Green Achiever - Registration Form

For your Free Environmental Health Check Report

Stay on the right side of the ever changing legislation!
In Strict Confidence and with no obligation.
 Please complete the boxes below answering as many question as you can.
The more information, the more meaningful the report. Our report will be sent to you in electronic format.
A link will be supplied to download a Green Achiever Logo for your website..

Title  
First Name  
Last Name    
Company Name    
Address
City
County
Postcode
Telephone
Your E-Mail
Your Website address :  http://    

General information about your company...

Please use the checkboxes below to select the business sectors
you normally participate in... (multiple selections ARE allowed)
 
Your Specific Type of Business
...Or if none suitable, please specify here »
Your main Business Activity Search Keywords
*This Field will be used in our 'company search' feature and will help interested visitors find YOUR
listing details and contact you with any enquiries.
- Simply enter some terms relating to the nature of your business, your services and what you do.
(Just seperate each term or phrase with a space)
characters remaining
Number of Employees
Annual Turnover
Do you have an Environmental Policy?
Do you have an Environmental Management System (e.g. ISO14001)?
Do you operate a Services Department?
Do you know your Carbon Footprint?
Would you know like to know your business Carbon Footprint?
Do you know about Carbon Offsetting?
Would you like to learn more about
Carbon Offsetting?
Section 1 - Manufacturing & Construction
/> If these questions do not apply  please go to section 2.
Do you carry out Paint Spraying?
Do you make Electrical or Electronic Goods?
Do your products carry the CROSSED OUT 'wheelie bin' logo?
Do you specify the packaging of the products manufactured?


Section 2 - Oils Policy
Is machine maintenance oil used or stored on site?
Do you store more than 200 litres (45 gals.) on site?
Do you have a 'spillage plan' in operation?


Section 3 - Drains - Do you know where your drains go?
(multiple selections ARE allowed)
Foul Water Sewer
Foul water via an interceptor on site
Soak Away
Septic Tank


Section 4 - Chemical Handling
Do you carry any notifiable Chemicals on Site?
Do you import or manufacture chemicals?
Do you use volumes of individual chemicals in excess of 1 tonne per year?


Section 5 - Waste Management - Do you dispose of any of the following?
Card?
Plastic?
Wood (Pallets?)
Electrical or electronic?
Paint Cans or Containers?
Oil?
Oil Rags?
Food and Canteen Waste?
Chemicals?
Batteries?
Fluorescent Light Bulbs?
Drugs / Pharmaceutical Products?
Used Swabs / Dressings?
Used Syringes / Needles?
Human or Animal Tissue?
Blood or Body Fluids?
Other General?
Do you recycle any waste?
Do you take back old and redundant products from customers?
What products do you recycle (If any)?


Section 6 - Packaging
Do you buy packaging for packing (e.g. plastic bags, shrink wrap, cartons)?


Section 7 - Energy - Which forms of energy do you use?
Electricity?
Gas?
Oil?
Energy generated on site?
Do you use any renewable energy?
Do you monitor your consumption?


Section 8 - Transport
Do you have your own fleet?
Do you have company cars?
Do you use Biofuels?
Do you carry out your own maintenance?
Do you use third party logistics?
Do you operate a Bike 2 Work Scheme?


Section 9 - Other general questions
Have you been asked for your Environmental Policy?
Do you ask your suppliers for their Environmental Policy?
Do you source supplies locally?
Do you import products?
Do you advertise your Green Credentials?
Do you feel any pressure to become a 'Greener' Company?
How did you hear of the Green Achiever Scheme?

I heard about your scheme from...
   
By completing this form, you indicate your consent for us to send you information about selected services, events and products from E4environment Ltd, our affiliated companies and from carefully chosen third parties, unless you object to receiving such messages by ticking the box below:-

   
   

If you have any difficulty, please call 01743 343403

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For the latest information on Environmental Legislation you can look at E4 Environment