ORF GREEN TEAM

PROPOSED INITIATIVE

Facilities/Technical

Please use this form to propose initiatives that are technical and/or facility-related. For educational/training initiatives, please use the “Education/Training” form.

* Please fill out as much as you can. If the item is unknown, please leave it blank. If the question is not applicable, please enter “N/A”.

Short Title:______

Detailed description:

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Which of the following benefits will the proposed initiative achieve? (Check all that apply)

☐Energy savings

☐Water savings

☐Environmental benefit (other than energy or water savings)

☐Health benefit

Please describe the benefits of the proposed initiative as identified by the checked boxes:

______

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If the benefit is energy savings, please estimate the energy savings and payback period:

Estimated energy savings? ______

Estimated payback? ______

Proposed step-by-step strategy for full implementation:

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Are any of the following required to implement the proposal (check all that apply, and provide comments):

☐Expanded use of an existing product

☐Change of product with same function

☐Adoption of a new technology

☐Equipment installation

☐Design

☐Construction

☐Training

☐Research

☐Other

Does the initiative involve acquisition of a product not already in use? If so, describe product and estimated purchase quantity:

______

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Estimated timeframe for completion of initiative? ______

Estimated cost to implement? ______

Estimated maintenance costs?______

Please identify any systems or equipment that may be impacted during/after implementation:

______

On-going projects or other activities that may be impacted during/after implementation:

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For each activity or system, describe the nature of impact and estimated timeframe of any impact to equipment or systems:

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Please identify personnel(or offices)thatneed to provide approval for all or part of the initiative:

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Please identify personnel (or offices)who should be involved in the implementation of the initiative:

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Notes and status updates:

Date / Status Update/Comments

ORF GREEN TEAM

PROPOSED INITIATIVE

Education/Training

Please use this form to propose initiatives that arerelated to education and/or training. Fortechnical and/or facility-related initiatives, please use the “Facilities/Technical” form.

* Please fill out as much as you can. If the item is unknown, please leave it blank. If the question is not applicable, please enter “N/A”.

Short Title:______

Detailed description:

______

______

______

______

______

Which of the following benefits is the proposed initiative expected to achieve? (Check all that apply)

☐ Energy savings

☐ Water savings

☐ Environmental benefit (other than energy or water savings)

☐ Health benefit

Please describe how education/training will contribute to the benefits identified by the checked boxes:

______

______

______

______

Proposed step-by-step strategy for full implementation:

______

______

______

______

______

______

______

Will this be a one-time, or recurring training? ______

Estimated timeframe for completion of training? ______

Please identify personnel(or offices)thatneed to provide approval for all or part of the education/training initiative:

______

______

______

______

Please identifypersonnel (or offices) who should attend the training:

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______

______

______

What facilities, equipment, or other resources are needed to conduct the education/training?

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Are the resource identified above currently available, or is an acquisition required?

______

Notes and status updates:

Date / Status Update/Comments