Green Business Program Application Form

Fill out the following information * = Required

Business name: *

Street address: *

City, State Zip Code: *

Website URL (if any):

Contact name: *

E-Mail address: *

Phone number: *

Fax number:

Sector (e.g. restaurant, hotel, office, printer etc.): *
Business Description: *

Approximate number of employees working in the area to be certified: *

Approximate square footage of the facility that will be certified: *

What permits does your building hold? *
(e.g. Air Permit, Hazmat, Wastewater, None, etc...)

Does your business have other branches in San Mateo County?
Yes No
In which Cities:
Please describe any actions you have already taken to make your business green:

Have any of your other branches in the Bay Area been certified green?
Yes No
Are you a tenant of a larger building?
Yes No
Are you a home office?
Yes No
Do you store hazardous materials onsite?
(e.g. paint, motor oil, pesticides, cleaning products)
Yes No
Does your building have a recycling program?
Yes No
How did you hear about this program?
Form Verification Code:

NOTE: If you are unable to submit this form online, please print the completed application and mail it to:

Green Business Program
County of San Mateo
555 County Center 5th Floor
Redwood City, CA 94061


By completing the Green Business application, you are giving the authorization to RecycleWorks and your City Green Business representative to receive energy and water usage data from your utility company for the purposes of completing the Green Business Certification process.

— We strive to assist businesses of every type and size but there are some that are outside the current scope of the program. We are presently only offering the Pilot Program to a limited number of businesses in the following jurisdictions: Burlingame, Daly City, Millbrae, San Carlos, San Mateo, Redwood City, and Unincorporated San Mateo County. The Pilot Program is serving four business types: Restaurants/Cafés, Offices/Retail, Hotels/Motels and Auto Repair Shops. Based on the success of the pilot program the San Mateo County's Board of Supervisors will consider expansion of the program into other cities and business types in the Spring of 2008.

If your business resides in an area outside the Pilot Program or is a different business type, Fill-out an application to be put on a waiting-list and to receive future updates on the program and how to become a Sustainable Business.