Environmental Questionnaire
for Loans/Leases to Environmentally Sensitive Industries (ESI)
not Secured by Real Estate
The purpose of this questionnaire is to provide information upon which the Bank will rely as part of the loan/lease
application review. Information provided will be for Bank use only.
Does your company engage in any of the following activities and operate facilities associated with the following?
Yes
No
Comment
Underground Storage Tanks
Above Ground Storage Tanks
Wastewater treatment systems
Storage and use of Hazardous or Toxic Chemicals or Materials
Auto, truck or other vehicle maintenance or repair
Manufacture, mixing and/or distribution of chemicals
Oil and or natural gas wells
Retail sale of gasoline
Drycleaning
Historic use of chlorinated solvents
Air quality emissions for which permits are required
Asbestos liability
Cleanup liability for properties owned or occupied by Company
Cleanup liability for properties not owned or occupied by Company
Hazardous waste transportation, transfer or disposal
Solid waste transportation, transfer or disposal
If all the above are answered “No”, proceed to end of Questionnaire and sign on behalf or your company.
Otherwise complete the following questions. Provide backup documentation and use additional pages for
answers as necessary.
Yes
ENVIRONMENTAL MANAGEMENT
Does the Company operate under the guidance of a published
corporate-wide environmental policy?
Does the company perform internal environmental audits of
facilities? If so, how often?
Does the company publish an annual environmental report or
include environmental reporting other documents? If so, provide
copies.
Does the Company have an environmental officer operating at the
company-wide level?
OPERATIONS
Do your operations require any of the following?
 EPA Hazardous Waste Generator ID
 Material Safety Data Sheets (attach a list of chemicals
and quantities.
 NPDES Permit
 Hazardous Waste Treatment Storage and Disposal
Facility (TSDF) Permit.
 Underground Storage Tank Use Permit
 Air Pollution Control/Emission Permit
 Emergency Hazardous Materials Management Plan or
Contingency Plan
 Asbestos Operations and Maintenance Plan
00-05-2954NSBW 04-2009
No
Comment
Yes
Have any citations been issued to your facility for permit violations
or non-compliance which require corrective action? If yes,
describe and attach a copy. What is the projected "cost to cure"
the above compliance issue?
Are any facility upgrades or capital improvements required or
planned to maintain, or renew any environmental permits or meet
compliance standards? If yes, describe the projected costs and
time frame.
Is your company accruing any monies to address current or
anticipated future permit and compliance issues? If yes, describe.
ENVIRONMENTAL LIABILITY
Has the company ever owned and/or operated any facilities that are
now federal, state or provincial Superfund sites (include equivalent
for non-US facilitites)?
If Yes provide a list of sites, projected
contribution and timing of expenditures. Documentation can refer to
Phase I ESAs being obtained for specific properties.
Has the company or any of its subsidiaries been named as a
potentially responsible party (PRP) for any non-owned state,
provincial or federal Superfund Site? If Yes, provide list of sites,
projected contribution and timing of expenditures.
Have any state, provincial or local regulatory agencies issued any
citations, violations or any soil/groundwater cleanup orders at any of
the facilities? If Yes, please list them and provide projected
timeframes and remediation costs.
Is the company involved with any outstanding litigation with third
parties relative to environmental contamination or compliance? If
Yes, please provide descriptions of issues and potential outcomes.
Does the company obtain indemnifications for environmental
problems from sellers of acquired facilities, especially major
acquisitions? If Yes, list and describe any ongoing environmental
issues at owned facilities being handled by other parties.
Is your business/corporation (or subsidiary thereof) subject to any
personal injury asbestos related litigation brought by parties alleging
injury through exposure to products or premises or other causes of
action related to asbestos? If Yes, complete the asbestos-specific
questionnaire provided by your Bank of America Client Manager.
Prepared by:
Corporate Title:
(print name)
On behalf of:
Date:
(applicant)
00-05-2954NSBW 04-2009
No
Comment