Form CalRecycle911-DOR-SV "Scrap Value Purchases Survey Form" - California

What Is Form CalRecycle911-DOR-SV?

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 CalRecycle911-DOR-SV 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 CalRecycle911-DOR-SV "Scrap Value Purchases Survey Form" - California

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SCRAP VALUE PURCHASES SURVEY FORM
State of California
Department of Resource Recycling & Recovery
Market Information Unit, 801 K Street, 17th Floor, MS 17-24, Sacramento, CA 95814
Clear
Print
Phone: (916) 323-5778 Fax: (916) 552-4913
Confidential
Bimetal:
Processor Name:
Entity Type
Total Weight
Total Net
Purchased From
Purchased (Tons)
Payment
Certification Number:
1. RC, RV
Survey Month:
2. CS
Address:
3. SP
Phone:
4. CP
E-mail Address:
5. Non-Cert
Date Prepared:
6. PR
To the best of my knowledge the information
submitted on this scrap value survey form is
7. Internal
complete, accurate and verifiable.
PETE Plastic:
Print Name:
(polyethylene terephthalate)
Entity Type
Total Weight
Total Net
Signature:
Purchased From
Purchased (Tons)
Payment
Glass:
1. RC, RV
Entity Type
Total Weight
Total Net
2. CS
Purchased From
Purchased (Tons)
Payment
3. SP
1. RC, RV
4. CP
2. CS
5. Non-Cert
3. SP
6. PR
4. CP
7. Internal
5. Non-Cert
6. Internal
HDPE Plastic:
(high density polyethylene)
Entity Type
Total Weight
Total Net
Monthly Total weight (tons) by color:
Purchased From
Purchased (Tons)
Payment
Flint:
Green:
1. RC, RV
Amber:
Mixed:
2. CS
Processor to Processor Transactions:
3. SP
Entity Type
Total Weight
Total Net
Purchased From
Purchased (Tons)
Payment
4. CP
7. PR BP
5. Non-Cert
8. PR Non-PB
6. PR
7. Internal
Monthly total weight (tons):
Color Sorted:
Mixed:
CalRecycle 911-DOR-SV (Rev. 2/18)
PAGE 1 of 2
SCRAP VALUE PURCHASES SURVEY FORM
State of California
Department of Resource Recycling & Recovery
Market Information Unit, 801 K Street, 17th Floor, MS 17-24, Sacramento, CA 95814
Clear
Print
Phone: (916) 323-5778 Fax: (916) 552-4913
Confidential
Bimetal:
Processor Name:
Entity Type
Total Weight
Total Net
Purchased From
Purchased (Tons)
Payment
Certification Number:
1. RC, RV
Survey Month:
2. CS
Address:
3. SP
Phone:
4. CP
E-mail Address:
5. Non-Cert
Date Prepared:
6. PR
To the best of my knowledge the information
submitted on this scrap value survey form is
7. Internal
complete, accurate and verifiable.
PETE Plastic:
Print Name:
(polyethylene terephthalate)
Entity Type
Total Weight
Total Net
Signature:
Purchased From
Purchased (Tons)
Payment
Glass:
1. RC, RV
Entity Type
Total Weight
Total Net
2. CS
Purchased From
Purchased (Tons)
Payment
3. SP
1. RC, RV
4. CP
2. CS
5. Non-Cert
3. SP
6. PR
4. CP
7. Internal
5. Non-Cert
6. Internal
HDPE Plastic:
(high density polyethylene)
Entity Type
Total Weight
Total Net
Monthly Total weight (tons) by color:
Purchased From
Purchased (Tons)
Payment
Flint:
Green:
1. RC, RV
Amber:
Mixed:
2. CS
Processor to Processor Transactions:
3. SP
Entity Type
Total Weight
Total Net
Purchased From
Purchased (Tons)
Payment
4. CP
7. PR BP
5. Non-Cert
8. PR Non-PB
6. PR
7. Internal
Monthly total weight (tons):
Color Sorted:
Mixed:
CalRecycle 911-DOR-SV (Rev. 2/18)
PAGE 1 of 2
SCRAP VALUE PURCHASES SURVEY FORM
State of California
Department of Resource Recycling & Recovery
Market Information Unit, 801 K Street, 17th Floor, MS 17-24, Sacramento, CA 95814
Phone: (916) 323-5778 Fax: (916) 552-4913
Confidential
PP:
(polypropylene)
Processor Name:
Entity Type
Total Weight
Total Net
Purchased From
Purchased (Tons)
Payment
Certification Number:
1. RC, RV
Survey Month:
2. CS
3. SP
4. CP
5. Non-Cert
6. PR
7. Internal
.
V:
PS:
(vinyl)
(polystyrene)
Entity Type
Total Weight
Total Net
Entity Type
Total Weight
Total Net
Purchased From
Purchased (Tons)
Payment
Purchased From
Purchased (Tons)
Payment
1. RC, RV
1. RC, RV
2. CS
2. CS
3. SP
3. SP
4. CP
4. CP
5. Non-Cert
5. Non-Cert
6. PR
6. PR
7. Internal
7. Internal
LDPE:
OTHER:
(includes multilayer)
(low density polyethylene)
Entity Type
Total Weight
Total Net
Entity Type
Total Weight
Total Net
Purchased From
Purchased (Tons)
Payment
Purchased From
Purchased (Tons)
Payment
1. RC, RV
1. RC, RV
2. CS
2. CS
3. SP
3. SP
4. CP
4. CP
5. Non-Cert
5. Non-Cert
6. PR
6. PR
7. Internal
7. Internal
CalRecycle 911-DOR-SV (Rev. 2/18)
PAGE 2 of 2
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