Site Evaluation Legal Business Name(s) * DBA (Doing Business As) name if different from legal business name(s) * License Number(s) * Facility Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Pickup Type (Check all that apply) * Administrative Hold Green Waste Other Pickup Frequency * Recurring One-Off Total Anticipated Volume of Waste * Waste types (Check all that apply) * Edibles Extracts 510 Carts All-In-One (Containing LI Battery) Canned Beverages Pre-Rolls Flower Other Green Waste (Extracted Biomass) Are items requiring destruction in consumer packaging? * Yes No Will your facility's cannabis waste come into contact or be treated with combustible solvents at any point? If yes, list all. * If yes, describe your facility's off-gassing procedures step by step. * If yes, does your facility(s) currently have a hazardous waste generators license? * Yes No Is there adequate parking lot space at your facility(s) for a box truck to safely render on-site and turn around? * Yes No Does your facility(s) have a working loading dock that is accessible? * Yes No Does your facility(s) have a secure area for storing cannabis waste? * Yes No Does your facility(s) have two cameras covering the rendering area? * Yes No Signee * First Name Last Name Title * Email * Phone * Accounts Receivable * All invoices will be directed to the following contact: First Name Last Name Title * Email * Phone * (###) ### #### Method of recurring payment * Card On File (Preferred) ACH Transfer Check How did you hear about us? Thank you!
