Application for Medical Exemption

The City of Airdrie will make an exemption to the weekly bag limit for residents who are not able to meet their weekly bag limit due to excess waste generated as a result of a medical or health related situation of a resident of that property.

Eligible applicants will receive excess waste tags to cover one extra garbage bag per week for a period of six months. An application must be completed every six months for continued service. This program is for residents in single family homes who currently receive City collection services. It is not for home-based businesses such as day homes or daycares. Participation in the City of Airdrie's curbside recycling and organics programs is still required under the Waste Management Bylaw No. B-07/2017.

Staff will review applications within one week of receipt. Once the application is reviewed staff will contact applicants via phone regarding pick-up of the excess waste tags.

Please complete this application in full.

Full Name of Applicant

Telephone Number

Address

Terms and Conditions

I am applying for this medical exemption due to a medical or health-related situation only

I acknowledge that this exemption application is for residential use only and is not meant to be used for excess waste generated by a home-based business (i.e. day homes etc.) and any information that is falsely supplied will be deemed fraudulent and will result in a fine pursuant to the Waste Management Bylaw No. B-07/2017

The excess bag tags will be used by the above-noted residence only, and will not be transferred or re-sold. I acknowledge that the bag tags hold no cash value

I acknowledge that the City does not accept hazardous bio-medical waste, including but not limited to, syringes, hypodermic needles, and sharps and agree that hazardous waste products will be disposed of properly through syringe/needle return programs at participating pharmacies

I will notify the City and return any remaining bag tags if the exemption is no longer required

I will notify the City if I move, and provide the City with my change of address within ten (10) business days

Neither I nor another member of my household has already made an application for a medical exemption for the six (6) month exemption period currently being applied for

Verification

Name

Date

Signature I CERTIFY that [by displaying/typing my name above] the information contained in this application is true, and to the best of my knowledge is correct and complete. I understand that providing false information on this application is fraudulent and will result in a fine pursuant to the Waste Management Bylaw No. B-07/2017.

FOIP (privacy statement)

FOIP

The information on this form is collected under the authority of Section 33(c) of the Freedom of Information and Protection of Privacy Act ("the Act") and will be used solely for the purposes of administering the application process to receive excess waste tags pursuant to a medical exemption under the City of Airdrie's Waste Management Bylaw No. B-07/2017. It will be treated in accordance with the privacy protection provisions of Part 2 of the Act.

Questions concerning collection of this information can be directed to the Waste & Recycling Services Program Coordinator at 15 East Lake Hill NE, Airdrie, Alberta T4A 2K3 or at 403.948.8800 Ext. 6291.

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