Supplier Questionnaire Section B
Supplier Name
Supplier Address
Form Completed By (Name)
(Position)
Date Completed
SUPPLIER ENVIRONMENTAL QUESTIONNAIRE
Please use a separate sheet of paper, where necessary, to complete your answers.
No Audit Question
Complies? Comments
Yes/No
1
Does your facility have written
environmental performance objectives?
In the rows below please list 3 of your environmental objectives for the next 12 months
1a
1b
1c
2
Does your facility have written
environmental performance targets?
In the rows below please list 3 of your environmental targets for the next 12 months
2a
2b
2c
Issue No.
4
5
Date
19/04/05
06/12/06
6
14/03/07
Amendment
Ref. added to GADSL.
Complete review. Supplier expectation defined. More detailed
information required. Explanations of EMS benefits given.
Company name added. Questions 1 and 2 added about EMS
systems and certification.
Authorised
~
~
~
Supplier Questionnaire Section B
No Audit Question
Complies? Comments
Yes/No
3
Does your facility have written
environmental performance
implementation plans to reduce cost or
risk?
In the rows below please list 3 aspects of your environmental implementation plan for
the next 12 months
3a
3b
3c
4
5
6
Is there a management representative
with assigned responsibility for
facilitating compliance with
environmental regulations?
Name & Title of the representative
from Q4
How does your facility track
environmental laws and regulations that
apply to your operations?
7
How is this information communicated
to the appropriate personnel?
8
How often are internal environmental
regulatory compliance audits of the
facility's operations conducted?
Who conducts these audits?
9
10
What training have these auditors
undertaken?
Issue No.
4
5
Date
19/04/05
06/12/06
6
14/03/07
Amendment
Ref. added to GADSL.
Complete review. Supplier expectation defined. More detailed
information required. Explanations of EMS benefits given.
Company name added. Questions 1 and 2 added about EMS
systems and certification.
Authorised
~
~
~
Supplier Questionnaire Section B
No Audit Question
Complies? Comments
Yes/No
11
Does your company have documented
processes to implement corrective
action plans for non-conformance to
environmental laws and regulations?
Environmental Permits, chemical registration & Compliance Status
12 Is your facility required to have any
permits or registrations for;
Industrial wastewater discharge?
13 Is your facility required to have any
permits or registrations for;
Hazardous waste storage?
14 Is your facility required to have any
permits or registrations for;
Hazardous waste treatment?
15 Is your facility required to have any
permits or registrations for;
Hazardous materials use/storage?
16 Is your facility required to have any
permits or registrations for;
Air emissions?
17 Is your facility required to have any
permits or registrations for;
Storage tanks?
18 Is your facility required to have any
permits or registrations for;
Radioactive materials?
19 Does your facility monitor its
operations, emissions, or discharges to
check compliance with permit
requirements?
20 Do regulatory agencies regularly
monitor and/or inspect the facility?
21
If Yes to Q20. Does your facility
comply?
Issue No.
4
5
Date
19/04/05
06/12/06
6
14/03/07
Amendment
Ref. added to GADSL.
Complete review. Supplier expectation defined. More detailed
information required. Explanations of EMS benefits given.
Company name added. Questions 1 and 2 added about EMS
systems and certification.
Authorised
~
~
~
Supplier Questionnaire Section B
No Audit Question
Complies? Comments
Yes/No
22
Has your company been convicted of
breaching any environmental legislation
in the last 5 years?
23
Is there any legal action pending?
24
Has there been any Civil action taken
against your Company in the last 5
years for any Environmental concerns?
Is there any Civil action pending?
25
Do you supply to Pritex Ltd., or use in the product or services you provide for Pritex
Ltd., any of the classified materials or substances as listed in the ‘Global Automotive
Declarable Substances List’ (GADSL) (NOTE: . The latest version of the GADSL is publicly
available on the Web at http://www.gadsl.org).
See list below.
26 Lead?
27
Mercury?
28
Cadmium?
29
Hexavalent Chromium?
30
Polybrominated Biphenyls?
31
Polybrominated Diphenyl Ethers?
32
Toluene?
33
Other Solvents / Substances containing
Volatile Organic Compounds (VOCs)?
34
Does your facility generate hazardous
waste?
Issue No.
4
5
Date
19/04/05
06/12/06
6
14/03/07
Amendment
Ref. added to GADSL.
Complete review. Supplier expectation defined. More detailed
information required. Explanations of EMS benefits given.
Company name added. Questions 1 and 2 added about EMS
systems and certification.
Authorised
~
~
~
Supplier Questionnaire Section B
No Audit Question
Complies? Comments
Yes/No
35
How are hazardous wastes that are
stored, treated, or disposed of on your
site managed so that they will prevent
future environmental impacts?
36
How does your facility ensure that offsite transporters and treatment,
storage or disposal facilities are
properly licensed?
37
Does your facility treat its industrial
wastewater prior to discharge?
38
Is your facility required to control its
industrial emissions?
39
If “yes”, does your facility have air
emission control equipment installed?
Please describe.
40
Does our facility use chemicals that, if
released accidentally, could create a
business interruption? (Examples include,
but not limited to, high volume chemicals,
either pressurized gases or liquids that are
flammable, highly toxic or radioactive)
41
Does your facility have written
emergency response plans in case of a
release to the environment?
(Examples include, but not limited to,
training, drills, chemical hazard
communication, hazard identification,
audits of high-risk areas, mutual aid
relations, emergency response and disaster
recovery equipment.)
Issue No.
4
5
Date
19/04/05
06/12/06
6
14/03/07
Amendment
Ref. added to GADSL.
Complete review. Supplier expectation defined. More detailed
information required. Explanations of EMS benefits given.
Company name added. Questions 1 and 2 added about EMS
systems and certification.
Authorised
~
~
~
Supplier Questionnaire Section B
No Audit Question
42
43
44
Complies? Comments
Yes/No
Is the company/facility aware of any
chemicals used in the facility's
manufacturing processes whose
availability is currently restricted or
scheduled to be restricted in the future
due to environmental requirements
(e.g., CFCs)?
What is the Business Interruption
Potential of these restrictions?
Do you have written plans to eliminate
these chemicals, or otherwise
accommodate their reduced availability?
Additional Comments (if required)
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Issue No.
4
5
Date
19/04/05
06/12/06
6
14/03/07
Amendment
Ref. added to GADSL.
Complete review. Supplier expectation defined. More detailed
information required. Explanations of EMS benefits given.
Company name added. Questions 1 and 2 added about EMS
systems and certification.
Authorised
~
~
~
Supplier Questionnaire Section B
GUIDANCE DOCUMENT
Continuous Improvement & Compliance Assurance
An environmental management system should measure, improve and communicate the
environmental aspects of the facility’s operations in a systematic way. An effective
environmental management system should have elements that can be integrated with other
management requirements to assist the supplier in achieving both environmental and
economic goals.
A written environmental policy statement outlines the commitment, purpose, objectives and
mission of a facility’s/company’s environmental practices. The environmental policy statement
provides direction and focus of the facility’s/company’s environmental improvements and
progress. Reviewing the policy statement may give indications of priorities and of the
strength of the commitment.
Written performance objectives/targets and implementation plans provide and communicate
direction, resources, commitment, and schedules to complete identified tasks. Reviewing the
plans ensures that the policy is being adequately and effectively implemented. Objectives
should be measurable and pertinent to the operation or activity.
Identifying a management representative provides focus, priority and direction for
environmental programs within a facility/company.
Regulatory compliance and environmental management system audits are an important
aspect of an effective environmental management system. A system to track environmental
laws and regulations provides greater assurances that a facility will stay in compliance.
Communication and training of the environmental laws and regulations is important to stay in
compliance.
Periodic compliance audits are a method to assure and to improve a facility’s/company’s
compliance to environmental regulations. The scope of the audit should take into
consideration the size, type of activities, and the risks of the facility/company and should be
conducted by persons who are technically qualified.
Documented processes to implement corrective action plans for non-conformance are an
essential part of compliance assurance.
A supplier’s knowledge of applicable environmental permits and registrations provide
assurance that a facility can meet specific compliance requirements. Facilities that do not
Issue No.
4
5
Date
19/04/05
06/12/06
6
14/03/07
Amendment
Ref. added to GADSL.
Complete review. Supplier expectation defined. More detailed
information required. Explanations of EMS benefits given.
Company name added. Questions 1 and 2 added about EMS
systems and certification.
Authorised
~
~
~
Supplier Questionnaire Section B
obtain registrations or permits for the use, importation or exportation of chemicals or
chemical wastes could be subject to temporary or permanent shutdowns and legal action.
To comply with our customer’s requirement and legal obligations, it is important we know
(and can therefore report) use of restricted substances.
The management of hazardous waste presents risks and liabilities for facilities.
Managing hazardous waste with care can reduce operational and legal exposure, and could
impact a supplier’s ability to deliver products in a timely manner.
Industrial wastewater is generated in a manufacturing process and discharged to a municipal
treatment plant, surface water, or to land. Facilities/companies should identify
environmentally harmful wastewater discharge, and provide necessary controls and/or
treatment to comply with applicable regulations.
Industrial air emissions are any emissions that are regulated by the government, or which
damage public health or the environment if concentrations are not controlled.
Facilities that use high volume dangerous chemicals can experience releases that create
business interruptions. Identification of these chemicals and quantities helps in determining
the relative risk of business interruption. Facilities/companies with emergency response plans
are more likely to recover more quickly after an accident.
Company’s/facility’s awareness of current and future restricted chemicals used in their
manufacturing process is crucial to avoid potential business interruption due to
environmental requirements. Identification of these chemicals and documented plans to
eliminate these chemicals can minimize unwanted business interruption.
Issue No.
4
5
Date
19/04/05
06/12/06
6
14/03/07
Amendment
Ref. added to GADSL.
Complete review. Supplier expectation defined. More detailed
information required. Explanations of EMS benefits given.
Company name added. Questions 1 and 2 added about EMS
systems and certification.
Authorised
~
~
~