California Department of Resources Recycling and Recovery (CalRecycle) 

Electronic Waste Management

Documents/Resources Supporting Participation in the Electronic Waste Recovery and Recycling Payment System

CalRecycle has developed a variety of tools to assist participants in the covered electronic waste recovery and recycling payment system. These resources are intended to ease compliance with regulations that were adopted to implement portions of landmark legislation that established a funding system for the collection and recycling of certain electronic wastes. Prospective collectors and recyclers must be approved prior to participation.

Important: Approved participants in the covered electronic waste (CEW) recovery and recycling payment system must keep all organizational information associated with applications updated with CalRecycle. This includes facility and operational status, locations, and personnel matters. Failure to do so may result in revocation of approval.

The tools listed below do not substitute for a thorough understanding of all system requirements. Prospective participants are urged to familiarize themselves with applicable statutes and regulations.

Application to Participate in the Covered Electronic Waste (CEW) Payment System

Form/Date Download Format Description
Application for Approval: Covered Electronic Waste Recovery and Recycling Payment System (Form 186)

Last revised: August 2014

Form 186, Word
Form 186, PDF
This application can be completed electronically using the text fields prior to printing; however it may not be submitted electronically and must be mailed or delivered to CalRecycle at the address noted on the form. Interested parties should review all payment system regulatory requirements and comply with any and all DTSC requirements regarding notification and inspections prior to applying.

This application is to be used by entities intending to participate in the CEW Recovery and Recycling Payment System (CCR Title 14, Division 7, Chapter 8.2) established pursuant to the Electronic Waste Recycling Act of 2003 (Chapter 526, Statutes of 2003).

Payee Data Record (Std. 204)

Last revised: June 2003

Form 204, PDF This form is used by State agencies to prepare information returns (Form 1099) and is required as part of a recycler's application for approval to participate in the payment system. Applicants for Collector should not submit this form.

Covered Electronic Waste (CEW) Payment System Forms and Documents

The following are forms and documents to support Approved Recyclers' and Approved Collectors' participation in the payment system. Note that these materials are provided as guidance and do not relieve participants of any other data, information or record maintenance requirements contained in regulation or statute.

Form/Date Download Format For Use By Description
Covered Electronic Waste Collection Log (Form 198) Last revised: November 2006 Form 198, Approved collectors Use this form to record required information on all Covered Electronic Waste (CEW) accepted by the Collector. Information on this sheet must accompany the CEWs transferred from an approved collector to an approved recycler. It must also be submitted to CalRecycle with the CEW Recycling Payment Claim (196).
Source-Anonymous CEW Collection Log (Form 198 SA) Last revised: November 2006 Form 198 SA Eligible approved collectors Eligible approved collectors may use this form to log and track the handling of source-anonymous covered electronic waste (SA CEW). SA CEWs must be logged separately from other CEWs. Depending on the circumstances, limitations may apply regarding who may collect SA CEWs. Refer to the regulation citations on the form.
Proof of Designation (Form 184) Form 184, PDF
(Rev. 4/17)
Local Government

This form may be used as a Proof of Designation (POD) under Title 14 CCR § 18660.49, when initiated by a California Local Government and duly executed by a representative authorized to take action on behalf of that Local Government. A copy of this POD must be transmitted to CalRecycle at least 30 days prior to CEW collection activities conducted under the Designation.

Evidence of this Proof of Designation must accompany the CEW collection logs associated with CEWs transferred from a Designated Approved Collector to an Approved Recycler, and must also accompany any recycling payment claim that includes CEWs recovered under this Designation. Interested parties should review the applicable regulations and guidance.

Covered Electronic Waste Recycling Payment Claim (Form 196) Form 196, Word
(Rev. 7/08)
Form 196, PDF
(Rev. 5/16)
Approved recyclers This form may be completed by Approved Recyclers for each reporting period within which payment is claimed. Information on this form includes calculation of payment claim, indication of supporting documents and declarations and signatures of authorized agents. additional documentation must accompany Form 196 to make a complete payment claim package. Approved Recyclers may attach  Form 196A (Worksheet A) and/or Form 196B (Worksheet B) depending on the type of covered electronic devices that are cancelled. If CRT and/or CRT-Containing and Non-CRT Covered Electronic Wastes are both cancelled, the approved recycler should submit both forms.
Worksheet A: Covered Electronic Waste Recycling Payment Claim (Cancellation of CRTs and/or CRT-Containing Wastes) (Form 196A) Form 196A, Word
(Rev. 7/08)
Form 196A, PDF
(Rev. 5/16)
Approved recyclers This form may accompany Form 196 if the Approved Recycler cancels CRTs and/or CRT-Containing Covered Electronic Wastes. Information documented will include the type of cancellation method used, calculation of payment, postcancellation disposition of glass cullet or bare CRTs, and estimated weights of treatment residuals for each reporting period.
Worksheet B: Covered Electronic Waste Recycling Payment Claim (Cancellation of Non-CRT Covered Electronic Wastes) (Form 196B) Form 196B, Word
(Rev. 7/08)
Form 196B, PDF
(Rev. 5/16)
Approved recyclers This form may accompany Form 196 if the Approved Recycler cancels Non-CRT Covered Electronic Wastes. Information documented will include calculation of payment, post-cancellation disposition of circuit boards and estimated weights of treatment residuals for each reporting period.
Covered Electronic Waste Transfer Receipt (Form 197)

Last revised: October 2006

Form 197, Word Approved collectors and/or approved recyclers This form may be used when materials are transferred between an Approved Collector and an Approved Recycler. The form allows for required declarations and weight verifications as required by regulation. While use of this form is not mandatory, if an approved recycler chooses not to use this form, they must provide equivalent information in supporting documentation and submit it as part of a complete payment claim package.
Covered Electronic Waste Transfer Summary (Form 197S)

Last revised: October 2006

Form 197S, Word Approved recyclers This form may be used to summarize transactions between Approved Collectors and an Approved Recycler. The form captures quantity and payment information as required by regulation. While use of this form is not mandatory, if an approved recycler chooses not to use this form, they must provide equivalent information in supporting documentation and submit it as part of a complete payment claim package.

Other Related Resources and Forms

  • Covered Electronic Waste Recycling Payment Claim Checklist
    This checklist is intended to provide guidance to approved recyclers who are preparing Covered Electronic Waste (CEW) Recycling Payment Claims to ensure that all requirements for the payment claim have been met prior to claim submittal. This checklist does not replace or supersede relevant statutes and regulations. Interested parties are advised to keep apprised of subsequent changes to relevant statutes and regulations.
  • Designated Approved Collector Guidance
    The Designated Approved Collector provision as described under Title 14 CCR Chapter 8.2, Article 7 § 18660.47 – 18660.51 provides a means for Local Governments to authorize Approved Collectors to conduct CEW recovery activities under specific circumstances. Revised regulations were approved March 16, 2017.
  • DTSC Notification of Intent to Handle CRTs and/or UWEDs
    Any entity handling a minimum threshold of discarded cathode ray tubes (CRT) or universal waste electronic devices (UWED) is required to notify the Department of Toxic Substances Control (DTSC), regardless of whether they are participating in the SB 20 payment system. Information on the process is available on the DTSC website, including an informative fact sheet. Please note that, depending on a handler's activities, other DTSC requirements may apply.
  • Net Cost Reporting Guidance
    Covers the reporting and documentation requirements and provides detailed, line-by-line instructions for completing the Annual CEW Net Cost Report (Form 220) and Net Cost Estimation Worksheets for Collectors (Form 220a) and Recyclers (Form 220b).
  • Collector Outreach Initiative
    CalRecycle has provided an informative flyer for participants to distribute to parties discarding their CEW. The flyer helps memorialize the transaction and explains why their personal information is needed for source documentation. English and Spanish versions are available for download with other languages available upon request.

As CalRecycle, in consultation with the Department of Toxic Substances Control (DTSC), works to implement this important legislation, more information will be available through this website. Note that any guidance provided by CalRecycle should not substitute for careful reading of the original statute or subsequent regulations. Interested parties are encouraged to check back often, or subscribe to an email newsletter to be kept apprised of developments and events.

Collector and Recycler Home Page

Last updated: April 11, 2017
Electronic Discards http://www.calrecycle.ca.gov/Electronics/
Contact: EWaste@calrecycle.ca.gov (916) 341-6269