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Get Solid Waste Origin And Disposal Form

To transport to the disposal site (Instructions on Reverse) 1. Name of Registered Transporter: ______________________________________ Phone No. ____________________ 2. NJDEP Registration No.: __________________ 3. Type of Transporter Registration: (Check One) A-901 Licensed Registered self-generator Registration Exempt 4. Waste Self- Generated: (Check One) YES NO 5. Name of LESSOR if the solid waste vehicle is leased: ____________________________________________________ 6. Decal No. Type License.

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