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Treated Wood Waste Handler Notification Form

All Treated Wood Waste (TWW) handlers that generate more than 10,000 pounds in any calendar year shall obtain an identification number and submit the notification within 30 days of exceeding the 10,000 pound limit.

TWW Generator Name *

EPA ID Number *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

TWW Contact Person

Name *

First

Last

Phone *

Example Phone Number Format

TWW Activity

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Date Exceeded 10,000 lbs. *

By submitting this notification, I am indicating that I am a duly authorized representative of this Treated Wood Waste (TWW) Handler and that the TWW Handler has generated more than 10,000 pounds of TWW this calendar year.

Name

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