Form 54-064 - Combined Request For Pollution Control And Recycling Property Tax Exemption And Certification Of Pollution Control And Recycling Property Page 3

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Combined Request for
Page 3
Pollution Control and Recycling Property Tax Exemption and
Certification of Pollution Control and Recycling Property
(d) Describe any by-product or material which, without the control property, would be lost and which is recovered or reprocessed
through the use of the facility. Indicate the disposition of each type of recoverable material, including, if applicable, the sale or other
disposition of recovered or reprocessed material to industrial waste recovery firms or others and its estimated value. Confinement
feeding operators and recycling facility managers are not required to complete this item.
(e) List in detail the property for which certification is requested. Include the manufacturer’s make or model number and model year, if
appropriate. Attach a copy of schematic, pictures or engineering drawings, plans or specifications. Note with an asterisk property
which has a function in addition to removal, treatment or disposal of air contaminants, sewage, industrial waste or other waste.
Provide the installed cost of the property described.
(f) Describe the function of any property listed above which has a function in addition to removing, treating or disposing of air
contaminants, sewage, industrial waste, other waste or recycling. Also, estimate the percentage of the property usage devoted to
nonpollution control or recycling functions.
54-064c(7/99)

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