TÜV Rheinland - ISO 14001

Legal Entity/Company Name:*

This is the name that will appear on your certificate and should be the full registered name.

Address (HQ or Site seeking certification)

Enter the main address to appear on your certificate.

Zip or Postal Code:*

City, State:*

Company Website (URL):

Contact Person/Main Contact

First Name:*

Last Name:*

Email Address:*

Business Phone:

Transfer of Certification

Please select your type of certification:

Gap Analysis

Initial Certification

Change to Certification (e.g. additional sites or change in scope)

Transfer of Certification

Standard:

Previous Certification Body:

Expiration Date (mm-dd-yyyy):

Processes are mostly:

Is your organization responsible for product or service design and development?

What are the outsourced processes / functions within the scope of your management system?

Total Number of Employees:

Primary Audit Language(s):

Please describe the nature of the product or services provided:

Please provide a brief description of the scope, identifying the business functions / processes that are in (& out) of scope, and any dependencies

Industry Description:

How many buildings/units are located on the site to be certified?

(Including but not limited to storage facilities, warehouse, buildings, etc.)

Which of the following SIGNIFICANT environmental aspects occur at each location?

Emissions to Air

(minor source, Title V, etc.)

Energy Emitted

E.g. ionizing radiation, heat and light emissions

Releases to Land

E.g. chemical storage, hazardous material storage, bulk fuel storage, use of pesticides/herbicides/fungicides

Waste Generation

E.g. hazardous waste, solid waste and/or bio-hazardous waste generation

Releases to Water

E.g. release to groundwater, industrial/process wastewater generation, storm water management

Interaction of Physical Attributes

Size, shape and color of buildings, structures and equipment with the local environment

Use of Raw Materials, Energy and Natural Resources

Environmental aspects of the organization:

Describe your environmental aspects (e.g., waste generation, energy consumption, air emissions, chemical use, oil/fuel management, wastewater generation, stormwater management, etc.)

Other information we should know:

(E.g. Notice of Violations within prior three years)

Expected timeline for initial activities:

Next 1-3 months

Next 3-6 months

More than 6 months

Has your company received Management System Consultation or Training?