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							DOE G 450.1-5

							    05-27-05



			Implementation Guide for 
			Integrating Pollution Prevention into 
			Environmental Management Systems

[This Guide describes suggested nonmandatory approaches for meeting requirements.  
Guides are not requirements documents and are not construed as requirements in any 
audit or appraisal for compliance with the parent Policy, Order, Notice, or Manual.]


U.S. Department of Energy
Washington, D.C. 20585

PREFACE

DOE G 450.1-5, Implementation Guide for Integrating Pollution Prevention into Environmental 
Management Systems, is one in a series of Guides that suggest approaches to meeting 
requirements of DOE O 450.1 (Change 1, 1-24-2005), Environmental Protection Program, dated 
4-15-03, which requires all Department of Energy (DOE) elements to ensure that Integrated 
Safety Management Systems include Environmental Management Systems that provide for the 
systematic planning, integrated execution, and evaluation of pollution prevention (P2) actions.  

DOE G 450.1-1, Implementation Guide for use with DOE O 450.1, Environmental Protection 
Program, dated 2-18-04, and DOE G 450.1-2, Implementation Guide for Integrating 
Environmental Management Systems into Integrated Safety Management Systems, dated 8-20-04, 
provide an overview and a detailed guide to Integrated Safety Management System (ISMS) and 
Environmental Management System (EMS) integration, respectively.  This Guide provides 
guidance on integrating P2 into ISMS/EMS.  

INTRODUCTION

Purpose

This document provides discretionary guidance for implementing the P2 requirements of      
DOE O 450.1, which requires implementation of sound stewardship practices that are protective 
of the air, water, land, and other natural resources impacted by DOE operations.  This objective 
is to be accomplished by implementing EMSs as part of existing ISMSs.  As part of that 
integration, DOE O 450.1 requires DOE elements, and contractors whose contracts include the 
CRD, to provide for the systematic planning, integrated execution, and evaluation of P2 and 
reduce or eliminate waste, pollutants, and Class I ozone-depleting substances (ODS) at DOE 
facilities through source reduction, reuse, segregation, and recycling and by procuring 
recycled-content materials and environmentally preferable products and services.  This Guide 
suggests approaches to integrating P2 into ISMS/EMS.  

Applicability and Scope

This Guide is for use by all DOE elements, including the National Nuclear Security 
Administration (NNSA) and contractors required to implement DOE O 450.1.  It can also be 
used by DOE elements and contractors not subject to DOE O 450.1 as they prepare the EMS 
required under Executive Order 13148, Greening the Government Through Leadership in 
Environmental Management, or as they comply with Acquisition Letter AL-2002-05, Greening 
the Government Requirements in Contracting. 

Use of Guidance

DOE Guides are not requirements documents and should not be construed as requirements in any 
audit or assessment of compliance with the associated Policy, Order, Notice, or Manual.  This 
Guide suggests acceptable methods for integrating P2 into site operations.  Other methods that 
are equally effective in meeting these requirements may be used.  

Background

The Resource Conservation and Recovery Act (RCRA), amended by the 1984 Hazardous and 
Solid Waste Amendments, made the elimination or reduction of hazardous waste generation a 
national policy.  Waste generators are required to develop and implement waste minimization 
programs and Federal procuring agencies to develop affirmative procurement programs to ensure 
that products composed of recovered materials will be purchased to the maximum extent 
practicable and consistent with applicable provisions of Federal procurement law.  

The Pollution Prevention Act of 1990 declared as national policy that

	“…pollution should be prevented or reduced at the source whenever feasible; 
	pollution that cannot be prevented should be recycled in an environmentally safe 
	manner, whenever feasible; pollution that cannot be prevented or recycled should 
	be treated in an environmentally safe manner whenever feasible; and disposal or 
	other release into the environment should be employed only as a last resort….”

P2 is also promoted through a series of Executive Orders (E.O.) imposing requirements 
on the activities of Federal agencies as follows:

*	E.O. 13101, Greening the Government through Waste Prevention, Recycling and Federal 
	Acquisition; 
	
*	E.O. 13123, Greening the Government through Efficient Energy Management; 
	
*	E.O. 13221, Energy-Efficient Standby Power Devices; 
	
*	E.O. 13148, Greening the Government through Leadership in Environmental 
	Management; 
	
*	E.O. 13149, Greening the Government Through Federal Fleet and Transportation 
	Efficiency; and  
	
*	E.O. 13327, Federal Real Property Asset Management.  
	
DOE Acquisition Letter (AL) 002-05 describes the roles and responsibilities of the DOE 
procurement community as they partner with other DOE personnel to implement the Federal 
government’s Greening the Government initiatives.  The Acquisition Letter cites Federal 
Acquisition Regulation [(FAR) Title 48 Code of Federal Regulations (CFR), 23.705, which 
requires that contracts for operation of government facilities contain the Waste Reduction 
Program clause (48 CFR 52.223-10)].  That clause requires contractors to establish a program to 
promote cost-effective waste reduction in all operations and facilities covered by the contract. 

The Acquisition Letter also indicates that contracts for operation of a DOE facility should 
contain the clause at Department of Energy Acquisition Regulations (DEAR) 
48 CFR 970.5233-2 if the purpose of the contract includes the procurement of any such items 
designated in the EPA Comprehensive Guidelines.  That DEAR clause provides for the 
contractor’s participation in the DOE Affirmative Procurement Program, now generally referred 
to as environmentally preferable purchasing. 

An additional DEAR regulation at 48 CFR 970.5223-1, Integration of Environment, Safety, and 
Health into Work Planning and Execution, states that contractors “shall ensure that management 
of environment, safety and health (ES&H) functions and activities becomes an integral but 
visible part of the contractor’s work planning and execution processes.”  The regulation clarifies 
that safety includes P2 and waste minimization.

Many P2 opportunities at DOE sites have already been exploited through past efforts.  
Identifying new, less-obvious opportunities may involve analysis, evaluation, and specialized 
technical know-how to procure, design, or engineer products or processes that advance P2.  The 
EMS provides the framework that allows DOE elements to identify, implement, and evaluate 
those opportunities.  

Overview 

This Guide is a companion piece to DOE G 450.1-2, Implementation Guide for Integrating 
Environmental Management Systems into Integrated Safety Management Systems, to which users 
should refer for information on integrating the EMS with the ISMS.  This Guide is organized 
around the four phases of establishing an EMS:

*	Phase I, Planning and Aspects Identification
	
*	Phase II, Implementation and Operation
	
*	Phase III, Checking and Corrective Action
	
*	Phase IV, Management Review and System Maintenance
	
In Chapters 2-5, this Guide employs the four-phase, ten-step format from DOE G 450.1-2 but 
does not attempt to replicate its material.  The Guide points out where and how P2 and related 
activities such as environmentally preferable purchasing (EPP) and sustainable design can fit into 
an ISMS/EMS.  

CHAPTER 1.  POLLUTION PREVENTION IN THE ISMS/EMS

DOE G 450.1-1, Implementation Guide for Use with DOE O 450.1, dated 2-18-04, describes the 
ISMS and the EMS as similar because both systems strive for continual improvement through a 
cycle of plan —> do —> check —> act.  

Plans are made for programs and procedures to carry out the systems’ scope and purpose and then 
emphasis is placed on doing them.  During and after implementation, plans are checked to assess 
their effectiveness, and any needed corrections are acted upon.  Because of this similar cycle, the 
two systems can be easily integrated into an ISMS/EMS.  

1.1	P2 in the ISMS/EMS
	
P2 is inherent in an integrated ISMS/EMS because it is based on a similar cycle of continuous 
improvement.  DOE O 450.1 requires that the ISMS/EMS provide for P2 systematic planning, 
integrated execution (doing), and evaluation and corrective action (checking and acting).  P2 
elements integrate with the ISMS/EMS elements as demonstrated in Figure 1.  

A primary objective of DOE O 450.1 is implementation of sound stewardship practices that are 
protective of the environment.  The most effective way to implement those practices is to integrate 
P2 policies, practices, and technologies into the ISMS/EMS continuous cycle of planning, 
implementing, evaluating, and improving the organization’s environmental performance.  Through 
this integration, P2 is an ongoing process that is the responsibility of all workers and is routinely 
considered at the front-end of the work-planning process for site operations and activities.  

A commitment to P2 can further the EMS goals of addressing the environmental aspects of site 
operations in a consistent and reliable manner through planned and implemented procedures and 
programs.  Reducing and/or eliminating an environmental risk is more efficient and effective than 
mitigating or managing its consequences.  Environmental risks can be eliminated or reduced most 
easily by evaluating P2 opportunities for each existing or new activity before automatically 
resorting to the more traditional alternatives of pollution management, treatment, control, and 
disposition.  

1.2	P2 as Site Policy 
	
As shown in Figure 1, the policy statement sets the stage for the ISMS/EMS cycle.  Incorporating 
P2 in the ISMS/EMS policy statement demonstrates site management’s commitment to achieving 
the DOE O 450.1 requirement for the systematic planning, integrated execution and evaluation of 
P2.  

The P2 component of the ISMS/EMS policy statement does not have to be lengthy.  DOE sites 
have established commitments to P2 in their policy statements by including concepts such as the 
following:

*	including pollution prevention concepts in site research, operations, and community 
	activities,


Figure 1:  Integration of P2/ISMS/EMS.  

*	applying national and DOE goals and policies that will make pollution prevention an 
	integral part of site operating philosophy, and
		
*	an environmental stewardship policy that is committed to integrating pollution prevention 
	and waste minimization, resource conservation, and compliance into site planning and 
	decision-making and to seeking cost-effective means to minimize environmental  
	impacts.  
		
1.3	Putting P2 to Work

P2 works effectively when EPP and P2 operational assessments are imbedded in the ISMS/EMS.  
Integrating P2 with the ISMS/EMS will be easier if the ISMS/EMS team includes people with 
experience in areas such as EPP, sustainable design, waste reduction, ODS use, chemical 
procurement, and recycling.  

Team members’ training, knowledge, and experience will be helpful in identifying 
environmental aspects and opportunities for cost-effective P2 operational assessments and 
solutions.  

P2 operational assessments can lead to solutions when new or existing operations and activities 
are approached as assessment opportunities for possible pollution prevention.  Paragraph 5d(6) 
of DOE O 450.1 and paragraph 9 of the CRD require conducting operational assessments to find 
source reduction, material segregation, and recycle/reuse opportunities.  

P2 operational assessments will vary in scope and scale but all share the same goal:  

To identify methods, services, or products that prevent pollution at the source, or, if that 
is not feasible or cost-effective, minimize the amount of wastes generated, and recycle 
those that are created.  

As part of the life-cycle analysis of existing, new or changing operations, P2 operational 
assessments can range from routinely scanning lists of required chemical purchases and 
identifying and recommending less toxic substitutes, to implementing site protocols requiring 
incorporation of sustainable design principles in new buildings, to formally structured pollution 
prevention opportunity assessments (PPOAs).  

A PPOA is a systematic assessment of a process or activity to identify opportunities to 

*	eliminate or reduce wastes, 
	
*	conserve natural resources, 
	
*	reduce toxic chemical or hazardous material use, and  
	
*	reuse and/or recycle materials.  
	
It involves 

*	understanding the process being reviewed, 
	
*	identifying environmental aspects and their impacts, 
	
*	developing alternative processes or materials, 
	
*	evaluating the cost and technical feasibility of the alternatives, 
	
*	choosing the best alternative, and 
	
*	documenting the findings.  
	
The conduct of a PPOA should include the people who plan and actually operate the process 
under review, and people with experience in areas such as EPP, sustainable design, waste 
reduction, recycling, and environmental compliance.  A PPOA sample worksheet is included in 
Appendix A.  Some commonly used P2 terms and concepts related to P2 operational assessments 
may be found in the glossary.  

CHAPTER 2.  P2 IN PHASE I—PLANNING AND ASPECTS IDENTIFICATION
Current Location on the P2-ISMS/EMS Integration Road Map

Phase I 

Planning & Aspects 
Identification	Phase II 	Phase III 	Phase IV

Phase II

Implementation & 
Operation

Phase III 

Checking &  
Corrective Action

Phase IV

Management 
Review & System 
Maintenance


Step 1—Identify Environmental Aspects

Sites identify and list their activities, products, and services and how they interact with the 
environment to identify environmental aspects and identify the impact of each environmental 
aspect.  

Environmental aspects can be identified through records review, walk-throughs, interviews, and 
activity reviews.  Walk-throughs and employee interviews enhance the record review, reveal 
additional activities that have environmental aspects, and sensitize employees to the 
environmental impact of their activities.  

Helpful records that should be readily available include chemical and materials procurement 
information, toxic release inventory (TRI) reports, material safety data sheets (MSDSs), waste 
management and disposal cost information, and regulatory permits.  

Methods can be organized to be more productive by using an interview or walk-through checklist 
or questionnaire that could ask for the following information.  

*	Are new processes or construction projects planned? Do the plans for these processes or 
	projects address energy and water efficiency and consider the substitution of 
	environmentally preferable materials or processes?
	
*	Are facility renovations planned which could promote pollution prevention and energy or 
	water efficiency through improved lighting, more efficient heating/cooling, or 
	environmentally preferable products or processes? 
	
*	Are projects slated for termination or facilities slated for demolition?
	
*	What is the process for project planning and how are life-cycle costs and impacts 
	considered?
	
*	What chemicals, radiological sources, or hazardous substances are used and in what 
	amounts?
	
*	What wastes are produced and in what amounts?
	
*	How are wastes managed and disposed?
	
*	What emissions are produced?
	
*	What are the water or energy demands involved? Do the plans for these demands address 
	the potential for energy and water efficiency?
	
*	Are pesticides and herbicides used?
		
These methods are valuable for identifying existing potential environmental aspects.  Table 1 
gives examples of identifying environmental aspects and the impacts they have on the 
environment.  

Table 1:  Identify Environmental Aspects (Example)
Aspect
Activity
Impact
Air Emissions 
Fire extinguishers using Class-I 
ozone-depleting substances  
(ODS)
Degrading effect on air quality
Hazardous Waste Generation
Use of formamide in genetic 
sequencing
Degrading effect on air, soil, and 
water; hazardous waste storage 
and disposal

Activity planning forms and process diagrams are valuable tools for identifying any new 
potential environmental aspects.  Some sites use activity planning forms (e.g., operations plans, 
project approval forms, work permits) as a routine practice.  

For example, the experiment safety review form (Appendix B) used at one of the Department’s 
laboratories requires applicants to provide information on the chemicals, controlled substances, 
gases, cryogens, radioactive materials, and biological materials that will be used; the types and 
amounts of wastes that will be generated; and the expected waste disposal method.  Applicants 
also are asked to describe how they plan to minimize waste generation and to identify pollution 
prevention opportunities.  They are asked to order or use the smallest amount of materials 
possible, use recycled materials, and substitute non-hazardous materials.  

A work permit form (Appendix C) requires applicants to identify safety and environmental 
concerns such as whether chemicals or toxic materials will be used.  Applicants also must 
indicate if a PPOA has been done or is not needed.  

Process flow diagrams are often used to identify environmental aspects of existing and new 
activities.  The advantage of a process flow diagram is that it graphically demonstrates materials 
used, resources needed, wastes and emissions created, and the disposal path for the wastes.  
Appendix D illustrates a process flow for an electrical discharge machine.  

Step 2—Determine Significant Aspects

Step 2 involves identifying all the environmental aspects that are regulated or have regulatory 
implications in addition to determining which aspects have significance based on environmental 
or organizational considerations.  

Paragraph 2.1.1 of DOE G 450.1-2 recommends that all environmental aspects subject to 
regulation should be managed through the ISMS/EMS.  The Guide defines these regulatory 
authorities as Federal, host nation, State, or local government agency statutes, laws, or 
regulations or Executive Orders and DOE regulations or directives that include requirements.  
Because of the potential impact of a violation of any regulated environmental aspect, the Guide 
suggests that all regulated aspects be automatically considered significant.  Table 2 provides 
examples of determining significant environmental aspects.  

Table 2:  Determine Significant Aspects (Example)
Aspect
Activity
Impact
Significance
Air Emissions 
Fire extinguishers using 
Class-I ozone-depleting 
substances  (ODS)
Degrading effect on air 
quality
Significant:  based 
on regulatory score 
(CAA, E.O. 13148 
and O 450.1 
provisions)
Hazardous Waste 
Generation
Use of formamide in 
genetic sequencing
Degrading effect on air, 
soil, and water; hazardous 
waste storage and disposal
Significant:  based 
on regulatory and 
overall score

Walk-throughs, interviews, and activity reviews can lead to identifying significant aspects 
resulting from the on-going or proposed activity.  Environmental aspects that do not carry a 
regulatory implication may still be significant and warrant being addressed.  Environmental 
aspects could be significant because of the potential harm that could result from high water or 
power needs, an accident, expensive product or waste management costs, or high volume of 
generated waste.  Environmental aspects could also be significant for programs that are crucial to 
fulfillment of a site’s mission.  Again, the presence of experienced P2 personnel on the 
ISMS/EMS team can aid in identifying and ranking significant environmental aspects.  

Including these experienced personnel on the ISMS/EMS teams, implementation review teams, 
and in line management is advantageous because they will be able to see the opportunity for P2 
operational assessments at the earliest part of work planning.  The possibility of including a 
PPOA or P2 solution is at its greatest in the earliest stage of activity planning because it will be 
perceived as a benefit to site operations and mission accomplishment from the start rather than a 
possibly expensive add-on after activity planning has progressed and important decisions have 
been made.  

Step 3—Set Objectives and Targets

In this step, objectives and targets are established to address significant environmental factors.  
Objectives are environmental performance goals and targets are specific, measurable steps to 
achieve objectives.  The environmental objectives and targets must be formalized, which means 
management must agree with the findings and associated resource needs.  

Objectives and targets will flow from the P2 solutions identified through assessments of existing 
and new projects or activities or will be based on DOE Orders and DOE’s pollution prevention 
goals (Appendix E), and Executive Orders.  For example, DOE O 450.1 requires sites to develop 
and implement programs and procedures to maximize the use of safe alternatives to ODS.  
(NOTE:  Class I ODS for all nonexcepted uses will no longer be procured after December 31, 
2010.)

An objective could be to comply with the Order’s requirement and targets could include phasing 
out Halon portable fire extinguishers by 2005 and replacing all nonexempt chillers by 2008.  
Gaining management approval of the objectives and targets will probably be easier when they 
are based on the Department’s P2 goals and DOE O 450.1.  Table 3 provides examples of setting 
objectives and targets.  

Table 3:  Set Objectives and Targets (Example)
Aspect
Activity
Impact
Significance
Objective/Target
Air 
Emissions 
Fire 
extinguishers 
using Class-I 
ozone- 
depleting 
substances 
(ODSs)
Degrading 
effect on air 
quality
Significant:  
based on 
regulatory 
score (CAA, 
E.O. 13148 and 
O 450.1 
provisions)
Objective:  discontinue procurement of Class I 
ODS for all but non-excepted uses by 12-31-10.  

Target 1:  inspect all fire extinguishers for Class 
I ODS use in 1st quarter of FY05

Target 2:  develop prioritized list of fire 
extinguishers using Class I ODS for replacement 
by end of  3rd quarter of FY05

Target 3:  using list, replace all fire 
extinguishers using Class I ODS by end of FY10
Hazardous 
Waste 
Generation
Use of 
formamide in 
genetic 
sequencing
Degrading 
effect on 
air, soil, and 
water; 
hazardous 
waste 
storage and 
disposal
Significant:  
based on 
regulatory and 
overall score
Objective:  identify possible alternatives to 
formamide

Target 1:  form P2 opportunity assessment team 
in 1st quarter of FY05

Target 2:  complete P2 opportunity assessment 
by end of 3rd quarter of FY05

ISMS/EMS objectives and targets should be developed and described specifically to ensure that 
they can and will be implemented and that progress and outcomes can be measured as required in 
the checking and corrective action phase of the ISMS/EMS (see step 8 in chapter 4).  Specificity 
also makes it easier to develop the processes, plans, resources, training needs, and timelines 
necessary to ensure that the targets, and ultimately, the objectives are achieved.  

Even though environmental aspects subject to regulation are normally evaluated as significant, 
P2 opportunities should still be considered.  If the operational controls built into the ISMS/EMS 
are geared solely to compliance, opportunities to eliminate or reduce a waste stream and its 
associated cost advantage could be lost.  A PPOA might reveal that use of an environmentally 
preferred product could result in regulatory compliance through a reduction in waste generation 
thereby contributing to the site’s progress in achieving its P2-related ISMS/EMS objectives and 
targets and moving beyond compliance.  

A PPOA could lead to removing an activity from regulatory control.  Los Alamos National 
Laboratory found that using a mixture of absorbents and microbes that digest oil-contaminated 
soil resulted in soil that no longer had to be specially managed and disposed of as a New Mexico 
special waste and could be used as base fill for the construction or renovation of vehicle parking 
lots and equipment storage areas.  

Conducting PPOAs can be ISMS/EMS objectives and targets.  An objective could be the 
completion of a PPOA on an operation and/or process with significant waste stream generation.  
Or, the objective could be to reduce the generation of a hazardous waste stream by 25 percent 
over a 2-year period, with the first target being the completion of a PPOA of the operation and/or 
process creating that waste stream.  

CHAPTER 3.  P2 IN PHASE II—IMPLEMENTATION AND OPERATION
Current Location on the P2-ISMS/EMS Integration Road Map

Phase I 

Planning & 
Aspects 
Identification	Phase II 	Phase III 	Phase IV

Phase II

Implementation & 
Operation

Phase III 

Checking &  
Corrective Action

Phase IV

Management 
Review & System 
Maintenance


Step 4—Document the ISMS/EMS

In this step, team members ensure that the EMS requirements in DOE O 450.1 are documented 
and fully incorporated into the existing ISMS.  

DOE O 450.1 lists several P2 requirements for inclusion in the ISMS/EMS, some of which will fit 
into the site’s policy statement, objectives and targets, or operational controls and environmental 
management programs.  P2 requirements that should be addressed in the ISMS/EMS by DOE 
elements are as follows (DOE O 450.1 paragraph references are shown in brackets):

*	Provide for the systematic planning, integrated execution, and evaluation of P2 [4a(1)];
	
*	Reduce or eliminate the generation of waste, the release of pollutants to the environment, and 
	the use of Class I ozone-depleting substances (ODS) through source reduction, re-use, 
	segregation, and recycling and by procuring recycled-content materials and environmentally 
	preferable products and services [4b(3)];
	
*	Obtain, as appropriate, local community advice relative to requirements of Executive Orders 
	13101, 13221, 13123, 13148, and 13149 [5d(3)];
	
*	Incorporate, where appropriate, environmentally and economically beneficial landscape 
	practices into all new landscaping programs, policies, and practices [5d(4)];
	
*	Ensure, where appropriate, implementation of centralized procurement and distribution 
	programs (e.g., pharmacy) for purchasing, tracking, distributing, and managing materials with 
	toxic or hazardous content [5d(5)];
	
*	Conduct operational assessments, such as PPOAs, of site operations to identify opportunities 
	for source reduction, material segregation, recycle/reuse, or other P2 projects and implement 
	cost-effective P2 projects, using life-cycle assessment concepts and practices in determining 
	return-on-investment (5d(6)];
	
*	Ensure site annual budgetary processes include the funding and resources necessary to 
	implement P2 program implementation and monitoring [5d(7)];
		
*	Monitor progress toward meeting the P2 requirements spelled out in paragraph 4b(3) (see 
	second item in this list) and make the information available on an annual basis [5d(9)];
		
*	Develop and implement a program and procedures to maximize the use of safe alternatives to 
	ODS whereby procurement of Class I ODS for all nonexcepted uses is discontinued by 
	December 31, 2010 and ODS removal or reclamation is coordinated with the Department of 
	Defense (DoD) [5d(10)];
	
*	Consider P2 in the specification and acquisition of departmental supplies to cost effectively 
	maximize procurement of environmentally preferable products [5d(11)];
	
*	Coordinate all acquisitions with DOE’s “Green Acquisition Advocates” established pursuant to 
	Acquisition Letter, AL-2000-03, superseded by AL-2002-05 dated 07/10/02, as appropriate 
	[5d(12)]; and
	
*	Comply with the requirements of the Emergency Planning and Community Right-to-Know Act 
	(EPCRA or Title III of Superfund Amendments and Reauthorization Act of 1986) and the 
	Pollution Prevention Act of 1990 [5d(13)] .  
	
The DOE O 450.1 CRD lists the P2 requirements for contractors whose contracts contain it. Those 
requirements are listed below with the paragraph reference shown in brackets:

*	Provide for the systematic planning, integrated execution, and evaluation of P2 [1(a)];
	
*	Reduce or eliminate the generation of waste, the release of pollutants to the environment, and 
	the use of Class I ozone-depleting substances (ODS) through source reduction, re-use, 
	segregation, and recycling and by procuring recycled-content materials and environmentally 
	preferable products and services [2(c)];
	
*	Assist DOE in its efforts to obtain, as appropriate, local community advice relative to 
	requirements of Executive Orders 13101, 13221, 13123, 13148, and 13149 [4];
	
*	Assist DOE in meeting its requirements under EO 13148 by ensuring, where appropriate, 
	implementation of centralized procurement and distribution programs (e.g., pharmacy) for 
	purchasing, tracking, distributing, and managing materials with toxic or hazardous content [5];
	
*	Incorporate, where appropriate, environmentally and economically beneficial landscape 
	practices into all new landscaping programs, policies, and practices [6];
		
*	Monitor progress toward meeting the P2 requirements spelled out in paragraph 2(c) (see 
	second item in this list) and make the information available on an annual basis [7];
	
*	Consider P2 in the specification and acquisition of departmental supplies to cost effectively 
	maximize procurement of environmentally preferable products and coordinate, as appropriate, 
	all acquisitions with DOE’s “Green Acquisition Advocates” established pursuant to 
	Acquisition Letter, AL-2000-03, superseded by AL-2002-05 dated 07/10/02, as appropriate 
	[8];
	
*	Conduct operational assessments, such as PPOAs, of site operations to identify opportunities 
	for source reduction, material segregation, recycle/reuse, or other P2 projects and implement 
	cost-effective P2 projects, using life-cycle assessment concepts and practices in determining 
	return-on-investment [9];
	
*	Develop and implement a program and procedures to maximize the use of safe alternatives to 
	ODS whereby procurement of Class I ODS for all nonexcepted uses is discontinued by 
	December 31, 2010 and ODS removal or reclamation is coordinated with the Department of 
	Defense (DoD) [12]; and
		
*	Assist DOE with the requirements of the Emergency Planning and Community Right-to-Know 
	Act (EPCRA or Title III of Superfund Amendments and Reauthorization Act of 1986) and the 
	Pollution Prevention Act of 1990 [13] .  
	
Step 5—Develop Environmental Management Programs

An Environmental Management Program (EMP) is created to achieve goals, objectives, and 
targets set for significant environmental aspects.  The EMP records the significant aspect  
being addressed, explains why it is significant, and describes the objectives and targets established 
to address the aspect.  The EMP will also describe required organizational resources, timeframes, 
and performance indicators to track progress, operational controls, roles and responsibilities, and 
training that might be required.  The scope of the EMP will depend on the site’s preference.  An 
EMP could be developed for each significant aspect or several related aspects could be addressed 
by a single EMP.  Alternatively, an EMP could be facility- or process-specific.  

The EMP should contain all the elements necessary to implement the P2 opportunities discovered 
through the PPOA or to undertake the suggested PPOA.  Just as the ISMS/EMS objectives and 
targets should be described with specificity, the elements necessary to achieve them should also be 
described clearly and thoroughly in the EMP.  

Step 6—Develop Operational Controls

Operational controls are either engineering controls or administrative controls put in place 
through the EMS to address objectives and targets.  Engineering controls are mechanical 
interventions (e.g., replace hose fittings with a more durable fitting to reduce air emissions) 
whereas administrative controls rely on procedural approaches (e.g., procurement specifies 
purchase of particular fittings.)  Operational controls spell out what will be done to achieve the 
objectives and targets.  

The operational controls required to achieve the P2 objectives and targets should be developed by 
a team consisting of the people who will carry out the control as well as experienced EPP, 
sustainable design, waste reduction, and recycling personnel.  These individuals may be able to see 
P2 opportunities in the way the controls are developed and carried out.  Table 4 provides examples 
of operational controls.

Table 4:  Develop Operational Controls (Example)
Aspect
Activity
Impact
Significance
Objective/Target
Operational 
Controls
Air 
Emissions 
Fire 
extinguishers 
using Class-I 
ozone- 
depleting 
substances  
(ODS)
Degrading 
effect on 
air quality
Significant:  
based on 
regulatory 
score (CAA, 
E.O. 13148 
and O 450.1 
provisions)
Objective:  discontinue 
procurement of Class I ODS 
for all but non-excepted uses 
by 12-31-10.  

Target 1:  inspect all fire 
extinguishers for Class I ODS 
use in 1st quarter of FY05

Target 2:  develop prioritized 
list of fire extinguishers using 
Class I ODS for replacement 
by end of 3rd quarter of FY05

Target 3:  using list, replace 
all fire extinguishers using 
Class I ODS by end of FY10
Operational Control 1:  
replace all fire 
extinguishers using 
Class I ODS

Operational Control 2:  
develop procurement 
process to ensure use 
of approved fire 
extinguishers only

Hazardous 
Waste 
Generation
Use of 
formamide in 
genetic 
sequencing
Degrading 
effect on 
air, soil, 
and water; 
hazardous 
waste 
storage 
and 
disposal
Significant:  
based on 
regulatory 
and overall 
score
Objective:  identify possible 
alternatives to formamide

Target 1:  form P2 
opportunity assessment team 
in 1st quarter of FY05

Target 2:  complete P2 
opportunity assessment by 
end of 3rd quarter of FY05
Modify standard 
operating procedure for 
genetic sequencing to 
replace formamide 
with a non-toxic 
chemical


Step 7—Integrate P2 into ISMS/EMS Procedures 

Standard operating procedures that are related to the ISMS/EMS need to be developed or 
existing procedures should be modified as needed to support the ISMS/EMS.  

Paragraph 4a(1) of DOE O 450.1 and paragraph 1(a) of the CRD require integrated execution of 
P2.  Operational controls and standard operating procedures are the methods that can satisfy this 
Order requirement.  Standard operating procedures describe what will be done, and how and 
when it will be done, and can serve two P2 purposes.  First, new standard operating procedures 
should be written, or existing ones should be modified, to ensure that the operational controls 
developed to execute the PPOA or P2 solution are actually implemented.  

Second, new standard operating procedures can ensure incorporation of P2 into ongoing site 
operations.  For example, in furtherance of DOE O 450.1 paragraph 5d(6) and paragraph 9 of the 
CRD, a site standard operating procedure should require P2 operational assessments of site 
operations that create waste and/or releases to the environment to identify opportunities for 
source reduction, material segregation, recycle/reuse or other P2 projects.  The use of 
environmentally preferable products and sustainable building design principles should also 
become a site standard operating procedure.  Sandia National Laboratories/NM and Los Alamos

National Laboratory modified their standard operating procedures to include sustainable design 
principles and energy efficiency criteria in their construction specifications, engineering 
standards, and operations and maintenance manual.

Other potential standard operating procedures, in addition to the requirement for operational 
assessments, include the following from DOE O 450.1.  The paragraph citations are to the DOE 
element requirement and the CRD respectively:

*	Incorporate environmentally and economically beneficial landscape practices into all new 
	landscaping programs and policies [5d(4); 6];
	
*	Ensure implementation of centralized procurement and distribution programs (e.g., 
	pharmacy) for purchasing, tracking, distributing, and managing materials with toxic or 
	hazardous content to reduce chemical use, waste and cost [5d(5); 5];
	
*	Develop and implement a program and procedures to maximize the use of safe 
	alternatives to ODS (in preparation for December 31, 2010, when procurement of Class I 
	ODS for all non-excepted is to be discontinued), and ODS removal or reclamation is to 
	be coordinated with DoD [5d(10); 12]; and
	
*	Consider P2 in the specification and acquisition of Departmental supplies to cost 
	effectively maximize procurement of environmentally preferable products and services 
	[5d(11); 8].  

CHAPTER 4.  P2 IN PHASE III—CHECKING AND CORRECTIVE ACTION
Current Location on the P2-ISMS/EMS Integration Road Map

Phase I 

Planning &  
Aspects 
Identification	Phase II 	Phase III 	Phase IV

Phase II

Implementation & 
Operation

Phase III 

Checking &  
Corrective Action

Phase IV

Management 
Review & System 
Maintenance


Step 8—Establish the ISMS/EMS Assessment Program

The assessment step is the third part of the plan-do-check-act ISMS/EMS cycle.  Performance 
assessment provides the necessary feedback to determine the effectiveness of the plan and do 
phases and act on any necessary changes.  

For DOE elements, DOE O 450.1 requires 

*	that site ISMS/EMS include the systematic planning, integrated execution and evaluation 
	of programs for P2 [4a(1)]; policies and procedures to assess performance and implement 
	corrective actions, where needed [4a(2)]; and annual review and updating, when 
	appropriate, of measurable environmental goals, objectives and targets [4a(3)];
	
*	monitoring and reporting on site progress toward meeting requirements to reduce or 
	eliminate waste, the release of pollutants to the environment, and the use of Class I 
	ozone-depleting substances [5d(9)]; and
	
*	that operations/field/site office managers ensure that contractor ES&H self assessment 
	programs are established within the framework of DOE P 450.5 and continue to be 
	effective [5d(16)].  
	
The CRD for DOE O 450.1 requires contractors to

*	ensure that the ISMS/EMS provides for the systematic planning, integrated execution and 
	evaluation of programs for P2; assessment of corrective actions to manage, control, and 
	mitigate the effects of activities with significant environmental impacts; and annual 
	review and updating of measurable environmental goals, objectives, and targets [1]; and
		
*	 monitor and report on site progress toward meeting requirements to reduce or eliminate 
	waste, the release of pollutants to the environment, and the use of Class I ozone-depleting 
	substances [7].
	
Progress assessments are easier when objectives are articulated clearly and targets are 
measurable.  The degree of specificity will vary depending upon the information needed to 
assess performance and point to necessary modifications.  Targets and objectives can include 

*	PPOAs conducted; 
	
*	P2 opportunities identified, funded, and implemented; 
	
*	purchases of environmentally preferable products; 
	
*	continued promotion of environmentally preferable procurement; 
	
*	amounts of emissions or wastes generation reduced; 
	
*	cost savings; 
	
*	operational efficiency; 
	
*	corrective actions implemented and assessed for adequacy;
	
*	centralized procurement and distribution of chemicals; 
	
*	elimination or reduction of purchase of ozone depleting substances; 
	
*	enhanced security performance; or 
	
*	reduced worker exposure or mission vulnerability 
	
An assessment of how well P2 is integrated into site activities will, by necessity, involve 
evaluating the adequacy of EMPs, operational controls, and standard operating procedures in 
place to achieve the P2 objectives and targets.  Table 5 provides examples of metrics that can 
be used in the assessment process. 

Table 5:  Checking and Corrective Action (Example)
Aspect
Activity
Impact
Significance
Objective/Target
Operational 
Controls
Checking/Corrective 
Action
Air 
Emissions 
Fire 
extinguishers 
using  
Class-I 
ozone- 
depleting 
substances  
(ODS)
Degrading 
effect on 
air quality
Significant:  
based on 
regulatory 
score (CAA, 
E.O. 13148  
and O 450.1 
provisions)
Objective:  discontinue procurement of Class I 
ODS for all but non-excepted uses by 
12-31-10.  

Target 1:  inspect all fire extinguishers for 
Class I ODS use in 1st quarter of FY05

Target 2:  develop prioritized list of fire 
extinguishers using Class I ODS for 
replacement by end of 3rd quarter of FY05

Target 3:  using list, replace all fire 
extinguishers using Class I ODS by end of 
FY10
Operational Control 
1:  replace all fire 
extinguishers using 
Class I ODS

Operational Control 
2:  develop 
procurement 
process to ensure 
use of approved fire 
extinguishers only 
Target 1:  percentage of 
fire extinguishers inspected

Target 2:  percentage of 
fire extinguishers replaced 

Operational Control 2:  
implementation of 
procurement process  
Hazardous 
Waste 
Generation
Use of 
formamide in 
genetic 
sequencing
Degrading 
effect on 
air, soil, 
and water; 
hazardous 
waste 
storage and 
disposal
Significant:  
based on 
regulatory and 
overall score
Objective:  identify possible alternatives to 
formamide

Target 1:  form P2 opportunity assessment 
team in 1st quarter of FY05

Target 2:  complete P2 opportunity assessment 
by end of 3rd quarter of FY05
Modify standard 
operating procedure 
for genetic 
sequencing to 
replace formamide 
with a non-toxic 
chemical
Target 1 and 2:  team 
formed and opportunity 
assessment completed on 
time

Operational control:

standard operating 
procedure for genetic 
sequencing modified and in 
use

CHAPTER 5.  P2 IN PHASE IV—MANAGEMENT REVIEW 
AND SYSTEM MAINTENANCE
Current Location of the P2-ISMS/EMS Integration Road Map

Phase I 

Planning &  
Aspects 
Identification	Phase II 	Phase III 	Phase IV

Phase II

Implementation & 
Operation

Phase III 

Checking &  
Corrective Action

Phase IV

Management 
Review & System 
Maintenance


Step 9—Develop the Management Review Process

Management review is the periodic review of the ISMS/EMS by senior management (i.e., 
managers who have the authority to make decisions for the site or facility.)  The goal of this 
review is to ensure that the ISMS/EMS continues to be suitable, adequate, and effective for its 
intended purposes:  that is, the ISMS/EMS is appropriate, adequately supported, and 
contributing to achieving site targets and objectives.  

Paragraph 5d(16) of DOE O 450.1 requires that DOE operations/field/site office managers 
ensure that contractor ES&H self-assessment programs are established within the framework of 
DOE P 450.5, Line Environment, Safety and Health Oversight, dated 6-26-97, and continue to be 
effective.  

Paragraph 5d(17) requires that the annual ISMS review process assess contractor ES&H 
performance objectives, performance measures, and commitments based on environmental risks, 
impacts of site activities, and established P2 goals.  

Management review should bring management attention to P2 successes, resource needs, and 
additional opportunities; should assess the adequacy of site P2 processes and activities; and 
should result in recommendations for necessary changes (e.g., new or modified objectives, 
measurable targets, or assessment criteria.) 

Step 10 Develop a Plan to Keep the ISMS/EMS Updated

The ISMS/EMS should be modified as site operations and missions change and new 
requirements are generated by laws, Executive Orders, or DOE directives.  

Regulatory or mission or program changes will require site re-evaluation of environmental 
aspects and their significance, which could lead to modification of objectives, targets, and 
corresponding EMS operational controls.  Successful completion of P2 objectives and targets 
also will trigger a revision of the P2 elements in the ISMS/EMS 

RESOURCES

The following is a brief listing of the types of available P2 resources.  More resources are 
available at http://epic.er.doe.gov/epic/ and http://www.eh.doe.gov/p2/

Affirmative Procurement Program for Recycled Content and Biobased Products—Guidance for 
Compliance with Section 6002 of the Resource Conservation and Recovery Act and Executive 
Order 13101 (http://twilight.saic.com/ap/APPG_2001.htm).  

Buying Green Training (http://www.eh.doe.gov/p2/p2train.asp).  

DOE Pollution Prevention Program Plan 
(http://www.eh.doe.gov/p2/p2integratedhomepage/p2plan.asp).  

DOE Sustainable Design Program (http://www.pnl.gov/doesustainabledesign/).  

Green Landscaping (www.epa.gov/greenacres/).  

Leadership in Energy and Environmental Design 
(http://www.usgbc.org/LEED/LEED_main.asp).  

P2 in the Environmental Restoration Program (http://www.eh.doe.gov/p2/p2iner/).  

Pollution Prevention and Energy Efficiency Leadership (P2/EE) Goals 
(http://www.eh.doe.gov/p2/wastemin/P2goals.PDF).  

Pollution Prevention Opportunity Assessment training 
http://mis.doe.gov/ess/training_catalog_detail.cfm?course_num=000723&skey=none

Responsibilities of DOE site recycling coordinators http://tis.eh.doe.gov/p2/ap/RCduties.doc

Strategic Plan to Implement Executive Order 13101 Greening the Department of Energy through 
Waste Prevention, Recycling, and Federal Acquisition 
(http://www.eh.doe.gov/p2/ap/StraPlan.pdf).  

U.S. Green Building Council (http://www.usgbc.org/).  

GLOSSARY

Bio-based Products—commercial or industrial products (other than food or feed) that use 
biological products or renewable domestic, agricultural, or forestry materials.  (Source:  
E.O. 13101)

Environmental Aspect—elements of an organization’s activities, products, or services that can 
interact with the environment.  (Source:  ISO-14001)

Environmental Impact—a change to the environment, whether adverse or beneficial, wholly or 
partially resulting from an organization’s activities, products, or services.  (Source:  ISO-14001)

Environmental Objective—an overall environmental goal, arising from the environmental policy 
that an organization sets itself to achieve, and which is quantified where practicable.  (Source:  
ISO-14001)

Environmentally Preferable—products or services that have a lesser or reduced effect on human 
health or the environment when compared with competing products or services that serve the 
same purpose.  The product or service comparison may consider raw materials acquisition, 
production, manufacturing, packaging, distribution, reuse, operation, maintenance, or disposal.  
(Source:  E.O. 13101)

Environmentally Preferable Purchasing—Procuring products or services that have a lesser or 
reduced effect on human health or the environment when compared with competing products or 
services that serve the same purpose.  (Source:  E.O. 13101)

Environmental Target—a detailed performance requirement, quantified where practicable, and 
applicable to the organization or parts thereof, which arises from the environmental objectives 
and needs to be set and met to achieve those objectives.  (Source:  ISO-14001)

Life-cycle Assessment—comprehensive examination of a product’s environmental and economic 
aspects and potential impacts throughout its lifetime, including raw material extraction, 
transportation, manufacturing, use and disposal.  (Source:  E.O. 13101)

Pollution Prevention—reducing or eliminating the generation of waste, the release of pollutants 
to the environment, and the use of Class I ozone-depleting substances (ODS) through source 
reduction, reuse, segregation, and recycling and by procuring recycled-content materials and 
environmentally preferable products and services.  [Source:  DOE O 450.1, paragraph 4b(3)]

Recycling—process by which recovered materials are transformed into new products.  [Source:  
Title 40, Code of Federal Regulations (CFR), section 246.101]

Significant Environmental Aspect—an environmental aspect that has or could have a significant 
impact on the environment, the organization, or to the organization’s mission.  (Source:  
ISO-14001)

Source Reduction—any practice that reduces—

*	the amount of any hazardous substance, pollutant, or contaminant entering waste streams 
	or otherwise released into the environment (including fugitive emissions) before 
	recycling, treatment, or disposal and  
	
*	the hazards to public health and the environment associated with the release of such 
	substances, pollutants, or contaminants.  (Source:  Pollution Prevention Act of 1990)
	
Sustainable Design—encompasses the materials used to build and maintain a facility, the energy 
and water needed in its operation, and the ability to provide a healthy and productive 
environment for facility users.  (Source:  Los Alamos National Laboratory Sustainable Design 
Guide)

Waste Prevention—any change in the design, manufacturing, purchase, or use of materials or 
products (including packaging) to reduce their amount or toxicity before they are discarded; the 
reuse of products or materials.  (Source:  E.O. 13101)

Waste Reduction—preventing or decreasing the amount of waste being generated using waste 
prevention, recycling or purchasing recycled and environmentally preferable products.  (Source:  
E.O. 13101)

APPENDIX A.  POLLUTION PREVENTION OPPORTUNITY ASSESSMENT FORMS

Pollution Prevention Opportunity Assessment 
Worksheet 1

Team and Activity Description

Date 	P2OA ID Code	Facility 	

Activity 			

Team Members (*Leader) 	Telephone	MSIN	
 			
Description of Activity to be examined in this P2OA

Pollution Prevention Opportunity Assessment 
Worksheet 2

Activity Flow Diagram

Date 	P2OA ID Code 	Facility  	

Activity 	

Chemical and  
Radioactive Inputs

Material Inputs

Energy Inputs
Name
Qty.

Name
Qty.

Name
Qty.

Activity

Activity 
Time Period

Product or Result Output

Hazardous Waste Output

Non-Hazardous Waste Output
Name
Qty.

Name
Qty.

Name
Qty.

Radioactive Waste Output

Mixed Waste Output

Other
Name
Qty.

Name
Qty.

Name
Qty.

Pollution Prevention Opportunity Assessment 
Worksheet 3

Pollution Prevention Opportunity Description

Date 	P2OA ID Code 	Facility	 

Activity 	

P2O No.  1	 P2O Title 	

Current Practice

Proposed Action

Calculation of Waste Reduction and/or Energy Savings

Calculation of Annual Cost Savings

Current Practice 				Costs

	Waste Disposal Costs		

	Purchasing Costs		

	Labor Costs		

Subtotal of Current Practice Costs = Waste Costs + Purchasing Costs + Labor Costs =		 

Proposed Action 				Costs

	Waste Disposal Costs		

	Purchasing Costs		

	Labor Costs		

Subtotal of Current Practice Costs = Waste Costs + Purchasing Costs + Labor Costs =		 

Annual Cost Savings = Current Practice—Proposed Action = 		 

Calculation of Implementation Cost and Payback

Vendor/Contact Information

Pollution Prevention Opportunity Assessment 
Worksheet 3

Pollution Prevention Opportunity Description

Date 	P2OA ID Code 	Facility	

Activity 	

P2O No.  2	 P2O Title 	

Current Practice

Proposed Action

Calculation of Waste Reduction and/or Energy Savings

Calculation of Annual Cost Savings

Current Practice 				Costs

	Waste Disposal Costs		

	Purchasing Costs		

	Labor Costs		

Subtotal of Current Practice Costs = Waste Costs + Purchasing Costs + Labor Costs =		 

Proposed Action 				Costs

	Waste Disposal Costs		

	Purchasing Costs		

	Labor Costs		

Subtotal of Current Practice Costs = Waste Costs + Purchasing Costs + Labor Costs =		 

Annual Cost Savings = Current Practice—Proposed Action = 		

Calculation of Implementation Cost and Payback

Vendor/Contact Information

Pollution Prevention Opportunity Assessment 
Worksheet 3

Pollution Prevention Opportunity Description

Date 	P2OA ID Code 	Facility	 

Activity 	

P2O No.  3	 P2O Title 	

Current Practice

Proposed Action

Calculation of Waste Reduction and/or Energy Savings

Calculation of Annual Cost Savings

Current Practice 				Costs

	Waste Disposal Costs		

	Purchasing Costs		

	Labor Costs		

Subtotal of Current Practice Costs = Waste Costs + Purchasing Costs + Labor Costs =		 

Proposed Action 				Costs

	Waste Disposal Costs		

	Purchasing Costs		

	Labor Costs		

Subtotal of Current Practice Costs = Waste Costs + Purchasing Costs + Labor Costs =		 

Annual Cost Savings = Current Practice—Proposed Action = 		

Calculation of Implementation Cost and Payback

Vendor/Contact Information

Pollution Prevention Opportunity Assessment

Worksheet 4

Pollution Prevention Opportunities Summary

Date 	P2OA ID Code 	Facility  	

Activity 	

P2O No.
P2O Title
Waste 
Class 
Reduced
Annual Waste 
Reduction or 
Energy Savings
Estimated 
Annual 
Savings
Estimated 
Implementation 
Cost
Payback
1


0
$ 
$ 
years
2


0
$ 
$ 
years
3


0
$ 
$ 
years

Other Brainstorming Opportunities

Pollution Prevention Opportunity Assessment  
Worksheet 5

Final Summary

Date 	P2OA ID Code 	Facility  		

Activity 	

Proposed Opportunities and Discussion

Recommendations and Schedule for Implementation

APPENDIX B.  EXPERIMENT SAFETY REVIEW FORM EXAMPLE
SAMPLE EXPERIMENT SAFETY REVIEW FORM

REVIEW NUMBER (supplied by ERC):       

PRINCIPAL INVESTIGATOR:       	DATE:       

DEPARTMENT/DIVISION/GROUP:       

EXT:       	E-MAIL:       	LIFE NUMBER:       
Project Title:  
     
Location(s):       
Funding Source/Account Number:       
Proposed Start Date and Duration:       
SIGNATURES:
Principal Investigator:

Date:
Experiment Review Coordinator:

Date:


Date:


Date:


Date:


Date:


Date:
Approval

Department Chairperson:  

Date:
Review/Approval Comments:  

Walkthrough Signature:  
Date:
Expiration Date (max 1 yr.):       

FUA Change Required? 0 Y   0 N 
Fire Rescue Run Card Changes Required?  0 Y   0 N
Has a NEPA Review been Performed for this Project? 0 Y   0 N

Project Termination Acceptance Signature:  
Date:  
Comments:       

I.	DEFINE THE SCOPE OF WORK

A.	Description
	
Describe the experiment purpose/scope.  Identify all apparatus that will be used and associated 
requirements.  List special equipment (X-ray generators, lasers, etc.) that will be used during the 
project.  Identify measurement and test equipment, apparatus operating conditions, and 
required maintenance procedures as appropriate.  Include calibration frequency for formal 
calibration requirements.  Attach supporting documents such as engineering calculations, 
drawings, and specifications.  

Indicate if modification of facility is required.  Include the setup and decommissioning phases of 
the experiment.  The Work Permit Process/Form may better address the hazards and controls 
of the set-up and/or tear-down phases.  Indicate if a Work Permit will be used.  

B.	Materials Used /Waste Generated
	
List materials to be used and wastes generated.  Refer to the site Chemical Management 
System for a complete listing of the chemicals in your locations.  Include samples, chemicals, 
controlled substances, gases, cryogens, radioactive materials, and biological material.  You may 
use generic chemical class descriptions for commonly used materials (e.g., organic solvents, 
acids).  List disposal methods.  

Denote disposal method using the codes below.  
Materials Used & Wastes Generated
Disposal Method 
Type 

(Code below)
Estimated Quantity 
(provide units)
Estimated Annual 
Waste Generation 


Per Use
Total/Yr
Note:  Identify Age Sensitive materials or special handling requirements.  
Disposal Method Codes:
Air Emissions
Liquid Effluents
Wastes
P=Point Source
S=Sanitary
H=Hazardous
F=Fugitive
ST=Storm water
I=Industrial (Non-hazardous waste e.g., oils)

O=Other
R=Radioactive


M=Mixed (Radioactive + Hazardous)

RM=Radioactive Medical
MW=Medical

T=Trash

C.	Waste Minimization/Pollution Prevention

Describe how you plan to minimize generation of the wastes described above, and identify 
pollution prevention opportunities.  Consider ordering/using the smallest amount, using recycled 
materials, and substituting non-hazardous materials.  The Pollution Prevention and Waste 
Minimization Subject Area describes how to plan, conduct, and close out work activities to 
eliminate or minimize the impact of their activities on the environment.  

II.	IDENTIFY AND ANALYZE HAZARDS ASSOCIATED WITH THE WORK

In this section, indicate the hazards in each class.  Include the setup and decommissioning 
phases of the experiment.  


Physical Hazards (check all that apply)
0 None
0 Cryogens
0 Oxygen deficient atmosphere
0 Noise > 85 dBA
0 Fall hazards (e.g., ladders, elevated platforms, towers)
0 Material handling equipment (e.g., cranes, hoists, forklifts)
0 Machine shop or nonportable powered tools use
0 Electrical hazards (exposed conductors, large batteries, capacitors, etc)
0 Confined space
0 Trenching/soil excavation
0 Extreme temperatures
0 Remote location
0 Other (specify):       
Pressure or Vacuum Systems (check all that apply)
0 None
0 Compressed gases (lecture bottles, cylinders, gas lines)
0 Pressurized vessels or systems
0 Vacuum chambers or systems with >1000 J stored energy
0 Autoclaves
0 Other (specify):       
Fire Hazards (check all that apply)
0 None
0 Open flames
0 Welding, Brazing, Silver Soldering
0 Flammable gases/liquids/solids
0 Other spark producing activity
0 Other (specify):       
Chemical Hazards (check all that apply)
0 None
0 Carcinogens
0 Highly acute toxins
0 Reproductive toxins
0 Corrosives
0 Flammable liquids
0 Flammable solids
0 Strong oxidizers
0 Oils
0 Explosives
0 Peroxidizables
0 Pyrophoric materials
0 PCBs
0 Asbestos
0 Pesticides/herbicides
0 Controlled substances
0 Highly reactive materials 
0 Perchlorates
0 Toxic metals (e.g., As, Ba, Be, Cd, Cr, Hg, Pb, Se, Ag)
0 Other (specify):       
Ionizing Radiation (check all that apply)
0 None
0 Sealed radioactive sources
0 Windowless radioactive sources
0 Dispersible radioactive materials
0 Neutron-emitting radioactive sources
0 Non-fissionable radioactive materials
0 Fissionable radionuclides
0 Ionizing radiation-generating devices (x-ray sources, accelerators)
0 Other (specify):       
Nonionizing Radiation (check all that apply)
0 None
0 Class II, IIIa, or IIIb (visible <15mW) lasers
0 Class IIIb (nonvisible >15mW) or IV lasers
0 Dynamic magnetic fields >1G at 60 Hz or dynamic electric fields > 1kV/m at 60 Hz
0 Static magnetic fields < 5 G.  No Exposure Form is required
0 Static magnetic fields > 5 G and < 600 G
0 Static magnetic fields exposure. Attach Static 
Magnetic Fields Exposure Form when required.
0 Static magnetic fields ? 600 G

0 Radio frequency (RF) or Microwave sources exceeding 10 mW radiated output
0 Infrared sources > 10 W
0 Ultraviolet sources > 1 W
0 Extremely low frequency (ELF) radio sources
0 Other (specify):       
Biological Hazards (check all that apply)
0 None
0 Regulated etiological agent
0 Recombinant DNA
0 Animals
0 Human blood/components, human tissue/body fluids
0 Human subjects
0 Other (specify):       
Offsite Work (check appropriate box)
0 None
0 Reviewed or controlled by ES&H programs 
at the offsite location
0 Requires additional controls (include in the next 
section)
See “ Identification of Significant Environmental Aspects and Impacts Subject Area” or your ECR if you need 
assistance completing the following table.
Significant Environmental Aspects (check all that apply)
0 None
0 Any amount of hazardous waste generation
0 Any amount of radioactive waste generation
0 Any amount of mixed waste generation (radioactive hazardous waste)
0 Any amount of transuranic waste generation
0 Any amount of industrial waste generation (e.g., oils, vacuum pump oil)
0 Any amount of Regulated Medical Waste (including sharps, hypodermic needles, or syringes)
0 Any atmospheric discharges that require engineering controls to reduce hazardous air pollutants or 
radioactive emissions, or are identified as a Title V emission unit, or require monitoring under 
NESHAP
0 Any liquid discharges that require engineering controls to limit the quantity or concentration of the 
pollutant, or include radionuclides detectable at the point of discharge from the facility, or contain any 
of the chemicals listed on the site’s SPDES permit



0 Storage or use of any chemicals or radioactive materials that require engineering controls – 
see “Storage and Transfer of Hazardous and Nonhazardous Materials Subject Area”
0 On-site or off-site transportation of chemicals or dispersible radioactive materials
0 Any use of once-through cooling water with a flow of 4 gpm—24 hrs/day (10 gpm—8 hrs/day, daily 
use of >15 gpm for >60 days) and discharging to the sanitary sewer
0 Soil contamination or activation
0 Any underground pipes/ductwork that contain chemical or radioactive material/contamination
0 Other environmental aspects related to your work (specify):       
0 Process Assessment Form required (determined by ECR or other qualified person)


III.	DEVELOP AND IMPLEMENT HAZARD CONTROLS

For each hazard identified in the previous section, describe how that hazard is controlled.  
Identify the Engineering Controls (e.g., interlocks, shielding), Administrative Controls 
(e.g., procedures, RWPs), or Personal Protective Equipment (e.g., respirators, gloves; 
see the Personal Protective Equipment Subject Area) that will be employed to reduce 
hazards to acceptable levels. .  

The Experiment Review Coordinator, along with the Principal Investigator (PI) and Building 
Manager, as appropriate, will evaluate this experiment for impacts that will require an update to 
the Facility Use Agreement (FUA), and or Fire/Rescue Run Cards.  

The PI develops and implements hazard controls in consultation with, and using feedback from, 
the personnel who will be performing the work.  

A.	Physical Hazards/Controls 

Hazard
Controls (Administrative, Engineered, Protective Equipment)

Note:	Include maintenance, inspection and testing, and formal calibration, including frequency as appropriate.  

B.	Chemical Hazards/Controls
Hazard
Controls (Administrative, Engineered, Protective Equipment)

Note:	Refer to the “Working with Chemicals Subject Area” for requirements regarding particularly hazardous 
chemicals such as carcinogens, reproductive toxins, and highly acute toxins, including postings, 
decontamination plan, and address above.  
C.	Environmental Hazards/Controls
Hazard
Controls (Administrative, Engineered, Protective Equipment)

Note:	Identify the requirements from applicable waste management subject area (hazardous, radioactive, mixed, 
regulated medical).  List all applicable environmental permits (Suffolk County Art. XII, Title V Emission 
Source, etc.) and the relevant controls required by those permits.  

D.	Radiation Hazards/Controls
Hazard
Controls (Administrative, Engineered, Protective Equipment)

Note:  List sources/materials. Attach or refer to Radiation Work Permits.  

E.	Biological Hazards/Controls
Hazard
Controls (Administrative, Engineered, Protective Equipment)

Note:	List additional approvals/permits/reviews required (e.g.,  Biosafety Committee approval). 

F.	Offsite Work Hazards/Controls
Hazard
Controls (Administrative, Engineered, Protective Equipment)

Note:	List the location of all off-site work and identify any off-site organization whose ESH requirements will be 
followed (e.g., other DOE Labs). Indicate additional controls (not specified above) that are needed.  

IV.	PERFORM WORK WITHIN CONTROLS

All work shall be performed within the controls identified within this document. It is the PI’s 
responsibility to ensure that this document is kept up to date. The PI should consult with the 
ERC as appropriate to determine if changes to this document are significant enough to require a 
new review/document.  

If a hazard assessment may be required for this experiment, the PI should contact the ES&H 
Coordinator and/or the ERC for assistance. The PI should document any hazard assessments 
performed for this experiment in Section VI.  

A.	Training

List all project personnel, indicating they are authorized and competent to perform the work 
described. List the training required for each individual. Identify any certifications or 
experiment-specific training required. Indicate if any project personnel are minors (18 years of 
age). Contact your Training Coordinator and ES&H Coordinator as appropriate for assistance.  

It is the responsibility of the PI to maintain a complete up-to-date list of personnel and their full 
training requirements, and to ensure that training and qualifications are maintained. 


Name
Life/Guest # 
Required Training (Course or JTA code)

Note:	The site Training and Qualifications Web Site contains course offerings and descriptions, required training 
checklist, and employee training records.  

B.	OSHA/DOE Required Medical Surveillance

Indicate if potential exposure is in excess of trigger levels listed.  Exposure evaluation and/or 
medical surveillance may be required.  Additional training may be required for any indicated 
agent.  See SBMS for additional information and controls on the hazards listed.  


Regulated Hazard
Hazard Specific  
Training Trigger
Medical Surveillance Exposure Trigger
0 Inorganic Arsenic
Any day above the OSHA 
action level (without regard to 
respirator use)
30 days/year above the action level 
(without regard to respirator use)
0	Biohazards 
(CDC/NIH/WHO listed 
Agent)
None
See Subject Area for guidance
0 Cadmium
Any day above the OSHA 
action level
30 or more days/year at or above the action 
level
0 Lasers
Use Class IIIb or Class IV 
Lasers
Use Class IIIb or Class IV Lasers
0 Lead
Any day above the OSHA 
action level
30 or more days/year at or above the action 
level
0 Methylene Chloride
Any day above the OSHA 
action level
-	30 days/year at or above the action level
-	
-	10 days/year above the 8-hour TWA PEL 
or the STEL
-	
-	Any time above the 8-hour TWA PEL or 
STEL for any period of time where an 
employee at risk from cardiac disease or 
other serious MC-related health condition 
and employee requests inclusion in the 
program
0 Noise 
Any day above the ACGIH TLV
Any time equal or greater then 85 dBA 
TWA 8-hour dose
0 OSHA Regulated 
Chemicals

Acrylonitrile	Benzene 
Benzidine	1,3 Butadiene

4-Dimethyl aminoazobenzene

Ethylene oxide	Ethyleneimine

Formaldehyde	Vinyl Chloride 
Any day above the OSHA PEL
-	Routinely above the action level (or in the 
absence of an action level, the PEL)
-	
-	Event such as a spill, leak or explosion 
results in the likelihood of a hazardous 
exposure
0 Static Magnetic Fields
Worker who routinely works in 
magnetic field
-	Any time at ³ 0.5 mT (5 G) for Medical 
Electronic Device wearer
-	
-	Any day at ³ 60 mT (600 G) to whole 
body [8 hour average]
-	
-	Any day at ³ 600 mT (6000 G) to limbs [8 
hour average]
-	
-	Any Time at ³ 2 mT (20 G) to whole body 
[ceiling]
-	
-	Any time at ³ 5 mT (50 G) to limbs  
[ceiling]

C.	Emergency Procedures
	
Identify any emergency actions, procedures, or equipment that must be in place to insure 
personnel safety and environmental protection.  Include the Building Local Emergency Plan, 
location of emergency shutoffs, and spill control materials.  

D.	Transportation
	
Identify materials, hazards, and controls for any on-site and off-site transportation of hazardous 
and/or radioactive materials.  See relevant SBMS Subject Areas.  

E.	Notifications
	
The PI or designee should notify building occupants of any activities that might impact them or 
their work, and document this here.  List external personnel/organizations that require 
notification related to experimental activities and/or to be notified of changes (e.g., a Site 
Committee for review/approval, Occupational Medicine Clinic, or Fire/Rescue).  

F.	Termination/Decontamination 
	
Describe any decommissioning plan, including decontamination of the area at termination of the 
experiment.  Identify any hazards and controls, special precautions, or procedures.  Include 
chemical and waste reconciliation.  Indicate if a walk-down or an ERE will be scheduled to 
ensure the area is suitable for future projects.  Indicate if Work Permit Form/Procedure will be 
used.  

G.	Community Involvement Issues
	
Identify issues that may require community involvement (see the Community Involvement in 
Laboratory Decision-making Subject Area) and describe the plan that addresses these issues.  
Attach the Community Involvement Checklist.  

V.	PROVIDE FEEDBACK ON ADEQUACY OF CONTROLS AND CONTINUE 
   	TO IMPROVE SAFETY MANAGEMENT

Provide comments on the review process, including the review form and communication.  
Identify any lessons learned or worker feedback contributing to modifications/improvements to 
the controls or process.  

VI.	ATTACHMENTS

Use this section to include any hyperlinks and/or additional documents, hazard assessments, 
figures, and tables that could not be entered into the previous sections of the form.  

Attachment 1.  Sample Signature Sheet

The PI is responsible for communicating the requirements in this Experiment Safety Review 
(ESR) to the project workers.  One way to accomplish this is to have each worker read the ESR 
and sign an agreement form, such as the one below.  This sheet is not submitted as part of the 
review process.  

I have read this Experimental Safety Review document and understand the 
hazards associated with my work activities and the controls in place to mitigate 
those hazards.  I understand the environmental aspects of my work activities and 
will continually work to minimize waste generated and look for areas of 
improvement.  I am aware of the training requirements and will maintain my 
qualifications.  

		Signature

Print Name
BNL #
Signature
Date

APPENDIX C.  WORK PERMIT APPROVAL FORM EXAMPLE


	Work Permit #     

	Work Order #     

	Job#         Activity#       

1.  Work requester fills out this section.	
Requester:       
Date:       
Ext.:       
Dept/Div/Group:       
Other Contact person (if different from requester):       
Ext.:       
Work Control Coordinator:       
Start Date:       
Est. End Date:       
Brief Description of Work:       
Building:       
Room:       
Equipment:       
Service Provider :       
2. WCC, Requester/Designee, Service Provider, and ES&H (as necessary) fill out this section or attach analysis
ES&H ANALYSIS
Radiation 
Concerns
0 None
0 Activation
0 Airborne
0 Contamination
0 Radiation
0 Other     
0  Special nuclear materials involved, notify Isotope Special Materials Group
0  Fissionable materials involved, notify Laboratory Criticality 
Officer
Safety Concerns
0  None
0  Ergonomics
0  Transport of Haz/Rad Material
0  Adding/Removing

     Walls or Roofs
0  Confined Space*
0  Explosives
0  Lead*
0  Penetrating Fire Walls

0 Corrosive
0  Flammable
0  Magnetic Field*
0  Pressurized Systems
0  Asbestos*
0  Cryogenic
0  Fumes/Mist/Dust*
0  Material Handling
0  Rigging/Critical Lift
0  Beryllium*
0  Electrical
0  Heat/Cold Stress
0  Noise*
0  Toxic Materials*
0  Biohazard*
0  Elevated Work*
0  Hydraulic
0  Non-ionizing Radiation*
0  Vacuum
0  Chemicals*
0  Excavation
0  Lasers*
0  Oxygen Deficiency*
0  Other       
* Does this work require medical clearance or surveillance from the Occupational Medicine Clinic?  0  Yes  0  No
Environmental Concerns
0  None
0  Work impacts Environmental Permit No.      
0  Atmospheric Discharges (rad/non-rad)
0  Land Use
0  Soil 
activation/contamination
0  Waste-Mixed
0  Chemical or Rad Material Storage or Use
0  Liquid Discharges
0  Waste-Clean
0  Waste-Radioactive
0  Cesspools (UIC)
0  Oil/PCB Management
0  Waste-Hazardous
0  Waste-Regulated Medical
0  High water/power consumption
0  Spill potential
0  Waste-Industrial
0  Underground Duct/Piping
Waste disposition by:       
0  Other       
Pollution Prevention (P2)/Waste Minimization 
Opportunity:  
0  None  0  Yes
FACILITYCONCERNS  
0  None
0  Access/Egress

     Limitations
0  Electrical Noise
0  Potential to Cause a False Alarm
0 Vibrations

0  Impacts Facility Use Agreement
0  Temperature Change
0 Other       
0  Configuration Control
0  Maintenance Work on Ventilation Systems
0   Utility Interruptions
WORK CONTROLS
Work Practices
0  None
0  Exhaust Ventilation
0  Lockout/Tagout
0  Spill Containment 
0  Security (see Instruction Sheet)
0  Back-up Person/Watch
0  HP Coverage
0  Posting/Warning Signs
0  Time Limitation
0  Other       
0  Barricades
0  IH Survey
0  Scaffolding-requires 
inspection
0  Warning Alarm (i.e. “high level”)
Protective Equipment
0  None
0  Ear Plugs
0  Gloves
0  Lab Coat
0  Safety Glasses
0  Coveralls
0  Ear Muffs
0  Goggles
0  Respirator
0  Safety Harness
0  Disposable Clothing
0  Face Shield
0  Hard Hat
0  Shoe Covers
0  Safety Shoes
0  Other      
Permits Required (Permits must be valid when job is scheduled.)
0  None
0  Cutting/Welding
0  Impair Fire Protection Systems
0  Concrete/Masonry 
Penetration
0  Digging/Core Drilling
0  Rad Work Permit-RWP No       
0  Confined Space Entry
0  Electrical Working 
Hot
0  Other       
Dosimetry/Monitoring
0  None
0  Heat Stress Monitor
0  Real Time Monitor
0  TLD
0  Air Effluent
0  Noise 
Survey/Dosimeter
0  Self-reading Pencil 
Dosimeter
0  Waste Characterization
0  Ground Water
0  O2/Combustible 
Gas
0  Self-reading Digital 
Dosimeter
0  Other       
0  Liquid Effluent
0  Passive Vapor 
Monitor
0  Sorbent Tube/Filter 
Pump

Training Requirements (List below specific training requirements)
     
Based on analysis above, the Walkdown Team determines the risk, 
complexity, and coordination ratings below:
If using the permit when all hazard ratings are low, only the 
following need to sign:  ( Although allowed, there is no need to 
use back of form)
ES&H Risk Level:
0  Low	0  Moderate	0  High
WCC:					Date:
Complexity Level:
0  Low	0  Moderate	0  High
Service Provider:				Date:
Work Coordination:
0  Low	0  Moderate	0  High
Authorization to start				Date:

(Departmental Sup/WCC/Designee)
3.  Both work requester and service provider contribute to work plan (use attachments for detailed plans)
Work Plan (procedures, timing, equipment, and personnel availability need to be addressed):       
Special Working Conditions Required:       
Operational Limits Imposed:       
Post Work Testing Required:       
Job Safety Analysis Required:  0  Yes  0  No
Walkdown Required:  0  Yes  0  No
Reviewed by:  Primary Reviewer will determine the size of the review team and the other signatures required based on hazards and job complexity.  
Primary Reviewer signature means that the hazards and risks that could impact ES&H have been identified and will be controlled according to site 
requirements.
Title
Name (print)
Signature
Life #
Date
Primary Reviewer
     
ES&H Professional
     
Other
     
Other
     
Work Control Coordinator
     
Service Provider

Review Done:   0  in 
series
0  team

4.  Job site personnel fill out this section.
Note:  Signature indicates personnel performing work have read and understand the hazards and permit requirements (including any attachments).
Job Supervisor:  
Contractor Supervisor:  
Workers:	
Life#:	
Workers :  	
Life#:	

Workers are encouraged to provide feedback on ES&H concerns or on ideas for improved job work flow.  Use feedback form or space below.

5.  Departmental Job Supervisor, Work Control Coordinator/Designee
Conditions are appropriate to start work:  (Permit has been reviewed, work controls are in place and site is ready for job.)
Name:       
Signature:  
Life#:       
Date:       

6.  Departmental Job Supervisor, Work Requester/Designee determines if Post Job Review is required.  0  Yes  0  No
Post Job Review (Fill in names of reviewers)
Name:       
Signature:
Life#:       
Date:       
Name:       
Signature:
Life#:       
Date:       

7.  Worker provides feedback.
Worker Feedback (use attached sheets as necessary).  

a)  WCM/WCC:  Is any feedback required?  0  Yes  0  No

b)  Workers:  Are there better methods or safer ways to perform this job in the future?  0  Yes  0  No.  
     
8. Closeout:  Work Control Coordinator (authorizing dept.) checks quality of completed permit and ensures the work site is left in an acceptable 
condition.  (WCC can delegate clean up of work area to work supervisor)
Name:       
Signature:
Life#:       
Date:       
Comments:       

INSTRUCTIONS FOR FILLING OUT THE WORK PERMIT

Header Information

The “Work Permit #” line shall be filled in by whatever numbering sequence a given department 
or group wants to use.  The Work Control Coordinator maintains a logbook or spreadsheet of 
work permit numbers issued.  The other three number lines are provided for tracking purposes 
and are filled in as appropriate.  The “Standing Work Permit” box is checked if the permit is 
being used as such.  

Section 1—Work Request

The work requester fills out the required information in this section.  The name in the “Work 
Control Coordinator” line is the requester’s WCC.  The “Service Provider” line is the department 
doing the work.  

Section 2—Hazard Analysis

The work requester initially fills out this section identifying the location hazards, facility concerns, 
work controls, and specific training needs.  The requester provides the work information to the 
service provider and schedules a walkdown of the job site.  A Walkdown Team composed of the 
requester, service provider, and ES&H support personnel (as needed) may provide further input 
for Section #2.  The service provider predominantly identifies the task hazards and appropriate 
controls.  

Notes:

-For each subsection, a “NONE” or a hazard or work control box must be checked.  

-The “Safety Concerns” items with an asterisk indicate work activities that may require Industrial 
Hygiene to investigate, and may then require OMC medical surveillance.  If the workers are 
already on the protocol list for the activity or hazard, then OMC surveillance would not be 
needed and the “No” box would be checked.  If not sure of the worker’s medical status or the 
particular work activity, mark “Yes” and contact Industrial Hygiene to evaluate.  

-When a job involves a significant change to the amount of chemicals or radioactive materials in 
a facility, the Building Manager must be notified to determine if the Facility Hazard Category has 
been affected as per the Facility Use Agreement.  

-For guidance in determining if security concerns are applicable see “Security Checklist.”

-Table 1 and 2 in the screening guidelines attachment provide additional definition to the ES&H 
issues.  

Section 2—Low, Moderate and High Hazard Determination

The bottom part of Section 2 is used by the WCC or Walkdown Team to make a final 
determination as to the rating levels (low, moderate, or high) for ES&H risk, complexity, and 
work coordination.  A given task may be a skill of the worker job, but the complexity of the 
system or the work coordination involved can dictate a higher level of planning.  

If the WCC or Walkdown Team decides that ES&H risk, complexity, and work coordination are 
all low, then the job is categorized as a low hazard and the work permit process can be 
terminated at this point.  If a permit will be used for low hazard work, the Work Control 
Coordinator, the service provider (supervisor, craft, or technician), and an individual authorizing 
work must sign in the lower right hand corner of the front side.  

If any of the ES&H risk, complexity, or work coordination rating levels are checked off as 
moderate or high, then the rest of the work permit form must be processed.  

Section 3—Work Plan

The work plan section is filled out predominantly by the work requester with input from the 
service provider and ES&H personnel as needed.  The job site should be visited by the 
Walkdown Team.  A written description shall detail the job and any precautions that need to be 
taken.  Use attachments for detailed plans (i.e., drawings) and longer narrative if needed.  

If the ES&H risk level is rated high, then a Job Safety Analysis, JSA, must be written and 
attached to the work permit.  

Section 3—Primary Reviewer

It is encouraged to review work permits in a team setting as opposed to circulating the permit for 
review and signoff in series. The team environment has proven to be more effective in achieving 
good ES&H reviews and in coordinating the required resources.  

The primary reviewer is responsible for assembling ES&H and subject matter experts as 
needed for the review based on the ESH risks, job complexities, and overall coordination.  If the 
Primary reviewer is a member of the Walkdown Team, then the team signoff in the “Reviewed 
By” section can occur following the walkdown if desired. Following review and approval, the 
work permit is returned to the work requester for scheduling with the work provider.  

Section 4—Supervisor and Worker Signoffs

A pre-job briefing with the crew to review job hazards, permits, and coordination requirements.  
(Required for moderate and high hazards)

The supervisor and the workers sign the form (or an attachment) to indicate that they 
understand the hazards, the controls and the permit requirements.  

Note:  The workers must sign for themselves; it is not permissible for the supervisor to write 
their worker’s names on the work permit.  

Section 5—Conditions Appropriate to Start Work

The affected department usually authorizes the start of the job.  Without this section, the 
workers could start any time without a final check with the department.  The person signing this 
section verifies that the requirements designated on that permit (work controls, etc.) have been 
met, and that the job may proceed.  

Section 6—Post Job Review

The job supervisor or work requester determines whether a post job review is needed.  In some 
cases, the review team may decide that a post job analysis would be beneficial for lessons 
learned and will request the review.  If a review is requested, print the name of the reviewer(s) 
on the line and check off the “Yes” block.  If no review is needed, check off the “No” block.  

Section 7—Worker Feedback

This section is provided for the workers to feedback comments on ES&H issues from the job or 
on how to improve the work efficiency.  The WCM/WCC may request worker feedback by 
answering yes to Section 7(a); if 7(a) is marked yes, then it is up to the WCM/WCC /Supervisor 
to solicit (and document on the WP or attached sheet) feedback from the workers.  Regardless 
of the answer to 7(a) workers are encouraged to answer Section 7(b).  

Section 8—Closeout

The original copy of the work permit is returned to the Work Control Coordinator who originated 
it initially.  The Work Control Coordinator reviews the permit for consistency, signs off to close it 
out, and files it.  The WCC provides feedback to appropriate personnel if any permit 
discrepancies occur.  

APPENDIX D.  METAL SHOP ELECTRICAL DISCHARGE MACHINE PROCESS MAP

APPENDIX E.  DEPARTMENT OF ENERGY POLLUTION PREVENTION AND 
ENERGY EFFICIENCY LEADERSHIP GOALS*

DOE will strive to minimize waste and maximize energy efficiency as measured by continuous, 
cost-effective improvements in the use of materials and energy, with the years 2005 and 2010 as 
interim measurement points.  

A.	Reducing Waste and Recycling.  
	
*	Reduce waste from routine operations by 2005, using a 1993 baseline, for these waste 
	types:
	
	o	Hazardous 90 percent
	
	o	Low Level Radioactive 80 percent
	
	o	Low Level-Mixed Radioactive 80 percent
	
	o	Transuranic (TRU) 80 percent.  
	
*	Reduce releases of toxic chemicals subject to Toxic Chemical Release Inventory 
	reporting by 90 percent by 2005, using a 1993 baseline.  
	
*	Reduce sanitary waste from routine by 75 percent by 2005, and 80 percent by 2010, using 
	a 1993 baseline.  
	
*	Recycle 45 percent of sanitary wastes from all operations by 2005 and 50 percent by 
	2010.  
	
*	Reduce waste resulting from cleanup, stabilization, and decommissioning activities by 10 
	percent on an annual basis.  
	
B.	Buying Items with Recycled Content.  
	
Increase purchases of EPA-designated items with recycled content to 100 percent, except when 
not available competitively at reasonable price or that do not meet performance standards.  

C.	Improving Energy Usage.  
	
*	Reduce energy consumption through life-cycle cost effective measures by 40 percent by 
	2005 and 45 percent by 2010 per gross square foot for buildings, using a 1985 baseline 
	20 percent by 2005 and 30 percent by 2010 per gross square foot, or per other unit as 
	applicable, for laboratory and industrial facilities, using a 1990 baseline.  
	
*	Increase the purchase of electricity from clean energy sources:
	
	o	Increase purchase of electricity from renewable energy sources by including 
		provisions for such purchase as a component of our request for bids in 100 percent of 
		all future DOE competitive solicitations for electricity.  
	
	o	Increase the purchase of electricity from less greenhouse gas-intensive sources, 
		including, but not limited to, new advanced technology fossil energy systems, and 
		other highly efficient generating technologies.  
	
D.	Reducing Ozone Depleting Substances and Greenhouse Gases.  
	
*	Retrofit or replace 100 percent of chillers greater than 150 tons of cooling capacity and 
	manufactured before 1984 that use class I refrigerants by 2005.  
		
*	Eliminate use of class I ozone depleting substances by 2010, to the extent economically 
	practicable, and to the extent that safe alternative chemicals are available for DOE class I 
	applications.  
	
*	Reduce greenhouse gas emissions attributed to facility energy use through life-cycle cost 
	effective measures by 25 percent by 2005 and 30 percent by 2010, using 1990 as a 
	baseline.  
	
E.	Increasing Vehicle Fleet Efficiency and Use of Alternative Fuels.  
	
*	Reduce our entire fleet's annual petroleum consumption by at least 20 percent by 2005 in 
	comparison to 1999, including improving the fuel economy of new light duty vehicle 
	acquisitions and by other means.  
	
*	Acquire each year at least 75 percent of light duty vehicles as alternative fuel vehicles, in 
	accordance with the requirements of the Energy Policy Act of 1992.  
	
*	Increase usage rate of alternative fuel in departmental alternative fuel vehicles to 75 
	percent by 2005 and 90 percent by 2010 in areas where alternative fuel infrastructure is 
	available.