Get Out-of-state Waste Tire Receiver Application Form - Mississippi ...

Filling out the Out-of-State Waste Tire Receiver Application Form is an important step for owners of out-of-state waste tire facilities intending to receive tires from Mississippi waste tire haulers. This guide will provide you with clear, step-by-step instructions to successfully complete this application online.

Follow the steps to complete your application with ease.

1. Click ‘Get Form’ button to obtain the application form and open it in your preferred editor.
2. In the 'Facility Information' section, fill out the business name, the title of the person submitting the form, and provide the contact person’s name.
3. Enter the mailing address, including city, state, and zip code for the facility.
4. In the 'Street Address' section, provide the actual location of the facility, including city, county, and fax number if applicable.
5. Fill in the business phone number and email address if available.
6. Under 'Operating Information', list permit number(s) and the issuing agency, along with a contact phone number and agency contact person's name.
7. Provide information regarding the compliance status of the facility.
8. Indicate the type of operation the facility engages in: shredding, chipping, splitting, or other.
9. Write a brief description of the processed waste tire material, including its size.
10. State the facility's processing capacity in terms of tires per day.
11. List all recycling, end use, or disposal sites for the processed waste tire material, including name, address, and permit number. Attach additional sheets if needed.
12. In the 'Certification' section, print the name and title of the person completing the application, and ensure to sign and date the form.
13. Finally, review the completed form for accuracy before submitting it as per the provided mailing instructions to the Mississippi Department of Environmental Quality.

Complete your Out-of-State Waste Tire Receiver Application Form online today!