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The following forms are available for local government program staff, operators of certified used oil recycling centers, and registered generators.
| Grant-Related Forms |
| Reliable Contractor Declaration |
CIWMB 168 |
Adobe PDF, 18 KB |
MS Word, 51 KB |
| Travel Expense Log Form (Includes a sample
completed form.) |
CIWMB 246 (Rev. 2/08) |
Adobe PDF, 28 KB |
MS Excel, 27 KB |
| Personnel Expenditure Summary |
CIWMB 165 |
|
MS Word, 41 KB |
| Expenditure Itemization Summary |
CIWMB 667 |
Adobe PDF, 18 KB |
MS Excel, 21 KB |
| Expenditure Itemization Summary (Sample) |
CIWMB 667 |
Adobe PDF,
30 KB |
|
Facility Construction/Expansion Evaluation Form  (6/08) |
CIWMB 12 |
Adobe PDF,
77 KB |
MS Excel,
54 KB |
| Recycled Content Certification Form |
CIWMB 74G-Oil |
Adobe PDF, 22 KB |
MS Word, 71 KB |
| Payment Request Form |
CIWMB 87 |
Adobe PDF, 78 KB |
MS Word, 125 KB |
| Project Evaluation Data Form (6/08) |
CIWMB 11 |
Adobe PDF,
19 KB |
MS Excel, 66 KB |
General Checklist of Business
Permits, Licenses, and Filings |
CIWMB 669 |
Adobe PDF, 278 KB |
MS Word, 188 KB |
Used Oil Block Grant Annual Report Form
 (Rev.
7/08)
|
CIWMB 644 |
Adobe PDF, 154 KB |
MS Word, 170 KB |
| Used Oil Collection Center Site Visit Forms |
| Site Visit Checklist (English)
(Rev. 7/08) |
CIWMB 664 |
Adobe PDF, 52 KB |
MS Word, 75 KB |
| Site Visit Checklist (Spanish)
(Rev. 7/08) |
CIWMB 664 |
Adobe PDF, 47 KB |
MS Word,
44 KB |
| Multiple Site Visit Checklist
(Rev. 7/08) |
CIWMB 665 |
Adobe PDF, 92 KB |
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