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Spill Response Contract
J & S Liquid Waste, Inc. has been contacted regarding your incident. Please print out this page and fax it to (260)490-0003 after completing it including authorized signature and date.
We have contracted J & S Liquid Waste, Inc. to respond, contain, and/or begin cleanup of an objectionable substance which may have leaked from a container, vessel, or mechanical vehicle in our care. It is our understanding that we are entitled to an hourly rate sheet within 24 hours of engagement of this contract. It is also understood that pursuant to the Indiana Spill Rule we are responsible to engage in a clean up of the substance in our care, regardless of its unintentional release. It is also understood it is our responsibility to file the neccessary reports to IDEM, EPA, and The National Response Center.
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Company Name
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Address
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Phone #
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Contact Name
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Authorized Signature
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