California Proof of Designation (Form 184)

Form Template

The California Proof of Designation (Form 184) mobile app makes it easy to complete a paperless designation form

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using a hand held mobile device. This recycling app generates a professional PDF that can be customized and personalized for your business. You can add or delete items in the app simply with the GoCanvas App Builder. The app includes detailed fields and records items such as designated approved collector, method of collection, name of designating authority representative , certification statement and captures signatures. Once the California Proof of Designation (Form 184) mobile app has been completed, it saves the results electronically as a secure PDF for your waste management records. This form may be used as a Proof of Designation under Title 14 of the California Code of Regulations (CCR) § 18660.49 when issued by a California Local Government. It must be completed by representatives authorized to act on behalf of that Local Government and the Designated Approved Collector. A copy must be transmitted to CalRecycle by the Local Government at least 30 days prior to use of the Designation.

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