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					Form 3




         Supplier’s Environmental Quality Survey Form                                                                                   EEI No. EN600-0010-007 Rev.2


                                           Company name                                                                                                           Delivery item

                                                Address                                                                                                     Date of self-evaluation

                                     Business category                                                                                             Person who conducted self-evaluation
                            (               
       Manufacturer Trading Company   Other                                                    )
   When selected "Trading company" or "Other" as business category                                                                                       Contact telephone number
   Commissioned manufacturing company:
   Address:

◆ Level of importance     3: Indispensable  2: Critical  1: Advisable
◆ Score method             3: Pass (with no problem)  2: Conditional pass (needs improvement)  1: Insufficient  0: Failure  -: Not applicable


1. Confirmation item                                                                                      Yes/No
      1. Uses no prohibited substance specified by TMD                                                       
      2. Implementing green procurement or plans to promote green procurement                                          Time started or scheduled to start:
                                                                                                                       Obtained date:               Certification body/certification No.:
      3. Has obtained ISO 14001

      4. Plans to obtain ISO 14001                                                                                     Planned date for screening: Certification body:

      5. Has obtained ISO 9001                                                                                         Obtained date:                Certification body/certification No.:

                                                                                                                       Planned date for screening: Certification body:
      6. Plans to obtain ISO 9001


2. Self-evaluation items concerning environmental quality
                                                                                                                                                        Self-evaluation result

A. Environmental policy/environmental objective/environmental structure                                   Importance   Score (A)X(B)           Comment (Enter related document, evidence name, etc.)
                                                                                                             (A)
                                                                                                                        (B)
 1 The supplier has a corporate philosophy concerning environmental protection.                               3                 -
   The supplier has an established environmental policy and has pledged to achieve continuous
 2                                                                                                            3                  -
   improvement and prevention of pollution.
 3 The supplier has pledged to comply with environmental laws and regulations in its environmental            3                  -
   The supplier's environmental policy describes the contents of activities concerning environment-
 4                                                                                                            3                  -
   related substances to be controlled,
 5 The supplier's environmental policy is approved by its CEO.                                                3                  -
 6 The supplier's environmental policy is documented and familiarized to all employees.                       3                  -
 7 The supplier's environmental policy is available to the general public.                                    3                  -
 8 The supplier's environmental objectives and targets are documented and familiarized to all                 3                  -
 9 The supplier's environmental objectives and targets are reviewed periodically.                             3                  -
   The organizations, responsible persons, their roles and authorities for achieving the objectives and
10                                                                                                            3                  -
   targets are determined.
   The execution plans clarifying the responsibilities, measures and schedules for achieving the
11                                                                                                            3                  -
   objectives and targets have been established.
   The responsibility, authority and role of the person responsible for environmental management have
12                                                                                                            3                  -
   been clarified.
                                                                                                              0          0       0




                                                                                     Toshiba Mobile Display Co., Ltd.                                                                                  1/6
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B. Environmental aspect                                                                                    Importance   Score (A)X(B)   Comment (Enter related document, evidence name, etc.)
                                                                                                              (A)
                                                                                                                         (B)
    The supplier is evaluating and controlling its environmental impact concerning air pollution and
1                                                                                                              3                 -
    performing improvement activities.
    The supplier is evaluating and controlling its environmental impact concerning water pollution and
2                                                                                                              3                 -
    performing improvement activities.
    The supplier is evaluating and controlling its environmental impact concerning waste and performing
3                                                                                                              3                 -
    improvement activities.
    The supplier is evaluating and controlling its environmental impact concerning resource
4                                                                                                              3                 -
    consumption and performing improvement activities.
    The supplier is evaluating and controlling its environmental impact concerning energy consumption
5                                                                                                              3                 -
    and performing improvement activities.
    The supplier is evaluating and controlling its environmental impact concerning odor, noise and
6                                                                                                              3                 -
    vibration, and performing improvement activities.
    The supplier is vigorously working on improvement of packaging, reuse and recycling of packaging
7                                                                                                              3                 -
    materials, and enhancement of efficiency of means of transport.
8   The supplier has and manages a system for product assessment.                                              3                 -
    The supplier is declaring to make efforts on biodiversity conservation in the web site, the
9                                                                                                              3                 -
    environmental report, etc.
                                                                                                               0          0      0

C. Laws, regulations and customer (TMD) requirements                                                       Importance   Score (A)X(B)   Comment (Enter related document, evidence name, etc.)
                                                                                                              (A)
                                                                                                                         (B)
    The supplier can respond without delay to TMD's requests for cooperation concerning environment-
1                                                                                                              2                 -
    conscious activities such as a survey regarding use of environment-related substances to be
    In response to laws and regulations, the registration forms related to environmental laws and
2                                                                                                              3                 -
    regurations are reviewed as needed.
3   The supplier has submitted Use/Non-use Report to TMD.                                                      3                 -
    The supplier has human resources/organizations with special expertise about environment-related
4                                                                                                              1                 -
    substances to be controlled.
5   The plan related to substances to be totally abolished/reduced has been prepared.                          3                 -
    For the implementation of the plan related to substances to be totally abolished/reduced, the person
6                                                                                                              3                 -
    responsible for environmental management has been appointed. And the progress has been
    The schedule of the total abolition/reduction plan is within the target time limit specified by TMD
7                                                                                                              3                 -
    standard for environment-related substances to be controlled.
8   The supplier has familiarized its employees with the latest contents of TMD's requirements.                3                 -
    The supplier has established specifications and standards that comply with TMD green procurement
9                                                                                                              2                 -
    criteria (environment-related substances to be controlled).
                                                                                                               0          0      0

D. Education/training                                                                                      Importance   Score (A)X(B)   Comment (Enter related document, evidence name, etc.)
                                                                                                              (A)
                                                                                                                         (B)
1 The supplier has environment-related education and training mechanisms and plans.                            2                 -
  The supplier has implemented the education and training related to environment (the items related
2                                                                                                              2                 -
  to environment-related substances to be controlled) and kept the records.
  The personnel who engages in the works with possibility to affect environment seriously receives
3                                                                                                              2                 -
  appropriate education and training separately, and attending status is controlled.
                                                                                                               0          0      0


E. Information                                                                                             Importance   Score (A)X(B)   Comment (Enter related document, evidence name, etc.)
                                                                                                              (A)
                                                                                                                         (B)
1 The information about own company's environmental protection is disclosed.                                   2                 -




                                                                                     Toshiba Mobile Display Co., Ltd.                                                                           2/6
Form 3




  The supplier timely provides communication, controls and instructions concerning environment-
2 related substances to be controlled, to inside the company, domestic and overseas business                    3                 -
  centers, each factory and group companies.
  Each business center, factory and group company obtains necessary information concerning
3                                                                                                               3                 -
  environment-related substances to be controlled and takes proper actions.
  The supplier has reported the environmental requirements from TMD to its CEO and the person
4                                                                                                               2                 -
  responsible for environmental management.
  The supplier has communicated the environmental requirements from TMD to the related
5                                                                                                               3                 -
  departments such as sales, design engineering, material, manufacturing and quality assurance
                                                                                                                0          0      0


F. Document control/environmental record                                                                    Importance   Score (A)X(B)   Comment (Enter related document, evidence name, etc.)
                                                                                                               (A)
                                                                                                                          (B)
    The documents are reviewed periodically, revised if necessary, and approved for their validities by
1                                                                                                               2                 -
    predefined responsible person.
2   The updated versions of documents are always available.                                                     3                 -
3   The supplier has the mechanism to prevent the accidental use of obsolete documents.                         3                 -
4   The obsolete documents to be kept are identified properly.                                                  2                 -
5   The documents are bearing dates (revision dates) and identifiable.                                          3                 -
6   The documents to be controlled are defined clearly.                                                         2                 -
7   The supplier has the procedures for identifying, maintaining and scrapping the environmental                2                 -
8   The storage limitation is set for environmental records.                                                    2                 -
9   The documents to obtain from outside are controlled properly.                                               3                 -
                                                                                                                0          0      0



G. Process Control                                                                                          Importance   Score (A)X(B)   Comment (Enter related document, evidence name, etc.)
                                                                                                               (A)
                                                                                                                          (B)
Incoming inspection
    Inspection standards, inspection methods and judgment methods are established for each of
 1                                                                                                              2                 -
    outsourced items (products/half-finished products), parts and materials.
    The supplier confirms the non-containing of prohibited substances on each incoming lot according to
 2                                                                                                              3                 -
    the inspection standard.
 3 Sub-materials to be used for manufacture and packaging materials are also objects of inspection.             2                 -
    The supplier makes its parts/materials suppliers submit analysis data, constituent list, etc. to
 4 support the non-use of prohibited substances. (The expiration dates of analysis data, constituent            3                 -
    list, etc. shall be within one year.)
    Regarding the incoming items, the supplier confirms the consistency between the actual items of
 5 and data as well as their expiration dates by using the analysis data and constituent list being             3                 -
    stored. <Regarding Cd in plastics, the measurement data by ICP shall be the standard.>
 6 When using recycled parts/materials, non-containing of prohibited substance is confirmed.                    2                 -
    In the case of in-house analysis, the supplier confirms that the accuracy (detection limit) of
 7                                                                                                              2                 -
    measuring equipment is appropriate.
    In the case of in-house analysis, the supplier has maintenance and calibration records on measuring
 8                                                                                                              2                 -
    equipments.
    In the case of analysis outside the company, the analysis is outsourced to a public institution or an
 9                                                                                                              2                 -
    equivalent one.
10 Incoming inspection records have been (will be) retained for 3 years or more.                                2                 -
Manufacturing process
    The supplier verifies that the products are not contaminated (cadmium, lead, hexavalent chromium,
11                                                                                                              3                 -
    mercury) from the equipments, tools and jigs being used.
12 The working procedures for preventing pollution and mixing in of prohibited substances are                   2                 -
    The supplier has the records on the type, volume, how to use, place, etc. of the prohibited
13                                                                                                              2                 -
    substance used in the past.




                                                                                      Toshiba Mobile Display Co., Ltd.                                                                           3/6
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14 The supplier is working for the prevention of mixing in of environmentally nonconforming products.            3                 -
15 The supplier is carrying out the identification and control of environmentally nonconforming products         3                 -
Outgoing inspection
    The supplier makes a final confirmation that the product does not contain or use TMD prohibited
16                                                                                                               3                 -
    substances.
    The material history from parts/materials to product (from product to parts/materials) about
17                                                                                                               3                 -
    environment-related substances to be controlled is available.
    If environmentally nonconforming products occurred, it is reported to the person responsible for
18                                                                                                               3                 -
    environmental management and such products are clearly discriminated from conforming products.
19 The inspection records have been (will be) retained for 10 years or more.                                     2                 -
Warehouse
20 The supplier is working for the prevention of mixing in of environmentally nonconforming products.            3                 -
21 The supplier is carrying out the identification and control of environmentally nonconforming products.        3                 -
Delivery control
22 If required by TMD, the supplier can submit analysis data without delay.                                      2                 -
23 Confirmation of delivery history to TMD is available.                                                         2                 -
    The supplier conducts an in-house verification (analysis) beforehand to confirm that parts contain
24                                                                                                               2                 -
    no prohibited substances. Analysis data and constituent lists are submitted to TMD.
                                                                                                                 0          0      0


H. Vendor management                                                                                         Importance   Score (A)X(B)   Comment (Enter related document, evidence name, etc.)
                                                                                                                (A)
                                                                                                                           (B)
     The supplier confirms with all vendors (including second-tier/third-tier vendors and purchased parts)
1                                                                                                                3                 -
     if they are implementing a mechanism to prevent the use of environment-related substances to be
     The supplier makes audits or other confirmations with all vendors (including second-tier/third-tier
2                                                                                                                3                 -
     vendors and purchased parts).
     The supplier obtains written guarantees for non-use of prohibited substances as well as their
3                                                                                                                2                 -
     supportive data from all vendors.
     The supplier concludes an agreement with all vendors that obliges each vendor to submit
4    information about the changing point related to environment-related substances to be controlled,            3                 -
     and has established the procedure after receiving such information.
5    The supplier has definite vendor selection criteria.                                                        2                 -
6    The supplier has definite purchase material selection criteria.                                             2                 -
     The supplier's part design criteria and material specifications clearly specify and indicate the non-
7                                                                                                                3                 -
     use of prohibited substances.
 8   The supplier uses the latest version of purchase specification (for parts and materials).                   3                 -
 9   The supplier has obtained the analysis data on parts and materials from their vendors.                      2                 -
10   The supplier has a system to verify (analyze) the analysis data on parts/materials furnished by             3                 -
11   The supplier has the records on changes in purchased parts and materials.                                   3                 -
                                                                                                                 0          0      0



I. Anomaly handling/emergency response                                                                       Importance   Score (A)X(B)   Comment (Enter related document, evidence name, etc.)
                                                                                                                (A)
                                                                                                                           (B)
1 The supplier has anomaly handling procedure.                                                                   2                 -
2 When environmental nonconformities occurred, the target lot is clarified and handled.                          3                 -
  When environmental nonconformities occurred, it is reported to the person responsible for
3                                                                                                                3                 -
  environmental management.
4 The environmental nonconformities were isolated and such record has been retained.                             3                 -
  If environmental nonconformities occurred, the cause investigation was conducted and the result of
5                                                                                                                2                 -
  countermeasure was led to the recurrence prevention.
6 The above-mentioned countermeasure has been applied to similar products.                                       2                 -
7 If the target environmental nonconformities had been delivered to TMD, it was reported to TMD.                 3                 -
  The parts that contain environment-related prohibited substances are disposed based on the
8                                                                                                                2                 -
  applicable laws of each area.




                                                                                       Toshiba Mobile Display Co., Ltd.                                                                           4/6
Form 3




    The supplier has a system to respond emergencies (in case of outflow of environmental
9                                                                                                                3                 -
    nonconformity to its customer or there is such possibility.)
                                                                                                                 0           0     0


J. Design control/change control                                                                             Importance   Score (A)X(B)   Comment (Enter related document, evidence name, etc.)
                                                                                                                (A)
                                                                                                                           (B)
    The supplier's parts design standard and material list describe environment-related substances to be
1                                                                                                                3                 -
    controlled (substances prohibited or to be abolished totally) (including subcontract ordering).
    The responsibilities, authorities and roles for the operation related to environment-related
2                                                                                                                2                 -
    substances to be controlled are defined clearly.
    When using recycled materials, the supplier's regulation specifies to use the material lot which has
3                                                                                                                2                 -
    obtained the material certificate.
    The supplier has a regulation for change control related to environment-related substances to be
4                                                                                                                3                 -
    controlled (the regulation covers all the contents of the change described in the change
    The supplier submits the application for approval to TMD (including TMD's subcontractors) based on
5                                                                                                                3                 -
    the change control regulation.
    The supplier has the procedure to make evaluation/confirmation beforehand when making a change.
6                                                                                                                3                 -
    And the supplier has such evaluation/confirmation records.
    The supplier is implementing the mechanism to prevent the change in product without obtaining
7                                                                                                                3                 -
    written prior agreement from the customer .
                                                                                                                 0           0     0


K. Corrective action/preventive action                                                                       Importance   Score (A)X(B)   Comment (Enter related document, evidence name, etc.)
                                                                                                                (A)
                                                                                                                           (B)
1   The procedure for corrective action is established.                                                          2                 -
2   The supplier examines and properly implements the action to assure the recurrence prevention.                2                 -
3   The supplier evaluates the effectiveness of corrective action.                                               3                 -
4   The procedure for preventive action is established.                                                          3                 -
5   The supplier examines and properly implements the action to prevent the occurrence of                        3                 -
6   The supplier evaluates the effectiveness of preventive action.                                               3                 -
                                                                                                                 0          0      0


L. Internal audit                                                                                            Importance   Score (A)X(B)   Comment (Enter related document, evidence name, etc.)
                                                                                                                (A)
                                                                                                                           (B)
    The supplier has the internal audit mechanism concerning the environment, establishes an audit
1                                                                                                                3                 -
    plan and conducts it periodically.
2   The contents concerning environment-related substances to be controlled are set as audit items.              3                 -
3   The supplier confirms the corrective action on nonconformity and its effectiveness.                          2                 -
4   The internal audit is conducted by qualified personnel.                                                      2                 -
    The supplier specifies the necessary skills for auditor and provides training. And such training
5                                                                                                                3                 -
    includes the matters related to the requirements of TMD's green procurement guidelines.
6   The person responsible for environmental management reports audit results to CEO with Audit                  2                 -
                                                                                                                 0           0     0
    Handling of private information
    The private information contained in this form is used only for the purpose of
    determining the compliance with the requirements relating to the green procurement,
    and may be transmitted to our affiliates and business partners when necessary.




                                                                                          Toshiba Mobile Display Co., Ltd.                                                                        5/6
                                                                                                                     EEI No. EN600-0010-007 Rev.1
■Environmental Quality Self-Evaluation Result
                          Evaluation Item                                           Self-Evaluation
                                                                      No. of      No. of               Converted         Comment
                                                                                             Scoring
  Symbol                Evaluation item            No. of items       scored      scored                 to 100-
                                                                                              result
                                                                       items      objects              point scale
           Environmental policy/environmental
    A      objective/environmental structure
                                                       12               0           0          0            -
    B      Environmental aspect                         9               0           0          0            -
           Laws, regulations and customer (TMD)
    C      requirements
                                                        9               0           0          0            -
    D      Education/training                          3                0           0          0            -
    E      Information                                 5                0           0          0            -
    F      Document control/environmental record       9                0           0          0            -
    G      Process control                             24               0           0          0            -
    H      Vendor management                           11               0           0          0            -
    I      Anomaly handling/emergency response         9                0           0          0            -
    J      Design control/change control               7                0           0          0            -
    K      Corrective action/preventive action         6                0           0          0            -
    L      Internal audit                              6                0           0          0            -
                                                       110              0           0          0           0.0

           Total score (On 100-point scale)




■Environmental Quality Self-Evaluation Result (Chart)

                                          A
                                  80
                          L                        B
                                  60
                K                 40                         C

                                  20
            J                         0                           D



                I                                            E


                          H                        F
                                          G
                    Self-Evaluation           80             60
                                                                               Toshiba Mobile Display Co.,Ltd.

				
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posted:9/3/2011
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