Apply - Technical/Technology Only

We suggest downloading a Word version of the Technical/Technology application and completing the application off-line. Once you have the answers complete, cut and paste the answers into this online application. Use the “All Others” application for the Innovative Operations/Management, Water Conservation, Pollution Prevention, Civic/Community, Education, Agriculture, Youth, and Individual categories.

Application must be postmarked or submitted online by October 14, 2011. Please complete the following information, as applicable, when submitting your environmental project for consideration in the 2012 Texas Environmental Excellence Awards competition.

Please review and verify your entries before selecting submit.

GENERAL INFORMATION

Date:

Company Name (List all entities being nominated):

Previous Name of Company:

State Solid Waste Registration Number:

Air Account Number:

EPA Identification Number:

TRI Identification Number:

Customer Reference Number:

Regulated Entity Reference Number:

Type of Business:

Business Subsidiary of:

No. of Employees:

Contact Information

Salutation:

First Name:

Last Name:

Title:

Mailing Address

Address:

City:

State:

Zip:

Physical Address

Physical Address:

City:

State:

Zip:

Daytime Phone:

Fax:

Email Address:

Website Address:

Total Number of Applications Submitted:

(1) Name of Project:

(2) Description:

Describe the project in detail (purpose, goals, history, description of the problem, accomplishments to date, how it is exceptional, etc.). What type of environmental improvement was made and how was the improvement accomplished? Are there any partnerships with the community? Does it address a high priority environmental need? Is it financially self-sustaining? Does it go above and beyond legal requirements? Is the project a response to anticipated future regulations or does it represent environmental leadership? Does the project address health and safety concerns of workers or the community? What measures of success are there such as cost savings, cost of project, rate of return, employees trained, etc. Were there economic or other benefits for the local community? (Describe in 600 words or less.)

(3) Innovative or Creative in Use or Application of Technology or Personnel?:

Is this project innovative or creative in its use or application of technology or personnel? If so, please explain. Can the technology be transferred to either a large number of similar industries or does it have applications in other industrial sectors (i.e. SIC codes)? (Explain in 100 words or less.)

(4) Describe how the project benefits the environment :

Describe how the project benefits the environment (for example, how it reduces hazardous waste or air emissions; by source reduction, recycling, or resources it conserves) and the specific waste streams that are being reduced. Can the project serve as a model on how to achieve waste reductions? (Describe in 100 words or less.)

(5) Project Summary

Year Project was Started:

Ongoing Project?:

Yes

Fully Implemented?:

Yes

Baseline year for evaluation if different than project start year?:

This application is:

Project Specific

Facility-wide Program

(6) Volumes or Reductions from Project

Check each category reduced as a result of your project or program. :

Hazardous Waste

Volatile Organic Compounds (VOCs)

Carbon Monoxide

Nitrogen Oxides (NOx)

Sulphur Dioxide

Other (i.e. Particulate Matter, Lead, Mercury)

TRI - Chemicals reported on TRI under releases and transfers

Quantify the reductions achieved by your project or program on the attached tables using the units indicated. For specific projects, volumes and reductions should be for specific waste, emissions, etc., targeted by project. For overall facility programs, volumes and reductions should be for facility-wide waste, emissions, etc., under that category.

Hazardous Waste (tons)

Baseline Year

Baseline Year :

Total volume generated (tons) :

2009

Total volume generated (tons) :

Volume reduced by project or program :

% reduced from project baseline year :

2010

Total volume generated (tons) :

Volume reduced by project or program :

% reduced from project baseline year :

2011

Total volume generated (tons) :

Volume reduced by project or program :

% reduced from project baseline year :

Chemicals reported on TRI under releases and transfers (pounds)

*Total of reportable amounts in Sections 5 and 6 of Form R.

Baseline Year

Baseline Year:

*Total volume released or transferred :

2009

*Total volume released or transferred :

Volume reduced by project or program:

% reduced from project baseline year :

2010

*Total volume released or transferred :

Volume reduced by project or program:

% reduced from project baseline year :

2011

*Total volume released or transferred :

Volume reduced by project or program:

% reduced from project baseline year :

Volatile Organic Compounds (tons)

Baseline Year

Baseline Year:

Total volume emitted :

2009

Total volume emitted :

Volume reduced by project or program :

% reduced from project baseline year:

2010

Total volume emitted :

Volume reduced by project or program :

% reduced from project baseline year:

2011

Total volume emitted :

Volume reduced by project or program :

% reduced from project baseline year:

Carbon Monoxide (tons)

Baseline Year

Baseline Year:

Total volume released or transferred :

2009

Total volume released or transferred :

Volume reduced by project or program :

% reduced from project baseline year:

2010

Total volume released or transferred :

Volume reduced by project or program :

% reduced from project baseline year:

2011

Total volume released or transferred :

Volume reduced by project or program :

% reduced from project baseline year:

Sulphur Dioxide (tons)

Baseline Year

Baseline Year:

Total volume released or transferred :

2009

Total volume released or transferred :

Volume reduced by project or program :

% reduced from project baseline year :

2010

Total volume released or transferred :

Volume reduced by project or program :

% reduced from project baseline year :

2011

Total volume released or transferred :

Volume reduced by project or program :

% reduced from project baseline year :

Nitrogen Oxides (tons)

Baseline Year

Baseline Year:

Total volume released or transferred :

2009

Total volume released or transferred :

Volume reduced by project or program :

% reduced from project baseline year :

2010

Total volume released or transferred :

Volume reduced by project or program :

% reduced from project baseline year :

2011

Total volume released or transferred :

Volume reduced by project or program :

% reduced from project baseline year :

Other Reductions (i.e. Particulate Matter, Lead, Mercury)

Please Describe:

Baseline Year

Baseline Year:

Total amount emitted (indicate unit):

2009

Total amount emitted (indicate unit):

Amount reduced by project or program (unit):

% reduced from project baseline year:

2010

Total amount emitted (indicate unit):

Amount reduced by project or program (unit):

% reduced from project baseline year:

2011

Total amount emitted (indicate unit):

Amount reduced by project or program (unit):

% reduced from project baseline year:

(7) How much water and/or energy is/are conserved by the project or overall program?

For specific projects, volumes and reductions should be targeted by project. For overall facility programs, volumes and reductions should be facility-wide numbers.

Water Conserved (gallons)

Baseline Year

Baseline Year:

Total volume of water used (gallons) :

2009

Total volume of water used (gallons) :

Volume reduced by project or program (gallons) :

% reduced from project baseline year :

2010

Total volume of water used (gallons) :

Volume reduced by project or program (gallons) :

% reduced from project baseline year :

2011

Total volume of water used (gallons) :

Volume reduced by project or program (gallons) :

% reduced from project baseline year :

Energy Conserved (Btu or kwh, specify which)

Baseline Year

Baseline Year:

Total volume of energy used :

2009

Total volume of energy used :

Volume reduced by project or program :

% reduced from project baseline year :

2010

Total volume of energy used :

Volume reduced by project or program :

% reduced from project baseline year :

2011

Total volume of energy used :

Volume reduced by project or program :

% reduced from project baseline year :

How did you hear about the awards?: