&EPA
National Environmental
Achievement Track
Application Instructions
National
Environmental
PerformanceTrack
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NATIONAL ENVIRONMENTAL ACHIEVEMENT TRACK
Application Instructions
Page
Application Instructions 2
Overview of the National Environmental Achievement Track 2
Section Instructions
Cover Page 3
Section A. Tell us about your facility 4
Section B. Tell us about your EMS 6
Section C. Tell us about your past achievements & future commitments... 8
Section D. Tell us about your public outreach and reporting 12
Section E. Read and sign the Application and Participation Statement..... 13
Submitting the Application 15
Attachments
Environmental Requirements Checklist. A1
(Use to answer Section A, Question 6)
Environmental Performance Table B1
(Use to answer questions in Section C)
paoe i Application Instructions for the National Environmental Achievement Track
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Application
Instructions
These instructions are provided to assist facilities in completing the National Environmental
Achievement Track application. The application consists of five sections:
Section A - Tell us about your facility.
Section B - Tell us about your Environmental Management System (EMS).
Section C - Tell us about your past achievements and future commitments.
Section D - Tell us about your public outreach and reporting.
Section E - Read and sign the Application and Participant Statement.
The first four sections (Section A through Section D) allow applicants to tell EPA about their
facility and qualifications. By completing and signing the Application and Participation Statement
(Section E), applicants certify that they have read, understand, and meet the terms, conditions and
requirements for participation established in the National Achievement Track Program Description.
The Program Description will be contained in a Federal Register Notice and is available through the
EPA Performance Track Website or from the Performance Track Information Center at (toll free)
l-888-339-PTRK(7875).
The application form is designed to minimize the burden for applicants while providing
sufficient information for EPA to evaluate whether a facility meets the program criteria. The
instructions follow the same order as the application form.
Overview of the National Environmental Performance Track
The National Environmental Performance Track is designed to recognize and encourage top
environmental performers-those who go beyond compliance with regulatory requirements -to attain
levels of environmental performance and management that benefit people and communities.
EPA is implementing the National Environmental Performance Track program at two levels.
The first leyelj ttieWatfowa/Environmental Achievement Track (Achievement Track), is designed
to recognize facilities that consistently meet their legal requirements and have implemented high-
quality envirbnme.ntal management systems, as well as to encourage them to achieve more by;
continuously improving their environmental performance and informing and involving the public.
Page 2 Application Instructions for the National Environmental Achievement Track
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The second level, the National Environmental Stewardship Track, is under development. It is
being designed to recognize and encourage broader and higher levels of voluntary environmental
performance than those expected under the Achievement Track. These may include improvement
in several categories of environmental performance; a focus on environmental management and
performance with regard to customers, suppliers, and transporters; attention to product stewardship;
and even better community engagement and public outreach.
The following instructions should be used by facilities to apply for acceptance into the National
Environmental Achievement Track. EPA does not believe any Confidential Business Information
(CBI) needs to be submitted in a completed application and asks firms not to submit any information
they consider Confidential on their application.
Section Instructions
Instructions for each section of the application, including the cover page, are provided below.
Facility Name. Provide the name of the facility applying for admission on the first line.
Name of Parent Company (if any). Fill in the name of the parent company, if the facility is owned
by another company, is a division of a larger company, or if another company retains overall
responsibility for the applicant facility.
Street address. List the street address of the facility.
Street address (cont). Use this line to complete the street address, if necessary.
City/State/Zip Code. List the city, state and zip code of where the facility is located.
Page 3
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Give us information about your contact person for the National Environmental Achievement
Track Program
Name. Enter the name of the individual who may be contacted for additional information concerning
the facility's application.
Title. Give the title of the contact person.
Phone: List the telephone number of the contact person (including area code).
Fax: Give the fax number for the contact person (including area code).
E-mail: List the e-mail address (if any) for the contact person.
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1. What do you do or make at your facility?
Briefly describe the primary products that are manufactured, prepared or assembled at your
facility. For non-manufacturing facilities, describe the services you provide or activities you
conduct.
2. List the Standard Industrial Classification (SIC) codes or North American Industrial
Classification System (NAICS) codes that you use to classify business at your facility.
If the facility has more than one SIC or NAICS code, please list the primary code for the
facility first, followed by all other codes. If you do not know your facility's classification code, please
consult the following website: http://www.census.gov/epcd/www/naicstab.htm. Note: The NAICS
is a new classification that is replacing the SIC code system.
3. Does your company meet the Small Business Administration definition of a small
business for your sector?
Check yes or no. For purposes of this question, your company is the parent company (if any)
identified on the Cover Page of your application. If no parent company is identified, then answer
the question based on the size of your facility. If you do not know if your company meets the Small
Business Administration (SBA) definition, you may contact your local SBA office or consult
http://www.sba.gOv/regulations/siccodes/orhttp://www.sba.gov/size/Guide.html
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4. How many employees (full-time equivalents) currently work at your facility?
Check the box that best corresponds to the number of full-time equivalent (FTE) employees
working at the facility. A FTE represents 2,000 hours per year. To calculate the number of FTEs,
add the total hours worked during the calendar year by all employees, including part-time and
seasonal employees, and divide the total by 2,000.
5. Does your facility have an EPA ID number(s)?
Check yes or no.
If you checked yes, enter the facility's EPA ID number in the space provided. Your facility
may have more than one number. If there is not enough room provided in the space to the right, list
the additional IDs on a separate piece of paper.
6. Identify the environmental requirements that apply to your facility. Use the
Environmental Requirements Checklist, at the back of the instructions, as a reference.
List your requirements to the right or enclose a completed Checklist with your
application.
This question asks you to identify the significant applicable major federal, state, tribal and
local environmental requirements at your facility. An Environmental Requirements Checklist is
provided at the end of the instructions for your reference. Use the Checklist to help identify the
requirements that may be applicable at your facility. The Checklist is not intended to be an
exhaustive list but rather as a reference to a number of federal, state, tribal, and local requirements
that are applicable to a wide range of facilities.
You may list the applicable requirements on the lines provided (attach additional sheets of
paper, if necessary) or you may complete the Checklist, including the facility identification
information at the top, and enclose the Checklist with your application.
7. Check the appropriate box in the right-hand column.
Check the box that corresponds to how you answered Question 6- either by listing above or
by enclosing the Checklist with your application. This will help determine if your application is
complete (i.e., whether you have enclosed the optional Checklist with your application).
8. Optional: Is there anything else you would like to tell us about your facility?
This question is optional. Use this section to share other information about your facility's
environmental accomplishments and activities that believe would be useful. You may attach
additional sheets.
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In this section, you tell us about the EMS that your facility has in place1 and that it meets
specific Achievement Track elements. The specific EMS elements are described in the National
Environmental Achievement Track Program Description, References to the appropriate section of
the Program Description are given for each question. Only those EMS's that meet each of the
program's elements qualify for the Achievement Track. (See National Environmental Achievement
Track Program Description, Section II. A.I, "Environmental Management System (EMS)" for a full
description of program elements).
1. Check yes if your EMS meets the requirements for each element below as defined in the
instructions.
a. Environmental policy
Check yes, if your EMS meets the elements specified for thePo/z'cy element as defined in
Section II. A.I (Environmental Management Systems) of the Program Description.
b. Planning
Check yes, if your EMS meets the elements specified for the Planning element as defined
in Section II. A. 1 (Environmental Management Systems) of the Program Description.
c. Implementation and operation
Check yes, if your EMS meets the elements specified for the Implementation and operation
element as defined in Section II. A.I (Environmental Management Systems) of the Program
Description.
d. Checking and corrective action
Check yes, if your EMS meets the elements specified for the Checking and corrective action
'For purposes of the Achievement Track, an EMS represents an organization's systematic
effort to meet its environmental requirements, including maintaining compliance, and achieving
performance objectives that may be related to unregulated aspects of the organization's activities.
Page 6 Application Instructions for the National Environmental Achievement Track
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element as defined in Section II. A.I (Environmental Management Systems) of the Program
Description.
e. Management review
Check yes, if your EMS meets the elements specified for the Management review element
as defined in Section II.A.I (Environmental Management Systems) of the Program
Description.
2. Have you completed at least one EMS cycle (Plan-Do-Check-Act)?
Check yes if your EMS has been in place through at least one "Plan-Do-Check-Act" cycle.
A complete cycle includes:
defining and documenting your EMS;
identifying significant environmental aspects and legal requirements;
setting measurable objectives and targets;
establishing roles and responsibilities for meeting EMS and legal requirements;
conducting training for personnel on EMS and legal requirements
undertaking steps to meet the established objectives and targets;
evaluating your progress in meeting the established objectives and targets;
conducting an EMS audit
completing a compliance audit
correcting any areas of EMS non-conformance or legal non-compliance;
completing a management review of the EMS, and its results.
3. Did this cycle include both an EMS and a compliance audit?
Indicate if you have completed an audit of the EMS and your compliance with applicable
federal, state, tribal and local environmental requirements.
4. Have you completed an objective self-assessment or third-party assessment of your EMS?
Check the box corresponding to whether you completed an objective self-assessment or a
third-party assessment.
If you completed a self-assessment, indicate the protocol you used by checking one of the
boxes under "Self-assessment."
GEMI = Global Environmental Management Initiative (http://www.gemi.org)
CEMP = Code of environmental Management Principles Self-Assessment Matrix
(http://es.epa.gov/oeca/cemp/cemptoc.html)
Other = Please fill in the blank with the method used.
Page 7 Application Instructions for the National Environmental Achievement Track
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If you completed a third-party assessment, indicate the protocol used by checking one of
the boxes under "Third-party assessment."
ISO 14001 Certification = International Standards Organization 14001 Certification
(http://www.iso.ch/)
Other = Please fill in the blank with the method used.
and future-commitments; ,?</" T*Y,
Each applicant demonstrates past achievements and commits to report on future
improvements. To demonstrate past performance, select a minimum of two environmental aspects
from any of the categories in the Environmental Performance Table (at the end of the instructions)
and describe the improvements in your facility's performance during the current year and proceeding
year. Small facilities have the option of documenting improvement for a minimum of one
environmental aspect from any category.2 Facilities are encouraged to document performance
achievements beyond the minimum. See National Environmental Achievement Track Program
Description, Section II.A.2, "Demonstrated Environmental Achievements and Commitment to
Continued Improvement" for a full description of program criteria.
The Achievement Track program uses the terms category and aspect to help quantify
environmental performance:
A Category is a class of environmental impacts (e.g., air emissions).
An Aspect is an element of an organization's activities, products, or services that interacts with
the environment.
Use the Environmental Performance Table (located at the end of these instructions which
lists categories, aspects, and likely units of measurement) to report on performance.
2 EPA recognizes that, depending on the nature and extent of a facility's operations, a
small facility may have fewer environmental aspects as well as more limited resources for measuring
and committing to specific improvements in performance. For purposes of this program, a facility
will be considered to be a "small" facility if the company as a whole is a small business as defined
by the Small Business Administration (see FR 30386, Vol. 65, No 94, May 15, 2000)a/irf if the
facility itself employs fewer than fifty full-time equivalent employees. Your facility is small if, in
Section A, you checked "yes" to Question 3 and "fewer than 50" to Question 4.
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1. Describe your past achievements for at least two environmental aspects. If you need more
space than is provided, attach copies of this page.
Note to small facilities: If you qualify as a small facility as defined in the instructions, you need
to report past achievement for at least one environmental aspect.
You qualify as a small facility if you answered "yes" to Question 3 in Section A ("Does your
company meet the Small Business Administration Definition of a Small Business for Your Sector?")
and if you have fewer than 50 full-time equivalent employees at your facility.
First aspect you 've selected
"What aspect have you selected?"
Write the name of the aspect (for example, energy use) in the gray area.
What was the previous level (2 years ago)?
In the gray area, write in the quantity and the units of the aspect that you measured two years
ago. Use an annual quantity if possible. You may report an absolute quantity for the aspect, for
example, 800,000 MMBTU, or you may report a quantity in terms of output or production, for
example, 20 MMBTU per car produced.
What is the current level?
In the gray area, write in the corresponding quantity and the units of the aspect for the most
recent 12- month period for which you have data. Again, you may report an absolute quantity for
the aspect, for example, 864,000 MMBTU, or you may report a quantity in terms of output or
production, for example, 18 MMBTU per car. Whether you chose to report in absolute quantities
or in terms of output or production, you should-express the quantity in the same units for the
previous level and for the current level.
I. How is the current level an improvement over the previous level?
Use this space to clarify or explain why you consider the reported current quantity an
improvement. For example, the current quantity could show a slight increase from past performance,
but you may want to explain that your production has doubled over the same time period.
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ii. How did you achieve this improvement?
Use this space to briefly describe what actions you took that caused the performance
improvements you reported above. Examples of these actions are pollution prevention strategies,
equipment upgrades, employee training, or process changes. Be as specific as you can. If the
performance improvements were in part the result of your participation in a voluntary program
sponsored by the federal government, your state or local government, or a non-governmental
organization, mention that program here.
Complete both Aspect boxes under Question 1, unless you are a small facility. If you are a
small facility, you can choose to complete only one.
You can report on more than two aspects (feel free to do so) by copying page 5 or 6 and attaching
the extra sheets to your completed application.
2. Select at least four environmental aspects (no more than two from any one category) from
the Environmental Performance Table in the instructions and then tell us about your future
commitments. If you need more space than is provided, attach copies of this page
Note to small facilities: If you are a small facility, you need to make commitments for at least
two environmental aspects in two different categories.
This question asks you to commit to specific improvement commitments over the next three
years. Your identified commitments will not rely on any actions that represent compliance with
existing legal requirements at the federal, state, tribal, or local levels. These improvements will
represent actions taken by a facility that go beyond existing legal requirements.
First aspect you*ve selected
a. What is the aspect?
Write the aspect you selected from the Environmental Performance Table, included at the
back of these instructions.
b. Is this aspect identified as significant in your EMS?
Choose significant aspects for future commitments that are related to the objectives and
targets in your EMS. Refer to the Planning portion of your EMS(See National Environmental
Achievement Track Program Description, Section II.A.2, "Demonstrated Environmental
Achievements and Commitment to Continued Improvement" for a full description of program
requirements.
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Check yes if this aspect is one of those identified as a significant aspect. Otherwise, check
no.
c. What is the current level? You may choose to state this as an absolute value or in terms of
units of production or output.
Write in the quantity and the units of the aspect for the most recent 12-month period for
which you have data. Check the box next to Option A if you are providing an absolute value and
write the quantity and units on the line to the right, for example, 864,000 MMBTU. Check the box
next to Option B if you are providing this level in terms of units of production or output and write
the quantity on the line to the right, for example, 18 MMBTU per car.
d. What is the improvement you are committing to over the next three years? You may choose
to state this as an absolute value or in terms of units of production or output.
Write in the difference between your current level of the aspect and the future level of the
aspect you are committing to. Check the box next to Option A if you are providing this level as an
absolute value and write the quantity and units on the line to the right, for example, 691,200
MMBTU. Check the box next to Option B if you will state this level in terms of units of production
or output and write the quantity on the line to the right, for example, 14.4 MMBTU per car.
e. How will you achieve this improvement?
Use this space to briefly describe what actions you will take to improve your performance
in this aspect. Examples of these actions are equipment upgrades, employee training, and process
changes. Be as specific as you can. If the performance improvements are linked to commitments
you have made in a voluntary program sponsored by the federal government, your state or local
government, or a non-governmental organization, mention that program here.
Complete the subsections for the second, third, and fourth aspect. You can choose to complete
only the subsection for the second aspect if you are a small facility. You may attach additional sheets
if you are making additional commitments.
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QUtreaiCK
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Use this section to describe your commitment to public outreach. See National
Environmental Achievement Track Program Description, Section II.A.3, "Public Outreach and
Performance Reporting" for a full description of program requirements.
1. How do you identify and respond to community concerns?
Briefly describe.
2. How do you inform community members of important matters that affect them?
Briefly describe.
3. How will you make the Achievement Track Annual Performance Report available to
the public?
Indicate here the likely means of distributing your Annual Performance Report by checking
one, or more, of the boxes. If using a website, provide the URL. If'Other', please describe what will
be done.
4. Are there any ongoing citizen suits against your facility?
Check yes or no. If yes, briefly describe the nature of the citizen suit or legal action and the
action(s) current status.
5. List references below.
References may be called to learn more about the facility. Please write in the organization
that the person represents, his or her name, and telephone number. A person who is associated with
your facility and who is also a member of a community/citizen group cannot be used as a reference.
See below for further explanation about group categories.
a. Representative of a community/citizen group. Name a person representing a
community/citizen group based in the facility's community. Examples include civic groups,
neighborhood associations, local chapters of environmental groups, and community
development organizations. Consider choosing a reference from a community/citizen group
that is familiar with your facility either through proximity (e.g., a group representing an
Page 12 Application Instructions for the National Environmental Achievement Track
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adjacent neighborhood) or other involvement with the facility (e.g., a group with
representation on a facility's community advisory committee).
b. State/tribal/local regulator. Name a person who is a regulator familiar with the
facility. This person need not be associated with an environmental regulatory agency or
department. For example, other appropriate regulatory agencies include those associated
with public health or housing.
c. Other community/local reference. Name a person who is either an additional
reference from one of the two categories above or a reference familiar with your facility and
who represents another type of organization in the community. Potential examples include
a member of the Local Emergency Planning Committee (LEPC), a local labor union
member, a representative from the local Chamber of Commerce, a university faculty
member, or another business owner or operator.
A full and complete Application for the Achievement Track Program consists of a fully
completed Application Form, a completed Environmental Requirements Checklist (if used), and a
signed Achievement Track Program Application and Participation Statement.
When you sign the Application and Participation Statement, it means that you are familiar
with and agree to fulfill the requirements of the program. It also means that all the information you
have included and statements you have made in your Application are true and accurate, in particular
that your facility's EMS meets all the specified requirements, and that you will keep the EMS in
place for the duration of your facility's participation in the program; that your facility has conducted
an objective assessment of compliance with all environmental requirements that apply to you, and
that you have corrected any noncompliance you may have found; and that based on your compliance
assessment, your facility is currently in compliance with applicable federal, state, tribal and local
environmental requirements. It also means that you understand that EPA's decision to accept or
remove you from the program is wholly discretionary with the Agency, and that you do not have a
right to challenge EPA's decision; and that your participation in the program is not relevant to any
issue of law or fact in any legal enforcement proceeding for violations of environmental
requirements.
In evaluating your potential eligibility for this program, you should assess, to the best of your
ability, your own compliance record using the same criteria that EPA, along with its state partners,
will use. These screening criteria are listed below. In addition, and as noted above, a condition for
entry into the Achievement Track program is that your facility is currently in compliance with all
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applicable federal, state, tribal and local environmental requirements, and you will maintain
compliance for the duration of your participation in the Achievement Track. Therefore, you should
be familiar with and consult relevant EPA policy, guidance, and interpretation of legal requirements
that apply to your facility when assessing your past record and current compliance status.
Lastly, when you sign the Statement, you are confirming that you are the senior facility
manager and, on behalf of the corporation or other legal entity that owns or operates your facility,
you are fully authorized to submit the Application, execute the Statement, and participate in the
Achievement Track Program.
Screening Criteria
Participation in the Achievement Track will not be appropriate if the compliance screen
shows any of the following, under federal or state law:
Corporate criminal conviction or plea for environmentally-related violations of criminal
laws involving the corporation or a corporate officer within the past 5 years
Criminal conviction or plea of employee at the same [the applicant's] facility for
environmentally-related violations of criminal laws within the past 5 years
Ongoing criminal investigation/prosecution of corporation, corporate officer, or employee
at the same facility for violations of environmental law
Three or more significant civil violations at the facility in the past 3 years3
Unresolved, unaddressed Significant Non-compliance (SNC) or Significant Violations (SV)
at the facility
Planned but not yet filed judicial or administrative action at the facility
Ongoing EPA- or state-initiated litigation at the facility
Situation where a facility is not in compliance with the schedule and terms of an order or
decree
In addition, EPA may also consider whether there are significant problems, or a pattern of
non-compliance, in an applicant's overall civil or criminal compliance history.
3The term "significant" with respect to violations or non-compliance refers to how the
violation is characterized under the applicable media enforcement response policy, available at
www.epa.gov/oeca/main/strategy/.
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Submitting the
Application
Submit your completed application and any attachments to:
The Performance Track Information Center
c/o Industrial Economics Incorporated
2067 Massachusetts Avenue
Cambridge, MA 02140
If you have any questions concerning the application process or the program in general, you
can call the Performance Track Information Center toll-free at 1-888-339-PTRK (7875).
Once you submit an application, EPA will conduct a preliminary review to determine that
it is complete and notify you that the substantive review has begun. The substantive review to
evaluate a facility's eligibility will be conducted by an EPA committee made up of representatives
from EPA headquarters and regional offices. Through the appropriate regional office, EPA will
consult with the state in which the facility is located to help determine the facility's eligibility for the
program.
When a facility is accepted, it will receive standard written notification from EPA. Facilities
that are accepted will be in the program for a period of three years, which is the standard term for
participation in the Achievement Track. Accepted facilities will also be announced on the National
Environmental Performance Track web site. Those not accepted will receive a brief explanation for
EPA's decision.
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National Environmental Achievement Track
Environmental Requirements Checklist
The following Checklist is provided to assist facilities in answering Section A, Tell us
about your facility, " Question 6. The Checklist is given to help facilities identify the major
federal, state, tribal, and local environmental requirements applicable at their facilities. The
Checklist is not intended to be an exhaustive list of all environmental requirements that may be
applicable at an individual facility..
If you use this Checklist and choose to submit it with your application, fill in your facility
information below and enclose the completed Checklist with your application (see instructions).
Facility Name:
Facility Location:
Facility ID Number(s):
(attach additional sheets if necessary)
Check All
Air Pollution Regulations That Apply
1. National Emission Standards for Hazardous Air Pollutants (40 CFR 61) D
2. Permits and Registration of Air Pollution Sources D
3. General Emission Standards, Prohibitions and Restrictions D
4. Control of Incinerators D
5. Process Industry Emission Standards D
6. Control of Fuel Burning Equipment D
7. Control of VOCs D
8. Sampling, Testing and Reporting D
9. Visible Emissions Standards D
10. Control of Fugitive Dust D
11. Toxic Air Pollutants Control D
12. Vehicle Emissions Inspections and Testing D
Other Federal, State, Tribal or Local Air Pollution Regulations Not Listed Above (identify)
13. D
14. D
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Hazardous Waste Management Regulations
1. Identification and Listing of Hazardous Waste (40 CFR 261) D
- Characteristic Waste D
- Listed Waste D
2. Standards Applicable to Generators of Hazardous Waste (40 CFR 262) D
- Manifesting D
- Pre-transport requirements D
- Record keeping/reporting D
3. Standards Applicable to Transporters of Hazardous Waste (40 CFR 263) D
- Transfer facility requirements D
- Manifest system and record-keeping D
- Hazardous waste discharges D
4. Standards for Owners and Operators of TSD Facilities (40 CFR 264) D
- General facility standards D
- Preparedness and prevention D
- Contingency plan and emergency procedures D
- Manifest system, Record keeping and reporting D
- Groundwater protection D
- Financial requirements D
- Use and management of containers D
-Tanks D
- Waste piles D
- Land treatment D
- Incinerators D
5. Interim Status Standards for TSD Owners and Operators (40 CFR 265) D
6. Interim Standards for Owners and Operators of New Hazardous Waste
Land Disposal Facilities (40 CFR 267) D
7. Administered Permit Program (Part B) (40 CFR 270) D
Other Federal, State, Tribal or Local Hazardous Waste Management Regulations Not
Listed Above (identify)
s. ; n
9. __ D
Hazardous Materials Management
1. Control of Pollution by Oil and Hazardous Substances (33 CFR 153) D
2. Designation of Reportable Quantities and Notification of Hazardous
Materials Spill (40 CFR 302) D
3. Hazardous Materials Transportation Regulations (49 CFR 172-173) D
4. Worker Right-to-Know Regulations (29 CFR 1910.1200) D
5. Community Right-to-Know Regulations (40 CFR 350-372) D
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Other Federal, State, Tribal or Local Hazardous Materials Management Regulations Not
Listed Above (identify)
6. D
7. D
Solid Waste Management
1. Criteria for Classification of Solid Waste Disposal Facilities
and Practices (40 CFR 257) D
2. Permit Requirements for Solid Waste Disposal Facilities D
3. Installation of Systems of Refuse Disposal D
4. Solid Waste Storage and Removal Requirements D
5. Disposal Requirements for Special Wastes D
Other Federal, State, Tribal or Local Solid Waste Management Regulations Not Listed
Above (identify)
6. D
7. " D
Water Pollution Control Requirements
1. Oil Spill Prevention Control and Countermeasures (SPCC) (40 CFR 112) D
2. Designation of Hazardous Substances (40 CFR 116) D
3. Determination of Reportable Quantities for Hazardous Substances
(40 CFR 117) D
4. NPDES Permit Requirements (40 CFR 122) D
5. Toxic Pollutant Effluent Standards (40 CFR 129) D
6. General Pretreatment Regulations for Existing and New Sources (40 CFR 403) D
7. Organic Chemicals Manufacturing Point Source Effluent Guidelines
and Standards (40 CFR 414) D
8. Inorganic Chemicals Manufacturing Point Source Effluent Guidelines
and Standards (40 CFR 415) D
9. Plastics and Synthetics Point Source Effluent Guidelines and Standards
(40 CFR 416) D
10. Water Quality Standards D
11. Effluent Limitations for Direct Dischargers D
12. Permit Monitoring/Reporting Requirements D
13. Classifications and Certifications of Operators and Superintendents
of Industrial Wastewater Plants D
14. Collection, Handling, Processing of Sewage Sludge D
15. Oil Discharge Containment, Control and Cleanup D
16. Standards Applicable to Indirect Discharges (Pretreatment) D
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Other Federal, State, Tribal or Local Water Pollution Control Regulations Not Listed
Above (identify)
17. _ D
18. _ D
Drinking Water Regulations
1 . Underground Injection and Control Regulations, Crieria and Standards
(40 CFR 144, 146) D
2. National Primary Drinking Water Standards (40 CFR 141) D
3. Community Water Systems, Monitoring and Reporting Requirements
(40 CFR 141) D
4. Permit Requirements for Appropriation/Use of Water from Surface or
Subsurface Sources D
5. Underground Injection Control Requirements D
6. Monitoring, Reporting and Record keeping Requirements for Community
Water Systems D
Other Federal, State, Tribal or Local Drinking Water Regulations Not Listed Above
(identify)
7. _ __ _ D
8. D
Substances
1 . Manufacture and Import of Chemicals, Record keeping and Reporting
Requirements (40 CFR 704) D
2. Import and Export of Chemicals (40 CFR 707) D
3. Chemical Substances Inventory Reporting Requirements (40 CFR 710) D
4. Chemical Information Rules (40 CFR 712) D
5. Health and Safety Data Reporting (40 CFR 7 16) D
6. Pre-Manufacture Notifications (40 CFR 720) D
7. PCB Distribution Use, Storage and Disposal (40 CFR 76 1 ) D
8. Regulations on Use of Fully Halogenated Chlorofluoroalkanes (40 CFR 762) D
9. Storage and Disposal of Waste Material Containing TCDD (40 CFR 775) D
Other Federal, State, Tribal or Local Toxic Substances Regulations Not Listed Above
(identify)
10. _ D
11. D
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Pesticide Regulations
1. FIFRA Pesticide Use Classification (40 CFR 162) D
2. Procedures for Disposal and Storage of Pesticides and Containers
(40 CFR 165) D
3. Certification of Pesticide Applications (40 CFR 171) D
4. Pesticide Licensing Requirements D
5. Labeling of Pesticides D
6. Pesticide Sales, Permits, Records, Application and Disposal Requirements D
7. Disposal of Pesticide Containers D
8. Restricted Use and Prohibited Pesticides D
Other Federal, State, Tribal or Local Pesticides Regulations Not Listed Above (identify)
9. D
10. _____ n
Environmental Clean-Up. Restoration. Corrective Action
1. Comprehensive Environmental Response, Compensation and Liability
Act (Superfund) (identify)
D
D
2. RCRA Corrective Action (identify)
Other Federal, State, Tribal or Local Environmental Clean-Up, Restoration, Corrective
Action Regulations Not Listed Above (identify)
3. D
4. D
Page A5 - Environmental Requirements Checklist Application for the National Environmental Achievement Track
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Environmental Performance Table
Select aspects from this table in completing Section C, "Tell us about your past
achievements and future commitments."
Categories
Aspects
Measures
ENERGY USE
WATER USE
MATERIALS USE
AIR EMISSIONS
WASTE
Total Energy Use
Total Water Use
Total Materials Use
Hazardous Materials Use
Recycled/Re-Used Materials
Use
Emissions of Greenhouse
Gases
Emissions of Ozone-
Depleting Chemicals
Emissions of VOCs
Emissions of NOx
Emissions of Sulfur Dioxide
Emissions of Particulate
Matter
Emissions of Carbon
Monoxide
Emissions of Toxics
Total Solid Waste
Hazardous Solid Waste
Toxic Releases to Land
BTU, MMBTU
gallons
tons, metric tons
tons, metric tons
tons, metric tons
tons, metric tons carbon-
equivalent of C02, CH4,
N20, and halo-carbons
pounds, tons
tons, metric tons
tons, metric tons
tons, metric tons
tons, metric tons PM10 and
PM2.5
tons, metric tons
pounds of chemicals listed
as toxic under CAA, TRI and
State statutes, also HPV and
PBT
tons, metric tons (including
production scrap, if not
recycled/reused)
tons, metric tons
tons, metric tons TRI, HVP,
PBT chemicals
Page Bl Environmental Performance Table
Application for the National Environmental Achievement Track
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DISCHARGES TO WATER
ACCIDENTAL RELEASES
PRESERVATION/RESTORATION
PRODUCT PERFORMANCE
COD Discharges to Water
BOD Discharges to Water
Discharges of Toxics to
Water
Release History
Vulnerability and Potential
for Releases
Habitat Impacts
Expected Lifetime Energy
Use of Product
Expected Lifetime Waste (to
air, water, land) of Product
Packaging Materials Used in
Product
Waste to Air, Water, Land
from Disposal or Recovery
of Product
pounds
pounds
pounds of chemicals listed
under CWA, TRI, HPV, PBT,
State statutes
number, quantity of RQ,
accidental releases
reportable under EPCRA
size of Vulnerable Zone per
Off-Site Consequence
Analysis
volume of Extremely
Hazardous Substances in
inventory
destruction, degradation,
creation, or enhancement of
habitat, including wetlands,
riparian areas
KWh, BTU
tons, metric tons, by aspects
in air, waste, water
categories above
tons, metric tons
tons, metric tons, by aspects
in air, waste, water
categories above
The following acronyms are used in the Environmental Performance Table
BOD
CAA
COD
CWA
BTU
EPCRA
Biological Oxygen Demand
Clean Air Act
Chemical Oxygen Demand
Clean Water Act
British Thermal Units
Emergency Preparedness and Community Right-to-Know Act
Page B2 - Environmental Performance Table
Application for the National Environmental Achievement Track
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HPV = High-Production Volume Chemicals (a list of chemicals covered by HPV
is available at http://www.epa.gov/chemrtk/hpvchmlt.htm
KwH = Kilowatt Hours
PBT = Persistent, Bio-accumulative, and Toxic Chemicals (a list of chemicals
covered by PBT is available at http://www.epa.gov/tri/pbtrule)
MMBTU = Million Metric British Thermal Units
PM10 = Particulate Matter less than 10 microns
PM2.5 = Particulate Matter less than 2.5 microns
RQ = Reportable Quantity under the Comprehensive Environmental
Responsibility and Cleanup Act (CERCLA)
TRI = Toxic Release Inventory (a list of chemical covered by TRI is available at
http://www.epa.gov/tri/chemical)
VOC = Volatile Organic Compounds
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