Site Evaluation Legal Business Name(s) * DBA (Doing Business As) name if different from legal business name(s) * License Number(s) * Signee Name * First Name Last Name Title * Email * Phone * Facility Address 1 * Address 1 Address 2 City State/Province Zip/Postal Code Country License Type(s) * Cultivation Manufacturing Testing Dispensary Pickup Frequency * Date of 1st Pickup(s) * Anticipated Volume(s) of Waste * Using lbs describe the anticipated volume of waste each license will produce Will your facility(s) produce noncompostable cannabis waste? If yes, list all waste streams and volumes. * Will your facility(s) produce compostable cannabis waste? If yes, list all waste streams and volumes. * Will your facility's cannabis waste come into contact or be treated with combustible solvents at any point? If yes, list all. * If yes, does your facility(s) currently have a hazardous waste generators license? * Yes No If yes, describe your facility's off-gassing procedures step by step. * 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 Method of recurring payment * Check ACH Transfer Accounts Receivable * All invoices will be directed to the following contact: First Name Last Name Title * Email * Phone * (###) ### #### Thank you!
