4 - Debris Recovery Statement.pdf

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Installation of Equipment- 13 Water Bottle Filling Stations- AMENDMENT 02
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W91QF4-25-B-0001
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About this file

This document is a Debris Recovery Statement template for post-demolition/construction projects, designed to track and report material waste management. The form requires contractors to document the disposal, recycling, and reuse of various construction materials, with a mandatory requirement to recycle at least 60% of all waste generated. The template includes a comprehensive table for tracking material types such as asphalt, brick, concrete, metal, wood, and other construction debris, with columns for reuse, recycling, and disposal, along with spaces to record facility service providers and material weights. A "Material Generation Synopsis" section at the bottom allows for calculating total materials generated, disposed, salvaged, and the percentage of materials recycled or reused. The form also provides a web resource link to the Monterey County Builders Guide to Reuse and Recycling for additional assistance in material recovery at construction sites.

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SOW - 9

Form Rev: 10 February 2021

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 County of Monterey, California.

https://www.co.monterey.ca.us/government/departments-a-h/health/environmental-health/recycling/construction-and-demolition-recycling

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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