Annual Report Form - Planning Unit Recycling Report · ANNUAL REPORT FORM – PLANNING UNIT...

DIVISION OF MATERIALS MANAGEMENT ANNUAL REPORT FORM – PLANNING UNIT RECYCLING REPORT

NOTE: WHEN FILLING OUT THIS FORM, PLEASE REPORT ALL WASTE/MATERIAL GENERATED WITHIN THE PLANNING UNIT (NOT JUST THOSE FACILITIES OWNED/OPERATED BY THE PLANNING UNIT).

ATTACH ADDITIONAL SHEETS AS NECESSARY.

REPORT YEAR:

PLANNING UNIT NAME:

ADDRESS:

COUNTY:

CONTACT PERSON:

EMAIL:

TELEPHONE NUMBER:

LIST ALL FACILITIES IN YOUR PLANNING UNIT FOR WHICH DATA ARE INCLUDED IN THIS REPORT (MUNICIPAL AND PRIVATE) FACILITY NAME REGISTRATION/PERMIT NO.

1.

2. 3.

4. 5.

6. 7. 8.

9. 10.

11. 12. 13.

14. 15.

16. 17. 18.

19. 20.

21. 22. 23.

24. 25.

WASTE GENERATED IN PLANNING UNIT SENT FOR DISPOSAL (MATERIAL NOT RECYCLED) In this section, report all material sent for disposal.

Using this data, material generated within the planning unit can be tracked from the point of generation to the place of final disposal.

An intermediate destination facility is a facility used for processing, sorting or consolidation before being sent to a disposal facility.

A final destination facility includes facilities that accept waste for final disposal (landfills, municipal waste combustors, out-of-state disposal facilities).

WASTE STREAMS

NAME AND COMPLETE ADDRESS DATA SOURCE

(Hauler/Facility Survey, Scale Weight, Truck, Estimate, Other)

INTERMEDIATE DESTINATION FACILITY (Transfer Station, C&D Debris Processor)

TONS FINAL DESTINATION FACILITY

(Landfill, Municipal Waste Combustor, Out-of-State)

TONS

Municipal Solid Waste

(MSW)

1.

2.

3.

C&D Debris

1.

2.

3.

Non-Hazardous Industrial

Waste

1.

2.

3.

Biosolids

1.

2.

3.

RECYCLABLES RECOVERED

Do not report recyclables that result from the Returnable Container Act (Bottle Bill) or are part of a Beneficial Use Determination.

Report all recyclable material quantities as marketed tonnages.

Municipal (Mixed

Material)



INTERMEDIATE DESTINATION FACILITY (Transfer Station, Recyclables Handling and

Recovery Facility) TONS

END USE/FINAL DESTINATION FACILITY (Market)

TONS

Single Stream 1.

2.

Commingled Containers

(metal, plastic,

glass)

1.

2.

Commingled Paper

(mixed, all grades)

1.

2.

Municipal (Paper)






TONS

Newspaper 1.

2.

Corrugated Cardboard

1.

2.

Paperboard/ Boxboard

(cereal, shoe and

gift boxes)

1.

2.

Office Paper 1.

2.

Magazines 1.

2.

Junk Mail 1.

2.

Municipal (Metal)






TONS

Tin/Aluminum Containers

1.

2.

Aluminum Foil/ Trays

1.

2.

White Goods/ Enameled Appliances

1.

2.

Propane Tanks 1.

2.

Bulk Metal (from residents)

1.

2.

Metal from Municipal

Waste Combustor Ash

1.

2.

Municipal (Glass)






TONS

Glass Containers (separated, only

clear)

1.

2.


brown)

1.

2.


green)

1.

2.

Glass Containers (mixed colors)

1.

2.

Non-container Glass

(vases, windows)

1.

2.

Municipal (Plastic)






TONS

Commingled Plastic

Containers (#1-7)

1.

2.

PET Containers (plastic #1, soda

and water bottles)

1.

2.

HDPE Containers

(plastic #2, milk

jugs, laundry and soap bottles)

1.

2.

Plastic #3-7 Containers

1.

2.

Rigid Plastics (buckets, laundry

baskets)

1.

2.

Plastic Film & Bags

(plastic wrap)

1.

2.

Municipal (Organics)






TONS

Leaves/Grass 1.

2.

Brush/Branches /Trees/Stumps (from residents)

1.

2.

Food Scraps (kitchen, grocery

stores, restaurants,

schools)

1.

2.

Fats, Oils and Grease

1.

2.

Municipal (Miscellaneous)






TONS

Textiles 1.

2.

Electronics 1.

2.

Tires 1.

2.

Wood Pallets 1.

2.

HOUSEHOLD HAZARDOUS WASTE FROM MUNICIPAL COLLECTION EVENTS

If the planning unit has a permanent HHH facility, please provide bellow its name and permit number. Facility name:

Registration/Permit No.

Location of Collection Event:

Number of Events:

1. Antifreeze Gallons 2. Hazardous Paint Gallons

3. Automotive Batteries Pounds 4. Hazardous Household Batteries Pounds 5. Pesticides (Solids) Pounds 6. Pesticides (Liquids) Gallons 7. Mercury Containing Devices Pounds 8. Bulk Mercury Pounds

9. Fluorescent Bulbs Pounds 10. # CRTs Pounds 11. # TVs Pounds 12. Other Electronics Pounds

13. Other HHW (Solids) Pounds 14. Other HHW (Liquids) Gallons 15. Miscellaneous Solid Waste (Solids) Pounds 16. Miscellaneous Solid Waste

(Liquids) Gallons

C&D Debris

NAME AND COMPLETE ADDRESS DATA SOURCE (Hauler/Facility Survey, Scale

Weight, Truck, Estimate, Other) INTERMEDIATE DESTINATION FACILITY (Transfer Station, C&D Debris Processor)

TONS END USE/FINAL DESTINATION FACILITY

(Market) TONS

Asphalt 1.

2.

Brick 1.

2.

Concrete 1.

2.

Wallboard (drywall)

1.

2.

Petroleum Contaminated

Soil (PCS)

1.

2.

Rock 1.

2.

Soil (clean)

1.

2.

Roofing Shingles 1.

2.

Wood (clean)

1.

2.

Wood (contaminated)

1.

2.

Land Clearing Debris

(including brush, stumps, trees, etc. NOT included

in Organics section)

1.

2.

C&D Debris Bulk Metal

(not from residents)

1.

2.

Non-Hazardous Industrial






TONS

Metal Reported from

Automobile Dismantlers

1.

2.

Metal Reported by Scrap Metal

Processors

1.

2.

Industrial Scrap Metal

(pre-consumer)

1.

2.

Industrial Scrap Glass

(pre-consumer)

1.

2.

Industrial Scrap Plastic

(pre-consumer)

1.

2.

Industrial Scrap Paper

(pre-consumer)

1.

2.

Food Processing Waste (brewery,

fish, fruit, vegetable

and dairy waste)

1.

2.

Wood (furniture)

1.

2.

Biosolids NAME AND COMPLETE ADDRESS DATA SOURCE


INTERMEDIATE DESTINATION FACILITY (Transfer Station)

TONS END USE/FINAL DESTINATION FACILITY

(Market) TONS

Biosolids (WWTP sludge)

1.

2.

Septage (septic tank sludge)

1.

2.

PLANNING UNIT RECYCLING SYSTEM INFORMATION

Please answer the following survey

WHAT RECYCLING SYSTEMS ARE AVAILABLE IN YOUR PLANNING UNIT?

Single stream recycling (Commingled) ☐

Dual stream recycling ☐

Both, single and dual recycling ☐

WHAT IS THE PERCENTAGE (ESTIMATE) OF THE PLANNING UNIT POPULATION THAT HAVE ACCESS TO EACH ONE OF THE RECYCLING SYSTEMS?

Single stream recycling (Commingled) %

Dual stream recycling %

Both, single and dual recycling %

NAME:

DATE:

SIGNATURE:

TITLE & ORGANIZATION:

COMMENTS/SUGGESTIONS:

SEND COMPLETED FORM VIA EMAIL TO [email protected]

IF EMAIL IS NOT AN OPTION SEND IT TO THE ADDRESS LISTED BELOW: NYS Department of Environmental Conservation

Division of Materials Management Attn: Bureau of Permitting and Planning 625 Broadway, 9th Floor Albany, NY 12233-7253

P: (518) 402-8678 F: (518) 402-9041

Annual Report Form - Planning Unit Recycling Report · ANNUAL REPORT FORM – PLANNING UNIT...

Documents

Transcript of Annual Report Form - Planning Unit Recycling Report · ANNUAL REPORT FORM – PLANNING UNIT...