Leaner Logistics - LLF14 Rubbish Material Clearance Request Form

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Material/Rubbish Clearance Request

• Name of project:

• Job No:

• Address:
  Address

• Date:

  Date

• Request Issued to. Name:

• Company:

• Package:

• Description and location of material / rubbish clearance works to be carried out:<br>

  Safety / Environmental Hazard (Immediate)

  Rubbish Removal / Storage

  Other (State)

• Our Reference No:

• Photo Reference No:

• Main contractor signature:

  Sign

Clearance works to be completed by:

• Date:

  Date

• Time:

  Date

• If works are not completed then we will clear the necessary materials at a cost of £........../hr per labourer.

• Estimated time to carry out works ..............hrs @ £.........hr=.................

• No. of labourers:

• Total cost:

• Works completed by (tick appropriate):<br>

  Subcontractor

  Logistics

• Date:

  Date

• Subcontractor signature:

  Sign

• Date:

  Date

• Note: Failure to complete the requested works within the stipulated time will result in it being completed by the multi service gang and costs recovered through your contract. When works have been rectified this Material/Rubbish Clearance Request must be signed and returned to the issuer for inspection.