Project Name Form No.

Project Location Date

Contractor's Name

WASTE HAULING FORM

1. Waste Carrier Section
1A. Waste Carrier's Company Name

1B. Waste Carrier's License Number

2. Waste Disposal Section

2A. Select all that applies and specify weight in kilograms ONLY
a. Mixtures of concrete, bricks,
tiles, and ceramics (kg) Reuse (kg) Recycle (kg) Dispose

b. Wood
(kg) Reuse (kg) Recycle (kg) Dispose

c. Metal (mixed)
(kg) Reuse (kg) Recycle (kg) Dispose

d. Plasterboard
(kg) Reuse (kg) Recycle (kg) Dispose

e. Mixed demolition and

construction wastes (kg) Reuse (kg) Recycle (kg) Dispose

f. Packaging - Cardboard
(kg) Reuse (kg) Recycle (kg) Dispose

g. Packaging - Plastic
(kg) Reuse (kg) Recycle (kg) Dispose

h. Insulation
(kg) Reuse (kg) Recycle (kg) Dispose

i. Furniture
(kg) Reuse (kg) Recycle (kg) Dispose

j. Rubber insulation
(kg) Reuse (kg) Recycle (kg) Dispose

k. Insulated copper wires

(kg) Reuse (kg) Recycle (kg) Dispose

l. Copper pipes
(kg) Reuse (kg) Recycle (kg) Dispose

m. EMT pipes and fittings

(kg) Reuse (kg) Recycle (kg) Dispose

n. Adhesives
(kg) Reuse (kg) Recycle (kg) Dispose

o. Others (please specify)

(kg) Reuse (kg) Recycle (kg) Dispose

p. Others (please specify)

(kg) Reuse (kg) Recycle (kg) Dispose
2B. Noted by (Contractor's Representative)

Name Signature
2C. Approved by (Construction Manager)

Name Signature
3. Receiving Facility Section
3A. Receiving Facility Name 3B. Receiving Facility's License Number

3C. Complete Address of the Receiving Facility