Used Oil Participant Form

Used Oil Reporting

Months Reporting:

Name of Site:(Required)

Location of Site(s)(Required)

Name of Person Reporting:(Required)

First Last

Phone(Required)

Total gallons of oil collected from outside participants.(Required)

Total gallons of oil collected from outside participants.

Total gallons of oil from your own site for the quarter:(Required)

Total gallons of oil from your own site for the quarter:

Grand Total of gallons collected:(Required)

Grand Total of gallons collected:

Total number of participants who brought oil to your site during the quarter:(Required)

Add your site as a participant if you collected your own oil:

Total number of participants who brought oil to your site during the quarter:(Required)

Total number of participants who brought oil to your site during the quarter:

Grand Total of participants:(Required)

Grand Total of participants:

Total gallons picked up from your site(s) by the vendor:(Required)

Total gallons picked up from your site(s) by the vendor:

Total number of participants who brought oil to your site during the quarter:(Required)

Total gallons picked up from another site due to your site’s referral (from a farmstead, etc.):

Grand Total gallons picked up by Used Oil Vendor:(Required)

Grand Total gallons picked up by Used Oil Vendor:

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