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Appendix 65
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WASTE MATERIALS REPORT
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Fund Cluster : _____________________
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Entity Name : Bureau of Soils and Water Management PMU-W2024-04-011
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Place of Storage : ___________________________________________
Date : March 22, 2024
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ITEMS FOR DISPOSAL
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ItemQuantityUnitDescriptionRecord of Sales
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Official Receipt
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No. DateAmount
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13pcBulb
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TOTAL
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Certified Correct :
Disposal Approved :
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Signature over Printed Name of Supply and/or Property CustodianSignature over Printed Name of Head of Agency/Entity or his/her Authorized Representative
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CERTIFICATE OF INSPECTION
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I hereby certify that the property enumerated above was disposed of as follows:
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Item________Destroyed
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Item________
Sold at private sale
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Item________
Sold at public auction
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Item________
Transferred without cost to __(Name of the Agency/Entity)__
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Certified Correct:
Witness to Disposal:
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Signature over Printed Name of Inspection OfficerSignature over Printed Name of Witness
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