Membership Application Print/View

OMB No. 2010-0032
Expiration Date 01/31/2010

Performance Track Membership Application
2008

Doughton Park Bluffs Lodge Forever Resorts
Forever Resorts

A040192

CONTACT INFORMATION

Name of your facility:

Doughton Park Bluffs Lodge Forever Resorts

Does your facility have a parent company?

Yes

Name of your parent company:

Forever Resorts

Facility contact person for the Performance Track program:

Name:

Mr. Bill Harrison

Title:

General Manager

Phone:

336-372-7323

Fax:

Email:

billh52@yahoo.com

Facility location:

Facility Address

Street Address:	45356 Blue Ridge Parkway
Address Cont:	Milepost 241
City:	Laurel Springs
State:	NC
Zip Code:	28644

Facility Mailing Address

Same as above? Yes

If your facility has multiple street addresses, please list any other addresses for its sites or buildings.

None

Facility's website address (if any):

http://www.blueridgeresort.com

SECTION A: ABOUT YOUR FACILITY

A.1

How did you learn about Performance Track? (select all that apply)

Internally within your company

A.2.a

List the activities, products, or services that take place at your facility.

Bluffs Lodge provides lodging, foodservice and retail sales at this drive-by and destination resort facility seasonally from late April through early November in the Naitonal Park Blue Ridge Parkway. Part of the operation is Price Lake Marina which provides canoe and non-motorized boat rentals and retail sales. This operation is also located in the Parkway, and is approximately 50 miles from Bluff's Lodge.

A.2.b

Provide the size and general description of your site.

Restaurant and Camp Store/Gift Shop are located in the N.W. corner of North Carolina, on a 5 acre site along side the Blue Ridge Parkway National Park at mile marker 241.1. The Lodge, with 24 rooms, is located on a 2 acre site, ¼ mile off the Parkway, offering a scenic view of high country meadows, distant mountains and valleys. The nearest town is Laurel Springs, NC; about 7 miles. The purpose of our facilities are to provide food, beverage and lodging for Blue Ridge Parkway visitors.

A.2.c

Describe any recent changes to facility operations or ownership (if applicable).

Forever Resorts acquired the Doughton Park Bluff Lodge operations in 2001.

A.2.d

Describe any activities, products, or services located on your site that are not intended to be included in the facility definition for purposes of Performance Track membership (e.g., business units, leased areas, tenants, or contractors) (if applicable).

None

A.3

For the purposes of where your facility would be listed in our Member Directory, please list the North American Industrial Classification System (NAICS) Code(s) that is (are) used to classify business at the facility:

Primary		Secondary		Tertiary		Quaternary		Quinary
72110		713930		44-45

A.4

Number of employees (full-time equivalents) who currently work in the facility:

Fewer than 50

A.5

Is your facility currently a member of a state voluntary environmental leadership program?

SECTION B: ENVIRONMENTAL MANAGEMENT SYSTEM

B.1

Is your facility's EMS (not your corporate office's EMS) certified to the American Chemistry Council's Responsible Care® program (i.e., has your facility successfully undergone a Responsible Care® third-party audit)?

B.2

Is your EMS certified to ISO 14001?

Yes

B.3

Have you done a comprehensive review of all activities conducted at your facility that could impact the environment (i.e., have you done an aspect analysis)?:

Yes

	a.	Have you classified your aspects based on their potential harm to the environment, on community concerns, and/or on other objective factors (i.e., have you determined your significant aspects)?:
		Yes
	b.	When did you last update your aspect analysis? (mo/yr):
		April 08

B.4

Have you completed at least one EMS cycle (plan-do-check-act)?:

Yes

	a.	Did this cycle include both an EMS and a compliance audit?
		Yes

B.5

Have you completed an independent assessment of your EMS in conformance with the Performance Track Independent EMS Assessment Criterion in the last two years?

Yes

	a.	What method of EMS assessment did you use?
		Corporate or Parent Company Protocol
	b.	When was your last independent EMS assessment? (mo/yr)
		April 2008
	c.	Who or what organization performed the independent assessment?
		Name and Title: Engineering Management Services (Mike Bloise, Lead ISO Auditor) Organization: Forever Resorts

SECTION C: PAST ACHIEVEMENTS

First Achievement
1a.	What category have you selected from the Environmental Performance Table?
	Energy Use
1b.	What indicator have you selected from the Environmental Performance Table?
	Total (non-transportation) energy use
1c.	Please provide any additional detail to describe your indicator (e.g., specific hazardous waste component, specific chemical that was reduced)
	All
1d.	What activities or process changes did you undertake at your facility to accomplish your goal e.g., technology changes in a particular process line, employee training?
	Convert lighting sytems to cfl's, Purchase energy saving devices and equipment for facility structures, establish computer power management procedures, implement thermostat management procedures, examine equipment electrical usages when making purchases, education and training of facility personnel at all levels. The reason the increase of power usage from 2005 to 2007 is due to an increase of approximately 25% occupancy rate. The facility also added a number of ceiling fans instead of AC's. Using the normalizing factor of .82, based on the occupancy rate, the facility shows an improvement in energy use.

		Past	Current
2a.	Please provide information for these calendar years.	2005	2007
2b.	List the past annual quantity of the indicator (from two years ago) and the current annual quantity of the indicator (from the most recent year for which you have data).	154,313	160,246
2c.	What units are you using to quantify this indicator?	kWh
2d.	Estimate your past normalizing factor.	.82	1.0
2e.	What is your normalizing factor based on? (e.g., production, employment)	Occupancy rate
2f.	Normalized Quantities	188,186.59	160,246.00

SECTION C: APPLICATION GOALS

Goal 1

1a	Category Water Use
1b	Indicator Total water used
1c	Does your goal include everything covered by the indicator (e.g., all VOCs, all non-hazardous waste), or a specific substance or component (e.g., ethane, cardboard)?
	All
1d	What activities or process changes do you plan to undertake at your facility to accomplish your goal e.g., technology changes in a particular process line, employee training?
	This facility is putting into policy that: 1) The water glasses for the guests in the dinning room will be reduced from 9 oz. to 6 oz. and each guest will be asked if they want water. 2) New sloan valves will be installed to greatly reduce the wate use of each toilet and urinal flush. 3) Will purchase and install restricted flow devices on the sinks and pressure dish rinser in the kitchen and dining room. Education, training the employees and guests to reduce water consumption in their daily use.
1e	Describe the data collection process and data source(s) that you will use to measure progress towards this goal.
	Utility invoice consumption data
2a	Are you proposing this as a Challenge Goal? No
2b	Does this goal address a significant aspect in your EMS?
	Yes

		Baseline	Future
3a	Please provide information for these calendar years.	2007	2010
3b	What units are you using to quantify this indicator?	Gallons
3c	List the baseline annual quantity of the indicator and the annual quantity you are commited to achieve by the future year. Assume a constant level of activity at your facility when setting your future goal.	762,070	720,000

4	Does the quantity presented in the future quantity column represent an absolute goal or a normalized goal?
	Normalized goal (i.e. indexed to level of business in baseline year)
5	Whether your goal is absolute or normalized, in your annual performance reports you will need to provide normalizing factors and normalized quantities of your annual data.
	Occupancy Rate
6a	Are you subject to Federal, State, Tribal, or local regulatory requirements for this indicator?
	No

Goal 2

1a	Category Energy Use
1b	Indicator Total (non-transportation) energy use
1c	Does your goal include everything covered by the indicator (e.g., all VOCs, all non-hazardous waste), or a specific substance or component (e.g., ethane, cardboard)?
	All
1d	What activities or process changes do you plan to undertake at your facility to accomplish your goal e.g., technology changes in a particular process line, employee training?
	Education, training, energy efficient lighting systems, thermostat management guidelines, computer system power management, equipment usage monitoring.
1e	Describe the data collection process and data source(s) that you will use to measure progress towards this goal.
	Utility invoice comsumption data, analyze consumption rates of equipment and material purchases.
2a	Are you proposing this as a Challenge Goal? No
2b	Does this goal address a significant aspect in your EMS?
	Yes

3a	Is the intent of your energy use goal to reduce total energy use, to use or invest in renewable energy fuel sources, or a combination of both?	Reduce Total Energy Use
3b	Please provide information for these calendar years.	Baseline: 2007	Future: 2010

3c	Off-site Sources
Electricity Purchased		Baseline: 2007	Future: 2010	Units
	Electricity from Grid/Utility	160,220	128,000	Kwh
	Electricity from Off-Grid Renewable Sources
	Total Electricity Purchased	546.67	436.74	MMBtus
	If your facility purchases electricity from the grid, please identify your facility's electricity geographic region.	MRO East
Steam
Total Energy Generated Off-Site		546.67	436.74	MMBtus

3d	On-site Sources	Baseline: 2007	Future: 2010	Units
Coal
Natural Gas
Crude Oil
Fuel Oil
Diesel
Propane/LPG
Gasoline
Hydrogen Powered Fuel Cells
Natural Gas / Methane Powered Fuel Cells
Biomass
Biodiesel
Solar
Wind
Landfill Gas
Geothermal
Hydroelectric
Tire Derived Fuel
Other Fuel or Source Specify: n/a
Total Energy Generated On-Site		0.00	0.00	MMBtus

3e	Total Energy Use and Associated Greenhouse Gas Emissions
Total Renewable Energy Use		42.09	33.63	MMBtus
Total Non-Renewable Energy Use		504.58	403.11	MMBtus
Total Energy Use		546.67	436.74	MMBtus
Metric Tons of CO₂ Equivalents		135.07	107.90	MTCO₂E
Metric Tons of CO₂ Equivalents Offset due to Investments in Green Energy, e.g. green tags				MTCO₂E
Net Metric Tons of CO₂ Equivalents		135.07	107.90	MTCO₂E

4	Does the quantity presented in the future quantity column represent an absolute goal or a normalized goal?
	Normalized goal (i.e. indexed to level of business in baseline year)
5	Whether your goal is absolute or normalized, in your annual performance reports you will need to provide normalizing factors and normalized quantities of your annual data.
	Occupancy Rate.
6a	Are you subject to Federal, State, Tribal, or local regulatory requirements for this indicator?
	No

SECTION D: PUBLIC OUTREACH AND REPORTING

D.1.a

Please describe your process to identify potential community environmental concerns.

We partnership with National Park Service and other regulatory agencies to discuss any environmental concerns and or improvements that can be made which will benefit the community. We also invite feedback from our guests and community through the use of customer cards and verbal communication. We encourage participation and suggestions from our guests and park visitors regarding our environmental efforts and initiatives.

D.1.b

Please describe how you informed the community about environmental matters related to your facility.

Park visitors are informed that we have an environmental policy for their review and comment. We have postings and displays throughout the facilities, informing guests of our environmental efforts and initiative.

D.2

How will you make the Performance Track Annual Performance Report available to the public?

Meetings, Press Releases, Bulletin Board, Web Site, Other

URL: http://www.foreverresorts.com

Please Specify Other:Displays and posting throughout facilities

D.3

Are there any ongoing citizen suits related to environmental issues against your facility

D.4

Please describe anything else you would like to tell us about your facility such as environmental awards or participation in other partnership programs at the local, tribal, state, or Federal level.

Green Restaurant Certification, Green Hotel Membership, Certified to ISO 14001, Recycling Program, Green Procurement Program

D.5

List references below:

Representative of a Community/ Citizen Group

Organization:

National Park Service

Name:

Lisa Davis

Phone:

828-271-4780

State/tribal/local regulator

Organization:

Apalacian District Health Department

Name:

Michael Roberson

Phone:

336-246-9449

Other community/local reference
(e.g., emergency management official or business associate)

Organization:

Alleghany Solid Waste (Recycling Center)

Name:

Duty staff personnel

Phone:

336-372-2836

SECTION E: Application and Participation Statement

On behalf of Doughton Park Bluffs Lodge Forever Resorts, I certify that:

I have read and agree to the terms and conditions for Application and Participation in the National Environmental Performance Track, as specified in the National Environmental Performance Track Program Guide and in the Application Instructions;
I have personally examined and am familiar with the information contained in this Application, including the Environmental Requirements Checklist. The information contained in this Application is, to the best of my knowledge and based on reasonable inquiry, true, accurate, and complete, and I have no reason to believe the facility would not meet all program requirements;
My facility has an environmental management system (EMS), as defined in the Performance Track EMS requirements, including systems to maintain compliance with all applicable Federal, State, tribal, and local environmental requirements in place at the facility, and the EMS will be maintained for the duration of the facility's participation in the program;
My facility has conducted an objective assessment of its compliance with all Federal, State, tribal, and local environmental requirements, and the facility has corrected all identified instances of potential or actual noncompliance;
Based on the foregoing compliance assessment and subsequent corrective actions (if any were necessary), my facility is, to the best of my knowledge and based on reasonable inquiry, currently in compliance with applicable Federal, State, tribal, and local environmental requirements.

I agree that EPA's decision whether to accept participants into or remove them from the National Environmental Performance Track is wholly discretionary, and I waive any right that may exist under any law to challenge EPA's acceptance or removal decision.

I am the senior facility manager and fully authorized to execute this statement on behalf of the corporation or other legal entity whose facility is applying to this program.

Signature/Date:	______________________________________________________
Name:	Mr. Bill Harrison
Title:	General Manager
Facility Name:	Doughton Park Bluffs Lodge Forever Resorts
Facility Street Address:	45356 Blue Ridge Parkway Milepost 241 Laurel Springs, NC 28644
Mailing Address:	45356 Blue Ridge Parkway
Address cont:	Milepost 241
City, State Zip:	Laurel Springs, NC 28644

ENVIRONMENTAL REQUIREMENTS CHECKLIST

Facility Identification Information

Do you have a RCRA identification number?
(A RCRA number is used in the RCRAInfo database for Resource Conservation and Recovery Act (RCRA) programs).

Do you have an AFS identification number?
(An AFS number is used in the AIRS Facility Subsystem of the Aerometric Information Retrieval System (AIRS) for Clean Air Act programs).

Do you have a PCS/NPDES identification number?
(A PCS/NPDES number is used in the Permit Compliance System (PCS) for Clean Water Act programs monitoring National Pollutant Discharge Elimination System (NPDES) permits).

Do you have a FIFRA identification number?
(A FIFRA number is given to facilities regulated by the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA)).

Air Characteristics

Is your facility an air permit holder?

Is your facility subject to New Source Performance Standards (NSPS)?

Is your facility subject to Section 112/Maximum Achievable Control Technology (MACT) standards/National Emissions Standards for Hazardous Air Pollutants (NESHAPS)?

Is your facility subject to Reasonably Available Control Technology (RACT) requirements?

Is your facility subject to Section 129 combustion requirements?

List relevant state/local/tribal/other air requirements:

n/a

Water Characteristics

Is your facility a water permit holder?

Is your facility subject to industry specific effluent guidelines and standards?

Is your facility Required to Pretreat?

Is your facility regulated under the Safe Drinking Water Act?

List relevant state/local/tribal/other water requirements:

All water facilities and infrastructure is operated by and maintained by the National Park Service.

Hazardous Waste Characteristics

Is your facility subject to hazardous waste regulations?

List relevant state/local/tribal/other hazardous waste requirements:

n/a

Environmental Clean-Up, Restoration, and Corrective Action Characteristics

Is your facility a Potentially Responsible Party under CERCLA or Superfund for onsite clean-up?

Is your facility a Potentially Responsible Party under CERCLA or Superfund for offsite clean-up?

Is your facility a Potentially Responsible Party in a federal or state clean-up of hazardous waste and/or oil?

Is your facility engaged in RCRA corrective action?

List other relevant federal/state/tribal/local environmental clean-up, restoration, or corrective actions not listed above. Please include date(s) of any remedy decisions.

n/a

Other Environmental Characteristics

Is your facility a Toxic Release Inventory (TRI) Reporter?

Is your facility subject to Underground Storage Tank (UST) Regulations?

Is your facility regulated under Toxic Substances Control Act (TSCA)?

Is your facility regulated under the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA)?

Is your facility subject to Worker Right-to-Know Regulations?

Yes

Is your facility required to file an emergency management plan under the Emergency Planning and Community Right-to-Know Act (EPCRA)?

List relevant state/local/tribal/other requirements:

n/a

2c	If neither, please explain why you believe this indicator should be included as a performance goal.

Goal 1

Goal 2

Attachments (if applicable):

Facility Identification Information

Air Characteristics

Water Characteristics

Hazardous Waste Characteristics

Environmental Clean-Up, Restoration, and Corrective Action Characteristics

Other Environmental Characteristics