HazMat Customer EHS&S Survey
Name
First Name
Last Name
Company
Email
example@example.com
Position
1. We consider HazMat a valued business partner of our company.
*
Stronly Disagree
1
2
3
4
Strongly Agree
5
1 is Stronly Disagree, 5 is Strongly Agree
2. HazMat values our company as a business partner.
*
Stronly Disagree
1
2
3
4
Strongly Agree
5
1 is Stronly Disagree, 5 is Strongly Agree
3. HazMat addresses any concerns our company has in a prompt manner to discover root cause and take corrective action.
*
Stronly Disagree
1
2
3
4
Strongly Agree
5
1 is Stronly Disagree, 5 is Strongly Agree
4. HazMat management supports and is involved in EHS&S performance.
*
Stronly Disagree
1
2
3
4
Strongly Agree
5
1 is Stronly Disagree, 5 is Strongly Agree
5. We receive clear, timely responses from HazMat when requesting service.
*
Stronly Disagree
1
2
3
4
Strongly Agree
5
1 is Stronly Disagree, 5 is Strongly Agree
6. HazMat is committed to continually improving its service.
*
Stronly Disagree
1
2
3
4
Strongly Agree
5
1 is Stronly Disagree, 5 is Strongly Agree
7. HazMat's business practices reflect a strong commitment to complying with all applicable Environmental, Health, Safety and Security regulations.
*
Stronly Disagree
1
2
3
4
Strongly Agree
5
1 is Stronly Disagree, 5 is Strongly Agree
8. HazMat Employees exhibit the importance of EHS&S protection and the role they play as stewards.
*
Stronly Disagree
1
2
3
4
Strongly Agree
5
1 is Stronly Disagree, 5 is Strongly Agree
9. Quality of HazMat’s drivers (appearance, performance)
*
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
10. Knowledge of HazMat drivers (equipment, loading, unloading, safety, compliance)
*
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
11. How would you rate the safety of HazMat’s drivers? (PPE, Safety Procedures, Site Procedures/Rules, etc.)
*
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
12. Quality of HazMat’s equipment (safe operationally, appearance)
*
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
13. How would you rate the overall satisfaction with HazMat?
*
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
14. HazMat's greatest strength is:
15. One area HazMat could improve in is:
16. General Comments:
Submit
Should be Empty: