Tire Disposal Report Form
Use this Tire Disposal Report Form to document and track all tire disposal activities, including responsible parties, tire details, locations, timing, quantities, disposal reasons or methods, and supporting documentation.
Disposing Party Name
*
First Name
Last Name
Organization or Company (if applicable)
Origin Location (Where did the tires come from?)
*
Disposal Site (Where are the tires being disposed?)
*
Date and Time of Disposal
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Number of Tires Disposed
*
Tire Type
*
Please Select
Passenger Car
Truck/Bus
Off-the-Road (OTR)
Motorcycle
Other
Reason or Method of Disposal
*
Please Select
Recycling
Energy Recovery
Landfill
Retreading
Other
Tire Condition
*
Please Select
New/Unused
Worn
Damaged
Mixed
Supporting Notes or Attachments
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