Attachment_6_-_Waste_Diversion_FORM_E.pdf
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- Solicitation number
- 140R3023R0003
About this file
This document is a waste diversion form template to be completed for federal construction projects. It includes spaces to report details of up to nine different waste materials generated on site, including the total quantity and unit of waste generated, quantity recycled or reused, date disposed and recycled, and description of disposition.
The related federal contract opportunity is solicitation number 140R3023R0003 from the Department of the Interior Bureau of Reclamation to renovate the exhibit level and offices at the Hoover Dam Visitor Center. Contractors should complete and submit the waste diversion form to report on waste handling for the project.
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Text version
LC-042
Document No.: SEMS-F004 Revision No.: 5 Document Date: 12/24/2015
FORM E
Waste Diversion Table
Project Name or Title: ______________________________________________ Contact:____________ Phone______________ Waste Name/description (One Waste Material per Row)
Total Quantity of Waste Generated
Unit (lbs/ gal/to n/cf)
Quantity of Waste Recycled/Reus ed1
Unit (lbs/gal /ton/cf)
Date Waste Disposed
(DD/MM/YYYY)
Date Waste Recycled/Reuse
(DD/MM/YYYY)
Description of the Disposition/Diversion of Material
1 Quantity of Waste Recycled/Reused – The amount of material/waste that is recycled or re-used.
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| Project Name or Title: |
| Contact: |
| Phone: |
| Waste Namedescription One Waste Material per RowRow1: |
| Total Quantity of Waste GeneratedRow1: |
| Unit lbs galto ncfRow1: |
| Quantity of Waste RecycledReus ed1Row1: |
| Unit lbsgal toncfRow1: |
| Date Waste Disposed DDMMYYYYRow1: |
| Date Waste RecycledReuse DDMMYYYYRow1: |
| Description of the DispositionDiversion of MaterialRow1: |
| Waste Namedescription One Waste Material per RowRow2: |
| Total Quantity of Waste GeneratedRow2: |
| Unit lbs galto ncfRow2: |
| Quantity of Waste RecycledReus ed1Row2: |
| Unit lbsgal toncfRow2: |
| Date Waste Disposed DDMMYYYYRow2: |
| Date Waste RecycledReuse DDMMYYYYRow2: |
| Description of the DispositionDiversion of MaterialRow2: |
| Waste Namedescription One Waste Material per RowRow3: |
| Total Quantity of Waste GeneratedRow3: |
| Unit lbs galto ncfRow3: |
| Quantity of Waste RecycledReus ed1Row3: |
| Unit lbsgal toncfRow3: |
| Date Waste Disposed DDMMYYYYRow3: |
| Date Waste RecycledReuse DDMMYYYYRow3: |
| Description of the DispositionDiversion of MaterialRow3: |
| Waste Namedescription One Waste Material per RowRow4: |
| Total Quantity of Waste GeneratedRow4: |
| Unit lbs galto ncfRow4: |
| Quantity of Waste RecycledReus ed1Row4: |
| Unit lbsgal toncfRow4: |
| Date Waste Disposed DDMMYYYYRow4: |
| Date Waste RecycledReuse DDMMYYYYRow4: |
| Description of the DispositionDiversion of MaterialRow4: |
| Waste Namedescription One Waste Material per RowRow5: |
| Total Quantity of Waste GeneratedRow5: |
| Unit lbs galto ncfRow5: |
| Quantity of Waste RecycledReus ed1Row5: |
| Unit lbsgal toncfRow5: |
| Date Waste Disposed DDMMYYYYRow5: |
| Date Waste RecycledReuse DDMMYYYYRow5: |
| Description of the DispositionDiversion of MaterialRow5: |
| Waste Namedescription One Waste Material per RowRow6: |
| Total Quantity of Waste GeneratedRow6: |
| Unit lbs galto ncfRow6: |
| Quantity of Waste RecycledReus ed1Row6: |
| Unit lbsgal toncfRow6: |
| Date Waste Disposed DDMMYYYYRow6: |
| Date Waste RecycledReuse DDMMYYYYRow6: |
| Description of the DispositionDiversion of MaterialRow6: |
| Waste Namedescription One Waste Material per RowRow7: |
| Total Quantity of Waste GeneratedRow7: |
| Unit lbs galto ncfRow7: |
| Quantity of Waste RecycledReus ed1Row7: |
| Unit lbsgal toncfRow7: |
| Date Waste Disposed DDMMYYYYRow7: |
| Date Waste RecycledReuse DDMMYYYYRow7: |
| Description of the DispositionDiversion of MaterialRow7: |
| Waste Namedescription One Waste Material per RowRow8: |
| Total Quantity of Waste GeneratedRow8: |
| Unit lbs galto ncfRow8: |
| Quantity of Waste RecycledReus ed1Row8: |
| Unit lbsgal toncfRow8: |
| Date Waste Disposed DDMMYYYYRow8: |
| Date Waste RecycledReuse DDMMYYYYRow8: |
| Description of the DispositionDiversion of MaterialRow8: |
| Waste Namedescription One Waste Material per RowRow9: |
| Total Quantity of Waste GeneratedRow9: |
| Unit lbs galto ncfRow9: |
| Quantity of Waste RecycledReus ed1Row9: |
| Unit lbsgal toncfRow9: |
| Date Waste Disposed DDMMYYYYRow9: |
| Date Waste RecycledReuse DDMMYYYYRow9: |
| Description of the DispositionDiversion of MaterialRow9: |
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