Scrap Material Information Form - R. M. Wester & Associates, Inc.

Please fill out all fields below. If you have more than 8 materials to list, please submit a second form.

We cannot accept individual items that weigh over 800 lbs.

Scrap Material Pick-Up Information

Name*

First

Last

Email*

Phone*

Company*

Address*

Street Address ^ Street Address Line 2 ^ City ^ State / Province / Region ^ Postal / Zip Code ^ Country ^

Inventory

Type of Material (bale, pipe, etc.)

Location (street add.)

Weight (lbs)

Geiger Counter Reading (mR/hr)

Material 1

Material 2

Material 3

Material 4

Material 5

Material 6

Material 7

Material 8

Upload Pictures*