WPC|  &vךqkG5X ,# Fa{ELpG@u1]5^(֑7J{*>N_#{oqxm޴/a]$y8x8'ɶ$BcB3x",WJU3NV:yNʎi&}L@vCYIOп} UWAkDkNr&=93u!/LųqCa"уE0<ݯswٿ3U"j b±viU(Xܩq q)uGR脁mcNj .4 QH̉AGOt!zl8PQK -og=zwC#Z UN %i 0:o U @ f 0&c 05wN 0 0O 0 0 0j 0E 0 D4 1ux 72^ w+4/CR mT 1kfNb6 0NFbafa"&&"<<<<<<<<<<<<<<< 1^^^^^^^^^^a 1fafaf 1aSSSSSSSS Bgggggggggggggggggggggggg 1 1   1 1 1 1'' 1 B555 1RR 1 1```` 1 1nn 1\\US_EPA\dec16-hp4000.deca.ny.r2.east.epa0(9 Z6Times New Roman RegularX($USUS.,(9 Z(Times New Roman @(;3$2#  0  .3  0  (O;$0  2#  a  .3  0` (#(#(b$0  0` (#(#2#   .3  0 ` (#` (#(xir$0  0` (#(#0 ` (#` (#2#(  0  )3  0 (# (#($0  0` (#(#0 ` (#` (#0 (# (#2#(  a  )3  0h(#(#(F$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#2#(   )3  0h(#h(#($0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#2#  0  )3  0(#(#({$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#0(#(#2#  a  )3  0p(#(#(F$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#0(#(#0p(#(#2#     )3  0p(#p(# 3#37=CIQYag1.a.i.(1)(a)(i)1)a)i):2 11sBackup3|xU(GIOU[agmsAutoList1701.1.1.1.1.1.1.1.Page of &mailto:longo.linda@epa.gov(O$Page of & X TABLE RTABLE C  X  X   X   X   X  X 0mGIOSY_ekqAutoList2471.1.1.1.1.1.1.TABLE A h[GIMQUY]aeAutoList254000000001)a)TABLE Nhttp://www.h2e TABLE D  h7GIMQUY]aeAutoList1221)a)TABLE E  d(&GIOU[agmsAutoList2251.1.1.1.1.1.1.1.(6GIOU[agmsAutoList2261.1.1.1.1.1.1.1.(FGIOU[agmsAutoList2271.1.1.1.1.1.1.1.(VGIOU[agmsAutoList2281.1.1.1.1.1.1.1.(fGIOU[agmsAutoList2291.1.1.1.1.1.1.1.(GIOU[agmsAutoList2301.1.1.1.1.1.1.1.(&GIOU[agmsAutoList2311.1.1.1.1.1.1.1. d pWGIMQUY]aeAutoList141&1)a) hf8GIMQUY]aeAutoList1421)a) pv8GIMQUY]aeAutoList1431)a) h8GIMQUY]aeAutoList1441)a) h8GIMQUY]aeAutoList1461)a) h8GIMQUY]aeAutoList1471)a) !USUS.,  _XX XX8PXXdd8/N$K%/V&/V(Kр X   U.S.EnvironmentalProtectionAgencyREGION2 V JAUDITSURVEYFOR R ̀HealthCareFacilities N #XPXx#  SPRING2005XXP J  E#XPX\# ThankyouinadvanceforprovidingvaluablefeedbackforUSEPAsAuditProgram.Yourexperiencesand 4   opinionsarevaluabletousandwillbeusedtoimprovetheAuditProgram.    NameofInstitution_____________________________________________________________󀀀   Address______________________________________________________________________   Ѐ_______________________________________________________________________ x  City,State,ZipCode____________________________________________________________ d NameofContact_______________________________________________________________ P PhoneNumber________________________________email__________________________ <   1.Approximatenumberofthefollowingwhoattendorareemployedbyyourinstitution: X Staff:򀀀󀀀NumberofBeds:򀀀   0 Numberofinpatients(annually):򀀀Numberofoutpatients(annually):򀀀     2.Numberoffacilitiesthatarepartofyourinstitution:򀀀 x (Thenumberoffacilitiesisthemaincampusplusadditionalbuildingsthatarenotcontiguouswiththemain d campus,butareconsideredpartoftheinstitution. ) P 3.WhatbestdescribesyourstatuswithourAuditInitiative:(checkbox) l    E ([x3"3"    3$ 2[03  0 S   Yes,signedanAuditAgreementwithEPARegion23$ o ݌X!!S5%S5% Ќ  "3"    3( 2[03  0 S   Yes,voluntarilyselfdisclosedcomplianceissueswithnoAuditAgreement 3( a ݌"b #S5%S5% Ќ  "3"    39 2[03  0 S   Yes,weauditedourinstitutionwithoutcommunicatingwithEPA39 r ݌$!%S5%S5% Ќ  "3"    39 2[03  0 S   No,wedidnotparticipateintheAuditPolicyanddidnotauditourfacility 39 r ݌~%&#'S5%S5% Ќ  Q  ]XXP @.+1 (K (XXXX (  SectionA : Changesinunderstanding,behaviorandpollutantreductions#XPX ]j#  X 4.Howusefuldidyoufindthefollowingtools? , *FIddd Xdd Xdd X5%5%,)dd ,edd ,#dd ,dd +  $pp $ComplianceAssistanceActivities '|" 'very | useful 'h" 'notuseful '|" 'dontknow/ | notapplicable h " EPAworkshops/training/presentations  @    @    @    @  EPAoutreachmaterials(i.e.,brochure,factsheets,CDs)   h    h    h    h EPARegion2_Websites_Ԁ  @    @    @    @  EPAresponsestophonecalls/_emails_   h     h     h     h  Other,pleasespecify:  @    @    @   @    XPXXXP#XPXXXP#5.Pleaserateyourlevelofunderstanding beforeandaftertheHealthCareComplianceInitiative. H  * dd[dd )pdd e-dd #dd FI5%5%,;dd ,Xdd ,dd ,Xdd ,Xdd ,dd ,Xdd ,edd +  (44 (XPXXXP   EnvironmentalRegulation  @  # Ad2#,!66 A  BeforeCompliance @" Initiative Bd3$,# d B  AfterCompliance @$ Initiative Bd3$,% d B>  Not @& Applicable B82,' 66d B &d H' &high 6,!(d 6some ') '&#%XXPnone#XPX%&## ,d* ,high 6,!+d 6some ', '&#%XXPnone#XPX%&## "- "  H- Wastemanagement ,. (i.e.,solidwastes,hazardouswastes,regulated p/ medicalwaste) d \0  $,1d $  ,2  d ,3  $,4d $  ,5   ,6   ,7 #XPXXXP#AbovegroundstorageXPXXXPԀtanks d 8  $9d $  :  d ;  $<d $  =   >   ? Undergroundstoragetanks d \@  $\Ad $  \B  d \C  $\Dd $  \E   \F   \G #XPXXXP#CleanAirAct:Airemissions H XPXXXP(i.e.,asbestos,_CFC_,_toxics_)#XPXXXP# d pI  $Jd $  K  d L  $Md $  N   O   P Wastewaterdischarge d HQ  $HRd $  HS  d HT  $HUd $  HV   HW   HX SpillPreventionControlCountermeasurePlans d pY  $pZd $  p[  d p\  $p]d $  p^   p_   p` ToxicSubstancesControlAct:Toxic H!a inventory/releasereporting(i.e.,_PCBs_,lead, 4"b asbestos) d  # c  $H!dd $  H!e  d H!f  $H!gd $  H!h   H!i   H!j Pesticides d $H"k  $$H"ld $  $H"m  d $H"n  $$H"od $  $H"p   $H"q  $H"r XPXXXP6.Regulatoryactionsasaresultof#XPXXXP$#theHealthCare ComplianceInitiativeXPXXXP: &P$s *QVd d;dd ;Xdd Xdd Xdd XXdd Xdd Xdd Xedd e 5%5%,dd ,dd +  $'<%t'<% $Didtake: ''%u 'Intendtotake: '%v #XPXXXP%#0Changedrecordkeeping g  x) 'w 0Improvedhazardouswastelabeling,manifesting d* (x 0Submittedneworrevisedpermitapplications, P+(y Ѐletters,formstoEPA <,)z 0Other,specify____________________________XPXXXP  (-*{ #XPXXXPU(#0Changerecordkeeping   x) '| 0Improvehazardouswastelabeling,manifesting d* (} 0Submitneworrevisedpermitapplications, P+(~ letters,formstoEPA <,) 0Other,specify____________________________XPXXXP (-*  #XPXXXP)#  D.+ &/V &XX &  7.Processchangesatyourfacilityasaresultofthe HealthCare ComplianceInitiative: X *X\ddIdd Idd QV5%5%,dd ,dd +  $DD $Didtake: 'P 'Intendtotake: P 0Additionaltrainingofemployees/staff ( 0Changedthestorageorhandlingofawaste  0Changedaprocessorpractice  0Changedfacilityoperationormaintenance  0Changedmonitoring,sampling,testing  procedures  l  0ConsideredEnvironmentalManagementSystem  X  Ѐ(EMS)  D  0Implementedmaterialorwasterecyclingsystem  0  0Installedpollutioncontrolequipment(e.g., t   Ѐscrubbers,controltechnique)   `  0Installedawastetreatmentsystem L  К0Purchasednewprocessequipment 8  0Other,specify___________________________ o  $  _   0Additionaltrainingofemployees/staff ( 0Changethestorageorhandlingofawaste  0Changeaprocessorpractice  0Changefacilityoperationormaintenance  0Changemonitoring,sampling,testing  procedures  l 0ConsiderEnvironmentalManagementSystem  X (EMS)  D  0Implementmaterialorwasterecyclingsystem  0  0Installpollutioncontrolequipment(e.g., t   scrubbers,controltechnique)   `  0Installawastetreatmentsystem L  К0Purchasenewprocessequipment 8  0Other,specify____________________________ $!      #   PollutantReductions  $  8.OftheactivitiesthatyouhaveimplementedasaresultoftheHealthCare ComplianceInitiative,haveyou & observedanypollutantreductionsand/orcostsavings?Toaidinansweringthisquestion,wearelookingfor p' activitiesrelatingtoareassuchaswastemanagement,energysavings,wateruse,airemissions,pesticideuse, \( reductionsinmercury,asbestos,lead,or_PCBs_. H) *"#ddIdd Idd X\5%5%,h dd ,h dd ,h dd +  $4*4 $ActivityType '+ 'Pollution/ReductionTypeand , EstimatedAmount(&#%XXPlbs,gal.,_ect#XPX%&#.7#_) '- 'AnnualCostSavings . EXAMPLE: \/ Replacingfluorescentlightsand H0 existingballastswithhigh 41 efficiencyT8lampsandnew  2 electricballasts.   !3 EXAMPLE: \4 22milligramsofmercuryper4 H5 foottubeoffluorescentlighting. 46     7 EXAMPLE: \8 35%energysavings; H9 35%operatingcostsavings; 4: Simplepayback4.7years.   ; EXAMPLE: "4 < Switchingfrom_disposalable_Ԁto x# != reusableplates,eatingutensils, d$ "> glassesandcupsforcafeteria P%"? services.  <&#@ EXAMPLE: "4 A 400,000pounds/yearreduction x# !B withsolidwastes.  d$ "C EXAMPLE: "4 D $500,000(Afterfactoringin x# !E increasedcostsforcleaning d$ "F reusablematerials)  P%"G   'd%H   'd%I   )<'L   +(M   +(N   ,*Q %/V %XX %   d   d  <    XXPSectionB:AuditPolicy#XPX y=# 0  9.PleaseindicatewhatinfluencedyoutoparticipateinanAuditAgreementorselfdisclosure?  |  L  Penaltyreduction    h    Avoidenforcementaction [      Other,pleasespecify_________________ c  $    Notapplicable V  L`>10.Whatpercentageofyourinstitutionincludingoffsitefacilitieswasaudited? t ! ! [ (7xxE L0  0100%0 5%5%` 5% 5%   050% :   0Greaterthan50% l 0  0Lessthan50%5%5% L@11.Whatroadblocksdidyouencounterinimplementingyouraudit?  *Add dd h dd h dd h "#5%5%, dd ,dd ,dd ,Jdd ,Pdd +     d  No d  roadblocks 'P 'Someissues, d  butnotmajor 'P 'Definite d  Roadblocks 'P 'Dont d  know P CostofAudit  x    x!   x"   x#   x$ CostofCompliance  P%   P&   P'   P(   P) Supportofuppermanagement  x*   x+   x,   x-   x. Identifyingappropriatecontractors  P/   P0   P1   P2   P3 Lackofknowledgeofregulations   x4    x5    x6    x7    x8 Overalltimeandcommitment  P"9   P":   P";   P"<   P"= Cooperationoffaculty/staff/students  #x!>   #x!?   #x!@   #x!A   #x!B Interactionwithregulatoryagencies  P%"C   P%"D   P%"E   P%"F  P%"G   7(m0x[ ! !12.Pleaseindicatetheamountoftimerequiredtocompletethecorrectionofallareasofnoncompliance. X'%H ! !";"  L;J0  2m3  0S5%5%  Within60days;JVJ݌D(%IS5%S5% Ќ  ";"  ;K0  2m3  0S5%5%  Morethan60daysbutlessthan120days;K.K݌v)'JS5%S5% Ќ  ";"  ;K0  2m3  0S5%5%  120daysorgreater;K L݌*P(KS5%S5% Ќ  ";"  ;L0  2m3  0S5%5%  Unknown;LL݌+)LS5%S5% Ќ  LDJ -+N $K $XXXX $  13.Whatisthetypicalauditfrequencyunderyourformalmultimediaenvironmentalcomplianceaudit X program? D ! !";"  L;N0  2m3  0S5%5%  Noformalmultimediaenvironmentalcomplianceauditprograminplace;NO݌0S5%S5% Ќ  ";"  ;O0  2m3  0S5%5%  Onceeveryyear;O,P݌b S5%S5% Ќ  ";"  ;P0  2m3  0S5%5%  Onceeverytwoyears;PQ݌<S5%S5% Ќ  ";"  ;Q0  2m3  0S5%5%  Onceeverythreetofiveyears;QQ݌nS5%S5% Ќ  ";"  ;R0  2m3  0S5%5%  Other:____________________________________;RR݌S5%S5% Ќ  LO14.Whatwastheapproximatecostoftheaudit?򀀀   15.Whatweretheapproximatecostsofcorrectinganynoncompliance?򀀀     XXPSectionC:EnvironmentalManagementSystems( EMS)#XPX T# Z    |(&807! !16.DoesyourinstitutionhaveaformalEnvironmentalManagementSystem(EMS)?    (Wp8 |! !";"  ;V0  2W&3  0S5%5%  Yes;VW݌S5%S5% Ќ  ";"  ;W0  2W&3  0S5%5%  No;WW݌~S5%S5% Ќ  ";"  ;sX0  2W&3  0S5%5%  Donotknow;sXX݌jS5%S5% Ќ  ݀ ~(68p ! !17.IfanEMSisnotinplace,areyouconsideringadoptinganEMS? B   (8x8 ~0  &Planned.5%5%   &Notplanned r   &Underconsideration ^   &Notapplicable J  (F8x ! !18.IfanEMSisnotinplace,whataretheroadblocks? "   (8x80  0Costconsiderations5%5%   0Lackofmanagementsupport    0Insufficienttechnicalresources  0  Other:______________________________0c5%5%zc5%c5%   0Notapplicable0  0[ 5% 5% f[5%[5%  (V8x ! !19.DoesyourEMSincludeaperiodic,systematicreviewofyourfacilityscompliance? "> !   (f8x80  0Yes#*!"5%5%   0No n$"#   0Donotknow Z%#$   0Notapplicable F&#%  (f8x ! !20.HasyourEMSbeenthebasisforanyoperatingchangesbeyondcompliance? (%'   (v8x80  Yes.Pleasedescribe:____________________________________________________ )&(5%5% ! !0  No)')5%5%   0Notapplicable *(*  (8x ! ! .:,. /N XX   21.DidtheComplianceInitiative/selfauditplayaroleinthedecisiontoimplementanEMSormodifyan X existingEMS? D   (8x8"3"  0  3e283  0S5%5%  Yes0 S5%S5%0 5% 5%0[ 5% 5%3ee݌0[5%[5% Ќ  "3"  0  3f283  0S5%5%  No0 S5%S5%3ff݌ 5% 5% Ќ  "3"  0  3g283  0S5%5%  Notapplicable3gg݌S5%S5% Ќ   (&8x ! ! Thankyouforyourinput!  ̀Pleasesendcompletedsurveyto: | $    Linda_Longo_ h     U.S.EPA,Region2 T    ComplianceAssistanceSection @    290Broadway,21stFloor ,    NewYork,NY10007  Forquestionsregardingthissurveycontact:  Linda_Longo_,2126373565,4 - O  5  longo.linda@epa.gov6/kOCk  7d+qkԀ   &#%XXPPublicreportingforthiscollectioninformationisestimatedtoaverage15to30minutespersurvey,includingtimefor H reviewinginstructions,gatheringinformation,andcompletingandreviewingtheinformation.Sendcommentsonthe x  Agencysneedforthisinformation,theaccuracyoftheprovidedburdenestimate,andanysuggestionsreducingthe P burden,includingtheuseofautomatedcollectiontechniquestotheDirector,OfficeofEnvironmentalInformation, ( 1200PennsylvaniaAvenue,NW,WashingtonDC20460andtotheOfficeofInformationandRegulatoryAffairs,  OfficeofManagementandBudget,72517thStreet,NW,WashingtonDC20503.Attention:DeskOfficerforEPA.  IncludetheEPAICR1860.01andtheOMBcontrolnumber20200015inanycorrespondence. X PLEASEDONOTSENDYOURCOMPLETEDSURVEYTOTHESEWASHINGTONDCADDRESSES#XPX%&#l# `  @* (88! !4KegO  5  6qOqatio  7egDq