Tire Recycling, Cleanup, and Enforcement Grants
Grant-Related Forms
The following forms are used for CIWMB's tire grant programs.
| Form Title | Form Number | Download |
|---|---|---|
| Annual Survey for the Tire-Derived Product Grant Program | CIWMB 223 (Revised 3/08) | MS Word, Fill-In, 131 KB |
| Crumb Rubber Modifier (CRM) Certification | CIWMB 74G-RAC | Adobe PDF, 278 KB | MS Word, 188 KB |
| General Checklist of Business Permits, Licenses, and Filings | CIWMB 669 | Adobe PDF, 278 KB | MS Word, 188 KB |
| Grant Self-Assessment Checklist | CIWMB 641 (New 6/08) | Adobe PDF, 73 KB | MS Word, 196 KB |
| Payee Data Record | Std. 204 | Adobe PDF, 39 KB |
| Payment Request Form | CIWMB 87 | Adobe PDF, 19 KB | MS Word, 89 KB |
| Personnel Expenditure Summary | CIWMB 165 | MS Word, 43 KB |
| Recycled Content Certification Waste Tire Grants |
CIWMB 74G-Tire | Adobe PDF, 27 KB | MS Word, 153 KB |
| Recycled Content Certification Waste Tire Enforcement Grants |
CIWMB 74G- Tire Enforcement |
Adobe PDF, 22 KB | MS Word, 111 KB |
| Recycled Content Certification Waste Tire Enforcement Grants: Completed Example |
Adobe PDF, 26 KB | |
| Reliable Contractor Declaration | CIWMB 168 | Adobe PDF, 18 KB | MS Word, 51 KB |
| Tire-Derived Product (TDP) Certification | CIWMB 227 (for TDP1 and TDP2 | MS Word, Fill-In, 120 KB |
| Tire-Derived Product (TDP) Certification | CIWMB 227 (for TDP3 and TDP4) | MS Word, Fill-In, 127 KB |
| Tire-Derived Product (TDP) Certification | CIWMB 227 (for TDP5 and TDP6) | MS Word, Fill-In, 67 KB |
| Travel Expense Log Form (includes completed example) | CIWMB 246 | Excel, 25 KB |
Last updated:
September 30, 2008
Tire Recycling, Cleanup, and Enforcement Grants http://www.ciwmb.ca.gov/Tires/Grants/
Contact: (916) 341-5062 grants@ciwmb.ca.gov
Tire Recycling, Cleanup, and Enforcement Grants http://www.ciwmb.ca.gov/Tires/Grants/
Contact: (916) 341-5062 grants@ciwmb.ca.gov