November 20, 2008   |  Login
 
 
Preliminary Questionnaire Minimize

 

Company Profile

 

Company:
Contact Person:
Title:
Address:
City:
State:
Postal Code:
Phone:
Fax:
E-Mail:
Web Address:
How did you find out about Alliance International Registrar, LLC?
What type of products or services do you provide?
What are your SIC and/or NACE Code(s)? (if known):
Are you "design" responsible for your products or services?

 

General Information

 

What type of Registration are you interested in?


Other:

 

If you are using assistance to implement your system please provide or indicate "NONE".

Consultant's Name:
Consultant's Phone Number:
E-Mail:
Are you currently Registered?
If so, Please provide a copy of your current Certificate(s).

File Size: 1000KB Maximum
File Types: .jpg .jpeg .jpe .gif .bmp .doc .pdf .zip

 

Facility and Implementation Information

 

Does your facility have more than one facility(site) requiring Registration?
If Yes, how many?
If Yes, is your Management System Centralized?
If Yes, what functions are Centralized?
What are your language requirements, if any? (i.e. Spanish, English, etc.)

 

What are your Target Dates for:

Documentation Review:
Stage I: (EMS only):
Pre-Audit (Optional):
Stage II / Registration Audit:

 

Please provide the following information for each facility:

1st. Plant Name & Location (Address)
Square Feet
Shift #1 Employees
Shift #2 Employees
Shift #3 Employees
Total Employees
2nd. Plant Name & Location (Address)
Square Feet
Shift #1 Employees
Shift #2 Employees
Shift #3 Employees
Total Employees
3rd. Plant Name & Location (Address)
Square Feet
Shift #1 Employees
Shift #2 Employees
Shift #3 Employees
Total Employees

 

Environmental Clients ONLY

Are any temporary sites, such as construction, storage, or maintenance buildings?
Is the site close to a wetland?
Is the site close to a body of water?
Are there any underground storage tanks at the site?
Does the site use well water?
Submit
  
Preliliminary Questionnaire: EMS ONLY Minimize

EMS ONLY

Identify the applicability of the following issues at the site with a checkmark.

 

Potential Environmental Aspects

 

Company
Biodegradable Solid Waste
Comment
Non-biodegradable Solid Waste
Comment
Hazardous Materials (including corrosive, reactive, flammable & explosive)
Comment
Hazardous waste
Comment
Non-hazardous waste
Comment
Toxic material, waste or emissions
Comment
Reactive material
Comment
Potentially contaminated storm water runoff
Comment
Liquid waste/effluents
Comment
Process contact water
Comment
Non-contact process water
Comment
Chemicals / herbicides
Comment
Pesticides / fungicides
Comment
Asbestos
Comment
PCBs
Comment
Significant Noise
Comment
Fugitive emissions
Comment
Gaseous emissions
Comment
Particulate emissions
Comment
Hazardous Air Pollutants
Comment
Heavy Metals
Comment
Other
Explain
Submit