4 - Debris Recovery Statement (DPW).pdf

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Amendment #0001 IFB-Harney Gym B-664 Renovations
Solicitation number
W91QF4-23-B-0005
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This document is a debris recovery statement template for post-demolition or construction projects. The template requires contractors to track materials generated from a project by weight and designate whether they were reused, recycled, or disposed. At least 60% of all waste must be recycled. Contractors must provide the name and contact information of each facility or service provider that handled materials, along with the weight of materials sent to each. Documentation verifying material handling, such as receipts or tags, must be attached. Contractors must also calculate the total weight of materials generated, disposed, salvaged/reused/recycled, and the percentage of materials recycled/reused based on the total generated.

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Form Rev: 10 February 2023

DEBRIS RECOVERY STATEMENT – Post Demolition/Construction

Project Address: _____________________________________ Contractor: _________________________________________ Date: ______________________________________________ Contact: ____________________________________________ Phone: _____________________________________ ________ Email: _____________________________________________ Project: ____________________________________________

Identify which materials were reused, recycled or disposed by completing the table below. You must recycle at least 60% of all waste generated. Check the designated box and provide the name of each facility or service provider and weight of materials. If the materials were reused on site, describe the reuse application under the facilities/service provider column. Salvaged materials from deconstruction should be designated as reuse. Attach copies of receipts, gate tags, or other verifying documentation.

Material Reuse Recycle Dispose Facility Service

Provider Weight (tons)

Asphalt Brick Cardboard Carpet Concrete Dirt/Clean Fill Dry Wall Metal Pallets Plastics Plant Debris Roofing - asphalt composition shingle, tile, wood shake, tar or gravel

Wood - clean Wood - treated Other Other

MATERIAL GENERATION SYNOPSIS

A. Total tons of materials generated for the project: _____________ B. Total tons of materials disposed (not recycled): _____________ C. Total tons of materials salvaged, reused, or recycled: _____________ D. Percentage of materials recycled/reused (divide C by A):_____________ %

For assistance in recovering materials at the jobsite, visit the following website for a Builders Guide to Reuse and Recycling for the Kansas Department of Health and Environment.

https://www.kdhe.ks.gov/710/Waste-Reduction-Grant-Guidelines-Forms

Project Address:
Contractor:
Date:
Contact:
Phone:
Email:
Project:
Other_2:
A Total tons of materials generated for the project:
B Total tons of materials disposed not recycled:
C Total tons of materials salvaged reused or recycled:
D Percentage of materials recycledreused divide C by A:
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