DEQ Reporting Form

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Thank you for taking the time to complete this form and for your cooperation in helping us to collect this data. The purpose of this form is to gather recycling and refuse data in order to measure our region’s progress in meeting the state mandated 25% recycling rate for the municipal solid waste stream. Please fill out all sections completely. Remember, full completion of this form is Mandatory.

The Virginia Department of Environmental Quality requires the Town of Blacksburg to report the total tonnage of all refuse and recycling collected within the Town. Section 20-142 of the Blacksburg Town Code states that all businesses and apartments or occupants of real property must regularly report information about the refuse and recycling that they generate within the Town. Non-reporting is a violation of the Blacksburg Town Code and can carry fines up to $3000 for noncompliance. 

REPORTING PERIOD: January – December 2016

 

1
Name of Business
 *
2
Blacksburg Address
 *
3
Mailing Address
 *
4
Name and Title of Contact Person
 *
5
Telephone Number
 *
6
Email Address
 *

GENERAL INSTRUCTIONS:

  • Please only report on recycling/trash that was generated within the Town of Blacksburg, Virginia from January – December 2016.
  • Please attempt to report in tons. If you are unable to report in tons, please list the unit of measurement you used (e.g. gallons, pounds, etc.)
7

If your business provides a recycling program for several locations, list those locations here. Total the combined tonnages, and report for all of them in sections 3-4. Please attach additional sheets as needed. 

SECTION 2: Principal Recyclable Material (PRM TYPE)

This information can be obtained from your recycling hauler/contractor.
8

Please list your recycling hauler/contractor. If material is picked up on a route and mixed with materials from many sources, your hauler may have trouble providing you with specific weights. If this is the case, please also indicate this by stating as such on the line provided below. Call your hauler and authorize them to release any information we may need in order to gain this data.

Hauler Information:

Please list your recycling hauler/contractor. If material is picked up on a route and mixed with materials from many sources, your hauler may have trouble providing you with specific weights. If this is the case, please also indicate this by stating as such on the line provided below. Call your hauler and authorize them to release any information we may need in order to gain this data. Hauler Information:
9

If your business does not recycle an item listed in the “Principal Recyclable Material” section please indicate this by marking that box with an “X”.

IMPORTANT!!! For the “Destination Facility” column, please indicate whether the material was sent to the Montgomery Regional Solid Waste Authority. If it was sent somewhere else, please include the name and address of the facility. Note that this is not your recycling hauler, but rather the facility where the hauler deposits your recycling.

Tons Recycled Jan-Dec. 2016 Destination Facility: MRSWA or “Other”
Commingled Containers
Metal
Mixed Paper
Single stream
Cardboard
Other
TOTAL IN TONS
10

SECTION 3: Supplemental Recyclable Material (SRM TYPE)

  • List materials and weight in tons.
  • If your business doesn’t recycle an item in the “Supplemental Recyclable Material” section, please indicate this by marking that box with an “X”.
  • You should easily be able to report specific weights and numbers for items in this section by contacting your hauler or checking your personal records. Please include any other materials not listed in the “other” boxes (e.g. electronics, fluorescent lamps, ink toner cartridges). Please attach additional sheets if necessary.
  • Please report any special wastes that you might recycle, or those materials or chemicals that are specific to your processes in the “other” categories.
  • IMPORTANT!!!For the “Destination Facility” column, please indicate whether the material was sent to the Montgomery Regional Solid Waste Authority (MRSWA) or another facility. Note that this is not your recycling hauler, but rather the facility where the hauler deposits your recycling.
Tons Recycled Jan-Dec. 2016 Destination Facility: MRSWA or “Other”
Tires (list size & amount)
Motor Oil (gallons)
Used Oil Filters
Cooking Oil (gallons)
Used Antifreeze
Transmission Fluid
Construction Waste
Demolition Waste
Auto Batteries
Household batteries
Ash
Yard Waste
Wood
Textiles
Other (indicate)
TOTAL IN TONS

SECTION 4: Refuse

11
Tons of refuse generated January - December 2016:
12

Refuse Hauler(s):

Refuse Hauler(s):
13

DESTINATION FACILITY (Please check one. Note that this is not your refuse hauler, but rather the facility where the hauler deposits your refuse.)

DESTINATION FACILITY (Please check one. Note that this is not your refuse hauler, but rather the facility where the hauler deposits your refuse.)
14

If material is picked up on a route and mixed with material from many sources, your hauler (vendor) may have trouble providing you with specific weights, if this is the case, please indicate this by stating as such on the line provided. Also, please call your hauler and authorize them to release any information we may need in order to gain this data.

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