PSL_F-001 Application Form

Certification Type SelectISO 9001:2015ISO 14001:2015ISO 45001:2018 Registration Type SelectNew registrationRe-CertificationTransfer of registration from another certification body Transfer Details Standard(s) Applicable SelectISO 9001ISO 14001OHSMS 45001ISO 22000Others Other Standard

Name of Organisation State Country Phone Number Mobile Number Contact Person Email Website No. of Sites and Shifts Address

Scope of Management System Main Process Exclusions Statutory & Regulatory Requirements and Outsourced Process Certificate Numbers, Expiry Date and Previous Audit Finding Consultant Details Business Associates Involved Other Than Marketing Legal Status of Company SelectPublic Ltd.Pvt. Ltd.ProprietorshipPartnershipTrustSocietyG.O. Current Registrations SelectYesNo Full Time Employees Part Time Employees Consultant Used? SelectYesNo

Is scope and boundaries of the environmental management system determined? SelectYESNOPartially Is company environmental policy defined by Top Management? SelectYESNOPartially Are procedures to identify environmental aspects created, maintained and updated? SelectYESNOPartially Are environmental objectives and targets created and documented? SelectYESNOPartially Are programs for objectives/goal values defined and followed? SelectYESNOPartially Is there documentation of the above? SelectYESNOPartially Are EMS tasks, responsibilities and authorities defined and communicated? SelectYESNOPartially Are procedures for training, environmental awareness and competence maintained? SelectYESNOPartially Are EMS basic elements and interactions documented? SelectYESNOPartially Are follow-up documentation links maintained? SelectYESNOPartially Are monitoring and measurement procedures documented? SelectYESNOPartially Is compliance evaluation procedure maintained? SelectYESNOPartially Are EMS internal audit programs and procedures maintained? SelectYESNOPartially Is management review carried and documented? SelectYESNOPartially No. of Location No. of Employees in Location Description of Activities in Location Significant Environmental Aspects Significant Legal Obligations Responsible/Contact Person Name Responsible/Contact Person Phone

Is company OH&S policy determined? SelectYESNOPartially Are OH&S management system boundaries determined? SelectYESNOPartially Is context of the organization determined and reviewed? SelectYESNOPartially Are OH&S objectives created and updated? SelectYESNOPartially Are programmes for objectives created and followed? SelectYESNOPartially Are hazard identification and risk assessment procedures maintained? SelectYESNOPartially Is legal and other requirements access procedure maintained? SelectYESNOPartially Are OHSMS tasks, responsibilities and authorities defined? SelectYESNOPartially Are training, awareness and competence procedures maintained? SelectYESNOPartially Are OHSMS basic elements and interactions documented? SelectYESNOPartially Are follow-up documentation links maintained? SelectYESNOPartially Is there documentation of the above? SelectYESNOPartially Are monitoring and measurement procedures documented? SelectYESNOPartially Is compliance evaluation procedure maintained? SelectYESNOPartially Are OHSMS internal audit programs and procedures maintained? SelectYESNOPartially Is management review carried and documented? SelectYESNOPartially Health Monitoring Responsible Person Participation SelectYESNO No. of Location Employees in Location - Admin Employees in Location - Production Activities/Processes in Location Main Hazards, Risks and Hazardous Materials Significant Legal Obligations Responsible/Contact Person Name Responsible/Contact Person Phone

Signature and Seal / Name Designation Date