Ecostar Application

Important: Applications due August 15

denotes required fields.

Contact Information

Contact information of business/non-profit/institution etc:

Name

Address

City

Zip

Number of Employees

Telephone

Website

Award Name Name as you would like it to appear on the award (if awarded).

Contact information for person submitting application:

Name

Title

Telephone

Fax

E-mail

Pollution Prevention (P2) By The Numbers

Summarize the annual P2 results of your business/organization etc. Be as specific as possible and use the EPA P2 data calculators available at the link when feasible. P2 Data Calculator

Hazardous Waste Reduced(type of material/waste)

Amount Reduced

(in pounds)

Money Saved

(in dollars)

Water Use Reduced(type of material/waste)

Amount Reduced

(in gallons)

Money Saved

(in dollars)

Greenhouse Gas Emissions Reduced/Avoided(type of material/waste)

Amount Reduced

(MT CO2e)

Money Saved

(in dollars)

Energy Saved(type of material/waste)

Amount Reduced

(in kWh)

Money Saved

(in dollars)

Non-Hazardous Waste Reduced(type of material/waste)

Amount Reduced

(in pounds)

Money Saved

(in dollars)

Materials Reused(type of material/waste)

Amount Reduced

(in pounds)

Money Saved

(in dollars)

Materials Recycled(type of material/waste)

Amount Reduced

(in pounds)

Money Saved

(in dollars)

Additional Details Regarding P2 Efforts Described Above:

Benefits to the Environment

Applications are judged on the following criteria: environmental benefit (energy & water savings, etc.), economic benefit, leadership, innovation, and ability to be modeled by others.

Describe your P2 efforts and the environmental, ecological, employee or customer health benefits experienced or expected from these P2 efforts, including those associated with life-cycles of products or materials.

Explain how the success of your P2 efforts has eliminated or reduced waste, toxicity or pollution as compared to past years or as compared to standards, averages or common practice?

Commitment and Leadership

Describe how your organization demonstrates commitment and leadership in P2 both internally as well as with suppliers, customers, and the community.

Innovation

Describe how your business/non-profit/community/school etc. is innovative or unique. Explain how you go beyond what is commonplace in your industry, community, organization, or market niche.

Economic Benefits

Discuss the costs and economic benefits of your P2 focus

Include project or program costs, savings and/or increased revenues and decreased disposal and/or raw material costs as a result of your P2 efforts.

Include the expected payback period needed to recover costs of your P2 efforts.

Describe any marketing advantage you may have received as a result of your P2 efforts.

A Model for Others

Explain how your business/non-profit/community/school etc. lends itself to replication by others to enhance P2 efforts community wide/industry wide etc.

Additional Benefits

Describe other benefits that do not fit in the above categories.

Looking Forward: Goals for Next Year

Set a specific, measurable pollution prevention goal for next year (i.e. switch to alternative fuel vehicles for company use, provide incentives for employees to actively engage in P2 practices; replace all cleaners with biodegradable alternatives, etc.)

List at least one step - with a time frame - that you will take next year to achieve this goal.

Renewal of Ecostar Status

Required for past recipients only

Did your business or organization achieve its goal as stated in your past EcoStar application?

Yes

If yes, how? If no, state the barriers and new plans for meeting the goal.

What new achievements did your business or organization accomplish this year towards sustainable pollution prevention (i.e. moving beyond reuse and recycling to a source reduction program; utiliziing an environmentally responsible procurement plan, etc.)?

I AM AWARE THAT A MT DEQ STATE REGULATORY COMPLIANCE CHECK WILL BE CONDUCTED

By submitting this application, I certify that, to the best of my knowledge, I am currently in compliance with applicable environmental regulations and that the information contained within this application is true and correct.

Contact Name

Title

Date

Important: Applications due August 15

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