Waste Transfer Note

Customer Details

Customer Name

Customer Company Name

Customer Address

Customer Email

Customer Phone Number

Waste Details

Waste Type / EWC Code

Waste Description

Quantity / Weight

Unit

Collection Date

Collection Time

Collection Details

Collection Address

Postcode

Special Instructions

Disposal Site

Site Permit Number

Site Email

Declaration / Confirmation

Declaration

“I confirm that the information provided is accurate and that the waste described above is correctly classified.”

Name of Person Completing Form

Date