A-Gas Drop-a-JUG | Registration Form

A-Gas NZ Drop-a-JUG™ Crate Collection Form

Business Name *

Collection Address *

Contact Name *

Contact Number *

Contact Email *

Please ensure the following before we can arrange collection:

Shrink wrap removed and DG labels visible

Only non-flammable refrigerant cylinders are loaded (No R32, R454B, R515, MAPP Gas, Hydrocarbons)

Crate is not overloaded (two cylinders deep)

Top layer fastened with strapping provided

Upload a photo of the crate (clearly showing contents in crate) *

Comments

Yes, I give permission to store and process my data