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