Municipal Building Monthly Zero Waste Reporting Form

Municipal Building Monthly Zero Waste Reporting Form
The City of Philadelphia is working toward becoming a Zero Waste and litter-free city. With this initiative, we are encouraging City departments to reduce waste and increase recycling at their facilities. By tracking waste generation monthly, you can develop a better idea of the composition of your facility's waste stream and benchmark its current waste diversion rate — the amount of waste being diverted from landfills and incineration through practices like recycling, composting, and donations.

Reducing trash and increasing recycling and donations can help you prevent valuable resources from entering landfills and can bring you closer to becoming a Zero Waste Building Partner. If you are looking to become or maintain status as a Zero Waste Partner, you must fill this form out monthly. Submit your form for a particular month by the last day of the following month. (For example, submit your form for August by September 30th).
Property and Contact Information
Property Name *
City Department *
Property Address *

Street Address

Street Address Line 2

Postal / Zip Code
Contact Name *

First Name Last Name
Contact Title *
Contact Phone Number *

Area Code Phone Number
Contact E-mail *
Manager Name *

First Name Last Name
Manager Phone Number *

Area Code Phone Number
Manager E-mail *
Property Type *

Airport facility Fire house Garage/maintenance facility Health center Judiciary court Laboratory Library Nursing home Office Older adult center Playground building Police station Prison facility Public utility facility Recreation center Transportation station Warehouse
Materials Generated and Waste Management Practices
What materials did your facility generate this month? Please check all that apply. *

Solid Waste (Trash) Single Stream Recycling (Could include #1, #2, & #5 plastic bottles and containers, aluminum and steel cans, glass bottles and jars, office paper, cardboard, and aseptic cartons)* Electronic Waste (Desktop and laptop computers and monitors, televisions, cell phones, and computer peripherals such as printers, keyboards, mice, etc.)* Source Separated Recycling (Could include any of the single stream materials listed above and/or organic waste) Waste Cooking Oil* Used Motor Oil* Universal Waste (fluorescent bulbs, batteries, pesticides, etc.)* Hazardous Waste (solvents, oil-based paint, etc.)* Medical Waste* Construction and Demolition (C&D) Debris Food Waste Yard and Leaf Waste Polystyrene (Styrofoam™) Plastic Bags Wood Metal Clothing Edible, Unopened Packaged Food
*These materials are mandated by state and/or municipal law to be recycled and/or disposed of properly according to industry-specific regulations. Do you need to find a hauler for one of the above listed materials? Visit the haulers list to find a Philadelpia hauling company.
Estimate Your Facility's Monthly Waste Diversion Rate

In this section, report on the amount of material your facility generates to estimate your facility's monthly waste diversion rate. Much of the information needed to complete the form may be found on your service provider invoices. If your service provider invoices for a particular material list the number of tons collected per month, please enter that number into the "Tons Collected per Month" column in the matrix below.

If you cannot obtain this information from your service provider invoices, use the Building Waste Generation Calculator Tool to estimate the number of tons of each material your facility generates using information about your current levels of collection service.

(NOTE: "Medical Waste" and "Edible, Unopened Packaged Food" are not included in the calculator tool. It is likely that your service provider or donation entity will provide weights for these materials, which you can enter directly into the matrix below.)

If you know the number of pounds of a certain material generated, type that number into the "Type Number of Pounds Here" field below to convert into tons before filling out the matrix.
Type Number of Pounds Here:
Pounds
Is Equal To
Tons
Reporting Month *
What month is this data for?
Reporting Year *
What year is this data for?

Please fill out the matrix below using your service provider invoices and/or the Building Waste Generation Calculator Tool. If your facility does not generate a particular type of waste, leave that row blank. If your facility separates and recycles materials not included in this list, please enter the information related to those materials in the last two rows of the matrix and use the fields below the matrix to identify those additional materials. The data entered below will be used to estimate your facility's overall waste diversion rate before you submit the form. (Enter values from calculator tool here). *

Tons Collected per Month

Name of Service Provider (Hauler)

Solid Waste (Trash)

Hazardous Waste

Medical Waste

Single Stream Recycling

Electronic Waste

Waste Cooking Oil

Used Motor Oil

Universal Waste

Construction & Demolition Debris

Food Waste

Yard and Leaf Waste

Polystyrene (Styrofoam ™ )

Plastic Bags

Wood

Metal

Clothing

Edible, Unopened Packaged Food

Additional Material 1

Additional Material 2

Additional Material 1
Name any additional materials here (if applicable).
Additional Material 2
Name any additional materials here (if applicable).
Your Facility's Estimated Waste Diversion Rate (%)
Your facility's diversion rate is calculated by dividing the weight of material diverted by the overall weight of material generated. [Diversion Rate = (Weight Diverted / Weight of Trash + Weight Diverted) x 100]
What challenges is your department facing in trying to reduce waste and increase recycling and donations at your facility as you strive toward Zero Waste? These comments will be used to inform future Zero Waste efforts in Philadelphia. *
Thank you for completing the Municipal Building Monthly Zero Waste Reporting Form. Click the "Submit" button below to submit your form. A confirmation email containing your completed form will be sent to the address you entered into the "Contact Email" field upon submission.
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