Part 2 - Ash Residue TRANSFERRED from the FACILITY Part 2A Recycled Ash Residue Transferred to RECYLING, END-MARKETS OR REUSE FACILITIES – – RECYCLING DESTINATION NAME & LOCATION Destination QUARTER TOTAL Type Tons Recycled (If Material Is Managed thru a Broker Indicate Broker Name – & Destination State or Country) Select from: Dropdown: If Other-Specify: Select from: Dropdown: If Other-Specify: Select from: Dropdown: If Other-Specify: Select from: Dropdown: If Other-Specify: v Select from: Dropdown: If Other-Specify: Select from: Dropdown: If Other-Specify: Disposed Ash Residue Transferred to DISPOSAL FACILITIES Part 2B (or to TSs for TRANSER to DISPOSAL) – – DISPOSAL QUARTER TOTAL DESTINATION TYPE DISPOSAL DESTINATIOI NAME/LOCATION Tons Disposed Select from Dropdown: If other –specify: Select from Dropdown: If other –specify: Select from Dropdown: If other –specify: Select from Dropdown: If other –specify: Select from Dropdown: If other –specify: Part 3 BALANCE SHEET ASH RESIDUE RECEIVED VS TRANSFERRED FROM THE FACILITY – – COMPARE TOTAL RECEIVED VS TOTAL Transferred (disposed + recycled) for Ash Residue for this reporting quarter Amount Received: Total Transferred: Difference (Recev’d % Vs Transferred): Discrepancy: If discrepancy is >10% - Explain: Part 4 CERTIFICATION –
Part 2 - Ash Residue TRANSFERRED from the FACILITY Part 2A – Recycled – Ash Residue Transferred to RECYLING, END-MARKETS OR REUSE FACILITIES RECYCLING DESTINATION NAME & LOCATION (If Material Is Managed thru a Broker – Indicate Broker Name & Destination State or Country) Destination Type QUARTER TOTAL Tons Recycled Select from: Dropdown: If Other-Specify: Select from: Dropdown: If Other-Specify: Select from: Dropdown: If Other-Specify: Select from: Dropdown: If Other-Specify: v Select from: Dropdown: If Other-Specify: Select from: Dropdown: If Other-Specify: Part 2B – Disposed – Ash Residue Transferred to DISPOSAL FACILITIES (or to TSs for TRANSER to DISPOSAL) DISPOSAL DESTINATIOI NAME/LOCATION DISPOSAL DESTINATION TYPE QUARTER TOTAL Tons Disposed Select from Dropdown: If other –specify: Select from Dropdown: If other –specify: Select from Dropdown: If other –specify: Select from Dropdown: If other –specify: Select from Dropdown: If other –specify: Part 3 – BALANCE SHEET – ASH RESIDUE RECEIVED VS TRANSFERRED FROM THE FACILITY COMPARE TOTAL RECEIVED VS TOTAL Transferred (disposed + recycled) for Ash Residue for this reporting quarter Amount Received: Total Transferred: Difference (Recev’d Vs Transferred): % Discrepancy: If discrepancy is >10% - Explain: Part 4 – CERTIFICATION
CommercialGP_Appendix_B_Fillable_Form_AshResidue.docx