ADEM Form 015 "Processing and Recycling General Information Recycling Registration Form" - Alabama

What Is ADEM Form 015?

This is a legal form that was released by the Alabama Department of Environmental Management - a government authority operating within Alabama. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2022;
  • The latest edition provided by the Alabama Department of Environmental Management;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of ADEM Form 015 by clicking the link below or browse more documents and templates provided by the Alabama Department of Environmental Management.

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Download ADEM Form 015 "Processing and Recycling General Information Recycling Registration Form" - Alabama

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This form is now available for electronic submittal using the
Alabama Environmental Permitting and Compliance System or
AEPACS.
[Note: The program encourages the use of an electronic form
submittal rather than a paper form submittal.]
Please click the link below to submit this form electronically
using AEPACS.
https://aepacs.adem.alabama.gov/nviro/ncore/external/home
This form is now available for electronic submittal using the
Alabama Environmental Permitting and Compliance System or
AEPACS.
[Note: The program encourages the use of an electronic form
submittal rather than a paper form submittal.]
Please click the link below to submit this form electronically
using AEPACS.
https://aepacs.adem.alabama.gov/nviro/ncore/external/home
PROCESSING AND RECYCLING GENERAL INFORMATION
015
RECYCLING REGISTRATION FORM 3___-
ALABAMA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
LAND DIVISION – SOLID WASTE BRANCH
POST OFFICE BOX 301463
MONTGOMERY, ALABAMA 36130-1463
INSTRUCTIONS: APPLICATIONS SHOULD BE TYPED OR PRINTED IN INK AND THE ORIGINAL AND ONE COPY SUBMITTED
TO THE DEPARTMENT IN DUPLICATE.
PLEASE CONTINUE ON AN ATTACHED SHEET OF PAPER IF
INSUFFICIENT SPACE IS AVAILABLE TO ADDRESS ANY ITEM BELOW.
PLEASE MARK N/A IN THE
APPROPRIATE BOX WHEN AN ITEM IS NON-APPLICABLE TO THE APPLICANT.
FACILITY TYPE
INITIAL REGISTRATION FOR FACILITY
MODIFICATION OF EXISTING REGISTRATION
If a new facility, estimated date for beginning of operation:______________________________
List total acreage of entire property on which the facility is located:____________________________________________
List total acreage used or to be used in connection with operation of the facility (including area for building and storage):________________________
________________________________________________________________________________________________________________________
Is the facility adjacent to or will it include, any other type of solid waste management activity (landfill, incinerator, water-to-energy plant, etc)?
Yes ___________ No _____________
If “yes” please explain:
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
MATERIALS COLLECTED
ESTIMATED QUANITY
ESTIMATED QUANITY
ESTIMATED QUANITY
(TONS/MONTH)
(TONS/MONTH)
(TONS/MONTH)
PLASTIC _________________________
MIXED PAPER______________________
ELECTRONICS ______________________
FERROUS METALS_________________
BATTERIES_________________________
GLASS__________________________
NEWSPAPER_____________________
OTHER METALS____________________
(OTHER) ___________________________
ALUMINUM _______________________
KITCHEN GREASE__________________
(OTHER) ___________________________
CARDBOARD_____________________
YARD WASTE______________________
(OTHER) ___________________________
Site Information:
Address:
(physical)
State/Area/Zip: _________________________________________
City:
County:
Country:
Registrant Information/Name:_______________________________________________________________________
Address:
________________________________________________________________________________________
(mailing)
City:
__________________________________
State/Area/Zip: _________________________________________
__________________________________
County:
Country:_________________________________________
Email:
_____________________________________________
Phone Number: _____________________________________
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015
RESPONSIBLE OFFICIAL (The responsible official will also be responsible for the submittal of semi-annual reports as
required by Solid Waste Regulations, Processing and Recycling Chapter 335-13-3-.05(4))
Prefix/Name/Title:
Address:
State/Area/Zip:___________________ Country:
City:
Phone Number:
Email:
FACILITY CONTACT
Prefix/Name/Title:
Address:
Country:
City:
State/Area/Zip:
Email:
Phone Number:
Physical Location where Records will be maintained:
Address:
Country:
City:
State/Area/Zip:
Phone Number:
RECORD CONTACT
Prefix/Name/Title:
Address:
City:
State/Area/Zip:
Country
Email:
Phone Number:
MAILING CONTACT
Prefix/Name/Title
Address:
State/Area/Zip
Country
City:
PROCESSING & RECYCLING FACILITY
ADEM Form 3___ Recycling Facilities 06/22 m2
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015
CERTIFICATION
A responsible official or representative as defined in Rule 335-13-3-.02(5) must provide their signature to verify the
statement below.
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine
and imprisonment for knowing violations.
SIGNATURE (Responsible official of applicant):
Title:
Date:
(print or type name)
SUPPLEMENTAL INFORMATION
In addition to this form the following information must be submitted.
• A Description of how the facility will be designed and operated in accordance with Solid Waste Regulations,
Processing and Recycling r. 335-13-3-.03.
• A Description of how the facility will comply with storage and accumulation limitations in accordance with Solid
Waste Regulations, Processing and Recycling r. 335-13-3-.04.
• How the facility will comply with requirements for Records and Reports in accordance with Solid Waste
Regulations, Processing and Recycling r. 335-13-3-.05.
OPERATING RECORD
The following records must be kept and maintained in accordance with ADEM Admin. Code r. 335-13-3 Solid Waste
Regulations, Processing and Recycling.
• Copies of material receipts received at the facility for use by ADEM staff, the person delivering the materials, and
the receiving recycling facility.
• Semi-annual reports that include reports of all materials received, stored, processed, or transferred.
• All recycling facilities exempt from registration in accordance to ADEM Admin. Code r. 335-13-3-.02(3) (Solid
Waste Regulations, Processing and Recycling ) must submit a semi-annual report as outlined in ADEM Admin
Code r. 335-13-3-.05(4).
• Any information submitted to ADEM may be considered confidential if requested in writing by the facility in
accordance with ADEM Admin. Code rs. 335-13-3-.02(a)(2) and 33-1-1-.06(2).·
• Records are to be kept and maintained for three years and made available for inspection by ADEM personnel
upon request.
For additional i nformation or questions concerning t he completion of t his form please c ontact A DEM R ecycling staff at
334-274-4201 or via email at Recycling@adem.alabama.gov.
ADEM Form 3___ Recycling Facilities 06/22 m2
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015
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