环境和健康安全调查问卷.doc

环境和健康安全调查问卷Environment ﹑Health and Safety Questrionnaire此问卷为台达对相关方相关综合信息调查的一部分，目的在于了解贵公司相关环境及职业健康安全信息。以促进双方对环境健康和安全信息的沟通交流，达成更好的企业社会责任，建立良好的企业形象。请给予配合，谢谢!?The questionnaire is a part of basic information investigation to Delta’s partners. The major purpose is to understand the system at Delta’s partners’ side regarding environment management and occupational health and safety management, to promote the communication on?EHS?with each other, to implement the social responsibility, and to build good corporate reputation. 1.公司基本信息 General Information:?1.1公司名称 Company Name:?1.2公司地址 Company Address:?1.3电话号码 Telephone Number:?1.4传真号码 Fax Number:?1.5主要联系人姓名及职称Primary Contact Name and Position?姓名Name：?职称 Position：?1.6贵公司总占地面积(平方米) The Total Site Area(sq. meter): m2?1.7贵公司为中达供应的产品或服务的名称The Product or Service provided for Delta?1.8 请描述贵公司附近的状况(如是否为居住区、商业区等及其分布位置) Please describe the status /environment nearby the company (such as if it’s residential area, commercial area and its location)?2.环境管理 Environment Management?2.1贵公司是否有专职的环境管理人员? Is an environment manager assigned in your company??■是Yes，如果“是”, 请提供以下联系数据 If “Yes”, please provide the following information:?姓名Name:?电子邮箱地址E-mail:?联系电话 Telephone:?传真号码 Fax:?否 No?2.2贵公司是否取得下列环境许可或意见书?Does your company have the operating ermits or consents listed below??1) 环境影响评价报告 Environmental Impact Assessment ■是Yes 否No?2) 环保设施竣工验收意见书(三同时) Environmental Protection Acceptance Approval (3 Synchronies) ■是Yes 否No?2.3大气污染物排放 Air Emissions?2.3.1请描述贵公司排放的大气污染物及其排放源？Please describe the air pollutants and the source of release？?苯、甲苯、二甲苯、乙醇、异丙醇?印刷、腹膜、上光过程排放?2.3.2 贵公司是否定期进行大气污染物的环境监测？Is there any routine monitoring of air pollution taken in your company??■是Yes 否No?如果“是”，请提供如下数据 If “Yes”, please provide the following information.?2.3.2.1负责大气污染物监测的机构名称 Name of the dept/institution who monitor?2.3.2.2监测项目及其监测结果 the items and results of monitoring：?达标排放?(1) 监测结果如未达到国家排放标准，贵公司是否取得污染物排放许可证？Does your company have the Pollu