B08_140P5121Q0040_Attach_0005_IR2_EA_AHS_-_Environmental_Questionnaire_0001.xlsx
XLSX spreadsheet 6 MB Posted
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- ENVIRONMENTAL MANAGEMENT PROGRAM AUDITS
- Solicitation number
- 140P5121Q0040
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Introduction
NPS Environmental Audit Program Environmental Questionnaire (EQ)
| PURPOSE |
| This environmental questionnaire (EQ) was developed to identify environmental areas to be reviewed during an audit. For the purpose of this questionnaire, the term “park” refers to the audited entity. The questions are not intended to determine the level of compliance. Rather, the questions are a way to identify which environmental requirements are applicable to the park so that time spent during the audit can be utilized most efficiently. |
| INSTRUCTIONS |
| Please answer all the questions on the green tabs to the best of your ability. Note that many questions have dropdown picklists. |
Please fill out responses on the gray tabs as applicable.
In some cases, you will be asked to send supplemental files to the audit team along with this completed EQ. These are summarized on the blue “Documents to Provide” tab.
| NAVIGATION | |
| Use the tabs at the bottom of the Excel Sheet, or navigate using the links below. | |
| General Information about the park | |
| Environmental Points of Contact (POCs) information. | |
| Air - questions related primarily to air conditioning and refrigeration systems, and air emissions. | |
| Hazardous Materials - questions related primarily to emergency planning and reporting, fuel, toxic substances, and pesticides. | |
| Contaminated Sites - questions related to known and potentially contaminated sites and associated studies. | |
| Safety - questions related to hazard communication and respiratory protection. | |
| Waste - questions related to non-hazardous waste and hazardous waste (including universal waste, used oil, and lab waste). | |
| Water Discharges - questions related to storm water and wastewater discharges. | |
| Sustainability - question related to environmental purchasing. | |
| Other - questions related to environmental management systems; regulatory inspections, notices, and enforcement actions; and contaminated sites. | |
| Documents to Provide - files that park staff should provide to the audit team prior to the site visit. |
General Information
| Date Environmental Questionnaire Completed | Comments (optional) |
| Date Environmental Questionnaire Completed: | |
| Park Environmental Audit Point-of-Contact (POC) Information | Comments (optional) |
| Park Environmental Audit POC Name: | |
| Park Environmental Audit POC Title: | |
| Park Environmental Audit POC Email: | |
| Park Environmental Audit POC Phone: | |
| Park Contact Information | Comments (optional) |
| Park Name: | |
| Park Headquarters address (street, city, state, zip): | |
| Park County(ies): | |
| Activities Conducted at the Park | Comments (optional) |
| Agriculture: | |
| Artifact or other Preservation: | |
| Facilities Management: | |
| Hospitality: | |
| Laboratory (e.g., analytical, wastewater treatment, photo lab, print shop): | |
| Landscaping: | |
| Museum/Curatorial: | |
| Research: | |
| Road Building/Maintenance: | |
| Trail Building/Maintenance: | |
| Vehicle Fueling: | |
| Vehicle Maintenance: | |
| Water/Boat Activities: | |
| Other: | |
| Park Facilities | Comments (optional) |
| Approximate number of park-owned facilities: | |
| Approximate number of facilities leased to the park: |
Provide names of leasees in Comments.
| Approximate Number of NPS Staff & Volunteers at the Park | Comments (optional) | |
| NPS Permanent: | ||
| NPS Seasonal: | ||
| Volunteers: | ||
| Other Organizations Operating in the Park | ||
| (Please identify what they are and what they do) | Comments (optional) | |
| Federal agencies other than the park: | ||
| Volunteer groups: | ||
| Partnering organizations: | ||
| Private organizations: | ||
| Concessioners: | ||
| Other: |
Click here to return to the Introduction worksheet.
/xl/drawings/drawing1.xml#Introduction!A1 Environmental POCs
| General Environmental Topic Area | Environmental Management Program Area | Park Contact(s) Name | Title | Phone Number | |
| Air | Air Quality Management (e.g., for emergency generator management and recordkeeping) | ||||
| Prescribed Burn/Control Management | |||||
| Air Conditioning and Refrigeration Systems - Stationary | |||||
| Motor Vehicle Air Conditioning | |||||
| Hazardous Materials | Emergency Planning and Reporting | ||||
| Fuel Storage Management | |||||
| Hazardous Materials & Toxic Substances Management | |||||
| Integrated Pest Management | |||||
| Spill Prevention, Control and Countermeasure (SPCC) Planning | |||||
| Safety | Hazard Communication (HAZCOM) | ||||
| Respiratory Protection | |||||
| Waste | Hazardous Waste Management | ||||
| Laboratory Chemical and Waste Management | |||||
| Universal Waste Management | |||||
| Used Oil | |||||
| Solid Waste Management (including Recycling) | |||||
| Water | Storm Water | ||||
| Wastewater Management | |||||
| Sustainability | Environmental Purchasing (office supplies) | ||||
| Environmental Purchasing (electronics) | |||||
| Environmental Purchasing (cleaning supplies) | |||||
| Environmental Purchasing (maintenance supplies) | |||||
| Environmental Purchasing (contracts) | |||||
| Other | Environmental Audit POC (taken from General Information tab) | 0 | 0 | 0 | 0 |
| Environmental Management System | |||||
| Contaminated Sites |
Click here to return to the Introduction worksheet.
/xl/drawings/drawing2.xml#Introduction!A1 Air
| Air Conditioning and Refrigeration Systems | Comments (optional) |
| Do park employees (versus contractors) service park chillers, such as building air conditioners? | |
| Do park employees (versus contractors) service motor vehicle air conditioners (MVACs)? | |
| Does the park have equipment that contains 50 pounds (per circuit) or more of refrigerant? |
If yes, please identify the equipment, refrigerant type, and pounds of refrigerant.
| Air Emissions | Comments (optional) |
| Does the park have air permits or registrations? |
If yes, please forward along with the completed EQ.
Does the park conduct air emissions monitoring?
If yes, please describe in Comments.
| If the park has stationary emergency or non-emergency generators, or any other type of stationary reciprocating internal combustion engines, please fill out the inventory here. |
| Does the park provide oversight for controlled or prescribed burns? |
| Does the park utilize any burn piles for management of slash, untreated wood, or other combustibles? |
| Does the park have boilers fired by fossil fuels or biomass? |
| Does the park have wood-burning furnaces, heaters, or stoves? |
| Does the park undertake demolition of renovation of facilities containing asbestos? |
| Does the park have used oil burners or heaters? |
| Does the park have gasoline dispensing facilities? |
Click here to return to the Introduction worksheet.
/xl/drawings/drawing3.xml#Introduction!A1 Hazardous Materials
| Emergency Planning and Reporting | Comments (optional) |
| Does the park submit a Tier 1 or Tier 2 hazardous chemical inventory report to the State Emergency Response Commission, the Local Environmental Planning Committee, and the local fire department? |
If yes, please forward along with the completed EQ if available.
Does the park submit a Toxics Release Inventory (TRI) to the U.S. Environmental Protection Agency (EPA) or the state?
If yes, please forward along with the completed EQ.
Is there a written policy, procedure, and/or plan for responding to hazardous substance (e.g., fuel, hazardous waste, pesticides) spills and releases at the park?
If yes, please forward along with the completed EQ.
Has there been a release of hazardous substances to the environment in the past three years?
If yes, please describe what was spilled, the quantity, and actions taken to respond to the spill in the Comments. Please also forward any reports filed with authorities.
| If tanks/containers are used to accumulate hazardous materials, please fill out the tank/container inventory here. | |
| Fuel Storage Management & SPCC Planning | Comments (optional) |
| Please fill out the tank/container inventory here (this includes but is not limited to propane, liquefied petroleum gas [LPG], liquefied natural gas, gasoline, diesel, biodiesel, heating oil, avgas, jet fuel, and used oil). | |
| Does the park have a spill prevention, control, and countermeasures (SPCC) plan? |
If yes, please forward along with the completed EQ.
| Toxic Substances | Comments (optional) |
| Does the park have equipment that contains polychlorinated biphenyls (PCBs)? |
If yes, please describe (e.g., transformers, ballasts, capacitors) in the Comments.
| Does the park have lead-based paint? | |
| Does the park have lead-based paint in park-owned housing? | |
| Does the park have asbestos? | |
| Does the park have schools or child-care facilities? | |
| Integrated Pest Management (IPM) | Comments (optional) |
| Do park employees apply pesticides (e.g. insecticides, herbicides, fungicides, rodenticides) at the park? | |
| Does the region apply pesticides at the park? | |
| Do contractors apply pesticides at the park (including spraying in buildings)? | |
| Are restricted use pesticides used at the park? | |
| Is pesticide usage reported through the NPS Pesticide Use Proposal System (PUPS)? |
If yes, please attach latest annual pesticide use report from PUPS.
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