2560-FM-BWM0168DW
Instructions
Rev. 12/2013
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF WASTE MANAGEMENT
Instructions for Completion of the
Municipal Waste Landfill and Resource Recovery Facility Waiver
Quarterly Fee and Operations Report
Part 2 – Operations/Detail Report
Form BWM0168DW
A. General Information
Permit No. – Enter your facility’s DEP permit number.
Facility Name – Enter your facility’s name.
Page
of
– Enter the page number of each sheet in the first space and the total number of pages of
the report in the second space, for example, Page 1 of 3. Do not count Form BWM0168D as a page.
Month
_______________, 20 – For the three months of the quarter for which you are reporting, enter
each month and the year on a separate page of this form. If more lines are needed for a given month or months,
please reproduce additional blank copies of the form as needed.
Throughout all pages of the report:
Express all weights in tons rounded to the nearest tenth (0.1) of a ton using the following weight conversion factors:
1 Cu. Yd. = 1 Ton, 1 Ton = 2,000 Pounds, 1 Gallon = 8 pounds, 1 kilogram = 2.2 pounds
B. Monthly Operations/Detail Report
Use a separate sheet for each month being reported.
Only wastes such as flood debris and Great American Cleanup waste, for which fees are waived by DEP, may
be included on this report.
Column 1, Line No., is used as a reference point for these instructions.
Column 2, County Code or State Abbrev is the PA county or the state from which the waste was received. If
waste was received from a county within PA, enter a two digit code from Table 1. If the waste was received
from out of state, enter the two-letter state abbreviation from Table 2.
Column 3, Flood Debris is the tons (rounded to the nearest tenth of a ton) of flood debris materials received
for which DEP has waived fees.
Column 4, Great American Cleanup is the tons (rounded to the nearest tenth of a ton) of materials received
from Great American Cleanup activities for which DEP has waived fees.
Column 5, Other is the tons (rounded to the nearest tenth of a ton) of materials received for which DEP has
waived fees that do not include flood debris or materials from Great American Cleanup activities.
Column 6, TOTAL, is the total across each line, or a total for each month of the quarter from each PA county
or state (other than PA).
Line 12, TOTAL, is the total of each type of waste. The sum of the TOTALs across Line 12 must equal the
sum of the TOTALs in Column 6.
Reproduce additional copies of Form 2560-BWM0168DW
Rev. 12/2013 as needed.
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2560-FM-BWM0168DW
Instructions
Rev. 12/2013
Table 1 - Pennsylvania Counties and Codes
County
Code
Adams........................... 01
Allegheny...................... 02
Armstrong ..................... 03
Beaver .......................... 04
Bedford ......................... 05
Berks ............................ 06
Blair .............................. 07
Bradford........................ 08
Bucks............................ 09
Butler ............................ 10
Cambria ........................ 11
Cameron....................... 12
Carbon .......................... 13
Centre ........................... 14
Chester ......................... 15
Clarion .......................... 16
Clearfield ...................... 17
Clinton .......................... 18
Columbia ...................... 19
Crawford ....................... 20
Cumberland .................. 21
Dauphin ........................ 22
Delaware ...................... 23
County
Code
Elk ................................. 24
Erie ............................... 25
Fayette .......................... 26
Forest............................ 27
Franklin ......................... 28
Fulton ............................ 29
Greene .......................... 30
Huntingdon ................... 31
Indiana .......................... 32
Jefferson ....................... 33
Juniata .......................... 34
Lackawanna ................. 35
Lancaster ...................... 36
Lawrence ...................... 37
Lebanon ........................ 38
Lehigh ........................... 39
Luzerne ......................... 40
Lycoming ...................... 41
McKean ........................ 42
Mercer........................... 43
Mifflin ............................ 44
Monroe ......................... 45
Montgomery.................. 46
County
Code
Montour ......................... 47
Northampton ................. 48
Northumberland ............ 49
Perry ............................. 50
Philadelphia .................. 51
Pike ............................... 52
Potter ............................ 53
Schuylkill ....................... 54
Snyder ........................... 55
Somerset....................... 56
Sullivan ......................... 57
Susquehanna ................ 58
Tioga ............................. 59
Union ............................. 60
Venango........................ 61
Warren .......................... 62
Washington ................... 63
Wayne ........................... 64
Westmoreland ............... 65
Wyoming ....................... 66
York ............................... 67
Table 2 - Two Letter State and Territory Abbreviations
Alabama ....................... AL
Arizona ......................... AZ
Arkansas ...................... AR
California ...................... CA
Colorado ....................... CO
Connecticut .................. CT
Delaware ...................... DE
District of Columbia ...... DC
Florida .......................... FL
Georgia ......................... GA
Idaho ............................ ID
Illinois ........................... IL
Indiana .......................... IN
Iowa .............................. IA
Kansas ......................... KS
Kentucky....................... KY
Louisiana ...................... LA
Maine ............................ ME
Maryland ....................... MD
Massachusetts .............. MA
Michigan ....................... MI
Minnesota ..................... MN
Mississippi .................... MS
Missouri ........................ MO
Montana ........................ MT
Nebraska ...................... NE
Nevada ......................... NV
New Hampshire ............ NH
New Jersey ................... NJ
New Mexico .................. NM
New York ...................... NY
North Carolina .............. NC
North Dakota ................ ND
Ohio .............................. OH
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Oklahoma ...................... OK
Oregon .......................... OR
Pennsylvania................. PA
Puerto Rico ................... PR
Rhode Island ................. RI
South Carolina .............. SC
South Dakota ................ SD
Tennessee .................... TN
Texas ............................ TX
Utah .............................. UT
Vermont ........................ VT
Virginia .......................... VA
Washington ................... WA
West Virginia ................. WV
Wisconsin...................... WI
Wyoming ....................... WY
Canada ......................... CN