1. THE PENNSYLVANIA MUNICIPAL WASTE PLANNING, RECYCLING AND WASTE REDUCTION ACT,
      2. ACT 101 OF 1988 (P.L. 556), Section 903
2500-FM-BWM0213 Rev. 9/2011
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF WASTE MANAGEMENT
   

 
 
2500-FM-BWM0213 Rev. 9/2011
 
 
 
2500-FM-BWM0213 Rev. 9/2011
 
 
 
2500-FM-BWM0213 Rev. 9/2011
 
 
 
2500-FM-BWM0213 Rev. 9/2011
 
 

APPLICATION FOR REIMBURSEMENT
FOR A COUNTY RECYCLING COORDINATOR

 


THE PENNSYLVANIA MUNICIPAL WASTE PLANNING, RECYCLING AND WASTE REDUCTION ACT,



ACT 101 OF 1988 (P.L. 556), Section 903

  
Please read all instructions before completing. The Department must receive this application by the announced deadline for all duties performed from January 1 through December 31 for the previous calendar year.
SECTION A
1.  COUNTY:        
2.  OFFICIAL BUSINESS ADDRESS:          
 
Number - Box
 
       
 
Street
 
       
 
Municipality
 
  P A                         
   
State
         
Zip Code
3.  FEDERAL I.D. #
 
          4.  FOR CALENDAR YEAR : 20     
DEPARTMENT USE ONLY
  Supplier Invoice #:        

VENDOR ID #:          Invoice Date:        

 
SAP FUND
GEN. LEDGER
COST CENTER
INT. ORDER
 
  20089     000
6600400
3522509000
   
           
  TOTAL AMOUNT APPROVED FOR PAYMENT: $                
 
 
 
            
  Signature   Date
 
 
 All supporting documentation for the application is on file in the County Office.

 
SECTION B - County Recycling Coordinator Job Description
(Explain responsibilities and duties)
     

SECTION C - County Contact
County Contact Person (Name and Title)

     

Telephone

(   )     -     

   
SECTION D - County Recycling Coordinator Identification
Name

     

Address       

City         State PA   Zip      

Telephone:  (   )     -      E-mail Address:       
Fax #:  (   )     -      Web Address:       
Certification:   Certified Recycling Professional
Sr. Certified Recycling Professional

None
Specialty: Composting   Processing   Enforcement

Collection  
Management   Processing

Education  
Composting Operator  Operator
SECTION E - County Recycling Coordinator Time/Employment Status
SECTION F - Summary of County Recycling Activ ity from January 1 through December 31 of preceding year
 
Recycling Programs in County
Number of Municipalities
with Curbside Recycling
Number of Municipalities
with Drop-Off Recycling
Number of Municipalities
without Recycling Programs
1.  Municipalities > 10,000 population  
     
     
     
2.  Municipalities 5,000-10,000 population  
     
     
     
3.  All others  
     
     
     
 TOTAL  
     
     
     
SECTION G

 

I hereby accept the terms described above.
 

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