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Please complete this form for WATER DELIVERY FROM TRUCK TO Yard, Takoradi Port
Name & Surname*
Enter Name & Surname of Agent Placing Water Order
Contact Number*
Enter Contact Number of Agent Placing Water Order
Email Address*
Enter Email Address of Agent Placing Water Order
Agency Name*
Enter Company Agency Name that is Placing Water Order
Client Name
Enter Company Name of Client on Who's Behalf Water Order is Placed (Optional)
Yard Name*
Enter Yard Name where Water Order Should Be Delivered To
Enter Date & Time for Delivery*
Specify +- the Arrival Date & Time of Vessel
Specify Product Requirment
Potable Water
Spesify Quantity in m/T*
Specify Quantity of Water Order in Metric Ton
Fresh Water
Spesify Quantity in m/T*
Specify Quantity of Water Order in Metric Ton
Additional Comments
Additional Comments i.e Special Requirements
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