Douglas County Public Works                    Douglas County, Oregon

3 R’S AT WORK AWARD

Application Form


Please print this application and provide the requested information, add additional sheets if necessary.
Or click here to download the .pdf version.

                                                    WB01508_.gif (325 bytes)        Business Nomination                                          WB01508_.gif (325 bytes)         Employee Nomination
 

I.      Business/Employee Name :   __________________________________________
                      Business Address :  ________________________________________________
                      Number of employees : ____________________________

II.     Person completing application :   ____________________________
                      Position :  ___________________________
                      Phone number:  _______________   E-mail:  ____________________

III.   When and how did your waste reduction program begin? Or When and how did the employee become involved in the business          waste reduction program?

 

 

 

 

 

 

IV.   Describe your current recycling program. (Include a list of materials recycled and/or reused in your business). How are
       materials collected, stored and transported for recycling or reuse? And (For employee applications) How is the employee
       involved in the on-site program?

 

 

 

 

V.    Describe any business-wide policies that reduce waste such as using both sides of paper or reusable items. And (For
        employee applications) How is the employee involved in creating or implementing these policies?

 

 

 

 

 

 

 

 

VI.    Describe steps (such as a waste audit) employed to determine amount and type of waste generated at your business site.
        What actions were implemented to reduce that waste. Has the volume of trash been reduced? Have you reduced costs
        associated with disposal? And (For employee applications) What role does the employee play in evaluating waste reduction
        programs?

 

 

 

 

 

 

 

 

VII.    How have employees been informed of the program? How can they participate?  And (For employee applications) How does
         the employee share his/her knowledge and commitment for reducing wastes?

 

 

 

 

VIII.   Describe purchasing practices that encourage waste reduction, ie. buying reusable items, avoiding excess packaging, and
         purchasing items made from recycled materials.

 

 

 

 

 

 

Please FAX, mail, or email completed application by October 31 to:

Douglas County Waste Reduction Manager
433 Rifle Range Road
Roseburg, OR 97470 FAX: 541-440-4881

Questions? Call 541-440-4867
jdpowell@co.douglas.or.us