ADEM Form 536 "Scrap Tire Manifest" - Alabama

What Is ADEM Form 536?

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 July 1, 2019;
  • 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 printable version of ADEM Form 536 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 536 "Scrap Tire Manifest" - Alabama

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ALABAMA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
SCRAP TIRE MANIFEST
Instructions for the use of this form may be found in ADEM Admin. Code 335-4-4-.05 available at:
adem.alabama.gov/regulations/regulations.htm
Certification: By my signature below I Certify under penalty of law that the information contained on this form 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 a fine for willful violations.
PART 1 – (check one) Receiver:
Transporter 1:
Transporter 2:
Processor:
SWDF / landfill:
Company Name:
Specify Quantities by Count or Tons
Address:
Whole Tires
___________
City:
ST:
ZIP:
__________
Tons of Tire Materials
Registration or Permit No.
Printed Name:
Signature:
Date:
PART 2 – (check one) Transporter 1:
Transporter 2:
Processor:
SWDF / landfill:
Receiver:
Company Name:
Specify Quantities by Count or Tons
Address:
Whole Tires
___________
City:
ST:
ZIP:
__________
Tons of Tire Materials
Registration or Permit No.
Printed Name:
Signature:
Date:
PART 3 – (check one) Processor:
SWDF / landfill:
Receiver:
Transporter:
Company Name:
Specify Quantities by Count or Tons
Address:
Whole Tires
___________
City:
ST:
ZIP:
__________
Tons of Tire Materials
Registration or Permit No.
Printed Name:
Signature:
Date:
ADEM Form 536 Revised 07/19 M4
page __ of __
ALABAMA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
SCRAP TIRE MANIFEST
Instructions for the use of this form may be found in ADEM Admin. Code 335-4-4-.05 available at:
adem.alabama.gov/regulations/regulations.htm
Certification: By my signature below I Certify under penalty of law that the information contained on this form 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 a fine for willful violations.
PART 1 – (check one) Receiver:
Transporter 1:
Transporter 2:
Processor:
SWDF / landfill:
Company Name:
Specify Quantities by Count or Tons
Address:
Whole Tires
___________
City:
ST:
ZIP:
__________
Tons of Tire Materials
Registration or Permit No.
Printed Name:
Signature:
Date:
PART 2 – (check one) Transporter 1:
Transporter 2:
Processor:
SWDF / landfill:
Receiver:
Company Name:
Specify Quantities by Count or Tons
Address:
Whole Tires
___________
City:
ST:
ZIP:
__________
Tons of Tire Materials
Registration or Permit No.
Printed Name:
Signature:
Date:
PART 3 – (check one) Processor:
SWDF / landfill:
Receiver:
Transporter:
Company Name:
Specify Quantities by Count or Tons
Address:
Whole Tires
___________
City:
ST:
ZIP:
__________
Tons of Tire Materials
Registration or Permit No.
Printed Name:
Signature:
Date:
ADEM Form 536 Revised 07/19 M4
page __ of __
Instructions for ADEM Form 536
Scrap Tire Manifest
This form must be used by those persons engaged in the transportation of scrap tires in Alabama. A
copy of the manifest must remain with any party that signs the manifest. This form must remain with the
tires while in transit.
PART 1 - This section must be completed by a receiver or person that has scrap tires or processed tire
material to be transported to another destination. Check the general class of person offering scrap tires
for transport (e.g., receiver, processor, transporter, SWDF), the company name, mailing address,
registration or permit number, and the number of whole tires or tons of tire materials released. A
responsible party must sign and print his name on this manifest and retain a copy in their operating
record.
PART 2 - This section must be completed by a transporter or other person that accepts scrap tires or
processed tire material. Check the general class of person completing Part 2 (e.g., transporter, receiver,
processor, SWDF), company name, mailing address, registration or permit number, and the number of
whole tires or tons of tire materials accepted. A responsible party must sign and print his name on this
manifest and retain a copy in their operating record.
PART 3 - This section must be completed by a permitted scrap tire processor or other person that
accepts scrap tires or processed tire material. Check the general class of person completing Part 3 (e.g.,
processor, SWDF, transporter, receiver), company name, mailing address, registration or permit number,
and the number of whole tires or tons of tire materials accepted. A responsible party must sign and print
his name on this manifest and retain a copy in their operating record.
Copies of manifest should not be submitted to ADEM. Copies of manifests must be
maintained in the operating record of all parties.
ADEM Form 536 Revised 07/19 m4
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