Waste 2 Energy Questionnaire

Waste to Energy Questionnaire

Please Complete the Form and click the submit button below when completed

* Required Field

1. General Information:

a. Company Name:

b. Contact Data

Name:

Job Title:

Address:

Telephone:

Website:

Fax:

Email:

Skype:

Other Apps:

c. Application Data:

Waste Type:

Throughput for a 24
hour per day basis:

Is There an Existing Plant:

Plant Site Location:

Site Access:

Expected Utilities Present:

Estimated Startup Date:

2. Waste Characterization (Type of Feedstock):

a. Waste Stream

Other (please explain)

%

%

%

b. Waste Stream Makeup by Weight

c. Chemical Composition of Waste
Stream:

%

%

%

3. Intended Ownership Data:

a. Who is the customer?

b. Who will be the owner?

c. Is funding / financing for the project in place? If yes, please explain

4. Customer Input Data (Process / Operating / Utilities)

a. Available Utilities at Site:

Electrical Power:

Water:

Gases:

b. Local Cost of Power ($.00/kwH)

c. Planned Operating Hours / Day

d. Local Personnel Direct Labor Rates

Plant Manager

Shift Supervisor

System Operator

Assistant

Other

e. Labor Markup (Fringe & OH)

f. Waste Tipping Fee ($/ton):

g. Anticipated Financing Rate:

i. Other Charges:

5. Financing Data

Type of Company:

If a public company, ticker symbol and listed Exchange:

Financing Plan:

Brief Company and Business Description

Financial/Investing Partners: (Please continue If Required)

Bank:

Contact:

Address:

Phone Number:

Has your
Company/Manicipality
Declared Bankruptcy?

Please check one:

Yes

6. Other Pertinent Information (Please List)

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All information is confidential

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