PDFWAC 173-303-9906

Special waste bill of lading.

special waste
bill of lading
example
1)
Receiving Facility Name:
 
  phone:
 
 
Address:
 
  fax:
 
2)
Customer Name:
 
  phone:
 
 
Address:
 
  fax:
 
3)
Property Owner Name
(where waste originated):
 
  phone:
 
 
Address:
 
  fax:
 
4)
Hauler Name:
 
  phone:
 
 
Address:
 
  fax:
 
5)
Consultant Name:
 
  phone:
 
 
Address:
 
  fax:
 
6)
Amount of waste:
 
 
7)
Original Location of Special Waste:
 
8)
Activity Which Generated Waste:
 
9)
Description of Waste. Include any Applicable Dangerous Waste Code:
 
 
 
10)
Does Waste Have Potential to Create Fugitive Dust?
Yes_____
No_____
 
 
 
 
If Yes, What is your Plan to Mitigate Dust?
 
 
11)
Amount of wastes in pounds or tons:
 
 
special waste
waste analysis
Customer Must Initial the Appropriate Item.
 
1.
Wastes were designated through testing
 
2.
Wastes were designated by other means
Customer Certifies That:
1.
The Waste sampled and intended for disposal under this Certification is special waste as defined in WAC 173 303 040
2.
The Waste has no free liquids per WAC 173-303-110 (3)(c)(i).
 
 
 
 
 
 
 
 
 
 
Signature
 
 
Date
 
[Statutory Authority: Chapters 70.105 and 70.105D RCW. WSR 95-22-008 (Order 94-30), § 173-303-9906, filed 10/19/95, effective 11/19/95; WSR 94-01-060 (Order 92-33), § 173-303-9906, filed 12/8/93, effective 1/8/94. Statutory Authority: Chapters 70.105 and 70.105D RCW, 40 C.F.R. Part 271.3 and RCRA § 3006 (42 U.S.C. 3251). WSR 91-07-005 (Order 90-42), § 173-303-9906, filed 3/7/91, effective 4/7/91. Statutory Authority: Chapter 70.105 RCW. WSR 87-14-029 (Order DE-87-4), § 173-303-9906, filed 6/26/87. Statutory Authority: RCW 70.95.260 and chapter 70.105 RCW. WSR 82-05-023 (Order DE 81-33), § 173-303-9906, filed 2/10/82.]