Rate Quote
Please complete the following questions to the best of your knowledge.
(The more complete your response, the better we can provide a rate)
EPA ID#
Company Name
Address
City
 State
 Zip
Phone
 Fax
Contact Person
Waste Common Name
 Process Generating Waste
Hazardous Non-Hazardous
EPA Waste Codes
If Listed Hazardous Waste, does the waste:
Meet Treatment Standards Exceed Treatment Standards
Physical Properties
Strong Odor
Solid
Powder/Dust
Liquid
Sludge
Free Liquids
Pumpable
Pourable
 Does your waste contain or is your waste:
PCB
Asbestos
Radioactive
Pyrophoric
Explosive
Dioxins
Shock Sensitive
Oxidizer
Flashpoint:
< 100
100 - 140
> 140
 pH:
< 2.0
2.0 - 12.5
> 12.5
If you have detailed analyses, please email to: jsmith@awmsi.com
Volume:
Packaging:
DrumsCubic Yard Containers
Bulk LiquidsTons ( > 2000 lbs/cubic yard)
Cubic Yards ( < 2000 lbs/cubic yard)
Frequency:
Ongoing 		One Time
Estimated Start Date
 If one time event, how long will it last:

Transportation
Waste Origin (City and State)
Type of transportation needed
Dump 20 yard Rolloff
30 yard Rolloff Hard Top Rolloff
Vac Box Straight Tanker
Vak Tanker Van
Flatbed Walking Floor
Frequency:
Weekly
Monthly
Quarterly
 Number of loads needed per day