If already a member, current level: Associate Advocate Ambassador

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1 Advanced Waste Characterization & Analysis Form This form requires more effort to complete than the Basic Membership Form. However, the results may be beneficial as you track the status of your program. All businesses must complete a Basic Membership form to become a member of the Mecklenburg County Wipe Out WasteAmbassador Business Recognition Program. Members make an annual commitment to implement a comprehensive solid waste reduction program and annually report their accomplishments in the following areas: Waste Reduction, Recycling, Education and Buying Recycled Products. (Sections I, II, III & IV are unique to this form only.) It is not required for a business to complete this form to become a member of or to maintain its membership in the Wipe Out Waste Ambassador Business Recycling Recognition Program. This should only take a few minutes of your time. If you need assistance please call I. Company Profile Date: Business Name: Address: Employee Completing Form: Additional Contacts: Telephone: E- Mail Address: Web Address: Facebook / Twitter Address: Number of Employees at this Location: New Member Level Applying for: Associate Advocate Ambassador If already a member, current level: Associate Advocate Ambassador The Advanced Waste Characterization Annual & Analysis Form requests additional information regarding disposal/recycling costs and the quantity and types of materials your business disposes of and recycles per year. This form will assist your business in identifying items that may be addressed in a Waste Reduction Program and track the progress being made.

2 I. Estimate the amount of waste you generate that is currently going to the landfill: (You may need to contact your waste collection company or review your invoice or contract.) Container Type Container Size (cu yd) Number of Containers Estimated % P.U. Number of Monthly P.U. Dumpster X X X = Volume (cu yd) Dumpster X X X = Compactor x 3 X X X = Compactor x 3 X X X = Roll- Off X X X = Roll- Off X X X = Roll- Cart X X X = Roll- Cart X X X = Total Cubic Yards Monthly: Total Cubic Yards Annually: Container Types D Dumpster = usually equals 2, 4, 6 or 8 cubic yards C Compactor = usually equals 15, 34 or 42 cubic yards (most compactors have a 3 to 1 compaction ratio) R/O Roll- Offs = usually equals 20, 30 or 40 cubic yards R/C Roll- Carts = usually equals 35- gallons (0.2 cu yd), 64- gallons (0.37 cu yd) or 96- gallons (0.55 cu yd) II. Determine total monthly waste disposal and collection costs: This information should be available on your waste hauling bill(s). If rental costs, disposal costs and transportation costs are not itemized, just add to Total Monthly s. This will help determine future savings due to Waste Reduction Programs implemented as a result of joining the Wipe Out Waste Ambassador Program. Monthly Container Rental + Monthly Haul + Monthly Disposal + Monthly Fuel $ $ $ $ + Other s = Monthly Total s $ $ Expect Flat Rate for Front- Load Dumpsters and Roll- Carts Expect Itemized invoice for Roll- Offs and Compactors

3 III. Determine total monthly recycling costs: Monthly Rebates - Monthly Container - Monthly Haul - Other s = Monthly Total s (Gain / Loss) $ $ $ $ $ Expect Flat Rate for Front- Load Dumpsters and Roll- Carts Expect Itemized invoice for Roll- Offs and Compactors IV. Assess total monthly costs: Year: Baseline Year Disposal & Collection s: Disposal Volume: Recycling s: Recycling Volume: Average Per Volume: V. Determine the waste streams and amounts (Mecklenburg County can assist in completing this section, contact Lexin Murphy, ). For an understanding of the types of waste generated; identify each waste stream from point of generation to placement in the garbage/recycling container that is taken off- site. It is often helpful to interview individuals familiar with the waste stream such as custodians or cleaning staff. Common Areas: Office, Restrooms, Copy Rooms, Mail Room, Break Rooms, Warehouse, etc. Items to look for: Office Paper, Aluminum Cans, Food Waste, Food Wrappings, Packaging, Plastic Bottles/Containers, Glass Bottles/Containers, Rest Room Waste, Ink Cartridges, Light Bulbs (types), Batteries, Shredded Paper, Manufacturing Waste, etc. Dept/Area Waste Generated How is it collected & Who Is responsible for placing the items in the Collection Receptacles? Office Office Paper, Aluminum Cans, Food & Food Wrappings, Cardboard Placed in desk- side waste receptacle and collected by custodians. Cardboard is segregated by custodians and placed into an 8- cu yd recycling dumpster. Custodians place all other items into 8- cu yd trash dumpster. Est. Amount of Waste Produced The custodians say they collect enough cardboard from the office to fill 1/3 of the 8 cu yd recycling dumpster each week. Of the waste collected, the custodians estimate: 40% is office paper 30% is cardboard 5% is aluminum cans 25% is food & food wrappings

4 VI. Determine the percentage of materials in the waste stream (Mecklenburg County can assist in completing this section.for assistance please call ) Use this Section to confirm you have identified all waste streams. It is often helpful to interview individuals familiar with the waste stream such as custodians or cleaning staff. Material % of Total Waste Material % of Total Waste VII. Identify Current Waste Prevention Strategies Examples: Reduce use of electricity by turning off office lights when not occupied, set copier for double- sided copying, participate in Opt- Out program for junk mail, reduce packaging by saving peanuts for reuse, reduce packaging by using shredded paper as packing material, etc. Strategy Currently Active (Yes / No) VIII. Identify Items Currently Being Recycled Examples: Cardboard, Plastic Wrap, Plastic Drinking Containers, Glass Drinking Containers, Ink Cartridges, Office Paper, etc. Item Currently Active (Yes / No) To be completed by: Advocate & Ambassador IX. Employee Educational Program (minimum one per year): Examples: Lunch & Learn don t forget about Mecklenburg County s FREE Waste Reduction 101 Lunch & Learn Classes Employee review of waste reduction activities Designated employee meeting, etc.

5 To be completed by: Advocate & Ambassador X. Actively Promote On- Site Waste Reduction Examples: Post and/or distribute miscellaneous waste reduction information Ensure site waste reduction activities are implemented XI. To be completed by: Ambassador Create directory or link: How do you plan to provide downloadable access of Mecklenburg County s Resource Guide for Commercial Waste Reduction and Recycling? (A copy of the Resource Guide may be found on the County s website XII. Actively promote and display Wipe Out Waste Ambassador initiatives (to include e- blasts): How do you currently promote and display Wipe Out Waste Ambassador initiatives? XIII. To be completed by: Ambassador Demonstrate commitment to purchase Green Goods : XIV. Agreement to Honor Commitment: During the next year, my company agrees to engage in the waste reduction activities listed above. Name (Printed or Typed): Telephone : E- Mail: Signature: Date: XV. Additional Contacts: NAME TITLE TELEPHONE