Florida Department of Environmental Protection Waste Tire Collector Registration Notification Expires April 1, 2018

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1 Florida Department of Environmental Protection Waste Tire Collector Registration Notification Expires April 1, 2018 Tuesday, October 03,2017 The Company listed below has registered with the Department as a Waste Tire Collector in accordance with Chapter , F.A.C., and registration decals have been issued to the vehicles listed below. These decals are valid until April 1, 2018 unless revoked. Decals must be affixed to the assigned vehicle on the driver's side door of that vehicle. Decals are $35.00 each. For further information call "Waste Tires" at WACS ID: Name: REPUBLIC SERVICES OF FL, LP DBA: EAST BAY SANITATION No Decal # YR MAKE TYPE VIN # TAG # ST Owner # MACK TK 1M2AT13C87M N1994K FL MACK TK 1M2AX13C39M N8615N FL MACK TK 1M2AT13C67M N1187R FL MACK RO 1M2AG11C16M N0077W FL 597

2 Florida Department of Environmental Protection Bob Martinez Center 2600 Blair Stone Road Tallahassee, Florida DEP Form # (18), F.A.C. Form Title Waste Tire Collector Registration Application Effective Date: January 6, 2010 DEP Application No. (Completed by DEP) WASTE TIRE COLLECTOR REGISTRATION APPLICATION Pursuant to Rule , Florida Administrative Code, to obtain a waste tire collector registration number and approval to transport waste tires, a collector shall submit the following information on this form to the Department. Type of Collector: For Hire Collector Not For Hire Registered with ICC Government Entity Part I- Business Information: 1. Business name of collector: REPUBLIC SERVICES OF FL, LP WACS ID Number: 2. Other business names of collector (DBA's): EAST BAY SANITATION (assigned by Department) 3. Mailing address of collector: City State Zip 4. Street address of collector: City Tampa Tampa 5603 N 50th St 5603 N 50th St 5. Telephone number of collector: address: 6. Federal Employer Identification number (FEID) of Collector: County State Zip (813) Hillsborough 7. Have any enforcement actions been taken by the Department or other governmental agency against the applicant for violation of Department rules relating to the collection or disposal of waste tires? This includes any Complaint, Notice of Violation, revocation or suspension of a registration, as well as any Consent Order in which a violation of Department rules is admitted. It does not include a Warning Letter, Warning Notice, Notice of Noncompliance, or other similar document which does not constitute agency action. Yes No If yes, attach a history and description of the enforcement actions. FL FL jbishop2@republicservices.com Part II- Person in charge of Waste Tire Collection Operations: 1. Name of Person in charge of Waste Tire Collection Operations: N/A 2. Date of Birth of Person in charge of Waste Tire Collection Operations: N/A Corporations also complete Part III. 1. Corporation Name: 2. Corporation Filing Date: State of Incorporation: 3. Corporation Officers: 12/27/1999 N/A 4. Florida Resident Agent of Corporation: EAST BAY SANITATION Jason Bishop DE DEP FORM (18) Page 1 of 2 Effective January 6, 2010

3 WACS ID: Part IV- Collection and Disposal Information: 1. List all known locations where you will be collecting waste tires (attach additional sheets if necessary) Name Address City State See attached sheet. 2. List all known locations where you will be delivering or depositing waste tires for recycling or disposal (attach additional sheets if necessary): See attached sheet. Name Address City State Part V.- Vehicles to be Registered: 1. Number of vehicles to be used: 4 2. Vehicles registration information: a. A legible copy of the current vehicle registration is required for each vehicle registered. The registration must show State of registration, year, make, tag number, vehicle identification number, and registered owner. b. IF the vehicle is not owned by the collector, an authorization from the vehicle owner for the vehicle to be registered for waste tire collection must be attached to this application. c. IF Common Carrier, list Interstate Commerce Commission (ICC) authority number for the company: Part VI. Registration Fee Information 1. Waste tire collector registration status: New Renewal If registration is a renewal, list previous registration number(s) N/A 2. Attach payment for registration fees pursuant to Rule (11), F.A.C. Number of vehicles # 4 x $35 = $ 140 = Amount of Payment Part VII. Certification To the best of my knowledge and belief, I certify the information provided in this application is true, accurate, and correct. I have attached all documents and/or authorizations that are required. Jason Bishop 08/07/2017 Jason Bishop Print Name of Authorized Agent Signature of Authorized Agent Date Mail completed form to: Florida Department of Environmental Protection Division of Waste Management / Tires 2600 Blair Stone Road, MS 4550 Tallahassee, Florida DEP FORM (18) Page 2 of 2 Effective January 6, 2010

4 Florida Department of Environmental Protection Bob Martinez Center 2600 Blair Stone Road Tallahassee, Florida Rick Scott Governor Carlos Lopez-Cantera Lt. Governor Noah Valenstein Secretary Waste Tire Collector Registration Collection and Disposal Locations Attachment WACS ID: Collector Name: REPUBLIC SERVICES OF FL, LP Year: 2015 Part IV - Collection and Disposal Information: 1. List all known locations where you will be collecting waste tires Name Address City State HillsboroCounty Public Schools 3838 N 50th St Tampa FL City of Oldsmar 300 Commerce Blvd. Oldsmar FL 2. List all known locations where you will be delivering or depositing waste tires for recycling or disposal WACS ID Name & Details State TOYTOWN SLF ~ ROOSEVELT BLVD & 16TH ST N ~ ST PETERSBURG ~ Florida MCKAY BAY REFUSE-TO-ENERGY PROJECT ~ 34TH ST & CLARK ST ~ TAMPA ~ Florida

9 Florida Department of Environmental Protection Bob Martinez Center 2600 Blair Stone Road Tallahassee, Florida DEP Form # (22), F.A.C. Form Title:Waste Tire Collector Annual Report Effective Date: January 6, 2010 DEP Application No. (Completed by DEP) WASTE TIRE COLLECTOR ANNUAL REPORT (For Calendar Year Ending 2015 ) Pursuant to Rule , Florida Administrative Code, waste tire collectors are required to submit the following information to the Department by March 1 of each year. The annual report must be submitted along with the annual registration renewal application and registration fee as a condition of holding a waste tire collector registration number. 1. Business name: 2. Business mailing address: City: State: WACS ID Number: (assigned by Department) 3. Business street address: 5603 N 50th St Tampa City: State: FL Zip: Business telephone: (813) address: jbishop2@republicservices.com 5. Total quantity of waste tires, expressed in tons, collected or generated during the calendar year (assume100 tires per ton or 10 tires per cubic yard): 15. tons tires 6. Describe how the waste tires collected were disposed of during the calendar year, reported in tons. (assume 100 passenger tires per ton, 20 truck tires per ton.) A. List total quantity of waste tires sold as used tires. A. tons tires B. List quantity of waste tire casings sold. B. tons tires C. List quantity of waste tires hauled off by other Waste Tire Collectors. Attach additional sheets, if necessary. See attached sheet. REPUBLIC SERVICES OF FL, LP 5603 N 50th St FL Name of Other Collector Collector Registration Number Quantity in tons Zip: C. tons tires D. List the facilities where waste tires were deposited for disposal or recycling and the quantity disposed at each location. Attach additional sheets, if necessary. See attached sheet. Name of Facility Address / City / State Quantity in tons D. tons tires TOTAL Tires sold or deposited for disposal or recycling A + B + C + D tons tires DEP FORM (22) Page 1 of 2 Effective January 6, 2010

10 DEP FORM (22) Page 2 of 2 Effective January 6, 2010 WACS ID: Explain any differences between Waste Tires Collected (item 5) and Waste Tires Deposited (item 6): 8. Waste tire collector registration number(s): N/A 9. Authorized person preparing report: 10. Telephone number of person preparing report: 11. Certification: Jason Bishop (813) To the best of my knowledge and belief, I certify the information provided in this report is true, accurate and correct. 08/07/2017 Jason Bishop Jason Bishop Print Name of Authorized Agent Signature of Authorized Agent Date Mail completed form to: Florida Department of Environmental Protection Division of Waste Management / Tires 2600 Blair Stone Road, MS 4550 Tallahassee, Florida

11 Florida Department of Environmental Protection Bob Martinez Center 2600 Blair Stone Road Tallahassee, Florida Rick Scott Governor Carlos Lopez-Cantera Lt. Governor Noah Valenstein Secretary Wate Tire Collector Annual Report Hauled & Disposal Locations Attachment WACS ID: Collector Name: REPUBLIC SERVICES OF FL, LP Year: Describe how the waste tires collected were disposed of during the calendar year, reported in tons. Assume 100 passenger tires per ton, 20 truck tires per ton.) D. List the facilities where waste tires were deposited for disposal or recycling and the quantity disposed at each location. WACS ID Name & Details State Quantity TOYTOWN SLF ~ ROOSEVELT BLVD & 16TH ST N ~ ST PETERSBURG ~ Florida MCKAY BAY REFUSE-TO-ENERGY PROJECT ~ 34TH ST & CLARK ST ~ TAMPA ~ Florida 10

12 DIVISION OF CORPORATIONS Department of State Division of Corporations Search Records Detail By Document Number Detail by Entity Name Foreign Profit Corporation REPUBLIC SERVICES, INC. Filing Information Document Number FEI/EIN Number Date Filed State Status F /09/1998 DE ACTIVE Principal Address Changed: 04/22/2015 Mailing Address Changed: 04/22/2015 Registered Agent Name & Address C T CORPORATION SYSTEM 1200 SOUTH PINE ISLAND ROAD PLANTATION, FL Officer/Director Detail Name & Address Title Chairman of the Board, Director Kadre, Manuel 5345 Hammock Drive Coral Gables, FL Collins, Tomago c/o Kroenke Sports & Entertainment 1000 Chopper Circle Denver, CO 80204

13 Crownover, James W. Two Houston Center 909 Fannin Suite #3675 Houston, TX Dunwoody, Ann E. c/o Republic Services, Inc. Phoenix, AZ Flynn, William J. c/o Atlas Air, Inc Westchester Avenue Purchase, NY Handley, Thomas W. c/o Ecolab, Inc. 370 Wabasha Street North St. Paul, MN Kirk, Jennifer M. c/o Occidental Petroleum Corporation 5 Greenway Plaza, Suite 110 Houston, TX Larson, Michael c/o Cascade Investments LLC 2365 Carillon Point Kirkland, WA Nutter, W. Lee c/o Republic Services, Inc.

14 Rodriguez, Ramon A. c/o Republic Services, Inc., President, CEO Slager, Donald W. Trani, John M. c/o John M. Trani, LLC 30 Stanford Drive Farmington, CT Volpe, Sandra M FedEx Drive Moon Township, PA Title Executive Vice President, Chief Development Officer Bales, Brian A. Title Executive Vice President, Chief Legal Officer, Secretary Ellingsen, Catharine D. Title Executive Vice President, Chief Administrative Officer Hughes, Jeffrey A. Title Executive Vice President, CFO Serianni, Charles F. Title Senior Vice President, Controller

15 Clark, Jerry S. Title Senior Vice President, Finance DelGhiaccio, Brian M. Title VP, Tax Focazio, Lawrence Title VP, Chief Accounting Officer Goebel, Brian A. Title Treasurer, VP Lacy, Marsha A. Title VP, Assistant Secretary Sweet, Andrew J. Title VP, Assistant Secretary Kort, Myndi M. Title VP, Assistant Secretary Wilhoit, Adrienne W. Title Assistant Secretary Schuler, Eileen B.

16 Annual Reports Report Year Filed Date /22/ /12/ /20/2017 Document Images 04/20/ ANNUAL REPORT View image in PDF format 04/12/ ANNUAL REPORT View image in PDF format 04/22/ ANNUAL REPORT View image in PDF format 04/16/ ANNUAL REPORT View image in PDF format 04/03/ ANNUAL REPORT View image in PDF format 04/28/ ANNUAL REPORT View image in PDF format 04/05/ ANNUAL REPORT View image in PDF format 04/08/ ANNUAL REPORT View image in PDF format 04/11/ ANNUAL REPORT View image in PDF format 04/28/ ANNUAL REPORT View image in PDF format 04/16/ ANNUAL REPORT View image in PDF format 02/27/ ANNUAL REPORT View image in PDF format 01/25/ ANNUAL REPORT View image in PDF format 02/10/ ANNUAL REPORT View image in PDF format 02/28/ ANNUAL REPORT View image in PDF format 03/20/ ANNUAL REPORT View image in PDF format 01/24/ ANNUAL REPORT View image in PDF format 01/27/ ANNUAL REPORT View image in PDF format 02/25/ ANNUAL REPORT View image in PDF format 07/09/ Foreign Profit View image in PDF format Florida Department of State, Division of Corporations

17 Thigpen, Hope From: Sent: Monday, August 7, :34 AM To: Waste Registration Subject: Waste Tire Collector Registration Attachments: 9eb962f1105e6459fb8f0d176eaa81a.pdf; eb6af035cdf5d8b0e026cca07050edae.pdf Florida Department of Environmental Protection Bob Martinez Center 2600 Blair Stone Road Tallahassee, Florida Rick Scott Governor Carlos Lopez-Cantera Lt. Governor Noah Valenstein Secretary Waste Tire Collector Registration Confirmation of Submission August 07, 2017 Jason Bishop has completed the registration process for the facility listed as: WACS ID: REPUBLIC SERVICES OF FL, LP 5603 N 50th St Tampa, FL County: HILLSBOROUGH Attached is a copy of the application and a copy of the annual report (if available). They reported: Tonnage Remaining: 0 Tonnage Collected: 15. Tonnage Disposed: 15 New Tonnage Remaining: 0 Copies of each vehicle registration uploaded are located at: pdf 1

18 pdf pdf pdf 2

Florida Department of Environmental Protection

Florida Department of Environmental Protection Florida Department of Rick Scott Governor Jennifer Carroll Lt. Governor Herschel T. Vinyard Jr. Secretary Receipt for Submission Thank you for applying for a Waste Tire Collector Registration for the facility