Industrial Emissions Survey Template
1. Facility Information
Facility Name
Location (Address)
Industry Sector/Type
2. Contact Information
Contact Name
Contact Email
Contact Phone
3. Emissions Overview
Primary Emission Sources
Main Pollutants Released
4. Emissions Data
Annual Emissions (tons/year)
Emissions Measurement Methods Used
5. Mitigation Measures
Emission Control Technologies/Techniques Used
Planned Improvements or Upgrades