Form Center

Business & Institutional Recycling Survey

2. Firm Name

3. Contact Person

5. Address

7. City

8. State

9. Zip Code

11. Phone Number

15. 1. Does your firm recycle any waste materials?

    1. Yes
    2. No (If no, skip to question 11)

17. If yes, how long have you been recycling? (Years)

19. 2. If your firm does recycle, please estimate quantities recycled of the following:

21. Weekly

23. Office/Computer Paper

24. Mixed Paper

25. Newsprint

26. Glass

28. Cardboard

29. Ferrous (Iron/Steel)

30. Non-Ferrous

31. Aluminum

33. Plastics

34. Rubber

35. Textiles

36. Yard Waste

38. Other (Specify)

40. Monthly

42. Office/Computer Paper

43. Mixed Paper

44. Newsprint

45. Glass

47. Cardboard

48. Ferrous (Iron/Steel)

49. Non-Ferrous

50. Aluminum

52. Plastics

53. Rubber

54. Textiles

55. Yard Waste

57. Other (Specify)

59. Annually

61. Office/Computer Paper

62. Mixed Paper

63. Newsprint

64. Glass

66. Cardboard

67. Ferrous (Iron/Steel)

68. Non-Ferrous

69. Aluminum

71. Plastics

72. Rubber

73. Textiles

74. Yard Waste

76. Other (Specify)

78. 3. Whether or not your firm recycles, please estimate what percentage of your total waste consists of the following recyclable materials:

80. Percent %

82. Office/Computer Paper

83. Mixed Paper

84. Newsprint

85. Glass

87. Cardboard

88. Ferrous (Iron/Steel)

89. Non-Ferrous

90. Aluminum

92. Plastics

93. Rubber

94. Textiles

95. Yard Waste

97. Other (Specify)

99. 4. Where do you send the materials recycled from your facility? (Name and Address)

101. 5. The total amount of waste generated by your firm at this address is

     (enter quantity and choose appropriate measure and frequency)

103. Measure
     -- Select One --Cubic YardsTonsOther

104. Frequency
     -- Select One --DayWeekMonthYear

105. (Example: 25 cubic yards per week)

     (Example: 25 cubic yards per week)

107. 6. How does your firm currently handle waste disposal?
     -- Select One --Self haul, company vehiclesContract with Hauler

109. If Contract with hauler, Hauler name:

111. 7. If you contract, what is payment based on?
     -- Select One --By the dumpsterBy the tonOther

112. If other, specify

114. 8. What is the specific product or service your firm provides?

116. 9. How many people are employed by your firm?

118. 10. Does your firm purchase any recycled materials:

     1. Yes
     2. No

119. If Yes, specify:

121. 11. Are you interested in learning more about recycling?

     1. Yes
     2. No

Leave This Blank:


123. 1. Receive an email copy of this form.
124. Email address

     This field is not part of the form submission.

125. Submit

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