Please fill this questionnaire and fax it to +971 4 2975086, or e-mail to in order to give you our quotation. Please let us know if you require any clarification; we will be glad to help.
GENERAL
Organization Name / :If member of a group,
give the group name / :
P. O. Box / :
City, Country / :
Telephone No. / :
Fax No. / :
E-Mail Address / :
Office Timing / :
Contact Person(s) / :
Designation/Mobile No. / :
ORGANIZATION DETAIL
Product or service of your organizationScope of certification
(Specify activities, you
want certified)
Number of sites included in the system
Locations
Distance from Head-Office
No. of employees
(please fill where applicable) / Management
(Including Supervisors) / Laborers
1 / Design & Engineering
2 / Purchasing / Procurement
3 / Marketing & Sales
4 / Production / Service
5 / Site (Construction / Installation)
6 / Material & Product Stores / Warehouses
7 / QC, Inspection & Testing Lab.
8 / Maintenance
9 / Delivery & Dispatching
10 / Technical Support
11 / Servicing
12 / Administration
13 / Finance
14 / Safety & Environment
15 / Others …
TOTAL
How many of the above are unskilled workers?
How many shifts are operated?
CERTIFICATION DETAILS
Proposed Standard: / ISO 9001:2000 / ISO 14001:2004 / OHSAS 18001:2007Require a pre audit: (Yes / No): / Any Other Standard:
Expected Audit Dates: ( Please specify) / Pre-assessmentDate(If required):
Language: / Certification Audit Date:
Authorized Signature: / Designation:
Name: / Date:
…. FOR OFFICE REVIEW….
EA Sector/NACE / :
Accreditation / :
Man-days / :
ENVIRONMENTAL SYSTEM INFORMATION
(Fill only if applying for Environmental System Audit)
Specify your type of Industry (Chemical, Construction, trading etc.)Approximate area (Sq. Ft)
What are your major processes or activities? (e.g. painting, metal fabrication, office operation)
Please tick the type of discharges or emissions whichyour industry / facility produces? / Waste water discharge
Hazardous waste
Air emissions / smoke / chemical /fumes / odor
Chemical waste
asbestos
Other (Please specify)
Which aspects of your activities have significant impact on environment? / Solid Waste Management
Use of Raw Material
Chemical Use
Energy Use (Electricity, petroleum, natural gas)
Hazardous Waste Management
Air Emissions
Storm Water
Noise
Significant use of water
Petroleum Storage Tanks
Other: (Please specify)
Please specify below
Process / Activity / Department / Main Environmental Aspect
Do you have any environmental permit? If yes, what type?
Are environmental regulations related to your industry identified and implemented?
Date/month since ISO 14001:2004 environment management system is implemented?
Any other important information you would like to mention:
SAFETY SYSTEMINFORMATION
(Fill only if applying for Safety System Audit)
Specify your type of Industry (Chemical, Construction, trading etc.)Approximate area (Sq. Ft)
Please write your major processes or activities (e.g. painting, metal fabrication, office operation)
Please identify the major type of processes / activities in your organization? / Office work
Construction
Welding
Painting
Metal fabrication
Chemical production & handling
Ware house & storage
Food processing
Trading
Others:
Please specify major hazards in your industry
Process / Activity / Department / Main hazard
Do you have anysafety permit? If yes, what type?
Are safety regulations related to your industry identified and implemented?
Is risk assessment carried out periodically in your facility?
Are the employees provided with necessary PPE?
Date/month since OHSAS 18001 safety management system is implemented?
Any other important information you would like to mention:
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