PRE-TRAINING SURVEY

The Montachusett Regional Planning Commission (MRPC) and the Massachusetts Office of Technical Assistance (OTA) are launching a program to reduce the risk of severe weather-related industrial accidents by incorporating toxics use reduction into emergency preparedness and hazard mitigation planning. The following questions are designed to gather a baseline of facilities’ needs and understanding of chemical management and emergency preparedness to withstand extreme storm events.  We will use this information to tailor training sessions.  All replies will be kept confidential.  Contact information you provide will only be used should you want to learn more about training, free and confidential technical assistance, or other resources available through MRPC and OTA.

Question Title

* 1. Do any of your facilities store and maintain hazardous materials on site?
(If yes, continue with survey.  If no, thank you for your time.)

Question Title

* 2. How would you rate your facility's level of chemical management and emergency preparedness?

Question Title

* 3. Has/Have your facility(s) conducted a hazard analysis and prepared an emergency response plan?

Question Title

* 4. Have you reviewed or updated your emergency response plan?

Question Title

* 5. Please identify three (3) specific goals related to hazardous chemical management in your plan, if applicable.

Question Title

* 6. Would you be willing to share your emergency response plan with OTA and MRPC?

Question Title

* 7. If yes, please upload the plan here:

DOCX, DOC, JPG, GIF, JPEG, PDF, PNG file types only.
Choose File

Question Title

* 8. Have you shared and reviewed your emergency procedures with your local fire department?

Question Title

* 9. Have your employees been trained in spill response and the implementation of your emergency plan?

Question Title

* 10. Have you identified nearby environmentally vulnerable points of interest (e.g. public water supplies, schools, hospitals, daycare or nursing facilities, etc.) that could be impacted by a chemical event at your facility?

Question Title

* 11. Are you concerned about natural hazards such as flooding, high winds, high heat/cold temperatures, severe rain/snow storms or any other natural hazards?

Question Title

* 12. Are any of your facilities in a flood zone?

Question Title

* 13. Has your facility initiated measures to reduce your use of toxic chemicals and materials?

Question Title

* 14. Has your facility taken measures to reduce the risk of toxic materials being released into the environment from your facility?

Question Title

* 15. Is your city/town required to obtain a NPDES Phase II MS4 Stormwater permit?

Question Title

* 16. If required to have a NPDES Permit, do you have Stormwater Pollution Prevention Plan(s) (SWPPP) for your applicable facilities, such as DPW yards and/or highway garages?

Question Title

* 17. Has/Have your facility(s) taken actions to reduce its energy consumption?

Question Title

* 18. Has your facility taken action to reduce its water consumption?

Question Title

* 19. Are you familiar with the free, confidential technical services provided by OTA?

Question Title

* 20. Would you be interested in learning more about how OTA offers free and confidential services to help communities and businesses reduce their use of toxic materials, decrease energy and water consumption, and secure resources such as grants?

Question Title

* 21. MRPC and OTA will be sponsoring free training sessions geared to communities and businesses with practical tips and suggestions for evaluating and managing chemical safety. Would you like to be included on the invitations list for the training planned as part of this initiative?

Question Title

* 22. When would be a preferable time for you to attend a training session?

Question Title

* 23. OPTIONAL:  Do you have any questions, additional comments and/or concerns?

Question Title

* 24. OPTIONAL: Please fill out below if you would like to receive notice of programs, resources and training available through OTA and MRPC.  All training across the state and other valuable information can be found at www.mass.gov/eea/ota-climate and www.mrpc.org

T