Household Hazardous Waste Participant Form

    Household Hazardous Waste Reporting

    "*" indicates required fields

    Name of Person Reporting*
    select one
    Conversions: 55 gal. barrel of paint weighs approx. 500 lbs. or use 10 lbs. per full can of paint-you may want to figure 10 lbs. per every two to three non-full cans of paint
    Conversions: 55 gal. drum holds about 300 lbs. of hazardous chemicals and a pallet holds 4 drums on average for 1200 lbs. per pallet

    Weight of Materials Collected:

    Please fill in 0 if not applicable.
    Household Cleaners
    Insecticides, Pesticides, etc
    Oil-based Paint
    Aerosol Paint
    Acids (Drainer Opener, etc.)
    Miscellaneous Chemicals
    Fluorescent Bulbs