Request exemption from recycling service

Applies to: Any business that does not contract for recycling service through their trash hauler

Businesses that decline recycling service must use the online form below or send us the pdf reporting version to report how they are keeping mandatory recyclables out of the landfill.

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Business, organization or resident info

Contact name(Required)

Title

Phone(Required)

Email(Required)

Business/Institution/Landlord name

Address of site generating recyclables(Required)

Street Address City ZIP Code

Mailing address (if different from site address)

Street Address City ZIP Code

Materials handling info

Name of trash hauler (choose one)

All mandatory (aka “blue bin”) recyclables generated by this entity are:

Option 1

Self-hauled to a recycling facility

Name and address of facility:

Option 2

Back-hauled by the business to a central facility, which then recycles the materials

Destination facility name and location:

Materials collected and back-hauled:

Option 3

Collected by a contracted third party for the specific purpose of recycling materials.

Third-party recycling service provider:

Phone:

Option 4

Recycled using a shared service at another place of business.

Business #2 Name & Address:

Business #2 Phone:

Certification and Signature

By completing the section below, I certify that the information contained on this form is true and accurate to the best of my knowledge and that I am the owner or have the lawful authority to sign this document on behalf of the owner.

By completing the section below, I certify that I have read and understand the requirement to comply with mandatory recycling as written in CSWD’s Solid Waste Management Ordinance. I also understand that changes to the information contained in this application must be reported to the District within five business days.

Name(Required)

Title(Required)

Date(Required)

Business #2(Required)

I certify I have read and understand the mandatory recycling requirement.

Name(Required)

Title(Required)

Date(Required)

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Business, organization or resident info

Materials handling info

Certification and Signature

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