ACT NOWaste WBRMCMr Fluffy CRM Disposal Form –Version 9 161123 Page 1 of 4

ACT NOWaste Project Code

ACT NOWaste Issued Weighbridge Docket Book Start & Finish Numbers ______

ACT NOWaste Mr Fluffy Asbestos Disposal Form

ACT NOWaste believes pre approval to transport MR Fluffy waste has been given by the EPA and is the account holder’s responsibility to obtain if required.

Section 1 –PRINCIPAL CONTRACTOR = ACCOUNT HOLDER & APPLICANT DETAILS

Company:
Contact person: / Phone:
Email:

Section 2 – DETAILS OF MR FLUFFY PROPERTY

Block number: / Section: / Address:
Suburb:

Section 3 – MATERIAL TYPE, QUANTITY, BOOKING DATES & TOTAL ANTICIPATED TRUCK MOVEMENTS TO ARRIVE THROUGH THE GATE

Please be accurate to enable adequate resourcing at WBRMC to avoid delays whilst tipping
TYPE / DETAILS / ESTIMATED TONNAGE / ACCURATE DELIVERY DATE/S
NO PUBLIC HOLIDAYS OR WEEKENDS PERMITTED / NO OF MOVEMENTS PER DAY
Other Clean up (furniture etc before excavator on site)
Main Demolition waste, excavator days (house, contaminated soil etc)
Post testing Hot Spot Removal / Resubmit this approved form when known (with SSP authorisation email or
Variation notice)

Note: The ACT NOWaste project officer will monitor transactions and if the amount of material delivered exceeds the estimated quantity the applicant may be contacted to explain the discrepancy.

Section 4 – TRANSPORT COMPANY DETAILS; IF MORE THAN ONE, LIST SEPARATELY AT THE END OF THIS FORM

Company:
Contact Person:
Email: / Phone:

Section 5 – VEHICLE REGISTRATION FOR WBRMC WEIGHBRIDGE DATA ENTRY

  • Nominated vehicles will only be able to access the site for the approved project duration.
  • Additions to the list will require 48 hours notice (in writing) to the ACT NOWaste project manager.
  • Only one vehicle registration number per box.

01 / 02 / 03 / 04 / 05
06 / 07 / 08 / 09 / 10
11 / 12 / 13 / 14 / 15
16 / 17 / 18 / 19 / 20

Section 6 – TERMS AND CONDITIONS

  1. Only material that meets appropriate classifications identified on this form will be accepted under this arrangement. Where necessary, material certification is required before deliveries commence.
  2. Site induction or project induction may be required for suppliers and/or transport company drivers.
  3. Tipping truck drivers must comply with all reasonable directions from the on-site operator. Failure to do so may result in cancellation of the approval for this project.
  4. The supplier must ensure that tipping trucks tare-in at the weighbridge before unloading and tare-out after unloading only for the first truck delivery of that day. Failure to tare-in will require re-loading of dumped material at the supplier’s expense.
  5. Tipping truck drivers must have aspecific issued weighbridge delivery docketwhen attending the weighbridge. The docket will contain the required disposal project code. Failure to produce a valid numbered weighbridge delivery docketwill require ‘parking-up’ until the necessary information has been obtained. Each Project Code is issued with specific docket numbers.
  6. The supplier must not send material to the facility for disposal until they have received written notification from ACT NOWaste that the disposal is approved and a disposal project code has been generated.
  7. Project code cancellation shall be at the sole discretion of the Territory as represented by ACT NOWaste.
  8. Tipping truck drivers are responsible for checking that tare-in and tare-out transaction dockets reflect the correct company, unloaded material, and charges that have been incurred. Failure to check transactions may jeopardise requests for refunds due to errors.
  9. Project code is allocated to a single numbered weighbridge docket book. No other docket books shall be used and when project is completed the book must be returned within 7 days.
  10. EPA approval to transport Mr Fluffy if required has been obtained by the account holder.

Section 7 –INDEMNITY CERTIFICATION - MUST BE SIGNED BY THE ACT NOWASTE ACCOUNT HOLDER ONLY

Company:
1.Indemnifies the Territory, its employees and agents against any liability in respect of the removal, cleanup and remediation cost in the event that the material delivered under this agreement is identified as unacceptable after it has been delivered.
2.Acknowledges and agrees that in the event the material delivered is assessed as unacceptable and is not removed within five (5) working days that the Territory as represented by ACT NOWaste may arrange for the removal of the material with all costs to be borne by the supplier.
Name: / Position:
(This must be a senior position with the authority to accept liability on behalf of the company)
Signature: / Date:

Section 8 – ACT NOWASTE USE ONLY

Confirmed Mr Fluffy House Y Project Code Issued Y
Disposal locations and dates:
ITEM / LOCATION / CONFIRMED DISPOSAL DATE/S
Demolition waste
Other
Applicant advised of Project Code & confirmed disposal date/s on (date) by return email
Applicant advised of agreed hot spot disposal dates on (date) by return form by email
Operations officer notified to re-activate existing Project Code by cc above email
WBRMC supervisor and weighbridge notified by cc above email
ACTNOWaste Project Officer: Signature:
To submit form scan and email to

ACT NOWaste Contact:Access Canberra
Phone: 132281
Email:

For Updates to your application, please resubmit your approved form with the changes added and clearly marked “Amended”. Updates can only be made via email and by the account holder.

Section 4a – FURTHER TRANSPORT COMPANY DETAILS

Company:
Contact Person:
Phone:
Email:

Section 4c – FURTHER TRANSPORT COMPANY DETAILS

Company:
Contact Person:
Phone:
Email: