Job Initiation Form - Logistics Information

Job Name / RA # Recycling Logistics Form This document is to be provided on all jobs. This form, a properly signed Recycling Agreement and a negative asbestos survey report for each jobsite must be provided and approved by Armstrong before Armstrong arranges a pick up. Return required documents to Armstrong Recycling Center: Fax: 1-800 572 8324 or 1-888 396 0877. Contact our Armstrong Recycling Center directly Phone: 1-877 276 7876, options 1 & 8.

A. Quantity of Material to Recycle: SF of material to recycle: sf or # of pallets

B.Address for Pickup:

Building Name: Street: City: State: Zip:

Jobsite Contact Name: Phone:

Jobsite Contact Fax Number:

C. Pick Up Date: Estimated date needed for pickup (list all dates if more than one trailer load) Please allow a minimum of three (3) days to a maximum of five (5) days for a shipment to be scheduled.

Load #1 Load #2

D. Special Loading Requirements? Loading Dock height or size, parking, city/state requirements, other trade traffic that needs to be factored into this pickup?

E. Job Details: List each project/owner for each job that is part of this shipment. If material from several jobsites is consolidated in one truckload, an Armstrong-approved Asbestos Survey must be on file with Armstrong for each jobsite List each site separately. Use page 2 for additional jobsites. needed.

1. Building Owner or Tenant: General Contractor: Demolition Contractor

Project Location (Address): B. Same as above

F. Documentation: Is a LEED letter needed? Yes No (If yes, indicate where LEED letter should be sent)

Recycling Recognition: Please indicate if a recycling certificate is to be issued to Recycler: Yes - Please include details of recipient: Company Name (indicate exact wording):

Contact Information to send certificate:

Recycling Logistics Form

E. Additional Sites: List each project/owner for each job that is part of this shipment. If material from several jobsites is consolidated in one truckload, an Armstrong-approved Asbestos Survey must be on file with Armstrong for each jobsite List each site separately.

2. Building Owner or Tenant: General Contractor: Demolition Contractor:

Project Location (Address):