SAMPLE TOLLER PRE-ASSESSMENT QUESTIONNAIRE

This assessment tool is referred to and explained in Chapter 2, The Toller Selection Process. It can be used to collect data about tollers before and during selection. As with all examples, this should be modified to address the user s specific needs. 

Type of Seryice to be pr (Check all that apply.) oyided  

For each topic item, check one (Y) Yes, (N) No and add any comments. Attach additional comment pages if necessary. 

Does your company have a documented Responsible Care (or equivalent) policy that is fully supported by your management  

Does your company have a documented product stewardship policy, or a health, safety and environmental policy which incorporates the management of chemicals through their total life cycle, thus minimizing adverse effects on human health and well-being and on the environment If so please attach.  

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Some companies have more detailed forms for the site visit. One example of an assessment questionnaire is provided in Appendix A, Sample Toller Pre-Assessment Questionnaire. 

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