AQA International :: Environmental Questionnaire


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Company Name:*

Contact Name:*

Phone Number:*

Email:*

Location of Buildings:

Main Building

Remote Building

Site Size:

Number of Employees:

Time of 1st Shift:

Time of 2nd Shift:

Time of 3rd Shift:

Other Shifts:

Which aspect of the facility's activities can have significant impact on the environment?
Solid Waste Management	Use of Raw Materials	POTW Discharge	Chemical Use
Releases to Water	Storm Water Discharge	Energy Use	Air Emissions
Petroleum Storage Tanks	Haz Waste Management
Other (specify):

Type of activities (operations and processes) conducted at the facility:

Environmental permit required:

Oil products (lubricating oil, hydraulic oil, diesel, etc) used or produced:

Is the facility a hazardous waste generator?	Yes	No
Types of hazardous materials utilized or produced:

Types of solid waste generated:

List any recognized standards, such as ISO 9001, the organization is registered to, subscribes to or comply with:

List existing management system elements (such as document control) to be used for ISO 14001: