质量环境管理体系认证申请书-华夏认证中心

1、华夏认证c c c /版本号 edition no.： 6.0 修订号 revision no： 0.0认证申请书application form合同编号：contract no在以 f屮扌j勾 “ j ” please tick in the proper box: iso9001 认证 iso9001 certification（国内证书口 ukas证书口初次认证口复评口其他） iso14001 认证 iso14001 certification（国内证书dukas证书初次认证口复评口其他）职业安全健康管理体系认证ohsms certification（初次认证口复评口其他）©d

2、omestic certificates ®ukas certificates ©initial assessment re-assessment others申请认证组织信息 general information of applicant名称 name： 邮编 post code： 地址 address： 管理者彳弋表 mmnagement representative： 联系人 contact person： 手机mobil : 电话tel： 传真fax： 电子邮件地址e-mail： 职工人数 number of employees : 工班数 number of s

3、hifts :倒班人数 number of employees in shift work （特别声明：请如实填报职工人数，不在同一市、县的工地现场数，如现场审核时发现与实际不符，认证中心为 保障审核的公正、有效性，将有权保留增加审核人fi、审核费用的权利。note: the applicant shall fill in the numbers faithfully and accurately. if the information is found to be in un confo rmity with the actual situati on duri ng on-site aud

4、its, ccci reserves the right to in crease audit days and audit fees to ensure the impartiality and effectiveness of audits.）厂区面积 plant space： 建筑血积 floor space : 产值 turnover： 不在同一市、县的机构数 number of department or branches in other places： 个；不在同一市、县的工地现场 number of construction sites in other places个。（请附

5、具体目录,详列名称和地点 please attach a detailed list with full names and addresses）请提供两年内向本组织提供体系咨询的机构、人员名称the names of organizations and people that have provided consultant services to the applicant in the past two years组织n前所处认证状态是否为暂停或撤销:whether the certification qualification of the applicant has been sus

6、pended or withdrawn： 何停 suspension 撤销 withdrawal,请说明悄况please specify体系覆盖范scope covered bv manaqement svstem质量管理体系覆盖的产品范围及主要过程、活动范围和地域场所（属异地经营或先产的请说明情况）product scope, main process, activities scope and sites covered by quality management system （please specify if have multi-site for activities or pro

7、duction）（ k要过程指：设计/开发、牛产/施工、安装等活动）（the main process refers to design/development, production and installation, etc.）对 iso9001:2000 的删减情况 whether any clauses in iso9001:2000 has been excluded：无 none 7.3 7.4 7.5 7.6（如只删减了某章的部分内容，请注明删减的小节序号if the clause has been partially excluded, please specifythe se

8、ction number） 环境管理体系和职业安全健康管理体系覆盖的产品和活动范围及地域场所products and activities scopeand sites covered by ems and ohsms体系运行时间及希望认证审核时间operation date of svstem and expected audit time质量管理体系开始运行吋间是the qms was put into operation on年year 月month日day；环境管理体系开始运行吋间是the ems was put into operation on年year月monthh day；职业

9、安全健康管理体系开始运行时间是the ohsms was put into operation on 年year月month日 dayc组织希望质量管理体系认证审核时间为the expected audit time for qms is： ；组织希望环境管理体系第一阶段审核时间为 the expected audit time for the first stage audit of ems is： 第二阶段审核吋间为 the expected audit time for the second stage audit of ems is： ；组织希望职业安全健康管理体系第一阶段审核吋间为

10、the expected audit time for the first stage audit of ohsms is： ；第二阶段审核时间为 the expected audit time for the second stage audit of ohsms is： ；(说明：环境管理体系和职业安全健康管理体系的认证审核均分为两个阶段进行，其小第二阶段审核吋间要根据第一阶段审核的结果最终确定)(note: the audit for ems and ohsms include two stages. the audit time for the second stage audit d

11、epends on the result of the first stage audits.)申请is014001认证需填写以下内容please provide the followinq information in applvinq for iso14001 certification1、排放的污染物(名称、浓度和总量)、排放方式(排放地点和去向)、排放标准(包括是否进行了监测及监测 结果:the discharged contaminations (name, density and gross quantity), the method of discharge (discharge

12、 place and discharge di recti o ns), discharge stan dards (in cludi ng whether supervisi on and measureme nts have bee n con ducted and the results)2、组织的活动、产品或服务(应包括主耍过程及辅助的相关过程)：the applicants* activities, products or services(in cludi ng major process and releva nt supporti ng process)3、环境管理状况（组织的

13、环境管理机构、机构负责人、近几年主耍业绩）：information about environmental management (environmental management department of the applicant, responsible person and major achievements in the recent years)4、能源、资源年消耗量及在同行业屮所处的水平(包括：主耍原材料及水、电、燃料等)：annual consumption of en ergy and resources and the positi on within the indu

14、stry (en ergy and resources in elude: major raw material, water, electricity, fuel, etc.)5、是否在近两年内受到过政府环保主管部门的处罚或发生过环境事故，如有请简述情况：whether the applicanthas been punished by the environmental protection authorities in the past two years and whether any envir on mental accide nt has happened .if any, pl

15、ease specify 申请职业安全健康管理体系认证需填写以下内容please provide the followinq information in applvinq for ohsms certification1 > 近两年发牛死亡、重伤 t 青况；职业病'情况：info rmation about death and serious in juries in the past two years and information about occupational-related disease2、nj能造成特、重大事故的活动或设施：activities or fac

16、ilities that may cause major accidents3、职业安全健康管理状况（职业安全健康管理机构、机构负责人、近儿年主要业绩）：information about occupational health and safety management （occupational health and safety management department of the applicant, responsible person and major achievements in recent years）4、千人负伤（死亡、重伤、轻伤）率在同行业中所处的水平:lnjur

17、y（death, serious injury and slight injury） rate per thousand employees and the position within the industry.5、是否在近两年内受到过安全主管部门的处罚或发生过安全事故，如有请简述情况：whether the applicant has been punished by the safety authorities in the past two years or whether any safety accident has happened. if any, please specif

18、y.有无特殊危险区域或限制及需说明的情况：please indicate any dangerous area or restrictions中请纟r织（公章）stamped by the applicant中请组织代表签名 signed by representative of 即plicant 职务 position of representative： 年 yearh month日 day认证所需资料required documents for certification质量管理体系方面的资料documents for qms1法律地位的证明文件，如营业执照或组织机构代码证及年检证明复印

19、件；documents that certify the legal status of applicants, such as business licenses, certificate of organization code, or annual surveillanee proof;2有效期内的许可证或资质证书及年检证明复印件；the valid permission license, qualification certificate and annual surveillanee proof;3、纟fl织简介；introduction of organization;4、产品生产

20、流程/工作过程简图：production flowing chart/flowing chart of working process;5、金业质量体系覆盖范围内的不在同一市、县的机构冃录（详列名称、地点）；list of departments or branches in other places covered by the same quality management system （please specify full titles and detailed addresses）;6、施工或勘测、设计、监理、物业管理、房地产开发、保洁等单位还应提供止在实施的所有工程项fi的现场（

21、包 括工程规模、进度、地点等）清单（加盖公章）；for the organizations engaged in constructions, exploration, design,supervision and management, property management, real estate development or cleaning industries, the list of project sites under construction shall be provided （including information about project scope, proc

22、ess and address）. the list shall be stamped by applicants;7、受控的质量手册和程序文件及必需的文件清单；the controlled quality manual, procedure documents and necessary document lists;8、除认证申请书中规定的认证所需资料外，华夏认证小心有权根据认证审核需要随时要求申请人补充提交资料。 in addition to the documents required by the application form, ccci has the right to req

23、uire supplementary documents when necessary环境管理体系/职业安全健康管理体系方面的资料documents for ems/ohsms1、法律地位的证明文件，如营业执照或组织机构代码证及年检证明复印件；documents that certify the legal status of appliesnts, such as business licenses, certificate of organization code, or annual surveillanee proof;2>有效期内的许可证或资质证书及年检证明复印件；the va

24、lid permission license, qualification certificate and annual surveillanee proof;3、组织简介（即组织相关的环境、女全状况简介）；introduction of organization （introduction of environment and safety situations related with to applicant）;4、环境/安全监测报告；环境/安全“三同时”验收报告；the environment/safety monitoring and measurement reports; che

25、ck and accept report of <three-existing,;5、“环评”、“安评”扌比复；the approval of environment assessment/safety assessment;6> 地理位査图及厂区平面示意图；the geographical m即 and sketch map of factories;7、主要工艺流程及污染物的产出示意图；the major technical flowing chart and sketch of outputflow of contamin at io n8、申请iso14001认证组织环境表

26、现审查表，安全行政主管部门的证明；evaluation report of environmental performs nee of the applica nt for iso14001 certification; proof from safety authorities;9、环境管理手册、程序文件（包括重耍环境因素清单、法律法规清单以及冃标指标和环境管理方案）； environ mental man ageme nt manual and procedure documents （includi ng list of major factors affecti ng the envi

27、ron mental elements, list of laws and regulations, objective and targets and environmental man agement program）;10、职业安全健康管理手册、程序文件（包括重人风险因索清单，法律法规清单及目标指标和管理方案）； occupational health and safety management manual and procedure documents （including list of major risky elements, list of laws and regulati

28、ons, objectives and targets, and management program）;11 >企业体系覆盖范围内的不在同一市、县的机构目录（详列名称、地点）；list of departments or branches in other places covered by the same management system （please specify full titles and detailed addresses）12、施工或勘测、设计、监理、物业管理、房地产开发、保洁等单位还应提供正在实施的所有工程项f1的现场（包括工程规模、进度、地点等）清单（加盖公

29、章）；for the organizations engaged in construction, exploration, design ,supervision and management, property management, real estate development or cleaning industries, the list of project sites under construction shall be provided （including information about project scope, process and address）. the list shall be stamped by applicants13、建筑类企业要标出各现场敏感区位置，现场（包括敏感区）污染物排放监测结果；the construction orga nizations shall in di cate the locations of sen sitive areas in construction site and shall provide monitoring result of discharge of contamination on sites （ineluding the sensitive areas）;14