Request for collection of
Waste Electrical & Electronic
Equipment Form
INSTRUCTIONS:
Fully complete ALL PARTS of this form and email a copy to
Estates-waste@swansea.ac.uk in order to request a collection.
A completed signed hard copy MUST be handed over at the time of collection.
Contact Name
Phone
Email
School
Holding Location
For Equipment
including Dept
Special Instructions
for contractor
Works Request
No
HD
List of Items for Collection
Type
Number Due
for Collection
Waste Code
No. collected
(Contractor use)
(Contractor use)
CRT Monitors
20-01-35
Flat-screen Monitors
20-01-36
Computer Base Units
20-01-36
(Provide full details on next sheet)
Printers
20-01-36
Box of keyboards, mice and cables
20-01-36
Other – please list over – e.g.
calculators, PCB boards, other
electrical / electronic equipment
(NO FRIDGES)
(Provide full details on next sheet)
Date due for collection
Date collected:
(Contractor use)
Signature of Authorised
Person (hard copy only)
Name of Driver collected by
(Contractor use)
Do not forget to complete following page
Page 1
Version 2 (Aug-08)
Detailed list of Base Units and “Other” items for Collection
Please provide a list of all Computer Base Units and all “Other” items. You must list the serial
number of every Base Unit below. If you know, you should also note whether or not the item is
working. If you need more space, please continue this list on the next page.
Collections containing Base Units WILL NOT be made unless this list is complete.
TYPE OF EQUIP
SERIAL NUMBERS
DOES IT WORK?
(For base units only)
(Please chose)
COLLECTED?
(Contractor use only)
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Page 2
Version 2 (Aug-08)
Please use these additional sheets if necessary.
SERIAL NUMBERS
TYPE OF EQUIP
(For base units only)
DOES IT WORK?
COLLECTED?
(Please chose)
(Contractor use only)
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Choose an item.
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Page 3
Version 2 (Aug-08)
TYPE OF EQUIP
SERIAL NUMBERS
DOES IT WORK?
COLLECTED?
(For base units only)
(Please chose)
(Contractor use only)
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Page 4
Version 2 (Aug-08)