Green Business Application
GENERAL BUSINESS INFORMATION
Business Name
Your answer
Street Address
Your answer
Mailing Address (if different)
Your answer
Type of Business
Your answer
Days/Hours of Operation
Your answer
Number of Employees
Your answer
Property
CONTACT
Name/Title
Your answer
Email
Your answer
Phone
Your answer
Date Application Completed
Your answer
COMPANY BIO/INTRODUCTION
The Recycle Utah Green Business Program does its best to promote each member business for its contribution to a sustainable Summit County. Please complete this section to be used for promotion.
Please briefly describe your company’s history, and the goods and/or services it offers.
Your answer
Please make a brief statement about your company’s commitment to environmental sustainability, including your future goals.
Your answer
Please provide any addition information you would like to share about your company (awards, recognition, etc.).
Your answer
UTILITY BASELINE
Please select the utilities you pay for:
Electricity: What is your annual (calendar year) electricity consumption in kilowatt hours? If this cannot be provided, what is your annual cost for electricity and your current cost p/kilowatt hour (Rocky Mountain Power bill)?
Your answer
Natural Gas: What is your annual (calendar year) natural gas consumption? If this cannot be provided, what is your annual cost for natural gas, and your current cost p/decatherm (Questar bill)?
Your answer
Water: What is your annual (calendar year) water consumption (CCF – hundred cubic feet)? What is your annual cost for water?
Your answer
Trash & Recycling: What is your annual bill for trash? Recycling? How many pickups do you have each week of trash? Recycling? What do you feel you could start recycling that you currently are not?
Your answer
Transportation: Do you have company vehicles? What vehicle type do you use with estimated mileage per gallon? Have you taken measures to reduce business vehicle usage? Does your business offer any employee incentives to reduce car commuting? Does your business involve air travel?
Your answer
Purchasing: What measures have you taken to reduce resource consumption, including purchasing products made from recycled material?
Your answer
Chemicals: Which of the following toxic chemicals do you use or store on site?
Do you store more than 25 gallons of any of the items listed above?
What types of less toxic cleaning alternatives do you use (i.e. vinegar, baking soda, other commercially available green cleaning agents)?
Your answer
GOALS
Please set at least three significant, quantifiable goals that you will meet for the next 12 months. Goals should address land waste reduction/recycling improvement, water conservation, non-renewable energy conservation, or alternative transportation. Please indicate when each goal should be completed.
Goal #1: (Example: Expand recycling program to include most materials/reduce trash pick ups by 50%)
Your answer
Goal #1 Start Date:
MM
/
DD
/
YYYY
Goal #1 Tasks/Strategies to achieve goal (including by whom and by when):
Your answer
Goal #2: (Example: Perform lighting efficiency upgrade to LED for all lights)
Your answer
Goal #2 Start Date:
MM
/
DD
/
YYYY
Goal #2 Tasks/Strategies to achieve goal (including by whom and by when):
Your answer
Goal #3: (Example: create an employee incentive program for public transit and ride sharing, or any practices that will reduce car use)
Your answer
Goal #3 Start Date:
MM
/
DD
/
YYYY
Goal #3 Tasks/Strategies to achieve goal (including by whom and by when):
Your answer
Thank you for carefully considering your goals. Recycle Utah will check in with you every three - five months to see if you’re on track. Please don’t hesitate to contact us should any questions arise involving goal achievement.
Park City Conservation Association (aka Recycle Utah) | 435-649-9698 | www.recycleutah.org
Completion of this application reveals your commitment to goal achievement. The Green Business program is a reputable community effort to recognize businesses for their sustainability endeavors. Recycle Utah reserves the right to withdraw you from the program if goals are not achieved and/or communication is not reciprocated with Recycle Utah staff for up to one year at a time.
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