[Form1] EnvironmentalProtectionEvaluationListEnterinformationin theboldboxes.

Suppliercode
Companyname / Dateofissue(YYYYMMDD)
Location / Approver(Titleandname) / Seal
Headofficeaddress
Businesscategory / Manufacturer / Tradingcompany(Note1) / E-mailaddress
Other / Evaluator(Titleandname) / Seal
Telephone
FAX / E-mailaddress

(Note1)Whensupplier’sbusinesscategoryis“Tradingcompany”,pleaseevaluatebothyour

company and your supplier,and submitseparateevaluations.

(Note2) FortheBusinesscategorycolumn, please fill in “O”on theleftside oftheapplicableitem.Inthecaseofotheritems,pleaseinputspecificinformation(service/softwaredesign, etc.) on therightside.

(Note3)We may ask you to provideuswithevidenceon thereport.

(1)Items relatedtoExternalCertificationExternalcertificationreferstoISO14001ortheenvironmentalmanagementsysteminconformancewithISOsuchasEco-action21.

Evaluationitem / YES/NO / Certificationacquisitiondate(Lastupdateddate)(YYYY/MM/DD) / Certificationauthority / CertificationNo.
Wehaveobtainedexternalcertification. / ( / )
Wehaveaplantoobtainexternalcertification.
(Ithas to be obtained within oneyear fromthe responsedate) / Plannedevaluationdate

The certificationauthorityhas tobe decidedifyou have aplan.(Enter “NO”ifundecided.)[Pleaseattach a copy of certificateif it hasbeen obtained]

(2)ItemsrelatedtoGreenProcurementActivities

Evaluationitem / YES / NO / Startdate/Plannedstartdate(YYYY-MM-DD) / Score
1. WeunderstandthecontentofGreenProcurementGuidelines. / 10 / 0
2. We haverespondedtotherequirementsofGreenProcurementGuidelines. / 10 / 0
3. We haveworkedonbiodiversityprotection. / 10 / 0
4. We haveimplementedgreenprocurement. / 15 / 0

(3)ItemsrelatedtoEnvironmentalProtectionActivities(Entryisnotrequiredifyouansweredintheabove(1)thatexternalcertification hasbeenobtained)

EvaluationItem / YES / NO / Score
Environmentalpolicy / 1.Wehaveacorporatephilosophyregardingenvironmentalprotection. / 5 / 0
2.Wehaveanenvironmentalbasicpolicywhichspecifiesthefundamentaldirectionofenvironmentalprotectionactivities. / 5 / 0
3.We have established anenvironmental policy, andarecommittedto continuous improvement and pollutionprevention. / 5 / 0
4.Weare committed to complying withlawsand regulationsthroughenvironmentalpolicy. / 5 / 0
5.Ourenvironmentalpolicy has been documented,hasbeen publicizedtoall employees, and is availabletothe generalpublic. / 5 / 0
6.Wehavereviewedtheenvironmentalpolicyperiodically. / 5 / 0
Planorganization / 7.Wehavepurposesandaimsabouttheenvironment,andtheyhavebeendocumented. / 5 / 0
8.Wehave establishedan actionplanthatdefinesresponsibility,means, andschedulesfor achievingthepurposesand aims. / 5 / 0
9.Wehave defined an organization,persons incharge,theirrolesand authority forachievingthepurposesand aims. / 5 / 0
Environmentalaspectssystem / 10.We evaluate andmanageenvironmentalimpactsfor airpollution, andmake effortstowardimprovement. / 5 / 0
11.We evaluateandmanage environmentalimpactsfor waterpollution,andmake efforts towardimprovement. / 5 / 0
12.We evaluate andmanage environmentalimpactsforwaste, andmake effortstowardimprovement. / 5 / 0
13.Weevaluate andmanage environmentalimpactsfor resourceconsumption, andmake effortstowardimprovement. / 5 / 0
14.Weevaluate andmanage environmentalimpactsfor energyconsumption, andmake effortstowardimprovement. / 5 / 0
15.Weevaluate andmanage environmentalimpactsfor odor,noise andvibration,andmakesefforttowardimprovement. / 5 / 0
16.Wehave activelyworked onimprovementofdelivery packing,reuse orrecyclingof packing, and efficiency improvementin transportation. / 5 / 0
17.Wehaveaproductassessmentmechanism. / 5 / 0
18.Wehaveanemergencymechanism. / 5 / 0
19.Wehaveaprocedureforcorrectiveandpreventivemeasurestocopewithnon-conformity. / 5 / 0
20.Wehaveaninternalauditmechanismconcerningtheenvironment. / 5 / 0
Education
informationdisclosure / 21.Weprovideenvironmentaleducationandtraining. / 5 / 0
22.We provide separate and appropriate education and training for those engagedin work that could have amajor impact ontheenvironment,andwealsocontroltheirparticipation. / 5 / 0
23.Wemakeourinformation ontheenvironmentalprotectionopentothepublic. / 5 / 0
Managementsystemfor
substancesinproducts / 24.Basedonenvironmentallawsandregulationsandcustomerrequests(abolitionterm,etc.),wehavedocumentedtheaimsandabolition,
reductionandsubstitutionplans,etc.forthemanagementofprohibitedandcontrolledsubstances,andwehavealsopromotedtheactivities. / 5 / 0
25.Wehavebuiltandoperatedamechanismthatperformscollection,transfer,managementanddirections,etc.,ofinformationaboutenvironment-relatedsubstances. / 5 / 0
(3)Totalscore
[Form1]EnvironmentalProtectionEvaluationListEnter informationin theboldboxes.
Supplementalexplanation:(2)Itemsrelated toGreenProcurementActivities
-“Workingonbiodiversityprotection”meansthatthesuppliersupportsthepurposeofthe“BasicActonBiodiversity(ActNo.58ofJune6,2008)”,andmakeseffortsforimprovementofenvironmentalinfluencesuchasenergyconsumption.
-“Implementingthegreenprocurementactivities”meansthat thesupplierhasgivenpriority tobusinesswithclientswhoareengagedinenvironmentalprotectionactivities,andhasalsogivenprioritytoprocurementitemsthatareenvironmentallyfriendly.
Supplementalexplanation:(3)Itemsrelated toEnvironmentalProtectionActivities
-Evaluation for(3)maybe requestedevenifcertification hasbeenobtained.
-ForNo.24and25listedintheManagementsystemforchemicalsubstancesinproducts,pleaserefertothelatest
“GuidelinesonChemicalSubstancesManagementin Products” issuedbyJAMP.
(4) Rank Evaluation
Evaluationresult / Score(totalof(2)and(3)) / Rank
Rank / Totalscore
170points, or“YESfor(1)Itemsrelatedto ExternalCertification / S
155 to lessthan170points / A
100 to lessthan155points / B
50 to less than100points / C
Lessthan50points / D