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Lexington County Green Business Certification
Program
Department of Public Works
And
Solid Waste Management
Green Business Membership Application
This form must accompany a signed statement by the CEO, President, or Owner on
company letterhead.
1. Company Name: _____________________________________________
2. Contact Person: ______________________________________________
3. Mailing Address: ______________________________________________
City:_____________________, SC Zip Code:_______________________
4. Phone Number: _______________________________________________
5. Email Address: _______________________________________________
6. Website Address:______________________________________________
7. What does your company do? Give a brief description of your business so we
can accurately list your business on the green business website.
8. Can other businesses contact you for ideas and suggestions?
Yes No
9. List the members of your Green Team?
Mission: Provide quality services to our citizens at a reasonable cost
Vision: Planned growth for our communities with abundant opportunities for all in a quality
environment.
10. In what areas are you certifying?
Energy Efficiency
Water Conservation/Urban Runoff
Indoor/Outdoor Air Quality
Waste Reduction/Recycling
11. Is your business already a Green Business Member? If so, in what area(s)?
Yes No
Energy Efficiency
Water Conservation/Urban Runoff
Indoor/Outdoor Air Quality
Waste Reduction/Recycling
12. List each green step and its associated point value. Attach supporting
documents such as memos or policies. Use additional pieces of paper if
necessary. (Refer to the Green Business Help Sheets)
Fax or mail your completion checklist and certifying statement to:
Lexington County Public Works
Green Business Program
440 Ball Park Road
Lexington, SC 29072
Fax: 803-785-8593
For Lexington County Only: Date Received:____________________ Received By:_________________________
Green Business Member Certified Green Business Member Member Number: _________________
Mission: Provide quality services to our citizens at a reasonable cost
Vision: Planned growth for our communities with abundant opportunities for all in a quality
environment.