供应商物料环境管理体系调查表(中英文)
供应商调查表中英文版

This Survey is prepared by 该调查表填写人Name 姓名
Title 职位Date 日期
The Company undertakes the above information is true and believable 本公司承诺以上资料真实可信附加材料说明
1、营业执照复印件(提供有效期内的有年检的营业执照复印件,字迹清晰并加盖公章)
2、开户许可证(提供有效期内的有年检的营业执照复印件,字迹清晰并加盖公章)
3、经销商提供代理证书或长期经销合同,代理产品或企业ISO9000认真复印件(字迹清晰,加盖公章)
4、生产企业提供企业认证证书复印件(字迹清晰,加盖公章)
5、企业情况介绍
XXCo., Ltd recognises the confidentiality of the information you provide and will treat the information accodingly.XX 有限公司认可贵司对于提供信息的保密性,
please complete the survey and send the email to the following address 请认真填写该调查表并以邮件的形式发送到下面的地址Department 部门:Sourcing Superior 采购主管
Email 邮箱M.B.手机Address 地址
SUPPLIER EVALUATION SURVAY
供应商调查表。
供应商环境管理调查表

需施加影响。
批准:____________
Result/现状 Yes No
Plan / Schedule
(如暂未完成,请注明计划)
2 3 4 5 6 7 8 9 10 11 12 13 14
供应商自我评价及环境改善计划:源自填报:___________
批准:____________
(请签名,并注明时间和职位)
评审结果: (以下由添威厂QA部填写) 环境管理合格; 需现场审核; 其它要求: 审核: ______________
供应商环境管理调查表 Environment Management of Supplier
供应商:
供应商联系人: Tel: Fax: E-mail: 年 月 日
Item
1
Question/ 调查问题
是否已通过ISO14001体系认证,何时获证? 是否建立环境管理体系(环境手册、程序文件)? 是否全体成员明白并理解公司所制定的环境政 策? 是否对全体成员进行环境保护的宣传与培训?是 否有相关的记录? 公司在生产经营活动中,对环境造成的影响因素 有哪些?即排放的污染有哪些? 对影响环境的因素,是否进行分类管理? 对不同的影响因素是否制定符合法规要求的企业 排放标准? 是否有相关的污染排放测试手段及测试记录?在 不具备测试手段时,如何保证污染排放达到标 准? 近期是否有国家/行业污染物排放抽查?如有结 果如何? 是否发生过重大环境事故或严重投诉? 是否进行内部环境体系审核?(如有,评审记录 及频次;如无,请说明原因) 是否进行管理评审?(如有,评审记录及频次; 如无,说明原因) 是否对你的供应商及协作伙伴、施加影响,提出 环境保护的要求,以达到共同改进?如有:相 关记录。 是否从产品开发、设计、生产、销售各个环节, 都考虑到环境保护的要求?
供应商调查表中英文

Managment profile 管理层简介
Name 姓 名
Specific Title 职位
E'mail
Note: Attach an organization chart if available请附上组织架构图
PQ: 4.007.000
Rev Q
Page 6 of 27
SUPPLIER SURVEY FORM 供 应 商 调 查 表
Supplier Name供应商名称:
SUPPLIER SURVEY FORM 供 应 商 调 查 表
COMPANY/SUPPLIER PROFILE供应商简介
Years in Business 经营年数:
Address 地址:
Business Classification (Large, Medium, Small) : 经营规模 (大, 中, 小)
COMPANY/SUPPLIER OPERATIONS PROFILE 供应商运作简介
Products or Services Description 产品或服务说明:
Regulations/Regulatory Agencies complied (UL, TUV, BABT, etc.) 符合的法规 (UL, TUV, BABT, 等.):
Company 公司名称
Award 奖 项
Year 年 度
List your company top 5 customers 列出前5位主要客户:
If you have a Company Strategic Plan please provide a copy.如果有公司战略性计划, 请提供一份复印件
Industrial Standards followed (NEMA, MMPA, IEC, etc) 遵循的工业标准(NEMA, MMPA, IEC,等)
供应商调查表(中英文参照)

填表日期
成立日
传真
法人代表
租赁
m2
工人 手机 手机 手机 利润 利润 利润
版本V.10.05
概况
中文名称
地址
公司性质 投资方 及股比
占地面积 自有
公司历史 沿革
下属工厂 或
分支机构 概况
主要产品/ 业务产品/业Biblioteka 业绩状况主要用户 (汽车行
业)
主要用户 (其它行
业)
与SVW的 主要
产品/业务
设备状况
员工状况
总数
公司负责人 营销负责人 销售联系人
姓名 及职位
姓名 及职位
姓名 及职位
资产总额 财务状况 (近3年) 资产总额
单位:万元 资产总额
认证情况 认证规格
资料提供
其它信息
供应商调查表 QUESTIONARY
行业 租赁
英文名称 邮编 电话
注册资本 m2 建筑面积 自有
主要项目 主要项目
管理 电话 电话 电话 负债总额 负债总额 负债总额 获得年度
技术/其中 设计研发 E-mail E-mail E-mail 营业收入 营业收入 营业收入 认证机关
供应商审核检查表中英文版

Light bulbs, fixtures, skylights or other glass suspended over any ingredient or packaging material exposed in any step of the operation are protected to prevent contamination.
Fixtures, ducts and pipes that drip or form condensation are not suspended over working areas where a potential of contamination may occur.
生产区域上方,设备、管路上的冷凝水、滴漏将是ห้องสมุดไป่ตู้在的污染
无不符合要求的储存:垃圾、废品、未切割的种子或者草,适合昆虫繁殖和鼠类藏匿的场所
There is adequate drainage in all areas to prevent the contamination of components through seepage or foot-borne filth.
在原料和包装材料上方的灯具、天窗以及其他悬挂的玻璃制品,必须有防护
Adequate ventilation or control equipment is provided to minimize odors and noxious fumes or vapors in areas where they may contaminate components
Separation by partition, location or other effective means is provided for those operations that may cause contamination of food products with undesirable microorganisms, chemicals, filth or other materials.
供应商调查表中英文版

供应商调查表中英文版供應商調查表編號(Code):年月日公司名稱(CompanyName) 中文Chinese 英文English公廠地址Factory Address公廠聯系電話Factory Phone NumberTel:Fax:辦公室地址Office Address辦公室電話Office Phone NumberTel:Fax:業務代表人Sales Representative業務聯系電話Sales Contact NumberTel:Fax:公司法人代表(中方)Company Owner法人代表(港.奧.臺.外方)公司營業證號Irrelevant to oversea vendor公司稅務證號Irrelevant to oversea vendor公司年營業業績Company Turn Over公司性質Company Type公司組織架構Company Structure管理人員狀況Management Personnel 高級管理人員/HigherLevel Manager 人, 中層管理人員/Mid Level Manager 人, 基層管理人員/Supervisory 人.技術人員/Engineer 高級工程師/Senior Engineer 人,工程師/Engineer 人, 技術人員/Technician 人.品管人員Quality Control Personnel 品管管理人員/QC Manager 人,品質工程師/QC Engineer 人, QA 人,QC 人,IQC 人.員工狀況No. of Worker 1.員工人數/Worker 人.2員工通過培訓/Trained Worker 人.3員工有拿到上崗證/Worker with working permit 人.品質系統Quality Certificate 1.有無通過ISO品質系統/Factory passed ISO Audit: 有無2通過哪個論證系列/Certification passed: ISO9001 GMPC QS14001,其它/Others主要產品Mainstream Product 1. 2. 3. 4.5. 6.月產能MonthlyProduction主要設備List of Majore Machinery儲存狀況Storage area 工廠總面積/Factory Floor Area 平方米,倉庫總面積/Warehouse Floor Area 平方米,儲存量/Store Volume 立方米.運輸能力狀況Transportation Capability車輛/No. Of Truck 輛,噸位/No. of Tonne樣板/Sample:合格/Pass:不合格/Fail:驗廠員/Auditor: 采購部主管/Purchasing Supervisor: 經理/Purchasing Manager:。
供应商基本材料调查表中英文对照版

has been presented发行日期.
Others其他:
1. Production activity产量:75 - 90 %
(based on one calendar year)公历年为基础50 - 74 %
< 49 % or > 90 %
2. Quality assurance质量保证:
6. Main focus technology主要关键技术:__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _
7. company size / area ( for production/administration)公司规模/面积_ _ _ _ __ __ __ _
Certification according to ISO 14001/OHSAS18001认证情况
Scheduling / Contact联系人
Production sites生产场所
Products产品
Main clients主要客户
Audited by接受的审核
Turnover营业额
Year年:
approx.约:万元(RMB)
Personnel人员
Total no总计.
QA
Year年
approx.约:万元(RMB)
Main suppliers主要供应商
Main prematerials主要材料
Organisational chart
8. Website/Email网址/邮件:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
供应商环境管理物质管制情况调查表

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第 1 页,共 4 页
FM:PE-07002-05(E)
调查项目 Item 18.有使用化学危险物品吗? Does the company apply hazardous chemical substances? 19.对化学危险品设有专门的管理文件并单独存放于化学 危险品仓吗? Does the company set up special management ducuments for hazardous chemical sustances and store them in a separate warehouse? 20.用电,用水,用油,用纸等能源资源利用方面有浪费 现象吗? 哪一方面节约潜力最大? Is there any waste in energy utilization, such as electricity, water, oil and paper? Which aspect has the greatest potential of curtailment? 21.包装材料是否回用? Will the packaging materials be reused? 22.环境保护违法行为行政处罚信息:如有,请说明 Any Information on official Penalty due to Violation 1.管理评审中是否包含了对环境管理物质控制的决议 Is the decision about Environment-related Substances control included in the management review? 2.环境管理物质控制的项目在整个组织内是否得到有效传 达 Is information about controlling Environment二,职责 2. Accountability related Substances effectively communicated throughout the company? and Responsibility 3.最高管理者是否对顾客进行了承诺 Does top management have a commitment statement affirming the company's commitment to control and management of Environment-related Substances? 4.相关部门是否有明确的职责 Are there the assigned and clear responsibilities for the related departments? 1.是否收集了包括环境管理物质在内的相关信息 Does the company collect information related to environmental management system, including Environment-related Substances? 三,文控 2.是否将这些信息传达到相关部门,是否使供应商也了解 3. Documentation Does the company communicate these information to and Records related departments and to its customers? 3.应制定文件及记录的保存期限 Do documents and records have a specified expiration date? 1.组织是否制订关于环境管理物质的教育训练计划并实施 Does the company provide Environment-related Substances training program to managers and workers? If yes, please describe how training is implemented. 四,培训 4.Training 2.是否有考核的依据并实施考核 Does the company implement evaluation and have an evaluation foundation? 3.是否有对仓库或制程中接触并参与环境管理物质进行特 殊培训 Is there the special training for the personnel who handle and process the Environment-related Substances? 1.工程图,规格书是否有标注禁止使用的环境管理物质 Do the engineering drawing and specifications remark the restricted Environment-related Substances? 2.变更的范围和定义是否明确 Are the change and definition clear ? 3.当改变生产方式,地点,设备或供应商时是否以文件呈 核形式取得权责单位评估及认可后才进行 五,设计与变更管制 Does the company have the documented procedure of 5. Change and evaluation if changing the production methods, Design Control places, equipments and suppliers ? 4.任何材料或镀层间物质分配方式变更,是否重新提供第 三方验证单位之分析报告给客户并重新进行承认或更新承 认书承认 In the event of changes to the allocation of any material and plating coats, is analysis report by a verification agent delivered to the customer for approval or is the acknowledgement renewed? 1.是否对材料供应商提出了禁止使用环境管理物质的要求 Does the company restrict the material vendors to use the Environment-related Substances?
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序号审核要素分数(0,1,2,NA)备注-1*Do you have an Environmental Management System(RoHS, REACH, Holagen Free)? 是否建立环境管理体系(RoHS, REACH, Holagen Free)?2*Do you have an Environmental Substance Management Database(RoHS, REACH, Holagen Free)? 是否建立环境物质管理数据库(RoHS REACH Holagen Free)?3*Does your company have an Environmental Policy? If so, please enclose/quote/give link-info.,the policy is covering the environmental controlled substances management.贵公司是否有环境方针? 如果有,请附上环境方针或提供链接信息,该方针包含环境管制物质的管理4*Does your company have a continuous environment improvement program/plan, including elimination and reduction for the environmental controlled substances? 是否有持续环境改善方案/计划包括消除和减少环境管制物质?5Is it ISO 14001 certified/EMAS registered/others? 是否已通过ISO14001认证?6*Is there a list of environmental controlled substances? and the controlled substances list is revised timely in response to applicable laws and regulations and the customer requirements.是否有环境管制物质清单,并依照相关法律法规或客户要求及时修订?7Are the responsibility and authority of the persons in charge of environmental management clearly defined? 负责环境管理的人员职责和权限是否已清楚定义?8Can the responsible department effectively get the laws, regulations and customer requirements? the related information is provided timely to the organization inside and suppliers. 责任部门是否能有效地获取法律法规和客户要求?相关信息及时传达到组织内部和供应商Are there the documented procedures used for environmentalManagement System管理体系9Are there the documented procedures used for environmental training(REACH, Halogen Free, RoHS…) ? 是否有文件化的环境培训程序?10Does your company submit the REACH declaration to Pulse? 是否对Pulse进行REACH声明?11Does your company submit the raw material bill of substance to Pulse?是否向Pulse提供原材料物质组成表?12*Are trainings conducted to the employees responsible for the environmental product compliance(REACH, RoHS, Halogen Free …)? The training records are kept. 负责环境产品符合的员工是否有经过培训并保存培训记录?13Have the used subtances been registered for REACH? If yes, please list the subtances name the registration ID.所用的物质是否已注册?若注册请列出被注册物质的注册号14*Are there SVHC substances list? Have the procedure for REACH notifiaction? Do you make the material declaration for REACH to your customers?是否有SVHC物质列表?是否有程序就REACH进行通报? 是否对客户进行材料通报?15Are environmental controlled substances included in internalaudit process? The related regulations and standards are usedfor internal audit. 内部审核是否包含环境管制物质,且相关法规和标准被用于内审?-16*Are there the environmental criteria for selecting the new supplier and raw materials/components?是否有建立选择新供应商和原材料/部件的环境标准?17Does your design process take into consideration environmental concerns?是否在产品设计中考虑到环境问题?18Is non-use of banned substances clearly identified in components/raw materials drawing/spec./purchase orders? 不使用禁用物质是否清楚地标识在物料图纸/规格书/采购订单上?19*Are there any inspection procedures for the environmental controlled substances to be used on the purchased materials inspection?是否有建立环境管制的物质检验程序,用于采购物料的检验?20Are the purchased materials verified not including the banned substances?采购的物料是否有验证不含禁用物质?Supplier Management 供应商管理序号审核要素分数(0,1,2,NA)备注21*Can the supplier provide the certificate of RoHS,HF and REACH compliance(RoHS,HF and REACH CoC)?是否能提供RoHS, HF and REACH符合保证书?22*Are MSDS/Chemical Ingredient List/Measurement data filed and managed for use?Test reports need be made by certified lab.是否有物料安全数据表/化学成分表/测试报告?测试报告是须由有资格的实验室提供23Do you use any tools to quantify/assess the environmental burden?是否有使用工具检测和评估环境影响?24Is there the schedule established for the supplier environmental management system survey? And the survey is implementedaccording to the schedule. 是否有供应商环境管理系统审核计划?并按计划执行-25*Is there a documented procedure on regulations/ requirements on hazardous substances (REACH, HF, RoHS European directive, Sony SS-00259 standard)? 是否有就危险物质限制使用的法规/要求(REACH, HF, RoHS指令,索尼SS-00259标准) 制订形成文件的程序?26*Are the environmental controlled substances controlled in the production?在生产过程中,是否有对环境管制物质进行管制?27Are checks performed to the production equipments,test equipments including environmental substance measurement equipment before use?生产设备,测试设备包括环境物质检测设备在使用前是否有检查?28Are verifications made to the equipments, fixtures and tools previously contacted the banned substances to ensure that they are not contaminated? 对曾接触过禁用物质的设备,治具和模具是否有验证以确保没有被污染?Are methods defined to prevent the products from contamination and mixture of the banned substances and verifications made to th l d t i l?Production Management 生产管理29the recycled materials? 是否有方法防止产品污染和混入禁用物质?再生料是否经验证?30Are the shipping goods inspected according to the outgoing inspection standards and inspection records available? 成品出货是否根据出货检验标准进行检验并保存相关记录?31Is there identification labels on the outer box of the RoHS/REACH/HF compliant materials/products? 符合RoHS/REACH/HF的物料及产品外包装是否有标签标识?32Are the RoHS/REACH/HF & non-RoHS/REACH/HF compliant products built on separate production equipment and line? 符合及不符合RoHS/REACH/HF的产品是否在分开的生产设备和生产线上生产?33Is there a separate storage location for RoHS/REACH/HF & non-RoHS/REACH/HF compliant parts including raw materials/sub-assembly/finish goods? 符合及不符合RoHS/REACH/HF的产品包括原材料/半成品/成品是否分开存储?34Is there a separate REWORK area for RoHS, REACH or HF compliant parts? 对于符合RoHS, REACH,或HF的产品是否有分开的”返工”区域?35Are there long term inventory management criteria, considering the possible change of legislation in the future? 考虑到将来法规的可能变更是否有长期库存管理办法?36Are actions taken to the inventories when there have changes inthe environmental laws, regulations and the customerrequirements? 环境的法律法规和客户要求变更时,是否对库存品采取必要的处理措施?-37*Is there any procedure to define the requirement of customer notification for any change to component related to RoHS/REACH/HF compliance?是否有程序定义任何有关符合RoHS/REACH/HF的产品变更须通知客户?38Are checks made to the changes to see if they can meet the customer requirements and verifications performed viaMSDS/material ingredient lists and test reports when necessary?是否有进行变更检查以确保符合客户要求,必要时通过MSDS/材料成分表和测试报告进行验证?Is a written change notification used for the change request and response of Pulse is documented? 是否有书面的变更通知用于申Change Control 变更管制39请变更并保存普思的回复?序号审核要素分数(0,1,2,NA)备注40Is there a similar change management procedure established for changes by secondary supplier? 对供应商的管理是否有类似的变更管理程序?-41Please provide your company’s definition of lead-free. 请提供贵公司的无铅标准定义(铅含量)42For all currently available lead-free product offerings, please specify, termination finishing (e.g. Sn, Sn/Ag/Cu, etc.), and moisture sensitivity levels per JEDEC standards. 请说明你们现有无铅产品端子镀层情况(如:锡,锡银铜合金等)和MSL防潮等级,按照JEDEC标准43Are the lead free components in compliance with a “high temperature soldering profile” with a peak of 260°C. 无铅产品是否能承受260°C峰值温度的高温回流焊接?44Is your qualification process for solder joint reliability in accordance with IPC 9701 standard? If no, please describe your process. 焊接点可靠性验证方法是否符合IPC 9701标准? 如果不符合请说明你们的验证方法45If pure Sn is one of the plating offerings, Is there any testingdone with regard to tin-whisker growth? 如果使用纯锡作为镀层,是否有进行锡须增长测试?-46*Do the transportation packaging materials comply with the European packaging directive? 运输包装物料是否符合欧洲包装指令?47Do you have a reuse and recycling program for these materials?是否有此类物料重复使用和再循环程序?-48Do you provide instructions for end-of-life treatment for delivered product?已出货的产品是否有提供产品终止使用处理说明? Have you a program for take back of products as delivered byLead-free Product (if applicable) 无铅产品 (如适用):Transportation Packaging Materials运输包装物料End-of-Life Treatment产品终止使用的处理49your company?是否有产品回收程序? Subtotal 本部分分数合计Percent 百分比。