Certification of Recycling Service

This form is to certify the business listed below does not subscribe to collection service of compost containers and/or recycling containers because it has arranged for all recyclable and/or compostable materials (organics) to be recycled by self-hauling, back-hauling, sharing service with another account holder, or contracting with a third party recycler. If this certification is approved, it will provide documentation that the site listed below is meeting the SB 1383 and Organics Reduction and Recycling Ordinance requirements for recyclable and/or compostable materials collection, as indicated in the form below.

If you have any questions about this form or the rules, you can ask a question with our online form, email rules@stopwaste.org, or call the Ordinance Helpline at (510) 891-6575 to leave a message for a call back.

Site Information

Organization Name *

Site Street Address *

City *

Zip Code

Please select the category that best describes the site

This form is to certify the above site has alternate arrangements for: *

Site Contact

First Name of Contact Person at Site *

Title/Role

Email Address *

Last Name of Contact Person at Site *

Phone Number *

Submitter Information

Person submitting form *

Certification Information

All recyclable and/or compostable/organic materials generated at this business are (check all that apply):

Self-hauled

Back-hauled

Shared Service

Collected by a contracted third party

Is there any additional information you’d like to provide?

Form Conditions and Electronic Signature

I certify under penalty of perjury under the laws of the State of California that the information provided on this form is true and correct to the best of my knowledge. I understand this information may be verified by an on-site visit or other investigation and is up for review at least once every 5 years. I hereby authorize the Alameda County Waste Management Authority or their designee to inspect the Service Address listed or otherwise investigate the above for the purpose of determining compliance with the Organics Reduction and Recycling Ordinance.

form conditions box must be checked to submit form

Please enter your full name in the box below *

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