Green Business Application
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GENERAL BUSINESS INFORMATION
Business Name *
Street Address *
Mailing Address (if different) *
Type of Business *
Days/Hours of Operation
Number of Employees
Property *
Business property total square footage (heated space only). Include all properties and indicate whether they are owned or leased. If you don't know exactly, please approximate. *
CONTACT
Name/Title *
Email *
Phone *
COMPANY BIO/INTRODUCTION
The 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.
Please make a brief statement about your company’s commitment to environmental sustainability, including your future goals.
Please provide any addition information you would like to share about your company (awards, recognition, etc.).
Please select the utilities you pay for: *
Required
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 the Schedule(s) that your meter(s) are on (see Rocky Mountain Power bills)?
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 the tariff noted on your Dominion bill?
Water: What is your annual cost for water?
Trash & Recycling: What is your annual bill for trash? Recycling? How many pickups do you have each week of trash? Recycling?
Transportation: Have you taken measures to reduce employee commutes or business travel? If yes, please explain.
Purchasing: What measures have you taken to reduce purchases/business supplies, and/or products that your business distributes?
Chemicals: Does your business use or store any toxic products on site, e.g. cleaning supplies that contain chlorine, ammonia, paints, pesticides? If yes, please explain.
Which level do you want to go for?
Clear selection
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; or reduce trash pick ups by 50%)
Goal #1 Tasks/Strategies to achieve goal (including by whom and by when):
Goal #2: (Example: Perform lighting efficiency upgrade to LED for all lights)
Goal #2 Tasks/Strategies to achieve goal (including by whom and by when):
Goal #3: (Example: create an employee incentive program for public transit and ride sharing, or any practices that will reduce car use)
Goal #3 Tasks/Strategies to achieve goal (including by whom and by when):
Please provide an additional contact
Thank you for carefully considering your goals. Please don’t hesitate to contact us should any questions arise involving goal achievement.
Park City Conservation Association (dba Recycle Utah) | 435-649-9698 | www.recycleutah.org
Completion of this application reveals your commitment to environmental action. The Green Business program is a reputable community effort to recognize businesses for their sustainability endeavors. The Green Business Program reserves the right to withdraw you from the program if progress is consistently delayed for impact on community goals and environmental leadership.
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