環(huán)境和健康安全調(diào)查問卷
Environment ﹑Health and Safety Questrionnaire

此問卷為臺達(dá)對相關(guān)方相關(guān)綜合信息調(diào)查的一部分，目的在于了解貴公司相關(guān)環(huán)境及職業(yè)健康安全信息。以促進(jìn)雙方對環(huán)境健康和安全信息的溝通交流，達(dá)成更好的企業(yè)社會責(zé)任，建立良好的企業(yè)形象。請給予配合，謝謝!
The questionnaire is a part of basic information investigation to Delta’s partners. The major purpose is to understand the system at Delta’s partners’ side regarding environment management and occupational health and safety management, to promote the communication on EHS with each other, to implement the social responsibility, and to build good corporate reputation.

1.公司基本信息 General Information:
1.1公司名稱 Company Name:
1.2公司地址 Company Address:
1.3電話號碼 Telephone Number:
1.4傳真號碼 Fax Number:
1.5主要聯(lián)系人姓名及職稱Primary Contact Name and Position
姓名Name： 職稱 Position：
1.6貴公司總占地面積(平方米) The Total Site Area(sq. meter): m2
1.7貴公司為中達(dá)供應(yīng)的產(chǎn)品或服務(wù)的名稱The Product or Service provided for Delta


1.8請描述貴公司附近的狀況(如是否為居住區(qū)、商業(yè)區(qū)等及其分布位置) Please describe the status /environment nearby the company (such as if it’s residential area, commercial area and its location)



2.環(huán)境管理 Environment Management
2.1貴公司是否有專職的環(huán)境管理人員? Is an environment manager assigned in your company?
■是Yes，如果“是”, 請?zhí)峁┮韵侣?lián)系數(shù)據(jù) If “Yes”, please provide the following information:
姓名Name:
電子郵箱地址E-mail:
聯(lián)系電話 Telephone: 傳真號碼 Fax: 否 No
2.2貴公司是否取得下列環(huán)境許可或意見書?Does your company have the operating ermits or consents listed below?
1) 環(huán)境影響評價報告 Environmental Impact Assessment ■是Yes 否No
2) 環(huán)保設(shè)施竣工驗(yàn)收意見書(三同時) Environmental Protection Acceptance Approval (3 Synchronies) ■是Yes 否No
2.3大氣污染物排放 Air Emissions
2.3.1請描述貴公司排放的大氣污染物及其排放源？Please describe the air pollutants and the source of release？
苯、甲苯、二甲苯、乙醇、異丙醇
印刷、腹膜、上光過程排放
2.3.2 貴公司是否定期進(jìn)行大氣污染物的環(huán)境監(jiān)測？Is there any routine monitoring of air pollution taken in your company?
■是Yes 否No
如果“是”，請?zhí)峁┤缦聰?shù)據(jù) If “Yes”, please provide the following information.
2.3.2.1負(fù)責(zé)大氣污染物監(jiān)測的機(jī)構(gòu)名稱 Name of the dept/institution who monitor

2.3.2.2監(jiān)測項(xiàng)目及其監(jiān)測結(jié)果 the items and results of monitoring：
達(dá)標(biāo)排放
(1)監(jiān)測結(jié)果如未達(dá)到國家排放標(biāo)準(zhǔn)，貴公司是否取得污染物排放許可證？Does your company have the Pollutant Discharge Permits if the monitoring results is not within the national allowable air emission standards 是Yes 否No
(2)如果“否”，貴公司是否有計(jì)劃在近幾年內(nèi)進(jìn)行大氣污染物的監(jiān)測？ If “No”, is your company planning to monitor the air pollution in the coming years?
是Yes 否No
2.3.3貴公司是否進(jìn)行大氣污染物處理凈化工程？Is there any air emission control devices been applied to sanitize the air emission sources?
是Yes ■否No 如果“是”，請簡要描述 If “Yes”, please simply describe

2.4 廢水排放 Waste Water Discharge
2.4.1請描述貴公司排放的廢水類型(如工業(yè)廢水、生活廢水或其它)？Please describe the type of waste water generated in your company (such as process wastewater, sewage or others) 工業(yè)廢水
2.4.2 貴公司是否定期對排放的廢水進(jìn)行監(jiān)測？Is there any routine monitoring been taken?
■是Yes 否No
2.4.2.1如果“是” 請?zhí)峁┤缦聰?shù)據(jù) If “Yes”, please provide the following information
(1)負(fù)責(zé)廢水監(jiān)測的機(jī)構(gòu)名稱 Name of the dept/institution who-monitoring :

(2)監(jiān)測項(xiàng)目及其監(jiān)測結(jié)果 The monitoring items and results:
達(dá)標(biāo)排放
監(jiān)測結(jié)果如未達(dá)到國家排放標(biāo)準(zhǔn)，貴公司是否取得污染物排放許可證？Does your company have Pollutant Discharge Permits if the monitoring results is not within the national allowable wastewater discharge standards？
是Yes 否No
2.4.2.2如果“否”，貴公司是否有計(jì)劃在近幾年內(nèi)進(jìn)行廢水的監(jiān)測？If “No”, is your company planning to undertake waste water monitoring in the coming years?
是Yes 否 No
2.4.3 貴公司是否進(jìn)行了污水處理工程Does your company apply the wastewater clean devices? ■是Yes 否 No
如果“是”，請簡要描述 If “Yes”, please simply describe 有污水處理設(shè)備

2.5 噪音污染 Noise Pollution
2.5.1 貴公司是否對廠界噪音進(jìn)行定期監(jiān)測？ In the facility, is there any routine boundary noise monitoring been carried out? ■是Yes 否No
2.5.1.1如果“是”，請?zhí)峁┤缦聰?shù)據(jù) If “Yes”, please provide the following information
(1)負(fù)責(zé)噪音監(jiān)測的機(jī)構(gòu)名稱 Name of the dept/institution who-monitoring :

(2)監(jiān)測結(jié)果 monitoring results: 達(dá)標(biāo)
監(jiān)測結(jié)果如未達(dá)到國家標(biāo)準(zhǔn)，貴公司是否取得污染物排放許可證？Does your company have the Pollutant Discharge Permits if the results is not within the national allowable noise pollution standards 是Yes 否No
2.5.1.2如果“否”，貴公司是否有計(jì)劃在近幾年內(nèi)進(jìn)行噪音的監(jiān)測？If “No”, is your company planning to monitor noise in the coming years? 是Yes 否No
2.6 固體廢棄物管理 Wastes Treatment
2.6.1 貴公司是否制定廢棄物管理控制作業(yè)指導(dǎo)或計(jì)劃?Does your company have a waste control plan? ■是Yes 否 No
2.6.2 貴公司是否采取措施來減少廢棄物的產(chǎn)生?Does your company take any procedure to minimize waste? ■是Yes 否 No
2.6.2.1如果“是”，請簡要描述 If “Yes”, please simply describe：
節(jié)約能源 削減計(jì)劃
2.6.3 貴公司是否產(chǎn)生危險廢棄物?Does the company produce the hazardous waste?
■是Yes 否 No
如果“是”，請簡要描述廢棄物的種類If “Yes”, please simply describe the type of wastes 紙、油墨（罐）、顯影液、洗版水、抹布、膠水

2.6.4 廢棄物是在公司內(nèi)處理還是在公司外處理?Is the waste disposed onsite or offsite? 公司內(nèi) Onsite ■公司外 Offsite
2.6.4.1如果是在公司內(nèi)If “onsite”
(1)請簡要說明公司內(nèi)部處理的廢棄物種類及處理設(shè)備的名稱Please simply describe the type of waste been disposed onsite and relevant disposal devices/equipment.
(2)廢棄物處理設(shè)備是否取得相應(yīng)的運(yùn)行許可證明? Does the disposal devices have the relevant operating permits? 是Yes 否 No
(3)公司是否接受處理來源于公司外的廢棄物? Does the company accept and dispose the wastes for other party? 是Yes 否 No
2.6.4.2如果是在公司外 If “offsite”
(1)請簡要說明處理的廢棄物的種類及其相應(yīng)的廢棄物處理廠商？Please simply describe the type of wastes and the relevant disposal contractors？
廢紙等—富泰紙業(yè) 廢PS版等—紅葉公司 廢油墨（罐）等—園區(qū)各順
(2)廢棄物處理廠商是否取得相應(yīng)的營運(yùn)資格? Does the wastes disposalcontractors have relevant permits or certification? ■是Yes 否No
如果“是”，請?zhí)峁┢鋸?fù)印件。If “Yes”, please provide the copy of the license/certificate.
2.7 環(huán)境管理體系 Environment Management System
2.7.1貴公司是否通過了ISO14000環(huán)境管理體系認(rèn)證？Have the company gotten the ISO14001 certification? ■是Yes 否 No
2.7.1.1如果“是”，請?zhí)峁��?fù)印件。If “Yes”, please provide the copy.
2.7.1.2如果“否”，貴公司是否計(jì)劃在最近幾年取得認(rèn)證？If “No”, does the company plan to apply for the certification in the coming years? 是Yes 否 No
2.7.2貴公司是否制定了由最高管理者確定的環(huán)境政策？Does the company have an environmental policy comfirmed by the top management?
■是Yes 否 No
2.7.2.1如果“是”，請?zhí)峁��?fù)印件 If “Yes”, please provide the copy.
2.7.2.2貴公司是否將方針傳達(dá)到所有為公司工作或代表它工作的人員？如何傳達(dá)？Is the policy communicated to all persons working for or on behalf of the company? Please simple describe the way to communicate?
教育訓(xùn)練、員工手冊

2.7.3貴公司是否建立一套體系以跟蹤收集并持續(xù)更新適合于公司的環(huán)保法律法規(guī)？Has the company established a system to collect, track and update environmental law and legislations applicable to the facility? ■是Yes 否 No
如果“是”，請?zhí)峁└�新的頻率。 If “Yes”, please provide the updated frequency.
每季度
2.7.4環(huán)境目標(biāo)指針和方案
2.7.4.1貴公司是否制定了與貴公司環(huán)境方針一致的環(huán)境目標(biāo)和實(shí)施方案？Has the company established the environmental improvement objectives, performing plan or program to achieve the environmental policy? ■是Yes 否 No
如果“是”，請例舉三項(xiàng)主要的目前正在實(shí)施的環(huán)境目標(biāo)、實(shí)施計(jì)劃或方案。If “Yes”, please describe three significant environmental objectives, performance plans or project in the process of practicing



2.7.4.2貴公司是否制定相應(yīng)的程序追蹤環(huán)境目標(biāo)指針和方案的執(zhí)行過程，并評估其達(dá)成情況，請簡要描述。Has the company established a procedure to track the environmental objective and project practicing process? And has the company have a evaluating procedure? Please describe simply.
重大環(huán)境因素目標(biāo)標(biāo)的及方案追蹤記錄
管理評審

2.7.5貴公司是否有一套系統(tǒng)使得環(huán)保信息及其相關(guān)規(guī)范及時有效地在公司內(nèi)部及外部傳達(dá)？Does the company have a system to make environmental protection information and relevant norm communicate effectively and timely inside and outside the company? ■Yes No
如果“是”，簡要描述(請?zhí)貏e說明信息交流的方式及頻率)？If “Yes”, please simply describe (especially the method and frequency of communication)
教育訓(xùn)練 資料共享 及時
2.7.5.1貴公司是否對其重要環(huán)境因素與外界進(jìn)行信息交流？Does the company communicate externally about its significant environmental aspects?
■是Yes 否No
如果“是”，請簡要描述交流方式：If “Yes”, Please simply describe the content and communicated method ? 電話 mail 傳真等

2.7.6貴公司是否向?yàn)樗�或代表它工作的人員提供綜合環(huán)境知識及環(huán)保培訓(xùn)以確保其具備相應(yīng)的能力？ Does the company provide general environment protection training to the person (s) that working for or on behalf of it, to ensure his/her ability?
■是Yes 否No
2.7.7貴公司是否制定程序追蹤相關(guān)方的環(huán)境活動，并要求其遵守環(huán)保法規(guī)的要求？Does the company establish programs to track its interested party’s environmental action and require them to comply with legal requirements? ■是Yes 否 No
2.8化學(xué)品的操作和儲存 Chemical Handling and Storage
2.8.1貴公司是否有包括名稱及使用部門的化學(xué)品清單？Are there chemical material inventory lists, including material name and used department ? ■是Yes 否 No
2.8.2貴公司是否使用或儲存國家規(guī)定的危險化學(xué)品？Does the company use or store chemical regulated as hazardous or dangerous materials? 是Yes ■否 No
2.8.3貴公司是否在政府部門辦理危險化學(xué)品登記手續(xù)？Has the company registered the handling and storage of hazardous chemical? 是Yes ■否No
如果“是”，請?zhí)峁└郊��?If “Yes”, please provide the copy.
2.8.4貴公司是否制定化學(xué)品的管制文件或計(jì)劃？Does the company have a document control or plan for chemical control? ■是Yes 否No
2.8.5貴公司是否有文件規(guī)定須對參與化學(xué)品操作和儲存的人員進(jìn)行培訓(xùn)？Does the company have documents to provide especial training employees engaged in chemical handling and storage ? ■是Yes 否 No
如果“是”，請?zhí)峁┫嚓P(guān)證明。 If “Yes”, please provide the copy of the proof.
教育訓(xùn)練
2.8.6貴公司是否有化學(xué)品儲存?zhèn)}庫？ Is there a chemical storage warehouse in the company? ■是Yes 否No
如果“是”，此倉庫是否具備公安部門頒發(fā)的消防設(shè)備竣工驗(yàn)收意見書？If “Yes”, does the warehouse have any fire protection device checked & accepted Report?
是Yes 否No
如果“是”，請?zhí)峁└郊�。If “Yes”, please provide the copy
2.8.7貴公司化學(xué)品儲存區(qū)是否有防溢設(shè)施？Are any spill prevention equipment employed in the chemical storage area? ■是Yes □否No
2.8.8貴公司是否有大容量化學(xué)品儲存容器？Does the company have bulk storage tanks? 是Yes ■否No
如果“是”，大容量儲存容器的導(dǎo)出泵是否有靜電防護(hù)設(shè)置和保護(hù)？If“Yes”, does the vent pumpers for the bulk storage tank have ESD protection?
是Yes 否No
2.9石棉 Asbestos
2.9.1貴公司是否使用或持有石棉？Does the company use asbestos or have asbestos in its facilities? 是Yes ■否No
2.9.2請簡要說明使用石棉的地點(diǎn)和使用石棉的類型。Please simply state the location using asbestos and the type of asbestos.

2.10 臭氧耗損物 Ozone Depleting Substances
2.10.1貴公司是否使用臭氧耗損物？Is there any ozone depleting substances used in the company? 是Yes ■否No
如果“是”，請指明使用的臭氧耗損物及其產(chǎn)生源 If “Yes”, please list the ozone depleting substances used in the company and sources.

2.10.2貴公司是否制定了臭氧耗損物的替換計(jì)劃？Is there any ozone depleting substances replacement program or plan in the company? 是Yes ■否No
2.11危險物質(zhì)限制 Restriction of Hazardous Substances
2.11.1貴公司是否制定了對危險物質(zhì)的管理控制作業(yè)程序或計(jì)劃？Does the company have any procedure or plan to control and manage the hazardous substances? 是Yes 否No
2.11.2貴公司是否對產(chǎn)品中的禁止物質(zhì)進(jìn)行鑒別？ Does the company identify the restricted substances in its products? 是Yes 否No
2.12貴公司是否收到過任何形式關(guān)于環(huán)境活動的投訴、改進(jìn)要求通告或罰款？ Has the company received any type of complaints, improvement notices or fines relating to environmental activity? 是Yes ■否No
如果“是”，請簡要描述。If “Yes”, please simply describe.

2.13貴公司是否定期評審其環(huán)境管理體系？若是？請?zhí)峁┰u審頻率。If “Yes”, please simply describe. 兩次/年
3. 職業(yè)健康和安全管理 Occupational Health and Safety Management
3.1貴公司是否有專職的職業(yè)健康和安全管理人員？Is there an occupational health and safety manager appointed in the company? 是Yes ■否No
如果“是”，請?zhí)峁┮韵侣?lián)系數(shù)據(jù)。 If “Yes”, please provide the following information:
姓名Name:
電子郵箱地址 E-mail:
聯(lián)系電話 Telephone: 傳真號碼 Fax:
3.2 貴公司是否取得消防設(shè)施竣工驗(yàn)收意見書？ Does the company have Fire Provention Checked & Accepted report? ■是Yes 否No
如果“是”，請?zhí)峁└郊��?If “Yes”, please provide the copy.
3.3貴公司是否設(shè)置員工食堂？Does the company provide the cafeteria for employees? ■是Yes 否No
如果“是”，食堂是否取得衛(wèi)生許可證 ？If “Yes”, does the cafeteria have any hygienic permit? ■是Yes 否No
如果“否”，請簡要說明未取得的理由。If “No”, please simply describe the reason .

3.4 工傷事故 Industrial Accident
3.4.1貴公司是否制定程序?qū)�工傷事故進(jìn)行報告和管理？ Does the company have a procedure to report and manage the industry injury? 是Yes ■否No
如果“是”，請簡要描述。If “Yes”, please simply describe.

3.4.2最近三年內(nèi)，貴公司是否發(fā)生過重傷或死亡的重大工傷事故？ Is there any serious injury or casualty accident happened in the company during the last 3 years?
是Yes ■否No
如果“是”，請?zhí)峁┳罱�三年�?nèi)貴公司發(fā)生的嚴(yán)重工傷事故數(shù)，并標(biāo)示出重傷或死亡的事故所占比率。If “Yes”, please provide the amount and mark the percentage of serious injury and casualty.

3.4.3貴公司是否按規(guī)定為員工交納工傷社會保險費(fèi)？ Does the company pay the Social Occupational Injury Insurance as regulation? ■是Yes 否No
如果“是”，請?zhí)峁┫嚓P(guān)文件。 If “Yes”, please provide relevant documentation.
3.5職業(yè)病 Occupational Disease
3.5.1貴公司是否有職業(yè)病防治計(jì)劃和實(shí)施方案？ Does the company have the plan and the implementation for the occupational disease prevention?
是Yes ■否No
如果“是”，請加以陳述 If “Yes”, please describe:

3.5.2貴公司是否發(fā)生過職業(yè)病危害事故？Is there any occupational disease happened in the company? 是Yes ■否No
如果“是”，請簡要描述。If “Yes”, please simply describe.


3.5.3貴公司是否為雇員建立職業(yè)健康監(jiān)護(hù)檔案？ Does the company establish the occupational health archives? 是Yes ■否No
如果“是”，請?jiān)敿?xì)說明檔案包括內(nèi)容及保存時間。If “Yes”, please provide the detail and retained time of the archive:

3.6緊急預(yù)案 Emergency Plans
3.6.1貴公司是否制定程序確定潛在的事故或緊急情況，并做出響應(yīng)？Does the company establish procedures to identify potential emergency situation and potential accidents, and make responses? ■是Yes 否No
3.6.2貴公司是否定期進(jìn)行緊急應(yīng)變演習(xí)？ Are emergency preparation and responses drill held periodically? ■是Yes 否No
如果“是”，請?zhí)峁┳罱�一次演�?xí)的時間及參加演習(xí)人數(shù)占全廠員工總數(shù)的比率。If “Yes”, please provide the time of the last drill and percentage of the employee participating in the drill. 2009/11/25 100%

3.6.3貴公司是否安裝緊急報警系統(tǒng)？ Does the company set the alarm system for emergency situation? ■是Yes 否No
如果“是”，貴公司是否定期對系統(tǒng)進(jìn)行測試？ If “Yes”, does the company test the system regularly? 是Yes 否No
3.6.4貴公司是否設(shè)置消防儲備用水水池？ Does the company have reservoir for fire fighting? 是Yes 否No
3.6.5貴公司是否提供應(yīng)急照明設(shè)施？ Does the company have emergency lighting devices? ■是Yes 否No
3.6.6貴公司是否對雇員進(jìn)行緊急救援的培訓(xùn)？Do employees receive the training on emergency situation? ■是Yes 否No
如果“是”，請?zhí)峁┡嘤?xùn)類型。If“Yes”, Please provide the type of training.
內(nèi)訓(xùn) 2010/5/18老師來廠培訓(xùn)
3.7職業(yè)健康和安全管理 Occupational Health and Safety Management
3.7.1貴公司是否通過了OHSAS18001職業(yè)健康和安全管理體系認(rèn)證？Has the company gotten the OHSAS18001 certification? 是Yes ■否No
3.7.1.1如果“否”，貴公司是否計(jì)劃在最近幾年取得認(rèn)證？ If “No”, Does the company plan apply for the certification in recent year? 是Yes 否No
3.7.1.2如果”是”，請?zhí)峁┳C件的復(fù)印件。 If “Yes”, Please provide the copy.
3.7.2貴公司是否制定了高層領(lǐng)導(dǎo)簽署的職業(yè)健康和安全政策？ Does the company have an Occupational Health and Safety policy signed by the top managemer?
是Yes ■否No
3.7.3貴公司是否建立一套體系以跟蹤收集并持續(xù)更新適合于公司的職業(yè)健康和安全法律法規(guī)？ Does the company establish a system to collect, track and update the occupational health and safety law and legislation applicable to the company?
是Yes ■否No
如果“是”，請?zhí)峁└�新的時間頻率。 If “Yes”, please provide the updated frequency.

3.7.4貴公司是否制定了為達(dá)成貴公司的職業(yè)健康和安全政策而制定的環(huán)境目標(biāo), 實(shí)施計(jì)劃或方案？ Does the company establish the improvement objectives and performance plan to meet the occupational health and safety policy?
是Yes ■否No
如果“是”，請列舉三項(xiàng)主要的目前正在實(shí)施的職業(yè)健康和安全目標(biāo)、計(jì)劃或方案。If “Yes”, please describe three significant on-going health and safety objectives, performance plans.



3.7.5貴公司是否有一套系統(tǒng)使得職業(yè)健康或安全信息及其相關(guān)規(guī)范及時有效地在公司內(nèi)部及外部傳達(dá)？ Does the company have a system to make occupational health or safety information and relevant norm communicate effectively and timely inside and outside the company? 是Yes ■否No
如果“是”，請簡要描述(請?zhí)貏e說明信息交流的方式及頻率)？If “Yes”, please simply describe (especially the way and frequency of communication)

3.7.6雇員是否有參加崗前和崗位OHS培訓(xùn)？Do employees receive pre-employment and on-job OHS training? 是Yes ■否No
如果“是”，請?zhí)峁┫嚓P(guān)的記錄。 If “Yes”, please provide relevant records .

3.7.7貴公司是否鼓勵員工參與職業(yè)健康安全管理體系的實(shí)施管理？Does the company encourage employees to participate in OHS performance and management?
如果“是”，請簡要描述。 If “Yes”, please simply describe the method.

3.7.8貴公司是否制定程序追蹤相關(guān)方的職業(yè)健康和工業(yè)安全活動, 并要求其遵守法規(guī)的要求？ Does the company have a procedure to track the interested party’s OHS, Industrial safety action and require them to comply with legal requirements? 是Yes ■否No
3.8貴公司是否因違反OHS法規(guī)收到過任何形式的投訴、改進(jìn)要求通告或罰款？Has the company received any complaints; improvement requirement notices or fines relating to disobey with OHS legal requirements? 是Yes ■否No
如果“是”，請簡要描述。 If “Yes”, please simply describe.

3.9車間空氣質(zhì)量 Air Quality Onsite
3.9.1貴公司工藝流程中是否有毒有害氣體或粉塵產(chǎn)生？ Are poisonous, pernicious gas or powder generated during the production processes? ■是Yes 否No
3.9.2如果“是”，貴公司是否定期對所在車間空氣進(jìn)行職業(yè)健康衛(wèi)生監(jiān)測？If “Yes”, does the company monitor air onsite regularly? 是Yes ■否No
如果“是”，請?zhí)峁┴?fù)責(zé)監(jiān)測的機(jī)構(gòu)名稱及監(jiān)測結(jié)果。If “Yes”, please provide the name of the dept/institution who monitoring air onsite and results.

3.10貴公司是否對工作現(xiàn)場的溫度進(jìn)行監(jiān)控？ Does the company monitor the temperature of work field? ■是Yes 否No
如果“是”，請?zhí)峁┳罱�一次的監(jiān)測時間及監(jiān)測結(jié)果。 If “Yes”, please provide the time and results of last monitor. 溫濕度管控表

3.11貴公司作業(yè)場所是否有足夠的照明？ Have the work field gotten adequately light?
■是Yes 否No
3.12貴公司是否配置了勞動防護(hù)用具？ Does the company employee the Personal Protective Equipment for employee?
如果“是”，請?zhí)峁┢鋶徫幻�稱及其所配備的勞動防護(hù)用具。If “Yes”, please list the type of the Personal Protective equipment and the using station.
手套 口罩 眼罩

3.13貴公司是否有儲備飲用水水池？ Does the company have the reservoir for drinking water? 是Yes ■否No
如果“是”，貴公司是否定期進(jìn)行消毒清洗？ If “Yes”,Is it been disinfected and cleaned regularly?
3.14貴公司是否定期對飲用水質(zhì)進(jìn)行檢測？Does the company have drinking water tested regularly? 是Yes ■否No
如果“是”，請?zhí)峁┳罱�一次的檢測報告。 If “Yes”, Please provide the tested report for recent time.
3.15貴公司特殊崗位作業(yè)人員是否接受了崗前的培訓(xùn)？ Are all employees engaged in especial operation received the training before working? ■是Yes 否No
3.16貴公司是否有特種設(shè)備？(如電梯、叉車、天車、壓力容器、鍋爐等) Does the company have particular equipment (e.g. Lift, forklift, air carrier, pressure container, boiler, natural gas station, etc.)? ■是Yes 否No
如果“是”，貴公司有何種特種設(shè)備？是否依法律法規(guī)進(jìn)行年檢？操作特種設(shè)備人員是否持有相關(guān)證件？及是否有進(jìn)行年審？If “yes”, what kind of particular equipments does the company have? Is there annual check per the law and regulations? Does the operators have relevant certificates? And are the certificates checked annually?
電梯、叉車
年檢

3.17貴公司是否有防雷系統(tǒng)？ Does the company have thunder-proof system?
是Yes 否No
如果“是”，是否依法律法規(guī)進(jìn)行年檢？ If “yes”, is the thunder-proof system being checked annually per the law and regulations?

3.18貴公司是否有高壓供電及低壓配電房？Does the company have rooms of high-voltage electricity supply and low-voltage reassignment?
是Yes 否No
如果“是”，高壓供電系統(tǒng)是否進(jìn)行測試？If “yes”, is the high-voltage electricity supply system being tested?

3.19貴公司是否有訂定特種作業(yè)崗位及人員名單？Does the company have a clear definition of particular positions and the name list of the worker?
■是Yes 否No
如果“是”，特種作業(yè)人員是否進(jìn)行體檢? 特種作業(yè)人員是否發(fā)放勞保用品？ If “yes”, do the worker have a medical inspection? Do the worker have labor protection supplies?


3.20貴公司是否有緊急廣播系統(tǒng)？ Does the company have emergency broadcasting system? ■是Yes 否No
如果“是”，緊急廣播系統(tǒng)是否定期進(jìn)行測試？ If “yes”, is the emergency broadcasting system tested periodically?
是
3.21貴公司是否對車間進(jìn)行噪音監(jiān)測？ Does the company have the noise in the workshop monitored? ■是Yes 否No
如果“是”，請?zhí)顚懴铝袛?shù)據(jù)。If “yes”, please finish the questionnaire hereinafter.
3.21.1請?zhí)峁┴?fù)責(zé)監(jiān)測的機(jī)構(gòu)名稱及監(jiān)測結(jié)果。Please provide the name of the monitoring institution in charge and the monitoring result.
自測
3.21.2監(jiān)測結(jié)果是否超標(biāo)？Does the result go beyond the standard?
是Yes ■否No
如果“是”，請?zhí)峁┫鄳?yīng)的防范措施。If “yes”, please suggest how to prevent?

3.22貴公司廠房及宿舍消防通道是否暢通？ Is the fire fighting channel smooth in the workshops and the dormitories in the company? ■是Yes 否No
如果“否”，請?zhí)峁┫鄳?yīng)的改善措施。If “no”, please suggest ways to improve.

3.23貴公司廠房及宿舍消防設(shè)備(滅火器、應(yīng)急燈、逃生圖等)數(shù)量是否足夠？Does the company have sufficient fire fighting equipments (e.g. fire extinguisher, emergency light, flee-for-life map) in the workshops and the dormitories? ■是Yes 否No
如果“否”，請?zhí)峁┫鄳?yīng)的改善措施。If “no”, please suggest ways to improve.