Hazardous Consignment Note Multiple Collections Blank

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Form HWMCCN01v051

The Hazardous Waste Regulations 2005: Multiple Collection Consignment Note


PART A Consignee details
The waste will be taken to (name, address, postcode):

PRODUCERS/HOLDERS/CONSIGNORS COPY

(Delete as appropriate)

PART B Carrier details


Carrier name: On behalf of (name, address, postcode, telephone, e-mail, facsimile): Carrier registration no./reason for exemption:

Vehicle registration no. (or mode of transport if not road):

Signature

Date D D M M Y Y Y Y

Time H H M M

PART C Summary of multiple consignments

If continuation sheet used, tick here

Enter every EWC code collected from each collection point and the quantity of each EWC code collected from that collection point. The table below provides three EWC codes on each of five consignments. This should be amended to identify appropriately the number of EWC codes on each consignment. To be completed by the carrier Consignment note code Individual EWC code(s) per consignment received To be completed by the consignee Quantity of each EWC code received (kg) EWC code accepted/ rejected Waste management operation (R or D code)

These consignments are described in detail in the Annex.

PART D Consignees certificate


1 I received all of the consignments described in Part C at the address given in Part A on 2 Vehicle registration no. (or mode of transport, if not road): 3 Where waste is rejected, please provide details below: I certify that waste permit no(s). Name: On behalf of (name, address, postcode, telephone, e-mail, facsimile): authorises the management of the consignments as described in Part C at the address given in Part A.

Date D D M M Y Y Y Y

Time H H M M

Signature

Date D D M M Y Y Y Y

Time H H M M

HWMCCN01v051

Form HWMCCN01v051

The Hazardous Waste Regulations 2005: Multiple Collection Consignment Note


PART A Consignee details
The waste will be taken to (name, address, postcode):

CARRIERS COPY

PART B Carrier details


Carrier name: On behalf of (name, address, postcode, telephone, e-mail, facsimile): Carrier registration no./reason for exemption:

Vehicle registration no. (or mode of transport if not road):

Signature

Date D D M M Y Y Y Y

Time H H M M

PART C Summary of multiple consignments

If continuation sheet used, tick here

Enter every EWC code collected from each collection point and the quantity of each EWC code collected from that collection point. The table below provides three EWC codes on each of five consignments. This should be amended to identify appropriately the number of EWC codes on each consignment. To be completed by the carrier Consignment note code Individual EWC code(s) per consignment received To be completed by the consignee Quantity of each EWC code received (kg) EWC code accepted/ rejected Waste management operation (R or D code)

These consignments are described in detail in the Annex.

PART D Consignees certificate


1 I received all of the consignments described in Part C at the address given in Part A on 2 Vehicle registration no. (or mode of transport, if not road): 3 Where waste is rejected, please provide details below: I certify that waste permit no(s). Name: On behalf of (name, address, postcode, telephone, e-mail, facsimile): authorises the management of the consignments as described in Part C at the address given in Part A.

Date D D M M Y Y Y Y

Time H H M M

Signature

Date D D M M Y Y Y Y

Time H H M M

HWMCCN01v051

Form HWMCCN01v051

The Hazardous Waste Regulations 2005: Multiple Collection Consignment Note


PART A Consignee details
The waste will be taken to (name, address, postcode):

CONSIGNEES COPY

PART B Carrier details


Carrier name: On behalf of (name, address, postcode, telephone, e-mail, facsimile): Carrier registration no./reason for exemption:

Vehicle registration no. (or mode of transport if not road):

Signature

Date D D M M Y Y Y Y

Time H H M M

PART C Summary of multiple consignments

If continuation sheet used, tick here

Enter every EWC code collected from each collection point and the quantity of each EWC code collected from that collection point. The table below provides three EWC codes on each of five consignments. This should be amended to identify appropriately the number of EWC codes on each consignment. To be completed by the carrier Consignment note code Individual EWC code(s) per consignment received To be completed by the consignee Quantity of each EWC code received (kg) EWC code accepted/ rejected Waste management operation (R or D code)

These consignments are described in detail in the Annex.

PART D Consignees certificate


1 I received all of the consignments described in Part C at the address given in Part A on 2 Vehicle registration no. (or mode of transport, if not road): 3 Where waste is rejected, please provide details below: I certify that waste permit no(s). Name: On behalf of (name, address, postcode, telephone, e-mail, facsimile): authorises the management of the consignments as described in Part C at the address given in Part A.

Date D D M M Y Y Y Y

Time H H M M

Signature

Date D D M M Y Y Y Y

Time H H M M

HWMCCN01v051

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