Appendix D
Appendix D
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DENR ID No : Tel No :
Quantity
A. Wastes with Cyanide _________ B. Acid Wastes _________ C. Alkali Wastes _________ D. Wastes with Inorganic Chemicals _________ E. Reactive Chemical Wastes _________ F. Inks/Dyes/Pigments/Paint/Latex/ Adhesives/Organic Sludge ______ G. Waste Organic solvents ________ Packaging Information:
(Indicate types, capacities and number of containers)
H. Putrescible/ Organic Wastes _______ I. Oil _______ J. Containers _______ K. Immobilized Wastes _______ L. Organic Chemicals _______ M. Miscellaneous Wastes ________
Date of Transport
Certification: I hereby declare that the content of this consignment are fully described above and are classified, packed, marked and labeled and in all respect in proper condition to transport to approved TSD facility in accordance with applicable national regulations. _______________________________ Owner or Authorized Representative ______________________________ Designation
APPENDIX D
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Section B : Transporters
Acknowledgement: Transporter # 1 Address : Date of Transport Name / Signature of Authorized Representative: Designation: Acknowledgement: Transporter # 2 Address : Date of Transport Name / Signature of Authorized Representative: Designation: DENR ID No : Tel No : Fax No: Date Waste Received : DENR ID No : Tel No : Fax No: Date Waste Received :
Section C: Treaters
TSD facility Name Address : Fax No: Name / Signature of Authorized Representative: Designation: Comments (to be filled by Generator, transporter, or TSD operators if any) : Date Waste Received : DENR ID No : Tel No :
APPENDIX D
The Treater must submit a completed signed copy of the manifest to the Generator and the DENR-EMB within five (5) days after completing the receiving the wastes from the transporter. Failure to submit the completed manifest to the Generator and to DENR-EMB within 30 days, the Generator should contact both the Transporter and the TSD premise owner/operator to determine the whereabouts of the waste. The Generator must report in writing along with the copy of the manifest signed by the Transporter to DENR-EMB if the completed manifest was not submitted by the Transporter within 45 days.
Environmental Management Bureau - Department of Environmental and Natural Resources Hazardous Waste Management Section Environmental Quality Division DENR Compound Visayas Ave. Diliman Quezon City
APPENDIX D