Location Name
 
 
 
 
First Name
 
 
Last Name
 
 
 
Email
 
 
Phone Number
 
 
 
Street Address
 
 
City
 
 
 
State
 
 
Zip Code
 
 
 
Industry
 
 
 
 
How many pounds of materials do you have ready to recycle? (estimate if unknown)
 
 
 
 
Which condition(s) are your batteries in?