Used Oil DIY Drop-Off Acceptance Form

Counter staff acceptance form for recording used oil brought in by do-it-yourself (DIY) customers, capturing volume, container condition, contamination checks, and chain-of-custody acknowledgment.

Transaction Details

• Date of Drop-Off
  Date the used oil was received at this location.
• Time of Drop-Off
  Time the used oil was received.
• Store / Collection Site
  Store number and location name where oil is being accepted.
• Counter Staff Name
• Transaction / Receipt Number
  Auto-generated reference number for this acceptance record.

Customer Information

• Customer Type
  Used oil from DIY generators is exempt from hazardous waste rules under EPA 40 CFR Part 279.24 only when generated from personal/household use.
• Customer First Name
• Customer ZIP Code
  Optional. Helps verify local DIY generator status if needed.

Used Oil Volume and Container

• Total Gallons Accepted
  Enter the total volume of used oil accepted in U.S. gallons. Most DIY programs cap at 5 gallons per visit.
• Number of Containers
• Container Type(s)
  Select all container types presented by the customer.
• Container Condition
• Leak / Container Issue Notes

Contamination Screening

• Visual Appearance of Oil
• Odor Check
  Halogenated solvent contamination (e.g., chlorinated solvents) disqualifies oil from used oil recycling per EPA 40 CFR Part 279.10(b)(ii).
• Is Contamination Suspected?
• Suspected Contaminant(s)
• Action Taken for Contaminated Oil
• Contamination Notes
• Was Oil Accepted into the Collection Tank?

Collection Tank Status

• Tank Level Before Acceptance (% full)
• Tank Level After Acceptance (% full)
• Does Tank Level Require Hauler Notification (≥ 80%)?

Additional Notes and Staff Sign-Off

• Additional Notes
• Photo Documentation (Optional)
  Attach a photo of the containers or any contamination concerns for the record.
• Staff Acknowledgment
• Staff Signature
  Sign to complete and submit this acceptance record.