Environmental Management System Survey Form

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9 Νοε 2013 (πριν από 4 χρόνια και 1 μέρα)

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1


Environmental Management System Survey Form


The purpose of this survey is to assess the environmental management systems of our suppliers,
based on Nippon Chemi
-
Con G
roup Green Procurement Guidelines (CEM
-
3551
-
05A).


Please assess the environmental management system of your company according to the following
instructions.


Please note that your responses to the survey is used only for environmental management work
with
in the group and is not released outside of the group.


How to fill in the survey form

Please answer the questions in Sections 1
-

3.


Please give answers concerning the branches and factories which are in the supply chain of
products or raw materials to N
ippon Chemi
-
Con Corporation.


If your company is a trading company or acts as a broker, please respond to the survey either by
obtaining answers from the relevant provider of the products or services or by forwarding the
survey form to the provider.


If mo
re than one branch or factory is involved in business with us, we would be grateful if you
could make copies of this survey form in the required numbers so that each branch or factory can
complete the survey.


Concerning the questions in Sections 2 and 3,
please check the applicable answers and write the
number of points for the answers of the boxes in the points column and then calculate the total
number of points.


Please complete the self
-
assessment and then send the completed survey form back to either
the
Material Procurement Department

or the Procurement Section, whichever requested you to
respond to the survey, at Nippon Chemi
-
Con Corporation by the specified date.


1.

Details of your company

Please answer the questions about your company.

* Tick mark

appropriate under bars.

Number of branches (factories) responding to the survey:



One



Mo r e t h a n o n e


T h i s i s t h e n u mb e r ( ) b r a n c h ( f a c t o r y ) o f a t o t a l o f ( ) b r a n c h e s ( f a c t o r i e s ) o f o u r c o mp a n y
r e s p o n d i n g t o t h i s s u r v e y.

C o mp a n y n a me


Da t e o f

r e s p o n s e

Mo n t h/D a y/Y e a r


B u s i n e s s
c a t e g o r y



Ma n u f a c t u r e r o r
s e r v i c e p r o v i d e r.



C o mp a n y a c t i n g a s a
b r o k e r, s u c h a s a
t r a d i n g c o mp a n y.

S e c t i o n o f t h e p e r s o n
r e s p o n d i n g


Na me o f t h e
r e l e v a n t b r a n c h
( f a c t o r y )


Na me a n d t i t l e o f t h e
p e r s o n r e s p o n d i n
g


P r o d u c t s o r s e r v i c e s s u p p l i e d t o
Ni p p o n C h e mi
-
C o n C o r p o r a t i o n


Do c u me n t No. : CE M
-
3 5 5 5
-
0 5 A/E

Ni p p o n Ch e mi
-
Co n Gr o u p

F o r g r e e n p r o c u r e me n t a s s e s s me n t


2

2.

Survey of the environmental management system

This section questions the environmental management system of your company
(factory/branch).

Notes

*

If your company has more than one bra
nch or factory, please respond concerning the branch or
the factory specified in Section 1.

*

Please check the box of the applicable response and write the number of points specified for
this response in the points column on the right.


N
o.

Question

Answer
s [points]

Points

1

Has your company (factory/branch)
acquired ISO14001 certification which is
the international standard for an
environmental management system?

Has your company (factory/branch)
implemented an environmental
management system other than I
SO14001
(such as EMAS Responsible Care)?



A l r e a d y a c q u i r e d ( i mp l e me n t e d ).
[ 6 0 ]



I n t e n d s t o a c q u i r e ( i mp l e me n t )
wi t h i n o n e y e a r. [ 5 0 ]

*
I f e i t h e r o f t h e a b o v e a p p l i e s t o y o u,
p l e a s e s k i p t h e f o l l o wi n g q u e s t i o n s
( n o s. 2
-

1 3 ).


P l e a s e c h e c k t h e a p p l i c a b
l e me t h o d o f
r e g i s t r a t i o n.



T h i r d p a r t y a g e n c y



S e c o n d p a r t y



S e l f
-
d e c l a r a t i o n


I f y o u r c o mp a n y ( f a c t o r y/b r a n c h ) h a s
i mp l e me n t e d a s y s t e m o t h e r t h a n
I S O1 4 0 0 1, p l e a s e wr i t e t h e n a me o f t h e
s y s t e m h e r e.



I n t e n d s t o a c q u i r e ( i mp l e me n t )
b u t n o t
wi t h i n o n e y e a r, o r h a s n o
s p e c i f i c s c h e d u l e.



Ha s n o p l a n t o a c q u i r e
( i mp l e me n t ).

*
I f e i t h e r o f t h e a b o v e a p p l i e s t o y o u,
p l e a s e a n s we r t h e f o l l o wi n g q u e s t i o n s
( n o s. 2
-

1 3 ).


2

Do e s y o u r c o mp a n y ( f a c t o r y/b r a n c h )
h a v e a n e n v i r o n me n t a l i d e o l o g y a n d a n
e n v i r o n me n t a l p o l i c y?



Y e s. [ 4 ]



No. [ 0 ]


3

Ha s y o u r c o mp a n y ( f a c t o r y/b r a n c h ) e v e r
i n v e s t i g a t e d t h e e n v i r o n me n t a l i mp a c t o f
i t s b u s i n e s s, p r o d u c t s a n d s e r v i c e s?



Y e s. [ 3 ]



C u r r e n t l y i n v e s t i g a t i n g, o r i n t e n d s
t o i n v e s t i g a t e. [ 2 ]



No. [ 0 ]


4

Do e s y o u r c o mp a n y ( f a c t o r y/b r a n c h )
h a v e a s y s t e m t o a l l o w t h e u n d e r s t a n d i n g
o f, a n d t o c h e c k c o mp l i a n c e wi t h,
e n v i r o n me n t a l l a ws a n d r e g u l a t i o n s?



Ha s a s y s t e m t o a l l o w t h e
u n d e r s t a n d i n g o f, a n d t o c h e c k
c o mp l i a n c e wi t h, r e l e v a n t l a ws
a n d r e g u l a t i o n s.
[ 1 0 ]



No. [ 0 ]


5

Do e s y o u r c o mp a n y ( f a c t o r y/b r a n c h ) s e t
p u r p o s e s a n d t a r g e t s f o r e n v i r o n me n t a l
c o n s e r v a t i o n a n d r e d u c t i o n o f
e n v i r o n me n t a l i mp a c t a n d p r e p a r e p l a n s,
e t c., t o c a r r y o u t me a s u r e s?



P r e p a r e s p l a n s a n d c a r r i e s o u t
me a s u r e s. [ 3 ]



C a r r i
e s o u t me a s u r e s wi t h o u t
p l a n s. [ 2 ]



Do e s n o t c a r r y o u t me a s u r e s. [ 0 ]


6

Do e s y o u r c o mp a n y ( f a c t o r y/b r a n c h )
h a v e a n e s t a b l i s h e d o r g a n i z a t i o n a n d d o e s
i t s e t r e s p o n s i b i l i t y a n d a u t h o r i t y f o r
e n v i r o n me n t a l c o n s e r v a t i o n?



Ha s a n e s t a b l i s h e d o r g a n i z a t i o n

a n d s e t s r e s p o n s i b i l i t y a n d
a u t h o r i t y. [ 4 ]



Ha s n o c l e a r l y s e t o r g a n i z a t i o n,
r e s p o n s i b i l i t y o r a u t h o r i t y. [ 0 ]


7

Do e s y o u r c o mp a n y ( f a c t o r y/b r a n c h )
p r o v i d e e mp l o y e e s a n d o t h e r s wi t h
t r a i n i n g a n d t h e i n s t r u c t i o n s r e q u i r e d t o
c o n s e r v e t h e e n v i r o n me n t?




P r o v i d e s t r a i n i n g a n d t h e
i n s t r u c t i o n s. [ 3 ]



No. [ 0 ]



3


8

Does your company (factory/branch)
have a system to publicly announce the
status of its measures and to respond to
inquiries?



Ha s a s y s t e m t o c o mmu n i c a t e wi t h
e x t e r n a l p a r t i e s. [ 3 ]



No.

[ 0 ]


9

Do e s y o u r c o mp a n y ( f a c t o r y/b r a n c h )
h a v e p r o c e d u r e s f o r f a c i l i t i e s a n d
e q u i p me n t f o r e n v i r o n me n t a l
ma n a g e me n t a n d f o r o t h e r
e n v i r o n me n t a l c o n s e r v a t i o n me a s u r e s i n
wr i t i n g?



Ha s p r o c e d u r e s a n d t h e n e c e s s a r y
p r o c e d u r e s a r e i n wr i t i n g. [ 3 ]



Ha s
s o me p r o c e d u r e s. [ 2 ]



Ha s f e w o r n o p r o c e d u r e s. [ 0 ]


10

Does your company (factory/branch)
have a system to prevent possible
emergencies or accidents that may affect
the environment and to limit the extent
of any damage in the case of occurrence
of suc
h emergencies and accidents? Does
your company (factory/branch) conduct
test regularly?



Ha s a s y s t e m a n d c o n d u c t s t e s t.
[ 1 0 ]



Ha s a s y s t e m b u t d o e s n o t c o n d u c t
d r i l l s t h o r o u g h l y. [ 4 ]



Ha s n o s y s t e m. [ 0 ]



No t a p p l i c a b l e ( i t i s n o t p o s s i b l e
f o r
s t a t e s o f e me r g e n c y t o o c c u r ).
[ 3 ]


11

Does your company (factory/branch)
have a system to understand the status
of measures and to rectify
inappropriateness and non
-
achievement
of plans for the environment?



Ha s a s y s t e m t o u n d e r s t a n d t h e
s t a t u s o f me
a s u r e s a n d t o r e c t i f y
t h e i n a p p r o p r i a t e n e s s. [ 6 ]



No. [ 0 ]


12

Does your company (factory/branch)
have a system to regularly monitor the
status of environmental management
measures by means such as inspections?



Ha s a s y s t e m t o r e g u l a r l y mo n i t o r
b y m
e a n s s u c h a s i n s p e c t i o n s. [ 3 ]



No. [ 0 ]


13

Does your company (factory/branch)
have a system that enables managers
and the staff responsible for
environmental management to review
environmental management measures to
make continuous improvements?



Re
sponsible people review such
measures for continuous
improvements. [3]



No. [ 0 ]


T o t a l n u mb e r o f p o i n t s f o r t h e e n v i r o n me n t a l ma n a g e me n t s y s t e m

( P l e a s e wr i t e t h e t o t a l o f t h e p o i n t s f o r e a c h q u e s t i o n i n t h e b o x o n t h e r i g h t.)





4

3.

Survey of the envi
ronmental management measures

This section questions the status of the environmental management measures of
your company (factory/branch).


No.

Question

Answers [points]

Points

Measures to cut energy consumption

14

Has your company (factory/branch)
adopt
ed any measures to reduce energy
consumption?



A d o p t s me a s u r e s b y p r e p a r i n g
p l a n s wi t h s e t t a r g e t s. [ 6 ]



A d o p t s me a s u r e s b u t wi t h o u t
p l a n s. [ 3 ]



Ha s n o t a d o p t e d a n y me a s u r e s. [ 0 ]


15

Did any of the energy consumption
reduction measures, etc., of
your
company (factory/branch) in the
previous year produce results or is any
of such measures, etc., for this year
expected to do so? Please write briefly
about up to two such measures, etc., on
the right.

1.



2.



[One point for each measure, etc.,
writt
en.]


Measures to cut resource consumption

16

Has your company (factory/branch)
adopted any measures to reduce
resource consumption (including
paperless measures)?



A d o p t s me a s u r e s b y p r e p a r i n g
p l a n s wi t h s e t t a r g e t s. [ 6 ]



A d o p t s me a s u r e s b u t wi t h o
u t
p l a n s. [ 3 ]



Ha s n o t a d o p t e d a n y me a s u r e s. [ 0 ]


17

Did any of the resource consumption
reduction measures, etc., of your
company (factory/branch) in the
previous year produce results or is any
of such measures, etc., for this year
expected to do so?
Please write briefly
about up to two such measures, etc., on
the right.

1.



2.



[One point for each measure, etc.,
written.]


Waste management

18

Has your company (factory/branch)
adopted any measures to eliminate or
reduce waste or to promote recyclin
g?



A d o p t s me a s u r e s b y p r e p a r i n g
p l a n s wi t h s e t t a r g e t s. [ 6 ]



A d o p t s me a s u r e s b u t wi t h o u t
p l a n s. [ 3 ]



Ha s n o t a d o p t e d a n y me a s u r e s. [ 0 ]


19

Did any of the measures, etc., of your
company (factory/branch) to eliminate
or reduce waste or to promote

recycling
in the previous year produce results or is
any of such measure, etc., for this year
expected to do so? Please write briefly
about up to two such measures, etc., on
the right.

1.



2.



[One point for each measure, etc.
written.]




5


Measures t
o prevent environmental pollution

20

Has your company (factory/branch)
adopted any measures to prevent
environmental pollution, such as
pollution of the air, surface water,
underground water and of the soil, and
noise, vibrations, offensive odors and
grou
nd subsidence?



No t o n l y c o mp l i e s wi t h r e l e v a n t
l a ws a n d r e g u l a t i o n s, b u t h a s a l s o
i mp l e me n t e d mo r e s t r i n g e n t
me a s u r e s s u c h a s s e t t i n g o wn
s t a n d a r d s. [ 8 ]



C o mp l i e s wi t h r e l e v a n t l a ws a n d
r e g u l a t i o n s. [ 6 ]



Do e s n o t f u l l y c o mp l y wi t h s o me
r e l e v a n t l
a ws. [ 4 ]



Ha s n e v e r t h o r o u g h l y c h e c k e d t h e
s t a t e o f c o mp l i a n c e wi t h r e l e v a n t
l a ws. [ 0 ]



No t a p p l i c a b l e. [ 1 0 ]


De v e l o p me n t o f e n v i r o n me n t a l l y f r i e n d l y p r o d u c t s

21

Does your company (factory/branch)
take into consideration reduction of the
impact on
the environment in the
development of products and the
improvement of services?



R e d u c i n g e n v i r o n me n t a l i mp a c t i s
c o n s i d e r e d i n t h e d e v e l o p me n t o f
p r o d u c t s a n d t h e i mp r o v e me n t o f
s e r v i c e s. [ 4 ]



R e d u c i n g e n v i r o n me n t a l i mp a c t i s
c o n s i d e r e d, b u t o t h e r m
a t t e r s s u c h
a s q u a l i t y a n d c a p a c i t y a r e
p r i o r i t i z e d. [ 3 ]



Do e s n o t t a k e s u c h a c t i o n. [ 0 ]



No t a p p l i c a b l e ( i n c l u d i n g c a s e s o f
n o t d o i n g a n y d e s i g n o r
d e v e l o p me n t, e t c.) [ 4 ]


22

If your company (factory/branch) has
developed any environmentally friend
ly
products or services, please write briefly
about up to two such products or
services on the right (products and
services which are not supplied to
Nippon Chemi
-
Con are acceptable).

1.



2.



[One point for each product or service
written.]


Green procu
rements and green purchases

23

Does your company (factory/branch)
make procurements and purchases
taking into consideration reduction of
the impact on the environment
(so
-
called green procurements and
green purchases)?



Ma k e s s u c h p r o c u r e me n t s a n d
p u r c
h a s e s. [ 3 ]



I n t e n d s t o ma k e s u c h p r o c u r e me n t s
a n d p u r c h a s e s. [ 2 ]



Ha s n o p l a n t o d o s o. [ 0 ]


T o t a l n u mb e r o f p o i n t s f o r t h e e n v i r o n me n t a l ma n a g e me n t me a s u r e s

( P l e a s e wr i t e t h e t o t a l o f t h e p o i n t s f o r e a c h q u e s t i o n i n t h e b o x o n t h e r i g h t.)


C a l c u l a
t i o n o f t o t a l a s s e s s me n t p o i n t s

P l e a s e a d d t o g e t h e r t h e t o t a l n u mb e r o f p o i n t s f o r t h e e n v i r o n me n t a l ma n a g e me n t
s y s t e m o n t h e p r e v i o u s p a g e a n d t h e t o t a l n u mb e r o f p o i n t s f o r t h e e n v i r o n me n t a l
ma n a g e me n t me a s u r e s s t a t e d a b o v e.


P l e a s e wr i t e A, B, C o r D b
a s e d o n t h e t o t a l n u mb e r o f p o i n t s i n t h e b o x o n t h e r i g h t.


A: 7 0
-

1 0 0 p o i n t s

B: 5 0
-

6 9 p o i n t s

C: 3 0
-

4 9 p o i n t s

D: 0
-

2 9 p o i n t s



F o r u s e b y Ni p p o n Ch e mi
-
Co n Co r p o r a t i o n