total Male Female questionnaire 1 2 3 4 5 6 7 FHC 19th Khoroo in Chingeltei 37 7 30 37 district 8 FHC 17th Khoroo in Bayanzurkh 60 24 36 56 district 9 SHC Erdenemandal Soum 145 47 98 134 10 SHC Tarialan Soum 124 34 90 123 11 SHC Bayan-Undur Soum 82 38 44 82 12 SHC Erdene Soum 101 29 72 88 13 SHC Dashinchilen Soum 176 52 124 159 Total 1107 349 758 1046 *A total of 1107 people attended consultation meetings at 13 Tranche-1 sites. Of which, 1046 people filled out questionnaire sheets.

C. Information Disclosure 597. In line with ADB’s Public Communications Policy, MOH is required to ensure that relevant project information about environment safeguard issues is made available during the initial stages to affected people and other stakeholders, including the general public at Aimag/district headquarters where it is publicly accessible in and any other vernacular local language. ADB and MOH will also upload and display the IEE documents for their respective websites once finalised. 598. Incorporation of the environmental concerns of affected persons (APs) through the public consultation in the decision-making process will avoid or minimize conflict situations during the implementation process as well as enable them to provide meaningful inputs into the project design and its implementation. During implementation period, MOH through the FHC/SHC/Hospital/construction company can conduct public consultation and information disclosure through public meetings and notice.

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VIII. GRIEVANCE REDRESS MECHANISM

A. Grievance Channels (Framework) 599. During public consultation sessions of the IEE study, the discussions with apartment dweller groups and individuals were conducted to make them aware of the proposed project. Thus, the project-affected community residing beside the proposed FHC/SHC/Hospitals has already gained a reasonable knowledge about the potential grievances, which may arise in future. 600. The public was informed that there will be no involuntary acquisition of land, or involuntary restrictions on land use which result in physical displacement and economic displacement. After construction of FHC/SHC/Hospital, the land used will be restored back to its original use.

B. Time Frame 601. A community awareness programme must be conducted one month prior to construction by the Project Implementation Unit (PIU) of MOH regarding the scope of the project, procedure of construction activities, utility of resources, identified impacts and mitigation measures. These awareness programmes will help the community to resolve problems, clarify their distrusts related to the proposed project at initial stage. The Community should be informed about the Grievance Redress Mechanism (GRM), which is already established as per MOH and Government of Mongolia procedure for making complaints, including the place and the responsible person to contact in practical way in this regard. Almost all the stakeholders related to the GRM will also be aware of the established grievance process, the requirement of grievance mechanism, goals, benefits, relevant laws regulations etc.

C. The Grievance Redress Mechanism 602. Environment or Social Safeguards Policy currently. ADB procedures require MOH to establish a Grievance Redressal Mechanism (GRM) for Environment having suitable grievance redress procedure for the project affected persons. The GRM would address affected persons’ concerns and complaints promptly, using an understandable and transparent process that is gender responsive, culturally appropriate, and readily accessible to the affected persons at no cost. This GRM consists of a Grievance Redress Committee (GRC) for Environment headed by the PIU Coordinator who is permanent official of the EA and supported by District/Soum officials, and environment specialist. The committee has the following constitution as listed in Table VIII.1: Table VIII.1: Constitution of Grievance Redress Committee 1 PIU Coordinator Chairman 2 District/Aimag Education officer/Hospital Management 3 PIU Environment Safeguards Specialist 4 Citizens’ Council representative and one women representative 5 Representative of Construction Company 6 Affected Person

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603. This Grievance Redress Mechanism (GRM) would provide an effective approach for resolution of complaints and issues of the affected person/community. Project Implementation Unit (PIU) shall formulate procedures for implementing the GRM and PIU’s engineering staff shall undertake GRM’s initiatives that include procedures of taking/recording complaints, handling of on-the-spot resolution of minor problems, taking care of complainants and provisions of responses to distressed stakeholders etc. paying particular attention to the impacts on vulnerable groups. 604. During Construction period, the GRM can have multiple tiers for grievance redress i.e. at Construction Company level, the district FHC/SHC/Hospital administrations levels; and/or the PIU level, or by courts. 605. Stage 1: Access to GRM. If a concern arises, the affected person (AP) [residents, government official, worker of contractor, etc.] may contact the FHC/SHC/Hospital administration and the construction company. They will register APs complaint giving all details, grievance issue, solution offered and the APs decision if he would like to resolve the issue of concern directly with the construction company, or make his/her complaint known to either the PIU directly, or through the bagh or Soum/whichever level of authority he/she is most comfortable with. If the AP files the complaint at bagh/Soum level, the bagh/Soum representative will forward to the PIU. 606. Stage 2: Official Complaint to PIU. The PIU will register the complaint, and must assess its eligibility. If the complaint is not eligible, e.g. related to an issue outside the scope of the project, PIU will provide a clear reply within five working days to the AP. It the complaint is related to the scope of the project, the PIU inform the AP accordingly and as well as inform the respective Aimag, construction company, the Steering Committee and ADB of the complaint. The PIU, with support of the loan implementation consultant will take steps to investigate and resolve the issue. This may involve instructing the construction company to take corrective actions. Within seven days of the redress solution being agreed upon, the contractor should implement the redress solution and convey the outcome to the PIU and notify ADB. However, if AP is still not satisfied or if no solution can be identified by the PIU, the complaint shall be sent to Stage 3. 607. Stage 3: GRC Meeting. Within two weeks of the complaint being referred to Stage 3, the head of PIU Coordinator will organize a GRC meeting together with local Aimag/district officials, citizen’s council, women representative, construction company representative, environment safeguards specialist (ESS) and the AP. The meeting should result in a solution acceptable to all, and identify responsibilities and an action plan. The construction company should implement the agreed redress solution and convey the outcome to the GRC within seven working days; 608. Stage 4: Aimag Governor Resolution/Court of Law. However, if the GRC meeting cannot resolve the problem and the AP is still unsatisfied, the PIU will set up a meeting with the Aimag Governor to identify a solution. For the solution provided by the Governor and agreed by the AP, the construction company must develop an implementation plan within 7 days for approval by the Governor. The GRM will not impede an AP’s desire to access judicial remedies.

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609. The PIU will keep records of all grievances received including: contact details of complainant, date that the complaint was received, nature of grievance, agreed corrective actions and the date these were effective, and final outcome. The PIU will issue public notices to inform the public within the project area of the GRM. The PIU’s phone number, fax, address, email address will be disseminated to the people at the bagh and Soum levels. The PIU will have facilities to maintain a complaints database and communicate with construction company, construction supervision engineers, the environmental inspectors of the local offices of GASI, local Aimag environmental authorities and representatives of affected Soums and baghs. Procedures and timeframes for the grievance redress process are as follows and shown in Figure VIII.1 610. The GRM will be in place for the first year of operations or until the Project Completion Report is issued; and will utilize the above mentioned GRM procedure for grievance redressal. The GRM will be linked to the Citizen Service Center in Ulaanbaatar City (established in 2012 by virtue of Mayor’s Ordinance /675 for a centralized system of receiving, referring, solving and responding to public grievances in the Capital City) and also in a similar nature in other Aimags and Soums Administrations. Figure VIII.1: Flow chart showing Grievance Redress Mechanism for Environment 611. The GRM will be in place for the first year of operations (or until the project completion report is issued – which ever one is the last); and will utilize the above mentioned GRM procedure for grievance redressal.

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Stage 1: Affected Person ap- Grievance proaches MOH/Hospital/FHC/ ineligible. AP SHC/Construction Company, informed in 5 Aimag/Soum. AP complaint send days by Aimag to PIU, PIU determines Eligible eligibility.

Stage 2: Grievance Addressed – MOH/Hospital/SHC/ FHC/Construction Respond to AP Company receive & construction complaint. If AP not company to satisfied refer to GRC implement within 7 days of agreement

Stage 3: Grivance AP not Redress Commit- satisfied tee (meeting within 2 weeks of referral by PIU) Grievance Addressed – implement Action Plan within 7 days of agreement Problem Not Not Addressed resolved

Stage 4: Aimag Governor, Court implement Action Plan within 7 of Law days of Governor’s decision

* (Affected person can take the matters to Court of Law at any point of GRM) PIU-Project Implementation Unit

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IX. ENVIRONMENTAL MANAGEMENT PLAN

A. Critical Environmental Review Criteria 1. Loss of irreplaceable resources 612. The FHC/SHC/Hospital projects do not involve any large-scale excavation and land Thus, there will be no net “Biodiversity Loss” due to project implementation due to felling of trees. 2. Accelerated use of resources for short-term gains 613. The project will not use any natural resources occurring in the area during construction, operation and maintenance phases. The construction material such as steel, cement, etc. shall come from factories while the excavated soil shall be disposed in designated waste management sites designated by urban body. Thus, the project shall not cause any accelerated use of resources for short term gains. 3. Endangering of species 614. No endangered species of flora and fauna exist in the project area and there seems to be no possibility of endangering/causing extinction of any species. 4. Promoting undesirable rural-to urban migration 615. The project will not cause any submergence or loss of land holdings that normally trigger migration. It also does not involve acquisition of any private land holdings. Hence, there is no possibility of any migration. 5. Increase in affluent/poor income gap 616. The project will increase availability of health care facilities to the neighborhood communities. Several vulnerable communities are also going to be benefitted due to these facilities. Thus, the project is expected to contribute to providing health care opportunities for nomadic population living near Aimag/Soum centers thereby making health care facilities available to them more efficiently and effectively.

B. Emergency Response, Disaster Management, Health and Safety 1. Emergency 617. An emergency response plan to take actions on accidents and emergencies, including environmental and public health emergencies associated with hazardous material spills and similar events will be prepared, and submitted to the PIU for review and appraisal. A fully equipped first-aid box in each construction site will be provided. 618. A site-specific emergency response plan will be prepared. This will define protocols to be followed in the event of emergencies or disasters in order to limit the impact on the employees and the local community. The plan will address both on-site and off-site emergency situations due to the operation of the project. The plan will disclose potential disasters and potential risks during construction and operations to the local community as well as the plan of action on emergency protocol in the event of any such eventuality. This 211

will also include awareness programs for the hospital personnel, local community and local administration. 619. A training and rehearsal of the emergency response by emergency team members and personnel on site will be done regularly. 2. Disaster Management 620. Though major earthquake in recent years, small to moderate earthquake have been felt in Mongolia. The flood risk in Ulaanbaatar, Dharkan and other Provinces is lower than that of the other parts of country. Aimag level Emergency Management Agency has been formed under the National Emergency Management Agency of Government has been designated to take care of disaster management issues. Disaster resilient features61 will be built into new and expanded FHC/SHC/Hospitals. The facilities will have sound seismic design to withstand earthquakes, winter snow storms, improved flood control and precipitation resistant features for all the proposed FHC/SHC/Hospital. EA must ensure that seismic design and checking of design by independent engineer since horpital is a community facility where evacuation in emergency is difficult. 3. Health and Safety Issues Management 621. To avoid/ minimize inherent risks during construction, operation and maintenance, the construction company will follow national and international Environment, Health and Safety Procedure for construction of additional buildigns62 of FHC/SHC/Hospitals and the operations and maintenance (O&M) period. Some other implications and mitigations from safety point of view are listed in Table IX.1 below: Table IX.1: Safety Implication and Mitigation

No Implication Mitigation 1 Minimise accidents from Proper signs to avoid areas where falling objects can hurt falling objects at site passer-byes, patients, etc. 2 Avoid open construction Construction company to install metal sheet barriers that are boundary high enough to make a boundary so that patients, residents, others cannot get unauthorized access into construction sites. 3 Minimise electrical shock/fire Ensure all access points to the FHC/SHC/Hospital do not have due to any open wiring at any open electrical connections/wires lying in open construction site 4 Minmise accidents at Alighting area for patients from cars, ambulance etc. FHC/SHC/Hospital gates due to congestion caused during construction

61 The ability of a system, community, or society exposed to hazards to resist, absorb, accommodate to, and recov- er from the effects of a hazard in a timely and efficient manner, including through the preservation and restoration of its essential basic structures and functions (UNISDR Terminology on Disaster Risk Reduction. https://www.unisdr.org/we/inform/terminology) Source: Reducing Disaster Risk by Managing Urban Land Use, Guidance Notes for Planners, ADB, 2016 62 Construction of additional buildings to expand services.

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C. Training Programs 622. The training program will be developed by PIU team comprising of Environment Safeguard Specialist who will be contracted with PIU during project implementation. Each of training should last 1 day with specific program and should include interactive problem- solving tasks 623. Trainings on EMP implementation for construction company, Emergency Response systems for all emergency situations, Occupational Health and Safety etc. are proposed to be held as per training program as shown below in Table IX.2. The costs for all the training programs are included in the ADB funding for the project. Table IX.2: Training programme - summary of training needs

Training topic: Summary of training purpose and Recipients/ Frequency or content Participants target date # Induction to EMP Overview of EMP including site All PIU At beginning of information, pollution risks and controls, engineers / project and programmes. Preparation of site contractors specific EMPs and training on implementation to staff of construction company (s) Review of EMP, Review of EMP including new changes All PIU One year after Refresher training on and updates to IEE/EMP. engineers / project start, or EMP contractors more frequently if required Training on specific pollution risks and controls Emergency case To identify on-site “potential accident All PIU During the response planning scenario” and how to plan potential Engineers project emergency response actions. /contractors/L implementation ocal residents Air Quality Monitoring Ambient Air Quality, Volatile Organic All PIU During the Compounds (VOCs), Particulate Matter Engineers project (PM), Ozone Depleting Substances /contractors implementation (ODS), Greenhouse Gases (GHGs) Water Conservation Water Monitoring and Management, All PIU During the Process Water Reuse and Recycling, Engineers project Heating Systems /contractors implementation Waste water and Liquid Effluent Quality, Discharge to All PIU During the Ambient Water Quality Surface Water, Discharge to Sanitary Engineers project Sewer Systems, Land Application of /contractors implementation Treated Effluent, Septic Systems, Wastewater Management Hazardous Materials General Hazardous Materials All PIU During the Management Management, Hazard Assessment, Engineers project Management Actions /contractors implementation 213

Training topic: Summary of training purpose and Recipients/ Frequency or content Participants target date # Fire safety Fire, and Explosion Prevention, Control All PIU During the Measures, Engineers project /contractors implementation Occupational Safety, Occupational Health and Safety All PIU During the Health and Safety Emergency Preparedness and Engineers project Response, Community Involvement and /contractors implementation Awareness Waste Management General Waste Management, Waste All PIU During the Management Planning, Recycling and Engineers project Reuse, Treatment and Disposal, Waste /contractors implementation Storage, Transportation, Treatment and Disposal, Commercial or Government Waste Contractors, Health Care Waste Climate change and Climate change perspectives due to All PIU During the adaptation (applicable snow, flooding, dzuds in Mongolia and Engineers project to eligible projects their impacts during construction and /contractors implementation under the Program) operations Good engineering and Sound construction practises. All PIU During the construction practices Engineers project as mitigation measures /contractors implementation Monitoring and evaluation Participatory M&E of Simple methods for recognizing adverse Local During the impacts. impacts on environment residents, project Methodology of monitoring and SHC / FHC implementation evaluation on the water quality /Hospital management / construction company Energy Efficiency and Introduction to energy efficiency, heat Local During the Green Buildings loss, green concept residents, project FHC / implementation SHC/Hospital management Project management M&E, Implementation assessment the All PIU At the and implementation program. Principle of donor Engineers beginning of organizations’ support to local /contractors the project beneficiaries. # Also consists of officials from concerned Khoroos, districts and Soums and involved hospitals, FHC’s and SHC’s.

D. Magnitude of Environmental Impacts 624. The environmental impacts management matrix has been prepared for the project that discusses the anticipated impacts, monitoring requirements, and development of mitigation measures with respect to the following stages: (i) pre-construction, (ii) construction, and (iii) operation and maintenance. Detailed, site-specific mitigation measures and monitoring plans were developed and will be implemented during the project implementation phase. A

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summary environmental impact matrix and the mitigation measures are mentioned in Table IX.3. 215

Table IX.3: Magnitude of Environmental Impacts - Matrix

Sl. Nº Environmental Potential Nature of Magnitude of impacts Mitigation measures Implementation and attribute impacts impact Monitoring Low Medium High A. Physical Resources 1. Topography Change in the Direct/Local/ X The surface soil will be During construction surface features irreversible restored to normal slope activity. and present after erection. If there is any aesthetics due excess soil, it shall be to the disposed off at suitable construction of location. Any loss of the project. vegetation will be attended by Construction company as per existing Government of Mongolia norms and per EMP. 2. Climate No impact on Direct/Local/ X No impact on the climatic the climatic irreversible conditions, hence no conditions mitigation is required. Climate resilient design required. B. Environmental Resources 1. Air Quality Project will have Direct/Local/ X Water sprinkling at During construction marginal impact reversible construction site, limited activity. on air quality bare soils, maintenance of during the vehicles. construction period due to increase in the dust emission due to cutting/filling, stockpiling of construction material and traffic 216

Sl. Nº Environmental Potential Nature of Magnitude of impacts Mitigation measures Implementation and attribute impacts impact Monitoring Low Medium High movement 2. Noise Noise from Direct/Local/ X Installation of noise barriers During construction digging, reversible to restrict noise propagation; activity. concreting and no noise generating equipment activities at night and use of installation. personal protective equipment like ear plugs, mufflers. 3. Surface and Runoff from the Direct/Local/ X Land development may Before and during Ground Water construction reversible create problems in local construction quality site. drainage pattern, minor activity. impact. Careful siting of soil dump and construction material at site. Domestic Direct/Local/ X Domestic waste treatment During construction wastewater from reversible by providing septic tank at and operation. construction work site for workers at each sites. location. Cutting/filling at construction site would create natural drainage blockade during rainy season. 4. Soils and Soil erosion due Direct/Local/ X Rehabilitation and During and after Geology to clearing of reversible stabilization of disturbed the construction topsoil at site. land at the activity. FHC/SHC/Hospital. Damage due to Direct/region X Site selection and proper Before the seismic activity. al/ reversible foundation design construction considering the geological activity. conditions and seismicity of the area. Settling of Direct/region X Site selection and proper Before the 217

Sl. Nº Environmental Potential Nature of Magnitude of impacts Mitigation measures Implementation and attribute impacts impact Monitoring Low Medium High foundations due al/ reversible foundation design construction to permafrost considering the geological activity. conditions of the area. C. Ecological Resources 1. Terrestrial Loss of Direct/Local/ X The tree planting/ Before the Ecology vegetation. irreversible transplantation for trees construction phase. felled will be done by the Construction Company 2. Terrestrial No significant Direct/Local/ X No direct impact Before and during Fauna impacts reversible construction phase. envisaged. 3. Aquatic No significant Direct/Local/ X Disposal of construction Before and during Ecology impacts reversible waste and other waste to construction phase envisaged. avoid polluting any water body and streams. D. Human Environment 1 Health and Fires, explosion Direct/Local X Use of personal protective During construction Safety and other equipment during and operation accidents, construction. Regular phase Health & safety inspection of construction of workers at site for faults prone to site may pose to accidents. Volatile organics risk in some to be handled cases. Banned Direct/Local X Presence of Asbestos in old During construction Substances; buildings, concentration of phase Safe drinking labour force creates un- water and hygienic condition; provide Sanitation proper facilities hazard 2. Agriculture No significant Direct/Local/ X No agriculture land used for Before and during impacts reversible new FHC/SHC/Hospital construction phase.

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Sl. Nº Environmental Potential Nature of Magnitude of impacts Mitigation measures Implementation and attribute impacts impact Monitoring Low Medium High envisaged. 3. Socio- Beneficial Direct/region X Unskilled labour and indirect During operational economics impacts job al benefits. Overall economic phase opportunities growth of the region. during construction phase 4. Resettlement Small Direct/Local/ X Resolve resettlement issue Before the resettlement reversible as per Mongolian law. construction phase. issues. 5. Archaeological No Direct/Local/ X No archaeological, historical -- /Cultural sites archaeological, reversible or cultural important sites historical or are affected. cultural important sites are affected by the construction. 6. Traffic and Traffic Direct/Local/ X Proper traffic signs at the During construction Transportation congestion due reversible construction site, ensuring phase construction availability and maintenance vehicles, ferry of of proper access roads.

construction and Ensuring separate entrance During construction waste material. is used by construction and operation Increase in vehicles and better traffic phase traffic management of construction temporararily at vehicles at entrance gates to the gates avoid obstruction in case of emergency. 7. Waste Probability of Indirect/Local X Minimization, reuse and During operation Generation Surface and / reversible recycle whenever possible. phase ground water Final wastes to be collected pollution. and disposed off in Improper compliance with applicable management of regulations and rules. 219

Sl. Nº Environmental Potential Nature of Magnitude of impacts Mitigation measures Implementation and attribute impacts impact Monitoring Low Medium High construction debris and solid waste may pose risk to the neighbours. Improper health Direct/Local/r X Complete waste disposal of During operation care waste eversible sharps, bandages, phase management chemicals to avoid spreading diseases amount staff, patients and community, Pollution from indirect/Local X No liquid discharge from the During operation liquid discharge / reversible project, domestic sewage phase should be disposed through septic tank Pollution from Direct/Local/r X Medical wastewater During operation Medical eversible treatment will be done as per phase Wastewater Mongolian and ADB requirements 8 Site Security Improper site Direct/Local/ X Proper fencing and During construction security may reversible protection at the construction phase pose risk to the sites, and manned security a hospital patients must at the site. or community

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E. Environmental Management Plan 625. The EMP included in this IEE together with the site-specific construction EMP (SEMP) that need to be prepared by the contractor provides the overall Project environmental management framework. 626. The SEMP must be submitted within 30 days of the contract award and Preconstruction and Construction cannot commence until the Construction EMP is approved by the PIU and the Engineer. 627. The Bid Documents for the potential Contractor(s) shall contain two sections relating to environmental issues, firstly a basic clause indicating that the Contractor will be responsible for following the requirements of this IEE/EMP and that he should prepare his own SEMP for the Project. Secondly, the EMP of the IEE shall be repeated in its entirety as an Annex to the Bid Documents so as the bidder is aware of his environmental requirements under the Project (both Pre-construction, Detailed Design and Construction) and help him put costs to his proposal (such as costs for noise monitoring, etc.). 628. The Contract Documents should follow a broadly similar pattern to the Bid Documents. It is not considered necessary to repeat the mitigation measures. The Contract should specify that the Contractor(s) is responsible for implementation of the EMP via the Construction EMP. Again, the EMP should be included at an Annex to the Contract so the Contractor(s) is liable for any non-conformance with the EMP, and thereby this IEE. 629. The Contractor(s) will be responsible for the preparation of the SEMP. The preparation of the SEMP requires a qualified environmental person. The work will need to be fully compliant with the SEMP and will need to be prepared within 30 days of Contract award. 630. During the Construction phase the Contractor must retain the expertise of an Environment and Social Officer (ESO) to update the SEMP and to oversee and report on the operation throughout the contract period. The ESO should be full-time member of contractor’s staff. 631. The Design and Construction Supervision Consultant team will include a national Environmental Specialist to ensure that the Contractor is compliant with his environmental obligations. Specifically, the Engineer should be responsible for preparing a monthly environmental report outlining the Contractors environmental performance during that period. The national specialist shall be engaged on a full-time basis to undertake day to day monitoring of the contractor’s activities. Similarly it is propsed to hire an Health and Safety (H&S) supervisor to review the health and safety procedures during construction and commissioning. 632. The EMP describes the various measures proposed under this Project, which were designed to avoid, mitigate, or compensate the adverse environmental impacts that may result from the Project. As such the EMP considers all phases of the Project cycle, namely the detailed design, construction and operational phases of the Project. 633. To ensure that the proposed mitigation measures will be carried out by the contractors during the construction stage, the design consultant will clearly set out in the tender and 221

contract documents the contractor’s obligation to undertake the respective environmental mitigation measures. 634. IEE investigations and other project reports have shown that potential project impacts will occur that will need to suitably mitigated through the implementation of the EMP. An effective environmental management system is a dynamic, continuous process initiated by management and involving communication between the project proponent, the workers, and the local communities directly affected by the project. 635. The Environmental Management Plan (EMP) for the project is attached Annexure 4 which identifies feasible and cost - effective measures to be taken to reduce potential significant, adverse, impacts to acceptable levels. Here, proper mitigation measures are proposed for each potential impact, including details on responsible parties for implementation of mitigation measures and supervision. The EMP also discusses the anticipated impacts, monitoring requirements, and development of mitigation measures with respect to the following stages: (i) pre-construction, (ii) construction, and (iii) operation and maintenance. 636. Proposed mitigation measures will be incorporated into tender documents, construction contracts, and Environmental Management Plans. Both Contractors and PIU will implement the measures and their effectiveness will be evaluated on the basis of the results of the environmental monitoring to determine whether to continue them or to make improvements. Detailed, site-specific EMP and mitigation measures and monitoring plans will be developed by the Contractor based on the EMP presented in Annexure 4.

F. Environmental Monitoring Plan (EMoP) 637. The mitigation measures suggested requires monitoring of environmental attributes both during construction and operational phase of the project by the PIU. During the construction and operation phase of this project, the monitoring of the environmental aspects shall be done at the project sites by the Environment Safeguards specialist and Design and supervision environmental consultants. 638. In addition to the EMP, to ensure that project would not be generating a negative impact to the overall environment quality, an Environmental Monitoring Plan (EMoP) will be prepared. The monitoring activities of the project include site supervision, verification of permits, monitoring of water quality, soil, noise and air. Monitoring of the quality of water, soil, air and noise during the construction stage is a responsibility of civil works contractors. PIU engineers (who are contracted by PIU) will supervise civil works contractors. Monitoring of sanitary waste treatment should be done periodically to avoid water pollution. Other environmental good practices include noise abatement, maintaining hygienic conditions, maintenance of fire and safety equipment etc. Monitoring report should be prepared once in six months with the corrective action plan for the problem areas. 639. Annexure 5 provides the periodicity of the measurements of environmental parameters – air, noise, soil and water at the various FHC/SHC/Hospitals to be implemented by the Construction Company during the construction phase.

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640. The environmental monitoring plan is to be utilized for measuring compliance with the EMP during the project implementation. The main objective of environmental monitoring is:  to evaluate the performance of construction company in mitigating negative impacts vs. the proposed measures in the EMP;  to provide information on unanticipated adverse impacts or sudden change in impact; to determine if any impacts are irreversible in nature which required remedial measures and monitoring;  to suggest improvement in environmental mitigation measures, if required.

G. Development of Site-specific Construction Environmental Management Plan (SEMP) 641. The construction contractor shall prepare a site-specific construction environmental management plan (SEMP) prior to the commencement of construction works in consultation with Environment safeguards specialist (ESS) of the PIU and Design and Supervision environment consultants including Health and Safety (H&S) supervisor and shall submit the same for review and approval. The plan shall include construction method statements on the implementation of pollution control and mitigation measures, adherence to energy-and resource- efficient construction practices, as well as an emergency spill contingency plan for containing and cleaning up accidental chemical spills on construction sites. The SEMP shall be updated as needed as and when environmental issues not covered by the plan arise. Annexure 5a gives the SEMP related Standard Construction Contract Environmental Management Clauses for preparation of the SEMP. 642. Prior to construction works, the contractor shall provide a comprehensive Construction EMP covering the following aspects:  Dust management which shall include schedule for spraying on hauling and access roads to construction site and details of the equipment to be used.  Layout of the work camp and details of the proposed measures to address adverse environmental impacts resulting from its installation.  Sewage management including provision of sanitary latrines and proper sewage collection and disposal system to prevent pollution of drainage system.  Waste management covering provision of garbage bins, regular collection and disposal in a hygienic manner, as well as proposed disposal sites for various types of wastes (e.g., domestic waste etc.) consistent with appropriate regulations.  Description and layout of equipment maintenance and storage facilities including distance from water sources and irrigation facilities. Storage facilities for fuels and chemicals will be located away from watercourses. Such facilities will be bounded and provided with impermeable lining to contain spillage and prevent soil and water contamination.  Soil Management Plan detailing measures to be undertaken to minimize effects of wind and water erosion on stockpiles of topsoil and excess materials, measures to minimize loss of fertility of top soil, timeframes, haul routes and disposal sites for excess materials.  Emergency response plan (in case of spills, accidents, fires and the like). 223

 Method statement or plan for the execution of construction works including measures that will be undertaken to address adverse environmental impacts such as air and noise pollution that may result from such activities. 643. The SEMP must be submitted within 30 days of the contract award. As noted before, construction activities cannot commence until the Construction EMP is approved by the PIU and the Engineer

H. Monitoring and Reporting

I. Monitoring and Reporting 1. Responsibilities 644. MOH will be responsible for implementing internal monitoring systems for EMP implementation and will forward semi-annual progress reports to the Government and ADB. The reports will cover EMP implementation with attention to compliance and any needed corrective actions. On-going consultation measures will be incorporated in the EMP. A template of the Environment Monitoring Report is attached as Annexure 6, which will be required to submit bi-annually by MOH to ADB. 2. Construction Contracts 645. The construction company will adhere and comply with all measures and procedures identified in the EMP. The EMP and EMoP which are endorsed by the EA and Government of Mongolia, will be monitored in accordance to ADB Safeguard Policy 2009 requirements. Mitigation measures related to construction as specified in the EMP will be incorporated into civil works contracts, and their implementation will be primarily the responsibility of civil works contractors. In addition, civil works contractors will be requested to submit monthly progress reports on the implementation of EMP measures to EA/PIU. 646. The Annex 5 also lays down the following checklist/clauses for the Contractor to adhere to.  Annex 5a: Environmental Safeguard Clauses for Civil Works Contracts, and  Annex 5b: Environmental Site Inspection and Monitoring Checklist. 3. Monitoring of Site-specific EMPs 647. The PIU Environment Safeguards Specialist will review the Contractor’s internal procedures and capacity to manage and implement site specific environmental management mitigation measures. To this end, the training program in Table IX.2 has provision for training of the Contractor’s staff. The PIU’s Environment Safeguards Specialist63 will be the key person reviewing the implementation of EMP. 648. During the construction phase, civil works contractors should ensure that activities like handling of earth works clearing work, access road construction, putting proper traffic signals

63 The TOR for Environment Safeguards Specialist lists this requirement and is attached to the Facility Administra- tion Manual (FAM)

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is done properly to have minimum impact. This in turn should be monitored by the construction supervision specialists responsible for the FHC/SHC/Hospital project. 649. Implementation of environmental mitigation measures will be ensured through both routine and periodic monitoring. Table IX.4 lists environmental monitoring activities during construction phase: Table IX.4: Construction Phase Monitoring

# Indicators of Monitoring Types of Monitoring/ Monitoring Responsibility Method of Monitoring Frequency 1 Safe transportation of Visual Inspection Regular Civil works construction material through Continuous during contractors neighbourhood and roads construction 2 Stockpiling of excavated Visual Inspection Regular FHC/SHC/Hospital/ materials and appropriate during Civil works disposal construction contractors 3 Occupational health and Use of PPE Regular Civil works safety, use of safety gears Visual Inspection during contractors by workers construction 4 Health and Safety aspects - Record of injury or Regular FHC/SHC/Hospital safety of patients, staff, accidents during apartment dwellers etc. construction 5 Inconvenience to apartment Visual Inspection Regular FHC/SHC/Hospital/ dwellers, water logging etc. Continuous during Civil works construction contractors 6 Solid waste segregation Visual Inspection Regular Civil works disposal during contractors construction 7 Cutting/trimming of trees Continuous Regular FHC/SHC/Hospital, during Civil works construction contractors 8 Environmental Parameters Air, Water, Noise, soil As mentioned Civil works Quality sampling Laboratory in Annexure contractors testing & comparison 5. with baseline of the area PPE: personal protective equipment

650. During the operation phase, the FHC/SHC/Hospitals through MOH could continue to conduct monitoring as specified below in Table IX.5. Table IX.5: Operations Phase Monitoring

# Indicators of Monitoring Types of Monitoring/ Method Monitoring Responsibility of Monitoring Frequency 1 Medical solid waste and Records of waste and Annual FHC/SHC/Hospi medical wastewater wastewater collected and tal/ PIU management system managed 2 Number of orientation and Number of orientation and Regular FHC/SHC/Hospi 225

# Indicators of Monitoring Types of Monitoring/ Method Monitoring Responsibility of Monitoring Frequency trainings on safety, facility trainings conducted tal/ PIU usage to patients, staff 3 Health and Safety Record of injury or accidents Regular FHC/SHC/Hospi aspects including safety during tal of patients, staff. construction 3 4 Preparation of monitoring Preparation of monitoring Annual FHC/SHC/Hospi reports and Impact audits reports and Compliance with tal/ PIU EMP EMP = environmental management plan, PIU = project implementation unit

4. Performance indicators 651. Performance indicators which will describe the desired outcomes for tranche 1 as measurable events to the extent possible, such as performance indicators, targets, or acceptance criteria that can be tracked over defined time periods will be designed and implemented. Once it is in place the performance monitoring shall be done by MOH for each component. General project Performance monitoring indicators are mentioned in Table IX.6 Table IX.6: Performance Indicators of Environmental Management prior to Construction. Indicator xvii. Measurement Methods Measurement Public Disclosure and Issues relating to resettlement settled by PIU before start Yes No consultations of the construction. Appropriate rounds of public consultation completed Yes No periodically. Grievance Redress Mechanism established with contact Yes No points and implemented by PIU and Government Bidding documents Bidding documents and contracts incorporating the Yes No and contracts environmental activities and safeguards listed as loan consistent with EMP assurances requirements Bidding documents and contracts incorporating the Yes No Environmental mitigation and management provisions of the EMP Contract Awards EMP and Environment Monitoring requirements included Yes No documents in contract documents for construction contractors. Preparation of SEMP and submission. Development of Tree replantation plans included in Yes No contracts and reported PIU Environmental PIU Environment Specialist hired and periodic reporting Yes No staff for monitoring and of ADB Environment Monitoring Reports submitted. supervision Special Protection PIU engineers trained by Environmental Specialist and Yes No Areas/ Design and Supervision Environmental Consultant in

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Indicator xvii. Measurement Methods Measurement Asbestos/Chance procedures find/Cultural heritage procedure EMP financial support Environment Mitigation measures fulfilled by construction Yes No contractors according to the financial plan. Environment Monitoring requirements in the project area Yes No fulfilled by construction contractor/PIU as per EMP Sources: PPTA Team

652. The PIU ESS working with design and supervision environment consultant will define more quantitative indicators jointly with the Construction companies before start of construction.

5. External Monitoring 653. This is Category B tranche and does not require hiring of any external experts64 for monitoring and review. 6. Reporting 654. The PIU will be responsible for internal monitoring of the EMP implementation and will develop semi-annual progress reports with details of activities and progress made during EMP implementation. The PIU will submit annual monitoring reports to ADB. 655. The EA in turn will be expected to report to the ADB on progress achieved against the EMP activities and milestones on a quarterly basis. Progress reports will include a description of implementable activities and their status; identify the responsible party (ies) involved in their implementation; and provide project management schedules and timeframes for doing so, along with their associated costs.

J. Environmental Management Plan Budget Costs 656. The main benefits of the environmental mitigation plan are (i) ensuring that environmental standards are met during design, construction, and operation of the project; (ii) providing offsets to negate project impacts especially ecological impacts. Without such expenditures, the project might generate significant environmental impacts, causing the biophysical environment in the area to deteriorate and indirectly depressing the economies of local communities. 657. The compliance with the EMP has been prepared based upon optimum and reasonable costs that are derived upon minimization of mitigation measures on a “least-cost” basis. The estimated budget for implementing the EMP for three tranches is USD$ 760,000 (approx. 1% of the total budget) of USD 81 million as shown in

64 External expert who is not involved in day-to-day project implementation or supervision. 227

658. Table IX.7.

228

Table IX.7: Estimated costs for implementing EMP for three tranches

# Type of expenses Cost Estimates USD $ 1 Promotion and advertisement of the EMP* 10,000 2 Support the implementation of mitigation activities** 300,000 3 Reviewing and revising of EMP*** 100,000 Environment Parameters testing (regularly quarterly) 200,000 4 Training and Consultancy **** 150,000 5 Budget for the Monitoring activities 50,000 6 Budget for public consultation and feedback 50,000 TOTAL 760,000 * “Promotion and advertisement of the EMP” include activities to provide awareness on EMP to relevant stakeholders and public communities in surrounding areas of construction sites as well as informing them of the roles and responsibilities of various parties involved. Costs may include development of promotional materials, advertising etc. ** Mitigation activities are approximately 0.5% for individual package *** Revision of IEE/EMP, if major scope of project activities change during implementation **** Training costs for items as per Table IX.2 above

659. The cost components include items such cost towards promotion, advertisement and implementation of mitigation activities (Construction Company’s civil works scope), review and revision of IEE/EMP is scope changes, Training and consultancy (identified in Table IX.2), monitoring of EMP and support implementation of mitigation activities etc. in entire location of FHC/SHC/Hospital and future public consultations required. These activities will be coordinated by the PIU Coordinator, Environment Supervision Specialist, Design and Supervision environment consultants and the construction company. 660. Table IX.8 below states the detailed EMP costs for the Construction company and the PIU. These costs are consistent with the Facility Administration Manual (FAM) developed for the Tranche 1, 2 and 3 costs. As a quick estimate, the EMP costs would be divided proportionately in the rate of 1:1:1 for each tranche – thereby making EMP costs an average of $253,333 per tranche for mitigation and monitoring. 661. If any capital investment for health care waste management works outside the premises of the hospital/FHC/SCH is required for developing capacity of the Aimag/Soum local agen- cies (such as transportation equipment for waste, liquids, development of engineering land- fills etc.), it will be budgeted separately from the EMP and the project – either by the Mongo- lian Government or through alternate sources.

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Table IX.8: Details of EMP costs for three tranches A Type of expenses Basis of Item Units/da EMP Estimated Remarks Where cost is costs (from ys Amount in USD covered in Total FAM/EARF) Project Cost 1 Public Disclosure of the $ 200 21 $ 4,200 Public disclosure at 7 places X 3 Government Cost- IEE/EMP* times during project implementation PIU pays 2 Support the $ 3,96,80,000 1.0% $ 3,08,500 EMP implementation by Construction implementation of construction company is max 1% of Company costs - mitigation activities works *($39.86 million) Included in contract 3 Reviewing and revising $ 250 40 $ 10,000 Revise twice @250 USD/day each Design and of IEE/EMP by 20 person days Supervision Firm costs Environment $ 12,700 14 $ 1,77,800 travel costs, Laboratory test Construction Parameters testing analysis cost and translation costs Company Costs - (regularly quarterly) 2 times in project cycle Included in contract 4 Training and $ 4,000 42 $ 1,68,000 14 training 3 times Costs included in Consultancy Training items of FAM 5 Budget for the $ 495 100 $ 49,500 Consulting team working for 100 Design and Monitoring activities person days Supervision Firm costs 6 Budget for public $ 2,000 21 $ 42,000 Consultation at 7 places, 3 times Government Cost- consultation and PIU pays feedback TOTAL $ 7,60,000 All costs included in tranche 1 costs

B Manpower Costs Environment Person Social Tasks Person months required Tasks months required 1 PIU Safeguards Staff Disclosure 0.25 Disclosure 0.25 Public 0.5 Public 0.5 Consultation Consultation Environment 1.5 Monitoring EM reports 1.5 Social Reports 1.5 230

B Manpower Costs Environment Person Social Tasks Person months required Tasks months required every 6 every 6 months months Total person months 6.00 3.75 2.25 PIU Safeguards Staff will hired from Government Budget 2 Design and Supervision Consultants a. Environment Construction 2 Full time Social 2 Part Time The DSC Safeguards persons will be hired by DSC firms under contracts D1 and D2 for FAM

231

K. Institutional Arrangements 1. Project Implementation Organizations: Roles and Responsibilities 662. The Environment Assessment and Review Framework (EARF) specifies the roles and responsibilities of institutions (including the Municipality of Ulaanbaatar, Ministry of Health, the Project Implementation Unit (PIU), contractors, and design and supervision environment consultants in overall environmental management. 663. The Ministry of Health (MOH) will be the executing agency of the project and will oversee overall project implementation and management activities to ensure smooth and timely implementation and completion of project activities. It has the overall responsibility for overseeing, monitoring and evaluation of project implementation at all 20 project sites in compliance with EARF, IEEs, and EMPs. 664. City Health Department has overall responsibility for overseeing, monitoring and evaluation of project implementation at 13 project sites within the Ulaanbaatar city in compliance with EARF, IEEs, and EMPs. 665. Aimag Health Departments of Khovd and Uvs, have responsibility for overseeing, monitoring and evaluation of project implementation at respective Aimag in compliance with EARF, IEEs, and EMPs 666. Hospitals will be engaged in capacity building and training programs of the loan project in relation to the expansion of additional services. In addition, they will also responsible for taking roles of monitoring the construction of new hospitals and provide necessary information for the Project Implementation Unit (PIU) and the consultants. 667. The project steering committee will be established by MOH and comprise MOH directors, representatives of MOF and MOH. The Ministry of Health (MOH) will be the investment program’s Executing Agency (EA). The MOH’s Policy Planning Department will be in charge of implementing the investment program in the country and the consulting services, the Ulaanbaatar City Mayor Office (UBCMO) and Ulaanbaatar City Health Department (UBCHD) will be in charge of implementing the investment in Ulaanbaatar and surrounding districts. A project implementation unit (PIU) will be established within the MOH. The MOH will form the Project Steering Committee that will be chaired by the MOH and will comprise representatives of MOF; MOH; MLSP; UBCMO, UBCHD; Ministry of Environment and Tourism (MET); Khovd, Uvs and other Aimag administrations; and the governor offices of Khan-Uul and Chingeltei Districts. 668. The MOH will be the implementing agencies. The project will be implemented from January 2019 to June 2024. The PIU will be established within the framework of the loan project at the MOH. The PIU will be responsible for day-to-day project coordination, monitoring and evaluation. The PIU will ensure compliance with assurances, including preparation, finalization, and implementation of the EMP for each tranche. The project implementation unit will be staffed with experienced professionals (a project coordinator, environment safeguards specialist (ESS), and a civil works subunit comprising civil, mechanical and electrical engineers, and to handle day-to-day project management. 232

2. Project Organizational Structure 669. The interactions between steering committed, Ministry of Health and the PIU at the project level are shown in Figure IX.1.

Executing Agency MOH

Steering Committee

Implementation Agency Implementation Agency Consultant Services Contracts – Aimags Ulaanbataar Investment MOH UBCMO - UBCHD

Technical Working Group

Program Implementation Unit

Advises (for project purposes)

Oversee (for project purposes) Consulting Services

Figure IX.1: Project Organization Structure (Source: FAM)

3. EMP implementation arrangements. 670. The Project Implementation Units (PIU) which will assume primary responsibility for the environmental assessment as well as implementation of EMP through Construction Company (civil works contractors). 671. ADB requires one full time PIU Environment Safeguards specialist (ESS) who supervises Environment activities until project completion report is issued. It is proposed that ESS must coordinate with each Construction Company to address environmental mitigation issues65.

65 ADB advises that all EAs develop in-house capability for environmental, health, and safety (EHS) program con- sistent with international best practices. The EHS program should include accounting for environmental benefits

233

The duties of the PIU Environmental Safeguards Specialist will include at a minimum: (i) oversight of Construction Company for monitoring and implementing mitigation measures; (ii) liaising with the FHC/SHC/Hospital management and Construction Company (civil works contractors) and seeking their help to solve the environment-related issues of project implementation; and (iii) technical progress reporting as well as preparation of environmental management reports every 6 months (as required by ADB). 672. The PIU environmental safeguard specialist will be responsible for coordination and supervision of the implementation of the EARF, IEE and EMP, including (but not limited to):  updating IEE and EMP after detailed project design for Tranche-1 and other subsequent tranches are approved;  overseeing incorporation of EMP recommendations into the bidding documents;  ensuring the procurement of environmentally responsible contractors;  ensuring that DEIA approval by MET has been secured prior to the awarding of civil works contract;  setting up baseline ambient air quality, noise and vibration levels, ground- and surface water quality and baseline in concerned Khoroos for subsequent tranches;  setting up, coordinating, and reporting on the grievance redress mechanism (GRM, see below);  monitoring contractors to ensure adherence to the EMP and the contractor EMPs;  preparing quarterly reports on project EMP implementation to the PIU;  coordinating consultation with local stakeholders as required, informing them of imminent construction works, updating them on the latest project development activities, GRM, etc.;  supporting the Design and Supervision environment consultants in conducting training, EMP compliance reviews, annual reporting, etc.; and  coordinating the preparation of IEEs, including EMPs, for subsequent tranches. 673. In compliance with the agreed upon procurement plan, the PIU will procure the services of Design and Supervision environment consultants to provide support in project preparation including updating the EMP; training; quarterly environmental quality monitoring (air, surface and ground water, and noise); semi-annual66 project EMP implementation reporting; identifying environment-related implementation issues and necessary corrective actions; and undertaking site visits as required.

resulting from investment projects within three months of loan approval. The monitoring agency shall report on semi-annual basis directly to ADB and determine whether sound environmental management practices have been achieved, and suggest suitable recommendations and remedial measures for midterm correction and im- provement. 66 SPS 2009 states: “The borrower/client will submit at least semiannual monitoring reports during construction for projects likely to have significant adverse environmental impacts, and quarterly monitoring reports for highly com- plex and sensitive projects. For projects likely to have significant adverse environmental impacts during operation, reporting will continue at the minimum on an annual basis. Such periodic reports will be posted in a location ac- cessible to the public. Project budgets will reflect the costs of monitoring and reporting requirements.”

234

Design and Supervision environment consultants

674. Design and Supervision Environmental Consultants will be hired under the loan implementation consultancy services. The Design and Supervision team would hire required national environment experts for reporting during construction to prepare SEMP, monitoring reports, testing reports, public consultations, Grievance redress etc. 675. The consultants are essential to completion of environmental pre-construction activities and should be recruited as soon as possible after loan effectiveness. The consultants will assist the PIU-ESS with the following:  Assist PIU-ESS to integrate the EMP mitigation and management measures into construction contracts and arrangements;  Ensure that relevant sections of the project EMP are incorporated in the construction contract documents;  Assist the PIU to establish and publicize the grievance redress mechanism (GRM);  Develop procedures to (i) monitor and report on the EMP implementation progress; and (ii) record and collate complaints and resolution under the GRM;  Provide support and training to PIU ESS and contractors on the specific requirements of the EMP as required;  Assess the environmental readiness of project components prior to first civil works, and regularly thereafter, based on indicators defined in performance indicator;  Conduct regular EMP compliance assessments, undertake site visits, identify any environment-related implementation issues, and propose necessary responses in corrective action plans;  Assist PIU to prepare annual environmental monitoring progress reports for submission to ADB;

676. The ESS will monitor contract requirements and any specialist functions by the construction supervision specialists (civil, mechanical and electrical engineers etc.) hired under the PIU. Contractors will be required to formulate contractor EMPs with complete management systems for adverse impacts, e.g., dust control, noise control, traffic management, health care waste management addressing as minimum the requirements of the EMP. The contractor EMPs will be reviewed and cleared by the PIU, and by the MET if necessary. To ensure that the contractors comply with the EMP provisions, the PIU will prepare and provide the following specification clauses for incorporation into the bidding procedures:  a list of environmental management requirements to be budgeted by the bidders in their proposals;  environmental clauses for contractual terms and conditions; and  the full EMP and DEIAs in both languages. 677. Further details on person/agencies responsible for EMP activities are in Table IX.9.

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Table IX.9: Institutional Roles and Responsibilities for EMP Implementation Activities Activity Responsible Person/Agency Sub-project Initiation Stage Establish PIU and award contracts Project Coordinator, Procurement Specialist, PIU MOH Clearances/approvals from relevant Government of Mongolia PIU, MOH agencies-urban, water, power etc. Disclosure of subproject EMP details on MOH website PIU, MOH Conducting discussions/meetings/workshops with APs and other ESS and other Specialists at PIU stakeholders Updating of EMP mitigation measures based on discussions ESS, PIU EMP Implementation Stage Meetings at community/household level with APs ESS, Construction Company Implementation of proposed EMP mitigation measures ESS, Construction Company Consultations with APs during EMP mitigation measures ESS, Construction Company implementation Grievances Redressal PIU /District Administration Internal monitoring PIU/ MOH ADB-Asian Development Bank; AP-Affected Persons; EA-Executing Agency; EMP-Environmental Management Plan; PIU- Project Implementation Unit, ESS – Environment Safeguards Specialist

L. Implementation Plan 678. The proposed project involves construction of 4 FHC, 5 SHC, 3 Hospitals on their premises and 1 National Emergency Health Call Center on government owned land. The project will involve survey work, land clearance, design and engineering of plant equipment, floating tenders for procurement, civil work and testing and commissioning of buildings. Total project work in is costing USD 81.6 million (including IDCs and contingencies). The overall draft project implementation schedule for the project is attached as Table IX.10.

236

Table IX.10: Overall Project Implementation Schedule

NOTE - This schedule is tentative and will be finalized based on each site as well as estimated schedule indicated by bidders for each contract.

237

X. CONCLUSION AND RECOMMENDATION

679. This report assessed various existing environmental parameters in and around the sub- project and the actions planned to minimize any significant negative impact. It was found that the existing designs used for the construction of FHC/SHC/Hospital buildings in Mongolia are reasonably sound. 680. The sub-project sites are not located near any sensitive areas as well no significant historical and cultural areas. The project will not cause any significant adverse environmental impacts during construction67 of FHC/SHC/Hospital buildings. If renovation or refurbishment for any component requires removal of asbestos containing materials (ACM), the particular activity will be dropped from funding. 681. Impacts are manageable and can be managed cost effectively - Environmental impacts are likely to result from the proposed construction of buildings. Careful mitigation and monitoring, specific selection criteria and review/assessment procedures for subprojects have been specified to ensure that minimal impacts take place. The detailed design would ensure inclusion of any such environmental impacts that could not be specified or identified at this stage are taken into account and mitigated where necessary. Those impacts can be reduced through the use of mitigation measures such as correction in work practices at the construction sites, or through the careful selection of sites and access locations. 682. The limited project impacts are associated with drainage congestion/water logging, dust and noise pollution, occupational health hazards, risk from poor sanitation system, improper lighting and ventilation system in Hospital, and management of labour at the site. Moreover, most of the associated impacts are expected to be limited to the construction phase, and will therefore be temporary in nature. Regular monitoring of the recommended mitigation measures shall also be carried out during the implementation phase of the project. EMP includes appropriate measures for mitigating all environmental impacts associated with operations of the facilities. 683. The selected lands for all new FHC/SHC/Hospital are located within the government land. Thus, acquisition of land will not be required from the surrounding communities. No endangered or protected species of flora or fauna are reported at any of the subproject sites. 684. The proposed project will have number of positive impacts and negative impacts to the existing environment as follows:  Construction of state-of-the-art new building for FHC/SHC/Hospital in Mongolia is the main positive impact.  Environment pollution due to cut and fill operations, transportation of construction materials, disposal of debris, disturbance to the Hospital activities, nuisance from dust, noise, vehicle fumes, black smoke, vibration etc. due to construction activities are the short-term negative impacts due to proposed project.

67 Construction of additional buildings to expand services. 238

 Although there is negligible removal of waste, noise, health and safety, trees for the FHC/SHC/Hospitals, which is the main negative impact to the proposed project area. It is required to establish baseline parameters in the beginning to monitor changes of the quality of water, air, soil and noise during the construction and operation periods. 685. Proper GRM will have to be implemented by MOH to overcome public inconvenience during the proposed project activities. 686. EMP and Environment Monitoring Plan has been prepared and attached as Annexures 4 and 5 respectively. One round of public consultations was conducted. The results indicate broad support for the project based on perceived economic and social benefits. Most impacts are expected to occur during the construction phase and are considered to be of a temporary nature. The construction sites were carefully selected after undergoing an options assessment. These construction drawings for each building will be designed to bypass important underground utilities water supplies and resources nearby any sensitive ecological areas. Current facilities for two FHCs and NECC will be shifted to temporarily to properties on rent nearby for continuous functioning during construction therefore minimosing nuisance to the patients and staff. All other facilities do not require closure during operations as these are separate buildings or new buildings. 687. Hospitals, FHC’s and NECC will generate hazardous, infectious and chemical waste during its operation that can be managed properly following to EMP. Proper Health Care Waste (HCW) that contains potentially harmful microorganisms, which can infect hospital patients, health workers and the public will need to be managed by the hospitals during operations. No other significant risks are anticipated during operation. An Emergency Response Program (ERP) will be prepared by Contraction Company in consultation with Environment safeguard specialist of the PIU. ERP training will be provided to all stakeholders in the project construction and operations stages. 688. Environment impact analysis have been done with various criteria like demographic factors, climate and natural habitat, community and employee health and safety etc. based on the impact analysis. It was found that there is no adverse impact on any natural existing land resources nor will affect the regular life of people resident in the subproject area. The environment impact associated with FHC/SHC/Hospital project is limited to the extent of construction phase and can be mitigated through a set of recommended measures and adequate provision for environment and social impact which cover monitoring, measuring and mitigation. The main project impacts are associated with clearing of digging, waste management and excavation and movement of soils. 689. The IEE performed is adequate for purposes of project implementation. Based on the environmental assessment and surveys conducted for the project, the potential adverse environmental impacts can be mitigated to an acceptable level by adequate implementation of the mitigation measures identified in the EMP. Adequate provisions are being made in the project to cover the environmental mitigation and monitoring requirements, and their associated costs. 690. The potential cumulative and residual impacts of the sub-components as a whole indicate the project classifies as a Category “B”, in accordance with ADB’s Safeguards Policy 239

Statement 2009 and MET Guidelines of Mongolia. Thus, IEE report has been prepared for the project. Thus, a full Environmental Impact Assessment (EIA) for the project is not required. The project is not considered highly sensitive or complex.

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ANNEXURES

Annexure – 1: Environmental quality and health and safety standards relevant to the subprojects under the program during construction and operation Table A1-1: Ambient Air Quality Standards MNS4585:2016 & Compared to International Standards

EHS Guidelines. World Health Organization Parameter MNS 4585:2016 (mg/m3) (WHO). Air Quality Guidelines Global Update.2005)-µg/m3) SO2 24-hour 50 24-hour 125 (Interim target-1) 50 (Interim target-2) 20 (guideline) 20 minute 450 10 minute 500 (guideline) 1-year 20 NO2 1-year 40 1-year 40 (guideline) 24-hour 50 24-hour - 20-min 200 1-hour 200 (guideline) PM10 1-year 50 1-year 70 (Interim target-1) 50 (Interim target-2) 30 (Interim target-3) 20 (v) 24-hour 100 24-hour 150 (Interim target-1) 100 (Interim target-2) 75 (Interim target-3) 50 (guideline) PM2.5 1-year 25 1-year 35 (Interim target-1) 25 (Interim target-2) 15 (Interim target-3) 10 (guideline) 24-hour 50 24-hour 75 (Interim target-1) 50 (Interim target-2) 37.5 (Interim target-3) 25 (guideline) CO Average in 1 hour 30g/m3 No standard

Interim targets are provided in recognition of the need for a staged approach to achieving the recommended guidelines. However, if airshed is degraded compared to WHO guideline, then standards more stringent than Mongolian standards must apply. 241

Table A1-2: Ambient Noise Standards MNS 4585:2016 & Compared to International Standards EHS Guidelines (Guidelines for Community Receptor MNS 4585:2007 Noise. World Health Organization (WHO), 1999) Residential, 07 00 - 23 00 60 dB(A) 07 00 - 22 00 55 dB(A) Institutional, 23 00 - 07 00 45 dB(A) 22 00 - 07 00 45 dB(A) Educational Higher MNS figures means (in Red) the EHS standard has to be followed.

able A1-3: Ambient surface water quality standard MNS 4586:1998 Parameter MNS 4586-98 pH 6 5-8 5 DO mg/l not less than 6&4 BOD mg/l 3 NH4*N mgN/l 05 NO2*N mgN/l 0 002 NO3*N mgN/l 9 PO,-P mgP/l 0.1 A mg/l 300 F mg/l 1.5 SO4 mg/l 100 Mn mg/l 0.1 Ni mg/l 0.01 Cu mg/l 0.01 Mo mg/l 0.25 Cd mg/l 0.005 Co mg/l 0.01 Pb mg/l 0.01 As mg/l 0.01 Cr mg/l 0.05 Cr6+ mg/l 0.01 Zn mg/l 0.01 Hg mg/l 0.1 Oil mg/l 0 05 Phenol mg/l 0 001 Active and washing substances mg/l 01 Benzipyren Mkg/1 0 005 There are no comparable EHS guidelines in this regard. * DO >6 mg/l for summer time and DO »4 mg/1 for winter time

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Table A1-4: Ground water quality Standard MNS 900-2005 Compared to International Standards68 Parameter MNS 900:2005 WHO Guidelines for Drinking Water Quality, Fourth Edition. 2011 Na- mg/l 200 None established K- mg/l 200 None established Ca2' mg/l 100 - Mg2- mg/l 30 - SO42 mg/l 500 None established HCO3 mg/l - - CO32 mg/l - - Cl mg/l 350 mg/l 5 P mg/i 0 7-1.5 - Br - None established Test, by mark mg/l 2 - Color degree 20° None proposed Odor mark 2 - pH 6.5-8.5 None established Electric Conductivity - - Y S/st General Minerals 1000 - Hardness mg-eqv/l 7 None established Acidity potential mB - Solid remains g/l 1 - NH4 mg/l 1.5 None established NO3 mg/l 50 mg/l 50 NO2 mg/l 1 mg/l 3 PO4 mg/l 35 - As mg/l 001 mg/l 001 Fe mg/l 0.3 None established Pb mg/1 003 mg/l 001 Ni mg/l 002 mg/l 007 Cr mg/l 005 mg/l 005 Cu mg/l 0.1 mg/l 2 Zn mg/l 5 None established

68 It is required that the entire suite needs to be tested where ground water is used for drinking water. 243

Parameter MNS 900:2005 WHO Guidelines for Drinking Water Quality, Fourth Edition. 2011 Mn mg/l 0.1 None established Cd mg/l 0003 mg/l 0003 Hg mg/l 00005 mg/l 0006 B mg/l 0.5 mg/l 24 Ba mg/l 0.7 mg/l 07 Mo mg/l 007 None established Se mg/l 001 mg/l 004 E coli or thermo * Must not be detectable in any tolerant coliform 100 ml sample bacteria

MNS 900:2005. Drinking Water Hygienic Requirement and Quality Control is the standard used for groundwater supply, which is the source for drinking water supply in Mongolia

Table A1-5: Soil Quality Standard MNS 5850-2008 MNS 5850:2008 Parameter Soil Mechanical Composition Maximum Acceptable Amount * Clay Loamy Sandy Pb 100 70 50 100 Cd 3 1.5 1 3 Hg 2 1 05 2 As 6 4 2 6 Cr 150 100 60 150 Cr6+ 4 3 2 4 Sn 50 40 30 50 Sr 800 700 600 800 V 150 130 100 150 Cu 100 80 60 100 Ni 150 100 60 150 Co 50 40 30 50 Zn 300 150 100 300 Mo 5 3 2 5 Se 10 8 6 10 B 25 20 15 25 F 200 150 100 200 CN 25 15 10 25 * There are no soil quality International standards for EHS guidelines.

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Table A1-6: Boiler Emission Guidelines MNS 6298:2011 and compared to International Standards Guideline Parameter in mg/Nm3) MNS 6298:2011 EHS Guidelines * SO2 mg/m3 400 urban mg/Nm3 600 remote 2000 areas NOx mg/m3 450-1.100 mg/Nm3 650 based on volatile coal PM mg/m3 50-200 mg/Nm3 50-150

Dry Gas Excess - - % O2 content 6 * Small Combustible facilities Emission Guidelines (3 MWth-50 MWth) - for Boilers using solid fuel MWth - Megawatt thermal Nm3 is at one atmospheric pressure. 0°C

Table A1-7: Standard for Wastewater Discharge to water bodies (MNS- 4943-2011) № Parameter Measuring Maximum EHS unit allowance Guidelines* 1 Water temperature C 20 2 Hydrogen ion activity (pH) - 6-9 6-9 3 Odor Sense No bad smell 4 Suspended solids (SS) mg/l 50 5 Biochemical Oxygen Demand (BOD) mg/l 20 30 6 Chemical Oxygen Demand (COD) mg/l 50 125 7 Permanganate mg/l 20 8 Dissolved Salt mg/l 100 9 Ammonia Nitrogen (NH4-N) mg/l 6 10 Total Nitrogen (TN) mg/l 15 10 11 Total Phosphorous (TP) mg/l 1.5 2 12 Organic Phosphorous (DOP) mg/l 0.2 13 Hydrogen Sulphide (H2S) mg/l 1 14 Total Iron (Fe) mg/l 1 15 Aluminium (A) mg/l 0.5 16 Manganese (MN) mg/l 0.5 17 Total Chromium (Cr) mg/l 03 18 Chromium +6 (Cr+6) mg/l Not specified 19 Total cyanide (CN) mg/l 0.05 20 Free cyanide (CN) mg/l 0.05 21 Copper (Cu) mg/l 0.3 22 Boron (B) mg/l 0.3 23 Lead (Pb) mg/l 0.1 24 Zinc (Zn) mg/l 1.0 25 Cadmium (Cd) mg/l 0.03 26 Antimony (Sb) mg/l 0.05 27 Mercury (Hg) mg/l 0.01 28 Molybdenum (Mo) mg/l 0.5 245

№ Parameter Measuring Maximum EHS unit allowance Guidelines* 29 Total Arsenic (As) mg/l 0.01 30 Nickel (Ni) mg/l 0.2 31 Selenium (Se) mg/l 0.02 32 Beryllium (Be) mg/l 0.001 33 Cobalt (Co) mg/l 0.02 34 Barium (Ba) mg/l 1.5 35 Strontium (Sr) mg/l 2 36 Vanadium (V) mg/l 0.1 37 Uranium (U) mg/l 0.05 38 Mineral oil mg/l 1 39 Fat oil mg/l 5 40 Surface active agents mg/l 2.5 41 Phenol (C5H20H) mg/l 0.05 42 Thrichloretilen mg/l 0.2 43 Tetrachloretilen mg/l 0.1 44 Remained chlorine (Cl) mg/l 1 45 Faecal conforms No/100ml Not occurring in 400 MPN/100ml 1 ml. * Based on IFC Standards for Hospital Effluents in Annexure 2

Table A1.8. MNS 5457- 2005 “Maximum acceptable level and measuring method of toxic elements (CO, SO2, NOx, ash) in the exhaust gases contents of heating boilers and home stoves”

Table A1.8.1. Boiler (NOx) (SO2) installed capacity Emitted by Emitted Concentration Emitted Emitted by Emitted Concentration Emitted (Q), MW burning by 1 MJ in the exhaust in unit burning by 1 MJ in the exhaust in unit 1kg fuel heat gases mg/m3 of time, 1kg fuel heat gases mg/m3 of time, equivalent, produced, g/s equivalent, produced, g/s g/kg f.e. g/MJ g/kg f.e. g/MJ 1 Q ≤ 0.8 6.75 0.23 450 0.3 12.0 0.4 800 0.4 2 0.8 ≤ Q 6.0 0.2 400 0.25 9.0 0.3 600 0.5 ≤ 3.15

Table A1.8.2. Boiler (CO) Ash installed capacity Emitted Emitted Concentratio Emitted Emitted Emitted Concentratio Emitted (Q), MW by by 1 MJ n in the in unit by by 1 MJ n in the in unit burning heat exhaust of time, burning heat exhaust of time, 1kg fuel produce gases g/s 1kg fuel produced gases g/s equivalent d, g/MJ mg/m3 equivalent , g/MJ mg/m3 , g/kg f.e. , g/kg f.e. 1 Home 4000 2500 stove 2 Q ≤ 0.8 37.5 1.28 2500 1.8 6.0 0.15 400 0.34

246

3 0.8 ≤ Q ≤ 30 1.02 2000 1.5 4.5 0.2 300 0.23 3.15

Assuming there are no incineration clinical wastes included in Project; however the following the EHS guidelines for health care facilities is also attached in Table A2.6 on Air Emissions from Hospital Waste Incinerator.

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Annexure – 2: General Environmental, Health and safety Guidelines- IFC-EHS Table A2.1. WHO Ambient Air Quality Guidelines

248

Table A2.2. Small Combustion Facilities Emissions Guidelines

249

Table A2.3. Indicative Values for Treated Sanitary Sewage Discharges

Table A2.4. Noise-Level Guidelines

250

Table A2.5. Effluent levels for Health Care facilities

Source: IFC Environmental, Health, and Safety Guidelines, April 30, 2007: Health Care Facilities

251

Table A2.6: Air Emissions from Hospital Waste Incinerator

Source: IFC Environmental, Health, and Safety Guidelines, April 30, 2007 : Health Care Facilities

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Annexure – 3: Inventory of FHC/SHC/Hospital LIST OF FHC/SHC/HOSPITAL CONSTRUCTION69 SITES

Table A3.1 FHC/SHC/Hospital No. Location Construction FHC/SHC/Hospital 1 Khan Uul District Construct additional building with size of Khan-Uul District 12,000 m2 inside boundary of Hospital Hospital 2 Khovd Province Construct additional building with size of Khovd, Hospital 12,000 m2 inside boundary of Hospital 3 Ulaangom city, Uvs Construct additional building with size of Uvs Hospital province 12,000 m2 inside boundary of Hospital 4 1st Khoroo in Construct new building and demolishing Emergency Health Sukhbaatar district of existing 816m2 building. Center 5 10th Khoroo in Demolish existing 103m2 building built in FHC Khan-Uul district 2000, construct new 1 storey building with 640m2 size 6 14th Khoroo in Newly construct 1 storey building with FHC Khan-Uul district 640m2 size 7 19th Khoroo in Newly construct 1 storey building with FHC Chingeltei district 640m2 size 8 17th Khoroo in Demolish existing 203m2 building built in FHC Bayanzurkh district 2001, construct new 1 storey building with 640m2 size 9 Erdenemandal Construct additional building with size of SHC Soum, Arkhangai 800 m2 inside boundary of SHC province 10 Tarialan Soum, Construct additional building with size of SHC Khuvsgul province 800 m2 inside boundary of SHC 11 Bayan-Undur Soum, Construct additional building with size of SHC Uvurkhangai 800 m2 inside boundary of SHC province 12 Erdene Soum, Construct additional building with size of SHC Dornogobi province 800 m2 inside boundary of SHC 13 Dashinchilen Soum, Construct additional building with size of SHC Bulgan province 800 m2 inside boundary of SHC

69 Construction of additional buildings to expand services. 253

Table A3.2 FHC/SHC/Hospital Physical Features

No Name of # of District Location Type of Type of Fire- Sewage water Heating supply Water supply hospital/FHC Schools /Soum GPS propose existing fighting management and d buildin facilities facility Kinderga constru g /year /alarm Conne Sept Holdi Conne Heati Elect From Fro From rtens ction constru system, cted to ic ng cted to ng ric centr m transpor cted hand central tank tank central from heati al own ted device Sewag heatin an ng water wat water e g own suppl er reserved system HOB y well in own syste water m reservoir . 1 Khan-Uul Middle Khan- 106°49'57 Construc Demolis Yes No Yes Yes No Yes district school Uul .80"E t 1 h 2 hospital #63 47°52'5.4 storey, small 0"N 12,000 building m2 s building (mortuar y and kitchen), 1981 2 Khovd Khovd 91°37'59. 1 storey, Yes Yes Yes Yes province provinc 51"E 48° 1250 m2 hospital e 0'13.58"N building 3 Uvs hospital 100m from kindergarte n No.5, 200m from Narhan Ulaango kindergarte Main Yes Yes Yes Yes m city n, 700m buildings from N46° 39' 1 storey, is 3 middle 58.5" 1200m2 storey, school E103° 11' extension built in No.1 05" building 1978 4 Emergency No Sukhba 106° 55' not 2 storey, Yes Yes Yes Yes Health Center schools atar 25.63" determin 816 m2, in UB city and 47° 54' ed yet 1971 kindergart 55.16" 254

No Name of # of District Location Type of Type of Fire- Sewage water Heating supply Water supply hospital/FHC Schools /Soum GPS propose existing fighting management and d buildin facilities facility Kinderga constru g /year /alarm Conne Sept Holdi Conne Heati Elect From Fro From rtens ction constru system, cted to ic ng cted to ng ric centr m transpor cted hand central tank tank central from heati al own ted device Sewag heatin an ng water wat water e g own suppl er reserved system HOB y well in own syste water m reservoir . en nearby 5 FHC at 10th Middle Khan- 106°45'38 construct Demolis Yes No Yes Yes No Yes Khoroo in school Uul .99"E 1 storey, h Khan-Uul #7, 47°51'30. 640 m2 existing kindergart 04"N building 103m2 en #49 building, 2000 6 FHC at 14th Middle Khan- 106°42'31 1 storey, Yes No Yes No Yes No Yes Khoroo in school Uul .52"E 640 m2 Khan-Uul #59, 47°47'25. building kindergart 00"N en #165 7 FHC at 19th Middle Chingel 106°55'17 1 storey, Yes No Yes No Yes No Yes Khoroo in school tei .40"E 640 m2 Chingeltei #117 47°59'41. building 31"N 8 FHC at 17th Middle Bayanz 107° construct Demolis none No Yes No Yes Yes Khoroo in school urkh 0'14.68"E 1 storey, h Bayanzurkh #79, 47°55'41. 640 m2 existing kindergart 85"N building 203m2 en #3 building, 2001 9 SHC in Middle Erdene 101°22'29 800 m2 Stone Yes No No Yes Yes Erdenemandal school mandal building building, .95"E Soum No.1, 1982. kindergart 48°31'45. en No.1 35"N in 350m 255

No Name of # of District Location Type of Type of Fire- Sewage water Heating supply Water supply hospital/FHC Schools /Soum GPS propose existing fighting management and d buildin facilities facility Kinderga constru g /year /alarm Conne Sept Holdi Conne Heati Elect From Fro From rtens ction constru system, cted to ic ng cted to ng ric centr m transpor cted hand central tank tank central from heati al own ted device Sewag heatin an ng water wat water e g own suppl er reserved system HOB y well in own syste water m reservoir . 10 SHC in Middle Tariala 101°59'18 800 m2 1 storey Yes No Yes Yes Yes Tarialan Soum school n building building, .13"E No.1, 1995 kindergart 49°36'53. en No.1 52"N in 360m 11 SHC in Middle Bayan- 104° 800 m2 Brick Yes No Yes Yes Yes Bayan-Undur school Undur building house, 7'7.53"E Soum No.1, Soum 1986 kindergart 46°29'51. en No.1 06"N in 180m 12 SHC in Middle Erdene 111° 800 m2 1 storey, Yes Yes Yes Yes Yes Erdene Soum school building 544m2 5'14.6"E No.1, 1999 kindergart 44°26'38. en No.1 4"N in 500m 13 SHC in Dashin 1 storey, Dashinchilen Middle chilen 1 storey 800m2 Soum school Soum, 47°51'0.3 building extensio Yes No No Yes No Yes No No Yes Yes No.1 in Bulgan 5"N 104° built in n 500m provinc 2'32.30"E 1988. building e FFH-Fire Fighting Hydrant, HOB-Heat Only Boiler, HT-Holding Tank, CSS-Central Sewage System, CHS-Central Heating System, CWS-Central Water Supply, BZD- Bayanzurkh district, BGD-Bengal district, SBD-Sukhbaatar district, SKD-SonginoKhairkhan district, KUD-Khan Uul district, SUD-Sukhbaatar district, .

256

Table A3.3 Other Physical Distances Aerial Aerial Aerial Aerial distance Aerial distanc Aerial distance distance from from power distance No Hospital/FHC/SH District/Sou e from distance Aerial distance from from solid waste station/powe from any . C name m Nation from gas railway/major road Industrial site/central r river/wat al station zones dumpsite line/substatio er body parks n 1.4km 1 gas station from 3.5 km from in 560m in 1.2km Khan-Uul district SPA, 11.8km from 280 m to public road. 4.42km to CHP3 and 1 Khan-Uul 3.5km NW. 2 gas from Tuul hospital within Moring Davaa railroad. 3km from stations in river buffer CHP4 420m in NE. zone 3.71km from 320m more 830m 1.4km from Khovd province 560m in Central from 2 than from open 120m to public road Khovd power hospital south dumpsite of Buyant 3km bazaar station Khovd city river 2.5km 3km from from Gashuuni Ulaangom 800m on 4.5km on 1km from paved road on 2.5km on 3 Uvs Hospital 25km power i river on city north southeast southwest south plant and southeas food plant t No 450m Emergency more 6.7km from industrial 770m in More than from 4 Health Center in Sukhbaatar than Tsagaan 5m to public road zones south west 5km Selbe UB city 3km Davaa nearby river 2.8km from FHC at 10th 1.8km Sonsgolo 1.44 km in 6.5km from 3.5km from 5 Khoroo in Khan- Khan-Uul 2km 234m from public road from Tuul n south Morin Davaa CHP4 Uul river industrial zone Power sub- No 1.2km FHC at 14th more station in industrial 620m in 4.7km from from 6 Khoroo in Khan- Khan-Uul than 540m to public road 35m zones west Moring Davaa Turgen Uul 3km distance in nearby river NE FHC at 19th more No 2 gas 6.5km from More than 520m 7 Chingeltei 50m to public road Khoroo in than industrial stations in Tsagaan 5km from 257

Aerial Aerial Aerial Aerial distance Aerial distanc Aerial distance distance from from power distance No Hospital/FHC/SH District/Sou e from distance Aerial distance from from solid waste station/powe from any . C name m Nation from gas railway/major road Industrial site/central r river/wat al station zones dumpsite line/substatio er body parks n Chingeltei 3km zones 300m Davaa, Selbe nearby distance in 11.2km from river east Narangiinn Enger 110m from 750m FHC at 17th more Automobil 3.4km from 820m in More than from 8 Khoroo in Bayanzurkh than e open Tsagaan 60m to public road west 5km Uliastai Bayanzurkh 3km bazaar Davaa river "Da Khuree" No 600m SHC in Erdene- 2.98km from industrial 170m in 350 to a sub- from 9 Erdenemandal mandal 27 km Soum central 20m to main public road zones west station Hanui Soum Soum dumpsite nearby river 1km to a 3.4km from 9.2km SHC in Tarialan Tarialan 560m in 320m to a 10 15km small flour Soum central 20m to main public road from Har Soum Soum northeast sub-station mill dumpsite buh river No 2.1km 1.5km from SHC in Bayan- Bayan- industrial 280m in 150m to a from 11 20km Soum central 15m to main public road Undur Soum Undur Soum zones southeast sub-station Nergui dumpsite nearby lake No No water 3km from 200m from main public road, SHC in Erdene Erdene industrial 300m in 400m from a body 12 38km Soum central 2km Soum Soum zones southeast Sub-station nearby dumpsite from railway nearby 9km from Dashinchilen sub-station Khar Buh Dashinchilen Soum, 560m on 3.4km on 13 31km No 20m from paved road in 320m on river on SHC Bulgan northeast southeast north northwes province t BZD-Bayanzurkh district, BGD-Bayangol district, SBD-Sukhbaatar district, SKD-SonginoKhairkhan district, KUD-Khan Uul district, SUD-Sukhbaatar district, KP- Khovd. Province, NP-National Park, SPA-Strictly Protected Area.

258

Table A3.4 Hospital Receptors

No Hospital/FHC City Distance from main Setback and type of buildings/distance in meters Adverse trees to be Debris/soil name road /all sides/ Front Back Left side Right side impact if cut/transferr disposal required any ed outside premises 1 2 3 4 5 6 7 8 9 10 11 1 Khan-Uul Khan-Uul 30m to north, 50m to site planned for site planned for apartments settlements 59 Populus Morin Davaa hospital west construction construction under /ger area/ trees central dumpsite construction 2 Khovd Khovd city 60m on south office buildings settlements /ger office settlements 7 Populus Khovd city central province area/ buildings /ger area/ trees dumpsite hospital 3 FHC at 10th Khan-Uul 76m on SE underground garage office buildings office kindergarten 5 Populus Narangiin Enger Khoroo in buildings trees, 20 central dumpsite Khan-Uul bushes 4 FHC at 14th Khan-Uul 540m on southern public road local Khoroo dirt road kindergarten Morin Davaa Khoroo in side administration central dumpsite Khan-Uul building 5 FHC at 19th Chingeltei 109 m on eastern side flood channel dirt road settlement local Khoroo Tsagaan Davaa Khoroo in areas administration central dumpsite Chingeltei building 6 FHC at 17th Bayanzurkh 60m on northern side settlements /ger area/ office building, parking settlements Tsagaan Davaa Khoroo in service centers space, dirt /ger area/ central dumpsite Bayanzurkh road 7 Emergency Sukhbaatar 3-5m on western side public road private house office office building 5-6 Populus Narangiin Enger Health Center buildings trees, several central dumpsite in UB city bushes 8 SHC in Erdene- 20m in west Ger area, trees a private hospital Ger area Empty space none Central dumpsite of Erdenemand mandal Soum al Soum Soum 9 SHC in Tarialan 20 in south WWTP in 100m Ger area beyond Apartment Weather 44 trees Central dumpsite of Tarialan Soum an empty space and office station Soum Soum 10 SHC in Bayan- 15m in south Empty space and road Old building and Empty Ger area none Central dumpsite of Bayan-Undur Undur earth track space beyond an Soum Soum Soum empty space 11 SHC in Erdene 200m in southwest Main public Ger area Parking Earth track none Central dumpsite of Erdene Soum road space Soum Soum 12 Dashinchilen Dashinchile 20-30m on each empty space pharmacy and public public road none Central dumpsite of SHC n Soum side empty space road Soum 259

No Hospital/FHC City Distance from main Setback and type of buildings/distance in meters Adverse trees to be Debris/soil name road /all sides/ Front Back Left side Right side impact if cut/transferr disposal required any ed outside premises 1 2 3 4 5 6 7 8 9 10 11 13 Uvs hospital Ulaangom 20m on south, kindergarten in apartment in gas station private none Central dumpsite of city 300m on east, 100m, apartment in 200m, private in 800m hospitals in Ulaangom 200m on north, 50m, shop in 30m hospital in 50m 100-250m 100m on west

BZD-Baynzurkh district, BGD-Bayangol district, SBD-Sukhbaatar district, SKD-SonginoKhairkhan district, KUD-Khan Uul district, SUD-Sukhbaatar district,

260

Table A3.5 Follow-up Actions No Hospital District Consultations Construction Access road for Preferred start of Additional recommendation Name safety training construction construction period 1 2 3 4 5 6 7 8 1 Khan-Uul Khan Uul No issues Construction safety Current paved No issue here. 1.59 Populus trees shall be Hospital District training is needed and tiny road re-planted at the green area because of can’t be used for planned within the design proximity to the construction, an works. current hospital unpaved road on 2.Walls with noise barrier building the west side of shall be erected on the side it the hospital will faces to the current hospital be used as building and on western side access road in order to minimize noise during disturbance on patients and construction nearby households. 2 Khovd, Khovd No issues No need No issue here No issue here. 1.existing pipelines for Hospital Province heating, water supply and sewage are in bad condition. Design works shall consider replacing with new pipelines. 2. 7-8 Populus trees shall be re-planted at the green area planned within the design works 3.Medical waste landfilling site in the Province must be upgraded by Municipal Government by its own funds. 3 Uvs hospital Ulaangom city No issue Construction safety No issue here Earthworks are preferred Civil works contractor shall training is needed to be conducted between pay attention to minimize because of June 10st and Aug 30th disturbance on nearby proximity to when the nearby kindergartens and private existing private kindergartens are on hospitals hospitals and summer vacation. kindergarten 4 Emergency Sukhbaatar The proposed Construction safety No issue here Earthworks are preferred 1.Five Populus trees and 18 health district construction site is training is needed to be conducted between bushes shall be re-planted at Center about 50 m away due to proximity to July 10th and August 20 the green area planned within from an office nearby office when people work at the the design works. 261

No Hospital District Consultations Construction Access road for Preferred start of Additional recommendation Name safety training construction construction period 1 2 3 4 5 6 7 8 building thus dust building neighbouring office 2. Walls with noise barriers and noise building goes for summer shall be erected at all sides in disturbance could be vacation. order to minimize noise high disturbance on neighbouring residents and office building. 5 FHC 10th Khoroo No issues Construction safety Current access Demolish works and 1.Five Populus trees and 23 in Khan-Uul training is needed to FHC goes earthwork are preferred bushes have to be re-planted district because of through to be conducted between at the green area determined demolition of apartments and June 1st and Aug 30th within the design works. building, and too tiny. An when the neighbouring 2.Wall with noise barrier shall proximity to a alternate access kindergarten is on be erected on western side kindergarten road shall be summer vacation. where there is a kindergarten. planned 6 FHC 14th Khoroo No issues No need No issue Earthworks are preferred Civil works contractor shall be in Khan-Uul to be conducted between attention to minimize district June 10st and Aug 30th disturbance on nearby middle when the nearby middle school kids and nearby school is on summer playground. vacation. 7 FHC 19th Khoroo Khoroo No need No issue No issue here. Design works shall include in Chingeltei administration says plan for parking space for district that planned both Khoroo administration construction site is complex and the FHC. New used as parking parking will be created within space for the Khoroo the yard of current 19th administration khoroo administration complex, if new FHC buidling. No land issue. building will be built on the current parking space, then a new parking space shall be designed for both Khoroo and newly built FHC

262

No Hospital District Consultations Construction Access road for Preferred start of Additional recommendation Name safety training construction construction period 1 2 3 4 5 6 7 8 8 FHC 17th Khoroo No issues Construction safety No issue No issue here. Walls with noise barrier shall in training to staff and be erected on southern and Bayanzurkh neighbourhood is northern sides in order to district needed because of minimize noise disturbance need to demolish on neighbouring households building and service center 9 SHC in Erdenemandal No issue No issue here No issue here Civil works contractor shall Erdenemandal Soum pay attention to minimize Soum disturbance on nearby middle Construction safety school kids and ger areas 10 SHC in Tarialan Soum No issue training is needed No issue here No issue here 44 trees need to be removed Tarialan Soum to ensure safety of and re-planted Soum center 11 SHC in Bayan-Undur No issue residents No issue here Earthworks are preferred Civil works contractor shall Bayan-Undur Soum to be conducted between pay attention to minimize Soum June 10st and Aug 30th disturbance on nearby middle when the nearby middle school kids and ger areas school is on summer vacation. 12 SHC in Erdene Soum No issue No issue here 30 trees need to be removed Erdene Soum and re-planted 13 Dashinchilen Dashinchilen No issue Construction safety No issue here No issue here Civil works contractor shall SHC Soum training is needed pay attention to minimize because of disturbance on nearby ger proximity to an areas existing ger area

Abbreviations: BZD-Baynzurkh district, BGD-Bayangol district, SBD-Sukhbaatar district, SKD-SonginoKhairkhan district, KUD-Khan Uul district, SUD- Sukhbaatar district 263

Annexure - 3b: Google Earth Images of FHC/SHC/Hospital Identified

Google image for the Khan-Uul district hospital

264

Google image for the Khovd district hospital

265

Google image for FHC in 10th Khoroo of Khan-Uul

266

Google image for FHC in 14th Khoroo of Khan-Uul

267

Google image for FHC in 19th Khoroo of Chingeltei

268

Google image for FHC in 17th Khoroo of Bayanzurkh

269

Google image for National Emergency Health Call Center

270

Google image for SHC in Erdenemandal Soum

Google image for SHC in Tarialan Soum

271

Google image for SHC in Bayan-Undur Soum

272

Google image for SHC in Erdenemandal Soum

273

Google image for SHC in Dashinchilen Soum

274

Google image for Uvs hospital

275

Annexure – 4: Environment Management Plan (EMP)

Project Potential Mitigation Action Parameters to be Standards70/ Institutional Implementat Activity Environmental Monitored Measurement/ Responsibilit ion Impact Frequency y and Costs Schedule Pre-construction and Design Physical Resources Building Release of effluents in Avoid all underground utilities during Construction Inspection MOH as part Detailed specifications receptors (air, water, design drawings Agency - Once. of design design. and design land). parameters. Structural Safety for FHC/SHC/Hospital to get Specialized Construction Inspection MOH as part Detailed ensuring proper Inspection Agency approval prior to drawings Agency - Once. of design design. demolition of old demolition. buidling Rehabilitation Decayed infrastructure Install modern fire control Structural safety of Inspection MOH as part Detailed of old will damage new systems/firewalls, building insulation, the old buildings and Agency - Once. of design design. infrastructure installations. Loss of plumbing and electric heating systems connected utilities to in heating and seepage instead of Heat only boilers (using the building FHC/SHC/Ho etc. in building coal). spital Environment Resources (Receptors) Location of Impact to the surface Construction facilities should be placed Water and Air Consultation with MOH as part Detailed land for water environment. 50 m away from water bodies, natural Quality. Site location local authorities of design design/Plann FHC/SHC/Ho flow paths, important ecological (distance to dwelling, and land owners. ing Stage. spital habitats and residential areas. Careful and/or utilities). Air quality site selection to avoid existing Standards and settlements. Water Quality standards – Once.

70 World Bank EHS guidelines will be used as a standard if any local Mongolian Standards are less stringent as per ADB SPS 2009. Standards are mentioned in Annexure 1 and 2 of IEE. 276

Project Potential Mitigation Action Parameters to be Standards70/ Institutional Implementat Activity Environmental Monitored Measurement/ Responsibilit ion Impact Frequency y and Costs Schedule FHC/SHC/Ho Noise generation FHC/SHC/Hospitals location/designed Expected noise Noise control MOH as part Detailed spitals Exposure to noise, to ensure noise will not be a nuisance emissions based on regulations of design design/Plann location and Nuisance to to neighbouring properties. FHC/SHC/Hospitals Noise levels to be ing Stage design for neighbouring design for noise specified in Noise. properties. levels. tender documents Interference Temporary flooding71 Appropriate siting. Site selection. Consultation with MOH as part Detailed with drainage hazards. local authorities of design location patterns and design survey and engineers. design. Shallow Digging, vibrations, Ensure proper borings and handling of Site selection Consultation with MOH as part Detailed ground heat water logging, safety muck, install noise shields, avoid local authorities, of design location pump vibrations in night. design engineers, survey and (including site and boring design survey and experts (to secure test borings) the safety). Dismantling of Asbestos present as Asbestos containing components will Air quality Air quality MOH as part Part of portions of insulation in some be dropped. standards – once of design detailed buildings section of the building project siting and survey and design. Ecological Resources Encroachmen Loss of precious Avoid encroachment by careful site Floral and faunal Enumeration of MOH as part Detailed t into precious ecological values/ and location selection and habitats loss. flora and fauna at of design design/Plann ecological damage to precious reconnaissance before final siting of site. ing Stage. areas. species. activities. Human Environment Involuntary Loss of lands and Compensation paid for temporary/ Public complaints Rates paid as per MOH as part Prior to resettlement structures. permanent loss of any residential land. the Resettlement of design construction or land plan/Frame work phase/Land

71 flood risk and drainage design to accommodate surface water runoff to greenfield rate at least 1 in 100yr flood + climate change allowance if feasible 277

Project Potential Mitigation Action Parameters to be Standards70/ Institutional Implementat Activity Environmental Monitored Measurement/ Responsibilit ion Impact Frequency y and Costs Schedule acquisition. for the project. Acquisition. Removal of Loss of trees. Avoid siting of structures to avoid any Statutory approvals Consultation with MOH as part Part of Trees permanent loss of trees wherever for tree trimming local authorities of design detailed possible. Implement tree replantation /removal from and design location or transplantation plan as the case may competent authority. engineers in survey and be consonance with design. MOH. Location and Disturbance to Maintain adequate clearance, Building Technical MOH as part Detailed design of adjacent lands and the construction of retaining structures, specifications and specification- of design design/Plann FHC/SHC/Ho people due to digging minimize digging close to the compliance with Once ing Stage. spitals. and construction dwellings. setback distances Measure setback operations. (“as-built” diagrams). distances to nearest house structures – Once. Location of Exposure to safety Setback of dwellings to designed in Location selection Setback MOH as part Part of siting FHC/SHC/Ho related risks. accordance with permitted safety with respect to distances to of design survey and spitals Seismic risk of distances. No shadow must full on nearest dwellings. nearest houses – detailed location and buildings adjoining buildings due to newly Seismic design Once. location design. proposed buildings. survey and Seismic design design. EA must ensure proper seismic design check - Once and checking of design by independent engineer since Hospitals are community facility where it is difficult to evacuate in emergency Explosions/Fir Hazards to life Design of FHC/SHC/Hospital to include FHC/SHC/Hospitals Tender document MOH as part Part of e modern fire control systems/firewalls. design compliance to mention of design detailed with fire prevention detailed FHC/SHC/H and control codes. specifications – ospitals Provision of firefighting equipment to Once. layout and be located close to electrical/heating design installations. /drawings Construction Phase

278

Project Potential Mitigation Action Parameters to be Standards70/ Institutional Implementat Activity Environmental Monitored Measurement/ Responsibilit ion Impact Frequency y and Costs Schedule Physical Resources Construction Removal of topsoil and prepare comprehensive dust mitigation Air and water Visual inspection Contractor Construction site clearance loose soil storage at plan given arid area. pollution (Dust) through period site may lead to dust Sprinkle water at site and cover soil contract emission dump against air pollution provisions under supervision of MOH Removal or Public inconvenience Advance notice to the public about the Disruption to other Technical MOH and Throughout disturbance to time and the duration of the utility commercial and specification Contractor construction other public disruption public activities / through period utilities Public complaints contract provisions Use of well trained and experienced machinery operators to reduce accidental damage to the public utilities

Restore the utilities immediately to overcome public inconvenience Electrical/fire Sparks and fire hazard Record of all FHC/SHC/Hospitals Electrical casings at As per MOH Throughout safety during construction electric fittings and fire safety devices FHC/SHC/Hospital International Contractor construction/ Equipment located within secure casings standards through erection layout and Once in year contract period installation provisions Asbestos is Lead to inhalation and Record all instances at Roofing and walls at Mongolian Contractor Construction found during long term health FHC/SHC/Hospitals and report to FHC/SHC/Hospitals national through period construction impact on workers and Mongolian authorities. Project standards (MNS) contract occupants components containing ACM will be 3838: 2008 and provisions dropped from funding. Construction under standard package supervision of # 91.040.– once a MOH year Use of Toxicity and air Use of low or no volatile organic Air quality – measure Mongolian Contractor Construction 279

Project Potential Mitigation Action Parameters to be Standards70/ Institutional Implementat Activity Environmental Monitored Measurement/ Responsibilit ion Impact Frequency y and Costs Schedule Volatile contamination inside compounds – water based nontoxic volatility as per national through period organic building etc. Mongolian standards standards (MNS) contract compounds – four times a year 3838: 2008 and provisions Construction under standard package supervision of # 91.040. – four MOH times a year Surplus Runoff to cause water Storage of excess soil near drainage Location and amount Visual inspection Contractor Construction earthwork/soil pollution, solid waste and settlement areas stored in (m3) of fill disposal (Turbidity and through period disposal restricted area and construction work Soil disposal sedimentation) contract should be carefully designed to provisions locations and volume Appropriate fill minimize obstruction or destruction to under (m3) disposal and natural drainage. supervision of dispersal MOH Excess soil from foundation excavation locations to be reused on site or disposed of in quarterly accordance to construction site management plan by contractor. Environment Resources Equipment Noise and vibrations Selection of construction techniques Construction Minimal ground Contractor Construction layout and and machinery to minimize ground techniques and disturbance through period installation disturbance. machinery Monthly contract provisions, MOH Provision of Contamination of Construction workforce facilities to Amenities for Presence of Contractor Construction facilities for receptors (land, water, include proper sanitation, water supply Workforce facilities. proper sanitation, through period construction air). and waste disposal facilities at work water supply and contract workers at site. waste disposal provisions work site facilities - under Once. supervision of MOH Mechanized Noise, vibration Construction equipment to be well Construction Technical Contractor Construction construction equipment wear and maintained. Construction techniques techniques and specifications, through period tear and operator and Machinery selection to minimize equipment - safety contract safety, efficient ground disturbance. Proper estimated noise provisions

280

Project Potential Mitigation Action Parameters to be Standards70/ Institutional Implementat Activity Environmental Monitored Measurement/ Responsibilit ion Impact Frequency y and Costs Schedule operation. maintenance and turning off plant not emissions and regulations, under in use. Noise barriers will be installed operating schedules. Noise control supervision of to reduce incidence of noise to local regulations- MOH. residents. Quarterly. Construction Increased land Separate gates used for construction Access gates, road, Construction Contractor Construction of access requirement for and maintenance access to the site locations (length and drawings for through period road for temporary wherever possible. width of access access restricted contract ingress into accessibility. roads). to from normal provisions premises Hospital under entrances not supervision of used by patients. MOH. Ecological Resources Site Vegetation. Marking of any vegetation to be Vegetation marking Clearance strictly Contractor Construction clearance. removed prior to clearance, and strict and clearance limited to target through period control on clearing activities to ensure control (area in m2). vegetation – contract minimal clearance. Construction Once. provisions Company will replant or transplant under trees to be cut within the supervision of FHC/SHC/Hospital premises. MOH. Trimming/cutti Loss of vegetation and Trees that can survive pruning to Species-specific tree Presence of MOH, Construction ng of trees deforestation. comply should be pruned instead of retention as target species Contractor period within cleared. Felled trees and other cleared approved by through FHC/SHC/Ho or pruned vegetation to be disposed of statutory authorities contract spital as authorized by the statutory bodies. (average and provisions boundary. Construction Company will replant or maximum tree height under transplant trees to be cut within the at maturity, in supervision of FHC/SHC/Hospital premises. meters). department Human Environment Construction Noise nuisance to No construction activities undertaken Timing of Construction as MOH, Construction schedules for neighbouring during the night and local communities construction (noise per Scheduled Contractor period. FHC/SHC/Ho properties. informed of the construction schedule. emissions in decibels timings only. through spitals. Noise barriers will be installed to (dBA). contract reduce incidence of noise to local provisions. 281

Project Potential Mitigation Action Parameters to be Standards70/ Institutional Implementat Activity Environmental Monitored Measurement/ Responsibilit ion Impact Frequency y and Costs Schedule residents. Temporary Losses to Contract clauses specifying careful Contract clauses Incorporating Contractor Construction use of land. neighbouring land construction practices. Design basis and good construction through period. uses/ values. layout. management, contract design provisions Land will be reinstated following Reinstatement of engineering under completion of construction. land status (area practices. supervision of affected, m2). C MOH Transportatio Nuisance to the Develop tranffic management plan to Water, Air Quality Mongolian Contractor Construction n and storage general public. minimize safety risk to road users at and Noise in Emission through period. of materials. hospital etc. Transport loading and decibels (dBA). standards and contract unloading of construction materials Water Quality provisions should not cause nuisance to the standards - under people by way of noise, vibration and Quarterly. supervision of dust. MOH. Avoid storage of construction materials beside the road, around water bodies, residential or public sensitive locations. Conduct a pre-reconnissance survey of road condition to ensure that no structure would be damaged by vibrations etc to avoid future claims Construction materials should be stored in covered areas to ensure protection from dust, emissions and such materials should be bundled in environment friendly and nuisance free manner. Temporary Loss of power supply Advance notice to the public about the Power disruption to Regular Contractor Throughout outage of the to the local community time and the duration of the utility houses and monitoring during through the electricity when distribution lines disruption. commercial the period of contract construction crossing the new premises. strengthening the provisions period. FHC/SHC/Hospitals conductors under Restore the utilities immediately to are switched off. supervision of

282

Project Potential Mitigation Action Parameters to be Standards70/ Institutional Implementat Activity Environmental Monitored Measurement/ Responsibilit ion Impact Frequency y and Costs Schedule overcome public inconvenience. MOH Health and Injury and sickness of Contract provisions specifying Contract clauses MOH and ADB Contractor Construction safety workers and members minimum requirements for construction (number of incidents Health and safety through period. of the public. camps72 if any. Drinking water to be and total lost-work standards - contract provided as per national and days caused by Monthly. provisions international drinking water standards73 injuries and under (whichever are most stringent). sickness). supervision of MOH.

Contractor to prepare and implement a health and safety plan and provide workers with required PPE.

Contractor to arrange for health and safety awareness programmes including on AIDS and sexually transmitted diseases (STD). Oil spillage Contamination of Develop pollution prevention plan to FHC/SHC/Hospitals Guideline on Contractor Construction due to land/nearby water ensure that all fuel, oil, chemical are bounding Transportation, through period. construction bodies. stored in 110% bundled area with (“as-built” diagrams)- storage, use and contract vehicles etc. impermeable floor, Monthly. disposal of toxic provisions Record of all oil spillage at and hazardous under FHC/SHC/Hospitals chemicals (2009) supervision of - Yearly MOH. Community Injury and accidents Installation of proper warning signage, Contract clauses EHS guidelines, Contractor Construction Health and caused to residents in installation of sheet barriers to avoid (number of incidents MN Health and through period. Safety the area people, children, animals falling into caused by injuries safety standards - contract trenches, or projectile material hitting and accidents in Monthly. provisions the residents walking by or damaging neighbourhood). under property supervision of

72 Construction Company to use EBRD/IFC guideline on worker accommodation for no. of toilets etc. 73 According to Annexure 5 (EHS Guidelines) 283

Project Potential Mitigation Action Parameters to be Standards70/ Institutional Implementat Activity Environmental Monitored Measurement/ Responsibilit ion Impact Frequency y and Costs Schedule MOH. Capacity Improve standards of Training of MOH. Training schedules. Number of MOH, Construction Building implementation and training program - contractor as period. monitoring. Yearly. part of provisions. Operation and Maintenance Phase

Physical Resources Operation of Electric sparks, fire Record of all FHC/SHC/Hospitals FHC/SHC/Hospitals MNS: 0640 FHC/SHC/Hos Throughout Electrical and explosion electrical switchbox located within electricity distribution (1989) Fire safety pital, part of the safety secure casings. boards – Monthly. standard - O&M costs operation. systems, fire Monthly safety systems. Environmental Resources Oil spillage. Contamination of Develop pollution prevention plan FHC/SHC/Hospitals Guideline on FHC/SHC/Hos Throughout land/nearby water to ensure that all fuel, oil, chemical bounding Transportation, pital, part of the operation bodies. are stored in 110% bundled area (“as-built” diagrams)- storage, use and O&M costs with impermeable floor, Monthly. disposal of toxic and hazardous Record of all oil spillage at chemicals (2009) FHC/SHC/Hospitals - Yearly Ecological Recourses Replanted Replanted trees die Proper upkeep, water etc. for ensuring Revival of plant Regular FHC/SHC/Hos Throughout Trees tree regenerate pital, part of operations O&M costs Human Environment Effluent Chemicals from FHC/SHC/Hospital to ensure that Water discharge Waste water FHC/SHC/Hos Throughout Management Chemistry laboratory, chemistry class effluent is collected parameters as standards – pital, part of operations from sewage flowing into and disposed off to the District Branch specified in EMoP quarterly O&M costs FHC/SHC/Ho city drains of Emergency Management Agency spital In cases where wastewater is not

284

Project Potential Mitigation Action Parameters to be Standards70/ Institutional Implementat Activity Environmental Monitored Measurement/ Responsibilit ion Impact Frequency y and Costs Schedule discharged to sanitary sewage EHS Health Care systems, FHC/SHC/Hospital should Facilities ensure that wastewater receives on- guidelines site primary and secondary treatment, in addition to chlorine disinfection. Maintenance and regular upkeep of septic tanks and holding tanks by to avoid surface discharge. Training on Lack of awareness for Training of personnel on safety and Training schedules. Number of FHC/SHC/Hos Operation Health and health and safety emergency response in compliance training program- pital, part of safety and procedure. with District’s Emergency Management Yearly. O&M costs emergency Agency requirements response Segregation Nuisance to local Training of personnel in proper Training by PIU Number of FHC/SHC/Hos Operation of Solid waste community segregation and storage and waste at training program- pital, part of hospital Yearly. O&M costs Health Care Risk of infectious Proper disposal of waste such as Quantities of wastes Wastewater and FHC/SHC/Hos Operations Waste diseases to sharps, bandages, medical hazardous waste pital, part of community, staff wastewater, medical waste, chemicals disposal O&M costs etc. standards-daily Management Low ambient air quality Monitoring of HOBs operations to Air quality and Air quality and FHC/SHC/Hos Operation of emissions inside premises ensure the air emissions, ash handling contamination of soil soil contamination pital, part of from HOB etc. are within permissible limits74 standards – every O&M costs six months O&M of Loss of heating, high Insulation to ensure efficient operations Energy efficiency Energy FHC/SHC/Hos Operation building operational costs parameters conservation pital, part of equipment- norms of O&M costs heating, buildings – building Once/year insulation and

74 All HOB’s must adhere to the Mongolian standards - MNS 5457- 2005 “Maximum acceptable level and measuring method of toxic elements (CO, SO2, NOx, ash) in the exhaust gases contents of heating boilers and home stoves”. The same is attached in Annexure 1 Table A1.8. 285

Project Potential Mitigation Action Parameters to be Standards70/ Institutional Implementat Activity Environmental Monitored Measurement/ Responsibilit ion Impact Frequency y and Costs Schedule generators etc. Electric shock Death or injury to the Security warnings around fittings. Proper maintenance Periodic FHC/SHC/Hos Throughout or accidents staff and public. Careful design using appropriate of distribution boxes maintenance. pital, part of the operation technologies to minimize hazards. and sign boards. O&M costs Usage of appropriate Number of technologies (lost programmes and work days due to percent of staff/ injuries). workers covered.

286

Annexure – 5: Environment Monitoring Plan (Environmental Parameters)

Environmental Project stage Parameters Sampling Location Monitoring Regulatory Standards for Agency component to be Frequency parameter responsible monitored for implementati on 1.Air Quality A. Pre-construction PM10, Boundary of One time National Air quality standards MOH as part and Design stage PM2.5, SO2, FHC/SHC/Hospitals of MNS 4585- 2016 “Air of design (Baseline NOx, SPM, quality. General technical development) CO (Visible requirements” (Maximum dust) acceptable level of toxic elements in outdoor air) B. Construction PM10, Boundary of Monthly National Air quality standards Construction Stage PM2.5, SO2, FHC/SHC/Hospitals of MNS 4585- 2016 “Air Company as NOx, SPM, quality. General technical part of contract CO (Visible requirements” (Maximum provisions dust) acceptable level of toxic elements in outdoor air) C. Operation Stage PM10, Boundary of One time at National Air quality standards FHC/SHC/Hos PM2.5, SO2, FHC/SHC/Hospitals commissioning of MNS 4585- 2016 “Air pitals as part NOx, SPM, quality. General technical of O&M costs CO (Visible requirements” (Maximum dust) acceptable level of toxic elements in outdoor air) 2.Water Quality A. Pre-construction EC, TSS, Nearest well near One time National water quality MOH as part and Design stage DO, BOD, FHC/SHC/Hospital standards of MNS 4586:1998. of design (Baseline PH Oil and Use full suite of testing as per development) grease, IFC EHS Safety standards in Pb,Coliforms Annexure 2, Table A2.6 B. Construction EC, TSS, Nearest well near One time National water quality Construction Stage DO, BOD, FHC/SHC/Hospital standards of MNS 4586:1998. Company as PH Oil and Use full suite of testing as per part of contract grease, Pb, IFC EHS Safety standards in provisions Coliforms Annexure 2, Table A2.6 C. Operation Stage EC, TSS, Nearest well near One time at National water quality FHC/SHC/Hos 287

Environmental Project stage Parameters Sampling Location Monitoring Regulatory Standards for Agency component to be Frequency parameter responsible monitored for implementati on DO, BOD, FHC/SHC/Hospital commissioning standards of MNS 4586:1998. pitals as part PH Oil and Use full suite of testing as per of O&M costs grease, Pb, IFC EHS Safety standards in Coliforms Annexure 2, Table A2.6 3.Noise/ A. Pre-construction Monitor Boundary of One time National standards for Noise MOH as part Vibration and Design stage noise over FHC/SHC/Hospitals MNS 4585:2007 of design (Baseline 48 hr period, development) in 1hr LA eq. Noise level [dB(A)] B. Construction Monitor Boundary of Monthly National standards for Noise Construction Stage noise over FHC/SHC/Hospitals MNS 4585:2007 Company as 48 hr period, part of contract in 1hr LA eq. provisions Noise level [dB(A)] C. Operation Stage Monitor Boundary of One time at National standards for Noise FHC/SHC/Hos noise over FHC/SHC/Hospitals commissioning MNS 4585:2007 pitals as part 48 hr period, of O&M costs in 1hr LA eq. Noise level [dB(A)] 4. Soil A. Pre-construction Visible spills 1 location inside One time Guideline on Transportation, MOH as part and Design stage to and/or soil FHC/SHC/Hospitals storage, use and disposal of of design ensure pre-existing staining, Oil toxic and hazardous condition of area. & grease chemicals (2009) B. Construction Visible spills 1 location inside One time Guideline on Transportation, Construction Stage and/or soil FHC/SHC/Hospitals storage, use and disposal of Company as staining, Oil toxic and hazardous part of contract & grease chemicals (2009) provisions C. Operation Stage Visible spills 1 location inside One time at Guideline on Transportation, FHC/SHC/Hos

288

Environmental Project stage Parameters Sampling Location Monitoring Regulatory Standards for Agency component to be Frequency parameter responsible monitored for implementati on and/or soil FHC/SHC/Hospitals commissioning storage, use and disposal of pitals as part staining, Oil toxic and hazardous of O&M costs & grease chemicals (2009) Health and Construction No of Inside contraction Record at time of Occupation health and safety Construction Safety accidents or area accident standards of Mongolia as well Company as hours lost as EHS Construction and part of contract Demolition provisions Operations No of Inside Hospital Record at time of Occupation health and safety FHC/SHC/Hos accidents or premises accident standards of Mongolia as well pitals as part heours lost as EHS Health Care facilities of O&M Costs. Abbreviations: SO2- -Sulphur Dioxide; NO2- - Nitrogen Dioxide; CO- Carbon Monoxide; Pb – Lead; PM2.5 - Particulate Matter <2.5; PM10 - Particulate Matter <10; EC – Electric Conductivity; TSPM- Total Suspended Particulate Matter; DO - Dissolved Oxygen; TSS - Total Suspended Solids; BOD - Biological Oxygen Demand; ORP – Oxidation Reduction Potential; NAAQS - National Ambient Air Quality Standards specified by MET

289

5a. Environmental Safeguard Clauses for Civil Works Contracts The general environment, health and safety obligations of the Contractor within this Contract, without prejudice to other official provisions in force, include the following:  The Contractor shall ensure that the construction and decommissioning of project facilities comply with (a) all applicable laws and regulations of Mongolia relating to environment, health and safety; (b) the Environmental Safeguards stipulated in ADB’s Safeguards Policy Statement (2009); and (c) all measures and requirements set forth in the Tranche-1 IEE and environmental management plan (EMP).  The Contractor shall establish a telephone hotline to received community complaints, staffed at all times during working hours. Contact details shall be prominently displayed at the sites. The Contractor shall disseminate in a timely manner information on the construction progress, including anticipated activities that might cause safety risk.  The Contractor shall secure all necessary permits and licenses before undertaking the works.  The Contractor shall assign sufficient qualified staff to manage SEMP implementation, one staff of health and safety and ensure adequate financial resources are available to implement the site-EMP throughout the construction period.  The Contractor shall keep records H&S incidents and report any near miss or fatal to ADB in 24 hr with corrective action; provide equal pay for equal work, regardless of gender or ethnicity; provide those they employ with a written contract; provide the timely payment of wages; use local unskilled labour, as applicable, comply with core labour standards and the applicable labour laws and regulations, including stipulations related to employment, e.g. health, safety, welfare and the workers’ rights, and anti-trafficking laws; and not employ child labour. The Contractor shall maintain records of labour employment, including the name, ethnicity, age, gender, domicile, working time, and the payment of wages.  All buildings shall be designed in compliance with relevant the Government of Mongolia’s design standards and codes for energy-efficient, safe buildings, including but not limited to: Mongolian national standards (MNS) 3838: 2008 and Construction standard package # 91.040. Only low or no volatile organic compound (VOC)-emitting materials shall be used (including paints, coatings, adhesives, carpet and furniture’s) to ensure high indoor air quality. Water-based nontoxic, no allergenic paint for drywall or plaster surfaces shall be preferred to latex or oil-based paints. All facilities shall be properly sited to minimize the risk of scouring that may result from increase intensity of precipitation as a result of climate change.  Existence of any hazardous materials, such as asbestos, in the current facilities shall be determined prior to development of design. If renovation or refurbishment for any component requires removal of asbestos containing materials (ACM), the particular activity will be dropped from funding.  The Contractor shall take necessary precautions to avoid interruptions to water supply, wastewater collection, heating and other utility services during the civil works. 290

 The Contractor shall prepare a construction site-EMP based on the Tranche-1 construction EMP.  The Contractor shall take appropriate sanctions against personnel violating the applicable specifications and provisions on environment, health and safety.  The Contractor shall document, and systematically report to the FHC/SHC/Hospital management and the project implementation unit (PIU), of each incident or accident, damage or degradation caused to the environment, workers or residents or their assets, in the course of the works.  The Contractor shall provide all relevant information about the Tranche-1 EMP and the Site-EMP to subcontractor/s and be responsible for their actions.  The Contractor shall provide the FHC/SHC/Hospital administration and the PIU with a written notice of any unanticipated environmental, health and safety risks or impacts that arise during implementation of the contract that were not considered in the Tranche-1 EMP.

291

5b. Environmental Site Inspection and Monitoring Checklist

Note: This form is designed for use by the project implementation unit (PIU) project coordinator during site inspections and monitoring and may not be exhaustive. Modifications and additions may be necessary to suit individual sub-projects and to address specific environmental issues and mitigation measures.

Name of FHC/SHC/Hospital: ______Location: ______Inspection Date: ______Inspection Time: ______Inspector(s): ______

Inspection Item Yes No N.A. Remarks (i.e. problem observed, possible cause of nonconformity and/or proposed corrective/ preventative actions) Has contractor appointed a construction supervisor and is the supervisor on-site? Is information pertaining to construction disclosed at construction site (including construction period, contractor information, grievance hotline, etc.)? Are chemicals/hazardous products and waste stored on impermeable surfaces in secure, covered areas? Is there evidence of oil spillage? Are chemicals stored and labelled properly? Is construction equipment well maintained (any black smoke observed)? Is there evidence of excessive dust generation? Are there enclosures around the main dust-generating activities? Does contractor regularly consult with FHC/SHC/Hospital management as well as nearby residents to identify concerns? Is there evidence of excessive noise? Any noise mitigation measures adopted (e.g. use noise barrier / enclosure)? Is construction wastewater and domestic wastewater discharged to sewer systems (if possible), or are on-site treatment facilities (septic tank) provided? Is there any wastewater discharged to soil or surface water?

292

Inspection Item Yes No N.A. Remarks (i.e. problem observed, possible cause of nonconformity and/or proposed corrective/ preventative actions) Is the site kept clean and tidy (e.g. litter free, good housekeeping)? Are separated labelled containers/areas provided for facilitating recycling and waste segregation? Are construction wastes/recyclable wastes and general refuse removed off site regularly? Does the site contain any hazardous material such as Asbestos, others etc. Is safe supply of clean water and an adequate number of toilets provided for workers? Is personal protection equipment provided for workers? Are clear information and warning signs placed at construction sites in view of the patients and staff as well as the public? Are all construction sites made secure, discouraging access through appropriate fencing? Are disturbed areas properly re-vegetate after completion of works? Were any complaints filed with the contractor, and have staff and nearby residents raised any concerns related to the performance of contractor? Any other problems identified or observations made?

______Date, Name and Signature of PIU staff/ consultant

293

Annexure - 6: Sample Environment Monitoring Report

Environmental Safeguards Document

Environment Monitoring Report ( -XX)

Document Stage: Project Number: Period – Reporting –

Mongolia: Improving Access to Health Services for Disadvantaged Groups

Prepared by Ministry of Health (MOH) for Asian Development Bank

The environment monitoring report is a document of the borrower. The views expressed herein do not necessarily represent those of ADB's Board of Directors, Management, or staff, and may be preliminary in nature.

294

Table of Contents

Page

Executive Summary

Brief status of environmental compliance during the coverage period

1.0 Introduction

1.1 Brief Project Description 1.2 Project Progress Status and Implementation Schedule

2.0 Compliance to National Regulations

2.1 Environmental Conservation

3.0 Compliance to Environmental Covenants from the ADB Loan Agreement

3.1 Schedule 5 Environment (prepare a matrix to show how compliance was achieved)

4.0 Compliance to Environmental Management Plan

(Refer to the EMP of the Project)

5.0 Safeguards Monitoring Results and Unanticipated Impacts

(Refer to the Environmental Monitoring Plan and document any exceedance to environmental standards (if any), or any unanticipated impact not included in the EMP and any correction action/measures taken)

6.0 Implementation of Grievance Redress Mechanism and Complaints Received from Stakeholders

(Summary of any complaint/grievance and the status of action taken)

7.0 Conclusion and Recommendations

295

Annexure - 7: Details of Public Consultation (Environment) 1. Details of Public Consultation (Environment) (1-4) No Participants’ opinion, comments and suggestions from consultation meetings with residents of surrounding area of sites. Issues 1. FHC at 10th 2. FHC at 14th 3. FHC at 19th 4. FHC at 17th Khoroo in KUD Khoroo in KUD Khoroo in Khoroo in CNGTD BYZD 1 2 3 4 1 Do you support for the Yes – 121 Yes – 60 (98%) Yes – 37 (100%) Yes – 54 (97%) construction at (100%) No – 1 No – 2 FHC/SHC/Hospital? 2 Do you have sufficient Sufficient – 50 Sufficient – 8 Sufficient – 11 Sufficient – 34 access to health services Not sufficient – Not sufficient – Not sufficient – Not sufficient – in your community? 71 53 27 20 Not answered – 2 3 Will this construction at Yes – 19 Yes – 1 Yes – 5 Yes – 7 FHC/SHC/Hospital give No – 102 No – 44 No – 31 No – 46 any negative impact to Not answered – Not answered – Not answered – your apartment complex? 16 1 3 4 What benefits do you Increased Increased Increased Increased perceive from this capacity – 46 capacity – 9 capacity – 16 capacity – 25 construction? Improved health Improved health Improved health Improved health service – 70 service – 52 service – 21 service – 31 Not answered – 5 5 Would you have any Yes – 18 Yes – 2 Yes – 3 Yes – 14 problem with No – 98 No – 56 No – 33 No – 42 FHC/SHC/Hospital if Not answered – Not answered – Not answered – construction company 5 3 1 makes access road in your parking area, dig any pipeline etc. for repair for diversion? 6 Would you be having Yes – 19 Yes – 14 Yes – 9 Yes – 19 trouble if construction No – 98 No – 43 No – 28 No – 36 causes some dust during Not answered – Not answered – Not answered – digging and storing in the 4 2 1 FHC/SHC/Hospital premises? 7 Will you have a problem if Yes – 16 Yes – 5 Yes – 3 Yes – 12 the construction company No – 102 No – 43 No – 34 No – 43 required to work during Not answered – Not answered – Not answered – the night to bringing 3 13 11 construction material and have earthworks that would cause noise? 8 Will you have a problem if Yes – 13 Yes – 4 Yes – 3 Yes – 11 the construction activity No – 98 No – 48 No – 34 No – 44 generates extreme Not answered – Not answered – Not answered – vibration and noise such 10 9 1 as concreting, cutting, 296 No Participants’ opinion, comments and suggestions from consultation meetings with residents of surrounding area of sites. Issues 1. FHC at 10th 2. FHC at 14th 3. FHC at 19th 4. FHC at 17th Khoroo in KUD Khoroo in KUD Khoroo in Khoroo in CNGTD BYZD 1 2 3 4 digging etc.? 9 Are you concerned about Yes- 52 Yes- 32 Yes- 18 Yes- 23 Health & Safety of No – 61 No – 21 No – 18 No – 31 patients, residents and Not answered – Not answered – Not answered – Not answered – staff during the 8 8 1 2 construction? 10 Would you like to Yes- 87 Yes- 42 Yes- 24 Yes- 38 participate in safety No – 29 No – 11 No – 11 No – 13 monitoring and controlling Not answered – Not answered – Not answered – Not answered – activities? And Would you 5 8 2 5 be willing to form a Committee to help to FHC/SHC/Hospital during the construction period? 11 Any other critical Yes- 8 Yes- 2 Yes- 7 Yes- 6 environment related issue No – 98 No – 42 No – 28 No – 43 and concern by the Not answered – Not answered – Not answered – Not answered – residents for the during 15 17 2 7 construction and operation stage? 12 If you have any problem To Khoroo or To Khoroo or To Khoroo or To Khoroo or caused by this district district district district FHC/SHC/Hospital administration – administration – administration – administration – construction, whom would 39 35 21 28 you like to contact? To hospital/FHC To hospital/FHC To hospital/FHC To hospital/FHC (Construction company, management – management – 7 management – 6 management – FHC/SHC/Hospital, urban 20 To construction To construction 9 department etc.) To construction company - 5 company - 1 To construction company - 15 I don’t know - 14 I don’t know - 9 company - 8 I don’t know - I don’t know - 47 11 13 What would you expect to Increased Increased Increased Increased improve at current capacity – 83 capacity – 50 capacity – 33 capacity – 41 building (such as Connected to Connected to Connected to Connected to changing coal heating to central lines – 5 central lines – 3 central lines – 2 central lines – electric heating etc.) I don’t know – I don’t know – 8 I don’t know – 2 15 33 14 Any shops/commercial Yes – 7 Yes – 2 Yes – 1 Yes – 4 establishments and No – 107 No – 52 No – 35 No – 49 industrial activity disturbed Not answered – Not answered – Not answered – Not answered – by this construction? 7 7 1 3 15 What other organizations Yes, there is – Yes, there is – 7 Yes, there is – 6 Yes, there is – 4 of environment & nature 23 (Tuuliin Har No, there are not No, there are not No, there are conservation Shugui NGO) any NGO – 54 any NGO – 31 not any NGO – (NGOs/CBOs/ Civil No, there are 52 Society) active in the not any NGO – area? Name of these 94 297 No Participants’ opinion, comments and suggestions from consultation meetings with residents of surrounding area of sites. Issues 1. FHC at 10th 2. FHC at 14th 3. FHC at 19th 4. FHC at 17th Khoroo in KUD Khoroo in KUD Khoroo in Khoroo in CNGTD BYZD 1 2 3 4 organizations Not answered – 4 16 Any other issues or Pay attention to We want a FHC The planned Green areas for comments? construction with in-patient construction site new FHC safety department is currently being Traffic safety They want a Quality of the used as parking new FHC new building is space for the urgently. important Khoroo administration FHC shall have office, thus a garage provide solution on new parking space for the Khoroo

2. Details of Public Consultation (Environment) (continuing-5-8) No Participants’ opinion, comments and suggestions from consultation meetings with residents of surrounding area of sites. Issues 5. Khan-Uul 6. Emergency 7. Khovd 8. Uvs hospital at Center in UB Hospital in Hospital in KUD Khovd city Ulaangom town 5 6 7 8 1 Do you support for the Yes – 37 Yes – 28 (96.5%) Yes – 43 Yes – 75 construction at (97.4%) I don’t know – 1 (100%) (100%) FHC/SHC/Hospital? No – 1 2 Do you have sufficient Yes – 6 Yes – 12 Yes – 17 Yes – 26 access to health services No – 32 No – 12 No – 25 No – 46 in your community? (84.2%) Not answered – 5 Not answered – 3 3 Will this construction at Yes – 13 Yes – 8 Yes – 13 Yes – 18 FHC/SHC/Hospital give No – 25 No – 20 No – 29 No – 53 any negative impact to your apartment complex? 4 What benefits do you Better access Better access to Better access to Better access perceive from this to health health services – health services to health construction? services – 32 28 – 17 services – 58 I don’t know – Not answered - 1 Increased Increased 2 capacity – 23 capacity – 10 Not answered Not answered - Not answered - - 4 3 7 5 Would you have any Yes – 10 Yes – 12 Yes – 12 Yes – 18 problem with No – 23 No – 17 No – 29 No – 56 FHC/SHC/Hospital if Not answered Not answered – construction company – 5 2 makes access road in your parking area, dig any pipeline etc. for repair for diversion? 6 Would you be having Yes – 19 Yes – 12 Yes – 14 Yes – 24 trouble if construction No – 15 No – 16 No – 27 No – 49 causes some dust during Not answered Not answered - 1 Not answered – Not answered -

298 No Participants’ opinion, comments and suggestions from consultation meetings with residents of surrounding area of sites. Issues 5. Khan-Uul 6. Emergency 7. Khovd 8. Uvs hospital at Center in UB Hospital in Hospital in KUD Khovd city Ulaangom town 5 6 7 8 digging and storing in the - 4 2 2 FHC/SHC/Hospital premises? 7 Will you have a problem if Yes- 9 Yes- 2 Yes- 8 Yes- 23 the construction company No – 24 No – 25 No – 33 No – 52 required to work during the Not answered Not answered - 2 Not answered – night to bringing - 5 2 construction material and have earthworks that would cause noise? 8 Will you have a problem if Yes – 8 Yes – 11 Yes – 11 Yes – 16 the construction activity No – 23 No – 16 No – 31 No – 54 generates extreme Not answered Not answered - 2 Not answered – Not answered - vibration and noise such as - 7 1 5 concreting, cutting, digging etc.? 9 Are you concerned about Yes – 16 Yes – 9 Yes – 17 Yes – 39 Health & Safety of patients, No – 12 No – 14 No – 23 No – 31 residents and staff during Not answered Not answered – 6 Not answered – Not answered the construction? - 10 3 – 5 10 Would you like to Yes- 20 Yes- 16 Yes- 29 Yes- 57 participate in safety No – 7 No – 8 No – 9 No – 14 monitoring and controlling Not answered Not answered – 5 Not answered – Not answered activities? And Would you - 11 5 – 4 be willing to form a Committee to help to FHC/SHC/Hospital during the construction period? 11 Any other critical Yes- 12 Yes- 5 Yes- 4 Yes- 23 environment related issue No – 9 No – 18 No – 32 No – 41 and concern by the Not answered Not answered – 6 Not answered – Not answered residents for the during – 17 7 – 11 construction and operation stage? 12 If you have any problem To Khoroo or To Khoroo or To Khoroo or To Khoroo or caused by this district district district district FHC/SHC/Hospital administration administration – 14 administration – administration construction, whom would – 19 To hospital/FHC 6 – 16 you like to contact? To management – 14 To hospital/FHC To (Construction company, hospital/FHC I don’t know - 1 management – hospital/FHC FHC/SHC/Hospital, urban management 19 management – department etc.) – 5 I don’t know - 39 I don’t know - 18 Construction 14 company-12 I don’t know - 2 13 What would you expect to Increased Increased capacity Increased Increased improve at current building capacity – 22 – 13 capacity – 13 capacity – 27 (such as changing coal Connected to Better service & Connected to Connected to heating to electric heating central equipment – 12 central central etc.) networks – 1 Not answered - 4 networks – 5 networks – 15 Better service Better service & Better service & equipment equipment – 25 & equipment – – 5 21 Not answered Not answered - 299 No Participants’ opinion, comments and suggestions from consultation meetings with residents of surrounding area of sites. Issues 5. Khan-Uul 6. Emergency 7. Khovd 8. Uvs hospital at Center in UB Hospital in Hospital in KUD Khovd city Ulaangom town 5 6 7 8 - 11 12 14 Any shops/commercial Yes- 3 Yes- 3 Yes- 1 Yes- 6 establishments and No – 24 No – 21 No – 39 No – 62 industrial activity disturbed Not answered Not answered – 5 Not answered – Not answered by this construction? – 11 3 – 7 15 What other organizations Yes, there is Yes, there is – 2 Yes, there is – Yes, there is – of environment & nature – 2 No, there are not 16 14 conservation No, there are any NGO – 18 No, there are No, there are (NGOs/CBOs/ Civil not any NGO Not answered – 9 not any NGO – not any NGO – Society) active in the area? – 24 24 50 Name of these Not answered Not answered – Not answered organizations – 12 3 – 11 16 Any other issues or # of in-patient There will be Khovd hospitals Availability of comments? beds or disturbance on will be provided entrance for capacity must staffs and patients with medical disabled be increased of the neighbouring equipment people, noticeably Lux Med hospital within another (a private hospital project funded Occupational in the next by Belgium safety during building) government. the Traffic Safety ADB need to construction, concerns make sure it Quality of the won’t provide new extension the same building equipment or repeat. Pay attention to safety during construction

3. Details of Public Consultation (Environment) (continuing-9-13) No Participants’ opinion, comments and suggestions from consultation meetings with residents of surrounding area of sites. Issues 9. SHC in 10. SHC in 11. SHC in 12. SHC in 13. SHC in Erdeneman Tarialan Bayan- Erdene Dashinchilen dal Soum Soum Undur Soum Soum Soum 9 10 11 12 13 1 Do you support for Yes – 134 Yes – 123 Yes – 82 Yes – 88 Yes – 154 the construction at (100%) (98%) (100%) (97%) (97%) FHC/SHC/Hospital ? 2 Do you have Sufficient – Sufficient – 92 Sufficient – Sufficient – Sufficient – sufficient access to 60 Not sufficient- 47 41 121 health services in Not 31 Not Not sufficient Not sufficient your community? sufficient–60 sufficient-35 – 47 – 33 Not Not answered answered – – 5 0 3 Will this Yes – 0 Yes – 1 Yes – 0 Yes – 5 Yes – 7 construction at No – 130 No – 122 No – 81 No – 83 No – 147 FHC/SHC/Hospital Not Not answered- Not Not Not answered

300 No Participants’ opinion, comments and suggestions from consultation meetings with residents of surrounding area of sites. Issues 9. SHC in 10. SHC in 11. SHC in 12. SHC in 13. SHC in Erdeneman Tarialan Bayan- Erdene Dashinchilen dal Soum Soum Undur Soum Soum Soum 9 10 11 12 13 give any negative answered-4 0 answered – answered – – 5 impact to your 1 0 apartment complex? 4 What benefits do Increased Increased Increased Increased Increased you perceive from capacity – 30 capacity – 27 capacity – capacity – capacity – 45 this construction? Improved Improved 42 33 Improved health health service Improved Improved health service service – 92 – 96 health health – 101 Not service – 40 service – 55 answered – 12 5 Would you have Yes – 5 Yes – 6 Yes – 1 Yes – 6 Yes – 8 any problem with No – 125 No – 115 No – 81 No – 75 No – 145 FHC/SHC/Hospital Not Not answered Not Not Not answered if construction answered – – 2 answered – answered – – 6 company makes 4 0 7 access road in your parking area, dig any pipeline etc. for repair for diversion? 6 Would you be Yes – 18 Yes – 8 Yes – 8 Yes – 14 Yes – 17 having trouble if No – 113 No – 115 No – 74 No – 70 No – 138 construction Not Not answered Not Not answered causes some dust answered – – 0 answered – – 4 during digging and 3 4 storing in the FHC/SHC/Hospital premises? 7 Will you have a Yes – 15 Yes – 3 Yes – 0 Yes – 8 Yes – 5 problem if the No – 118 No – 117 No – 82 No – 78 No – 153 construction Not Not answered Not Not answered company required answered – – 3 answered – – 1 to work during the 1 2 night to bringing construction material and have earthworks that would cause noise? 8 Will you have a Yes – 6 Yes – 4 Yes – 1 Yes – 1 Yes – 5 problem if the No – 125 No – 116 No – 81 No – 81 No – 150 construction Not Not answered Not Not answered activity generates answered – – 3 answered – – 4 extreme vibration 3 6 and noise such as concreting, cutting, digging etc.? 9 Are you concerned Yes- 44 Yes- 29 Yes- 7 Yes- 29 Yes- 49 about Health & No – 75 No – 82 No – 74 No – 47 No – 102 Safety of patients, Not Not answered Not Not Not answered residents and staff answered – – 12 answered – answered – – 8 during the 15 1 12 301 No Participants’ opinion, comments and suggestions from consultation meetings with residents of surrounding area of sites. Issues 9. SHC in 10. SHC in 11. SHC in 12. SHC in 13. SHC in Erdeneman Tarialan Bayan- Erdene Dashinchilen dal Soum Soum Undur Soum Soum Soum 9 10 11 12 13 construction? 10 Would you like to Yes- 66 Yes- 81 Yes- 69 Yes- 48 Yes- 97 participate in No – 62 No – 36 No – 11 No – 19 No – 53 safety monitoring Not Not answered- Not Not Not answered and controlling answered – 6 answered – answered – – 9 activities? And 6 2 11 Would you be willing to form a Committee to help to FHC/SHC/Hospital during the construction period? 11 Any other critical Yes- 17 Yes- 14 Yes- 4 Yes- 9 Yes- 18 environment No – 88 No – 92 No – 73 No – 50 No – 102 related issue and Not Not answered Not Not Not answered concern by the answered – – 15 answered – answered – – 39 residents for the 29 5 29 during construction and operation stage? 12 If you have any To Soum To Soum To Soum To Soum To Soum problem caused by administratio administration administratio administratio administration this n – 50 – 40 n – 38 n – 28 – 57 FHC/SHC/Hospital To SHC To SHC To SHC To SHC To SHC construction, management management – managemen managemen management- whom would you – 67 69 t-45 t-40 67 like to contact? To To To To To (Construction construction construction construction construction construction company, company - company - 8 company - 5 company - 4 company - 7 FHC/SHC/Hospital 17 I don’t know – I don’t know I don’t know I don’t know – , urban department I don’t know 6 – 14 – 16 28 etc.) - 0 13 What would you Increased Increased Increased Increased Increased expect to improve capacity – 58 capacity – 40 capacity – capacity – capacity – 70 at current building Connected Connected to 28 36 Connected to (such as changing to central central lines – Connected Connected central lines – coal heating to lines – 30 29 to central to central 50 electric heating Better Better lines-28 lines – 17 Better etc.) equipment- equipment-54 Better equipment-27 39 I don’t know-0 equipment- I don’t know – I don’t know 20 12 – 7 I don’t know – 6 14 Any Yes – 6 Yes – 1 Yes – 2 Yes – 2 Yes – 5 shops/commercial No – 117 No – 116 No – 77 No – 81 No – 140 establishments Not Not answered Not Not Not answered and industrial answered – – 6 answered – answered – – 14 activity disturbed 11 3 5 by this construction? 15 What other Yes, there is Yes, there is- Yes, there is Yes, there is Yes, there is

302 No Participants’ opinion, comments and suggestions from consultation meetings with residents of surrounding area of sites. Issues 9. SHC in 10. SHC in 11. SHC in 12. SHC in 13. SHC in Erdeneman Tarialan Bayan- Erdene Dashinchilen dal Soum Soum Undur Soum Soum Soum 9 10 11 12 13 organizations of – 13 36 – 10 – 10 – 20 environment & No, there are No, there are No, there No, there No, there are nature not any NGO not any NGO – are not any are not any not any NGO conservation – 116 69 NGO – 66 NGO – 64 – 127 (NGOs/CBOs/ Civil Not Not answered Not Not Not answered Society) active in answered – – 18 answered – answered – – 12 the area? Name of 5 6 14 these organizations 16 Any other issues or Construction In-patient Quality of Pay Safety comments? safety is department new SHC attention to management important, need to have building is safety during is very provide 22 beds in important, construction, important, modern accordance need the SHC Engage local equipment with MOH new facility capacity workforce in for SHC, standard, asap, needs to be construction, need X-Ray dental clinic is construction increased, Quality of the device needed, 2 safety is quality of new building storey building important new SHC is important, is needed building is Enhance important capability of doctors and nurses

List of People met during the site visit No. Name of the Occupation Contact Participant Aimag/Soum or District/Khoroo Governments 1 O.Gankhuyag Governor of 4th Khoroo of Khan-Uul District 88080763 2 N.Lodonsharav Citizen Khural Chairman of 4th Khoroo of Khan-Uul 99154470 District 3 Ts.Chinzorgt Governor of 10th Khoroo of Khan-Uul District 99108750 4 Sh.Adiyasuren Citizen Khural Board Member of 10th Khoroo of Khan- 99456258 Uul District 5 B.Sainchuluun Citizen Khural Board Member of 10th Khoroo of Khan- 99115706 Uul District 6 B.Unurjargal Coordinator at 19th Khoroo of Chingeltei district 88007151 7 Ch.Enkhbold Coordinator at 19th Khoroo of Chingeltei district 96011200 8 L.Erdenetsetseg Governor of 17th Khoroo of Bayanzurkh District 91158282 9 N.Narantsatsral Governor of 14th Khoroo of Khan-Uul District 99012514 10 N.Dorjdulam Citizen Khural Chairman of 14th Khoroo of Khan-Uul 99831842 District 11 Ts.Munkh-Erdene Citizen Khural Board Member of 14th Khoroo of Khan- 88091300 Uul District 12 B.Odontsetseg Citizen Khural Board Member of 14th Khoroo of Khan- 90110936 Uul District 13 N.Bayarmaa Citizen Khural Board Member of 14th Khoroo of Khan- 80606733 Uul District 14 S.Burneebaatar Citizen Khural Board Member of 14th Khoroo of Khan- 91430414 Uul District 15 Ts.Gandanpovron Governor of Jargalant Soum of Khovd province 99088749 16 E.Ganbayar Erdene Soum governor 96001454 303 No. Name of the Occupation Contact Participant 17 G.Altantsatsral Erdene Soum, Head of Governor’s Office 96261121 18 S.Enkhtuya Erdene Soum, Head of Citizen council 96654930 19 Ts.Khuvsguldalai Tarialan Soum governor 99383940 20 D.Batjargal Tarialan Soum, vice governor 93045454 21 D.Baasanbat Tarialan Head of Governor’s Office 96386799 22 S.Khishigdorj Bayan-Undur Soum governor 99273646, 88900117 23 Ch.Purevsuren Bayan-Undur Soum, Head of Citizen council 99717799 24 E.Nasantsogt Bayan-Undur Head of Governor’s Office 99923134 25 N.Altansuh Erdenemandal Soum, vice governor 99413316 26 Z.Batmunkh Erdenemandal Head of Governor’s Office 99330210 27 D.Luttumur Dashinchilen Soum governor 99142618 28 Ts.Bolortsetseg Head of Dashinchilen Soum governor’s office 99021761 29 B.Uuganbayar Dashinchilen Soum , 4th bag governor 99251336 30 A.Chimegee Dashinchilen Soum, Secretary of Citizen council 88075069 31 Ts.Purevjav Ulaangom Soum governor 99457001 32 N.Gantsogt Ulaangom Soum, Head of Citizen Council 99228014 33 N.Otgonbayar Head of Health Department of Uvs province 99452221 FHC/SHC/Hospitals 34 S.Ariunbold Vice Director of Emergency Center 99074710 35 Sh.Purevdash Director of Emergency Center 99117034 36 S.Akerke Head of Human Resource Department of Emergency 93135003 Center 37 B.Otgontenger General Accountant of Emergency Center 99094807 38 D.Munkhtsetseg Head of Quality Department of Emergency Center 98031036 39 B.Tanatsetseg Head of Health Service Department of Emergency Center 40 D.Baast Director of Khan-Uul District Hospital 96006135 41 S.Tsevelmaa Vice director of Khan-Uul District Hospital 99902501 42 G.Tserendolgor Quality Department of Khan-Uul District Hospital 99902502 43 D.Shurentuya HR Manager of Khan-Uul District Hospital 99682277 44 G.Odonchimeg Senior Accountant Khan-Uul District Hospital 99088093 45 B.Amarjargal Director of Khovd Hospital 99998771 46 N.Bayasgalmaa Vice director of Khovd Hospital 99837716 47 Ya.Byambadorj Head of Finance Department Khovd Hospital 95552901 48 B.Altanchimeg Head of Training and Foreign Relations Department 99143807 Khovd Hospital 49 B.Maralmaa Quality Department Khovd Hospital 99526364 50 B.Saikhantsetseg Director of FHC 14th Khoroo in Khan-Uul 99017664 51 B.Amarzaya Doctor at FHC 14th Khoroo in Khan-Uul 80787848 52 B.Chantsal Social staff at FHC 14th Khoroo in Khan-Uul 88636343 53 D.Dolgormaa Senior nurse at FHC 14th Khoroo in Khan-Uul 99560402 54 N.Yanjindulam Nurse at FHC 14th Khoroo in Khan-Uul 96017745 55 B.Ankhtuya Director of FHC at 17th Khoroo of Bayanzurkh 56 L.Bayarmaa Senior nurse at FHC 17th Khoroo of Bayanzurkh 80116933 57 M.Enkhchimeg Doctor at FHC 17th Khoroo of Bayanzurkh 88141416 58 O.Munkhtuya Social staff at FHC 17th Khoroo of Bayanzurkh 99531068 59 T.Amarjargal Nurse at FHC 17th Khoroo of Bayanzurkh 96096174 60 D.Tuul Director of FHC at 10th Khoroo of Khan-Uul 88114268 61 B.Bolormaa Doctor at FHC at 10th Khoroo of Khan-Uul 91661387 62 D.Erdenetsetseg Doctor at FHC at 10th Khoroo of Khan-Uul 70049700 63 Sh.Enkhjargal Senior nurse at FHC at 10th Khoroo of Khan-Uul 88147325 64 S.Bulgan Nurse at FHC at 10th Khoroo of Khan-Uul 99265294 65 J.Altantuul Director of FHC at 19th Khoroo of Chingeltei 99026227 66 Ts.Namjilmaa Accountant at FHC at 19th Khoroo of Chingeltei 99019368

304 No. Name of the Occupation Contact Participant 67 Ya.Yeruult Nurse at FHC at 19th Khoroo of Chingeltei 88134459 68 P.Ragchaa Senior Nurse at FHC at 19th Khoroo of Chingeltei 96049298 69 O.Odgarig Doctor at FHC at 19th Khoroo of Chingeltei 88212186 70 Sh.Tsetsegmaa SHC in Erdene Soum, director 88224661 71 S.Tsetsegsuren SHC in Erdene Soum, statistics officer 91687568 72 A.Uuganbayar SHC in Erdene Soum, social health officer 96463938 73 D.Dulamsuren SHC in Tarialan Soum, director 99384339 74 B.Ariunjargal SHC in Tarialan Soum, statistics officer 96858985 75 Erdenechimeg SHC in Tarialan Soum, social health officer 96528586 76 B.Dashdelger SHC in Bayan-Undur Soum, director 99320988 77 M.Nyamdolgor SHC in Bayan-Undur Soum, statistics officer 99952465 78 H.Oyungerel SHC in Bayan-Undur Soum, social health officer 80175898 79 J.Batsukh SHC in Erdenemandal Soum, director 99714411 80 B.Enkhtuya SHC in Erdenemandal Soum, statistics officer 99412454 81 .Shinechimeg SHC in Erdenemandal Soum, social health officer 99784276 82 M.Soyolmaa SHC in Dashinchilen Soum, director 99251738 83 Ts.Ariunbuyan SHC in Dashinchilen Soum, statistics officer, doctor 99615475 84 N.Bulgantsetseg SHC in Dashinchilen Soum, office staff 99653363 85 D. Uvs hospital, Director 99452228 86 B. Uvs hospital, Vice director 99458449 87 J. Uvs hospital, Head of Quality Control Dept 94999688 88 Ch. Uvs hospital, Head of Finance Dept 90005445

Attendance Sheet 1 (Fill One sheet per FHC/SHC/Hospital): Khan-Uul District Hospital Date 2018.05.17 Location Meeting Room of Khan-Uul Hospital Consulted Group Potentially affected people: nearby residents, hospital staffs and patients Organized by Environmental Specialist E. Khasar Structure of participants 1. Representatives of nearby settlement Artsatiin 18 Zadgai: 30 people 2. Representatives of patients of the hospital: 20 people 3. Representatives of hospital staffs: 10 people 4. Representatives of Khoroo administration: 9 people Total number of participants: 69 people. Of which 13 were male and 56 were female. Information on questionnaire- 38 people have filled in the questionnaire sheets. based survey respondents

Attendance Sheet 2 (Fill One sheet per FHC/SHC/Hospital): Khovd Hospital Date 2018.05.28 Location Meeting Room of Khovd Hospital Consulted Group Potentially affected people: residents of Jargalant Soum, hospital staffs and patients Organized by Environmental Specialist E. Khasar Structure of participants 1. Representatives of Jargalant Soum residents: 20 people 2. Representatives of patients of the hospital: 10 people 3. Representatives of hospital staffs: 26 people 4. Representatives of Khoroo administration: 1 people Total number of participants: 57 people. Of which 15 were male and 42 were female Information on questionnaire-based 43 people have filled in the questionnaire sheets. survey respondents

Attendance Sheet 3 (Fill One sheet per FHC/SHC/Hospital): Emergency Center Date 2018.05.30 Location Meeting Room of Emergency Center Consulted Group Potentially affected people: nearby offices and hospital staffs Organized by Environmental Specialist E. Khasar Structure of participants 1. Representatives of nearby office building: 11 people 2. Representatives of hospital staffs: 18 people Total number of participants: 29 people. Of which 16 were male and 13 were female. 305 Information on questionnaire- 29 people have filled in the questionnaire sheets. based survey respondents

Attendance Sheet 4 (Fill One sheet per FHC/SHC/Hospital): FHC at 14th Khoroo of Khan-Uul Date 2018.05.17 Location Meeting Room of 14th Khoroo Office, Khan-Uul district Consulted Group Potentially affected people: nearby residents, hospital staffs and Khoroo administration Organized by Environmental Specialist E.Khasar Structure of participants 1. Representatives of Khoroo residents: 60 people 2. Representatives of FHC staffs: 3 people 3. Representatives of Khoroo administration: 7 people Total number of participants: 70 people. Of which 22 were male and 48 were female. Information on questionnaire- 59 people have filled in the questionnaire sheets. 2 additional questionnaire sheets based survey respondents have been filled in after the meeting. In total, 61 people filled in the questionnaire sheets.

Attendance Sheet 5 (Fill One sheet per FHC/SHC/Hospital): FHC at 10th Khoroo of Khan-Uul Date 2018.05.18 Location Meeting Room of School #7, Nisekh area, Khan-Uul district Consulted Group Potentially affected people: nearby residents, hospital staffs and Khoroo administration Organized by Environmental Specialist E.Khasar Structure of participants 1. Representatives of nearby residents: 60 people 2. Representatives of FHC staffs: 9 people 3. Representatives of Khoroo administration: 10 people Total number of participants: 79 people. Of which 33 were male and 46 were female. Information on questionnaire- 79 people have filled in the questionnaire sheets. 42 additional questionnaire sheets have based survey respondents been filled in after the meeting. In total, 121 people filled in the questionnaire sheets.

Attendance Sheet 6 (Fill One sheet per FHC/SHC/Hospital): FHC at 19th Khoroo of Chingeltei Date 2018.05.21 Location Meeting Room of 19th Khoroo office, Chingeltei district Consulted Group Potentially affected people: nearby residents, hospital staffs and Khoroo administration Organized by Environmental Specialist E.Khasar Structure of participants 1. Representatives of Khoroo residents: 29 people 2. Representatives of FHC staffs: 4 people 3. Representatives of Khoroo administration: 4people Total number of participants: 37 people. Of which 7 were male and 30 were female. Information on questionnaire- 37 people have filled in the questionnaire sheets. based survey respondents

Attendance Sheet 7 (Fill One sheet per FHC/SHC/Hospital): FHC at 17th Khoroo of Chingeltei Date 2018.05.24 Location Meeting Room of 17th Khoroo office, Bayanzurkh district Consulted Group Potentially affected people: nearby residents, hospital staffs and Khoroo administration Organized by Environmental Specialist E.Khasar Information of participants of 1. Representatives of Khoroo residents: 55 people the consultation meeting 2. Representatives of FHC staffs: 3 people 3. Representatives of Khoroo administration: 2 people Total number of participants: 60 people. Of which 24 were male and 36 were female. Information on questionnaire- 56 people have filled in the questionnaire sheets. based survey respondents

Attendance Sheet 8 (Fill One sheet per FHC/SHC/Hospital): SHC in Erdenemandal Soum Date 2018.06.26 Location Soum governor’s office Consulted Group Potentially affected people: nearby residents, hospital staffs and Soum administration Organized by Environmental Specialist E. Khasar

306 Information of participants of Representatives of Khoroo residents: 130 people the consultation meeting 2. Representatives of FHC staffs: 12 people 3. Representatives of Soum administration: 3 people Total number of participants: 145 people. Of which 47 were male and 98 were female. Information on questionnaire- 134 people have filled in the questionnaire sheets. based survey respondents

Attendance Sheet 9 (Fill One sheet per FHC/SHC/Hospital): SHC in Tarialan Soum Date 2018.06.27 Location Soum governor’s office Consulted Group Potentially affected people: nearby residents, hospital staffs and Soum administration Organized by Environmental Specialist E. Khasar Information of participants ofRepresentatives of Soum residents 106 people the consultation meeting Representatives of FHC staffs: 15 people Representatives of Soum administration: 3 people Total number of participants: 124 people. Of which 34 were male and 90 were female. Information on questionnaire- 123 people have filled in the questionnaire sheets. based survey respondents

Attendance Sheet 10 (Fill One sheet per FHC/SHC/Hospital): SHC in Bayan-Undur Soum Date 2018.06.24 Location Soum governor’s office Consulted Group Potentially affected people: nearby residents, hospital staffs and Soum administration Organized by Environmental Specialist E. Khasar Information of participants ofRepresentatives of Soum residents: 67 people the consultation meeting Representatives of FHC staffs: 10 people Representatives of Soum administration: 5 people Total number of participants: 82 people. Of which 38 were male and 44 were female. Information on questionnaire- 82 people have filled in the questionnaire sheets. based survey respondents

Attendance Sheet 11 (Fill One sheet per FHC/SHC/Hospital): SHC in Erdene Soum Date 2018.06.29 Location Soum governor’s office Consulted Group Potentially affected people: nearby residents, hospital staffs and Soum administration Organized by Environmental Specialist E. Khasar Information of participants of Representatives of Soum residents: 87 people the consultation meeting Representatives of FHC staffs: 11 people Representatives of Soum administration: 3 people Total number of participants: 101 people. Of which 29 were male and 72 were female. Information on questionnaire 88 people have filled in the questionnaire sheets. based survey respondents

Attendance Sheet 12 (Fill One sheet per FHC/SHC/Hospital): SHC in Dashinchilen Soum Date 2018.09.19 Location Soum cultural palace Consulted Group Potentially affected people: nearby residents, hospital staffs and Soum administration Organized by Environmental Specialist E.Khasar Information of participants of Representatives of Soum residents: 126 people the consultation meeting Representatives of SHC staffs: 37 people Representatives of Soum administration: 13 people Total number of participants: 176 people. Of which 52 were male and 124 were female. Information on questionnaire 159 people have filled in the questionnaire sheets. based survey respondents 307

Attendance Sheet 13 (Fill One sheet per FHC/SHC/Hospital): Uvs Hospital Date 2018.10.16 Location Uvs Hospital Conference Room Consulted Group Potentially affected people: nearby residents, hospital staffs and Soum administration Organized by Environmental Specialist E.Khasar Information of participants of Representatives of Soum residents: 34 people the consultation meeting Representatives of SHC staffs: 38 people Representatives of Soum administration: 3 people Total number of participants: 78 people. Of which 19 were male and 59 were female. Information on questionnaire 75 people have filled in the questionnaire sheets. based survey respondents

MON: Improving Access to Health Services for Disadvantaged Groups- Tranche 1 Notes of Consultations No. Date Hospital/FHC name No. of Discussion/Responses/ Outcomes Participants Total F M 1 2018.05.17 Khan-Uul district hospital 69 56 13 1. Objective/s of the consultation were: - present the program and subprojects 2 2018.05.17 FHC at 14th Khoroo, Khan-Uul 70 48 22 - discuss potential environmental & social issues, concerns, impacts 3 2018.05.18 FHC at 10th Khoroo, Khan-Uul 79 46 33 2. Responses: - More positive than negative response/reactions 4 2018.05.21 FHC at 19th Khoroo, Chingeltei 37 30 7 on the program/subprojects, some good recommendations raised. 5 2018.05.24 FHC at 17th Khoroo, Bayanzurh 60 36 24 3. Outcomes: - Built awareness on the program and potential 6 2018.05.28 Khovd Hospital 57 42 15 impacts and benefits - Active participation in discussion and raising 7 2018.05.30 National Emergency Call 29 13 16 their views Center - Elicited their willingness to participate in 8 2018.06.26 145 98 47 environmental monitoring SHC in Erdenemandal Soum - Collected suggestions and opinions in written 9 2018.06.27 124 90 34 form during and after the consultation meetings SHC in Tarialan Soum 10 2018.06.25 82 44 38 SHC in Bayan-Undur Soum 11 2018.06.29 101 72 29 SHC in Erdene Soum 12 2018.09.19 176 124 52 SHC in Dashinchilen Soum 13 2018.10.16 78 59 19 Uvs Hospital

308 PHOTOGRAPHS OF CONSULTATIONS

Consultation meeting in Khan-Uul Hospital

309 Consultation meeting in Khovd Province

Consultation meeting at National Emergency Health Call Center

310 Consultation meeting at FHC in 10th Khoroo of Khan-Uul district

Consultation meeting at FHC in 14th Khoroo of Khan-Uul district

311 Consultation meeting at FHC in 17th Khoroo of Bayanzurkh district

Consultation meeting at FHC in 19th Khoroo of Chingeltei district

312

Consultation meeting at SHC in Erdenemandal Soum

313

Consultation meeting at SHC in Tarialan Soum

Consultation meeting at SHC in Bayan-Undur Soum

314

Consultation meeting at SHC in Erdene Soum

Consultation meeting at SHC in Dashinchilen Soum

315

Consultation meeting at Uvs hospital

316 SIGNED ATTENDANCE SHEETS OF PARTICIPANTS

317

318

319

320

321

322

\ 323 Registration sheets for SHC in Erdenemandal Soum

324

325

326

327 Registration sheets for SHC in Tarialan

328

329

330

331 Registration sheets for SHC in Bayan-Undur Soum

332

333 Registration sheets for SHC in Erdene Soum

334

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336 Registration sheets for SHC in Dashinchilen Soum

337

338

339 Registration sheets for Uvs Hospital

340

341

Annexure – 8: Grievance Registration Form

Project Management Office Improving Access to Health Services for Disadvantaged Groups

The Project Management Office (PMO) welcomes complaints, suggestions, comments and queries from the public regarding the implementation of its projects. We encourage persons with grievance to provide their name and contact information to enable us to get in touch with you for clarification and feedback

Should you choose to include your personal details but want to remain confidential, please inform us by writing/typing “(CONFIDENTIAL)” beside your name.

Contact Information Name Gender o Male o Female Home Address Age Phone Number Sub Project E-mail

Complaint/Suggestion/Comment/Question: Please provide the details (who, what, where, and how) of your grievance below:

How do you want us to reach you for feedback or update on your comment/grievance?

Potion to be filed by the Project Staff Date Received

Received through o In person o Mail o E-mail o Other Name of staff who received comment/ complaint Position of staff member

Type of Grievances Type A Type B Type C Type D 342

Remarks

Signature of Staff member

Update on the case

Date Update

343

Annexure - 9: Biodiversity In Project Areas

A. Plant species around Ulaanbaatar area

№ Scientific/latin name Mongolian name Lifecycle Distribution types POACEAE – 1 gropyron cristatum Perennial Pastureland 2 Achnatherum splendens Perennial Pastureland 3 Bromus inermis Perennial Pastureland 4 Elymus sibiricus Perennial Pastureland 5 Leymus chinensis Perennial Pastureland 6 Stipa baicalensis Perennial Pastureland 7 Stipa Krylovii Perennial Pastureland 8 Setaria viridis Annual Pastureland 9 Elytrigia repens Perennial Pastureland 10 Hordeum vulgare Э Perennial Pastureland 11 Cleistogenes squarrosa Perennial Pastureland

12 Puccinellia tenuiflora Perennial Pastureland CYPERACEAE- 13 Carex duriuscula Perennial Pastureland CHENOPODIACEAE- Chenopodium 14 Annual acuminatum 15 Ch.album Annual 16 Ch.aristatum Annual 17 Ch.strictum Annual 18 Ch.urbicum Annual 19 Ch.glaucum Annual 20 Atriplex sibirica Annual 21 Kochia prostrata Perennial Pastureland Corispermum 22 Annual declinatum 23 Salsola pestifera Annual 24 Bassia dasyphylla Annual Pastureland BRASSICACEAE- 25 Lepidium densiflorum Annual 26 Descurainia Sophia Annual Pastureland AMARANTHACEAE- 27 Amaranthus retroflexus Annual ROSACEAE- 28 Potentilla bifurca Perennial Pastureland Potentilla anserina Perennial Pastureland FABACEAE- 29 Astragalus galactites Perennial Э 30 . adsurgens Perennial , 31 Medicago falcata Perennial Pastureland 32 Melilotus Suaveolens Annual Pastureland 33 Vicia cracca Perennial Pastureland

344

№ Scientific/latin name Mongolian name Lifecycle Distribution types 34 Oxytropis glabra Perennial Э PLANTAGINACAEA- 35 Plantago major Perennial Э, ASTERACEAE- 36 Artemisia adamsii Perennial Pastureland 37 A. frigida Perennial Pastureland 38 A. palustris Annual 39 A. scoparia Annual 40 A. macrocephala Э Annual 41 A. mongolica Perennial 42 Scorzonera austriaca Perennial 43 Heteropappus altaicus Perennial Э 44 Saussurea amara Perennial Э 45 Saussurea dahurica Perennial Pastureland 46 Saussurea salsa Perennial Pastureland 47 Taraxacum officinale Э Perennial Э URTICACEAE- 48 Urtica cannabina Perennial COMPOSITAE-

49 Sonchus arvensis Perennial Pastureland Lactuca tatarica Perennial 50 Heteropappus hispidus BORAGINACEAE- 51 Lappula intermedia Annual ZYGOPHYLLACEAE- 52 Tribulus terrestris Annual Э, GERANIACEAE- 53 Erodium tibetanum Perennial MALVA- 54 Malva mauritiana Annual Э, CONVOLVULACEAE- 55 Convolvulus arvensis Perennial 56 Convolvulus Ammanii Perennial SOLANACEAE- 57 Hyoscyamus niger Annual LAMIACEAE- Dracocephalum 58 foetidum 59 Thymus baicalensis Perennial Э POLYGONACEAE- 60 Polygonum aviculare Annual Pastureland RANUNCULACEAE- 61 Clematis tangutica Perennial Pastureland SALICACEAE- 62 Salix Ledebouriana Perennial 63 Salix triandra Perennial

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B. Registered plant species in Khovd Area Zone Names Dominant Species Cerastium lithospermifolium, Dryadanthe tetrandra, Parrya exscapa, Kobresia belardii, Carex melanatha, Carex orbicularis High mountain Festuca lenensis, Oxytropis oligantha, Potentilla nivea, Stellaria pulvinata, Artemisia argyrophylla, Kobresia filifolia Festuca lenensis, Helictotrichon desertorum, Festuca valesiaca, Poa Mountain attenuate, Silene repens, Arenaria capillaries, Onosma arenaria, Spiraea steppe hypericifoloa, Agropyron cristatum, Carex pedifopmis, Galium verum Festuca lenensis, Agropyron cristatum, Krylovia eremophylla, Peucedanum histrix, Allium edaurdii, Potentilla sericea Dry steppe Caragana bundei, Caragana pugmaea, Stipa krylovii, S.kirghisorum, Festuca valesiaca, Agropyron cristatum, Artemicia dolosa, Melandrium viscosum, Saussuea pricei Stipa gobica, Agropyron nevskii, Agropyron cristatum, Artemisia frigida, Arenaria capillaries, Caragana leucophloea, Eurotia ceratoides Desert steppe Stipa glareosa, S.sibirica, Agropyron cristatum, Cleistogenes squarrosa, Allium equardii, Artemisia rutifolia, Caragana bundei, Lophanthus chinensis Nanophyton grubovii, Eurotia ceratoides, Stipa glareosa, Artemisia Grasses – gracilescens, Reamurea songorica undershrub Anabasis brevifolia, Stipa glareosa, Arthemisia xerophytica, A.hanthochroa, desert Ajania fruticosa, Zygophyllum pterocarpum, Ephedra sinica Euratia certoides, Reamurea songorica, Haloxylon ammodendron, Artemisia Undershrub terrae-albae, Anabasis salsa, A. truncata and shrub Haloxylon ammodendron, Anabasis brevifolia, Zygophyllum xanthoxylon, desert Reamurea songorica, Achnathuerum splendens, Leymus, Iris lacteal, Carex enervis, Kalidium Hamad foliatum, Reamurea songorica, Phragmites communis, Tamarix ramosissima, Haloxylon ammodendron, Popolus diversifolia Source: Government of Mongolia. 2007. EIA. Ulaanbaatar.

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C. Conservation status of mammals species in Bogdkhan Mount SPA Conservation status

)

d e IUCN ( № Name of mammal species R i n i

d e t s Not protected Threatened (IUCN) Endangered , Law on Fauna (IUCN) Li Book of Ml Hunting value CITES, appendix II, sensitive Insectivora- 1 Erinaceidae- Hemiechinus dauricus - + + Chiroptera- Vespertiloinidae- 2 Plecotus auritus- + 3 Myotis mystacinus- + Lagomorpha- 4 Ochotonidae- Ochotona daurica- + + 5 Ochotana hyperborae- + 6 Leporidae- Lepus timidus- + + 7 Lepus tolai- + + Rodentia- Scuiridae- 8 Sciurus vulgaris- + + 9 Tamias sibiricus- + + 10 Pteromys volans- + + 11 Spermophillus undulatus- + + 12 Marmota sibirica- + + 13 Cricetidae- Phodophus campbelli- + 14 Cricetulus barabensis- + 15 Alticola argentatus- + 16 Clethrionomys rufocanus- 17 Clethrionomys rutilus- + 18 Microtus grigalis- + 19 Microtus oeconomus- + 20 Microtus fortis- + 21 Myospalax aspalax- + 22 Myopus schisticolor- + Muridae- 23 Apodemus peninsula- + 24 Allactaga sibirica- + Carnivora- 25 Canidae- Canis lupus- + + + 26 Vulpes vulpes- + + 27 Vulpes corsac- + +

347

Conservation status

)

d e IUCN ( № Name of mammal species R i n i

d e t s Not protected Threatened (IUCN) Endangered , Law on Fauna (IUCN) Li Book of Ml Hunting value CITES, appendix II, sensitive Mustelidae- 28 Mustela erminae- + + 29 Mustela nivalis- + + 30 Mustela sibirica- + + 31 Mustela vison- + + 32 Mustela eversmanni- + + 33 Martes zibellina- + 34 Meles meles- + + Felidae- 35 Felis lynx- + + 36 Otocolobus manul-- + + Artoidactyla- Cervidae- 37 Capreolus pygargus- + + 38 Cervus elaphus- + + 39 Moschus moschiferus- + + Suidae- 40 Sus scrofa- + + Total 31 1 3 2 22 3 Note: Law on Fauna (2000) IUCN category (E.L. Clark & Munkhbat. 2007. Mongolian Red List of Mammals. Pp. 23; Ed. E.L.Clark, Munkhbat, S.Dulamtseren et all. 2007. Summary Conservation Action Plans for Mongolian Mammals)

348

D. Living form and conservation status of birds in Bogdkhan Mountain Habitation Conservation status type

№ Name of bird species ecies p Migratory Permanentl y dwelling Non- protected Rare s Listed in Red Book of Mongolia CITES 1. Ardea cinerea- + - - 2. Ciconia nigra- + - + + 3. Anser anser- + - - - 4. Anser fabalis- + - - - 5. Tadorna ferruginea- + - 6. Tadorna tadorna- + - - - 7. Anas platyrhynchos- + - - 8. Anas crecca- + - - 9. Anas strepera- + - - 10. A.nas Penelope- + - - - 11. Anas acuta- + - - - 12. Anas querquedula- + - - - 13. Anas clypaeta- + - - - 14. Aythya nyroca- + - - - 15. Aythya fuligula- + - - - 16. Aythya ferina- + - - - 17. Bucephala clangula- + - - 18. Mergus merganser- + - - 19. Pandion haliaetus- + - - + + 20. Pernis ptilorhynchos- + - - - + Haliaeetus albicilla- . 21. + - - + + 22. Gypaetus barbatus-Ё - + - + 23. Aegypius monachus- - + - + 24. Milvus migrans- + - - + 25. Circus cyaneus- - + - + 26. Accipiter gentilis- - + - + 27. Accipiter nisus- - + - + 28. Accipiter gularis- - + - + 29. Buteo hemilasius- - + + 30. Buteo lagopus- + - - + 31. Buteo buteo- + - - + 32. Buteo rufinus- - + - + 33. Hieraaetus pennatus- - + - + 34. Aquila nepalensis- - + - + 35. Aquila chrysaetos- + + - - + 36. Spizaetus nipalensis- + - - - + 37. Falco naumanni- - + - - + 38. Falco tinnunculus- - + - + Falco amurensis- + - + - + 39.

349

Habitation Conservation status type

№ Name of bird species ecies p Migratory Permanentl y dwelling Non- protected Rare s Listed in Red Book of Mongolia CITES 40. Falco subbuteo- + - - + 41. Falco cherrug- - + - + 42. Falco columbarius- + - - - + 43. Lyrurus tetrix- - + - - 44. Tetrasres bonasia- - + - - 45. Perdix dauuricae- - + - 46. Coturnix japonica- + - - - 47. Grus grus- + - + 48. Anthropoides virgo- + - + 49. Vanellus vanellus- ( ) + - - - 50. Charadrius dubius- + - - 51. Calidris ruficollis- + - - - 52. Tringa ochropus- + - - - 53. Tringa glareola- + - - - 54. Tringa nebularia- + - - - 55. Tringga hypoleucos- + - - 56. Tringa stagnatilis- + - - 57. Gallinago gallinago- + - - 58. Gallinago stenura- + - - 59. Gallinago solitaria- \+ - - 60. Gallinago megala- + - - - 61. Scolopax rusticola- + - - - 62. Larus argentatus- + - - - 63. Larus canus- + - - - 64. Sterna hirundo- + - - 65. Chlidonias leucopterus- + - - - 66. Columba livia- - + - 67. Columba rupestris- - + - 68. Columbia oenas- + - - - 69. Streptopelia orientalis- + - - 70. Cuculus canorus- + - - 71. Cuculus saturates- + - - 72. Bubo bubo- - + - + 73. Surnia ulula- - + - - + 74. Aegolius funereus- + - - - + Glaucidium passerinum- - + - + 75. 76. Athene nocuta- - + - + 77. Strix uralensis- - + - + 78. Asio otus- - + - + 79. Asio flammeus- + - - - + 80. Caprimulgus europaeus-Э + - - -

350

Habitation Conservation status type

№ Name of bird species ecies p Migratory Permanentl y dwelling Non- protected Rare s Listed in Red Book of Mongolia CITES 81. Hirundapus caudacutus- + - - 82. Apus apus- + - - 83. Apus pacificus- + - - 84. Upupa epops- + - - 85. Jynx torquilla-ё + - - 86. Picus canus- - + - 87. Dendrocopus major- - + - 88. Dendrocopus minor- - + - 89. Picoides tridactylus- - + - Melanocorypha mongolica- - + - 90. 91. Alauda arvensis- + - - Eremophila alpestris- - + - 92. 93. Riparia riparia-Э + - - 94. Hirundo rustica- + - - 95. Delichon urbica- + - - 96. Calandrella cinerea- + - - 97. Galerida cristata- + - - 98. Motacilla cinerea- + - - 99. Motacilla alba- + - - 100. Motacilla flava- + - - 101. Motacilla citreola- + - - 102. Anthus richardi- + - - 103. Anthis campestris- + - - 104. Anthus trivialis- + - - 105. Anthus hodgsoni- + - - 106. Anthus spinoletta- + - - Anthus godlewskii- 107. + - - 108. Lanius cristatus- + - - 109. Lanius excubitor- + - 110. Lanius isabellinus- + - - 111. Bombycilla garrulous-Э + - - 112. Cinclus cinclus- - + 113. Prunella montanella- + - 114. Prunella fulvescens- - + - 115. Prunella collaris- + - - 116. Saxicola torquata- + - - 117. Oenanthe oenanthe- - - - 118. Oenanthe pleschanka- + - - 119. Oenanthe isabellina- + - -

351

Habitation Conservation status type

№ Name of bird species ecies p Migratory Permanentl y dwelling Non- protected Rare s Listed in Red Book of Mongolia CITES 120. Monticola saxatilis- + - - 121. Phoenicurus phoenicurus- + - - 122. Phoenicurus ochruros- + - - Phoenicurus auroreus- + - - 123. 124. Phoenicurus erythronotus- + - - Lusciana calliope- 125. + - - 126. Erithacus svecica- + - - 127. Erithacus cyane- + - - 128. Tarsiger cyanurus- + - - 129. Turdus obscurus- + - - - 130. Turdus sibiricus- + - - 131. Zoothera dauma- + - - 132. Turdus ruficollis- + - - - 133. Turdus atrogularis- + - - - 134. Turdus naumanni- + - - - 135. Turdus pilaris- + - - - 136. Locustella certhiola- + - - - 137. Locustella lanceolata- + - - - 138. Phragmaticola aedon- + - - 139. Sylvia communis- + - - 140. Sylvia curruca- + - - Phylloscopus borealis- 141. + - - Phylloscopus trochiloides- 142. + - - Phylloscopus tenellipes- 143. + - - - 144. Phylloscopus inornatus- + - - Phylloscopus proregulus- 145. + - - - 146. Phylloscopus fuscatus- + - - - Phylloscopus collybita- 147. + - - 148. Muscicapa parva- + - - 149. Muscicapa striata- + - - 150. Muscicapa sibirica- + - - 151. Muscicapa latirostris- + - - 152. Aegithalos caudatus- - + - 153. Remiz pendulinus- + - + 154. Parus palustris- - + -

352

Habitation Conservation status type

№ Name of bird species ecies p Migratory Permanentl y dwelling Non- protected Rare s Listed in Red Book of Mongolia CITES 155. Parus montanus- - + - 156. Parus cinctus- - + - 157. Parus ater- - + - 158. Parus major- - + - 159. Parus vyanus- - + 160. Sitta europaea- - + 161. Certhia familiaris- - + 162. Emberiza citronella- - + Em.eriza leucocephala- - + 163. 164. Emberiza godlewskii- + - 165. Emberiza cioides- - + 166. Emberiza fucata- + - 167. Emberiza pallasi- + - Emberiza schoeniclus- 168. + - 169. Emberiza aureola- + - 170. Emberiza rutile- + - 171. Calcarius lapponicus- + - 172. Emberiza pusilla- + - 173. Emberiza spodocephala- + - 174. Emberiza hortulana- + - 175. Acanthis cannabina- - + 176. Acanthis flavirostris- - + 177. Acanthis flammea- - + Acanthis hornemannii- - + 178. 179. Uragus sibiricus- + 180. Carpodacus erythrinus- + - 181. Pinicola enucleator- - + 182. Pyrrhula pyrrhula- - + Fringilla montifringilla- 183. + - 184. Carduelis spinus- + - 185. Leucosticte arctoa- - + 186. Carpodacus rubicilla- + - Loxia curvirostra- 187. - + Coccothraustes coccothrausres- + - 188. 189. Passer domesticus- - + 190. Passer montanus- - +

353

Habitation Conservation status type

№ Name of bird species ecies p Migratory Permanentl y dwelling Non- protected Rare s Listed in Red Book of Mongolia CITES 191. Petronia petronia- - + 192. Montifringilla davidiana- - + 193. Sturnus vulgaris- + - 194. Oriolus oriolus- + - 195. Sturnus cineraceus- + - 196. Gallulus glandarius- - + 197. Perisoreus infaustus- + 198. Cyanopica cyana- - + 199. Pica pica- - + 200. Nucifraga caryocatactes- - + 201. Pyrrhocorax pyrrhocorax- - + 202. Corvus dauricus- + - 203. Corvus frugilegus- + - 204. Corvus corone- - + 205. Corvus corax- - + Total 137 68 163 4 4 33

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Annexure – 10: Specialized Inspection Agency

Unofficial translatio n

SPECIA LIZED INSPEC TION AGENC Y OF THE MUNICIPAL AUTHORITY OF ULAANBAATAR CITY

355

2018.10.31 No.02-03/4170

TO: CAPITAL CITY EMERGENCY CALL CENTER

This letter refers to the letter issued by your organization to us.

The current existing building of the Emergency Call Center was built in 1970. It has walls made of solidified bricks, thus the the wall frame does not have any asbestos materials in it. When replacing the engineering pipelines outside and inside of the building with new pipelines back in 2013, Gangar Invest LLC did not use any asbestos materials for insulation purposes.

Currently, it can be concluded that asbestos materials are not used both in the existing building of Emergency Call Center and in insulation of its engineering pipelines.

Vice Chairman S.Davaasuren