1. PENNSYLVANIA DEPARTMENT OF ENVIRONMENTAL PROTECTION
  2. COMMONWEALTH OF PENNSYLVANIA
  3. CHANGES TO AND CLARIFICATIONS FOR THE 904 PERFORMANCE
  4. PENNSYLVANIA DEPARTMENT OF ENVIRONMENTAL PROTECTION
  5.  Anyplace Twp., Where Co. 
    1. A. Residential Tonnage
  6. COMMONWEALTH OF PENNSYLVANIA
  7.         
  8.         
  9.        
    1. A. Residential Tonnage
  10.        
    1. B. Commercial Tonnage


 

 
 
 
 
 
 

 

 

 
MUNICIPAL RECYCLING PROGRAM PERFORMANCE GRANTS
UNDER SECTION 904 OF ACT 101
THE MUNICIPAL WASTE PLANNING, RECYCLING AND WASTE REDUCTION ACT
OF JULY 1988
 


 
904

 
 
 
 
 
 
 
 

      
CALENDAR YEAR 2016
APPLICATION
Due Date: October 2, 2017
PENNSYLVANIA DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF WASTE MANAGEMENT
DIVISION OF WASTE MINIMIZATION AND PLANNING
www.dep.pa.gov
An Equal Opportunity Employer
2520-FM-BWM0013.3 Rev. 3/2017

Back to top


  
COMMONWEALTH OF PENNSYLVANIA
Department of Environmental Protection
   
RE: Act 101, Section 904 Grant Application Information
  
TO: All Prospective Act 101 Municipal Recycling Program Performance Grant Applicants
        
FROM: Mark Vottero
Municipal Recycling Grants Coordinator
Division of Waste Minimization and Planning
Bureau of Waste Management
Thank you for your interest in recycling and the Act 101 Recycling Performance Grant Program. All Pennsylvania municipalities that had a recycling program in 2016 may be eligible to apply. The grants are based on the success of your municipality’s recycling efforts. Performance is judged according to the weight of DEP-approved eligible materials recovered and marketed last year and the population of your municipality. The grant award can increase as a municipality’s recycling rate grows each year.
To apply, you must have records indicating the types and amounts of materials that were recycled in the previous year. If materials were recovered from both residential and commercial sources, they must be clearly identified and reported separately. Any residues, materials not listed as eligible, or any materials that cannot be documented as being generated within your municipality or marketed or recycled into new products or uses are not eligible for consideration toward your grant.
A standard 15% residue rate will be utilized to calculate residential and commercial residue unless marketed receipts are included with your grant application. Documentation must be in the form of a signed marketed receipt from the end user containing the amount of tons recycled in 2016. Grant funds will also not be awarded for glass and plastics that cannot be documented as being recycled in 2016. Materials that are used as daily cover, stockpiled or for resource recovery will not be considered as recycled.
Each year, the department conducts reviews of documentation from a certain number of applicants. If selected, your municipality will be given at least 30 days notice in order to provide the documentation necessary to support your application, including a list of those commercial establishments whose recycling figures were counted toward your recycling program. Your grant award will be determined based on the documentation evaluated at the time of the review. No additional/supplemental documentation will be accepted after the review is completed. Failure to submit a complete and accurate application may result in a denial of your grant request and possible enforcement proceedings. Your application is also subject to audit by the Office of Auditor General, Office of the Treasurer, or agents of those offices. For this reason, you are required to maintain the documentation supporting this grant application for up to four years from the date the application is submitted. You are   not required to submit the documentation when you submit your application; however, you may be requested to provide documentation at a later date.
Act 140 of 2006 established prerequisites for the awarding of Act 101, Section 904 Performance Grants. Mandated recycling communities that apply for the grant, as well as any other municipality (other than a county) awarded more than $10,000 in performance grant funds must institute certain recycling program components as specified by the act. Any Act 140 municipality that failed to meet the provisions set forth in this Act will not be considered for funding. Please see the Municipal Recycling Program Performance Grant Fact Sheet attached in this application for further details on the Act 140 recycling program components.
The application deadline for calendar year 2016 Performance Grants is October 2, 2017. Your application must be received by the department or post-marked by that date in order to be considered for funding. If your application is being hand delivered, it must be received by 4 p.m. If your application is submitted after the deadline, it will not be processed and will be returned to you. Please submit your application to one of the following addresses:
   
If by U.S. Postal Service:
Department of Environmental Protection
Bureau of Waste Management
P.O. Box 8472
Harrisburg, PA 17105-8472
OR
If by Ground Service (UPS, RPS, etc) or hand delivered:
Department of Environmental Protection
Bureau of Waste Management
14th Floor Rachel Carson State Office Building
400 Market Street
Harrisburg, PA 17101-2301
The Performance Grant instructions, frequently asked questions, documentation requirements and examples booklet, and a sample commercial recycling reporting form is available on the Department’s website at www.dep.pa.gov , keyword: Recycling Grants. If you have any questions regarding the Performance Grant Program or the application procedures, please contact me at mvottero@pa.gov.
Thank you again for recycling. The DEP looks forward to receiving your application.

Back to top



CHANGES TO AND CLARIFICATIONS FOR THE 904 PERFORMANCE
GRANT PROGRAM
CY2016
 
 

1.   STANDARD RESIDUE RATE

 
For residential tonnage, municipalities that market some or all of their own material are not subject to the 15% residue deduction for those materials. “Marketed” means that the materials were sold to a manufacturer for the purposes of converting the recyclables into new product. Compensation/rebates from a collector or processor do not count as the marketing of materials.
 
Materials that go to a second-hand processor are subject to the 15% residue deduction—market receipts from that entity cannot be considered as market receipts for the municipality (the processor cannot “pro-rate” marketed to one or more municipalities).
 
For commercial tonnage, materials that go directly from the generator to a market can be exempt from the 15% rate. Documentation must include a statement from the commercial entity or home office of the commercial entity that the materials are directly marketed without further processing. Any commercial materials that are sorted /processed after leaving the generator are subject to the 15% residue rate.
 
If an application is claiming an overall residue rate of less than 15%, it must describe why and supply supporting documentation to justify the claim.
 
 

2.   MULTI-MUNICIPAL APPLICATIONS
 

Multi-municipal applications under the Act 101, Section 904 Recycling Performance Grant Program will only be accepted by the Department from the following:
 
A.   Council of governments, consortiums or other similar entities established by two or more municipalities under 53 Pa.C.S. Ch 23 Subch. A (relating to intergovernmental cooperation); and,
B.   Two or more municipalities where the collection of recyclables has been accomplished either through a joint bid for services or a joint municipally-operated collection system (curbside or drop-off) accompanied by a joint recycling education program.
 
Any application submitted jointly to the Department by two or more municipalities that does not meet one of the above criteria will be held until the participating municipalities supply individual applications. Submittals from county governments are not considered multi-municipal applications and are therefore not subject to these criteria.
 

Back to top



PENNSYLVANIA DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF WASTE MANAGEMENT
ACT 101
MUNICIPAL RECYCLING PROGRAM PERFORMANCE GRANT

PROGRAM OVERVIEW

1.  Statutory Authority:

Grants are authorized under Section 904 of the Municipal Waste Planning, Recycling and Waste Reduction Act (Act 101 of 1988, P.L. 556).

All funds are allocated from the Recycling Fund authorized under Act 101.

2.  Basic Provisions:

Grants are based on available funds under Section 706 and shall be available to all municipalities that had a recycling program in existence during the previous calendar year.

Eligible applicants are restricted to municipalities as defined in the Act as amended (i.e., incorporated towns, townships, boroughs, cities, counties, home rule municipalities, authorities, councils of governments, consortiums, or similar entities established by two or more municipalities under 53 PA. C.S. Ch. 23 Subch. A (Relating to intergovernmental cooperation)).

Grants are awarded based on the weight of source-separated recyclable materials identified in Section 1501 of Act 101 that were recycled or marketed in the previous calendar year and the population of the municipality. These materials include: old newsprint, high-grade office paper, corrugated paper, other marketable grades of paper, aluminum cans, steel or bimetallic cans, amber glass containers, green glass containers, clear glass containers, PET plastics, HDPE plastics, and all other plastics.

Source-separated recyclable materials are materials separated from municipal waste at the point of origin (home, business, institution) for the purpose of recycling. These include commingled recyclables and single stream recyclables (recyclables collected together), but do not include materials recovered from collected loads of municipal solid waste, residual waste or hazardous waste.

Grant funds will not be awarded for residues, materials not listed as eligible, or any materials that cannot be documented as being recycled into a new product or use. In particular, recovered glass that is being stockpiled or used as daily cover at a landfill will not be considered as recycled. Also, plastics collected and used for resource recovery are not eligible. Residue includes materials collected but not processable, or materials that become contaminated through the act of collection, sorting, or processing. The weight of raw or processed yard waste cannot be claimed under this application. Grants are awarded only for the eligible materials that were generated within a municipality’s political boundaries.

A recycling operation/program serving more than one municipality may apportion each participating municipality’s contribution to its recovery efforts.

The applicant must be able to provide a breakdown of materials collected from residential and/or commercial sources. If the breakdown is estimated, the basis for the estimate must be identified by the applicant.

3.  Application Procedures:

Applications delivered and postmarked by the announced deadline will receive grant credit for all eligible materials recycled and marketed in the previous calendar year. Applications submitted after the deadline will be returned.

The DEP will notify each applicant of its receipt of the application. If notification is not received, please call the department at 717-787-7382.

Applicants must be able to substantiate:
-  That recycled material was source separated;
-  That recycled material was generated within the municipality’s borders;
-  The quantity of material recycled and marketed (in pounds and/or tons-not cubic yards) in the previous calendar year;
-  The quantity of non-recyclable residue removed through processing; and

-  That recycled material was not landfilled, reused in the same form, or used for energy recovery.

Documentation for all tonnage claims must be supported by actual records (i.e., weight slips or receipts from each hauler or market verifying all tonnage claims). These records should NOT be submitted with the application, but must be on file with the municipality and be available to the department upon request. Records documenting the weight of materials claimed in this application must be retained by the applicant for four (4) years from the end date of the year the materials were recycled and marketed.

4.  Grant Limitations:

A county applicant may receive no more than 10 percent of the funds available under this grant in any fiscal year.

A grant will not be awarded to any county or municipality that has failed to comply with the conditions set forth in previously awarded grants, the grant requirements of Act 101, or the regulations of the act.

The availability of grants is contingent upon the availability of monies in the Recycling Fund.

Act 140 of 2006 established performance requirements for Recycling Performance Grant applicants. Mandated municipalities that apply for the grant as well as any other municipalities (except for counties) that receive or have received in excess of $10,000, must meet the following performance requirements:

· Require, through ordinance, that all residents have waste and recycling service.
· Have an implemented residential recycling program and facilitates a commercial recycling program or participates in a similar county or multi-municipal program.
· Have a residential and business recycling education program.
· Have a program of enforcement that periodically monitors participation, receives complaints and issues warnings for required participants and provides fines, penalties, or both, in its recycling ordinance.
· Have provisions, participate in a county or multi-municipal program or facilitates a private sector program for the recycling of special materials.
· Sponsor a program, facilitate a program or support an organization to address illegal dumping and/or littering problems.
· Have a person or entity designated as recycling coordinator who is responsible for recycling data collection and reporting recycling program performance in the municipality or municipalities.
Municipalities that have not achieved the performance requirements listed above and are now obligated to meet the requirements of Act 140 due to this grant application will be notified in writing by the department and must use the awarded performance grant funds to comply with those requirements. If any component of Act 140 has not been implemented by the next grant submission, the municipality will not be considered for a recycling grant.
All grants are subject to audit by the department, the Office of the Auditor General, the Office of the Treasurer, and their agents. Any tonnage not properly documented at the time of audit will not be credited toward a municipality's Performance Grant Award. No additional/supplemental documentation will be accepted after the review is completed. Failure to submit a complete and accurate application may result in a denial of your grant request and possible enforcement proceedings.
5. Grant Award Formula:
Grant awards will be calculated as follows:
Base Award = Approved Residential Tonnage + Approved Commercial Tonnage x $5
* Approved Tonnages cannot include any residues. Approved commercial tonnage for the base award cannot exceed the approved residential tonnage.
Bonus Award =
Approved Residential Tonnage + Approved Commercial Tonnage x Municipality’s Recycling Rate X $1
* Approved Tonnages cannot include any residues. Approved commercial tonnage for the bonus award cannot exceed the approved residential tonnage. A municipality’s recycling rate is determined in this manner:
Approved Residential Tonnage + Approved Commercial Tonnage/(municipality’s population x 0.8) x 100
Where 0.8 tons/person/year is the average state-wide waste generation rate. Approved commercial tonnage for the Recycling Rate calculation cannot exceed the approved residential tonnage.
Commercial Incentive =
Documented Commercial Tonnage in excess of that approved for base and bonus award x $10
Total Award = (Base Award + Bonus Award + Commercial Incentive) X 60%
 
Instructions for
Filing the Application for
Act 101, Section 904
Municipal Recycling Program Performance Grants
A. GENERAL INSTRUCTIONS
1. Read all instructions carefully before completing your application. Failure to submit required information will result in a delay in payment.
2. Only include the weight of eligible materials. Eligible materials include old newsprint, high-grade office paper, corrugated paper, other marketable grades of paper, aluminum cans, steel or bimetallic cans, amber glass containers, green glass containers, clear glass containers, PET plastics, HDPE plastics, and all other plastics. Materials not eligible include motor oil, scrap metals, white goods, tires, and yard wastes.
All materials claimed must be:
Source separated;
Post consumer;
Generated within the boundaries of the local government applicant;
Diverted from the municipal waste stream; and
Recycled or marketed in 2016.
Post-Consumer Materials refer to recovered materials that have been used as a consumer item and are diverted from municipal solid waste for the purpose of collection and recycling. The term excludes materials generated in manufacturing and converting processes such as manufacturing scrap and trimmings/cuttings. Also, print overruns, over issue publications, and obsolete inventories that did not leave the generating facility would be classified as pre-consumer materials.
Residual waste materials from a manufacturing process are ineligible and are not to be included.
3. Gather all documentation needed to support the weight of the eligible materials claimed in the application. Review all documentation and determine if it is valid. (Refer to the booklet on Documentation Requirements and Examples). Separate any invalid documentation and do not include it in the application; or, try to obtain valid documentation to replace the invalid documentation prior to completing the application. Although the documentation is not required to be submitted with the application, the applicant must have valid documentation on file to support all tonnage claimed prior to submission of application. All documentation for this application must be maintained by the applicant for four (4) years from the end date of the year the materials were recycled and marketed. In the event of an audit, any tonnage not substantiated by valid documentation at the time of the audit will be disallowed and the grant award will be adjusted. No additional/supplemental documentation will be accepted after the review is completed. Failure to submit a complete and accurate application may result in a denial of your grant request and possible enforcement proceedings.
4. Using the valid documentation gathered as instructed in #3 above, calculate the total number of tons of each eligible residential and commercial material recycled and marketed by your municipality during the calendar year covered by the application. You will need this information to determine the total number of eligible residential and commercial tons to be reported in PART II-C, #1 of the application, and to report the weight of each eligible material in PART III A & B of the application.
5. The completed application must be submitted to the Pennsylvania Department of Environmental Protection, Bureau of Waste Management, Waste Reduction & Recycling Section, P.O. Box 8472, Harrisburg, PA 17105-8472, by October  2,  2017. If your application is hand delivered, it must be received by 4 p.m. Any applications delivered or postmarked after the deadline will not be processed and will be returned to the applicant.
A completed application consists of:
 
1. Part I – Application Information
2. Part II A – Contact Information
3. Part II B – Performance Information
4. Part II C – Statement and Verification
5. Part III A & B – Tonnage Summary Form
6. Part IV – W-9 Form, Request for Taxpayer Identification Number and Certification
Make sure you are using the most current version of the application. You can determine this by looking at #5 on the first page of the application. It will indicate the application is for the Calendar Year 2016. Only forms provided by the department may be used in completing this application.
B. PART I - APPLICANT INFORMATION
1. APPLICANT: Enter the name of the municipality applying for the grant. Only municipalities as defined in Act 101, as amended, are eligible for grants (i.e., county, city, township, incorporated town, borough, home-rule municipality, authorities, COGs, consortiums, or similar entities). If the recycling program is a joint effort of several municipalities, a lead municipality must submit the application on behalf of all of the participating municipalities. No municipality should be included in more than one application. COGs, consorting, or similar entities must submit proof of their establishment under 53 Pa.Cs.Ch.23 Subch A.
2. OFFICIAL BUSINESS ADDRESS: Enter the Applicant’s Box Number, Street Address and City or Town.
3. COUNTY: Enter the Applicant’s County.
4. FEDERAL I.D. NUMBER: Enter the applicant’s federal I.D. number.
C. PART II A – CONTACT INFORMATION
1. Question #5, Population: Enter the applicant’s population as determined by the 2010 decennial census. If this is a multi-municipal application, the total populations of all participating municipalities must be used and a separate sheet must be attached listing the participating municipalities and their populations. For counties operating a drop-off recycling program, the total county population must be used (unless it can demonstrate which municipalities are not participating in the drop-off program).
Please enter, in the upper right hand corner of the page, your municipality’s name and the county in which your municipality is located.
PART II B - PERFORMANCE INFORMATION
  
1. Total Tons of Eligible Materials Recycled:
a) Residential Tons: Enter the total tons of eligible material recycled and marketed from the municipality’s residential recycling program during the 2016 calendar year. (Refer to #2 of the General Instructions for eligible material requirements.) Please round this number to the nearest tenth (0.1) of a ton. (Please Note: Recyclables generated in multi-family dwellings are considered “residential” even if they were collected by a “commercial” hauler.) The total amount of residential tons claimed must be substantiated by valid documentation. (Refer to the booklet on Documentation Requirements and Examples.)
b) Residential Residue: Enter the amount of non-recycled residue which was a part of the total residential tons. This is material collected with the recyclables but was not recycled. DEP uses a 15 percent average to calculate residue. If you use a rate other than 15 percent to calculate the residential residue, you must have marketed receipts to verify the rate you used. Documentation must be in the form of a signed market receipts statement from the end user containing the amount of tons or the percent of residue to be deducted from the total residential tons collected for the calendar year under consideration. If you leave this space blank, the department will automatically deduct 15 percent from the residential tons claimed.
c) Commercial Tons: Enter the total tons of eligible commercial (including municipal & institutional) materials recycled and marketed from commercial establishments within the municipality in the 2016 calendar year. (Refer to #2 of the general instructions for eligible material requirements.) Please round the number to the nearest tenth (0.1) of a ton. The amount claimed must be substantiated by valid documentation. (Refer to the booklet on Documentation Requirements and Examples.)
d) Commercial Residue: Enter the amount of non-recycled residue which was a part of the total commercial tons. This is material collected with the recyclables but was not recycled. The department uses a 15 percent average to calculate residue. If you use a rate of other than 15 percent to calculate the amount of non-recycled commercial residue, you must have marketed receipts to verify the rate used. Documentation must be in the form of a signed marketed receipts from the end user containing the amount of tons of commercial residue or the percent of residue of the total commercial tons collected for the calendar year under consideration. If you leave this space blank, the department will automatically deduct 15 percent from the commercial tons claimed.
e) Total Tons: Enter the total tons of eligible material in the space provided.
PART II C – STATEMENT AND VERIFICATION
The application must be signed by an authorized official of the municipality or county applying for the grant.
D. PART III - TONNAGE SUMMARY FORM A & B
Please enter, in the upper right hand corner of the page, your municipality’s name and the county in which your municipality is located.
You are not permitted to substitute your own form in Part III A & B. Please use the form provided in this application.
FORM A: List, by hauler or market (or from the entity that is supplying you the documentation), the total tons of each eligible residential material recycled and marketed on behalf of your municipality in the 2016 calendar year. If you have more than one piece of documentation from a particular hauler or market, you may summarize them on one line rather than listing each report or weight ticket separately (i.e. if you receive monthly reports from a recycling collector, you do not have to list that collector and the total of each report twelve times on the form - you may list that collector only once and record the total of the twelve monthly reports for each material on that line). You should calculate the total for each hauler or market, the total for each material and the total residential tons recycled by all of your haulers or markets.
FORM B: List, by hauler or market (or from the entity that is supplying you the documentation), the total tons of each eligible material recycled and marketed on behalf of your municipality in the 2016 calendar year from commercial, institutional or municipal establishments. If you have more than one piece of documentation from a particular hauler or market, you may summarize them on one line rather than listing each report or weight ticket separately (i.e. if you receive monthly reports from a recycling collector, you do not have to list that collector and the total of each report twelve times on the form - you may list that collector only once and record the total of the twelve monthly reports for each material on that line). You should calculate the total for each hauler or market, the total for each material and the total commercial tons recycled by all of your haulers or markets.
Please refer to the attached example on Page 9 for guidance in completing these forms.
Old newsprint is comprised of newspapers offered for circulation (i.e. delivered to homes, businesses, newsstands, etc.) and later collected for recycling.
Other marketable grades of paper includes magazines, telephone books, kraft bags and any post-consumer paper fiber not suitable for inclusion under another category.
Aluminum, steel or bimetallic cans includes containers (primarily food and beverage cans) originating from homes, businesses and institutions. These categories do not include scrap metal (aluminum furniture, stainless steel, iron scrap, 55 gallon drums, etc).
Commercial tonnages are those generated by businesses, institutions (hospitals, nursing homes, schools etc.) and municipal (government offices, libraries, etc.) establishments.
If the eligible materials were collected and marketed as commingled materials (two or more eligible materials collected together), then place the total tons of those materials in the space provided for commingled residential or commingled commercial tons. In this case you are not required to determine the tonnage of each material separately. LIST THE MATERIALS INCLUDED IN THE COMMINGLED TONNAGE IN THE SPACE PROVIDED at the bottom of the Tonnage Summary Form. The above should also be followed for single stream materials.
The weight of the eligible residential materials must be reported separately from the weight of the eligible commercial materials. All weights must be in tons.
The Total Residential Tons and the Total Commercial Tons reported on the Tonnage Summary Forms must match the total eligible residential and commercial tons reported in PART II B, #1 of the application.

Back to top


Anyplace Twp., Where Co.
Municipality, County
 
PART III - TONNAGE SUMMARY FORM



A. Residential Tonnage
 

Business Hauler/Market
Old Newsprint
High Grade Office Paper
Corrugated
Other Marketable Grades of Paper
Mixed Paper
Aluminum Cans
Steel or Bimetallic Cans
Mixed Cans (not scrap metals)
Amber Glass
Clear Glass
Green Glass
Mixed Glass
PET Plastics
HDPE Plastics
Other Plastics
Mixed Plastics
Commingled*
Single Stream*
Total
ABC hauling
301.4
 
     
     
     
15.1
28.9
     
     
     
     
52.3
     
     
     
     
     
     
397.7
Ron's Recycling
     
     
157.2
     
77.0
     
     
     
     
     
     
     
     
     
     
     
41.8
     
276.0
Boy Scouts
189.5
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
189.5
Ambassador Apartments
10.2
     
     
     
     
     
     
1.7
     
     
     
3.6
     
     
     
     
     
     
15.5
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Totals
501.1
     
157.2
     
77.0
15.1
28.9
1.7
     
     
     
55.9
     
     
     
     
41.8
     
878.7
 

Total Residential Tons  878.7  


 
*If claiming residential commingled or single stream tonnage, use the space below to list the materials included in the tonnage:
Ron's Recycling collects all glass, aluminum and steel cans as commingled.
 

 

 

E.  PART IV - FORM W-9

Complete this form according to the instructions provided with the form and attach it to the application. Payment cannot be made without submittal of this form. Also, the Name, Address and I.D. Number reported on the Form W-9 must match the applicant name, address and federal I.D. number reported in PART I of the application.


 

 

Back to top



COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF WASTE MANAGEMENT
DIVISION OF WASTE MINIMIZATION AND PLANNING

 

Application for Municipal Recycling Program Performance Grant
The Pennsylvania Municipal Waste Planning, Recycling and Waste Reduction Act,
Act 101 of 1988 (P.L. 556) Section 904
PART I - APPLICANT INFORMATION

 

PLEASE FOLLOW ALL INSTRUCTIONS AS PROVIDED  

1.  APPLICANT:
 


 NUMBER - BOX

2.  OFFICIAL BUSINESS ADDRESS:
 

 
 STREET

   

 CITY  —  TOWN

   

 STATE  ZIP CODE

    P A            

3.  COUNTY:

 
 

 

4.  FEDERAL I.D. NUMBER:

 
  5.  FOR CALENDAR YEAR: 2 0 1 6
 

 

DEPARTMENT USE ONLY
Vendor Number:        
Invoice Number: 904-  -16  Invoice Date:        

SAP FUND
 
BUDGET PERIOD
GEN. LED. COST CENTER INT. ORDER
2009500000
20     
6600400 3522509000 35250000   
           
TOTAL AMOUNT APPROVED:
     
 
APPROVED FOR PAYMENT:
 
 
 
              
 Sign Here   Date
 
   

Back to top



           

   Municipality, County  2016


PART II - A: CONTACT INFORMATION
 

Directions: Please answer the questions below. Attach additional pages if necessary. Please type or print all entries. DO NOT LEAVE ANY QUESTION BLANK.
 

1.  Contact Person for this application:        

Name of individual or company that compiled/completed this application (if different than above):        

 
2.  Contact Person Telephone Number: (     )          Fax Number: (   )        

Days of the Week and Times you may be contacted at above telephone number:

       

 
3.  Contact Person Email Address:        
 
4.  Applicant's Designated Recycling Coordinator (if different than #1 above):        

   Telephone Number: (     )        

Email Address:        

 

 
5.   Population (per the 2010 Decennial Census):          

  Participating Municipalities:        

 
6.   Municipality website address:           Mucni
 

Back to top



           

    Municipality, County   2016
 

PART II - B: PERFORMANCE INFORMATION

1.   TOTAL TONS OF ELIGIBLE MATERIALS RECYCLED: Use totals from Part III A & B - Tonnage Summary Forms to list the total tons of material recycled by your municipality for the calendar year covered by this application. Enter all figures in TONS. Round to the nearest tenth (0.1) of a ton.
  Residential   Residential   Commercial   Commercial  
  Tons   Residue*   Tons   Residue*   TOTAL TONS
 
            -             +             -             =          
 
*Residues are materials collected and weighed with recyclables but are not recycled. See Section C. Part II C 1. (b) and (d) of the instructions for more information.
 
2.   If you are claiming a residue of less than 15 percent of the total Residential and/or Commercial tons recycled, Please include signed market receipts with your grant applications..
 
3.   If the totals of materials listed in #1 above is greater or less than the amount collected in the previous year, list those factors that could account for the difference.

       
 

PART II - C: STATEMENT AND VERIFICATION

  The information contained in this application is true and correct to the best of my personal knowledge or information and belief.

  I also understand the requirements of both Act 101 and Act 140. I hereby acknowledge that all of the requirements are being met by all municipalities participating jointly in this application (this statement is only applicable to those municipalities required to meet the requirements of one or both Acts).
  This statement and verification is made subject to the penalties of 18 Pa. C.S.A § 4904 relating to unsworn falsification to authorities, which provides that if I make knowingly false averments, I may be subject to criminal penalties.


 

 
Signature of Elected/Appointed Municipal Official

 

 

       
  Title

 

 

       

    Date

 

Back to top



         
 

    Municipality, County


PART III - TONNAGE SUMMARY FORM
 



A. Residential Tonnage
 

Business Hauler/Market
Old Newsprint
High Grade Office Paper
Corrugated
Other Marketable Grades of Paper
Mixed Paper
Aluminum Cans
Steel or Bimetallic Cans
Mixed Cans (not scrap metals)
Amber Glass
Clear Glass
Green Glass
Mixed Glass
PET Plastics
HDPE Plastics
Other Plastics
Mixed Plastics
Commingled*
Single Stream*
Total
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Totals
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
 

Total Residential Tons          


 

*If claiming residential commingled or single stream tonnage, use the space below to list the materials included in the tonnage:
     

 
 

Back to top



         

    Municipality, County


PART IZII - TONNAGE SUMMARY FORM
 



B. Commercial Tonnage
 

Business Hauler/Market
Old Newsprint
High Grade Office Paper
Corrugated
Other Marketable Grades of Paper
Mixed Paper
Aluminum Cans
Steel or Bimetallic Cans
Mixed Cans (not scrap metals)
Amber Glass
Clear Glass
Green Glass
Mixed Glass
PET Plastics
HDPE Plastics
Other Plastics
Mixed Plastics
Commingled*
Single Stream*
Total
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Totals
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
 

Total Commercial Tons          


 

*If claiming commercial commingled or single stream tonnage, use the space below to list the materials included in the tonnage:
     










 
Bureau of Waste Management
P.O. Box 8472
Harrisburg, PA 17105-8472

Back to top