Company Name: ____________________________ (2015 Quarters 3 & 4)
2015 Quarters 3 & 4 Waste & Recyclable Materials Summary Report
PLEASE ONLY INCLUDE MATERIALS COLLECTED FROM FORT COLLINS CUSTOMERS
Quantity (in Tons)
Jul
Aug
Sep
Oct
Nov
Dec
Residential Curbside Recycling (including HOA customers and all dwellings without shared dumpsters):
Residential Single-stream
Commercial and Multi-Family Recycling:
Total Tons
0
Total Tons
Commercial Single-stream
0
Multi-family Single-stream
0
Paper Mix (ONP, OMX, etc.)
0
Office Paper
0
Corrugated Cardboard
0
Glass
0
Commingled Containers
0
Scrap Metal
0
Organic Wastes, Other Recyclables
Total Tons
Food Waste (Residential )
0
Food Waste (Commercial)
0
Yard Waste (Residential)
0
Yard Waste (Commercial)
0
Spent Brewery Grain
0
Wood Wastes (Commercial)
0
Electronics
0
Plastic Bags / Shrink Wrap
0
Concrete / Other (please write in)
0
Continue to page 2 of this form Please return completed form by February 12 to Caroline Mitchell:
[email protected]
City of Fort Collins Environmental Services • P.O. Box 580, Fort Collins, CO 80522-0580
1/12/2016
Page 1 of 2
Company Name: ____________________________ (2015 Quarters 3 & 4)
Total TRASH
Customer Accounts
SUMMARY OF FORT COLLINS CUSTOMERS
(use customer count as of 12/31/15)
Total RECYCLING
Customer Accounts
Residential Curbside
Multi-family -- Number of complexes served
Commercial
Industrial (include roll-off customers)
TONS OF LANDFILLED WASTE from Fort Collins Customers
Jul
Aug
Sep
Oct
Nov
Dec
Total Tons
Residential
0
Multi-family
0
Commercial
0
Industrial / Roll-off Container
0
Total
0
0
0
0
0
0
0
ADDITIONAL QUESTIONS
1. What percentage of your landfill waste is hauled to:
a.
Larimer County Landfill: ________________________________________
b. North Weld Landfill in Ault: ______________________________________
c.
Elsewhere (please list location): __________________________________
2. What percentage of your residential yard waste is hauled to Hageman Earth Cycle? _________________________
3. What percentage of your commercial yard waste is hauled to Hageman Earth Cycle? ________________________
4. What percentage of your wood waste is hauled to Hageman Earth Cycle? _________________________________
I certify that the information provided on this form is true, accurate, and complete. I understand that the City of
Fort Collins has the right to audit the information provided on this form.
Signature:________________________________________
Print Name: ________________________________
Title: ____________________________________________
Date: _____________________________________
Email address: ____________________________________
Phone: ____________________________________
1/12/2016
Page 2 of 2