Zero Waste Solutions Inc.

Solid Waste Evaluation Form

If you would like an evaluation of your business' waste reduction potential, please fill in this short questionnaire. We will contact you to provide information or answer questions you might have, about reducing your solid waste.

Contact Information (Mandatory fields are marked with *)

COMPANY *
COMPANY ADDRESS
CITY
STATE
ZIP CODE
PHONE NO
COMPANY FAX
CONTACT PERSON *

TYPE OF BUSINESS
EMAIL ADDRESS *

DESIRED SERVICES
RECYCLING	SOLID WASTE
DOCUMENT DESTRUCTION	EMPLOYEE AWARENESS
COMPOSTING	VENDOR MANAGEMENT
OTHER

HOW OFTEN IS YOUR TRASH COLLECTED?
WHAT TYPE OF TRASH IS COLLECTED?

DO YOU RECYCLE?	Yes No
WHAT DO YOU RECYCLE? (Use CTRL key for multiple selections)
WHAT SIZE ROLL-OFF CONTAINER DO YOU CURRENTLY USE? (Use CTRL key for multiple selections)
DO YOU CURRENTLY HAVE A WASTE REDUCTION PLAN OR POLICY?	Yes No
WHAT IS YOUR APPROXIMATE WASTE HAULING CHARGE (PER MONTH)?
DO YOU HAVE A DEDICATED STAFF MEMBER TO COORDINATE YOUR SOLID WASTE SERVICE REQUIREMENTS?	Yes No

PLEASE MAIL ME FURTHER INFORMATION ON REDUCING WASTE DISPOSAL COSTS WHILE
HELPING THE ENVIRONMENT.

YOUR COMMENTS
HOW DID YOU HEAR ABOUT ZERO WASTE SOLUTIONS?