environmental Risk Assessment (ERA) Initial Survey

The foundation of an environmental Management Strategy (eMS) is the environmental Risk Assessment (eRA). An eRA identifies the various direct and indirect environmental issues impacting a business. An eRA does not attempt to meet any specific governmental standards or follow specific due diligence models that have been developed such as All Appropriate Inquiry (AAI), ASTM Phase I & II reports, ISO 14000….

The footings of an eRA:

eRA Part One: What’s coming in your front door, i.e. raw materials, supplies, vendors, sales….? What if a vendor had an environmental loss that impeded their ability to deliver goods and services? If this were to occur, what’s your strategy? Can a vendor have a negative environmental impact upon your business? Clients can create indirect environmental liabilities. It’s critical to know, who you are doing business with.

eRA Part Two: What’s going on, inside your corporate walls? How do you store, handle and treat, raw materials, supplies, waste? Are you subject to any environmental laws or regulations? What vendor services are being performed inside your corporate walls?

eRA Part Three: What’s going out your back door? From finished products or services, recyclables, waste materials, vendor services, etc?

eRA Part Four: Who are your neighbors? You can be executing your eMS and still experience an indirect environmental impact from one of your neighbors. Who are your neighbors and what potential environmental liabilities can they create?

The environmental Strategist (eS) will compile the four parts of the ERA and distribute it to your TEAM members via the www.estrategist.com eRAM Tool. TEAM members will add their professional competitive intelligence so you can prioritize and budget for the strategy laid out by your eMS TEAM. Your eMS will move you beyond just meeting government compliance, allowing you to control your destiny while being environmentally transparent.

Company Name:_____________________________________________________

Mailing Address:_____________________________________________________

Physical Address:_____________________________________________________

Company is: Corporation:_____ LLC:_____ Partnership:_____ Other:_____

Phone:____________________ Fax:____________________

Web Site Address:______________________________

Company Contact:_________________________ Job Title:___________________

Email Address:_________________________ Phone:______________________

Date firm was established:____________________

Total number of employees:____________________

SIC Code/s:__________________________________________________________

Do you qualify as: Minority Owned Business:_____ Women Owned Business:_____

Is the company: Union:_____ Non-union:_____

Union Name:____________________ Contract Expiration Date:_______________

Has the company been involved in any bankruptcy or reorganization proceedings? Yes_____ No_____ (Attach Separate Sheet With Specific Details)

Are there any judgments, claims, arbitration proceedings or suits pending or outstanding against the company? Yes_____ No_____(Attach Separate Sheet With Specific Details)

Ha the company been involved in any environmental proceedings, suits, arbitration, remediation? Yes:_____ No:_____ (Attach Separate Sheet With Specific Details)

Has your company field any lawsuits or requested any arbitration in the last five years? Yes_____ No_____(Attach Separate Sheet With Specific Details)

List corporate officers, time with the company and attach resume:

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Does the company have any subsidiaries? Yes:_____ No:_____

Describe current permits for your company and if they are federal, state, local:

(Supply copies of current permits)

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Describe company operations:___________________________________________

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Is your company dependent upon any one customer, vendor or supplier? Yes:_____ No:_____

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Annual gross receipts: $________________________

What percentage of your gross receipts are attributable to subcontractors? ________

List subcontracted services:______________________________________________

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(Attach copies of contracts used with vendors and client’s)

Do you have a formal process for incident investigations? Yes:_____ No:_____

(Attach Copy Of Incident Investigation Procedures)

Do you have employee Safety Meetings? Yes:_____ No:_____

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Do you have a written Substance Abuse Program? Yes_____ No:_____

(Attach Copy of Program)

Do you have a written medical monitoring program: Yes:_____ No:_____

(Attach Copy of Program)

Do you have all of the required Material Safety Data Sheets (MSDS) for materials your

company will use? Yes:_____ No:_____ (Attach copies)

What programs do you have on file with the Fire Department, Law Enforcement,

Hospitals?___________________________________________________________

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When is the last time the Fire Department inspected your company?_____________

When is the last time your law enforcement inspected your company?____________

Do you have an in house emergency response team? Yes:_____ No:_____

Do you have an emergency response vendor? Yes:_____ No:_____

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(Attach copies of agreement)

How does your company keep up to date with regulatory and technical changes affecting

Your company?_______________________________________________________

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List trade organizations, associations the company belongs:

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Has your company had any operations sold, acquired, or discontinued in the last five years? Yes:_____ No:_____

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Does your company plan to buy, sell or discontinue any operations? Yes:_____ No:_____

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Does you company select, own or manage disposal sites? Yes:_____ No:_____

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Does your company generate a waste manifest? Yes:_____ No:_____

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When is the last time you had your waste stream characterized?_________________

Are you aware of any notices of violation, fines, penalties, complaints, or received any claims or suits relating to any pollution conditions? Yes:_____ No:_____

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Are you aware of any past or present pollution conditions, or any circumstances which may reasonably be expected to give rise to a liability claim? Yes:_____ No:_____

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Are you aware of any operations that are in non-compliance of any federal, state or local environmental regulations, standards or statues? Yes:_____ No:_____

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Please indicate which of the following training programs are provided to your Employees and give frequency:

40 Hr Haz Waste Emergency Response____________________

8 Hr Haz Waste and Emergency Response Update____________________

8 Hr Haz Waste and Emergency Response Supervisor____________________

Hazard Identification and Evaluation____________________

Personal Protective Equipment____________________

Respirator Protection____________________

Permit Required Confined Spaces____________________

Right to Know____________________

OSHA____________________

RCRA Compliance____________________

Lock / Tagout____________________

First Aid / CPR____________________

Hearing Protection____________________

Powered Platforms (aerial lifts)____________________

Fork Lift____________________

Fall Protection___________________

Scaffolding____________________

Welding / Cutting_______________

Asbestos____________________

Lead____________________

Mold____________________

Air Monitoring Instruments____________________

Trenching / Excavating____________________

Signs / Barricades / Flagging____________________

Hazard Communications____________________

Equipment Operation____________________

Other_________________________________________________________

What type of personal protective equipment is used by your employees?

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How does your company monitor employee training certification to assure

employees are current with required training?_________________________

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Are certificates of training available? Yes:_____ No:_____

Who provides training?_________________________________________________

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Are trainers credentials available? Yes:_____ No:_____

PRODUCT(S)

Does your company manufacture, buy, sell a product(s)? Yes:_____ No:_____

(If No move to next section)

What component or finished product do you manufacture, buy, sell?_______

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Do you make your product to the customers specifications?_______________

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Does your company do the design work for your product? Yes:_____ No:_____

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Do you offer any warranties / guarantees? Yes:_____ No:_____ (Attach Copy)

Does your company install, service or demonstrate products? Yes:_____ No:_____

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Does your company import or export products? Yes:_____ No:_____

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Do you enter into contracts where you assume the liability of others? Yes_____ No:_____ (Attach Copies)

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Has your company had any products recalled or discontinued? Yes:_____ No:_____

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PROPERTY

Does your company own, lease or occupy real property, i.e. buildings, land: Yes:_____ No:_____

(If No move to next section)

****Attach environmental due diligence, reports, studies, audits you have on your property/s.

Describe your companies real property: (historical use, present use, type of construction, square footage, year built, number of stories, sprinklers, alarms,….)

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(Attachment descriptions of additional properties if necessary)

Any properties with deed restrictions? Yes:_____ No:_____

(Attach copy of deed restrictions)

Does your company conduct regular environmental compliance audits? Yes:_____ No:_____ (Attach most recent copy)

Describe your neighbors within a one mile radius of your property:_____________

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(Attach detailed sheet if more space is needed)

Do you know of any neighbors within a one mile radius that have had environmental remediation performed or identified as having an environmental problem? Yes:_____ No:_____

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Describe the natural resources within one mile of your property/s:_______________

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Is the property within a flood plain? Yes:_____ No:_____

Are all properties serviced by municipal water and sewer? Yes:_____ No:_____

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Are you aware of any ground water wells or disposal wells in the area? Yes:_____ No:_____

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Any properties with EFIS (Exterior Finish and Insulation System)? Yes:_____ No:_____

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Are there other occupants of your real property that are not associated with your company? Yes:_____ No:_____ (If Yes supply copy of lease agreement)

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Any onsite waste treatment facilities? Yes:_____ No:_____

(Size, age, average daily throughput, waste treated, maximum permitted amount treated)

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Where is effluent discharged?____________________________________________

Does the facility work with any radioactive material or radioactive waste? Yes:_____ No:_____

Any past waste treatment facilities on property? Yes:_____ No:_____

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Any above ground or under ground storage tanks? Yes:_____ No:_____

Describe if tank/s is above or under ground, age, construction, size, number, secondary containment, confirm UST/s in compliance with 1998 federal UST standards, contents:

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What type of raw materials, products, waste does your company store on site? List quantities stored, storage method, annual amounts used….

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How does your company purchase raw materials? FOB point of shipment_____ FOB point of delivery_____

Do you have a side track agreement? Yes:____ No:_____

Is your company responsible for loading or unloading materials, products or waste to or from motor vehicles, rail roads, ships or aircraft? Yes:_____ No:_____

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Are there any plans for future development of your real property/s? Yes:_____ No:_____

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Any Brownfield property/s? Yes:_____ No:_____

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Do you perform annual inspections of non-owned disposal facilities? Yes:_____ No:_____ (Attach copy of most recent inspection)

TRANSPORTATION

Does your company own or operate motor vehicles? Yes:_____ No:_____

Does your company hire owner/operators? Yes:_____ No:_____

Do you confirm owner/operators are properly licensed carriers? Yes:_____ No:_____

(If No move to next section, If yes supply vehicle list))

Get copies of MVR’s for all drivers

How often are MVR’s reviewed?_______________

Method of shipment: railroad_____ auto_____ truck_____

With the exception of encumbrances, is any vehicle not solely owned by and registered to your company? Yes:_____ No:_____

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Do employees use their own personal vehicles for business? Yes:____ No:_____

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Describe any products, materials, wastes, samples that will be transported by company owned/leased vehicles or employee vehicles:

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Are vehicles left loaded overnight? Yes:_____ No:_____

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Do you have a vehicle maintenance program? Yes:_____ No:_____

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Do you perform in house vehicle maintenance/service work? Yes:_____ No:_____

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Do you keep individual services records for each vehicle? Yes:_____ No:_____

Does your company perform any maintenance on owner/operator equipment? Yes:_____ No:_____

Describe your driver selection and training procedures:

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List address and phone number of where records, manifests, inspection reports, and personnel records are maintained:

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List all transportation incidents during the last five years:

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Do you have an accident review board? Yes:_____ No:_____

WATERCRAFT

Does your company own or operate any watercraft: Yes:_____ No:_____

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AIRCRAFT

Does your company own or operate any Aircraft? Yes:_____ No:_____

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RISK TRANSFER / INSURANCE

Describe your risk transfer strategy and changes or additions you feel need to be addressed: (Supply copies of your current property & casualty insurance policies)

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What size of a financial loss can the company handle? $______________________

What size financial loss could put you out of business? $_________________

Include copies of: environmental due diligence reports_____ contracts used with vendors, subcontractors, clients_____ brochures or marketing material_____ quality policy_____ health and safety plan_____ mold awareness/management plan_____ spill contingency and counter measure plan_____ emergency response plan_____ copies of current property and casualty insurance policies_____ two years financial statements_____ resumes of key personnel_____ MSDS’s_____ maps of property and descriptions_____ storage tank list_____ substance abuse program_____ employee manual_____ certificate of insurance_____ Motor vehicle list_____ ISO 14000_____ FIN 47_____ SAB 92 Ruling_____ Copies of permits_____ Incident investigation procedures_____ Waste disposal facility inspection reports_____

As an authorized representative for our company I warrant and represent the previous statements and particulars as contained in this document and any attachments, are in all respects complete and true, that they are material, and that I have not suppressed or misstated any material facts and I agree that this document and its attachments shall be the basis for which my company will be evaluated.

Company Officer:________________________________________

Print Name:______________________________

Title:______________________________

Copyright 2007