To protect the health and safety of our employees and customers, all loads of construction,
remodeling and demolition waste brought to Metro Central or Metro South transfer stations are
screened before, during and after unloading for materials that may contain asbestos. This form is
required for all such loads of waste that contain construction and demolition waste.
Analytical test results are required for the following products commonly known to
contain asbestos:
Interior walls and ceilings: acoustical tiles, glue dots, plaster, and textured surfaces
Exterior walls: cement siding, stucco
Flooring: vinyl tiles, sheet vinyl, some mastic adhesives
Insulation/fireproofing: block, boiler, spray-applied, vermiculite, monokote, sink
undercoating, thermal system insulation (fiberglass, cellulose, and mineral wool are
Gaskets: furnace, mechanical, boiler, wood stove (automotive gaskets are exempt)
Heating: white paper or seam tape on ducts, air-duct cement and insulation
Roofing materials: tar paper, felt, silver/white roofing paint, Nicolite paper
Fire doors, fire/kiln brick and fireproofing
Various compounds: window glazing, adhesives, caulks, patching, mastics, vapor barrier
products (plastic or synthetic materials such as Tyvek are exempt)
Electrical: switch gear, circuit boxes and fuse panels; wiring with cloth insulation (Romex
wiring is exempt)
PLEASE NOTE: Flat/built-up roofing is not accepted, even if customers present negative
analytical test results.
This form is required for all loads containing construction, remodeling or demolition
This form should be completed by the person responsible for and knowledgeable about
the contents of the load.
For multiple-load projects, copies of this form will be accepted, but the contents of the
load must match the description of the waste materials on the form.
All parties involved (generator, contractor and hauler) may be held responsible for the
abatement of positive (greater than one percent asbestos by weight) asbestos-containing
materials unloaded at Metro's transfer stations, including but not limited to the costs for
testing, a licensed abatement contractor, fines and administration.
Revised October 2018
Construction and demolition waste acceptance form
Revised October 2018
Did waste materials originate from a structure or RV constructed after January 1, 2004, or
were the materials manufactured after January 1, 2004?
Yes (if yes, skip to #4) No
Was an asbestos survey conducted?
Yes (if yes, attach survey)
No (if no, skip to #4)
If any asbestos-containing materials were identified in the survey, submittal of this form is
my statement that those materials were handled properly and are not present in this load.
Signature: ____________________________________________________________________________________________
Address of work site ________________________________________________________________________________
City _____________________________________________ State _____________________ Zip _____________________
Property owner _____________________________________________________________________________________
Phone ________________________________________________________________________________________________
Mailing address (if different) _______________________________________________________________________
City ____________________________________________ State ____________________ Zip ______________________
Hauled by: (if self, skip to #6)
Building Contractor
Waste Hauler
Name of hauling company or contractor: _________________________________________________________
Company contact: ___________________________________________________________________________________
Phone number: ______________________________________________________________________________________
Description of waste:
Certification: I certify that the above information is true and correct to the best of my
knowledge, and that the documentation presented represents the materials delivered to the
transfer station. I also attest that the waste materials in this load do not contain asbestos.
Name (Print): ________________________________________________________________________________________
Signature: ____________________________________________________________________________________________
Please print this document, sign and bring to a Metro transfer station with any required analytical test results.
Date _____________________ Time ________________ AM/PM Facility:
ACCEPTED: Y N Comments: ________________________________________________________________________
Approver: _____________________________________ TRACKING NUMBER: _____________________________________