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NameofInstitution_____________________________________________________________________󀀀   Address______________________________________________________________________________   Ѐ______________________________________________________________________________ x  City,State,ZipCode____________________________________________________________________ d NameofContact_______________________________________________________________________ P PhoneNumber________________________________email_________________________________ <   1.Approximatenumberofthefollowingwhoattendorareemployedbyyourinstitution: X Faculty:򀀀 Staff:򀀀Students:򀀀  0  2.Numberoffacilitiesthatarepartofyourinstitution:򀀀  (Thenumberoffacilitiesisthemaincampusplusadditionalbuildingsthatarenotcontiguouswiththemain  campus,butareconsideredpartoftheinstitution. ) x 3.WhatbestdescribesyourstatuswithourAuditInitiative:(checkbox) <  E ([x3"3"    3z 2[03  0 S   Yes,signedanAuditAgreementwithEPARegion23z ݌(S%S% Ќ  "3"    3~ 2[03  0 S   Yes,voluntarilyselfdisclosedcomplianceissueswithnoAuditAgreement 3~ ݌ !S%S% Ќ  "3"    3 2[03  0 S   Yes,weauditedourinstitutionwithoutcommunicatingwithEPA3 ݌D"#S%S% Ќ  "3"    3 2[03  0 S   No,wedidnotparticipateintheAuditPolicyanddidnotauditourfacility  XXX\3 ݌#N!%S%S% Ќ    -F+. D/V DX D  SectionA : Changesinunderstanding,behaviorandpollutantreductions #X\X X_ # X 4.Howusefuldidyoufindthefollowingtools? , *FIddd Xdd Xdd X5%5%,)dd ,edd ,#dd ,dd +  $pp $ComplianceAssistanceActivities '|" 'veryuseful '|" 'notuseful '|" 'dontknow/ | notapplicable h" EPAworkshops/training/presentations  @    @    @    @  EPAoutreachmaterials(i.e.,brochure,factsheets,CDs)   h     h    h    h EPARegion2_Websites_Ԁ  @    @    @    @  EPAresponsestophonecalls/_emails_   h     h     h     h  Other,pleasespecify:  @    @    @   @    HX\XXX\#X\XXHX\#5.Pleaserateyourlevelofunderstanding beforeandaftertheCollege/UniversityComplianceInitiative. H  * dd[dd )pdd e-dd #dd FI5%5%,;dd ,Xdd ,dd ,Xdd ,Xdd ,dd ,Xdd ,edd +  (44 (HX\XXX\HcXHX\   EnvironmentalRegulation #HX\XHch# @  8d)#> @?? 8  BeforeCompliance @! Initiative 9d*$," d 91  AfterCompliance @# Initiative 9d*$,$ d 9  Not @% Applicable B82,& 66d B d H& :high $'d $some  ( none d ) high $*d $some  + none  ,   H, Wastemanagement ,- HXHX\(i.e.,solidwastes,hazardouswastes,regulatedmedicalwaste)#HX\XH# d p.  $,/d $  ,0  d ,1  $,2d $  ,3   ,4   ,5 #X\XXHX\I#AbovegroundstorageHX\XXX\Ԁtanks d \6  $\7d $  \8  d \9  $\:d $  \;   \<   \= Undergroundstoragetanks d 4>  $4?d $  4@  d 4A  $4Bd $  4C   4D   4E #X\XXHX\Z#CleanAirAct:Airemissions \F  XX\H  (i.e.,asbestos,_CFC_,_toxics_)#  H##X\X # d HG  $\Hd $  \I  d \J  $\Kd $  \L   \M   \N Wastewaterdischarge d O  $Pd $  Q  d R  $Sd $  T   U   V SpillPreventionControlCountermeasurePlans d x W  $x Xd $  x Y  d x Z  $x [d $  x \   x ]   x ^ ToxicSubstancesControlAct:Toxic _ inventory/releasereporting XX\(i.e.,_PCBs_,lead,  ` asbestos)#X\X v!# d !xa  $bd $  c  d d  $ed $  f   g   h Pesticides d (# i  $(# jd $  (# k  d (# l  $(# md $  (# n   (# o  (# p HX\XXX\6.Regulatoryactionsasaresultof#X\XXHX\##theCollege/University ComplianceInitiativeHX\XXX\: 0%"q *QVd d;dd ;Xdd Xdd Xdd XXdd Xdd Xdd Xedd e 5%5%,dd ,dd +  &#r&# Didtake:  &($s Intendtotake:  &($t #X\XXHX\Q$#0Changedrecordkeeping g  (%u 0Improvedhazardouswastelabeling,manifesting (&v 0Submittedneworrevisedpermitapplications, )'w Ѐletters,formstoEPA *l(x 0Other,specify____________________________HX\XXX\  +X)y #X\XXHX\i'#0Changerecordkeeping   (%z 0Improvehazardouswastelabeling,manifesting (&{ 0Submitneworrevisedpermitapplications, )'| letters,formstoEPA *l(} 0Other,specify____________________________HX\XXX\ +X)~  #X\XXHX\(#  -`+ Ї7.Processchangesatyourfacilityasaresultofthe College/University 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.OftheactivitiesthatyouhaveimplementedasaresultoftheCollege/University ComplianceInitiative, & haveyouobservedanypollutantreductionsand/orcostsavings?Toaidinansweringthisquestion,weare p' lookingforactivitiesrelatingtoareassuchaswastemanagement,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(lbs,gal.,_ect_)  - 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 GK GXXXX G   d   d  <  Q XX\ SectionB:AuditPolicy#X\X Q;#   9.PleaseindicatewhatinfluencedyoutoparticipateinanAuditAgreementorselfdisclosure? H   L  Penaltyreduction   4     Avoidenforcementaction [  f     Other,pleasespecify_________________ c   @    Notapplicable r  L<10.Whatpercentageofyourinstitutionincludingoffsitefacilitieswasaudited?  ! ! [ (7xxE L0  0100%0 5%5%| 5% 5%   050%    0Greaterthan50% 8 0  0Lessthan50%j5%5% L?11.Whatroadblocksdidyouencounterinimplementingyouraudit? 0 *Add dd h dd h dd h "#5%5%, dd ,dd ,dd ,Jdd ,Pdd +  tt    No  roadblocks  l Someissues,  butnotmajor  l Definite  Roadblocks  l Dont  know  l CostofAudit  D    D!   D"   D#   D$ CostofCompliance  l%   l&   l'   l(   l) Supportofuppermanagement  D*   D+   D,   D-   D. Identifyingappropriatecontractors  l/   l0   l1   l2   l3 Lackofknowledgeofregulations  D!4   D!5   D!6   D!7   D!8 Overalltimeandcommitment  "l 9   "l :   "l ;   "l <   "l = Cooperationoffaculty/staff/students  D$!>   D$!?   D$!@   D$!A   D$!B Interactionwithregulatoryagencies  %l#C   %l#D   %l#E   %l#F  %l#G   7(m0x[ ! !12.Pleaseindicatetheamountoftimerequiredtocompletethecorrectionofallareasofnoncompliance. 't%H ! !";"  L; H0  2m3  0S5%5%  Within60days; H_H݌(`&IS5%S5% Ќ  ";"  ; I0  2m3  0S5%5%  Morethan60daysbutlessthan120days; I7I݌)'JS5%S5% Ќ  ";"  ;I0  2m3  0S5%5%  120daysorgreater;I)J݌+(KS5%S5% Ќ  ";"  ;J0  2m3  0S5%5%  Unknown;JK݌N,)LS5%S5% Ќ  LMH l.,N 1/N 1XX 1  13.Whatisthetypicalauditfrequencyunderyourformalmultimediaenvironmentalcomplianceaudit X program? D ! !";"  L;L0  2m3  0S5%5%  Noformalmultimediaenvironmentalcomplianceauditprograminplace;LM݌0S5%S5% Ќ  ";"  ;M0  2m3  0S5%5%  Onceeveryyear;M'N݌b S5%S5% Ќ  ";"  ;N0  2m3  0S5%5%  Onceeverytwoyears;NO݌<S5%S5% Ќ  ";"  ;O0  2m3  0S5%5%  Onceeverythreetofiveyears;OO݌nS5%S5% Ќ  ";"  ;P0  2m3  0S5%5%  Other:____________________________________;PP݌S5%S5% Ќ  LM14.Whatwastheapproximatecostoftheaudit?򀀀   15.Whatweretheapproximatecostsofcorrectinganynoncompliance?򀀀    Q XX\SectionC:EnvironmentalManagementSystems( EMS) Z  #X\X QR#  |(&807! !16.DoesyourinstitutionhaveaformalEnvironmentalManagementSystem(EMS)?    (Wp8 |! !";"  ;T0  2W&3  0S5%5%  Yes;TU݌S5%S5% Ќ  ";"  ;U0  2W&3  0S5%5%  No;UU݌~S5%S5% Ќ  ";"  ;nV0  2W&3  0S5%5%  Donotknow;nVV݌jS5%S5% Ќ  ݀ ~(68p ! !17.IfanEMSisnotinplace,areyouconsideringadoptinganEMS? B   (8x8 ~0  &Planned.5%5%   &Notplanned r   &Underconsideration ^   &Notapplicable J  (F8x ! !18.IfanEMSisnotinplace,whataretheroadblocks? "   (8x80  0Costconsiderations5%5%   0Lackofmanagementsupport    0Insufficienttechnicalresources  0  Other:______________________________0c5%5%zc5%c5%   0Notapplicable0  0[ 5% 5% f[5%[5%  (V8x ! !19.DoesyourEMSincludeaperiodic,systematicreviewofyourfacilityscompliance? "> !   (f8x80  0Yes#*!"5%5%   0No n$"#   0Donotknow Z%#$   0Notapplicable F&#%  (f8x ! !20.HasyourEMSbeenthebasisforanyoperatingchangesbeyondcompliance? (%'   (v8x80  Yes.Pleasedescribe:____________________________________________________ )&(5%5% ! !0  No)')5%5%   0Notapplicable *(*  .:,.  (8x ! !21.DidtheComplianceInitiative/selfauditplayaroleinthedecisiontoimplementanEMSormodifyan X existingEMS? D   (8x8"3"  0  3ic283  0S5%5%  Yes0 S5%S5%0 5% 5%0[ 5% 5%3icc݌0[5%[5% Ќ  "3"  0  3rd283  0S5%5%  No0 S5%S5%3rdd݌ 5% 5% Ќ  "3"  0  3Re283  0S5%5%  Notapplicable3Ree݌S5%S5% Ќ   (&8x ! ! Thankyouforyourinput!  ` Pleasesendcompletedsurveyto:  8    Linda_Longo_ | $    U.S.EPA,Region2 h     ComplianceAssistanceSection T    290Broadway,21stFloor @    NewYork,NY10007 ,  Forquestionsregardingthissurveycontact:  Linda_Longo_,2126373565cXX\   #X\Xch# cXX\ #X\Xc@i#&%XX\Publicreportingforthiscollectioninformationisestimatedtoaverage15to30minutespersurvey,includingtimefor n reviewinginstructions,gatheringinformation,andcompletingandreviewingtheinformation.Sendcommentsonthe F Agencysneedforthisinformation,theaccuracyoftheprovidedburdenestimate,andanysuggestionsreducingthe v burden,includingtheuseofautomatedcollectiontechniquestotheDirector,OfficeofEnvironmentalInformation, N 1200PennsylvaniaAvenue,NW,WashingtonDC20460andtotheOfficeofInformationandRegulatoryAffairs, & OfficeofManagementandBudget,72517thStreet,NW,WashingtonDC20503.Attention:DeskOfficerforEPA.  IncludetheEPAICR1860.01andtheOMBcontrolnumber20200015inanycorrespondence. ~ PLEASEDONOTSENDYOURCOMPLETEDSURVEYTOTHESEWASHINGTONADDRESSES#X\X%&i# XX\ . #X\X m# @* (88! !4KegO  5  6nOnatio  7ego