Thông tư 27/2015 TT-BTNMT về kế hoạch bảo vệ môi trường

2 CNG BO/S 639 + 640/Ngy 29-6-2015

PHN VN BN QUY PHM PHP LUT

B TI NGUYN V MI TRNG

Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 v nh gi mi trng chin lc, nh gi tc ng mi trng

v k hoch bo v mi trng

(Tip theo Cng bo s 637 + 638)

Ph lc 2.4 Mu vn bn ca ch d n gi xin kin tham vn y ban nhn dn

cp x/c quan, t chc chu tc ng trc tip bi d n v ni dung ca bo co nh gi tc ng mi trng

(Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,

nh gi tc ng mi trng v k hoch bo v mi trng)

(1)

S:... V/v xin kin tham vn cng ng v ni dung bo co

TM ca d n (2)

CNG HA X HI CH NGHA VIT NAMc lp - T do - Hnh phc

(a danh), ngy... thng... nm...

Knh gi: (3)

Thc hin Lut Bo v mi trng nm 2014 v cc quy nh ca php lut v

nh gi tc ng mi trng (TM), (1) lp bo co TM ca d n (2). (1) Gi n (3) bo co TM ca d n v rt mong nhn c kin tham

vn ca (3).

Ni nhn: - Nh trn; - ...; - Lu:...

(4) (K, ghi h tn, chc danh, ng du)

Ghi ch: (1) ch d n; (2) Tn y , chnh xc ca d n; (3) C quan, t chc

c xin kin tham vn; (4) i din c thm quyn ca (1).

CNG BO/S 639 + 640/Ngy 29-6-2015 3

Ph lc 2.5 Mu vn bn tr li ca c quan, t chc c xin kin tham vn



(1)

S:... V/v kin tham vn

v d n (2)

CNG HA X HI CH NGHA VIT NAM c lp - T do - Hnh phc


Knh gi: (3)

(1) nhn c Vn bn s... ngy... thng... nm... ca (3) km theo bo co

nh gi tc ng mi trng ca d n (2). Sau khi xem xt ti liu ny, (1) c kin nh sau:

1. V cc tc ng tiu cc ca d n n mi trng t nhin, kinh t - x hi v sc khe cng ng: nu r kin ng hay khng ng vi cc ni dung tng ng c trnh by trong ti liu gi km; trng hp khng ng th ch r cc ni dung, vn c th khng ng .

2. V cc bin php gim thiu tc ng tiu cc ca d n n mi trng t nhin, kinh t - x hi v sc khe cng ng: nu r kin ng hay khng ng vi cc ni dung tng ng c trnh by trong ti liu gi km; trng hp khng ng th ch r cc ni dung, vn c th khng ng .

3. Kin ngh i vi ch d n: nu c th cc yu cu, kin ngh ca cng ng i vi ch d n lin quan n vic cam kt thc hin cc bin php, gii php gim thiu cc tc ng tiu cc ca d n n mi trng t nhin, kinh t - x hi, sc khe cng ng v cc kin ngh khc c lin quan n d n (nu c).

Trn y l kin ca (1) gi (3) xem xt v hon chnh bo co nh gi tc ng mi trng ca d n./. Ni nhn: - Nh trn; - ...; - Lu:...


Ghi ch: (1) C quan, t chc c xin kin tham vn; (2) Tn y ca d n; (3) Ch d n; (4) i din c thm quyn ca (1).

4 CNG BO/S 639 + 640/Ngy 29-6-2015

Ph lc 2.6 Mu bin bn hp tham vn cng ng dn c

chu tc ng trc tip bi d n (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,



BIN BN HP THAM VN CNG NG DN C

CHU TC NG TRC TIP BI D N Tn d n: Thi gian hp: ngy... thng... nm... a ch ni hp:... 1. Thnh phn tham d: 1.1. i din y ban nhn dn cp x ni thc hin d n ch tr cuc hp v

ch nh ngi ghi bin bn cuc hp 1.2. Ch d n l ng ch tr phin hp 1.3. n v t vn lp bo co nh gi tc ng mi trng (nu c) 1.4. i biu tham d: i din ca y ban mt trn T quc cp x, cc t

chc chnh tr - x hi, t chc x hi ngh nghip, t dn ph, thn, bn Lu : Lp bng danh sch ghi r h tn, chc v, ch k ca nhng ngi

tham d. 2. Ni dung v din bin cuc hp: (Yu cu ghi theo trnh t din bin ca

cuc hp, ghi y , trung thc cc cu hi, tr li, cc kin trao i, tho lun ca cc bn tham gia cuc hp tham vn cng ng)

2.1. Ngi ch tr cuc hp thng bo l do cuc hp v gii thiu thnh phn tham d.

2.2. Ch d n trnh by tm tt bo co TM ca d n gm cc ni dung ca d n, cc tc ng tch cc v tiu cc ca d n n mi trng v sc khe cng ng, cc bin php gim thiu.

2.3. Tho lun, trao i gia cng ng dn c chu tc ng trc tip vi ch d n, y ban nhn dn cp x v cc vn m ch d n trnh by ti cuc hp.

Lu : Ghi chi tit v y cc ni dung trao i, tho lun, phn hi, kin ngh ca i din cng ng dn c, phn hi ca ch d n.

3. Ngi ch tr cuc hp tuyn b kt thc cuc hp

I DIN UBND CP X (K, ghi h tn)

I DIN CH D N (K, ghi h tn)

CNG BO/S 639 + 640/Ngy 29-6-2015 5

Ph lc 2.7 Mu quyt nh ph duyt bo co nh gi tc ng mi trng



(1)

S:...



QUYT NH

Ph duyt bo co nh gi tc ng mi trng ca D n (2) (3)

Cn c Lut Bo v mi trng ngy 23 thng 6 nm 2014; Cn c Ngh nh s 18/2015/N-CP ngy 14 thng 02 nm 2015 ca Chnh

ph quy nh v quy hoch bo v mi trng nh gi mi trng chin lc, nh gi tc ng mi trng v k hoch bo v mi trng;

Cn c Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B Ti nguyn v Mi trng v nh gi mi trng chin lc, nh gi tc ng mi trng v k hoch bo v mi trng;

Cn c (4); Cn c (5) (nu c); Theo ngh ca hi ng thm nh bo co nh gi tc ng mi trng

ca d n (2) hp ngy... thng... nm... ti...; Xt ni dung bo co nh gi tc ng mi trng ca d n (2) c

chnh sa, b sung gi km Vn bn s... ngy... thng... nm... ca (6); Xt ngh ca c quan thng trc thm nh,

QUYT NH:

iu 1. Ph duyt bo co nh gi tc ng mi trng ca d n (2) (sau

y gi l d n) c lp bi (6) (sau y gi l ch d n) vi cc ni dung ch yu sau y:

1. Phm vi, quy m, cng sut ca d n: 1.1.... 1.2.... ...

6 CNG BO/S 639 + 640/Ngy 29-6-2015

2. Yu cu bo v mi trng i vi d n: 2.1.... 2.2.... ... 3. Cc iu kin km theo (nu c): 3.1.... 3.2.... ... iu 2. Ch d n c trch nhim: 1. Lp v gi k hoch qun l mi trng ca d n nim yt cng khai

theo quy nh php lut. 2. Thc hin nghim tc cc yu cu v bo v mi trng, cc iu kin nu

ti iu 1 Quyt nh ny v cc ni dung bo v mi trng khc xut trong bo co nh gi tc ng mi trng.

3. Bo co kt qu thc hin cc cng trnh bo v mi trng c kim tra, xc nhn hon thnh trc khi a d n vo vn hnh chnh thc theo quy nh php lut hin hnh v bo v mi trng (ch p dng i vi cc d n thuc ct 4 Ph lc II Ngh nh s 18/2015/N-CP).

4. Trong qu trnh thc hin nu d n c nhng thay i so vi bo co nh gi tc ng mi trng c ph duyt, ch d n phi c vn bn bo co v ch c thc hin nhng thay i sau khi c vn bn chp thun ca (1).

iu 3. Quyt nh ph duyt bo co nh gi tc ng mi trng ca d n l cn c cp c thm quyn xem xt, quyt nh cc bc tip theo ca d n theo quy nh ti Khon 2 iu 25 Lut Bo v mi trng.

iu 4. y nhim (7) thc hin kim tra cc ni dung bo v mi trng trong bo co nh gi tc ng mi trng c ph duyt ti Quyt nh ny.

iu 5. Quyt nh ny c hiu lc thi hnh k t ngy k./.

Ni nhn: - Ch d n; - ...; - Lu:...


Ghi ch: (1) Tn c quan ph duyt bo co TM ca d n; (2) Tn y , chnh

xc ca d n; (3) Th trng hoc ngi ng u (1); (4) Tn y ca vn bn quy nh chc nng, nhim v, quyn hn v c cu t chc ca (1); (5) Vn bn ca c quan c thm quyn y quyn cho (1) thm nh v ph duyt bo co TM ca d n (nu c); (6) Ch d n; (7) C quan c giao trch nhim t chc kim tra, gim st cc cng trnh bo v mi trng phc v giai on vn hnh ca d n.

CNG BO/S 639 + 640/Ngy 29-6-2015 7

Ph lc 2.8 Mu xc nhn bo co nh gi tc ng mi trng c ph duyt



(1) xc nhn: bo co nh gi tc ng mi trng ca d n (2) c ph duyt bi Quyt nh s... ngy... thng... nm... ca (3). (a danh), ngy... thng... nm...

Th trng c quan xc nhn (K, ghi h tn, chc danh, ng du)

Ghi ch: (1) C quan ph duyt bo co nh gi tc ng mi trng hoc c quan

thng trc thm nh khi c c quan ph duyt bo co nh gi tc ng mi trng y quyn xc nhn; (2) Tn gi y , chnh xc ca d n; (3) Th trng hoc ngi ng u c quan ph duyt bo co nh gi tc ng mi trng.

8 CNG BO/S 639 + 640/Ngy 29-6-2015

Ph lc 2.9 Mu trang ba k hoch qun l mi trng ca d n



Tn c quan ch qun (1)

K HOCH QUN L MI TRNG ca (2)

i din ca (1) (K, ghi h tn, ng du) (*)

a danh(**), thng... nm...

Ghi ch: (1) Ch d n; (2) Tn gi y , chnh xc ca d n; (*) Ch th hin ti trang ph ba; (**) a danh cp tnh ni thc hin d n hoc ni t tr s chnh ca ch d n.

CNG BO/S 639 + 640/Ngy 29-6-2015 9

Ph lc 2.10 Cu trc v ni dung ca k hoch qun l mi trng ca d n



(1)



K HOCH QUN L MI TRNG

ca d n (2)

1. Thng tin chung v d n v ch d n Tn ch d n:...................................................................................................... a ch:..........................; in thoi:.........................; Fax:................................; Tn d n:............................................................................................................. a im thc hin d n:..................................................................................... Quyt nh ph duyt bo co nh gi tc ng mi trng s... ngy...

thng... nm... ca... (3). 2. Ni dung chnh ca k hoch qun l mi trng 2.1. Bin php, k hoch gim thiu tc ng xu n mi trng trong giai

on chun b (nu c) v giai on xy dng d n, bao gm: - Gim thiu tc ng xu n mi trng nc mt (nu c); - Gim thiu tc ng xu n mi trng nc ngm (nu c); - Gim thiu tc ng xu n mi trng khng kh (nu c); - Gim thiu tc ng xu do ting n, rung (nu c); - Gim thiu tc ng xu n cng ng dn c (nu c); - Thu gom, lu gi tm thi, vn chuyn v x l cht thi; - Gim thiu cc tc ng xu khc (nu c). 2.2. D kin k hoch xy lp cc cng trnh bo v mi trng phc v giai

on vn hnh ca d n (nu c), bao gm: - Cng trnh x l nc thi sinh hot; - Cng trnh x l nc thi sn xut; - Cng trnh x l kh thi;

10 CNG BO/S 639 + 640/Ngy 29-6-2015

- Cng trnh lu gi, x l cht thi rn thng thng, cht thi nguy hi; - K hoch xy lp cc cng trnh bo v mi trng khc (nu c). Lu : ni dung k hoch xy lp cc cng trnh bo v mi trng phc v

giai on vn hnh ca d n cn nu r thi gian d kin xy dng, lp t v hon thnh.

2.3. Chng trnh gim st mi trng trong giai on thi cng xy dng d n: Lu : ni dung chng trnh gim st mi trng cn nu r v tr gim st,

tn sut gim st, thng s gim st v tiu chun, quy chun k thut p dng nh gi cht lng mu mi trng km theo s v tr ly mu c ph duyt trong bo co nh gi tc ng mi trng.

Ni nhn: - Nh trn; - ......; - Lu:...


Ghi ch: (1) Ch d n; (2) Tn gi y , chnh xc ca d n; (3) T chc ni

tin hnh tham vn, c quan ph duyt bo co nh gi tc ng mi trng; (4) i din c thm quyn ca ch d n.

CNG BO/S 639 + 640/Ngy 29-6-2015 11

Ph lc 2.11 Mu vn bn ca ch d n gi y ban nhn dn cp x nim yt

cng khai k hoch qun l mi trng ca d n (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,


(1)

S:... V/v cng khai k hoch qun l mi trng ca d n (2)



Knh gi: y ban nhn dn (3)

Chng ti l: (1), ch d n ca d n (2) (sau y gi tt l d n), c (4)

ph duyt bo co nh gi tc ng mi trng ti Quyt nh s... ngy... thng... nm...

Theo quy nh ti iu 10 Thng t s 27/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc, nh gi tc ng mi trng v k hoch bo v mi trng, xin gi ti qu y ban bn k hoch qun l mi trng ca d n nim yt cng khai.

Xin trn trng cm n s hp tc ca qu y ban./.

Ni nhn: - Nh trn; - (4); - Lu:...


Ghi ch: (1) Ch d n; (2) Tn gi y , chnh xc ca d n; (3) Tn y ban

nhn dn cp x tham vn kin trong qu trnh thc hin nh gi tc ng mi trng; (4) C quan ph duyt bo co nh gi tc ng mi trng ca d n; (5) i din c thm quyn ca ch d n.

12 CNG BO/S 639 + 640/Ngy 29-6-2015

Ph lc 2.12 Mu vn bn thng bo

k hoch vn hnh th nghim cng trnh x l cht thi (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,


(1)

S:...

CNG HA X HI CH NGHA VIT NAM c lp - T do - hnh phc


Knh gi: (2)

K HOCH VN HNH TH NGHIM CC CNG TRNH X L CHT THI

ca d n (3) (hoc ca hng mc/phn k u t ca d n (3)) 1. a im thc hin d n:... 2. Quyt nh ph duyt bo co nh gi tc ng mi trng: s.....

ngy... thng... nm... ca... 3. Ch d n:... - a ch lin h:... - in thoi:...; Fax:...; E-mail:... 4. Thi gian d kin thc hin vn hnh th nghim (*): (a ra danh mc cc cng trnh x l cht thi ca d n phi hon thnh

trc khi d n hoc hng mc/phn k u t ca d n i vo vn hnh chnh thc km theo thi gian biu d kin thc hin vn hnh th nghim). Ni nhn: - Nh trn; - ...; - Lu:...


Ghi ch: (1) Ch d n; (2) C quan ph duyt bo co nh gi tc ng mi trng ca d

n; (3) Tn y ca d n; (4) i din c thm quyn ca ch d n; (*) Vic vn hnh th nghim cc cng trnh x l cht thi ko di khng qu su

(06) thng, k t thi im bt u vn hnh th nghim.

CNG BO/S 639 + 640/Ngy 29-6-2015 13

Ph lc 2.13 Mu vn bn ly kin y quyn thm nh, ph duyt

bo co nh gi tc ng mi trng (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,


(1)

S:... V/v ly kin y quyn thm nh, ph duyt bo co nh

gi tc ng mi trng

CNG HA X HI CH NGHA VIT NAMc lp - T do - hnh phc


Knh gi: B Ti nguyn v Mi trng

Theo quy nh ti Khon 4 iu 11 Thng t s 27/2015/TT-BTNMT ngy 29

thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc, nh gi tc ng mi trng v k hoch bo v mi trng, (1) bo co v ngh B Ti nguyn v Mi trng cho kin i vi vic (1) y quyn cho (2) thm nh, ph duyt bo co nh gi tc ng mi trng i vi cc d n u t thc hin ti cc khu cng nghip sau y trn a bn (3):

1... 2... .... (1) gi km theo h s (*) v ngh B Ti nguyn v Mi trng xem xt,

chp thun./.

Ni nhn: - Nh trn; - ...; - Lu:...


Ghi ch: (1) Tn UBND cp tnh; (2) Tn Ban qun l c y quyn; (3) Tn a danh cp tnh; (4) i

din c thm quyn ca (1). (*) H s km theo gm c: 1. Vn bn ca (2) ngh (1) y quyn; vn bn ca S Ti nguyn v Mi trng ngh (1)

y quyn; 2. Bn sao vn bn quy nh chc nng, nhim v, quyn hn, t chc b my ca (2); bn sao

vn bn thnh lp b phn chuyn mn v bo v mi trng ca (2) km theo danh sch (c ghi r h tn, ngy thng nm sinh, ngch cng chc, hc hm, hc v, chuyn ngnh c o to) cc cng chc trong b phn chuyn mn v bo v mi trng ca (2);

3. Bn tm tt tnh hnh xy dng c s h tng v bo v mi trng ca cc khu cng nghip trn a bn (1); bn sao cc vn bn thnh lp khu cng nghip;quyt nh ph duyt quy hoch khu cng nghip; quyt nh ph duyt bo co nh gi tc ng mi trng; bn sao giy xc nhn vic thc hin cc cng trnh, bin php bo v mi trng ca cc d n xy dng c s h tng khu cng nghip.

14 CNG BO/S 639 + 640/Ngy 29-6-2015

Ph lc 2.14 Mu vn bn y quyn thm nh, ph duyt bo co nh gi tc ng

mi trng ca y ban nhn dn cp tnh cho Ban qun l cc khu cng nghip



(1)

S:...



QUYT NH

V vic y quyn thm nh, ph duyt bo co nh gi tc ng mi trng

(1) Cn c Ngh nh s 18/2015/N-CP ngy 14 thng 02 nm 2015 ca Chnh

ph quy nh v quy hoch bo v mi trng, nh gi mi trng chin lc, nh gi tc ng mi trng v k hoch bo v mi trng;

Cn c Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc, nh gi tc ng mi trng v k hoch bo v mi trng;

Cn c (2) quy nh chc nng, nhim v, quyn hn v c cu t chc ca (1); Cn c Vn bn s... ngy... thng... nm... ca B Ti nguyn v Mi trng; Theo ngh ca Gim c S Ti nguyn v Mi trng v Trng Ban (3),

QUYT NH:

iu 1. y quyn cho (3) thm nh, ph duyt bo co nh gi tc ng mi trng i vi cc d n u t thc hin ti cc khu cng nghip sau y:

1... 2... .... iu 2. (3) c trch nhim: 1. T chc thm nh, ph duyt bo co nh gi tc ng mi trng, iu

chnh ni dung bo co nh gi tc ng mi trng do mnh ph duyt i vi

CNG BO/S 639 + 640/Ngy 29-6-2015 15 cc d n thc hin ti cc khu cng nghip nu ti iu 1 Quyt nh ny theo ng quy nh ca php lut.

2. Thc hin gim st cng tc bo v mi trng trong qu trnh trin khai cc d n do mnh ph duyt bo co nh gi tc ng mi trng; ch tr tr li kin ca t chc, c nhn lin quan n bo co nh gi tc ng mi trng do mnh ph duyt.

3. Chu trch nhim trc (1) v trc php lut v vic thc hin cc ni dung c y quyn.

4. Tng hp s liu v bo co nh k n (1) v cc ni dung thc hin theo y quyn ti Quyt nh ny trc ngy 31 thng 12 hng nm.

5. Thng bo rng ri cc ni dung c y quyn ti Quyt nh ny n cc t chc, c nhn bit v lin h cng tc.

iu 3. Quyt nh ny c hiu lc k t ngy... thng... nm... Trng Ban (3), Gim c S Ti nguyn v Mi trng, Th trng cc c

quan thuc y ban nhn dn (1) chu trch nhim thi hnh Quyt nh ny./. Ni nhn: - Nh iu 3; - ...; - Lu:...


Ghi ch: (1) Tn UBND cp tnh; (2) Tn y ca vn bn quy nh chc nng, nhim v,

quyn hn v c cu t chc ca (1); (3) Tn Ban qun l c y quyn; (4) i din c thm quyn ca (1).

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Ph lc 3.1 Mu vn bn ngh kim tra, xc nhn hon thnh cng trnh

bo v mi trng phc v giai on vn hnh d n (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,


(1)

S:... V/v ngh kim tra, xc nhn

hon thnh cng trnh bo v mi trng phc v giai on vn hnh

ca d n (hoc ca hng mc/phn k u t ca d n)



Knh gi: (2)

Chng ti l: (1), ch d n ca d n (3) (sau y gi tt l d n), c

(4) ph duyt bo co nh gi tc ng mi trng ti Quyt nh s... ngy... thng... nm...

- a im thc hin d n:... - a ch lin h:... - in thoi:...; Fax:...; E-mail:... thc hin cc cng trnh bo v mi trng phc v giai on vn hnh ca

d n (hoc ca hng mc/phn k u t ca d n) gm c: 1... 2... ... (Lu : ghi r cc hng mc/phn k ca d n ang ngh xc nhn hon

thnh cng trnh x l mi trng) Gi n qu (2) h s gm: - Mt (01) bn sao quyt nh ph duyt km theo bn sao bo co nh gi tc

ng mi trng c (4) ph duyt; - By (07) bn bo co kt qu thc hin cc cng trnh bo v mi trng

phc v giai on vn hnh ca d n (trng hp d n nm trn din tch t ca t 02 tnh, thnh ph trc thuc Trung ng tr ln, phi gi thm s lng bo co bng s lng cc tnh tng thm, hoc s lng tng thm theo yu cu ca (2) phc v cng tc kim tra);

CNG BO/S 639 + 640/Ngy 29-6-2015 17

Chng ti bo m v trung thc ca cc thng tin, s liu c a ra trong cc ti liu nu trn. Nu c g sai tri, chng ti hon ton chu trch nhim trc php lut ca Vit Nam.

ngh qu (2) kim tra, xc nhn vic (1) hon thnh cng trnh, bo v mi trng phc v giai on vn hnh ca d n (hoc ca hng mc/phn k u t ca d n)./. Ni nhn: - Nh trn; - ...; - Lu:...


Ghi ch: (1) Ch d n; (2) Tn c quan c trch nhim kim tra, xc nhn; (3) Tn y ca d n; (4) C quan ph duyt bo co nh gi tc ng mi trng ca d n; (5) i din c thm quyn ca ch d n.

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Ph lc 3.2 Mu bo co kt qu thc hin cng trnh bo v mi trng

phc v giai on vn hnh ca d n (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,


(1)

S:...



Knh gi: (2)

BO CO KT QU THC HIN CNG TRNH BO V MI TRNG PHC V GIAI ON VN HNH

ca D n (3)

1. Thng tin chung v d n: Tn ch d n:...................................................................................................... a ch vn phng:................................................................................................ in thoi:.............................. Fax:........................ E-mail:.................................. a im thc hin d n:..................................................................................... Quyt nh ph duyt bo co nh gi tc ng mi trng s... ngy...

thng... nm... ca... 2. Cc cng trnh bo v mi trng ca d n (hoc ca hng mc/phn

k u t ca d n) hon thnh 2.1. Cng trnh x l nc thi 2.1.1. Mng li thu gom nc thi, thot nc (cn m t r cc thng s

k thut ca h thng thu gom, thot nc; v tr ca cc cng trnh ny km theo s minh ha)

2.1.2. Cng trnh x l nc thi c xy lp: (cn m t r quy trnh cng ngh, quy m cng sut, cc thng s k thut ca cng trnh, cc thit b c xy lp)

2.1.3. Kt qu vn hnh th nghim cng trnh x l nc thi (cn nu r tn v a ch lin h ca n v thc hin vic o c, ly mu phn tch v mi trng: thi gian, phng php, khi lng mu gi nh c to lp (nu c); thi gian tin hnh o c, ly mu, phn tch mu; thit b, phng php o c, ly mu v phn tch mu c s dng)

CNG BO/S 639 + 640/Ngy 29-6-2015 19

Kt qu vn hnh th nghim cng trnh x l nc thi c trnh by theo mu bng sau:

Thng s nhim c trng (*) ca d n

Thng s A (n v tnh)

Thng s B (n v tnh)

v.v...

Ln o c, ly mu phn tch; Tiu

chun, Quy chun i chiu

Lu lng thi

(n v tnh)

Trc khi x

l

Sau khi x

l

Trc khi x

l

Sau khi x

l

Trc khi x

l

Sau khi

x l

Ln 1 ... ... TCVN/QCVN........

Ghi ch: (*) Thng s nhim c trng ca d n l nhng thng s nhim do d n

trc tip hoc gin tip to ra. 2.2. Cng trnh x l bi, kh thi: cn lit k y cc cng trnh; bin

php x l bi, kh thi c xy lp; ngun gc v hiu qu x l ca cc thit b x l bi, kh thi chnh c lp t; kt qu vn hnh th nghim cc cng trnh x l bi, kh thi v thng k di dng bng tng t nh i vi nc thi (tr ct trc khi x l).

2.3. Cng trnh lu gi, x l cht thi rn: m t cng trnh lu gi cht thi rn; lm r quy m, cc thng s k thut km theo thit k chi tit ca cc cng trnh x l cht thi rn trong trng hp ch d n t x l.

2.4. Cng trnh lu gi, x l cht thi nguy hi: m t cng trnh lu gi cht thi nguy hi; lm r quy m, cc thng s k thut km theo thit k chi tit ca cc cng trnh x l cht thi rn trong trng hp ch d n t x l.

2.5. Cng trnh phng nga, ng ph s c mi trng v cc cng trnh bo v mi trng khc: (nu c)

3. Cc cng trnh bo v mi trng ca d n c iu chnh, thay i so vi bo co nh gi tc ng mi trng c ph duyt (kt qu trnh by cn th hin di dng bng c thuyt minh km theo, trong nu r nhng ni dung c iu chnh, thay i v vn bn ng /cho php ca c quan ph duyt bo co TM)

20 CNG BO/S 639 + 640/Ngy 29-6-2015

STT Tn cng

trnh bo v mi trng

Phng n xut trong bo

co TM

Phng n iu chnh, thay i thc hin

Vn bn ng /cho php ca c quan ph duyt bo co TM

1 ... ... ... 2... ... ... ...

Chng ti cam kt rng nhng thng tin, s liu nu trn l ng s thc; nu c g sai tri, chng ti hon ton chu trch nhim trc php lut./. Ni nhn: - Nh trn; - ...; - Lu:...


Ghi ch: (1) Ch d n; (2) Tn c quan kim tra, xc nhn hon thnh cng trnh bo v mi

trng; (3) Tn y , chnh xc ca d n hoc ca hng mc/phn k u t ca d n (3); (4) i din c thm quyn ca ch d n.

Ph lc km theo bo co kt qu thc hin cc cng trnh bo v mi trng phc v giai on vn hnh ca d n, bao gm cc ti liu sau (ty loi hnh d n v tng d n c th m c th c mt s hoc tt c cc ti liu ny):

- Cc bn v k thut hoc h s thuyt minh cng trnh bo v mi trng; - Cc chng ch, chng nhn, cng nhn ca cc thit b x l mi trng ng b

nhp khu hoc c thng mi ha; - Cc phiu kt qu o c, phn tch mu vn hnh th nghim cc cng trnh x l

cht thi; - Cc vn bn ca c quan c thm quyn chp thun thay i, iu chnh bo co

TM ca d n; - Bin bn nghim thu cc cng trnh bo v mi trng hoc cc vn bn khc c

lin quan n cc cng trnh bo v mi trng.

CNG BO/S 639 + 640/Ngy 29-6-2015 21

Ph lc 3.3 Mu Quyt nh thnh lp on kim tra vic thc hin

cng trnh bo v mi trng phc v giai on vn hnh ca d n (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,


(1)

S:...



QUYT NH

V vic thnh lp on kim tra vic thc hin cng trnh bo v mi trng phc v giai on vn hnh ca d n (2)

(3)

Cn c Lut Bo v mi trng ngy 23 thng 6 nm 2014; Cn c Ngh nh s 18/2015/N-CP ngy 14 thng 02 nm 2015 ca Chnh



Cn c (4); Cn c Quyt nh s... ngy... thng... nm... ca (5) v vic ph duyt bo

co nh gi tc ng mi trng ca d n (2); Xt ngh ca (6) ti Vn bn s... ngy... thng... nm v vic ngh kim

tra, xc nhn hon thnh cng trnh bo v mi trng ca d n (2); Theo ngh ca (7),

QUYT NH: iu 1. Thnh lp on kim tra vic thc hin cc cng trnh bo v mi

trng phc v giai on vn hnh ca d n (2) (hoc ca hng mc/phn k u t ca d n (2))gm cc ng/B c tn sau y:

TT H v tn Hc hm, hc v Ni cng tc Chc danh trong on kim tra

1 ... ... ... Trng on 2 ... ... ... Ph Trng on 3 ... ... ... Th k 4 ... ... ... Thnh vin

22 CNG BO/S 639 + 640/Ngy 29-6-2015

iu 2. on kim tra c trch nhim kim tra v lp bin bn kim tra vic (6) thc hin cc cng trnh bo v mi trng phc v giai on vn hnh ca d n (2) theo quy nh. on kim tra t gii th sau khi hon thnh nhim v.

iu 3. Chi ph cho hot ng ca on kim tra c thc hin theo quy nh ca php lut hin hnh v ly t ngun kinh ph ca (1).

iu 4. Quyt nh ny c hiu lc k t ngy k. (6), (7) v cc ng/B c tn ti iu 1 chu trch nhim thi hnh Quyt

nh ny./. Ni nhn: - Nh iu 4; - ...; - Lu:...


Ghi ch: (1) C quan c thm quyn ra quyt nh thnh lp on kim tra; (2) Tn

y , chnh xc ca d n hoc ca hng mc/phn k u t ca d n (2); (3) Th trng hoc ngi ng u c quan ra quyt nh thnh lp on kim tra; (4) Tn y ca vn bn quy nh chc nng, nhim v, quyn hn v c cu t chc ca (1); (5) Tn c quan ph duyt bo co nh gi tc ng mi trng ca d n; (6) Ch d n; (7) Th trng c quan ch tr thc hin vic kim tra.

CNG BO/S 639 + 640/Ngy 29-6-2015 23

Ph lc 3.4 Mu bn nhn xt, nh gi vic thc hin cng trnh bo v mi trng

ca thnh vin on kim tra (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,



BN NHN XT, NH GI VIC THC HIN CNG TRNH

BO V MI TRNG ca d n... (hoc ca hng mc/phn k u t ca d n...)

1. H v tn ngi nhn xt, nh gi:... 2. Hc hm, hc v, chc v cng tc:... 3. Ni cng tc (tn c quan/n v, a ch, s in thoi, Fax, E-mail):... 4. Quyt nh thnh lp on kim tra: s... ngy... thng... nm... ca... 5. Chc danh trong on kim tra:... 6. Nhn xt, nh gi vic thc hin cng trnh bo v mi trng phc v giai

on vn hnh ca d n (hoc ca hng mc/phn k u t ca d n...): nhn xt ngn gn v nhng mt c, nu chi tit nhng tn ti ca tng cng trnh bo v mi trng thc hin

6.1. Cng trnh x l bi, kh thi 6.2. Cng trnh x l nc thi 6.3. Cng trnh lu gi, x l cht thi rn thng thng 6.4. Cng trnh lu gi, x l cht thi nguy hi 6.5. Cng trnh phng nga, ng ph s c mi trng 6.6. Cng trnh gim thiu tc ng tiu cc n mi trng khc 6.7. Nhng ngh, khuyn ngh 7. Kt lun v mc hon thnh cng trnh bo v mi trng phc v giai

on vn hnh ca d n: ghi r mt (01) trong hai (02) mc : t yu cu hoc khng t yu cu. Trng hp khng t yu cu cn nu r l do (a danh ni vit nhn xt, nh gi), ngy... thng... nm...

NGI VIT NHN XT, NH GI (K, ghi h tn)

24 CNG BO/S 639 + 640/Ngy 29-6-2015

Ph lc 3.5 Mu bin bn kim tra vic thc hin

cng trnh bo v mi trng phc v giai on vn hnh ca d n (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,



BIN BN KIM TRA VIC THC HIN CNG TRNH

BO V MI TRNG PHC V GIAI ON VN HNH ca d n (1) (hoc ca hng mc/phn k u t ca d n (1))

on kim tra c thnh lp theo Quyt nh s... ngy... thng... nm... ca (2)

tin hnh kim tra vic thc hin cng trnh bo v mi trng phc v giai on vn hnh ca d n (1) (hoc ca hng mc/phn k u t ca D n):

- Thi gian kim tra: t.... gi.... ngy.... thng.... nm.... n.... gi.... ngy.... thng... nm...

- i tng kim tra: d n (1) (hoc cc hng mc/phn k u t ca d n) c kim tra: ghi r tn d n hoc cc hng mc/phn k u t ca d n c kim tra

- a im kim tra: ghi r a im thc hin vic kim tra - Thnh phn on kim tra: + Thnh vin c mt: ch cn ghi s lng thnh vin c mt trn tng s

thnh vin trong quyt nh thnh lp on, v d: 7/9 + Thnh vin vng mt: ghi y s lng, h tn v chc danh trong on

kim tra ca cc thnh vin vng mt, l do vng mt - i din ch d n: ghi y h, tn, chc v ca i din c thm quyn

ca ch d n - Vi s tham gia ca: ghi y h, tn, chc v, n v cng tc ca nhng

ngi c mt, nu c Sau khi kim tra, cc bn lin quan thng nht nh sau: I. Kt qu kim tra cc cng trnh bo v mi trng phc v giai on

hot ng ca d n 1. Cng trnh thu gom, x l nc thi: (Lit k cc cng trnh thu gom, x

l nc thi hon thnh phc v giai on vn hnh ca d n (hoc ca hng mc/phn k u t ca d n); m t r quy m cng sut v quy trnh vn hnh ca cc cng trnh x l nc thi).

CNG BO/S 639 + 640/Ngy 29-6-2015 25

2. Cng trnh x l bi, kh thi: (Lit k cc cng trnh x l bi, kh thi hon thnh phc v giai on vn hnh ca d n (hoc ca hng mc/phn k u t ca d n); m t r quy m cng sut v quy trnh vn hnh ca cc cng trnh x l bi, kh thi)

3. Cng trnh lu gi, x l cht thi rn, cht thi nguy hi: (Lit k cc cng trnh lu gi, x l cht thi rn, cht thi nguy hi hon thnh phc v giai on vn hnh ca d n (hoc ca hng mc/phn k u t ca d n); m t r quy m cng sut v quy trnh vn hnh ca cc cng trnh ny).

4. Cng trnh phng nga, ng ph s c mi trng v cc cng trnh, bo v mi trng khc: (ghi r thc trng xy dng, lp t cc cng trnh ng ph s c mi trng; cc cng trnh bo v mi trng khc nu trong bo co nh gi tc ng mi trng).

II. Cc cng trnh bo v mi trng c thay i, iu chnh so vi phng n xut trong bo co nh gi tc ng mi trng (nu c) (lit k v m t r cc cng trnh bo v mi trng phc v giai on vn hnh ca d n c ch d n thc hin nhng c thay i, iu chnh so vi xut nu trong bo co nh gi tc ng mi trng c ph duyt v s ph hp vi vn bn ng /cho php ca c quan ph duyt bo co nh gi tc ng mi trng).

III. kin ca on kim tra Ch ghi nhng tn ti lin quan n cc cng trnh bo v mi trng phc v

giai on vn hnh ca d n (hoc ca hng mc/phn k u t ca d n) cn c tip tc thc hin m bo cc quy nh, quy chun, tiu chun c lin quan.

IV. kin ca ch d n (ch ghi cc kin ca ch d n khc vi ni dung kt lun ca on kim tra nu ti mc I, II v III).

Bin bn c hon thnh vo hi... gi... ngy... thng... nm... ti... v c k cho nhng ngi tham d cng nghe./.

i din ch d n (K, ghi h tn, chc v)

Th k on kim tra (K, ghi h tn)

Trng on kim tra (hoc Ph Trng on trong trng hp c Trng on y quyn)

(K, ghi h tn) Ghi ch: Nhng ngi k ti trang cui cng ca bin bn phi k vo pha di ca tng

trang bin bn trong trng hp bin bn nhiu hn mt (01) trang. (1) Tn y , chnh xc ca d n; (2) C quan thnh lp on kim tra.

26 CNG BO/S 639 + 640/Ngy 29-6-2015

Ph lc 3.6 Mu giy xc nhn hon thnh cng trnh bo v mi trng

phc v giai on vn hnh ca d n (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,


(1)

S:...



GIY XC NHN

HON THNH CNG TRNH BO V MI TRNG ca D n (2)

(3) xc nhn: I. Thng tin chung v d n/c s: Tn ch d n: a ch vn phng: a im hot ng: in thoi: Fax: Ti khon s:............................................ ti..............................................................Giy chng nhn ng k kinh doanh s............. Ngy cp:......... Ni cp: Quyt nh ph duyt bo co nh gi tc ng mi trng s................................II. Ni dung xc nhn: Xc nhn hon thnh cng trnh bo v mi trng phc v giai on vn hnh ca

D n (2) (ti Ph lc km theo). III. Trch nhim ca ch d n: Tun th cc quy nh ca php lut v bo v mi trng; thng xuyn vn hnh

v lp nht k vn hnh cc cng trnh bo v mi trng nu ti Mc..... ca Ph lc km theo Giy xc nhn ny; thc hin ch bo co v bo v mi trng v chng trnh gim st mi trng theo quy nh ca php lut.

IV. T chc thc hin: Giy xc nhn ny l cn c ch d n a d n vo hot ng chnh thc; l

cn c c quan nh nc c thm quyn kim tra, thanh tra vic chp hnh php lut v bo v mi trng trong qu trnh hot ng ca c s./. Ni nhn: - (4); - - Lu:...


CNG BO/S 639 + 640/Ngy 29-6-2015 27

PH LC (Km theo Giy xc nhn s:.......... ngy..... thng.....nm...... ca (1))

1. Cng trnh x l nc thi: Lit k cc cng trnh x l nc thi hon thnh phc v giai on vn

hnh ca D n (hoc ca hng mc/phn k u t ca D n); m t r quy m cng sut v quy trnh vn hnh ca cc cng trnh x l nc thi.

2. Cng trnh x l bi, kh thi: Lit k cc cng trnh x l bi, kh thi hon thnh phc v giai on vn

hnh ca D n (hoc ca hng mc/phn k u t ca D n); m t r quy m cng sut v quy trnh vn hnh ca cc cng trnh x l bi, kh thi.

3. Cng trnh x l, qun l cht thi rn, cht thi nguy hi: Lit k cc cng trnh x l, qun l cht thi rn, cht thi nguy hi

hon thnh phc v giai on vn hnh ca D n (hoc ca hng mc/phn k u t ca D n); m t r quy m cng sut v quy trnh vn hnh ca cc cng trnh ny.

4. Cng trnh x l nhim ting n v rung: Lit k cc cng trnh x l nhim ting n, rung hon thnh phc v

giai on vn hnh ca D n (hoc ca hng mc/phn k u t ca D n); m t r quy m v quy trnh x l ca cc cng trnh ny.

5. Cng trnh bo v mi trng khc: 6. H s km theo Giy xc nhn: H s sau y c (1) ng du xc nhn trang ba v du gip lai l b phn

khng tch ri km theo Giy xc nhn ny: B h s ngh xc nhn hon thnh cng trnh bo v mi trng vi dng

ch sau trn ba: Km theo Giy xc nhn s..... do (1) cp ln.... ngy thng...... nm.......

7. Yu cu khc: Trong qu trnh hot ng, nu c s c bt thng xy ra i vi cng trnh

bo v mi trng hoc c s thay i ni dung trong Giy xc nhn ny, Ch c s phi bo co bng vn bn n c quan xc nhn kp thi x l hoc iu chnh cho ph hp vi thc tin./.

Ghi ch: (1) C quan kim tra, xc nhn hon thnh cng trnh bo v mi trng; (2) Tn y , chnh xc ca D n hoc ca hng mc/phn k u t ca D n (2); (3) Th trng C quan kim tra, xc nhn hon thnh cng trnh bo v mi trng; (4) Ch d n

28 CNG BO/S 639 + 640/Ngy 29-6-2015

Ph lc 4.1 Mu quyt nh thnh lp hi ng thm nh bo co nh gi mi trng

chin lc (bo co nh gi tc ng mi trng) (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,


(1)

S:......



QUYT NH

V vic thnh lp hi ng thm nh bo co nh gi mi trng chin lc (bo co nh gi tc ng mi trng) ca (2)

(3) Cn c Lut Bo v mi trng ngy 23 thng 6 nm 2014; Cn c Ngh nh s 18/2015/N-CP ngy 14 thng 02 nm 2015 ca Chnh



Cn c (4); Cn c (*) v vic y quyn thm nh v ph duyt bo co nh gi tc ng

mi trng (nu c); Xt Vn bn s... ngy... thng... nm... ca (5) v vic ngh thm nh bo co

nh gi mi trng chin lc (bo co nh gi tc ng mi trng) ca (2); Xt ngh ca (6),

QUYT NH: iu 1. Thnh lp hi ng thm nh bo co nh gi mi trng chin lc

(bo co nh gi tc ng mi trng) ca (2) gm cc ng (B) c tn sau y:

TT H v tn Hc hm, Hc v Ni cng tc Chc danh trong hi ng 1 ... ... ... Ch tch 2 ... ... ... Ph Ch tch (nu c) 3 ... ... ... y vin Th k

CNG BO/S 639 + 640/Ngy 29-6-2015 29

TT H v tn Hc hm, Hc v Ni cng tc Chc danh trong hi ng 4 ... ... ... y vin phn bin 5 ... ... ... y vin phn bin 6 ... ... ... y vin ... ... ... ... ... iu 2. Hi ng c nhim v xem xt, thm nh bo co nh gi mi

trng chin lc (bo co nh gi tc ng mi trng) ca (2), chu trch nhim v kt qu thm nh v gi kt qu cho (3). Hi ng t gii th sau khi hon thnh nhim v.

iu 3. Chi ph cho hot ng ca hi ng c ly t ngun thu ph thm nh bo co nh gi tc ng mi trng (i vi thm nh bo co nh gi tc ng mi trng) hoc ly t ngun kinh ph s nghip mi trng (i vi thm nh bo co nh gi mi trng chin lc) theo quy nh ca php lut.

iu 4. Quyt nh ny c hiu lc k t ngy k. (7) v cc thnh vin hi ng c tn ti iu 1 chu trch nhim thi hnh

Quyt nh ny./. Ni nhn: - Nh iu 4; - Ch d n; - ...; - Lu:...

(3) (K, ghi h tn, chc v, ng du)

Ghi ch: (1) Tn c quan thm nh bo co nh gi mi trng chin lc, bo co nh

gi tc ng mi trng; (2) Tn y , chnh xc ca chin lc, quy hoch, k hoch hoc d n; (3) Th trng hoc ngi ng u c quan thm nh; (4) Tn y ca vn bn quy nh chc nng, nhim v, quyn hn v c cu t chc ca (1); (5) Ch d n; (6) Chc danh ca th trng hoc ngi ng u c quan thm nh; (7) Chc danh ca th trng hoc ngi ng u cc c quan lin quan trc thuc c quan thm nh;

(*) Tn y ca vn bn y quyn thm nh v ph duyt bo co nh gi tc ng mi trng.

30 CNG BO/S 639 + 640/Ngy 29-6-2015

Ph lc 4.2 Mu bn nhn xt v bo co nh gi mi trng chin lc, bo co nh gi tc ng mi trng dnh cho thnh vin hi

ng khng phi y vin phn bin (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,



BN NHN XT

BO CO NH GI MI TRNG CHIN LC (BO CO NH GI TC NG MI TRNG)

CA Y VIN HI NG 1. H v tn ngi nhn xt: 2. Hc hm, hc v, chc v cng tc: 3. Ni cng tc: tn c quan, a ch, s in thoi, Fax, e-mail 4. Chc danh trong hi ng: 5. Tn chin lc, quy hoch, k hoch hoc tn d n: 6. Nhn xt v bo co: 6.1. Nhn xt chung v nhng u im, mt tch cc ca bo co:.. 6.2. Nhng ni dung cha t yu cu, cn c chnh sa, b sung: nhn xt

chi tit, c th theo trnh t cc chng, mc ca bo co nh gi mi trng chin lc hoc bo co nh gi tc ng mi trng

6.3. Nhng ngh v lu khc: nu c 7. Kt lun: nu r 01 trong 03 mc : thng qua khng cn chnh sa, b

sung; thng qua vi iu kin phi chnh sa, b sung; khng thng qua (a danh ni vit nhn xt), ngy... thng... nm...

NGI VIT NHN XT (K, ghi h tn)

CNG BO/S 639 + 640/Ngy 29-6-2015 31

Ph lc 4.3 Mu phiu thm nh bo co nh gi mi trng chin lc,

bo co nh gi tc ng mi trng (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,


(1)

(c ng du treo ca c quan thm nh hoc c quan thng trc thm nh tng ng vi tn c quan (1))


PHIU THM NH

BO CO NH GI MI TRNG CHIN LC (BO CO NH GI TC NG MI TRNG)

1. H v tn: 2. Ni cng tc: tn c quan, a ch, s in thoi, Fax, E-mail 3. Lnh vc chuyn mn: ch ghi ti a hai (02) lnh vc chuyn mn c kinh

nghim nht v lin quan n vic thm nh bo co nh gi mi trng chin lc hoc bo co nh gi tc ng mi trng

4. Chc danh trong hi ng thm nh: 5. Quyt nh thnh lp hi ng thm nh: s... ngy... thng... nm... ca... 6. Tn chin lc, quy hoch, k hoch hoc tn d n: 7. kin thm nh v bo co nh gi mi trng chin lc (bo co nh

gi tc ng mi trng): la chn bng cch k tn vo 01 trong 03 mc: 7.1; 7.2 hoc 7.3 sau y:

7.1. Thng qua khng cn chnh sa, b sung: 7.2. Thng qua vi iu kin phi chnh sa, b sung: 7.3. Khng thng qua: 8. Kin ngh: i vi ch d n, n v t vn lp bo co, c quan thng

trc thm nh v c quan ph duyt d n (nu c) (a danh ni hp), ngy... thng... nm...

NGI VIT PHIU THM NH (K, ghi h tn)

Ghi ch: (1) Tn c quan thng trc thm nh.

32 CNG BO/S 639 + 640/Ngy 29-6-2015

Ph lc 4.4 Mu bn nhn xt bo co nh gi mi trng chin lc

ca y vin phn bin (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,



BN NHN XT

BO CO NH GI MI TRNG CHIN LC CA Y VIN PHN BIN

1. H v tn ngi nhn xt: 2. Hc hm, hc v, chc v cng tc: 3. Ni cng tc: tn c quan, a ch, s in thoi, Fax, E-mail 4. Tn chin lc, quy hoch, k hoch (CQK): 5. Nhn xt v ni dung bo co: 5.1. Nhn xt chung v nhng u im, mt tch cc ca bo co: 5.2. Nhng ni dung cha t yu cu, cn c chnh sa, b sung: nhn xt

chi tit, c th theo trnh t cc chng, mc ca bo co 6. Nhng nhn xt khc: 6.1. V phng php p dng trong nh gi mi trng chin lc: trong

lu n tnh thch hp, mc y ca cc phng php p dng 6.2. V thng tin, s liu lm c s cho nh gi mi trng chin lc: trong

lu n mc y , chi tit, chnh xc ca cc thng tin, s liu c lin quan n ni dung ca CQK, hin trng mi trng v cc iu kin t nhin, kinh t, x hi c lin quan

6.3. V mc tha ng ca cc nh gi, kt lun nu trong bo co: 7. Kt lun v ngh: trong cn nu r 01 trong 03 mc : thng qua

khng cn chnh sa, b sung; thng qua vi iu kin phi chnh sa, b sung; khng thng qua. (a danh ni vit nhn xt), ngy... thng... nm...

Y VIN PHN BIN (K, ghi h tn)

CNG BO/S 639 + 640/Ngy 29-6-2015 33

Ph lc 4.5 Mu bn nhn xt bo co nh gi tc ng mi trng

ca y vin phn bin (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,



BN NHN XT

BO CO NH GI TC NG MI TRNG CA Y VIN PHN BIN

1. H v tn ngi nhn xt: 2. Hc hm, hc v, chc v cng tc: 3. Ni cng tc: tn c quan, a ch, s in thoi, Fax, E-mail 4. Tn d n: 5. Nhn xt v ni dung bo co: 5.1. Nhng ni dung t yu cu: nhn xt chung v nhng u im, nhng

mt tch cc ca ni dung bo co 5.2. Nhng ni dung cha t yu cu, cn c chnh sa, b sung: nhn xt

chi tit, c th theo trnh t cc chng, mc ca bo co 6. Nhng nhn xt khc: 6.1. V phng php p dng trong nh gi tc ng mi trng: trong

lu n tnh thch hp, mc y ca cc phng php p dng 6.2. V thng tin, s liu lm c s nh gi tc ng mi trng: trong

lu n mc y , chi tit, chnh xc ca cc thng tin, s liu 6.3. V mc tha ng ca cc nh gi, kt lun nu trong bo co: 7. Kt lun v ngh: trong cn nu r 01 trong 03 mc : thng qua

khng cn chnh sa, b sung; thng qua vi iu kin phi chnh sa, b sung; khng thng qua. (a danh ni vit nhn xt), ngy... thng... nm...

Y VIN PHN BIN (K, ghi h tn)

34 CNG BO/S 639 + 640/Ngy 29-6-2015

Ph lc 4.6 Mu bin bn hp thm nh ca hi ng thm nh




BIN BN PHIN HP CHNH THC HI NG THM NH

BO CO NH GI MI TRNG CHIN LC (HI NG THM NH BO CO NH GI TC NG MI TRNG)

Tn chin lc, quy hoch, k hoch (hoc tn d n): Quyt nh thnh lp hi ng thm nh s... ngy... thng... nm... ca... Thi gian hp: ngy... thng... nm... a ch ni hp:... 1. Thnh phn tham d phin hp: 1.1. Hi ng thm nh - Thnh vin c mt: ch nu s lng thnh vin hi ng c mt trn tng s

thnh vin trong quyt nh thnh lp Hi ng, v d: 7/9. - Thnh vin vng mt: ghi s lng km theo h tn, chc danh trong hi

ng ca cc thnh vin vng mt, l do vng mt; trng hp y quyn tham d hp, nu y tn ca vn bn y quyn.

1.2. Ch d n: ghi r h, tn, chc v tt c cc thnh vin ca c quan c giao nhim v xy dng chin lc, quy hoch, k hoch i vi bo co nh gi mi trng chin lc hoc ch d n i vi bo co nh gi tc ng mi trng (trong Ph lc ny gi chung l ch d n) tham d hp; trng hp y quyn tham d hp, nu y tn ca vn bn y quyn.

1.3. n v t vn lp bo co nh gi mi trng chin lc, bo co nh gi tc ng mi trng: ghi r h tn, hc v v chc v ca i din n v t vn tham d hp.

1.4. i biu tham d (nu c): 2. Ni dung v din bin phin hp: Yu cu ghi theo trnh t din bin ca

phin hp hi ng, ghi y , trung thc cc cu hi, tr li, cc kin trao i, tho lun ca cc bn tham gia phin hp hi ng thm nh.

CNG BO/S 639 + 640/Ngy 29-6-2015 35

2.1. y vin Th k thng bo l do cuc hp v gii thiu thnh phn tham d; gii thiu ngi ch tr phin hp (Ch tch hi ng hoc Ph Ch tch hi ng trong trng hp c Ch tch hi ng y quyn) iu hnh phin hp.

2.2. Ch d n v n v t vn trnh by ni dung bo co: ghi nhng ni dung chnh c ch d n v n v t vn trnh by, c bit ch trng vo cc ni dung trnh by khc so vi bo co nh gi mi trng chin lc, bo co nh gi tc ng mi trng.

2.3. Tho lun, trao i gia thnh vin hi ng vi ch d n v n v t vn v ni dung ca chin lc, quy hoch, k hoch, ni dung ca d n v ni dung ca bo co nh gi mi trng chin lc, bo co nh gi tc ng mi trng: ghi chi tit v y cc ni dung trao i.

2.4. kin nhn xt v bo co ca cc thnh vin hi ng: 2.5. kin ca cc i biu tham d (nu c): 2.6. kin phn hi ca ch d n: 3. Kt lun phin hp 3.1. Ngi ch tr phin hp cng b kt lun ca hi ng thm nh: c

tng hp trn c s kin ca cc thnh vin hi ng thm nh, trong tm tt ngn gn nhng u im ni tri, nhng ni dung t yu cu ca bo co, nhng ni dung ca bo cn phi c chnh sa, b sung theo tng chng, mc ca bo co nh gi mi trng chin lc, bo co nh gi tc ng mi trng.

3.2. kin khc ca cc thnh vin hi ng thm nh (nu c): 3.3. kin ca ch d n v kt lun ca hi ng: 4. Kt qu kim phiu thm nh: 4.1. S phiu thng qua bo co khng cn chnh sa, b sung: 4.2. S phiu thng qua bo co vi iu kin phi chnh sa, b sung: 4.3. S phiu khng thng qua bo co: 5. Ngi ch tr phin hp tuyn b kt thc phin hp

NGI CH TR PHIN HP

(Ghi r l Ch tch hi ng hoc Ph Ch tch hi ng khi c Ch tch hi ng y quyn)

(K, ghi h tn)

TH K HI NG (K, ghi h tn)

Ghi ch: Ch tr phin hp v Th k hi ng k pha di ca tng trang

bin bn (tr trang cui).

36 CNG BO/S 639 + 640/Ngy 29-6-2015

Ph lc 5.1 Danh mc cc d n thuc thm quyn xc nhn ng k k hoch bo v

mi trng ca S Ti nguyn v Mi trng (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,


Tt c cc d n thuc i tng lp k hoch bo v mi trng quy nh ti Khon 1 iu 18 Ngh nh s 18/2015/N-CP thuc cc loi hnh v quy m sau:

TT D n Quy m

1 D n nm trn a bn 02 huyn tr ln Tt c

2 D n trn vng bin c cht thi a vo a bn tnh x l

Tt c

3

D n c s dng t ca khu di tch lch s - vn ha; khu danh lam thng cnh c xp hng cp tnh; D n lm mt rng; chuyn i mc ch s dng t rng; chuyn i mc ch t trng la

Tt c i vi d n c s dng t ca khu di tch lch s - vn ha; khu danh lam thng cnh c xp hng cp tnh; Tt c cc i tng di 5 ha i vi rng phng h, rng c dng; T 01 ha n di 10 ha i vi rng t nhin; T 10 ha n di 50 ha i vi cc loi rng khc; T 01 ha n di 5 ha i vi t trng la chuyn i sang t phi nng nghip

4 D n xy dng c s khm cha bnh v c s y t khc

Di 50 ging bnh

5 D n xy dng c s sn xut clinker Tt c cc d n xy dng c s sn xut clinker cng sut di 500.000 tn clinker/nm

6 D n xy dng c s sn xut tm lp fibro xi mng Di 500.000 m2 tm lp fibro xi mng/nm

7 D n xy dng cng sng, cng bin Tt c cc d n xy dng cng tip nhn tu trng ti di 1.000 DWT

8 D n xy dng nh my thy in Tt c cc d n xy dng h cha c dung tch di 100.000 m3 nc hoc cng sut di 10 MW

CNG BO/S 639 + 640/Ngy 29-6-2015 37 TT D n Quy m

9 D n xy dng cng trnh h cha nc Tt c cc d n c dung tch h cha di 100.000 m3 nc

10 D n khai thc ct hoc no vt lng sng, ca bin Cng sut di 50.000 m3 vt liu nguyn khai/nm

11

D n khai thc khong sn rn (khng s dng cc cht c hi, ha cht hoc vt liu n cng nghip)

Tt c i vi d n c khi lng m (bao gm khong sn v t thi) di 50.000 m3 nguyn khai/nm hoc c tng khi lng m (bao gm khong sn v t thi) di 1.000.000 m3 nguyn khi

12 D n ch bin khong sn rn khng s dng cc cht c hi, ha cht

Cng sut di 50.000 m3 sn phm/nm

13 D n tuyn, lm giu t him, khong sn c tnh phng x

Tt c cc d n c cng sut di 500 tn sn phm/nm

14

D n xy dng c s ti ch, x l, chn lp hoc tiu hy cht thi rn thng thng

Tt c cc d n c cng sut t 05 n di 10 tn cht thi rn thng thng/ngy

15 D n xy dng nh my luyn kim

Tt c i vi d n s dng nguyn liu khng phi l ph liu c cng sut di 1.000 tn sn phm/nm

16 D n xy dng c s cn thp

Tt c i vi d n s dng nguyn liu khng phi l ph liu c cng sut di 2.000 tn sn phm/nm

17 D n xy dng c s ng mi, sa cha tu thy Tt c i vi tu c trng ti di 1.000 DWT

18 D n xy dng c s sn xut, lp rp xe my, t

Tt c i vi d n c cng sut di 5.000 xe my/nm hoc di 500 t/nm

19 D n xy dng c s ch to my mc, thit b cng c

Tt c nhng d n c cng sut di 1.000 tn sn phm/nm

20 D n xy dng c s m, phun ph v nh bng kim loi

Tt c i vi d n c cng sut di 500 tn sn phm/nm

38 CNG BO/S 639 + 640/Ngy 29-6-2015 TT D n Quy m

21 D n xy dng c s sn xut vn p Tt c cc d n c cng sut di 100.000 m2/nm

22 D n xy dng nh my sn xut s v sinh Cng sut di 10.000 sn phm/nm

23 D n xy dng c s sn xut ng Cng sut di 10.000 tn ng/nm

24 D n xy dng c s sn xut bt ngt Cng sut di 5.000 tn sn phm/nm

25 D n xy dng c s ch bin bt c Cng sut di 500 tn sn phm/nm

26 D n xy dng nh my sn xut phn ha hc Cng sut di 1.000 tn sn phm/nm

27 D n xy dng c s sn xut dc phm, thuc th y

D n sn xut dc phm, thuc th y khng phi l vc xin cng sut di 50 tn sn phm/nm

28 D n xy dng c s sn xut cc sn phm t sn, ha cht, cht do

Cng sut di 100 tn sn phm/nm

29 D n xy dng c s sn xut cht ty ra, ph gia Cng sut di 100 tn sn phm/nm

30 D n xy dng c s sn xut bt giy v giy t nguyn liu th

Cng sut di 300 tn sn phm/nm

31 D n xy dng c s sn xut giy, bao b cc tng t bt giy hoc ph liu

Cng sut di 5.000 tn sn phm/nm

32 D n ch bin cao su, m cao su Cng sut t 500 n di 1.000 tn sn phm/nm

33 D n xy dng c s sn xut c quy, pin Cng sut di 50.000 KWh/nm hoc di 100 tn sn phm/nm

34

D n c hng mc vi quy m tng ng hoc tnh cht tng t cc d n th t t 1 n 33 Ph lc ny

Tt c

CNG BO/S 639 + 640/Ngy 29-6-2015 39

Ph lc 5.2 Mu vn bn y quyn xc nhn ng k k hoch bo v mi trng

ca y ban nhn dn cp huyn cho y ban nhn dn cp x (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,


Y BAN NHN DN (1)

S:...



QUYT NH

V vic y quyn xc nhn ng k k hoch bo v mi trng

Y BAN NHN DN (1) Cn c Ngh nh s 18/2015/N-CP ngy 14 thng 02 nm 2015 ca Chnh



Cn c (2) quy nh chc nng, nhim v, quyn hn v c cu t chc ca y ban nhn dn (1);

Theo ngh ca Trng phng Ti nguyn v Mi trng, Ch tch y ban nhn dn (3),

QUYT NH:

iu 1. y quyn cho y ban nhn dn (3) xc nhn ng k k hoch bo v

mi trng i vi d n, phng n sn xut, kinh doanh, dch v quy m h gia nh trn a bn (3).

iu 2. y ban nhn dn (3) c trch nhim: 1. T chc thc hin vic xc nhn ng k k hoch bo v mi trng cho

cc i tng quy nh ti iu 1 Quyt nh ny theo quy nh ti iu 34 Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc, nh gi tc ng mi trng v k hoch bo v mi trng v cc quy nh c lin quan ca php lut v bo v mi trng.

40 CNG BO/S 639 + 640/Ngy 29-6-2015

2. Thc hin cc trch nhim quy nh ti iu 34 Lut Bo v mi trng. 3. Chu trch nhim trc (1) v trc php lut v vic thc hin cc ni dung

c y quyn. 4. Tng hp s liu v bo co nh k n (1) v cc ni dung thc hin theo

y quyn ti Quyt nh ny trc ngy 31 thng 12 hng nm. 5. Thng bo rng ri cc ni dung c y quyn ti Quyt nh ny n cc

t chc, c nhn bit v lin h cng tc. iu 3. Quyt nh ny c hiu lc k t ngy... thng... nm... Ch tch y

ban nhn dn (3), Trng Phng Ti nguyn v Mi trng, Th trng cc c quan thuc y ban nhn dn (1) chu trch nhim thi hnh Quyt nh ny./.

Ni nhn: - Nh iu 3; - ...; - Lu:...


Ghi ch: (1) Tn a danh hnh chnh cp huyn; (2) Tn y ca vn bn quy

nh chc nng, nhim v, quyn hn v c cu t chc ca y ban nhn dn (1); (3) Tn a danh hnh chnh cp x; (4) i din c thm quyn (1).

CNG BO/S 639 + 640/Ngy 29-6-2015 41

Ph lc 5.3 Mu vn bn y quyn xc nhn ng k k hoch bo v mi trng

cho Ban qun l cc khu cng nghip, khu ch xut, khu kinh t (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,


(1)

S:...



QUYT NH

V vic y quyn xc nhn ng k k hoch bo v mi trng

(1) Cn c Ngh nh s 18/2015/N-CP ngy 14 thng 02 nm 2015 ca Chnh



Cn c (2) quy nh chc nng, nhim v, quyn hn v c cu t chc ca (1); Theo ngh ca Trng Ban (3) v...,

QUYT NH: iu 1. y quyn cho (3) xc nhn ng k k hoch bo v mi trng thuc

thm quyn ca (1) i vi d n u t, phng n sn xut kinh doanh, dch v thc hin trong khu cng nghip, khu ch xut, khu kinh t sau y:

1... 2... ... iu 2. (3) c trch nhim: 1. T chc thc hin vic xc nhn ng k k hoch bo v mi trng cho

cc i tng quy nh ti iu 1 Quyt nh ny theo quy nh ti iu 34 Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn

42 CNG BO/S 639 + 640/Ngy 29-6-2015 v Mi trng v nh gi mi trng chin lc, nh gi tc ng mi trng v k hoch bo v mi trng v cc quy nh c lin quan ca php lut v bo v mi trng.

2. Thc hin cc trch nhim quy nh ti iu 34 Lut Bo v mi trng. 3. Chu trch nhim trc (1) v trc php lut v vic thc hin cc ni dung

c y quyn. 4. Tng hp s liu v bo co nh k n (1) v cc ni dung thc hin theo

y quyn ti Quyt nh ny trc ngy 31 thng 12 hng nm. 5. Thng bo rng ri cc ni dung c y quyn ti Quyt nh ny n cc

t chc, c nhn bit v lin h cng tc. iu 3. Quyt nh ny c hiu lc k t ngy... thng... nm... Trng Ban

(3)... chu trch nhim thi hnh Quyt nh ny./. Ni nhn: - Nh iu 3; - ...; - Lu:...


Ghi ch: (1) Tn c quan y quyn; (2) Tn y ca vn bn quy nh chc nng,

nhim v, quyn hn v c cu t chc ca (1); (3) Tn Ban qun l c y quyn; (4) i din c thm quyn ca (1).

CNG BO/S 639 + 640/Ngy 29-6-2015 43

Ph lc 5.4 Mu trang ba ca k hoch bo v mi trng thuc thm quyn xc nhn

ng k ca S Ti nguyn v Mi trng (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,


(1)

K HOCH BO V MI TRNG ca (2)

i din (1) (*) (K, ghi h tn, ng du (nu c))

i din n v t vn (nu c) (*) (K, ghi h tn, ng du)

Thng... nm 20...

Ghi ch: (1) Ch d n, phng n sn xut, kinh doanh, dch v; (2) Tn d n, phng n sn xut, kinh doanh, dch v.

(*) Ch th hin ti trang ph ba.

44 CNG BO/S 639 + 640/Ngy 29-6-2015

Ph lc 5.5 Cu trc v ni dung ca k hoch bo v mi trng thuc thm quyn

xc nhn ng k ca S Ti nguyn v Mi trng (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,



(a danh ni thc hin d n), ngy... thng... nm...

Knh gi: (1) ................................................................................................. Chng ti gi n (1) bn k hoch bo v mi trng ng k vi cc ni

dung sau y: I. Thng tin chung 1.1. Tn d n, phng n sn xut, kinh doanh, dch v (gi chung l d n):

nu ng tn gi nh c nu trong bo co u t (bo co nghin cu kh thi hoc ti liu tng ng).

1.2. Tn ch d n:... 1.3. a ch lin h:... 1.4. Ngi i din theo php lut:... 1.5. Phng tin lin lc vi ch d n: (s in thoi, s Fax, E-mail...). 1.6. a im thc hin d n: M t v tr a l (ta cc im khng ch ranh gii theo h VN2000) ca

a im thc hin d n km theo s minh ha ch r cc i tng t nhin (sng ngi, ao h, ng giao thng,...), cc i tng v kinh t - x hi (khu dn c, khu th; c s sn xut, kinh doanh, dch v; cng trnh vn ha, tn gio, di tch lch s,...), hin trng s dng t trn v tr thc hin d n v cc i tng xung quanh khc.

Ch r ngun tip nhn nc thi ca d n km theo cc tiu chun, quy chun k thut v mi trng hin hnh p dng i vi cc ngun ny.

1.7. Quy m d n M t tm lc v qu trnh thi cng xy dng; quy m/cng sut sn xut;

cng ngh sn xut; lit k danh mc cc thit b, my mc km theo tnh trng ca chng.

CNG BO/S 639 + 640/Ngy 29-6-2015 45

1.8. Nhu cu nguyn liu, nhin liu s dng - Nhu cu v nguyn liu, nhin liu phc v cho sn xut c tnh theo gi,

ngy, thng hoc nm; phng thc cung cp nguyn liu, nhin liu. - Nhu cu v ngun cung cp in, nc cho sn xut. Yu cu: - i vi trng hp m rng, nng cp, nng cng sut ca c s sn xut,

kinh doanh, dch v ang hot ng cn phi b sung thng tin v c s ang hot ng, c bit l cc thng tin lin quan n cc cng trnh, thit b, hng mc, cng ngh s c tip tc s dng hoc loi b hoc thay i, iu chnh, b sung.

II. Cc tc ng xu n mi trng 2.1. Tc ng xu n mi trng do cht thi 2.1.1. Kh thi:... 2.1.2. Nc thi:... 2.1.3. Cht thi rn:... 2.1.4. Cht thi nguy hi:... 2.1.5. Cht thi khc:... (nu c) i vi mi loi cht thi phi nu cc thng tin v: ngun pht sinh, tng

lng pht sinh trn mt n v thi gian, thnh phn cht thi. i vi kh thi v nc thi cn phi nu r hm lng/nng ca tng thnh phn nhim c trng v so snh vi tiu chun, quy chun, quy nh hin hnh trong trng hp cha p dng cc bin php gim thiu tc ng xu.

2.2. Tc ng xu n mi trng khng do cht thi Nu tm tt cc tc ng xu n mi trng khc (nu c) do d n gy ra:

xi mn, trt, st, l, ln t; s xi l b sng, b sui, b h, b bin; s bi lng lng sng, lng sui, lng h; s thay i mc nc mt, nc di t; xm nhp mn; xm nhp phn; s bin i vi kh hu; s suy thoi cc thnh phn mi trng; s bin i a dng sinh hc v cc yu t khc.

Yu cu: cc loi tc ng xu n mi trng phi c th hin theo tng giai on, bao gm mt, mt s hoc ton b cc giai on sau theo c th ca tng d n c th: (1) chun b u t, (2) thi cng xy dng, (3) vn hnh d n v (4) hon thnh d n.

III. K hoch bo v mi trng 3.1. Gim thiu tc ng xu do cht thi - Mi loi cht thi pht sinh u phi c km theo bin php gii quyt tng

ng v c thuyt minh v mc kh thi, hiu sut/hiu qu gii quyt. Trong trng hp khng th c bin php hoc c nhng kh kh thi trong khun kh

46 CNG BO/S 639 + 640/Ngy 29-6-2015 ca d n phi nu r l do v c kin ngh c th cc c quan lin quan c hng gii quyt, quyt nh.

- Phi chng minh sau khi p dng bin php gii quyt th cc cht thi s c x l n mc no, c so snh, i chiu vi cc tiu chun, quy chun, quy nh hin hnh. Trng hp khng p ng c yu cu quy nh th phi nu r l do v c cc kin ngh c th cc c quan lin quan c hng gii quyt, quyt nh.

3.2. Gim thiu cc tc ng xu khc Mi loi tc ng xu pht sinh u phi c km theo bin php gim thiu

tng ng, thuyt minh v mc kh thi, hiu sut/hiu qu gim thiu tc ng xu . Trng hp khng th c bin php hoc c nhng kh kh thi trong khun kh ca d n th phi nu r l do v c kin ngh c th cc c quan lin quan c hng gii quyt, quyt nh.

3.3. K hoch gim st mi trng - Gim st lu lng kh thi, nc thi v nhng thng s nhim c trong

kh thi, nc thi c trng cho d n, ph hp vi quy chun k thut v mi trng hin hnh, vi tn sut ti thiu mt (01) ln/06 thng. Khng yu cu ch d n gim st nc thi i vi d n c u ni nc thi x l ti h thng x l nc thi tp trung v khng yu cu ch d n gim st nhng thng s nhim c trong kh thi, nc thi m d n khng c kh nng pht sinh hoc kh nng pht sinh thp.

- Cc im gim st phi c th hin c th trn s vi ch gii r rng v ta theo quy chun hin hnh.

Yu cu: - Ngoi vic m t bin php gim thiu tc ng xu n mi trng nh

hng dn ti mc 3.1 v 3.2 Ph lc ny, bin php gim thiu tc ng xu n mi trng mang tnh cng trnh phi c lit k di dng bng, trong nu r chng loi, c tnh k thut, s lng cn thit v km theo tin xy lp c th cho tng cng trnh.

- i vi i tng m rng quy m, nng cp, nng cng sut, ni dung ca phn III Ph lc ny cn phi nu r hin trng cc cng trnh, bin php bo v mi trng hin c ca c s hin hu v mi lin h ca cc cng trnh ny vi h thng cng trnh, bin php bo v mi trng ca d n ci to, nng cp, nng cng sut.

IV. Cam kt Chng ti cam kt v vic thc hin cc bin php gim thiu tc ng xu

n mi trng nu trong k hoch bo v mi trng t cc quy nh, tiu chun, quy chun k thut v mi trng v thc hin cc bin php bo v mi trng khc theo quy nh hin hnh ca php lut Vit Nam.

CNG BO/S 639 + 640/Ngy 29-6-2015 47

Chng ti gi km theo y cc vn bn c lin quan n d n (nu c v lit k c th).

Chng ti bo m v trung thc ca cc thng tin, s liu, ti liu trong

bn k hoch bo v mi trng, k c cc ti liu nh km. Nu c sai phm, chng ti xin hon ton chu trch nhim trc php lut ca Vit Nam.

(2) (K, ghi h tn, chc danh, ng du (nu c))

Ghi ch: (1) C quan xc nhn ng k k hoch bo v mi trng; (2) i din c

thm quyn ca ch d n. Yu cu: Bn k hoch bo v mi trng c lp thnh ba (03) bn gc, c ch k

ca ch d n pha di tng trang v k, ghi h tn, chc danh, ng du (nu c) ca i din c thm quyn ca ch d n trang cui cng.

48 CNG BO/S 639 + 640/Ngy 29-6-2015

Ph lc 5.6 Cu trc v ni dung ca k hoch bo v mi trng thuc thm quyn

xc nhn ng k ca y ban nhn dn cp huyn (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,



(a im), ngy..... thng..... nm 20.....

Knh gi: (1) ..................................................................................................... Gi n (1) k hoch bo v mi trng ng k vi cc ni dung sau y: I. Thng tin chung 1.1. Tn d n, c s (gi chung l d n):... 1.2. Tn ch d n:... 1.3. a ch lin h:... 1.4. Ngi i din theo php lut:... 1.5. Phng tin lin lc vi ch d n: (s in thoi, s Fax, E-mail...). II. Thng tin c bn v hot ng sn xut, kinh doanh 2.1. a im thc hin d n:.............................................................................. ............................................................................................................................... 2.3. Loi hnh sn xut, kinh doanh, dch v; sn phm v s lng ............................................................................................................................... ............................................................................................................................... ............................................................................................................................... 2.4. Din tch mt bng c s sn xut, kinh doanh, dch v (m2):...................... 2.5. Nhu cu nguyn liu, vt liu s dng trong qu trnh sn xut: .................. ............................................................................................................................... ............................................................................................................................... 2.6. Nhin liu s dng trong qu trnh sn xut (du, than, ci, gas, in...) ..... ............................................................................................................................... ...............................................................................................................................

CNG BO/S 639 + 640/Ngy 29-6-2015 49

III. K hoch bo v mi trng trong giai on thi cng xy dng

Tnh trng Tnh trng Yu t gy tc ng C Khng

Bin php gim thiu C Khng

S dng phng tin, my mc thi cng qua kim nh

S dng loi nhin liu t gy nhim nh k bo dng phng tin, thit b

Kh thi t cc phng tin vn chuyn, my mc thi cng

Bin php khc: ...

Cch ly, phun nc gim bi Bi Bin php khc: ...

Thu gom, t x l trc khi thi ra mi trng (ch r ngun tip nhn nc thi)

Thu gom, thu n v c chc nng x l

thng ra h thng thot nc thi khu vc

Nc thi sinh hot

Bin php khc: ...

Thu gom, x l trc khi thi ra mi trng (ch r ngun tip nhn nc thi)

thng ra h thng thot nc thi khu vc

Nc thi xy dng

Bin php khc: ...

Thu gom ti ch hoc ti s dng

T thi ti cc a im quy nh ca a phng (ch r a im)

Thu n v c chc nng x l

Cht thi rn xy dng

Bin php khc: ...

50 CNG BO/S 639 + 640/Ngy 29-6-2015



T thi ti cc a im quy nh ca a phng (ch r a im)

Thu n v c chc nng x l

Cht thi rn sinh hot

Bin php khc: ...

Thu n v c chc nng x l Cht thi nguy hi

Bin php khc: ...

nh k bo dng thit b B tr thi gian thi cng ph hp

Ting n

Bin php khc ...

nh k bo dng thit b B tr thi gian thi cng ph hp

Rung

Bin php khc ...

Nc ma chy trn

C h thng rnh thu nc, h ga thu gom, lng lc nc ma chy trn trc khi thot ra mi trng

Bin php khc ...

IV. K hoch bo v mi trng trong giai on hot ng



Lp t h thng x l bi v kh thi vi ng khi

Lp t qut thng gi vi b lc khng kh cui ng ng

Bi v kh thi

Bin php khc ...

Thu gom v ti s dng X l s b bng b t hoi trc khi thi vo h thng thot nc chung

Nc thi sinh hot

Bin php khc ...

CNG BO/S 639 + 640/Ngy 29-6-2015 51



Thu gom v ti s dng X l nc thi cc b v thi vo h thng x l nc thi tp trung

X l nc thi p ng quy chun quy nh v thi ra mi trng (ch r ngun tip nhn v quy chun t c sau x l)

Nc thi sn xut

Bin php khc ...

Thu gom v ti s dng Gii nhit v thi ra mi trng

Nc thi t h thng lm mt

Bin php khc ...

Thu gom ti ch hoc ti s dng T x l Thu n v c chc nng x l

Cht thi rn

Bin php khc ...

Thu n v c chc nng x l Cht thi nguy hi

Bin php khc ...

Lp t qut thng gi Mi Bin php khc ...

nh k bo dng thit b Cch m gim ting n

Ting n

Bin php khc ...

Lp t qut thng gi Nhit d Bin php khc

...

C h thng rnh thu nc, h ga thu gom, lng lc nc ma chy trn trc khi thot ra mi trng

Nc ma chy trn

Bin php khc

52 CNG BO/S 639 + 640/Ngy 29-6-2015

V. Cam kt 5.1. Chng ti/ti cam kt thc hin nghim chnh cc quy nh v bo v mi

trng ca Lut Bo v mi trng nm 2014, tun th cc quy nh, tiu chun, quy chun k thut v mi trng v chu hon ton trch nhim nu vi phm cc quy nh v bo v mi trng.

5.2. Chng ti/ti cam kt thc hin y cc k hoch bo v mi trng c nu trn y.

5.3. Chng ti/ti m bo trung thc ca cc thng tin v ni dung in trong k hoch bo v mi trng ny./.

(2) (K, ghi h tn, chc danh, ng du (nu c))

Ghi ch: (1) C quan xc nhn ng k k hoch bo v mi trng; (2) i din c

thm quyn ca ch d n. Yu cu: Bn k hoch bo v mi trng c lp thnh ba (03) bn gc, c ch k

ca ch d n pha di tng trang v k, ghi h tn, chc danh, ng du (nu c) trang cui cng.

CNG BO/S 639 + 640/Ngy 29-6-2015 53

Ph lc 5.7 Mu giy xc nhn ng k k hoch bo v mi trng



(1)

S:...



GIY XC NHN NG K K HOCH BO V MI TRNG

(1) xc nhn (2) ng k k hoch bo v mi trng ca (3) ti (1) vo

ngy... thng... nm... (2) c trch nhim thc hin cc ni dung sau: 1. T chu trch nhim trc php lut v thng tin, cc bin php bo v mi

trng xut trong bn k hoch bo v mi trng ng k. 2. T chc thc hin cc bin php bo v mi trng theo k hoch bo v

mi trng ng k v cc trch nhim khc theo quy nh ti iu 33 Lut Bo v mi trng nm 2014.

3.... ... K hoch bo v mi trng ca (3) km theo Giy xc nhn ng k ny

c cp cho (2) thc hin v lu c ti c quan Nh nc kim tra, gim st (*). (4)

(K, ghi h tn, chc danh, ng du) Ghi ch: (1) Tn c quan xc nhn ng k k hoch bo v mi trng; (2) Ch d

n, phng n sn xut, kinh doanh, dch v; (3) Tn gi y , chnh xc ca d n, phng n sn xut, kinh doanh, dch v; (4) i din c thm quyn ca (1).

54 CNG BO/S 639 + 640/Ngy 29-6-2015

Ph lc 5.8 Mu vn bn thng bo

v vic cha xc nhn ng k k hoch bo v mi trng (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,


(1)

S:...



THNG BO V vic cha xc nhn ng k k hoch bo v mi trng

Knh gi: (2) Sau khi xem xt h s ng k k hoch bo v mi trng ca (3), (1) thng

bo nh sau: K hoch bo v mi trng ca (3) cha c xc nhn ng k v cc l do

sau y: 1.... 2.... ... (1) thng bo (2) bit v thc hin theo quy nh ca php lut./.

Ni nhn: - Nh trn; - ...; - Lu:...


Ghi ch: (1) C quan xc nhn ng k k hoch bo v mi trng; (2) Ch d n,

phng n sn xut, kinh doanh, dch v; (3) Tn y , chnh xc ca d n, phng n sn xut, kinh doanh, dch v; (4) i din c thm quyn ca (1).

CNG BO/S 639 + 640/Ngy 29-6-2015 55

Ph lc 6.1 Mu bo co hot ng ng k, xc nhn ng k

k hoch bo v mi trng ca y ban nhn dn cp huyn v S Ti nguyn v Mi trng



(1)

S:... V/v bo co v cng tc ng

k, xc nhn ng k k hoch bo v mi trng



Knh gi: (2)

Thc hin quy nh ti Thng t s 27/2015/TT-BTNMT ngy 29 thng 5

nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc, nh gi tc ng mi trng v k hoch bo v mi trng, (1) bo co (2) v hot ng ng k, xc nhn ng k k hoch bo v mi trng ca cc d n, phng n u t sn xut, kinh doanh, dch v trn a bn trong thi gian (3) nh sau:

1. Tng hp thng tin, s liu: thc hin theo mu quy nh ti Ph lc 6.2 Thng t ny.

2. Nhng kh khn, vng mc: nu nhng kh khn, vng mc trong qu trnh t chc vic ng k, xc nhn ng k k hoch bo v mi trng.

Trn y l bo co ca (1) knh gi (2) xem xt, ch o./. Ni nhn: - Nh trn; - ...; - Lu:...


Ghi ch: (1) y ban nhn dn cp huyn hoc S Ti nguyn v Mi trng; (2) y

ban nhn dn cp tnh; (3) K bo co quy nh ti iu 21 Ngh nh s 18/2015/N-CP; (4) i din c thm quyn ca (1).

56 CNG BO/S 639 + 640/Ngy 29-6-2015

Ph lc 6.2 Mu bng tng hp cng tc ng k, xc nhn ng k

k hoch bo v mi trng (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,


BNG TNG HP CNG TC NG K, XC NHN NG K K HOCH BO V MI TRNG

nm... (km theo Vn bn s... ngy... thng... nm... ca...)

- y ban nhn dn cp huyn/S Ti nguyn v Mi trng:... - a ch lin h:... - in thoi:...; Fax:...; E-mail...

TT 1 2 3 4 5 6 1 ... ...

NGI LP BNG

(K, ghi r h tn) TH TRNG C QUAN

(K, ghi h tn, chc danh, ng du) Ghi ch: Bo co tng hp kt qu nu trn trnh by trn nn Microsoft Excel, s dng bng

m chun quc t Unicode, font Times New Roman ting Vit theo cc ni dung sau y: - Ct 1: Lit k tt c tn cc d n, phng n sn xut, kinh doanh, dch v

ng k k hoch bo v mi trng; - Ct 2: a im thc hin d n, phng n sn xut, kinh doanh, dch v, trong

ghi r a danh cp x hoc ghi tn khu sn xut, kinh doanh, dch v tp trung i vi trng hp nm trong khu sn xut, kinh doanh, dch v tp trung;

- Ct 3: Ngnh ngh sn xut, kinh doanh, dch v ca d n, phng n sn xut, kinh doanh, dch v;

- Ct 4: Thi im xc nhn ng k k hoch bo v mi trng, trong ghi r ngy, thng, nm;

- Ct 5: Tn c quan thc hin xc nhn ng k; - Ct 6: Ghi ch nhng vn khc c lin quan.

CNG BO/S 639 + 640/Ngy 29-6-2015 57

Ph lc 6.3 Mu bo co ca y ban nhn dn cp tnh v hot ng thm nh bo co nh gi mi trng chin lc; thm nh, ph duyt bo co nh gi tc ng mi trng; kim tra, xc nhn hon thnh cng trnh bo v mi

trng; ng k v xc nhn ng k k hoch bo v mi trng (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,


(1)

S:... V/v hot ng thm nh bo co nh gi mi trng chin lc;

thm nh, ph duyt bo co nh gi tc ng mi trng; kim tra, xc nhn hon thnh cng trnh bo v mi trng; ng k v xc nhn ng k k

hoch bo v mi trng




Thc hin quy nh ti Thng t s 27/2015/TT-BTNMT ngy 29 thng 5

nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc, nh gi tc ng mi trng v k hoch bo v mi trng, (1) bo co B Ti nguyn v Mi trng v hot ng thm nh bo co nh gi mi trng chin lc; thm nh, ph duyt bo co nh gi tc ng mi trng; kim tra, xc nhn hon thnh cng trnh bo v mi trng; ng k v xc nhn ng k k hoch bo v mi trng trn a bn nh sau:


2. Nhng kh khn, vng mc: nu nhng kh khn, vng mc trong qu trnh t chc thc hin.

Trn y l bo co ca (1) gi n B Ti nguyn v Mi trng xem xt, tng hp./. Ni nhn: - Nh trn; - ...; - Lu:...


Ghi ch: (1) y ban nhn dn cp tnh; (2) i din c thm quyn ca (1).

58 CNG BO/S 639 + 640/Ngy 29-6-2015

Ph lc 6.4 Mu bng tng hp hot ng thm nh bo co nh gi mi trng chin lc; thm nh, ph duyt bo co nh gi tc ng mi trng; kim tra,

xc nhn hon thnh cng trnh bo v mi trng; ng k v xc nhn ng k k hoch bo v mi trng ca y ban nhn dn cp tnh



BNG TNG HP HOT NG THM NH BO CO NH GI MI TRNG CHIN LC; THM NH, PH DUYT BO CO NH GI TC NG MI TRNG; KIM TRA, XC NHN

HON THNH CNG TRNH BO V MI TRNG; NG K V XC NHN NG K K HOCH BO V MI TRNG

nm... (*) (km theo Vn bn s... ngy... thng... nm... ca... )

- Tn c quan bo co:... - a ch lin h:... - in thoi:...; Fax:...; E-mail...

TT 1 2 3 4 5 I Thm nh bo co nh gi mi trng chin lc 1 ... II Thm nh, ph duyt bo co nh gi tc ng mi trng 1 ... III Kim tra, xc nhn hon thnh cng trnh bo v mi trng 1 ... IV ng k v xc nhn ng k k hoch bo v mi trng 1 ...

NGI LP BNG


(K, ghi h tn, chc danh, ng du)

CNG BO/S 639 + 640/Ngy 29-6-2015 59

Ghi ch: (*) K bo co thc hin theo quy nh ti Khon 2 iu 21 Ngh nh s 18/2015/N-CP; Bo co tng hp kt qu nu trn trnh by trn nn Microsoft Excel, s dng bng

m chun quc t Unicode, font Times New Roman ting Vit theo cc ni dung sau y: Ct 1: Lit k tt c tn: - Cc chin lc, quy hoch, k hoch c thm nh bo co nh gi mi

trng chin lc (MC) trong nm bo co i vi mc I; - Cc d n c ph duyt bo co nh gi tc ng mi trng (TM) trong

nm bo co i vi mc II; - Cc d n c ph duyt bo co TM v cp giy xc nhn vic hon

thnh cng trnh bo v mi trng phc v giai on vn hnh trong nm bo co i vi mc III;

- Cc d n, phng n sn xut, kinh doanh, dch v c xc nhn ng k k hoch bo v mi trng i vi mc IV;

Ct 2: Phm vi ca chin lc, quy hoch, k hoch i vi mc I; a im thc hin d n, phng n sn xut, kinh doanh, dch v (ghi c th a danh cp x, huyn, tnh hoc ghi tn khu sn xut, kinh doanh, dch v tp trung i vi cc d n nm trong cc khu ny km theo a danh cp huyn, tnh) i vi cc mc II, III, IV;

Ct 3: Ngy nhn c y h s hp l: H s ngh thm nh bo co MC i vi mc I; h s ngh thm nh, ph duyt bo co TM i vi mc II; h s ngh kim tra, xc nhn vic thc hin cc cng trnh bo v mi trng phc v giai on vn hnh ca d n i vi mc III; h s ng k k hoch bo v mi trng i vi mc IV;

Ct 4: Ghi y s, ngy, thng, nm ca cc vn bn: Vn bn bo co kt qu thm nh bo co MC i vi mc I; quyt nh ph duyt bo co TM i vi mc II; giy xc nhn hon thnh cng trnh bo v mi trng phc v giai on vn hnh ca d n i vi mc III; giy xc nhn ng k k hoch bo v mi trng i vi mc IV;

Ct 5: Ghi ch nhng vn khc lin quan n cng tc thm nh bo co MC; thm nh, ph duyt bo co TM; kim tra, xc nhn hon thnh cng trnh bo v mi trng phc v giai on vn hnh ca d n; xc nhn ng k k hoch bo v mi trng.

60 CNG BO/S 639 + 640/Ngy 29-6-2015

Ph lc 6.5 Mu bo co ca B, c quan ngang b v hot ng thm nh bo co nh gi mi trng chin lc; thm nh, ph duyt bo co nh gi tc ng mi trng; kim tra, xc nhn hon thnh cng trnh bo v mi trng



(1)

S:... V/v hot ng thm nh bo co nh gi mi trng chin lc;

thm nh, ph duyt bo co nh gi tc ng mi trng; kim tra,

xc nhn hon thnh cng trnh bo v mi trng




Thc hin quy nh ti Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc, nh gi tc ng mi trng v k hoch bo v mi trng, (1) bo co B Ti nguyn v Mi trng v hot ng thm nh bo co nh gi mi trng chin lc; thm nh, ph duyt bo co nh gi tc ng mi trng; kim tra, xc nhn cc cng trnh bo v mi trng thuc thm quyn ca mnh nh sau:


2. Nhng kh khn, vng mc: nu nhng kh khn, vng mc trong qu trnh t chc thc hin.

Trn y l bo co ca (1) gi n B Ti nguyn v Mi trng xem xt, tng hp./. Ni nhn: - Nh trn; - ...; - Lu:...


Ghi ch: (1) B, c quan ngang b; (2) i din c thm quyn ca (1).

CNG BO/S 639 + 640/Ngy 29-6-2015 61

Ph lc 6.6 Mu bng tng hp hot ng thm nh bo co nh gi mi trng

chin lc; thm nh, ph duyt bo co nh gi tc ng mi trng; kim tra, xc nhn hon thnh cng trnh bo v mi trng

ca B, c quan ngang b (Ban hnh km theo Thng t s 27/2015/TT-BTNMT ngy 29 thng 5 nm 2015 ca B trng B Ti nguyn v Mi trng v nh gi mi trng chin lc,


BNG TNG HP HOT NG THM NH BO CO NH GI MI TRNG CHIN LC; THM NH, PH DUYT BO CO NH GI TC NG MI TRNG; KIM TRA, XC NHN

HON THNH CNG TRNH BO V MI TRNG nm... (*)

(km theo Vn bn s... ngy... thng... nm... ca...) - Tn c quan bo co: - a ch lin h: - in thoi:...; Fax:...; E-mail...

TT 1 2 3 4 5 I Thm nh bo co nh gi mi trng chin lc 1 ... II Thm nh, ph duyt bo co nh gi tc ng mi trng 1 ... III Kim tra, xc nhn cc cng trnh bo v mi trng 1 ...

NGI LP BNG


(K, ghi h tn, chc danh, ng du) Ghi ch: (*) K bo co thc hin theo quy nh ti Khon 3 iu 21 Ngh nh s 18/2015/N-CP;

62 CNG BO/S 639 + 640/Ngy 29-6-2015

Bo co tng hp kt qu nu trn trnh by trn nn Microsoft Excel, s dng bng m chun quc t Unicode, font Times New Roman ting Vit theo cc ni dung sau y:

Ct 1: Lit k tt c tn: - Cc chin lc, quy hoch, k hoch c thm nh bo co nh gi mi

trng chin lc (MC) trong nm bo co i vi mc I; - Cc d n c ph duyt bo co nh gi tc ng mi trng (TM) trong

nm bo co i vi mc II; - Cc d n c ph duyt bo co TM v cp giy xc nhn hon thnh cng

trnh bo v mi trng phc v giai on vn hnh trong nm bo co i vi mc III; Ct 2: Phm vi ca chin lc, quy hoch, k hoch i vi mc I; a im thc

hin d n, phng n sn xut, kinh doanh, dch v (ghi c th a danh cp x, huyn, tnh hoc ghi tn khu sn xut, kinh doanh, dch v tp trung i vi cc d n nm trong cc khu ny km theo a danh cp huyn, tnh) i vi cc mc II, III;

Ct 3: Ngy nhn c y h s hp l: H s ngh thm nh bo co MC i vi mc I; h s ngh thm nh, ph duyt bo co TM i vi mc II; h s ngh kim tra, xc nhn vic thc hin cc cng trnh bo v mi trng phc v giai on vn hnh ca d n i vi mc III;

Ct 4: Ghi y s, ngy, thng, nm ca cc vn bn: Vn bn bo co kt qu thm nh bo co MC i vi mc I; quyt nh ph duyt bo co TM i vi mc II; giy xc nhn hon thnh cng trnh bo v mi trng phc v giai on vn hnh ca d n i vi mc III;

Ct 5: Ghi ch nhng vn khc lin quan n cng tc thm nh bo co MC; thm nh, ph duyt bo co TM; kim tra, xc nhn hon thnh cng trnh bo v mi trng phc v giai on vn hnh ca d n.

Thông tư 27/2015 TT-BTNMT về kế hoạch bảo vệ môi trường

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