Certificate recycling electronics by 2mz1O10

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									                                        Take it Back Network
                                       Certificate of Recycling
TAKE IT BACK NETWORK MEMBER:

MEMBER ADDRESS:

This document certifies that the materials received by (BUSINESS NAME) were handled in compliance with the
guidelines set by the Washington Department of Ecology’s interim enforcement policy pending formal proposal
and adoption of a conditional exclusion for cathode ray tubes (CRTs) from the Dangerous Waste Regulations,
Chapter 173-303 WAC.

                                     EQUIPMENT ACCEPTED FOR RECYCLING

CUSTOMER NAME:

CUSTOMER ADDRESS:

Equipment Accepted          TVs            Computer Monitors     CPUs/Laptops       Cell Phones           Other Peripherals
Quantity (lbs or
number of pieces)

The following section lists the recycled materials and the final processing facilities where each of the materials
were delivered for recycling.

     Component       Quantity     Recycling Company            Address              City          State         Country
Monitor Glass
Plastics
Metals
Circuit boards
Other

								
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