Small Business Loan Environmental Questionnaire Form

Small Business Loan Environmental Questionnaire Form
Please complete the Small Business Loan Environmental Questionnaire Form to provide essential information about your business’s environmental practices and impacts.
Business Name
Business Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Type of Business Activity
Waste Management Practices (e.g., recycling, hazardous waste disposal)
Average Monthly Energy Usage (kWh)
Average Monthly Water Usage (gallons)
Do you have any on-site air or water emissions?
List any current environmental permits held by your business
Describe any site impacts (e.g., storage tanks, contaminated soil, wetlands, endangered species)
Does your business use, store, or dispose of hazardous materials?
Should be Empty: