Plastic Supplier

The information you provide is strictly confidential and for the sole purpose of identifying collection of your waste materials. If you prefer not to use the Internet, feel free to print this form, fill it out, and FAX to 714 964 8600.

If you have any questions or concerns, please call Doug Leman, Indiana Professional Dairy Products, 317 695 8228,
Email Doug

Thank you

    Name of Farm

    Owner/Contact

    Email

    Phone Number

    Prefer to be contacted c/o IPDP

     

    Address

    City, State, and Zip Code

    County

     

    # of Dairy Cows

    1-100101-500501-10001001-15001501-20002001-3000Over 3000

     

    Type of Waste Materials Generated

    Dairy Wrap (White)Silage Film(White/Black)Clear Plastic FilmMulch Plastic ( for ground)Hoop House

     

    5, 15 gallon containers (Soap, teat dip, etc. no hazardous/pesticide)

    WhiteBlackOrangeOther

     

    35 gallon drums (non hazardous/pesticide)

    BlackWhiteBlueOrangeOther

     

    55 gallon drums (non hazardous/pesticide)

    BlackWhiteBlueOrangeOther

     

    Pallets/Skids

    WoodPlastics

    (No Composite)

     

    Other Materials

    TwineNetafim tape/tubingPond LinerOther Material

     

    Does your farm have a place to store your used materials?

    Indoors

    YesNo

    If so, indicate amount of space

     

    Outdoors

    YesNo

    If so, indicate amount of space

     

    What is your current method of disposing of these materials?

    LandfillBurnBuryRecycleDon't Know

     

    Do you have a baler?

    YesNo

     

    If not, do you have a location with power where a baler could be installed?

    YesNo

     

    Is there a central location for other farmers to drop off their plastic for baling?

    YesNo

     

    Would you consider participating in a low to no cost pilot program that would reduce your cost of disposing of these materials, and a program that would assure you that material being collected would be reused in American-made products and not wasted?

    YesNo

     

    What percentage of your total operation would you consider to be Green

    0%10%25%50%75%100%

     

    Would you like your operation to be 100% GREEN CERTIFIED

    YesNo

     

    Thank you for participating in our survey to help reduce OUR carbon footprint. We look forward to working WITH you on this Stewardship of YOUR land program.