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Industrial Waste Service Request Form
Organization Details
Organization name*
Contract No. (if exist)*
City or Zone* District name*
Mail Box*
Telephone no.* Fax no.*
E-mail
Person in Charge Information:
Person in charge*
Job Title:*
Extension no. Mobile no.*
E-mail*
Waste Service Request Details :
Brief about type of waste*
Attach file (optional) only word or pdf files allowed
The requested service is *
Quantity
Period *
Wastes Location*
Material Safety Data Sheets (optional) only word or pdf or Excel files allowed
Hazardous and non Hazardous substances details (optional) only word or pdf files allowed
* Requeired fields