BLS-Green Form 326 Green Form 326199

Quarterly Census of Employment and Wages Green Goods and Services Sector Industry Pre-testing

Green form 326199 4_6

QCEW Green Goods and Services Sector Industry Pre-testing - Forms Testing

OMB: 1220-0181

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Green Goods and Services Survey

O.M.B. No. 1220−0181

Expires September 30, 2010

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Please return this form within 14 days. If you need help completing this form, contact information is listed on the last page. Thank you!

Statename


UI (10 digits)


Shape4 Shape3 Please report for location(s) in Using Unemployment Insurance account number


1


What is the address where your business establishment is physically located?

Report data for the location below. If this address is no longer correct, please provide us with an updated address in the space provided.

Enter Physical Location Address Corrections Here

T_name

Phy_addr2

PHY_addr1

Phy_city, Phy_state phy_zip-phy_zip_ext


H

2

ave we identified your main business activity correctly?

We have listed below a description of your main business activity at this location. If this description is incorrect, please call 202-691-5185 or email [email protected].


NAICS code: 326199

All other plastics product manufacturing

We have identified your main business activity as the following:

Does NOT include:

Establishments primarily engaged in:

  • Manufacturing plastics products




  • Assembling plastic components into plumbing fixture fittings such as faucets

  • Foam (except polystyrene) products

  • Heavy-duty inflatable plastics boats

  • Laminating plastics profile shapes, such as plate, sheet, and rod

  • Plastics bottles

  • Plastics film, plastics unlaminated sheet, plastics bags

  • Plastics furniture parts and components

  • Plastic pipes, pipe fittings, plastics profile shapes (except film, sheet, bags)

  • Plastic plumbing fixtures

  • Polystyrene foam products

  • Resilient floor coverings

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hat is your business establishment’s fiscal year?

Please provide us with your fiscal year that includes April 15, 2009 for the location listed in Item 1.

Start of Fiscal Year


End of Fiscal Year

MM

DD

YYYY


MM

DD

YYYY








W

4

hat is your business establishment’s employment?

Please provide us with the employment figure you reported on your State’s Quarterly Contributions Report for September 2009 for the location listed in Item 1. This figure is the count of all employees subject to State Unemployment Insurance taxes that worked or received pay for the pay period that included September 12th, 2009.

Employment for pay period that includes September 12, 2009


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5


What is your percent revenue from specific product lines?

In Columns 1 and 3, please estimate the percent of total revenue for the location listed in Item 1 from products containing more than 50% recycled or spent plastic resins. Please base your estimate on total revenue for your fiscal year from Item 3. The sum of Columns 1 and 3 may not equal 100%.


Note: This section may best be completed by someone at your firm with access to financial data.


Percent of total revenue for fiscal year listed in Item 3

1

Percent of total revenue for products with greater than 50% recycled or spent resins

2




Product line


3

Percent of total revenue for products with greater than 50% recycled or spent resins

4




Product line


Awnings, rigid plastics or fiberglass, manufacturing



Lens blanks, plastics ophthalmic or optical, manufacturing


Badges, plastics, manufacturing



Mattresses, air, plastics, manufacturing


Balloons, plastics, manufacturing



Microwaveware, plastics, manufacturing


Bathroom and toilet accessories, plastics, manufacturing



Motor vehicle moldings and extrusions, plastics, manufacturing


Bolts, nuts, and rivets, plastics, manufacturing



Netting, plastics, manufacturing


Bottle caps and lids, plastics, manufacturing



Nozzles, aerosol spray, plastics, manufacturing


Bowls and bowl covers, plastics, manufacturing



Organizers for closets, drawers, and shelves, plastics, manufacturing


Bubble packaging materials, plastics, manufacturing



Packaging, plastics (e.g., blister, bubble), manufacturing


Building materials (e.g., fascia, panels, siding, soffit), plastics, manufacturing



Pails, plastics, manufacturing


Building panels, corrugated and flat, plastics, manufacturing



Paint sticks, plastics, manufacturing


Bushings, plastics, manufacturing



Picnic jugs, plastics (except foam), manufacturing


Cigar and cigarette holders, plastics, manufacturing



Radio housings, plastics, manufacturing


Clothes hangers, plastics, manufacturing



Reels, plastics, manufacturing


Clothespins, plastics, manufacturing



Reflectors, plastics, manufacturing


Combs, plastics, manufacturing



Rulers, plastics, manufacturing


Coolers or ice chests, plastics (except foam), manufacturing



Screening, window, plastics, manufacturing


Countertops, plastics, manufacturing



Septic tanks, plastics or fiberglass, manufacturing


Credit and identification card stock, plastics, manufacturing



Shoe parts (e.g., heels, soles), plastics, manufacturing


Cultured marble products (except plumbing fixtures) manufacturing



Shutters, plastics, manufacturing


Cultured stone products (except plumbing fixtures) manufacturing



Siding, plastics, manufacturing


Cups, plastics (except foam), manufacturing



Sponges, plastics, manufacturing


Dinnerware, plastics (except polystyrene foam), manufacturing



Swimming pool covers and liners, plastics, manufacturing


Doormats, plastics, manufacturing



Swimming pools, fiberglass, manufacturing


Doors and door frames, plastics, manufacturing



Tanks, storage, plastics or fiberglass, manufacturing

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Drums, plastics (i.e., containers), manufacturing



Television housings, plastics, manufacturing


Footwear parts (e.g., heels, soles), plastics, manufacturing



Tires, plastics, manufacturing


Fruits and vegetables, artificial, plastics, manufacturing



Trash containers, plastics, manufacturing


Gloves, plastics, manufacturing



Tumblers, plastics, manufacturing


Gutters and down spouts, plastics, manufacturing



Utility containers (e.g., baskets, bins, boxes, buckets, dishpans, pails), plastics (except foam), manufacturing


Hampers, laundry, plastics, manufacturing



Watch crystals, plastics, manufacturing


Handles (e.g., brush, tool, umbrella), plastics, manufacturing



Watering cans, plastics, manufacturing


Hardware, plastics, manufacturing



Window sashes, vinyl, manufacturing


Ice buckets, plastics (except foam), manufacturing



Windows and window frames, plastics, manufacturing


Jars, plastics, manufacturing



Windows and window frames, vinyl, manufacturing


Kitchen utensils, plastics, manufacturing



Windshields, plastics, manufacturing


Ladders, fiberglass, manufacturing



Other (please specify):


Lamp shades, plastics, manufacturing



Other (please specify):


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hat is your contact information? For the person or persons who helped complete this form.

  1. Contact 1’s name: __________________________________________

Title:___________________________________

Phone number: (_____)________ - _____________________ email:__________________________________

Business website:______________________________________________

  1. Contact 2’s name: ____________________________________________

Title:___________________________________


Phone number: (_____)________ - _____________________ email:________________________________



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Do you have any questions about completing this form?

Please send an email to [email protected], or call (202)-691-5185.



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4

onfidentiality Statement. The Bureau of Labor Statistics, its employees, agents, and partner statistical agencies, will use the information you provide for statistical purposes only and will hold the information in confidence to the full extent permitted by law. In accordance with the Confidential Information Protection and Statistical Efficiency Act of 2002 (Title 5 of Public Law 107-347) and other applicable Federal laws, your responses will not be disclosed in identifiable form without your informed consent. This report is authorized by law 29 U.S.C.2. Paperwork Reduction Act Statement. Your voluntary cooperation is needed to make the results of this survey comprehensive, accurate, and timely. We estimate that completing this form will take an average of 20 minutes. This estimate takes into account time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the information. If you have any comments regarding this survey, including suggestions for reducing the burden, send them to the Bureau of Labor Statistics, Office of Industry Employment Statistics, Paperwork Reduction Project, 2 Massachusetts Avenue, N.E., Room 4840, Washington, DC 20212. The OMB control number for this voluntary survey is 1220-0181 and expires on September 30, 2010. Without a currently valid number BLS would not be able to conduct this survey.

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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleIndustry Verification Form, BLS 3023−NVS
AuthorPLASKIE_W
File Modified0000-00-00
File Created2021-02-02

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