Certification Statement

I certify that I am a resident of the Town of Clifton Park, Town of Ballston, Town of Malta or Town of Halfmoon and that the waste listed on this form is household generated and that the wastes are not from any institutional, commercial, or inudstrial facilities, or any commercial farming operations. Also, any waste oil being brought for disposal is household generated and does not contain transformer oils, solvents or chemical products.

For questions or additional assistance with this form, please call Scott Reese - Planning Department at 371-6054.
Please fill out ALL information fields in order to accurately provide us your contact information.

Choose One: Town of Clifton Park Town of Halfmoon

First Name:
Last Name:
Full Address:
City:
Zip Code:
Mailing Address:
(If Different)
Email Address:

Daytime Phone:
Evening Phone:
Preferred
Appointment Time:



Items Not Acceptable: appliances, tires, explosives of any kind, microwaves, roofing materials, asbestos materials, machinery and any commercial or farm waste.
Due to changes in the program we will no longer be accepting latex paint.
Please see http://www.dec.ny.gov/docs/materials_minerals_pdf/paint.pdf for latex paint disposal.

NO ELECTRONICS WILL BE COLLECTED AT THIS EVENT

ELECTRONICS ARE COLLECTED AT THE TRANSFER STATION ON A REGULAR BASIS


Waste Materials
Batteries, Lead Acid (car and smaller) total number
Batteries, Lithium total number
Batteries, NiCad total number
Cleaners, Solvents total # of containers
Compact Fluorescent Lights total number
Driveway sealers, oil based total # of pails
Fire extinguishers total number
Fluorescent bulbs total linear foot
Gasoline total gallons
Herbicides total # of containers
Mercury containing materials total number
Oil based paints total gallons
Paints and stains, polyurethane total gallons
Paints, aerosols total cans
Pesticides total # of containers
Pool chemicals total # of containers
Propane containers, grill size total number
Propane containers, smaller than grill size total number
Smoke detectors total number
Used Oils total cans