Clean Business Award Nomination Form

Nominee Information:

Name of Business*

Street Address*

Street Address City ZIP Code

Phone (Home)*

Phone (Work)

Email*

The Nominated Property Must Meet the Following Criteria:

Please place a check mark denoting that the nominated property meets the following criteria:*

The property is litter free
Outside trash receptacles are present
Cigarette receptacles are present unless the property is smoke free
The business participates in some sort of recycling program for their employees or the refuse/byproducts of their business
The property manager gives permission to participate in the program
The property has not won this award in the past five years
The property is within Henrico County limits
I will include include at least three pictures of the property with this nomination (see field below)

Sustainable practices and best management practices to improve water quality and soil health are encouraged. If you are implementing any of the following, please let us know.

Use of erosion control methods
Reduction or elimination of herbicides, pesticides, and fertilizers
Use of a rain cistern/barrel or planting of a rain garden
Use of permeable pavement
Implementation of LEED building practices
Use of Solar Panels
Composting of waste
Participation in the Virginia Conservation Assistance Program through Henricopolis SWCD
Other sustainable practices

If you selected 'other sustainable practice', please describe.

For judging purposes, please tell us why your property should win this award:

Person Nominating Property

Name*

First Last

Title

Address

Street Address City ZIP Code

Phone (Daytime)*

Submit at least three pictures and a maximum of six. Please include one photo of the property from the street.

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 50 MB, Max. files: 6.

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To be considered for an award:

We encourage sustainability and best management practices to improve water quality and soil health.

Nominee Information:

The Nominated Property Must Meet the Following Criteria:

Person Nominating Property

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