____________________________________ ____________________________________ Name: Jason Linnell Date: Date:_____________________ Appendix A: Additional Collection Sites Please list each registered collection facility operating under the parent collector on page 1. If your only collection location is the company/site listed on page 1, please leave this section blank. Storage Capacity. Will this site transport Does this site Please use the selections from a collection separate covered Site Name EW# in question 2 on Page 1 to location to another from non-covered note the capacity of this collection location? devices?* location.** ☐ ☐ ☐ ☐ YES NO YES NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ ☐ YES ☐ ☐ YES NO NO ☐ YES ☐ ☐ YES ☐ NO NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ ☐ ☐ ☐ YES NO YES NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO
____________________________________ ____________________________________ Name: Jason Linnell Date: Date:_____________________ Appendix A: Additional Collection Sites Please list each registered collection facility operating under the parent collector on page 1. If your only collection location is the company/site listed on page 1, please leave this section blank. Site Name EW# Will this site transport from a collection location to another collection location? Does this site separate covered from non-covered devices?* Storage Capacity. Please use the selections in question 2 on Page 1 to note the capacity of this location.** ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO ☐ YES ☐ NO
NCER%20Vermont%20SSP%20Collector%20Contract%20Jul16-Dec17%20fillable%20REVISED.docx