Form Center

2. Entity Name*
4. Owner Name*
6. Mailing Address*
8. Physical Address*
10. Contact Name*
11. E-mail*
15. Does your organization dispose of four (4) or more cubic yards of waste per week?

    1. Yes
    2. No
16. Is your facility a multi-family dwelling of five or more (5+) units?*

    1. Yes
    2. No
20. Which organics do you currently recycle at your place of business? (Check ALL that apply)

    1. Food Waste
    2. Food Soiled Paper *Multi-family units must arrange for recycling services for the same material with the exception of food waste and food soiled paper.
    3. Pruning Waste

    1. Green Waste
    2. Landscape Waste
    3. Non-Hazardous Wood Waste

    1. Other (Describe below)
    2. None
22. If other was selected, please explain below.
26. The organic materials are...*

    1. Source separated (separated by material type)
    2. Comingled (organic materials are mixed together)
27. The organics are composted through

    1. On-site composting
    2. Self-haul from my facility to a compost facility
    3. Landscaper/contractor
    4. Service provider/hauler
29. Which organics do you currently separate for composting?

    1. Tons (Enter on the right)
    2. Pounds (Enter on the right)
30. Tons
31. Pounds
35. Which organics do you currently separate for composting?

    1. Grass/plant trimmings
    2. Soiled paper products
    3. Wood waste/chipping
    4. Food waste
    5. None
36. The organics are composted through:

    1. On-site composting
    2. Self-haul from my facility to a compost facility
    3. Landscaper/contractor
    4. Service provider/hauler
40. Signer certifies that they are a duly authorized representative of the above named entity for purposes of regulatory compliance reporting and that the foregoing is true and correct to the best of their knowledge.
42. Signature:*
    Type in name to acknowledging statement above.
43. Date:*
45. This information will be used to determine compliance with AB1826 and may be reported to the State of California. For questions or concerns, please call Xavier Guluarte at (209) 895-8068 or visit www.ci.patterson.ca.us/564/Mandatory-Commercial-Recycling
47. Additional Information about California's Mandatory Commercial Organics Recycling legislation can be found by visiting the California Department of Recycling Resources and Recovery's webpage at: www.calrecycle.ca.gov/recycle/commercial/organics/
Leave This Blank:


49. 1. Receive an email copy of this form.
50. Email address

    This field is not part of the form submission.

51. Submit Submit and Print

* indicates a required field