Pre-Delivery Report for Self-Haul Facilities

Notice: Please schedule your delivery with your assigned recycler prior to filling out this form.

Pre-Delivery Report for Self-Haul Facilities (CARE Public DoS)

NOTE: A pre-scheduled delivery date with the destination facility is required to complete this form. This form is intended as a notification to CARE of a pending delivery (Pre-Delivery Report). It will assign a Work Order number for invoicing reference.

This form is intended for use by a certified CARE California Public Drop-Off site to announce the delivery of a SCHEDULED Post Consumer Carpet (PCC) load to an authorized CSE/Processor.
Any related invoice(s) must reference the CARE Work Order number that is generated by this submission, and must include a certified weight ticket that documents NET Weight.
CARE Drop-Off Site*
Origin Service Date*
Enter the date the load was picked up from the origin location.
Month
Day
Year
Other Address
Street Address Address Line 2 City State ZIP Code
Drop-Off Site Contact Person*
Enter the information for the person CARE should contact in the event of questions and/or invoice issues.
First Last
Phone*
Email*
Delivery Information
Destination*
Please provide the name of the facility the load is being delivered to.
STOP! This load is not authorized for delivery at this destination. Please select the delivery point assigned to your facility. Please contact your CARE representative if you have any questions.
Scheduled delivery Date**
The date you have an appointment scheduled with a CARE CSE (Destination Facility). (This form does not replace scheduling with your destination facility.)
Container type and size*
Net Weight of Shipped Load (Tons)*
Load must be pre-weighed before form can be submitted. Weight must be NET WEIGHT tonnage of load (Heavy - Empty = NET), Attach a copy of the weight ticket in the photo upload section below.
Type of Material Shipped*
Please identify the primary contents of the load. Mixed carpet may include some loose carpet tiles.
Mixed Carpet (Residential and/or Commercial)
100% Carpet Tile (Stacked, Strapped & Wrapped)
Photo Upload*
Please upload a photo of the container. Maximum 3 photos permitted.
Drop files here or
Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 256 MB, Max. files: 3.
Notes / Comments
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Pre-Delivery Report for Self-Haul Facilities (CARE Public DoS)

Delivery Information

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Pre-Delivery Report for Self-Haul Facilities (CARE Public DoS)

Delivery Information

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