Environmental Screening Document

Annex B

Ex-Im Bank Environmental Screening Document (download PDF)

Must Accompany All Applications For Long-Term Financial Support 

The information provided on this form is used to environmentally categorize the application and thereby determine the information needed (if any) for Ex-Im Bank to evaluate the environmental effects of the transaction, a process that is crucial to the appropriate and timely review of your application. Please check the boxes that apply. 

Are the products or services covered in your application destined for an identified physical project?
No, explain  ____________________________________________.
Yes a) identify the project________________________________________________________
            b) Provide a brief description, including output, capacity, size, etc._______________________
            ________________________________________________________________________
            ________________________________________________________________________

            c) Indicate whether this is a new project, a rehabilitation or an expansion in size or output of an
                 existing project___________________________

PROJECT LOCATION


Is the project located in or near an environmentally sensitive site or area? (Check all applicable):
Tropical Forests or Other Areas with High Biological Diversity
Nationally or Internationally Designated Protected Areas, such as Wetlands, Seashores, Wildlands or Refuges, National Parks
Habitat of Endangered Species
Location Affecting Indigenous, Tribal or Other Vulnerable Populations
Location having Historical / Archaeological Significance
Large Scale Resettlement? (Potential Number of People Affected: ________________________)
Properties on the UNESCO World Heritage Site List

PROJECT SECTOR OR INDUSTRY


Check classification(s) describing the project for which the exports are destined:

Large Infrastructure
Airport 
Ports/harbors 
Pipelines 
Highways 
Other Large Infrastructure 		 Iron & Steel Plant 
Smelter 
Pulp & Paper Plant 
Petroleum Refinery or Petrochemical Plant 
Chemical / Pharmaceutical 
Natural Gas Liquefaction Plants 
Industrial Plants - large scale 
Agro-industries - large scale Transportation (Aircraft, Locomotives, Boats)
Forestry Telecommunications or Satellites 
Mining & Mineral Processing Plant Air traffic control or navigational aids
Oil & Gas Field Development Railway Signaling
Hydropower Plant / Water Reservoir 
Thermal Power Plant 		 Hospitals and Medical Equipment
over 140 MWe
under 140 MWe 
Nuclear Power Plant  Pre-project Services, Feasibility/Environmental study
Geothermal Power Consulting services
Waste Management Other, specify:_____________________________

Name of Applicant____________________________________ Date__________________

For inquiries and information please contact the Engineering & Environment Division at (202)565-3570.