Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697800052500.pdf (Dominica)
DOMINICA HOUSING RECOVERY PROJECT SITE SPECIFIC ENVIRONMENTAL AND SOCIAL MANAGEMENT AUDIT DURING CONSTRUCTION Beneficiary Details Contractor Details PROJECT IMPLEMENTATION UNIT SAFEGUARDS FORM Beneficiary Name Beneficiary ID Community Parish PIU Random Inspection Details Construction Stage  Complete Ground Floor Slab  Complete Roof Slab  Practical Completion Audit Conclusion Audit undertaken by: Inspection date Name of Contractor Contractor telephone On-site Supervisor if different Supervisor telephone if different  Pass  Resolution Required  Comment: Signature ESMP Category Question ESMP Sub-category Rating Site Security Traffic Management Is the level of access control adequately maintained to reduce liability?
Are materials and equipment adequately stored to protect material quality and reduce theft?

Are there adequate provisions for workers to store their personal items?

Is the construction site and equipment secured against severe weather?

Site Security Comment (optional) Is communication to stakeholders (including timely and accurate relay of information for temporary halt, parking locations, diversion and or closure of road, pedestrian and vehicle safety) adequate?

Is there appropriate signage?
(includes the signs, their placement and removal for public and private use) Maintain access control Material & equipment storage Worker storage arrangement Secure construction site & equipment  Good  Adequate  Poor/ Non-existent  Not Applicable  Good  Adequate  Poor/ Non-existent  Not Applicable  Good  Adequate  Poor/ Non-existent  Not Applicable  Good  Adequate  Poor/ Non-existent  Not Applicable Stakeholder communication  Good  Adequate  Poor/ Non-existent  Not Applicable Signage  Good  Adequate  Poor/ Non-existent  Not Applicable Dominica HRP ESMP Beneficiary Site Audit Form: Second to Fourth Tranches Page 1 of 4 Chance Find Site Stabilization, Erosion & Flood Control Air Quality/Noise control Pest Management Is movement controlled to allow ease of transport flow?
(including movement of large equipment or parking location or increase traffic or difficulty to maneuver construction vehicles in unusual locations) Traffic Management Comment (optional) Have historical remnants been discovered during construction?

Have human remains been discovered during construction?

Chance Find Comment (optional) Is soil erosion adequately controlled on the site?

Is adequate site drainage provided as per designs or as required during construction?
Is the site drainage system installed?

Is the site drainage system performing adequately?

Site Stabilization Comment (optional) Are there material haulage vehicles that may release dust covered?

Is air pollution adequately managed?

(including waste odors and dust from unvegetated areas) Are noise levels adequately minimized on the site, including control of equipment volume during appropriate hours, and radio/other music devices at all times?
Air Quality Comment (optional) Describe pest control measures practiced on site (eg.

prevention of mosquito breeding grounds etc.)
Describe site access restriction measures to unauthorized personnel/companies during pest management activities Pest Management Comment (optional) Movement control  Good  Adequate  Poor/ Non-existent  Not Applicable Physical cultural resource Human Site stabilization Erosion control  Yes  No  Not Applicable  Good  Adequate  Poor/ Non-existent  Not Applicable  Good  Adequate  Poor/ Non-existent  Not Applicable Drainage Installed  Good  Adequate Drainage Performance Dust control Air pollution Noise control  Poor/ Non-existent  Not Applicable  Good  Adequate  Poor/ Non-existent  Not Applicable  Good  Adequate  Poor/ Non-existent  Not Applicable  Good  Adequate  Poor/ Non-existent  Not Applicable  Good  Adequate  Poor/ Non-existent  Not Applicable Control method Authorized personnel/company  Good  Adequate  Poor/ Non-existent  Not Applicable  Good  Adequate  Poor/ Non-existent  Not Applicable Dominica HRP ESMP Beneficiary Site Audit Form: Second to Fourth Tranches Page 2 of 4 Hazardous Materials/Chemicals Management Does asbestos handling, storage and disposal conform to proper handling requirements?
Does the use and management of hazardous materials, fuels, solvents, and petroleum products conform to proper handling requirements?
 Good  Adequate  Poor/ Non-existent  Not Applicable  Good  Adequate  Poor/ Non-existent  Not Applicable Asbestos handling, storage and disposal Use and management of hazardous materials, fuels, solvent, paints and petroleum products Hazardous Materials/Chemicals Management Comment (optional) Waste Management Are construction debris, hazardous waste, and daily Waste separation  Yes  No  Not Applicable waste separated?

Does waste storage conform to the standards established?
Does waste transportation conform to the standards for separation, cover, transport safety and worker safety?

Is there proof of a tipping fee paid as evidence the waste has been disposed to landfill or authorized location?

Waste Management Comment (optional) Is the volume of running water controlled to avoid wastage?

Is liquid waste adequately managed to prevent run-off to waterways?

Has the septic tank been properly installed to prevent run-off to waterways?
Has the house been adequately connected to the septic tank and wastewater system to prevent run-off to waterways?
Waste Water Management Comment (optional) Secure storage and use on site Transportation of waste Disposal to landfill or authorized location Manage running water Manage liquid waste Install septic tank House connection to septic tank and wastewater system  Yes  No  Not Applicable  Yes  No  Not Applicable  Yes  No  Not Applicable  Good  Adequate  Poor/ Non-existent  Not Applicable  Good  Adequate  Poor/ Non-existent  Not Applicable  Good  Adequate  Poor/ Non-existent  Not Applicable  Good  Adequate  Poor/ Non-existent  Not Applicable Wastewater/ Sewage Management Dominica HRP ESMP Beneficiary Site Audit Form: Second to Fourth Tranches Page 3 of 4 Workers Code of Conduct Is there evidence of workers training and orientation on environment, social, health and safety principles?
Community Relations/ Social Sensitivity Has a worker sanitation facility been arranged and kept clean?

Do labour and working conditions conform with established requirements?

Are appropriate occupational health and safety measures in place?

Including the use of PPE, conform to procedure as per job hazard analysis, tools and equipment handling and storage Are site operations compliant to established emergency management plan?
Workers Code of Conduct Comment (optional) Is the potential for conflict with neighbours minimized?

How are relations with the immediate community surrounding the site?

Has a Grievance Redress Mechanism (GRM) or conflict resolution plan been activated?

(including contact with relevant stakeholders such as the Kalinago Council?)

Are all communications, consultations and or awareness campaigns adequate and appropriate?

(are they suited for the various types of audiences, including the Kalinago people?)
Community Relations Comment (optional) Training / orientation of workers Worker sanitation facility Labour & working conditions Occupational health & safety Emergency management Potential conflict with neighbours Community relations GRM activated, conflict resolution plan Communications, Consultations, Awareness  Yes  No  Not Applicable  Yes  No  Not Applicable  Yes  No  Not Applicable  Yes  No  Not Applicable  Yes  No  Not Applicable  Yes  No  Not Applicable  Good  Adequate  Poor/ Non-existent  Not Applicable  Yes  No  Not Applicable  Good  Adequate  Poor/ Non-existent  Not Applicable Emergency Protocol Does the emergency protocol conform to the Emergency Protocol  Good  Adequate established plan?
(eg.

COVID-19 guidelines, natural disaster preparedness, health and safety plan etc.)

Emergency Protocol Comment (optional)  Poor/ Non-existent  Not Applicable Dominica HRP ESMP Beneficiary Site Audit Form: Second to Fourth Tranches Page 4 of 4