SUBPROJECT: BUILDING OF NEUROSURGERYINTERNATIONAL HOSPITAL

E2122 V2 SUBPROJECT: BUILDING OF NEUROSURGERY INTERNATIONAL HOSPITAL ENVIRONMENTAL DOCUMENT: PART 1: ENVIRONMENT IMPACT ASSESSMENT (P 02) PART 2: ENVIROMENT REPORT (P 66) PART 3: RISK MANAGEMENT PLAN (P 88) PART 1: ENVIRONMENT IMPACT ASSESSMENT CHAPTER 1: BRIEF DESCRIPTION OF THE PROJECT 1.1 1.2 1.3 1.4 1.4.1 1.4.2 1.4.3 1.5 1.5.1 1.5.2 1.5.3 1.5.4 1.5.5 NAME OF PROJECT INVESTOR: LOCATION OF PROJECT LAND MAIN CONTENTS OF PROJECT Structure of planning Hospital architect space design Land arrangement plan TECHNICAL INFRASTRUCTURE NETWORK Transportation network Electricity network Water supply network Fire prevention network Communication network CHAPTER NATURAL – ECONOMIC – SOCIAL CONDITION AT PROJECT LAND 2.1 NATURAL AND ENVIRONMENTAL CONDITIONS 2.1.1 Geographical and geological conditions 2.1.1.1 Geographical location 2.1.1.2 Ground and geomorphology features 2.1.1.3 Geology 2.1.2 Meteoric and hydrographical conditions 2.1.2.1 Temperature 2.1.2.2 Humidity 2.1.2.3 Wind 2.1.2.4 Pluvial index 2.1.3 Status of natural environmental conditions 2.1.3.1 Status of air quality 2.1.3.2 Status of underground water quality 2.2 SOCIAL AND ECONOMICAL CONDITIONS 2.2.1 Economical conditions 2.2.2 Social conditions 2.2.2.1 Population 2.2.2.2 Medicine CHAPTER ENVIRONMENT IMPACT ASSESSMENT 3.1 DEFINE THE POLLUTION SOURCES 3.1.1 Impact sources relating to the waste 3.1.2 Impact sources not relating to the waste 3.1.3 Prediction of the environmental risks from the project 3.1.3.1 The environmental risks in the construction stage 3.1.3.2 The environmental risks in the operation stage 3.2 IMPACT ENTITY AND SCALE 3.2.1 The entity impacted in the stage of construction and equipment installation 3.2.1.1 Dust and waste gas 3.2.1.2 Wastewater 3.2.1.3 Waste solid 3.2.1.4 Noise 3.2.1.5 Accident, fire and explosion 3.2.2 The entity impacted in the stage of operation 3.2.2.1 Air polluted waste 3.2.2.2 Wastewater 3.2.2.3 Waste solid 3.2.2.4 Noise 3.3 IMPACT ASSESSMENT 3.3.1 Environmental impact assessment in the stage of construction and equipment installation 3.3.1.1 Impact of the source of air polluted waste 3.3.1.2 Impact of waste water 3.3.1.3 Impact of waste solid 3.3.1.4 Other impacts 3.3.2 Environmental impact assessment in the stage of operation 3.3.2.1 Impact of the source of air polluted waste 3.3.2.2 Impact of waste water 3.3.2.3 Impact of waste solid 3.3.2.4 Social impact CHAPTER MINIMIZATION MEASURES OF NUISANCE, PREVENTION AND COUNTERMEASURES OF ENVIRONMENTAL ACCIDENT 4.1 BAD IMPACT MINIMIZATION MEASURES, PREVENTION AND COUNTERMEASURE OF ENVIRONMENTAL RISK IN CONSTRUCTION STAGE 4.1.1 The impact minimization measures on the water 4.1.2 The impact minimization measures on the air 4.1.3 The impact minimization measures from site hut 4.1.4 The measures to ensure the labor safety 4.1.4.1 The use of vehicles and construction machines 4.1.4.2 The safety in site hut installation and dismantling 4.1.4.3 The labor safety land work 4.1.4.4 The labor safety in masonry work 4.2 BAD IMPACT MINIMIZATION MEASURES, PREVENTION AND COUNTERMEASURE OF ENVIRONMENTAL RISK IN OPERATION STAGE 4.2.1 The measures to control the air pollution 4.2.1.1 Control the impact from the traffic 4.2.1.2 Control the air pollution from the operation of wastewater treatment system and solid waste collection 4.2.1.3 Control the impact from the waste gas from the generator 4.2.1.4 The measures to control the noise and vibration 4.2.2 The measures to minimize the bad impact from wastewater 4.2.2.1 Classification of waste water 4.2.2.2 Drainage construction 4.2.2.3 Preliminary domestic wastewater 4.2.2.4 The wastewater treatment system 4.2.2.5 The measures to prevent the water pollution 4.2.3 The measures to manage and treat the solid waste 4.2.3.1 Collection and classification stage 4.2.3.2 Treatment stage 4.2.4 The measure to prevent the environmental risks 4.2.4.1 The measures to prevent the fire and explosion 4.2.4.2 The accident relating to electricity 4.2.4.3 The accident relating to radiation 4.2.4.4 The accident from labor and occupational diseases CHAPTER COMMITMENT TO IMPLEMENT THE ENVIRONMENTAL PROTECTION MEASURES CHAPTER ENVIRONMENTAL TREATMENT BUILDING, ENVIRONMENTAL MANAGEMENT AND MONITORING 6.1 THE LIST OF ENVIRONMENT TREATMENT BUILKDINGS 6.2 MANAGEMENT PROGRAM 6.2.1 Environment management program during the construction stage 6.2.2 Environment management program during the operation stage 6.3 ENVIRONMENT MONITORING PROGRAM 6.3.1 Air quality monitoring 6.3.1.1 Surrounding atmosphere quality monitoring 6.3.1.2 Hospital atmosphere quality monitoring 6.3.2 Water quality monitoring 6.3.2.1 Wastewater quality monitoring 6.3.2.2 Monitoring of solid waste management CHAPTER COST ESTIMATION FOR ENVIRONEMNTAL BUILDING 7.1 COST ESTIMATION OF WASTE TREATMENT BUILDINGS 7.1.1 Building 7.1.2 Equipments – Installation – Operation - Acceptance 7.2 COST ESTIMATION OF ENVIRONMENTAL QUALITY MONITORING CHAPTER COMMUNITY CONSULTING 8.1 OPINIONS OF TAN THOI HOA WARD’S PEOPLE COMMITTEE 8.2 OPINIONS OF TAN THOI HOA WARD’S FATHERLAND COMMITTEE CHAPTER DATA SOURCE AND EVALUATION METHOD CONCLUSION AND PROPOSAL 9.1 DATA SOURCE 9.1.1 Data source for reference 9.1.2 Data source created by the investor 9.2 APPLIED METHOD IN EIA 9.3 REMARK ON THE DETAILED, RELIABLE EVALUATION METHOD I CONCLUSION II PROPOSAL PREFACE I THE ORIGIN OF PROJECT In the industrialization time, stresses and demands of life have made many people infectious with diseases of nerves and spine But at present the number of patients under the neurosurgery is very large (disk buffer to release the spine, neck, spine, waist) In Ho Chi Minh City, the overload of faculty of neurosurgery in the public hospitals is increasing, affecting the quality of treatment and service of public health, not to meet the needs of health care quality for patients having the high economic condition Treatment at the specialized hospitals in Singapore, Thailand have the cost much more many times than in Vietnam and is not always convenient for patients and their families While the provincial hospitals, although having the neurosurgery faculty but only solve the cases of brain injury (such as blood from surgery ) and almost not be able to resolve the common diseases in neurosurgery field (brain and spine) The southern provinces in general and HCMC in particular there are no neuro specialized hospital (currently, only Cho Ray hospital with specialized in neurosurgery is the only treatment only in the South and may be for all the country) In Ho Chi Minh City it has a number of private specialized hospitals as the eye hospital in Saigon, ITO Hospital (trauma specialized in Orthopedics), international puerperal hospital, their success have proven to require the beneficiaries to high health care quality by patients is real and the formation of the specialized hospital is right in the selective development of health branch today II THE LEGAL AND TECHNICAL BACKGROUND II.1 Legal Documents The EIA of the project “Investment of the International Neurosurgery Hospital” is based on the following legal documents: - The Environment Protection Law 2005 approved by National Assembly dated 29 November 2005 and signed to issue by State President dated 12 December 2005 - Decree No 80/2006/ND-CP of the Government issued on August 2006 to stipulate in details and direct the implementation of some articles of The Environment Protection Law - Circular 08/2006/TT-BTNMT dated 08 September 2006 of Ministry of Natural Resource and Environment on “The direction of Strategic Environment Assessment, Environment Impact Assessment, Environment Protection Commitment” - Decree 21/2008/NĐ-CP dated 28 February 2008 on the modification, supplementation some articles of Decree No 80/2006/ND-CP of the Government issued on August 2006 to stipulate in details and direct the implementation of some articles of The Environment Protection Law - Ordinance 07/2003/PL-UBTVQH dated 25 February 2003 on Private Medicine and Pharmacy Professional Practice - Decree 103/2003/NĐ-CP dated 12 September 2003 of the Government to stipulate in details and direct the implementation of Private Medicine and Pharmacy Professional Practice - Circular 12/2006/TT-BTNMT dated 26 December 2006 of Ministry of Natural Resource and Environment on “The direction of practice conditions and the formality to form the documents, registration, professional practice issue code for management of the hazardous wastes - Decision 22/2006/QD-BTNMT dated 18 December 2006 of Ministry of Natural Resource and Environment on being compulsory to apply Environment Vietnam standards - Decision 23/2006/QD-BTNMT dated 26 December 2006 of Ministry of Natural Resource and Environment on issuing the list of the hazardous wastes - Decision 43/2007/QD-BYT on issuing the regulation of medical waste management The environment standards - The allowable maximum limits of the noise in the public and people regions (equivalent sound level TCVN 5949 – 1998) - TCVN 6772 – 2000 The standards of water quality – domestic wastewater – The allowable pollution limit (Level I) - TCVN 5937 – 2005: The air quality – surrounding air quality - TCVN 5938 – 2005: The air quality – The allowable maximum concentration of some hazardous substances in the surrounding air II.2 Technical Documents - The data and documents on the status of natural, environmental, and socio – economical conditions of Tan Thoi Hoa ward, Tan Phu District, HCMC - Documents of the technical design of The INH project implemented by construction company - WHO’s Documents for fast evaluation to estimate the pollution load from the project activities - The EIA implemented in VN during the past years, especially the projects similar to the INH project III EIA IMPLEMENTATION ORGANIZATION The EIA of “INH investment project” is consulted by AQC (Water and Environment Technology Development Company) Director: Mr Ho Xuan Nham, MS Address: 80/125B Tran Quang Dieu St, Ward 14, District 3, HCM city Office: 27/41 Hau Giang St, Ward 4, Tan Binh District, HCM city Phone: 08 – 39484383 Fax: 08 – 39484183 Group of EIA implementation MS Ho Xuan Nham, Director of AQC Company Eng Do Van, Environment Engineer, AQC Company Eng Nguyen Ngoc Anh, Environment Engineer, AQC Company Bac Do Tran Mong Thuy, Environment Bachelor, AQC Company Eng Nguyen Dang Quynh Nhu, Environment Engineer, AQC Company CHAPTER 1: BRIEF DESCRIPTION OF THE PROJECT 1.1 INVESTOR: INTERNATIONAL NEURISURGERY HOSPITAL JOINT STOCK COMPANY Address: 203 Dong Khoi Street, District 1, Ho Chi Minh city Phone: 08.38277308 Representative: Tran Ngoc Lan Trang Position: Chairman of BOM 1.2 LOCATION OF PROJECT LAND The investment project of building The International Neurosurgery Hospital is located at 65A Luy Ban Bich St, Tan Thoi Hoa Ward, Tan Phu District, HCMC which area is 1,257.1 m2 with their directions are:  North East is Luy Ban Bich street;  South East is inhabitants;  South West is inhabitants;  North West is inhabitants and school Total land area: 1,257.1 m2 Year of the section factor to map number 32 (Peta) and belongs to Tan Thoi Hoa Ward, Tan Phu District, HCMC There is a state hospital old can improve, repair, use the right 1.3 MAIN CONTENTS OF PROJECT The project of building and improving The International Neurosurgery Hospital mobilizes 100% of capital contribution by Enterprises law with the scale of 100 patient beds and has achievable planning target  Total land area: 1,257.1 m2  Construction site area: 715.5 m2  Construction density: 57%  Land for trees: 514.5 m2  Level of construction: stories  Coefficient of land use: 3,28  Total site area: 4,125.5 m Table 1.1 : Item need be improved, built No Item Flooring height (m) Construction area (m2) Newly-built technical operating room in terrace : brick walling, reinforced concrete column, tole roof 4.4 144.00 Roofing stair - Items improvement, repair and new construction on the present reflected in the following table 1.3.1 Structure of planning According to plan of building hospital, international neurosurgery hospital is built and improved on the foundation of old hospital with land using structure Land for main building Land for planting trees Land for internal transportation 1.3.2 Hospital architect space design The project of building new international neurosurgery hospital consists of floored block Main block is rectangular shape, has green space middle isolated with the outer space options on architecture outline and the beautiful block, durable and environmental friendly materials nature and the environment, creating maximum sense of healthy, consistent, safety and ventilation 1.3.3 Land arrangement plan Ground floor: 715.5 m2 is reception, patient receiving, emergency aid, and professional support … 1st floor: 756.0 m2; ultrasonic test, cardio electricity, XR interference, rooms for patient, nurses, doctors… 2nd floor: 756.0 m2; rooms for patient, kitchen, canteen… 10 3.3.2 Monitoring cost Environment monitoring of the WWTS and gas treatment system is to ensure that the quality of wastewater and waste gas after treatment attains the designed standards as approved EIA is TCVN 6772-2000 level I The monitoring cost is estimated for monitorings per year Total yearly monitoring cost is about 6,000,000 VND The prices are from the Circular Number 83/2002/TT-BTC dated 25th September 2002 of Ministry of Ftnance 3.4 Internal monitoring reports After participating HDP and put the WWTS and INH into operation, the investor of INH has to report periodically about the RMP implementation to HIFU Based on the report, HIFU synthesizes with other subprojects to submit to WB The reporting will be terminated after DONRE issues an operational license of the WWTS The internal monitoring reports in Vietnamese should be done every three months during test run and every six months after approved for opeartion by DONRE and submitting all reports to HIFU The contents of internal reports could be referred to “Environmental Safeguard Guideline of HDP 3.5 RMP implementation supervision carried out by specialists of WB and HIFU Beside the internal inspection of Investor, the subproject belongs to HIFU’s program that it will be inspected strictly by WB and HIFU The schedule of inspection of RMP/EMP will be informed in advance to investor by HIFU The content of inspection is mainly the evaluation of RMP/EMP compliance which were agreed by both sides 3.6 Responsibility to implement the RMP As soon as all sides approve the RMP, the investor is responsible (1) Publicize the RMP at the office of the people’s committee of Tan Thoi Hoa ward, Tan Phu District (2) Implement all contents stated in the RMP and environment report 85 Conclusion and recommendation During the preparation of this ES report, the investor’s officials and environment consultant company were very active to support the HIFU consultant in providing information, discussing to complete the last report Therefore, the investor and HIFU consultant achieved the agreement in term of contents and the investor committed to implement proposals in the report that was showed in the working minute signed between the HIFU’s official and consultant and the investor’s representative at INH dated on 2009 It notes that if classified as WB, the subproject is a high-risk classification The RMP approval is just the initial step in meeting ES requirements of WB The key point is to develop and implement this plan Thus the consultant recommends that HIFU needs to request the investor to commit to implement the EMP/RMP and it is one of the conditions to reimburse for the subproject Annex 5.1 List of agencies/officials contacted by the consultant Table 6: List of agencies/officials contacted by the consultant No Name of agencies Officials Titles International Ms Nguyen Thi Lan Trang President Neurosurgery hospital Mr Dang Van Nhan Director Mr Trieu Environment Company Mr Tham Environment Company Hochiminh City Nguyễn Hà Lam Official of HIFU Investment Fund for Vũ Bá Minh Environment consultant Urban Development (HIFU) 5.2 Tài liệu tham khảo [1] CÔNG TY CỔ PHẦN BỆNH VIỆN QUỐC TẾ , “Dự án Bệnh viện Ngoại Thần kinh Quốc tế”có bổ sung chỉnh sửa, tháng 7/2008 [2]CÔNG TY CỔ PHẦN BỆNH VIỆN QUỐC TẾ , “Báo cáo đánh giá tác động môi trường Dự án Bệnh viện Ngoại Thần kinh Quốc tế”, tháng 10/2008 [3] Ngân Hàng Thế giới Bộ Kế hoạch Đầu tư, “Chính sách an tồn mơi trường Ngân hàng giới – Hướng dẫn kỹ thuật”, NXB Thống kê, 12/2004 86 Các văn tham khảo [1] Decision No 43-2007 BYT of Ministry of Health about Management of the hospital waste [2] Joint Circular No 2237/1999/TTLT/BKHCNMT-BYT dated 28th December 1999 on the direction of radiation safety in health [3] Decision No 763/QĐ-TNMT-QLMT dated 27th November 2008 of DONRE approved EIA of INH Project [4] Construction license number 260/GPXD dated 28th December 2007 issued by HCM city Department of Construction [5] Results of X ray Safety Assessment No 1087/HĐKT-TTHN issued by HCMC Atomic Safety Center dated 26th November 2008 [6] Results of Radiation Safety Assessment for CT Scanner Room No 748/HĐKTTTHN issued by HCMC Atomic Safety Center dated 08th September 2008 [7] Formal letter No 230/UBND dated 22 nd October 2008 of People Committee of Tan Thoi Hoa Ward on community comments on environment of INH [8] Formal letter No 05/UBMTTQ dated 22nd October 2008 of Fatherland Committee of Tan Thoi Hoa Ward on community comments on environment of INH [9] Standard of Domestic Waste Water 6772-2000 [10] Standard of waste gas TCVN 5937-2000 5.3 Some images Hand Washing for Solid Waste The covers of the underground watewater treatment system collection 87 Deodor pipe Deodor pipe Chemical tank and meter pump Door of compressed oxygen room Washing vessel 88 PART 3: RISK MANAGEMENT PLAN INTRODUCTION Safety Environment Guide HDP project requires when a sub-project had Report of environmental impact assesment (DTM) or commit to environmental protection (CKBVMT) even approved the last evaluation report found that this did not meet the requirements of ATMT HDP is the borrower must prepare a risk management plan(KHQLRR) Hướng dẫn An Tồn Mơi Trường (ATMT) dự án HDP yêu cầu: tiểu dự án có Báo cáo đánh giá tác động môi trường (ĐTM) cam kết bảo vệ môi trường (CKBVMT) chí phê duyệt, qua đánh giá cho thấy báo cáo chưa đáp ứng yêu cầu ATMT HDP bên vay phải chuẩn bị Kế hoạch quản lý rủi ro (KHQLRR) In this project the Investor that is International Hospital Corporation has:  EIA approved by Decision No 763/QD-TNMT-QLMT dated 27/11/2008 of the Department of Natural Resources and Environment of Ho Chi Minh City  Bulding lience no.260/GPXD on 28/12/2007 of HCMC Department of Construction  The results of radiation safety assessment of CT Scanner No.748/HDKTTTHN dated 08/9/2008 and result of evaluating radiation safety of Xrays No.1087/HDKT-TTHN dated 26/11/2008 of HCMC Nuclear Center The construction of International Neurosurgery Hospital was complied with the following documents:  Construction license number 260/GPXD dated 28th December 2007 issued by HCM city Department of Construction;  Decision No 763/QĐ-TNMT-QLMT dated 27th Novmber 2008 approved EIA;  Results of X ray Safety Assessment No 1087/HĐKT-TTHN issued by HCMC Atomic Safety Center dated 26th November 2008;  Results of Radiation Safety Assessment for CT Scanner Room No 748/HĐKT-TTHN issued by HCMC Atomic Safety Center dated 08 th September 2008 89 Therefore, the sub-projects should just develop a risk management plan on the basis of environmental impact assesment (EIA) approved as presented below Expectedly, the utilization of loan from HDP project’s fund to make the investment investing in the following items in the projects: Item Land Existinf building Design and construction cost Medical Equipment Other assets Emergency cost Other cost Working capital Total Rate Fund (1.000VND) Total (1.000VND) Own fund HDP’s loan 45.645.000 45.645.000 4.628.000 4.628.000 31.849.816 31.849.816 77.683.974 26.419.337 51.264.637 5.791.441 1.739.894 4.051.547 2.834.000 2.834.000 5.757.000 5.757.000 6.143.000 6.143.000 180.332.231 90.332.231 90.000.000 100% 56% 44% RISK MANAGEMENT PLAN: Due to not having any standard for risk management plan RMP, consultant has proposed the basic content for risk management plan of International Neurology Hospital subproject The contents of RMP include: (1) Process of operating wastewater treatment system (2) Assessment of the potential risks, mitigation measures and performance of respomsibility (3) Monitoring plan (4) Estimated cost of monitoring/inspection (5) Propose the ability enhancement program (6) Internal monitoring/ inspection report presented in turn below: (1) OPERATIONAL PROCESS OF WWTS (provided by design/construction contractor) PART 1: OPERATING SYSTEM I SAFETY Before starting the system, operator needs to read carfully “Operation Manual” It is only the responsible official operate the system Unresponsible workers go in and operate the system is strictly prohibited 90 II PREPARING SYSTEM IN OPERATION: 4- Check the water leval in chemical tanks 5- Move all contral keys to OFF or STOP position 6- Swich on CB into ON position- The main lamp turns on III OPERATING MODE The system has modes of operation: Manual or Automatic and selected by button “AUTO – MENU” IV.TECHNOLOGY DESCRIPTION: Wastewater from the hospital’s activities was collected by the drainage system leading to manhole terminal prior to the treatment system Wastewater from the collector is flowed to regulating tank to be regulated, stable flow and concentration of the pollution Wastewater in regulating tank is continuously mixed with the underwater pumping system to prevent the sedimentation and reducing smell due to anaerobic decomposition In addition, in regulating tank has also anoxic decomposition which significantly reduce the organic pollution Then, wastewater will be taken through AEROTANK Here, under the effect of the aerobic microorganism (microbiological sludge) and oxygen continuously supplied by submerged air blower, organic pollutions (COD, BOD, N {nitrat, nitrit , amonium, here are the characteristic pollutions of wastewater },, and P) will be decomposed This process also created a large amont of mud called biological mud After biological process, wastewater is brought to biological clarifier which clarifies biological sediment swimming (biological sludge) generated by the above biological processing Meanwhile, there is process of eliminating part of other pollutions remaining in the wastewater (nitrat, Amonium) through aerobic process Clarified wastewater in biological clarifer will flow to pasteurizing tank to kill bacteries and remaining contituents that may cause disease such as Ecoli bacteria Then, water is pumped to the absorption FILTER (pressure filter) to absorb all remaining pollutants before wastewater go to the city sewer Created sludge in the treatment processing is partly turned back to Aerotank, the remaining is flowed into sludge tank and will be taken periodically by sludge exhausting truck 91 All tanks in the treatment system are built underground Each tank has collector to collect the gas and let the gas (smell) to the adsorption equipment with the activated carbon before released to the surroundings Wastewater after treatment attains standard of level I (according to TCVN 6772 - 2000) V.SYSTEM OPERATION C Treatment phase:  Control the quantity of chemical enough for all day operation  Control the set of chemical pump  Turn on the valves: Adjust the water flow from regulating tank to aerotank accordance with the capacity design adjust the volume of sludge circulating to Aerotank or sludge tank  Switch on CB in electric The system only works when chemical tank and regulating tank is not exhausted Automatic mode: Change control bar to AUTO position, the system will work as follows:  Wastewater from regulating tank to Aerotank by wastewater pump 1A / B Chemical metering pump is also working  Waste water from equalizing tank is pumped to Aerotank by pump 1A/B and chemical meterpump is also operated at the same time  Using pump to mix waste water in equalizing tank and submerged compressor in Aerotank is operating continuously to ensure the treatment process  Sludge pump is operated periodically by the set time Mannual mode: Move control bar to MENU position, the system will work depending on operator’s control D Stop the entire system Stop the entire system by moving all switch , CB to “OFF” position 92 VI PERIODIC MAINTENANCE PLANNING: Daily maintenance Checking chemical tanks to detect leakage Checking the amount of chemicals in chemical tank that enough for daily use, prepare additional chemicals when 1/3 remaining tank Checking valves and pipes to detect leakage Checking electrical control cabinet  Check equipments: Wastewater pump Every week, being sure to check the pipes of pump and waste in pump’s wings Chemical metering pump: being sure to daily check the operation and pipeline of pump Being sure to weekly clean one way valve and compressing head of pump by opening and cleaning Air blower being sure to check regularly in oder to detect problems and have method of overcoming Odor treatment system Checking regularly to detect congestion and replace adsorbent as needed Monthly, Annual Maintenance + Lubricating pump appropriately + Clean the internal side of pump, air blower (2) Risk assessment, mitigation measures and implementation duties Table 1: Risk assessment and reducing measures of environmental treatment system No Risk / Potential Problem Reasons/Minimization Measures Responsibility Building stage: (since the progress of construction is finished now, consultant have not deal with impacts and migitation measures in construction more) Operating stage Bad odor, quantity of organic substances at the drainage gate ove r the standards - Intense aeration to increase the oxygen content to raise the rate of decomposition of organic substance Develop the tree corridor around the hospital and its WWRS to reduce the odor to surrounding area The width is as large Operators Investor 93 Polluting the drainage - as possible depending on the remaining land Control the active sludge as directed by the contractor Control regularly the quality of the treated waste water; Control the opeartion process Operators Plan to deal with the risk in WWTS operation Rubbish choking - Control regularly the screning bars screning bars pH is not right at pH - Control the pH sensor; adjusting tank - Control the electricity circuit - Control the chemical content Troubleshooting at aeration biological tank - White foam on the Less activated sludge, no taking out of sludge surface - Black sludge Less oxygen, increase the aeration Operators - Air foam at some Air difuser is cracked nd need to replace places in tank Troubleshooting at sedimentation tank - Black sludge on the - High residence time of sludge, remove the surface sludge more reguarly - Turbid waste water - Less sedimentation of sludge, increase the content of sludge Prevent to discharge - Sludge from WWTS still has the high the sludge not as microbiological content and hdden risk of regulation disease and pollution - Investor signs the contract with City Environment Company (Contract attached in Index) Operators Operators Operators Operators Operators Operators Operators Operators nt (3) Environment parameter monitoring plan 3.1 Monitoring plan Effectiveness of the WWTS is assessed via monitoring the quality of environmental parameters The monitoring is to find in time environment problems and suggest treatment measures if there is something unusual Monitoring plan 94 (internal monitoring implemented by the investor of INH) is to reserve the human and budget resources for the WWTS operation Table 2: Environmental quality monitoring Frequency Source Parameters Waste water pH after BOD treatment COD SS 4.Settlable solids Total dissolved solid Sunfur (H2S) Nitrate (NO3) Oils (food) Phosphate (PO43-) 10 Total colifoms Surroundin Temperature g Humidity atmosphere Dust CO SO2 NO2 Air quality CO at the SO2 treatment NO2 system Noise Location At the per outside of quarter wastewater treatment system and attain TCVN 6772-2000 level I TCVN 5937 - per 2005 quarters per quarter Number of sample per year 4 see appendix (4) MONITORING COST  Wastewater: Environment monitoring of the WWTS and gas treatment system is to ensure that the quality of wastewater and waste gas after treatment attains the designed standards as approved EIA is TCVN 67722000 level I The monitoring cost is estimated for monitorings per year Total yearly monitoring cost is about 6,000,000 VND The prices are from the Circular Number 83/2002/TT-BTC dated 25th September 2002 of Ministry of Ftnance 95  Solid waste and toxic solid waste: Collecting solid waste and hazardous waste, CDT has sign an agreement no.5869 dated 28/11/2008 with HCMC Urban Environment company in accordance with collecting daily medical waste including treatment process of hazardous waste which are: - Waste containing infectious subtances (hazardous waste Code: 13 01 01) - Chemical waste including or containing harmful elements (hazardous waste Code: 13 01 02) - The types of pharmaceutical waste poisioning cells (cytotoxic and cytostatic) (hazardous waste Code: 13 01 03) - Quality Welding almagam that waste (hazardous waste Code: 13 01 04) - The types of pharmaceutical waste may contain harmful ingredients (hazardous waste Code: 13 01 05) And other contents, including other medical waste (lancet needle injection, with 100 kg of each month x 15,000 VND / kg = 1,500,000 VND/month In case of exceeding,accounting on the number of reality  Radioactive waste Radioactive Waste is only in X-ray, CT Scanner and DSA computer room Doctors and technicians directly managed this room which has no radioactive waste but only have X-beam (investor has already built copper system surrounding the room and lead glass, lead shirt to protect patients and people around Standards of X-beam’s distance is achieved by test that reach the certificates of HCMC Nuclear Center about licensing nuclear safety certificate no.748 / HDKT TTHN-dated 15/9/2008 (5) SUGGESTION STRENTHENING OF INVESTOR  Solid waste: Investor hire Pan Pacific company specialized in keeping clean and hygiene in the hospital to collect hospital’s waste in oder to transfer to HCMC environmental sanitation company  Waste water Nước thải: AQC company will be responsible for operating waste treament system AQC is the company building the waste treament system system for investor and responsible for operating reach the requirement of level I of TCVN 6772-2000 96  CT Scanner X ray: The operation of CT Scanner X-ray equipment by doctors, technicians that have been through professional trainning Investor should check and filed records and qualifications, professional certificates  High pressure cylinder Cylinders used in hospitcal are put in focus, instead of each room, then piping Employee control the operation with specific process Investor builds process of operation, problems can occur and how to overcome So requiring the strengthening of environmental management for investor in this sub-projects is not essential (6) Internal monitoring reports After participating HDP and put the hospital into operation, the investor of International Hospital has to report periodically about the RMP implementation to HIFU Based on the report, HIFU synthesizes with other subprojects to submit to WB The reporting will be terminated after DONRE issues an operational license of the WWTP The internal monitoring reports in Vietnamese should be done every three months during test run and every six months after approved for opeartion by DONRE and submitting all reports to HIFU The contents of internal reports could be referred to “Environmental Safeguard Guideline of HDP RMP implementation monitoring carried out by specialists of WB and HIFU Apart from internal monitoring is carried out by the investor, the subproject belongs to the pilot program of HIFU, therefore it will be supervised closely by WB and HIFU Monitoring schedule of EMP/RMP implementation will be informed beforehand by HIFU to the investor The contents of supervision are mainly the assessment of level of compliance of EMP/RMP which approved by all sides RESPONSIBILITYT TO IMPLEMENT THE RMP As soon as all sides approve the RMP, the investor is responsible for (3) Publicizing the RMP at the office of the commune people’s committee of Tan Thoi Hoa Ward, Tan Phu DIST and some near the hospital’s barriers (4) Implementing all contents stated in the RMP ANNEX Table – Pollutiom parameters and allowed limitation TCVN 6772-2000 97 Parameters pH BOD Suspended solid Sedimented solid 5.Total dissolved solid Sulfur (H2S) Nitrate (NO3) Oil (food-grade) Phosphat (PO43-) 10 Total colifoms Unit mg/l mg/l mg/l mg/l mg/l mg/l mg/l mg/l PMN/ 100ml Level I 5-9 30 50 0.5 500 1.0 30 20 Allowed limitation Level Level Level II III IV 5-9 5-9 5-9 30 40 50 50 60 100 0.5 0.5 0.5 500 500 500 1.0 3.0 4.0 30 40 50 20 20 20 Level V 5-9 200 100 KQĐ KQĐ KQĐ KQĐ 100 1000 1000 KQĐ 10000 10 5000 10 5000 Table : Price for sampling and analysis No CRITERION UNIT PRICE(VND) METHOD pH 30,000TCVN 6492:2000 BOD 80,000APHA 5210 BTCVN 6001-95 Total suspended solid (TSS) 50,000APHA 2540 DTCVN 4560:1998 Total solid (TS) 60,000APHA 2540 BTCVN 4560:1998 50,000APHA 2540 CTCVN 4560:1998 Total dissolved solid (TDS) H2S Nitrat 60,000APHA 4500-NO -TCVN 6178-96 Total grease, oil Total P, PO43- 60,000APHA 4500 –P TCVN 6202-96 10 Total Coliform 80,000TCVN 4882:2001 70,000APHA 4500, TCVN 5370-91 300,000APHA 5220 98 Fee for sampling/person/1 time 100,000In HCM city Transport cost 200,000In HCM city TOTAL 1,140,000 99