Waiver Application - AB 1826 & SB 1383

Contact Information

First Name

Last Name

Email Address

Phone Number

Property/Business Name

Property Address (include city and zip code)

Mailing Address (if different from property address)

WM Customer/Account Number

Business Type

Is this a multi-family (5 units or more) business?

Number of units:

Type of business.

Acknowledgement

Please mark all boxes below acknowledging the statements listed.

Questions	Agree
I understand that the submittal of this exemption application does not constitute automatic approval and that I may be required to submit additional documentation and/or photos to support my exemption request.	Agree
I attest that all information presented herein is true and accurate and that no recyclable or organic waste materials generated at this property will be landfilled if this exemption is approved.	Agree
I understand that if the circumstances listed on this exemption request change in such a way that this property no longer satisfies the applicable criteria for an exemption, I will be required to notify the County of Shasta and the exemption will be rescinded.	Agree
I understand that approved Organics Waste Collection Waivers expire five years after the signature date below and upon the property changing ownership, at which time this property will need to submit a new exemption request at that time.	Agree

Signature

Please provide the first and last name of the person completing the exemption application.

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Commercial Organics Waste Collection Exemption Application