Organic Waste & Recycling Collection Service Waiver Application

Type of Waiver Requested (required)

Physical Space Constraints

De Minimus Generation

Services you are requesting waiver for (required)

Organic Waste- Green Waste Only

Organic Waste - Food Waste Only

Organic Waste -Green and Food Waste

Commercial Generator Type (required)

Commercial Business

Multi Family Dwelling

Date (required)

Business or Property Name (required)

Goods or Services Provided by the Business (required)

Applicant Name (required)

Business or Property Physical Address (required)

Phone Number (required)

Email (required)

For De Minimus Waiver Requests only, what is your current combined collection service for trash, recycling, and organic waste (includes green waste and food waste)

More than 2 Cubic Yards of combined waste serviced weekly

Less than 2 Cubic Yards of combined waste serviced weekly

Describe how green waste is managed at the business or property (required)

A landscaper collects, removes and recycles green waste from the premises

We manage our own green waste onsite (i.e. onsite compost bin)

We have no green waste of any kind.

Our collector collects green waste through bin service

Our collector collects green waste through cart service

What are you currently doing with your food waste (required)

Submittal (required)

By checking this box, I acknowledge that I understand this application is incomplete if no photographs are provided when it is submitted. Photos of all trash, recycling, and green waste containers (carts and/or bins) currently served on the property are required. Exterior photos (front and back of property) or business required.

Photo Documentation (required)

Please provide any additional information

Declaration (required)

I declare that I, the owner/property manager (or designee), have read the foregoing document and the facts stated herein are true to the best of my knowledge. I understand by submitting this form, there is no guarantee the waiver will be granted and the information will be confirmed independently by the Channel Islands Beach Community Services District (CIBCSD). I understand if CIBCSD obtains information at any time that my business or property exceeds the organic waste and recycling threshold of compliance, the CIBCSD will rescind the waiver. I understand the approved waiver is valid for (5) years from the date of approval. At the end of (5) years, I must reapply for a waiver if my business or property is below the threshold for compliance with state and local recycling mandates.

I agree and understand that by signing this Organic Waste & Recycling Collection Service Waiver Application electronically, my electronic signature is the legal equivalent of my manual/handwritten signature, and I consent to be legally bound to all statements in this Organic Waste & Recycling Collection Service Waiver Application. I further agree my signature on this document is as valid as if I signed the document in writing.

First Name

Last name

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