WASTE TRANSFER DECLARATION FORM

WASTE TRANSFER DECLARATION

Submission of waste from collector to third-party:

1. Contractor Name :
Address/Telp :

2. Third-Party Company Name :

Address/Telp :
No SK and No Permit :
Waste will be sent to :

3. Category of waste Domestic (Organic/inorganic)

4. Transportation mean :
5. Vehicle number :
6. Driver name :

Submission of waste Signature

No Date Amount of waste to be Date of Amount of waste to Manifest

Transport Sender Receiver
transported received be received No.
of waste
1 2 3 4 5 6 7 8

Total Total

Reported By Approved By