Deq Form 515 081 PDF Details

In the realm of environmental responsibility and regulatory compliance, the Oklahoma Used Tire Tracking Manifest, designated as DEQ Form #515-081, emerges as a pivotal document ensuring the proper handling and recycling of used tires within the state. This form serves not only as a tracking tool but also as a certification of compliance, underscoring the stringent measures Oklahoma has adopted to address the environmental concerns associated with tire disposal. Central to the form are two main sections: one to be completed by the tire dealer or generator and the other by the hauler, each accompanied by a declaration of accuracy and completeness under penalty of law. The form meticulously records details ranging from the tire dealer's information and certification of fee remittance to the hauler's acknowledgment of tire collection, thereby streamlining the accountability for every tire's journey from collection to recycling. The requirement for tire generators to certify their adherence to the Oklahoma Used Tire Recycling Act and for haulers to verify the accuracy of their cargo underscores the state's commitment to reducing environmental impact. Additionally, the stipulation that all parties involved retain a copy of the manifest for a minimum of five years reinforces the long-term commitment to environmental stewardship and regulatory compliance, making this document a cornerstone in the state's efforts to ensure that used tires are managed in an environmentally sound and legally compliant manner.

QuestionAnswer
Form NameDeq Form 515 081
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesapplicable, InstructionsManifests, INDEMNITY, DEQ

Form Preview Example

OKLAHOMA USED TIRE TRACKING MANIFEST

(SEE INSTRUCTIONS FOR THE USE OF THIS FORM ON THE REVERSE SIDE)

CERTIFICATION: I CERTIFY THAT THE INFORMATION CONTAINED IN THIS DOCUMENT IS TRUE, ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.

I. TIRE DEALER/OTHER GENERATOR INFORMATION AND CERTIFICATION

TIRE DEALER/GENERATOR NAME:

TIRE RECYCLING FEE ACCOUNT #:

SALES TAX PERMIT #:

STREET ADDRESS:

 

CITY:

 

COUNTY:

ZIP CODE:

PHONE #:

 

 

 

 

 

 

 

 

 

 

 

# MOTORCYCLE

# ≤ 19.5 INCH RIM DIAMETER TIRES:

 

# >

19.5 INCH RIM DIAMETER

 

# AGRICULTURAL TIRES:

 

TIRES:

 

 

TIRES:

 

 

 

 

CERTIFICATION: I CERTIFY THAT I HAVE REMITTED APPROPRIATE FEES TO THE OKLA. TAX COMMISSION AS A PARTICIPATING TIRE DEALER PURSUANT TO THE PROVISIONS OF THE OKLA. USED TIRE RECYCLING ACT. I FURTHER CERTIFY THAT THE NUMBER OF TIRES RELINQUISHED BY ME, INCLUDING THE NUMBER OF TIRES SHOWN ON THIS DOCUMENT, IS EQUAL TO OR LESS THAN THE NUMBER OF TIRES FOR WHICH I HAVE REMITTED THE TIRE RECYCLING FEE REQUIRED BY 27 O.S. § 2-11-401.2. I UNDERSTAND THAT ANY FALSE STATEMENT MADE HEREIN, KNOWING SUCH STATEMENT TO BE FALSE IS A VIOLATION OF 21 O.S. § 358 AND MAY SUBJECT ME TO FINES AND/OR IMPRISONMENT AS PROVIDED BY 21 O.S. 359.

PRINTED NAME OF RESPONSIBLE INDIVIDUAL:

SIGNATURE:

DATE:

II. HAULER INFORMATION AND CERTIFICATION

HAULER NAME:

 

 

 

TRAILER #:

 

TRUCK LENGTH:

 

 

 

 

 

 

 

 

 

 

 

 

 

STREET ADDRESS:

 

CITY:

 

 

STATE:

 

ZIP CODE:

PHONE #:

 

 

 

 

 

 

 

 

 

 

 

 

# MOTORCYCLE

# ≤ 19.5 INCH

RIM DIAMETER TIRES:

 

# > 19.5 INCH RIM DIAMETER

 

 

# ≤14 INCH

AND ≤44 INCH AG

TIRES:

 

 

 

 

TIRES:

 

 

TIRES:

 

CERTIFICATION: I CERTIFY THAT THE INFORMATION PROVIDED IN THIS SECTION IS TRUE AND CORRECT AND THAT TIRES IN THE NUMBERS

SHOWN WERE PICKED UP FROM THE GENERATOR IDENTIFIED ABOVE.

 

 

 

 

 

 

 

 

 

PRINTED NAME OF RESPONSIBLE INDIVIDUAL:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE:

 

 

 

 

 

 

DATE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DEQ FORM #515-081 (Revised January 2013)

THIS FORM IS TO BE USED FOR THE TRACKING OF ALL TIRES EXCEPT THOSE TRANPSORTED DIRECTLY TO A PERMITTED USED TIRE RECYCLING FACILITY WHO IS SEEKING REIMBURSEMENT FROM THE OKLAHOMA USED TIRE RECYCLING INDEMNITY FUND.

Instructions-

Manifests must be printed on appropriate forms in accordance with OAC 252:515-21-51 (a)(b)(c). A copy of the form is to be given to the generator; if applicable, a copy should be attached to the used tire reimbursement manifest when waste tires are picked up from the primary hauler and delivered to a permitted used tire recycling facility; a copy should be retained by the primary hauler or final recipient. Color coding is optional.

Section I. Section I is to be completed and signed by the generator (i.e., tire dealer or other used tire generator).

Section II. Section II is to be completed and signed by the primary hauler or final recipient.

The final recipient of the tires must (within 30 days) return a copy of the completed manifest to the generator.

All parties must retain their copy of the manifest for a minimum of five years.

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