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IDENTIFICATION OF ASPECTS AND IMPACTS FORM

(1 activity per sheet)

1.0 Describe the activity that you can control or influence:


___________________________________________________________________________________
___________________________________________________________________________________
_________________________________________________________________

2.0 List of Aspects

Situation
Consume Release Discharge Emit Use
Emergency
Abnormal
Normal

Aspects Quantity

3.0 Are the aspect(s) governed by National/International/local government act or law?


Yes No

3.1 Specify the main act, regulation and applicable clause:

______________________________________________________________________________
______________________________________________________________________________
____________________________________________________________

4.0 Are the aspect(s) governed by other requirements? Yes No

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4.1 Specify: (customer requirements, corporate requirement, trade association)

______________________________________________________________________________
______________________________________________________________________________
____________________________________________________________

5.0 Impacts to the environment: Adverse Beneficial

i. Normal
_________________________________________________________________________
_________________________________________________________________________

ii. Abnormal
_________________________________________________________________________
_________________________________________________________________________

iii. Emergency
_________________________________________________________________________
_________________________________________________________________________

6.0 Is there any procedure (s) to reduce and manage the risk to the environment?
Yes No

Specify:
______________________________________________________________________ _______
_____________________________________________________________________________

7.0 Are there any environmental good practices that are in place to manage the environmental impacts?
_____________________________________________________________________________
_____________________________________________________________________________

8.0 Have there been any past emergency situations and accident. Yes No

Specify
___________________________________________________________________________________
_______________________________________________________________________

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9.0 Evaluation of significant

9.1 Criteria for Significance

High – 3; Medium – 2; Low – 1

9.2 High Medium Low

a. Scale of impact to the environment


b. Probability/frequency of occurrence
c. Severity of impact to the environment
d. Concern to interested parties
e. Risk of non compliance to legal and other
requirements
Total score

9.3 Score

Total score greater than 10 is significant


Total score below 10 is not significant provided it is not governed by environmental related
legislation and other requirements.

10.0 Result:
SIGNIFICANT NOT SIGNIFICANT

11.0 Transfer to list of significant environmental aspects and impacts Yes No

If NO please state reason(s) ______________________________________________________


_____________________________________________________________________________

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