Form CalRecycle908 "Certification Application for Dropoff or Collection & Community Service Programs" - California

What Is Form CalRecycle908?

This is a legal form that was released by the California Department of Resources Recycling and Recovery - a government authority operating within California. Check the official instructions before completing and submitting the form.

Form Details:

  • Released on February 1, 2018;
  • The latest edition provided by the California Department of Resources Recycling and Recovery;
  • 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 Form CalRecycle908 by clicking the link below or browse more documents and templates provided by the California Department of Resources Recycling and Recovery.

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Download Form CalRecycle908 "Certification Application for Dropoff or Collection & Community Service Programs" - California

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Certification Application
DROPOFF OR COLLECTION & COMMUNITY SERVICE PROGRAMS
State of California
Department of Resources Recycling & Recovery
CalRecycle 908
Mail to:
(Rev. 2/18)
CalRecycle • Division of Recycling • Certification Section
801 K Street • MS 15-59 • Sacramento, CA 95814-3533
Questions? Call: (916) 324-8598
Instructions
Office Use Only
App. #
• Print In Ink Or Type.
Category: ❏ Dropoff or Collection Program ❏ Community Service Program
• Submit A Separate Form For Each
Location Or Category.
❑ Neighborhood Dropoff Program
• Indicate N/A For Any Items Which
Certification No.
Are Not Applicable.
❑ 2 year
❏ Probationary: Expiration
OPERATOR INFORMATION
1)
Contact Person
First
Middle
Last
Title
Organization Name
Fictitious Business Name, If applicable
Business Address
Address
City
County
State
Zip Code
Mailing Address
Address
City
County
State
Zip Code
(
)
Telephone Number (
)
Fax
Type Of Organization
2)
(Check one box)
a.
Individual:
Partnership:
General or
Limited Submit copy of current partnership agreement.
b.
Corporation: Submit Articles of Incorporation and list of current corporate officers.
c.
Corporate # as filed with Secretary of State
Profit
or
Nonprofit (Select one)
Domestic or
Foreign (Select one) If foreign, submit copy of certificate from California Secretary of State.
Agent for service of process
Limited Liability Company: Submit Articles of Organization, Statement of Information and operating agreement.
d.
Domestic or
Foreign (Select one) If foreign, submit copy of certificate from California Secretary of State.
Agent for service of process
Husband and Wife Co-Ownership: Name of Spouse
e.
f.
Nonprofit Organization with State of California or Federal Tax Exempt Status.
g.
Government or Public Agency:
____
City
County
City & County
School
State
Federal
____
____
____
____
____
Submit governing board resolution authorizing this application.
h.
Other (Explain):
3)
Submit a copy of the fictitious business name statement, if applicable
4)
Federal ID # (Employer ID#)
Corporations, partnerships and other organizations with paid employees must provide a Federal ID#.
Printed on recycled paper
State of California
Print
Clear
Certification Application
DROPOFF OR COLLECTION & COMMUNITY SERVICE PROGRAMS
State of California
Department of Resources Recycling & Recovery
CalRecycle 908
Mail to:
(Rev. 2/18)
CalRecycle • Division of Recycling • Certification Section
801 K Street • MS 15-59 • Sacramento, CA 95814-3533
Questions? Call: (916) 324-8598
Instructions
Office Use Only
App. #
• Print In Ink Or Type.
Category: ❏ Dropoff or Collection Program ❏ Community Service Program
• Submit A Separate Form For Each
Location Or Category.
❑ Neighborhood Dropoff Program
• Indicate N/A For Any Items Which
Certification No.
Are Not Applicable.
❑ 2 year
❏ Probationary: Expiration
OPERATOR INFORMATION
1)
Contact Person
First
Middle
Last
Title
Organization Name
Fictitious Business Name, If applicable
Business Address
Address
City
County
State
Zip Code
Mailing Address
Address
City
County
State
Zip Code
(
)
Telephone Number (
)
Fax
Type Of Organization
2)
(Check one box)
a.
Individual:
Partnership:
General or
Limited Submit copy of current partnership agreement.
b.
Corporation: Submit Articles of Incorporation and list of current corporate officers.
c.
Corporate # as filed with Secretary of State
Profit
or
Nonprofit (Select one)
Domestic or
Foreign (Select one) If foreign, submit copy of certificate from California Secretary of State.
Agent for service of process
Limited Liability Company: Submit Articles of Organization, Statement of Information and operating agreement.
d.
Domestic or
Foreign (Select one) If foreign, submit copy of certificate from California Secretary of State.
Agent for service of process
Husband and Wife Co-Ownership: Name of Spouse
e.
f.
Nonprofit Organization with State of California or Federal Tax Exempt Status.
g.
Government or Public Agency:
____
City
County
City & County
School
State
Federal
____
____
____
____
____
Submit governing board resolution authorizing this application.
h.
Other (Explain):
3)
Submit a copy of the fictitious business name statement, if applicable
4)
Federal ID # (Employer ID#)
Corporations, partnerships and other organizations with paid employees must provide a Federal ID#.
Printed on recycled paper
State of California
CalRecycle 908 (Rev. 2/18)
OPERATOR INFORMATION
(Continued)
5)
Are you or this program currently certified by CalRecycle, Division of Recycling, in any category? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If YES, Certification Number(s)
6)
Were you or this program previously certified by CalRecycle, Division of Recycling, in any category? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If YES, Certification Number(s)
7)
Do you or this program have other applications pending with CalRecycle, Division of Recycling, in any category? . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
8)
Have you or this program ever been denied certification by CalRecycle, Division of Recycling, in any category? . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
9)
Do you speak English? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If No, which language is spoken?
PROGRAM DESCRIPTION
10) Program Name
11) What types of empty beverage containers do you collect or accept?
Aluminum
Glass
Plastic
Bimetal
12) Are you applying as a Neighborhood Dropoff Program? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If yes, submit a copy of a letter of authorization from city, county, or city and county specifying the dropoff locations, and a regional map outlining the
geographical area served.
List the address of the dropoff location(s) served under the neighborhood dropoff program
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
13) Do you have an established (or regular) route you follow to collect empty beverage containers?
14) Do you have a regular schedule for collecting empty beverage containers? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
15) Do you collect empty beverage containers directly from bars, restaurants, hotels and motels?
If yes, please list the name, address, phone and contact person for three of any of the following: bars, restaurants, hotels and motels where you collect.
. . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
16) Do you collect empty beverage containers directly from office buildings, industrial/commercial buildings?
If yes, please list the name, address, phone and contact person for three of any of the following: office buildings, industrial/commercial buildings where you
collect.
17) Where else do you collect empty beverage containers?
Streets/Alleys
Apartment Complexes
Parks/Recreation Areas
Parking Lots
Residential Garbage
Transfer Station
Landfill Disposal Site
Material Recovery Facility (MRF)
Special Events
Other (explain):
CalRecycle 908 (Rev. 2/18)
PROGRAM DESCRIPTION
(Continued)
18) Do you have donation bins at specific locations? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If yes, how many?
If yes, where are your donation locations? (e.g., school, store parking lot, church, specific address, etc.)
19) Do you collect empty beverage containers at residential curbside under contract or with written acknowledgment by a local government agency?
..................................................................................................................
Yes
No
20) Do you separate beverage containers from mixed municipal waste under permit by a local government agency? . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If yes, attach a copy of your current permit or formal acknowledgment of operation from the local government agency.
21) Do you operate a dropoff or collection program located on federal land? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
National Park
Military Installation
Other Federal Property
If yes, submit authorization for State Inspectors to enter property.
22) Do you pay refund value for the empty beverage containers? ................................................................
Yes
No
23) Do you pay scrap value for the empty beverage containers? .................................................................
Yes
No
24) Do you accept/collect containers only in California? .......................................................................
Yes
No
DECLARATION AND SIGNATURES
25) a. I agree to operate my program in compliance with the California Beverage Container Recycling and Litter Reduction Act, including all relevant regulations
contained in Chapter 5 of Division 2 of Title 14 of the California Code of Regulations.
b. I declare under penalty of perjury under the laws of the State of California that all information on this application and supporting documents is true and
correct and that I am authorized to sign this application.
Note: Please refer to note below (*) for information on who is eligible and required to sign this form.
Executed at
on
City
County
State
(Month/ Day/Year)
Signature
Title
Residence Phone _ (
)
Printed Name
Residence Address
Address
City
State
Zip Code
Vehicle License #
California Driver License #
Social Security # **
Executed at
on
City
County
State
(Month/ Day/Year)
Signature
Title
Residence Phone _ (
)
Printed Name
Residence Address
Address
City
State
Zip Code
Vehicle License #
California Driver License #
Social Security # **
* Who must sign affidavit: For Individuals-the applicant; Partnerships-each partner; Husband & Wife Co-ownerships-both husband & wife; Corporations, Limited Liability Companies,
Government or Public Agencies-persons with authority to legally bind said entity to a contract (e.g., Executive Officer, Managing Member).
** Providing the Social Security Number is voluntary in accordance with the Privacy Act of 1974 (PL 93-579). This information is used for applicant identification purposes.
Authority: California Beverage Container Recycling and Litter Reduction Act (Public Resources Code Section 14500 et seq.).
CalRecycle 908 (Rev. 2/18)
FOR INFORMATION ONLY
What other recyclable material(s) do you collect or accept?
Newsprint
White Paper
Computer Paper
Cardboard
Construction/Demolition
Styrofoam
Other Aluminum
Scrap Metal
Other Glass
Other Plastic
Telephone Books
Magazines
Oil
Auto Batteries
Used Oil
Yard Waste
Oil Filters
Tin Cans
Tires
Wood
Mixed Paper
Steel
Copper
Iron
Toner Cartridges
Other
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