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First Name

Company Name

Position In The Company

Phone Number

Email Address

Province

Address

Nearest Landfill Site

A brief description of the company’s business

A brief description of the company’s by-products

What is the company’s average spending on landfill disposal costs?

Have you ever received fines for illegal dumping?

Waste Classification

Do you have a current analysis or material composition of the waste material (not older than 3 months)?

Yes No

Do you have samples of the waste material available for analysis ?

Yes No

What is the current volume of the waste material being generated ?

Do you have a backlog volume

Yes No