Sample Environmental Impact Worksheet by bbu90505

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									                           Sample Worksheet for Review and Ranking of Environmental Impacts
                               Score each impact (on a scale of 1‐5) according to its frequency, severity and probability




                                                                                                                                                      Impact on Air, Land, W




                                                                                                                                                                                                          Impact on humans
                                                                                                                                                                               Impact on plants/animals
                                                                                                                                    Materials Usage
                                                                                                       Energy Usage

                                                                                                                      Water Usage




                                                                                                                                                                                                                             Total Score
Activity        Activity, Product, Services                   Environmental Aspect
Manufacturing
                                                              VOC emissions
                                                              Electricity consumption
                                                              Natural Gas consumption
                                                              Water consumption
                                                              Raw materials
                                                              Non Hazardous waste
                                                              Hazardous waste
                                                              Waste water
                                                              Scrap materials generation
                                                              Packaging materials
                                                              Electronics

Sales & Marketing
                                                              Electricity
                                                              Paper
                                                              Solid wasate
                                                              Transportation
                                                              Electronics

Shipping/Receiving/Warehousing
                                                              Transportation
                                                              Packaging
                                                              Electricity
                                                              Materials handling
                            Sample Worksheet for Review and Ranking of Environmental Impacts
                                Score each impact (on a scale of 1‐5) according to its frequency, severity and probability




                                                                                                                                                       Impact on Air, Land, W




                                                                                                                                                                                                           Impact on humans
                                                                                                                                                                                Impact on plants/animals
                                                                                                                                     Materials Usage
                                                                                                        Energy Usage

                                                                                                                       Water Usage




                                                                                                                                                                                                                              Total Score
Facilities
                                                               Electricity consumption
                                                               Natural Gas consumption
                                                               Water consumption
                                                               Refrigerants
                                                               Stormwater
                                                               Electroncis

Administration
                                                               Paper
                                                               Solid waste
                                                               Electroncis
                                                               Solid waste

Employees
                                                               Commuting
                                                               Solid waste
                                                               Electricity
                                                               Water

								
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