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Scrap Disposal Authorization Form

This document is a scrap disposal authorization form from the Ministry of National Guard - Health Affairs in Saudi Arabia. The form requests authorization to dispose of equipment, furniture, or other items and requires information about the item, reason for disposal, and approval from various departments. Upon approval, the item will be disposed of through the proper disposal committee and channels.

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Letlotlo Lebete
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© © All Rights Reserved
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Download as PDF, TXT or read online on Scribd
1K views

Scrap Disposal Authorization Form

This document is a scrap disposal authorization form from the Ministry of National Guard - Health Affairs in Saudi Arabia. The form requests authorization to dispose of equipment, furniture, or other items and requires information about the item, reason for disposal, and approval from various departments. Upon approval, the item will be disposed of through the proper disposal committee and channels.

Uploaded by

Letlotlo Lebete
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Kingdom of Saudi Arabia ‫ﺍﻟﻤﻤﻠﻜﺔ ﺍﻟﻌﺮﺑﻴﺔ ﺍﻟﺴﻌﻮﺩﻳﺔ‬

Ministry of National Guard - Health Affairs ‫ ﺍﻟﺸﺆﻭﻥ ﺍﻟﺼﺤﻴﺔ‬- ‫ﻭﺯﺍﺭﺓ ﺍﻟﺤﺮﺱ ﺍﻟﻮﻃﻨﻲ‬

Scrap Disposal Authorization Form - Assets

Part I - To be completed by the Requesting Department

Requester Name : Badge No. :

Position : Ext. No. :

Department : Fax No. :

I request to dispose the following item: Equipment Furniture Other

GP/KN Number : Serial # : Model # :


Manufacturer : Quantity :

Description : PO # :

Reason For Disposal : Obsolete Damaged In Excess Worn-out Contaminated


Expired Unusable Other

Acquisition Date :

Comments/Remarks :

Approved By:

Requester Signature Date Department Head/Chairman Date


(Name & Signature)
Part II - To be completed by the Technical Department

Evaluated by : Technical Report Attached

Recommendation : Obsolete Damaged Excess Worn-out Comtaminated

Comments :

Technician Badge No. Date Department Head/Chairman Date


(Name & Signature) (Name & Signature)
Part III - To be completed by Property Management

Data Verification By:

IR No. : Acquisition No. :

Department Head Date


(Name & Signature)
Part IV- To be completed by the Disposal Committee

Approved By: Approved Disapproved

Comments :
Disposal Committee Stamp

Non-Clinical Form Rev. 01/2014 Ref# APP 1429-31 Page 1 of 1 Appendix A O&M# 0401-0229
Distribution: Original - Disposal Committee cc: Custodian Scrap & Salvage Yard Requesting Department Property Management

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