Your Company Name Here
Form :
Contact us at:
phone: 732.396.9777
fax: 732.396.9778
USA Waste

Survey Questionnaire

Dear Manager,

USA Waste Management LLC  would like to offer to analyze, review,
develop, and manage waste services for  your property's daily solid waste  
&  recycling needs. The  purpose of this questionnaire  is to ensure that
the needs of all properties,regardless of size or volume, receive the type
of service that they require. Your  response  will be  utilized  as part of our
process  to build up the  necessary  information  needed to  streamline
disposal needs & maximize the savings for your property.
This form is for general informational purposes only. Please feel free to
contact our office at any time if necessary. We may contact you for further
discussions regarding your requirements after our review of your

Please describe the property that you manage:

Approximate Office Square Footage

Average percentage of occupancy

Approximate square foot warehouse space

How many floor levels does your facility utilize?

Does your building have trash chutes?

                Site Name & Address

                   Container size used

                Quantity of containers

Explain current Waste Frequency of Pick-ups

Explain current Recycling Frequency of Pick-ups

Current Method of monitoring proficiency level of fill capacity of
each container
Example: Loose Open Top Container Prior to each pick up service
fill level checked by eye.
Example: Closed Compactor Box Prior to each service fill level
checked via pressure gauge
Example: Closed Compactor Box Prior to each service fill level
checked with 80% full light
Example: Closed Compactor Box Prior to each service fill level
checked  by eye in compression hopper area.

Current Height of lift operation to reach fill area of each container
Example: Have waste guided with trash chute directly into
Example: 4-Yard slant with load area 4 feet from ground.
Example: 8-Yard square container with side door
Example: Loading dock ground level com

Do you feel that the current method of disposal is adequate for
your property?
If not, please explain what you would like to see changed

Please describe specific problems that you have experienced at
your property
including but not limited to, space limitation, equipment condition,
service provider, etc.

                                                       Compactor Size

                                                Make & Model Number

Is the compactor rented, leased, owned or on loan?

Is your compactor a (1) one-piece unit              (Self Contained)

Is your compactor a (2) two piece breakaway  (Stationary)

Electric supply line   (1) 230V 3-Phase or (2) 480V 3-Phase

                    Completed by  
                                                     Company Name
                                                     City, State & Zip Code
                                                     Phone Number

                   Other Contact necessary
                                                     Company Name
                                                     City, State & Zip Code
                                                     Phone Number

If possible, please E-Mail Photos of all site containers &
compactors to jim@usawastemanagement.comto,