Dental Office Business Name Business Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Business Phone NumberBusiness Website Point of Contact First Last Point of Contact Phone NumberPoint of Contact Email PPA Visit Date:PPA Specialist's NameCertification DateAmalgam We have no mercury-containing products or materials in our facility. Amalgam wastewater does not go to a septic/on-site sewage system. All contact and non-contact scrap amalgam is stored inside tightly closed containers labeled Dangerous Waste: Mercury and Toxic. Waste Disposal Procedures for handling scrap and trap amalgam waste, vacuum filters, spent X-ray fixer, lead foils, used chemiclave solution, and mercury-containing lights are recorded and readily available to employees. Vacuum filter wastes are treated as a dangerous waste, unless there is an inline filter following the amalgam separator unit. Cold sterilant, such as glutaraldehyde, is diluted to < 4% or (0.01%) and discharged to sewer. A steam autoclave is used to sterilize instruments. A chemiclave is used to sterilize instruments. Spent chemiclave solution is managed as dangerous waste. X-rays Spent X-ray fixer is put in a container labeled “used fixer only” and kept separate from developer. General Maintenance Waste and recycling containers are properly labeled, easily accessible, closed when not in use, and inspected regularly. Waste and recycling containers are placed together to reduce contamination. Water leaks are repaired immediately. Chemicals, grease, or dangerous waste are not dumped down the drain. We conduct routine inspections on our property – such as outdoor storage, waste containers, dumpsters, and drains – to identify and prevent possible contamination sources. Product container lids are kept closed when not in use. We use environmentally friendly cleaning products such as Green Seal, ECOLOGO, EPA’s Safer Choice, etc. We have replaced disposable cleaning cloths such as shop cloths or paper towels with reusable cloths. Waste receptacles are in the bathrooms so that only toilet paper and seat covers are flushed. Stormwater There are no improper connections to storm drains and an “only rain down the drain” policy is followed. Stormwater drains are clearly labeled as “no dumping”. Wash water with soap, detergent, or cleaning product doesn’t go down the storm drains. Company vehicles are washed off-site at a commercial facility. Rakes and brooms are used instead of leaf blowers or hoses when removing dirt and debris. Inventory Management Shipments are inspected for leaks or damage before they are accepted. Vendors take back damaged or unused products. We use an inventory system to streamline product purchasing and prevent overstock. Stock is organized by the to be used by, purchase, or expiration date. Shelf life is considered when purchasing products. Office supplies are reused/recycled whenever possible. Recycled products are purchased whenever possible. When replacing electronics, computers or furniture, eco-friendly/sustainable products are purchased such as Energy Star, EPEAT, etc. Employee Training All employees receive proper product storage, waste disposal, and spill cleanup training. Employees are trained as to why wastewater is not put in the storm drain and their role in protecting the aquifer. Manufacturer’s instructions for all products are followed. Pollution prevention handouts provided during the PPA visit are made available to employees. Employees have been made aware of the Waste Directory and know how to access it. Waste Reduction Dangerous waste hauling service is scheduled to match volume and frequency needs. Equipment is repaired, instead of replaced, when possible. Reduction, reuse, recycling, or elimination of all wastes produced has been explored. Specific procedures have been added to improve our practices overall. We review our disposal and recycling records monthly to monitor the amount of waste generated and evaluate progress in reducing waste, as well as to maintain SQG status. Energy consumption is monitored to identify areas for improvement. Motion sensors, LEDs, or natural lighting is used. Electronic communication with employees and customers is used whenever possible. Printer settings default to double-sided printing. A materials reuse/exchange location is available. Community We participate in, and/or sponsor, neighborhood clean-ups or other projects in our community to encourage environmental stewardship. Provide specific examples. We participate in educating the industry leaders of tomorrow via internships, vocational tech, or college programs. We research, purchase and stay current on new technologies, products, or service innovations that reduce waste or prevent pollution. We encourage other businesses to become EnviroCertified. We encourage our customers to support other EnviroCertified businesses. We support other certified businesses in our community whenever possible. We advertise our EnviroCertified status in our customer outreach materials (website, social media, ads, newsletters, etc.). We promote the Waste Directory to customers. Other sustainable actions that you are taking that are not listed in this application:Visit Notes:
