Company Name:

Existing Customer:
—Please choose an option—YesNo

Full Company contact details (For billing and 6th Scheduled Requirements):

Address:

Office Number:

Office Number:

Mobile Number:

Email Address:

Full Name (as per I.C No):

Current Position:

Is your company registered on Department of Environment's ESWIS?
—Please choose an option—YesNo

Collection Site (if differs from company address):

List of scheduled waste codes for recycling and Estimated Quantity Per Year. E.g. Waste Code | Process | Waste Criteria | Estimated Quantity