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Click ‘Get Form’ to open it in the editor.
Begin by filling out the 'Facility Information' section. Enter the Facility Name, Permittee Name, and Federal Employer ID No. (EIN). Select the Landfill Type and provide the Facility Physical Address along with the Permit Number and County.
Complete the contact information for both the Primary Facility Contact Person and Annual Report Contact Person. Ensure all fields are filled accurately, including names, titles, mailing addresses, phone numbers, and emails.
In the 'Waste Disposal Information' section, list the total amount of waste disposed by type and source. If weight scales are unavailable, report in cubic yards and tons. Attach a separate sheet for conversion calculations if necessary.
Continue to fill out sections on segregated waste information, remaining capacity, gas collection systems, disclosure information, financial assurance details, and any other required information as specified in each section.
Finally, review all entries for accuracy before signing and certifying your report at the end of the document.

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