ISO 14001 Self-Assessment Questionnaire

• Client / Site

• Location
  Address

• Conducted on

  Date

• Prepared by

General Information

• Nature of Business

  Select Agriculture/Forestry/Fisheries Manufacturing Construction Distribution Finance/Insurance Community Services Power/Gas/Water Wholesale/Retail/Hire Communication/IT Public Sector Entertainment/Tourism Healthcare Charity Consultants Others

  • Agriculture/Forestry/Fisheries
  • Manufacturing
  • Construction
  • Distribution
  • Finance/Insurance
  • Community Services
  • Power/Gas/Water
  • Wholesale/Retail/Hire
  • Communication/IT
  • Public Sector
  • Entertainment/Tourism
  • Healthcare
  • Charity
  • Consultants
  • Others

• Please specify nature of business

Air Emissions

• Do you generate air emissions?

  Yes

  No

  N/A

• Do you monitor air emissions?

  Yes

  No

  N/A

• Do you have objectives and targets for air emissions?

  Yes

  No

  N/A

• Do you have documented procedures for identifying, monitoring and controlling air emissions?

  Yes

  No

  N/A

• Have you conducted training for air emissions procedures?

  Yes

  No

  N/A

• Have you audited these procedures?

  Yes

  No

  N/A

• Do you have a site plan illustrating emission points?

  Yes

  No

  N/A

• Where is the plan kept?

Waste Water Management

• Do you generate waste water?

  Yes

  No

  N/A

• Do you monitor waste water discharges?

  Yes

  No

  N/A

• Do you have objectives and targets for waste water discharges?

  Yes

  No

  N/A

• Do you have documented procedures for identifying, monitoring and controlling waste water discharges?

  Yes

  No

  N/A

• Have you conducted training for waste water discharge procedures?

  Yes

  No

  N/A

• Have you audited these procedures?

  Yes

  No

  N/A

• Is any waste water discharged directly into rivers/streams/canals?

  Yes

  No

  N/A

• Is stormwater on your site discharged directly into rivers/streams/canals?

  Yes

  No

  N/A

• Is any waste water treated on your site?

  Yes

  No

  N/A

• Do you have a site plan illustrating drainage plans and discharge points?

  Yes

  No

  N/A

Waste Management

• Do you produce or handle any of the following?

• • Solid waste (e.g. inert waste, general waste, domestic waste)

  Yes

  No

  N/A

• • Hazardous waste (e.g. flammables)

  Yes

  No

  N/A

• • Special waste (e.g. metals/oil residues)

  Yes

  No

  N/A

• • Clinical waste (e.g. healthcare waste)

  Yes

  No

  N/A

• Do you monitor your waste streams?

  Yes

  No

  N/A

• Do you have objectives and targets for dealing with waste?

  Yes

  No

  N/A

• Do you have documented procedures for identifying, monitoring and controlling waste?

  Yes

  No

  N/A

• Have you conducted training for your waste management procedures?

  Yes

  No

  N/A

• Have you audited these procedures?

  Yes

  No

  N/A

• Do you hold your own Waste Management licence?

  Yes

  No

  N/A

• Do you have copies of Licences for your waste transporters or disposal sites?

  Yes

  No

  N/A

• Do you have a register of consignment/transfer notes?

  Yes

  No

  N/A

• Do you have a site plan of waste generation and storage points?

  Yes

  No

  N/A

• Where is this plan kept?

• Do you dispose of any waste on your site?

  Yes

  No

  N/A

• Where?

• Do you treat any waste on your site?

  Yes

  No

  N/A

• Where?

Handling and Storage

• Do you handle/store hazardous materials?

  Yes

  No

  N/A

• Do you have any of the following?

• • Underground storage tanks?

  Yes

  No

  N/A

• • Above ground storage tanks?

  Yes

  No

  N/A

• • Bulk storage (e.g. drums)?

  Yes

  No

  N/A

• Do you have procedures for managing storage areas, spills, and potential contamination?

  Yes

  No

  N/A

• Have you audited these procedures?

  Yes

  No

  N/A

• Do you conduct any integrity testing of underground storage tanks?

  Yes

  No

  N/A

• Do you have site plans of storage areas?

  Yes

  No

  N/A

Soil and Groundwater Protection

• Is there any historic evidence of soil and groundwater contamination?

  Yes

  No

  N/A

• Have you conducted any soil and groundwater contamination surveys?

  Yes

  No

  N/A

• Have you found any soil or groundwater contamination?

  Yes

  No

  N/A

• Have objectives and targets been set to remediate this soil or groundwater contamination?

  Yes

  No

  N/A

• Have you remediated this contamination?

  Yes

  No

  N/A

Noise Control

• Do you have any sensitive noise receptors? (e.g. residents, neighbors)

  Yes

  No

  N/A

• Have you set any objectives and targets to control external noise?

  Yes

  No

  N/A

• Do you have procedures for monitoring external noise?

  Yes

  No

  N/A

• Have you conducted training regarding your noise monitoring procedures?

  Yes

  No

  N/A

• Have you audited these procedures?

  Yes

  No

  N/A

• Are controls imposed on you by regulatory authorities?

  Yes

  No

  N/A

• Describe the controls

Resource Consumption

• Do you monitor water consumption?

  Yes

  No

  N/A

• Do you monitor energy consumption?

  Yes

  No

  N/A

• Do you have any objectives and targets directed at resource consumption?

  Yes

  No

  N/A

• Do you monitor consumption of raw materials?

  Yes

  No

  N/A

• Do you have any recycling/reuse/redesign initiatives for products, materials and processes?

  Yes

  No

  N/A

Other environmental impacts

• Have you considered any of your activities giving rise to:

• • Odour?

  Yes

  No

  N/A

• • Dust?

  Yes

  No

  N/A

• • Vibration?

  Yes

  No

  N/A

• • Visual impact?

  Yes

  No

  N/A

• Do you manufacture, use or store any ozone-depleting substances?

  Yes

  No

  N/A

• Do you manufacture, use or store polychlorinated biphenyls?

  Yes

  No

  N/A

• Do you have any radioactive sources?

  Yes

  No

  N/A

• Are there any special heritage considerations in the operations, developments or activities at your site?

  Yes

  No

  N/A

• Do you – in any part of your activities or properties – engage in activities that promote the interests of wildlife?

  Yes

  No

  N/A

• Please describe

Other issues

• Are there any special requirements on your processes or products that relate to human health or life?

  Yes

  No

  N/A

• Are your products or services used in warfare in any way?

  Yes

  No

  N/A

• Are your products or services used to control growth of flora or fauna in any way?

  Yes

  No

  N/A

Supply Chain Impact

• Have you communicated with your suppliers regarding their environmental impacts?

  Yes

  No

  N/A

• Do you have any influence on your suppliers to improve their environmental impact?

  Yes

  No

  N/A

Environmental Aspects Identification

• Have you conducted an exercise to identify the environmental aspects of your activities, products or services?

  Yes

  No

  N/A

• When was this completed?

  Date

• Have you determined significant environmental impacts?

  Yes

  No

  N/A

• What are they?

• Do you have an environmental policy?

  Yes

  No

  N/A

• When was it issued?

  Date

• How is the policy made available to the public?

Multiple Sites

• Do you have more than one site that is to be covered by your Environmental Management System (EMS)?

  Yes

  No

  N/A

• Is the structure of your EMS common to all sites?

  Yes

  No

  N/A

• Please give a brief description of the structure of your EMS

Completion

• Recommendations

• Full Name and Signature of the Inspector

  Sign