Generator Name*

Contact Name*

Physical Address*

Street Address Address Line 2 City Postal Code

Telephone Number / Extension*

Fax

Email Address*

Hours of Operation*

Anticipated Annual Volume*

Please enter a number greater than or equal to 0.

Unit*

Pallets
Kilograms

Processor Name*

Please enter the name of the processor you have selected. This processor must be approved by the Recycler Qualification Office (RQO) and their ICIRP application must have been accepted by EPRA-Québec.

If your products are acceptable for reuse and you wish to give them second life, you can contact one of the RQO-approved reusers participating in the EPRA-Québec program. Complete information is available on our website in the Reusers section under the Service Providers menu. Please select the sentence that applies to you:

Want/do not want*

the products that may have a second life to be sent by the selected processor to an RQO-approved reuser participating in the EPRA-Québec program.

Consent*

By applying for the EPRA ICI Recovery Program (ICIRP) for the province of Québec and submitting this application:

I understand that this is a recycling program for end-of-life electronics.

I understand that if data sensitive products are to be included in shipments, such as CPUs, desktop and portable computers, cellular phones, etc., EPRA will not be responsible for any loss of products, data, or private information on shipped products due to theft or misplacement of these materials that are being shipped to the processor or reuser.

I understand that EPRA will not be responsible for any liability or hazardous material clean up due to inappropriate packaging or transportation damage; any responsibility of transportation of shipment and/or hazardous material clean up remains with the Processor.

By submitting this form, I confirm that all the above statements are accurate and that I, the Generator, certify that all products submitted under this program will have originated in the province of Québec.*

Email

This field is for validation purposes and should be left unchanged.

Generator Application Form – ICIRP

Generator Application Form

Upcoming Events

HHW and ICT Collection Event – Saint-Esprit – MRC de Montcalm

HHW and ICT Collection Event, Mobile Ecocentre – Bury

HHW and ICT Collection Event – Anjou Borough

HHW Collection Event (June 3-4) – Pierrefonds-Roxboro Borough

ICT Collection Event – Nation Huronne-Wendat