Collection/Drop Off Booking Request Sales

ENVIROSTREAM AUSTRALIA PTY LTD
Unit 1, 79-83 High Street, Kew, Vic, 3101
envirostream@liviumcorp.com
1800 72 72 74
Collection/Drop Off Booking Request
How do you intend to get your batteries to Envirostream?*

I require a pick upI want to deliver to Laverton North facility (self-arranged)I require a pick up and swapover of my unit(s)I want to deliver to Laverton North facility (self-arranged) and take my empty unit back myself
Do you have any Fire Resistant Liners and DG Transport Cartons that need replenishing inside the unit?

YesNo
If yes, how many Fire Resistant Liners and DG Transport Cartons do you need for the empty unit?
Is there a specific date requested for collection/drop off? (Please allow on average 48 hours notice)*

DayMonthYear
Date
Please indicate your business hours for collections:
Is your site an accredited B-cycle Drop Off Point/Incidental Receiver ?*

YesNo

SITE DETAILS
Company Name*
Site Name / Store Name
if applicable
Service Address*

Unit No. & Street Address

Street Address Line 2

CityState

Postal
Collection Address Vehicle Size Restrictions (Please select the largest size vehicle your site can accept):*

Van/UteRigid TruckSemi TrailerB-Double
Does your site have a forklift?*

YesNo
Does your site have any height or clearance restrictions?*

YesNo
If yes, what is the max height of the vehicle access in meters?

SERVICE REQUEST
Does this consignment contain battery modules or packs which weigh 20kgs or more?*

YesNo
If so, do you know the State of Charge of the batteries?*

YesNo
Can you confirm that the State of Charge of the batteries are less than 30%?*

YesNo
Product Type*

Batteries or battery productNon-battery product

Please confirm the box dimensions IF NOT palletised (Length x Width x Height mm):
Please confirm the pallet dimensions IF palletised (Length x Width x Height mm):
Total Battery Net Weight (kgs) of all Packages*
Total Shipment Gross Weight (kgs) of all Packages*
Total Number of Pallet(s)

Please confirm the box dimensions IF NOT palletised (Length x Width x Height mm):
Please confirm the pallet dimensions IF palletised (Length x Width x Height mm):
Total Material Gross Weight (kgs)
Total Number of Pallet(s) / Bin(s)
Do you require a Teardown Report for this battery? (Not applicable for small household batteries)*

YesNo
Has the product been packaged in line with the Australian Dangerous Goods requirements?*

YesNo
Photo Of Packaging For Collection/Drop Off*

Cancelof
Do you require a Material Disposal Certificate?

YesNo
Customer Reference #
Enter Customer PO# if available
Note

GEO-TAGGED PHOTOS EVIDENCE
Geo-tagged photo of battery receptacle & packages*

Ensure geo-tag function is turned on while taking photo
Cancelof
See link below to find an information sheet on Geo-Tagging photos:

https://bcycle.com.au/wp-content/uploads/2022/12/B-cycle-Info-Sheet-Geo-tagging-Photos-20220119.pdf