Professional Documents
Culture Documents
Requirements: a. b. c. d. e. Duly accomplished Hazardous Waste Registration Form A Process Flow Diagram of all waste streams Material Balance of manufacturing process Analysis of wastes Other relevant information e.g. planned changes in production processes or output
SCREENING OFFICER
Requirements Complete?
No
Yes RECORDS SECTION 1 day HAZARDOUS WASTE MANAGEMENT SECTION 15 days Evaluation & Site Inspection
Yes
No POLUTION CONTROL DIVISION CHIEF 2 days Comments/Revision OFFICE OF THE REGIONAL DIRECTOR (Approval/Disapproval) 2 days RECORDS SECTION (Releasing)
Steps: a. Applicant/Generator submits duly accomplished Hazardous Waste Generators (HWG) Form A together with the complete requirements . b. The Screening Officer shall determine the completeness of the documents. - If the documents are complete, pay the required fees. - If not complete, the documents will be returned to the applicant. c. EMB Records Section receives the complete documents and forward to the Office of the Ha zardous Waste Mgt. Section (HWMS). d. HWMS evaluates/processes the application, conduct sites inspection, prepares evaluation report and assigns HWG DENR ID No. and forwards to Chief, Pollution Control Division (PCD) e. The PCD Chief reviews and recommends approval/denial of the application f. ORD approves/deny the application A maximum of 20 working days processing time application for the Registration of Hazardous Waste Generators
Please append the following: ? (1) Process flow diagram of all waste streams ? (2) Material Balance of manufacturing process ? (3) Analysis of waste(s) ? (4) Other relevant information e.g. planned changes in production processes or output I certify that the enclosed information is a true and accurate record as available. Pollution Control Officer: Signature: *1: to be filled up by EMB Registration Fees O.R. No. Date (D/M/Y): / /
Date
II.
Permit to Transport Hazardous Waste (Can be secured by either Waste Generator or Treater).
Requirements: a. Official Letter of request from the transporter (Pro-forma) b. Duly accomplished Application Form (Generator or Treater) c. Memorandum of Agreement or Affidavit of Joint Undertaking between the transporter, generator and treater/recycler/disposal facility indicating responsibilities and liabilities of each party (Pro-forma, to include the responsibility of Waste Generator to submit duly accomplished Manifest Form)
Note: * Transport Permit shall be issued by the EMB Regional Office where the treater is located. ** If application will be submitted to the provincial office, five (5) days will be given to that office to transmit the application to the regional office after which the timeframe of 20 working days will start.
SCREENING OFFICER
Requirements Complete?
No
Yes RECORDS SECTION 1 day HAZARDOUS WASTE MANAGEMENT SECTION 15 days Evaluation and Site Inspection
Yes
No POLUTION CONTROL DIVISION CHIEF 1 day Comments/Revision OFFICE OF THE REGIONAL DIRECTOR (Approval/Disapproval) 3 days RECORDS SECTION (Releasing)
Steps: a. The Applicant/Transporter submits letter of request enclosed with duly accomplished Application Form and the complete requirements; b. The Screening Officer shall determine the completeness of the documents. - If the documents are complete, pay the required fees. - If not complete, the documents will be returned to the applicant; c. Records Section of EMB Regional Office receives the complete documents and forwards to the Hazardous Waste Management Section (HWMS); d. Hazardous Waste Management Section (HWMS) processes/evaluates the application, conducts field inspection, prepares report and indorse the evaluation report to the Chief Pollution Control Division (PCD); e. The PCD Chief reviews and recommends approval/denial of the application; f. ORD approves/denies application
A maximum of 20 working days processing time for Permit to Transport Hazardous Wastes
Name of Applicant : Tel. No Plant Address: Type of Waste : Class No. : Quantity of Waste : Brief description of waste applied for transport : _________________________________________________________________________________________ _________________________________________________________________________________________ ________________________________________________________________________________________ Generator : Transporter : Treater : ATTACHMENTS :
a. Official Letter of request from the Transporter (Pro-forma) b. Memorandum of Agreement or Affidavit of Joint Undertaking between the transporter, generator and treater/recycler/disposal facility indicating responsibilities and liabilities of each party (Pro-forma, to include the responsibility of Waste Generator to submit duly accomplished Manifest Form)
___________________________________
Applicants Signature
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I.
Requirements: a. b. c. d. e. f. g. h. i. j. k. Official Letter of Request Duly accomplished Registration Form for Hazardous Waste Transporter Business Permit/SEC Registration Certificate Description/Specification of Conveyance. Details of Transport Service Photographs of conveyance (inside and outside shots of vehicle) Sketch/Provision of a garage Proof of ownership of vehicle (Certificate of Registration and Contract of Lease and/or Deed of Sale, if applicable) Certification from the Bureau of Fire Protection, in case of tank lorry Contingency/Emergency Preparedness Plan and Certificate of Training from EMB Accountability Statement (duly notarized) Copy of the Certificate of Registration and Official Receipt ( LTO)
A maximum of 20 working days processing time application for Registration of Hazardous Waste Transporter.
SCREENING OFFICER
Requirements Complete?
No
Yes RECORDS SECTION 1 day HAZARDOUS WASTE MANAGEMENT SECTION 15 days Evaluation and Site Inspection
Yes
No ENVIRONMENTAL QUALITY DIVISION CHIEF 2 days Comments/Revision OFFICE OF THE DIRECTOR (Approval/Disapproval) 2 days
(Releasing)
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Steps: a. Applicant/Transporter submits official letter of request together with duly accomplished Registration Form and the complete requirements. b. The Screening Officer shall determine the completeness of the documents. - If the documents are complete, pay the required fees. - If not complete, the documents will be returned to the applicant. c. EMB Records Section of the Central Office receives the complete documents and forwards to the EQD-Hazardous Wastes Management Section (HWMS). d. EQD-Hazardous Waste Management Section (HWMS) evaluates/processes the application and the submitted documents; conducts site inspection (if necessary) and prepares evaluation report and indorse the report to the Chief Environmental Quality Division (EQD) e. The EQD Chief reviews and recommends approval/denial of the application f. EMB Director approves/denies application
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Form : Registration form for HW Transporter Section C1. General Information of Transporter 1. DENR ID: 2. Date of issued (D/M/Y): / / 3. Registered Company Name: 4. Address: 5. Date of Establishment: 6. Tel: 7. Fax: 8. Name of contact person: 9. Tel: 10. Fax: 11. e-mail: 12. General Description of Business/Operation 13. Authorized Capitalization (P/year): 14. Paid- up Capitalization (P/year): 15. Total Employees: 16. Admin. Employees: 17. Number of Drivers Please append the following:
? ? ? ? ? ? ? ? ? ? ?
Official Letter of Request (Pro- forma) Duly accomplished Registration Form C for Hazardous Waste Transporter Business Permit/SEC Registration Certificate Description/Specification of Conveyance. Details of Transport Service Photographs of conveyance (inside and outside shots of vehicle) Sketch/Provision of a garage Proof of ownership of vehicle (Certificate of Registration and Contract of Lease and/or Deed of Sale, if applicable) (8) Certification from the Bureau of Fire Protection, in case of tank lorry (9) Contingency/Emergency Preparedness Plan and Certificate of Training from EMB (10) Accountability Statement (duly notarized) (11) Vehicle certificate of road worthiness from LTO
Contact Person:
O.R. No.
Date(D/M/Y) Date
/ /
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II.
13
PROCEDURAL FLOW Registration for Hazardous Wastes Treatment, Storage and Disposal Facility
APPLICANT
Not complete Hazardous Waste TSD Facility Application Form : 1. Accomplish form for registration 2. Environmental Compliance Certificate 3. Permit to Operate (PO) Wastewater Treatment Facility (WTF) and Air Pollution Control Device (APCD) (if applicable) Issued by the EMB Regional Office 4. Copy of Environmental Impact Statement or Initial Environmental Examination and 5. Emergency/Contingency Plans including Abandonment Plan Process flow for all treatment/recycling/disposal technologies including overall material balance
Complete
1 day
1 day
2 days
Comments/Inquiries/Revision
5 days
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Steps: a. The treater submits duly accomplished Registration Form together with the complete requirements; b. The Screening Officer shall determine the completeness of the documents. - If the documents are complete, pay the required fees - If not complete, the documents will be returned to the applicant. c. The Record Section receives application and the requirements and forwards to the EQD-HWMS d. EQD-Hazardous Waste Management Section (HWMS) processes/evaluates application; conducts site inspection and prepares report and forwards to Chief, Environmental Quality Division (EQD); e. The Chief EQD reviews and recommends approval of registration with the corresponding TSD Facility DENR ID Number f. EMB Director approves/disapproves.
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Form : Registration form for HW Treater B1: General Information of Treater 1. DENR ID: 2. Date of issued (D/M/Y): 3.Registered Company Name: 4. Address of head office: 5. Name of the President 6. Tel: 7. Fax: 8. Address of the Plant: 9. Tel: 10. Fax: 11. Pollution Control Officer: 12. 13. Fax: 14. e-mail: Tel: / / 15. Date of Establishment (D/M/Y): 16: Authorized Capitalization (P/year): 17: Paid-up Capitalization (P/year): 18. Total Employees: 19. Admin. Employees:
/ /
21. Treatment method and Capacity: A: Physico-Chemical treatment B: Thermal treatment C: Solidification D: Storage E: Disposal F: Recycle Treatment Date of permit to Treatment Capacity Type of HW can be treated Method Operate (ton/day) / / / / / / / / / / Please append the following for each TSD premises: ? (1) Copy of Environmental Compliance Certificate (ECC) ? (2) Copy of Valid Permit to Operate pollution control facilities ? (3) Initial Environmental Examination (IEE) or Environmental Impact Statement (EIS) submitted to the EMB Regional offices ? (4) Process flow Diagram and detailed description of each treatment/recycling process identifying all/by-products, end-products and residues ? (5) Pollution control officer accreditation certificate ? (6) Storage management plan for raw materials, residues, by-products and end-products ? (7) Long term plan for the recycled/processed/end-product ? (8) Photograph/s of the facilities showing processing areas, storage areas ? (9) Accountability statement (Duly notarized) I certify that enclosed information is a true and accurate record as available.
President:
O.R. No.
Date(D/M/Y) Date
/ /
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III.
Requirements: a. b. c. d. Official Letter of Request; Duly accomplished Importer Registry Sheet Copy of Environmental compliance Certificate (ECC); Copy of Permits to Operate - Air Pollution Source/Control Facility - Wastewater Treatment Facilities
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PROCEDURAL FLOW
Applicant
Not Importer Registry Sheet Application
Importer Information Waste Generator/Shipper Information Recycling Facility Information Attach all Environmental Permits of Recycling Facility Recyclable Material Information Transportation Information Physical Characteristics of Recyclable Material Importer Certification
Complete
EMB RECORDS SECTION
1 day
Environmental Management Bureau HAZARDOUS WASTE MANAGEMENT SECTION
2 days
OFFICE OF THE DIRECTOR
Comments/Inquiries/Revisio 5 days
Importers Registry Certificate
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Steps: a. The Importer submits Official Letter of Request and duly accomplished Importer Registry Sheet b. The Screening Officer shall determine the completeness of the documents. - If the documents are complete, pay the required fees. - If not complete, the documents will be returned to the applicant. c. The Record Section receives the application and the complete requirements and forwards to the EQD-HWMS. d. EQD/HWMS evaluates application and conducts inspection of Recycling Facility; prepares report and recommendations for the approval of Registry Certificate to the Chief Environmental Quality Division (EQD) e. The EQD, Chief reviews and recommends the approval to the Director f. EMB Director approves/disapproves the Registration
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Department of Environment and Natural Resources Environmental Management Bureau IMPORTER REGISTRY SHEET Please read instruction before filling up this application. A.
Form No. ____________ Sheet No. ____________ (to be filled out in triplicate)
IMPORTER INFORMATION Name of Importer____________________________________________________ Address_____________________________________________________________ Contact Person_______________________________________________________ Telephone No. _______________________ Fax No.:_________________________ Reason for Import: ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ WASTE GENERATOR/SHIPPER INFORMATION Generator/Shipper Name:______________________________________________ Facility Address (site of recyclable material generation):______________________ Generator Company Name: CITY, STATE/PROVINCE, COUNTRY ______________ Technical Contact: __________________________________________________ Phone No.: __________________________________ Fax No.:________________ RECYCLING FACILITY INFORMATION Name of Company:___________________________________________________ Address:____________________________________________________________ Telephone No.:_______________________________ Fax No.:________________ Contact Person:______________________________________________________ Method of Processing:_________________________________________________ Description Process: ______________________________________________________________________ ______________________________________________________________________ ? Methods for handling, including collection, packaging, labelling, transportation, and route which must conform with internationally accepted standards; ________________________________________________________________ ________________________________________________________________ Listing of personnel who will be responsible for supervising the collection, transport and unpacking of the recyclable materials and their respective qualifications; and ________________________________________________________________ ________________________________________________________________ Emergency response plan describing steps to be taken by parties concerned in case of spill/accident which may occur during transport from the premises of the recyclable material generator to the importer. ________________________________________________________________ ________________________________________________________________ (Please use separate sheet if necessary)
B.
C.
Attach all Environmental Permits of Recycling Facility D. RECYCLABLE MATERIAL INFORMATION (See instructions) Recyclable Materials/s Name ___________________________________________ Original Form of the Recyclable Material:__________________________________ Amount/Units to be imported for the whole year:_____________________________ Frequency of the importation: Weekly Quarterly Other, specify Monthly Semi-Annually TRANSPORTATION INFORMATION Type of Packaging : Bulk Liquid Drum/Box Mode of Shipment Air Bulk Sludge Tanked Sea Bulk Solid Others, Specify
E.
This form is to be completed per recyclable material to be registered. Instructions for completing this form are attached
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F.
Color
<2-4
10 <12.5 >2000F/930C
NA
None
Open Cup
CHEMICAL COMPOSITION
following(MIN-MAX) ____________________ _____________________ _____________________ _____________________ _____________________
RANGE
(MIN-MAX) ________% ________% ________% ________% ________%
2.
Does the waste contain any of the (provide concentration if known): NO or LESS THAN or ACTUAL 50 ppm____ _____ 50 ppm____ _____ 50 ppm____ 50 ppm____ _____ _____
* If applicable, a certified laboratory analysis from the country of origin should be attached
IMPORTER CERTIFICATION By signing this profile sheet, the importer verifies: 1. This recyclable material is not Hazardous Waste as defined by GOPs RA6969 and/or international regulations. 2. This recyclable material does not contain regulated radioactive materials or PCBs (Polychlorinated Biphenyls). 3. The recyclable material does not contain regulated concentration of banned and controlled pesticides. 4. This recyclable material does not contain halogenated compounds such as: tetrachloroethylene, trichloroethane, methylethylene chloride, 1,1,1-trichloroethane, trichlorofluoromethane 1, 1 dichloroethylene, and 1, 2-dicloroethylene at greater than 0.1% (1,000 ppm) total solvent concentration. 5. This sheet and the attachments contain true and accurate descriptions of the recyclable materials. All relevant information regarding known or suspected hazards in the possession of the Generator have been disclosed. 6. The Importer has read and understand the form. All types and amounts of hazardous substances provided in incidental amounts have been identified in Section G of this form. 7. The analytical data presented herein or attached hereto were derived from testing a representative sample taken in accordance with RA6969, if required, or equivalent rules. 8. If any changes occur in the character of the recyclable material, the Importer shall notify the Environmental Management Bureau prior to the shipping of the recyclable material to the consignee/recycler. 9. Signature:_____________________________________________________ 10. Title:_________________________________________________________ 11. Name (type or Print) ____________________________________________ 12. Date_________________________________________________________ Do not write below this line -------------------------------------------------------------------------------------------------------------------------ENVIRONMENTAL MANAGEMENT REGISTRY REFERENCE CODE BUREAU Date: Accept Reject AUTHORIZED NAME: (Print or Type) AUTHORIZED SIGNATURE: TITLE Place EMB seal here
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IV.
22
Importation Clearance Requirements: - General Information of Importer - Official Letter of Request - Accomplished Application Form - Environmental Compliance Certificate (ECC) - Permits to Operate - Notification/Consent of Exporting Country - Registered/Accredited Recycler - Insurance (Shipment) - Purchase Order - Last Bill of Lading - Affidavit of Joint Undertaking of Exporter/Importer
COUNTRY OF EXPORT
NOTIFICATION
1 day
1 day
10 days Evaluation
2 days
Additional Requirements
5 days Import Clearance
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Steps: a. The Importer submits Official Letter of Request together with the complete requirements, -if still not yet registered as importer, duly accomplished Hazardous Waste Registration Form and Importer Registry Sheet -if already registered, at least sixty (60) days prior to importation, the applicant submits the Importation Clearance for Recyclable Materials Form and copy of the Basel Convention Notification form submitted by the competent authority of the exporting country. b. The Screening Officer shall determine the completeness of the documents. -If the documents are complete, pay the required fees. -If not complete, the documents will be returned to the applicant. c. Record Section receives the application for Importation Clearance and the complete requirements, forwards to the EQD-HWMS d. EQD/HWMS evaluates application and conducts inspection of Recycling Facility; prepares report and recommendations for the approval of Importation Clearance and forwards to Chief, Environmental Quality Division (EQD) e. The EQD Chief reviews and recommends the approval of Clearance to the Director f. EMB Director approves/disapproves Importation Clearance
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IMPORTAT ION CLEARANCE FOR RECYCLABLE MATERIALS to be filled out in triplicate A. IMPORTER INFORMATION : 1. Name of Importer ___________________ ___________________________ 2. Registry Reference Code_________________________________________ 3. Address _____________________________________________________ 4. Contact Person _______________________________________________ 5. Telephone No. __________________ Fax No. ________________________ WASTE GENERATOR/SHIPPER INFORMATION 1. Generator (Shipper Name) ________________________________________ 2. Facility Address _______________________________________________ RECYCLING FACILITY INFORMATION: 1. Name ________________________________________________________ 2. Address _____________________________________________________ RECYCLABLE MATERIAL INFORMATION : 1. Type of Material _______________________________________________ 2. Volume of Material Imported ______________________________________ 3. Type of Packaging_________________________________________________ 4. Intended Carriers _______________________________________________ 5. Mode of Shipment AIR SEA 6. Port of Entry __________________________________________________ 7. Expected Date of Arrival_________________________________________ ATTACHMENTS: To be attached to this IC are the following affidavits of undertaking specifying the following: 1) Liabilities for clean up operations in case of spill and emergencies; 2) Responsibility of the exporter to retrieve/return the waste when denied entry by the Government of the Philippines; 3) Copy of insurance coverage for the shipment; and 4) Liabilities of parties to compensate for damage to properties and life in case of emergencies and accidents. F. Signature ______________________________ Title _____________________ Name (Type or Print)_________________________ Date_______________________________ --------Do not write below this line--------(to be filled up by EMB) DISAPPROVED APPROVED: Pursuant to DAO ____which hereby grants you clearance to import only the above cited material subject to the conditions stated hereunder: _____________________ Date _______________________________ Director, Environmental Management Bureau
B.
C.
D.
E.
Registration Fees
O.R. No.
Date
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Exportation Clearance & Permit to Transport Hazardous Wastes/ Recyclable Materials 1. General Information of the Exporter 9. Movement Document/ 2. Official Letter of Request Manifest of Previous Export 3. Accomplished Notification Form 10. Affidavit of Joint Undertaking 4. HW Generators DENR ID Number of Exporter and Importer 5. HW Generators Latest Quarterly Report 6. Insurance (Shipment) 7. Purchase Order 8. Last Bill of Lading, for renewals
Not complete
Complete
1 day
1 day
Additional Requirements
10 days - Evaluation and Site Inspection/Inspection
2 days
Comments/Inquiries/Revision
5 days Exporters Notification Transit Country
Country of Destination
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TRANSIT COUNTRY
COUNTRY OF DESTINATION
OFFICIAL CONSENT
OFFICIAL CONSENT
1 day
1 day
10 days
2 days
Additional Requirements
5 days Export Clearance
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Steps: a. The Exporter submits official letter of request for Transmittal Notification to the EMB Director with the complete requirements and payment of corresponding fee. b. The competent authority of the country of import/transit countries sends consent to the transboundary movement of hazardous wastes. c. The Screening Officer shall determine the completeness of the documents. - If the documents are complete, pay the required fees. - If not complete, the documents will be returned to the applicant. d. EMB Records Section receives the complete documents from the exporter; forwards to the Environmental Quality Division-HWMS. e. EQD/Hazardous Waste Management Section (HWMS) processes/evaluates request/application, conducts site inspection, prepares report and recommends issuance of Transmittal Notification Certificate and/or Export Clearance, whichever is applicable and forwards to Chief Environmental Quality Division (EQD) f. The EQD Chief reviews and recommends the approval g. EMB Director approves/disapproves Exporters Notification and/or Export Clearance.
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Contact person:
Tel.: Fax/Telex:
Yes No (To be completed for a recovery facility located in an OECD State) 4. Total intended number of shipments : 5. Estimated quantity (3) ________________ kg ________________ liters
Contact person:
Contact person:
Tel.: Fax/Telex:
Contact person:
Tel. Fax/Telex:
Actual site of disposal : 9. Method(s) of disposal: D code/ R code (4) Technology employed: (Attach details if necessary) 11. Means of transport (4):
Contact person:
Tel. Fax/Telex:
Site generation & process: 13. (1) Designation & chemical composition of the waste:
(ll) Special handling requirements 14. Physical characteristic (4):
17. Y number (4): 15 Waste identification code in country of export : in country import : Customs code: 16. OECD Classification (1): amber red acid number: IWIC : EWC : Other (specify) : 19. (I) UN identification No.: UN Shipping name: 18. N number (4):
other (attach details) 20. Concerned states, code number of competent authorities, and specific points of entry and exit: State of export States of transit State of import
23. Exporters/Generators declaration: I certify that the information is complete and correct to my best knowledge. I also certify that legally enforceable written contractual obligations have been entered into and that any applicable insurance or other financial guarantees are or shall be in force covering the transboundary movement.
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DISPOSAL (NO RECOVERY) (Block 9) 01 Deposit or unto land (e.g. landfill, etc.) 02 Land treatment (e.g. biodegradation of liquid or sludgy discards in soils, etc.) 03 Deep injection (e.g. injection of pumpable discards into wells, salt domes or naturally occurring repositories, etc.) 04 Surface impoundment (e.g. placement of liquid or sludge discards into pits, ponds of lagoons, etc.) 05 Specially engineered landfill (e.g. placement into lined discrete cells which are capped and isolated from one another and the environment, etc. 06 Release into a water body except seas/oceans 07 Release into seas/oceans including sea bed insertion 08 Biological treatment not specified elsewhere in this list which results in final compounds and mixtures which are discarded by means of any of the operations numbered 01 to 012 09 Physico chemical treatment not specified elsewhere in this list which results in final compounds or mixtures which are discarded by means of any of the operations numbered 01 to 012 (e.g. evaporation, drying, calciration, etc.) 010 Incineration on land 011 Incineration at sea 012 Permanents storage (e.g. emplacement of containers in a mine, etc.) 013 Blending or mixing prior to submission to any of the operations numbered 01 to 012 014 Repackaging prior to a submission to any of the operations numbered 01 to 012 015 Storage pending any of the operations numbered 01 to 012 R9 R7 R4 R5 R3 R1
RECOVERY OPERATIONS (Block 9) Use as fuel (other than in direct incineration) or other means to generate energy R2 Solvent reclamation/regeneration not used as solvents Recycling/reclamation of metals and metal compounds Recycling/reclamation of other inorganic materials R6 R8 Regeneration of acids or bases Recovery of components used for pollution abatement Recovery of components from catalysts Recycling/reclamation of organic substances which are
R10 Land treatment resulting in benefit to agriculture or ecological improvement R11 Used of residual materials obtained from any of the operations numbered R1 to R10 R12 Exchanges of wastes for submission to any of the operations numbered R1 to R11 R13 Accumulation of material intended for any operation numbered R1 to R12
11 NUMBER (Block 18) AND UN CLASS (Block 19) MEANS OF TRANSPORT (Block 11) R - Road PACKAGING TYPES UN Class 1. Drum 2. Wooden barrel 1 - Train/Rail S - Sea 3. Jerrican 4. Box 5. Bag 6. Composite packaging A - Air 7. Pressure receptacle 8. Bulk W - Inland Waterways 9. Other (specify) 51 52 61 61 8 PHYSICAL CHARACTERISTICS (Block 14) 1. Powdery / powder 2. Solid 3. Viscous / paste 4. Sludgy 5. Liquid 6. Gaseous 7. Other (specify) 9 9 9 9 115 1 115 2 116 1 116 2 118 1110 1111 1112 1113 43 114 3 1 3 41 42 111 113 114 1 114 2 Explosive Inflammable liquids Inflammable solids Substances or wastes liable to spontaneous combustion Substances or wastes which in contact with water emit inflammable gasses Oxidizing Organic Peroxides Poisonous (acute) Infectious substances Corrosives Liberation of toxic gases in contact with air or water Toxic (delayed or chronic) Ecoloric Capable by means after disposal, of yielding another material e.g. leachate, which possesses any of the characteristics listed above II Number Designation
Y numbers (block 17) refer to categories of waste listed in Annex I and II of the Dasel Convention. These codes, as well as more detailed information can be found in an Instruction Manual available from the Secretariat of the Dasel Convention.
26.
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Movement Document Notification for waste shipment was issued: Date of issuance: __/__/__ Notification for a single shipment Notification for a multiple shipments for the period ______ This shipment is nb.________of total shipments included in the general notification: ________________ 1. EXPORTER (NOTIFIER) (1) Telephone: Telefax:
2.
Name: Address : Contact Person (name, address, telephone, telefax) : Process by which the waste was generated :
Site of generation :
3. DISPOSER OF THE WASTE Name : Address : Telephone : Telefax: Contact Person in case of emergency (name,address,telephone,telefax): Approximate date of Disposal :
Certification of receipt of waste at Designated disposal facility Method of disposal (3) D code R code Date : __/__/__ Signature : Actual date of disposal : __/__/__ Signature of disposer:
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4.
WASTE
Description of the waste : Y number H number UN class UN number UN Shipping name IWIC Code
paste/viscous
sludge
liquid
Point of entry (when designated ) : Point of exit (when designated) : Point of entry (when designated ) : Point of exit (when designated) : Point of entry (when designated ) : Point of exit (when designated) : Point of entry (when designated ) : Point of exit (when designated) :
3) 4)
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Contact Person (name, address, tels., telefax): Means of transportation: Sea Road 2. Name : Address : Telephone : air rail inland waters
Date of transboundary movement started: __/__/__ Telefax : Signature of the carrier(s) or agent :
Contact Person (name, address, tels., telefax); Means of transportation: Sea Road 3. Name : Address : Telephone : air rail inland waters
Date of transboundary movement started: __/__/__ Telefax : Signature of the carrier(s) or agent :
TO BE COMPLETED BY THE GENERATOR OR EXPORTER Declaration that the information is correct: Declaration indicating no objection from the competent authorities of all States concerned which are Parties to the BC: Date of consent of Exporting State : __/__/__ Date of consent of Importing State : __/__/__ Date of consent of Transit State : __/__/__
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Annex to the Notification and Movement Document 1. The Notifier is: 2. the person who wants to import hazardous waste within ______; or the person who wants to export hazardous waste within ______; or the person who wants to transit hazardous waste through _____.
Designation of the waste means a designation of the nature and the concentration of the most hazardous components in terms of toxicity and other dangers presented by the waste both in handling and in relation to the proposed disposal method As per Annex IV of the Basel Convention : D or R code This must include the point of entry and the point of exit of the waste, inside or outside the country. In the case of a general notification covering several shipments, the expected dates of each shipment have to be specified. If this is not known, the expected frequency of the shipments.
3. 4.
5.
..
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