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Run: Used Oil DIY Drop-Off Acceptance Form

Record DIY used oil drop-offs with volume, container condition, contamination checks, and staff sign-off in one intake form. It helps counter staff document ...

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Transaction Details

Date of Drop-Off (required)

Date the used oil was received at this location.

Time of Drop-Off (required)

Time the used oil was received.

Store / Collection Site (required)

Store number and location name where oil is being accepted.

Counter Staff Name (required)

Transaction / Receipt Number

Auto-generated reference number for this acceptance record.

Customer Information

Customer Type (required)

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 (required)

Enter the total volume of used oil accepted in U.S. gallons. Most DIY programs cap at 5 gallons per visit.

Number of Containers (required)

Container Type(s) (required)

Select all container types presented by the customer.

Container Condition (required)

Leak / Container Issue Notes

Contamination Screening

Visual Appearance of Oil (required)

Odor Check (required)

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? (required)

Suspected Contaminant(s)

Action Taken for Contaminated Oil

Contamination Notes

Was Oil Accepted into the Collection Tank? (required)

Collection Tank Status

Tank Level Before Acceptance (% full)

Tank Level After Acceptance (% full) (required)

Does Tank Level Require Hauler Notification (≥ 80%)? (required)

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 (required)

Yes No N/A

Staff Signature (required)

Sign to complete and submit this acceptance record.

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Email (required)

Your name (optional)

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