I Aqencv - Environmental Protection Agency · WP 2007/20 IE 312479 Louth County Council PM Recovery...
Transcript of I Aqencv - Environmental Protection Agency · WP 2007/20 IE 312479 Louth County Council PM Recovery...
APPENDIX B AUTHORISED RECOVERY AND DISPOSALFACILITIES
~'Alrth~~i;;d'1~~clJlty Ad~~~i':';;';"\ir~; .,'~
''''.,;;y-'"
.:....:..;~.:::. W.ete Permltl Organlaetlon
, Neme.,~::
Ucence R~I.tef whlc'" gnmted)
·':::~f:: 'Nl;lmber ' theW.st._,'C
IMrmltlllce"~t 1:I-'___~~;";;ii/ '" -:.,-':'~
.;c; ,'; ~ .~~:..~ j. .~;>'~.<:2' '0 .. '.
Cedar Resource Site No" 14A1, Greenogue Business Park, W0185-01 EnvironmentalManagement Limited Rathcoole, Co. Dublin Protection
1-,___0_- AoencvEco-Safe Systems Unit 1 A, Allied Industrial Estate, Kylemore W0054-02 EnvironmentalLimited Road, Ballyfermot, Dublin 10 Protection
AgencyEnva Ireland Limited Clonminam Industrial Estate, Portlaoise, W0184-01 Environmental
County Laois ProtectionAoency
Enva Ireland Limited Smithstown Industrial Estate, Shannon, W0041-01 EnvironmentalCo" Clare" Protection
AqencvIEnvironmental Metal Station Road, Clondalkin, Dublin 12 WPR 045 South DublinRecycling Ltd. T/A County CouncilNational Recvclinq, -Fingal 0 & 0 Ltd, T/A Unit 1 IDA Industrial Estate, Balbriggan, WPT89 Fingal CountyFMW Recycling Co" Dublin, Council
Gandon Enterprises Ltd. 77 Broomhill Road, Tallaght, Dublin 24 WPRO/33/2 South DublinT/A Rehab Recycle County Council
: Indaver Ireland Limited Tolka Quay Road, Dublin Port, Dublin 1, W0036-2 Environmental: Dublin protection AQencvI Irish Lamp Recycling Kilkenny Road, Athy, Co. Kildare 02/2000B Kildare CountyI Ltd. Council
, Returnbalt Ltd. Unit 1 Old Mill Industrial Estate, Kill, Co. WP 97/2002A Kildare CountyKildare. Council.-. ,,_..~----
Rilta Ltd. trading as Block 402, Greenogue Business Park, W0192-01 EnvironmentalSITA Environmental Rathcoole, County Dublin, Dublin, Protection
---- Aqencv
Source Imaging Unit 2 Banagher Enterprise Centre, WP 124/06 Offaly CountySupplies Ltd. Banagher, Co. Offaly CouncilTechRec Ireland Limited Unit 51, Park West Industrial Estate, W0233-01 Environmental
Nangor Road, Dublin 12 ProtectionAoencv
The Hammond Lane Pigeon House Road, Ringsend, Dublin 4 WP98107 Dublin CityMetal Co, Ltd. CouncilPurton Carbons UK Purton Water Treatment Works, PP3232SB EnvironmentLtd., Riddle Street, Purton Nr Berkeley, Agency
--~-'--~"--'
Gloucestershire, GL 13 9HN, England.AppaRec, Baeckelmansstraat 125, 2830 Tisselt MLAV1/0200000
- Willibroek, Belgium. 470/GVDAlfsTRV Thermische Ruckstandsverwertung 55.8851.8.1-
Rodenkirchener StraBe, 0-50389 73/94-KolnWesseling, Germany,GmbH & Co.Kg.
~N__
Sita Decontamination Westvaartdijk 97, B-1850 D/PMVC/01 F281Grimbergen, Belgium. 33629
Nehlsen GmbH & CO. NI _01"",,,0_'
,vv U
KG Bremen, Louis-Krages-Strasse 10,28237 Bremen, Germany,
Dow Haltermann Cargo Fleet Road, Middlesbrough, AG8420/BK7978Custom Processing Cleveland, TS3 6AF, England
... _---
------·-----·-----------------·---hH--Waste Collection Permit No. WCP- DC-08-1139-01 41/46
For
insp
ectio
n pur
pose
s only
.
Conse
nt of
copy
right
owne
r req
uired
for a
ny ot
her u
se.
EPA Export 29-05-2012:04:44:02
Indaver NV
SRM (Knott.) Ltd. Weeland Road, Knottingley, W Yorks AG8462/BYWF11 8DZ, Enqland. 4106
Indaver NV Industriele Afvalverwerking, MLAV1/9800Poldervlietweg, B·2030, Antwerpen 3,Belqium.
Johnson Matthey Orchard Road, Royston, Herts SG8PLC SHE, Enqland.
VP3430BN
Kommunekemi a/s, ; DK-5800, Nyborg, Denmark.
Lindholmvej 3 l'Mulberry Waste Ltd. Unit 117/120 Cydesdale Place, Moss(formerly P & R Side Industrial Estate, Leyland,Disposal Services I Lancashire, PR5 30S, England.Ltd.)
8·76-1-449-492005WMU54447
Shanks Vlaanderen i' Roeselare, Regenbeekstraat 7c, B- 5230/1NV Division Roeslare ! 8800 Roeslare, Belgium.
Nickelhuelte AueGmbH
R.-Breltscheid-Strasse, D-08280 Aue, 64-8823.12-Germany. 9104-1.31
BayerMaterialScience AG
Industriegelande Sud, DE-25541, A51 D1 0521 &Brunsbuttel, A51 RO 1521
~_ ..._-----+-:---,----=--,---------+-:-=---~-_.--_ ..Chemogas NV Grimbergen, Belgium. , D/PMVC/05F09/
! 039331-:-:----,--.... --... - .. ---1--------------... - ..--..--j--.----..----I-----------I
Veolia Environmental formerly Cleanaway Ltd.). D4 & D5 i BU 5500lCServices Pic Red Scar Industrial Estate, Longridge I(Preston) Road, Preston, PR2 5NO, .
Lancashire, Enqland.SRM Ltd. (Rye) Harbour Road, Rye, East Sussex
TN31 7TE, EnqlandGP3437PL
46003/44/A/1Indaver Relight NV Haven 1940 - Molenweg, B-9130
1--__-,- -+--=Do-:0:.,::ec...I--=B.=.ev~e:..:.r.=.en~,....:B:.:=el~::.:m~._,_----_+_:_..,.,___,-___:--_+-------1Indaver NV Poldervlietweg, B-2030 Antwerpen, MLAV1/9800000
Belqium 485/MV/bdNehlsen GmbH & Co.KG
NL Nehlsen-Plump, Betriebsstatte 430 UBremen, Louis-Krages-Strasse 10,28237 Bremen, Germanv.
Accurec RecyclingGmbh
Wiehegen 12-14, D-45472 Mulheiman der Ruhr, DE D45472
E11715338
_...._-----.<
11/05/2005IB2234/AVGGENB-2430 U
Borgistrasse 2, D-22113 Hamburg,Germany.
_" .~, VL' , I fie , ....,Lvv,.3784Netherlands.
AVG, Abfall. Verwertungs! Gesellschafl mbHnJehlsen GmbH & Co. NL Nehlsen-Plump, Betriebsstaltei KG Bremen, Louis-Krages-Strasse 10,I 28237 Bremen, Germanv.i ATM· .. --··---~P~O=:=-=B,.:....o.:::.x,.:....3::::.0,~N::;.I.:!...4...::7:.,::8,.:....0~AA:::...:.lMc...o-e-rd-iJ..,..·k-, --+--82-1-7-8-0-02137·6-2--+------
.. ,~
AVG Borsgistrasse,! Abfall-Verwertungs: Gesellschafl mbhi (AVG)
Borsigstrasse 2, D-22113, Hamburg,Germany.
E23/316-15 i
i
Waste Collection Permit No WCP- DC-08-1139-01 42/46
For
insp
ectio
n pur
pose
s only
.
Conse
nt of
copy
right
owne
r req
uired
for a
ny ot
her u
se.
EPA Export 29-05-2012:04:44:02
;~~::p~~d~~~lJIiY{~r:I.. ·c ,;,. ";:, :o'.~';~"~ .;.":,::\,'\;,.. '.~=~~~1~r;:: t~~:~'I:~'~cr '.:~~;:~({ ·,;.c;:{,;'..;:{ .•<·i ".:;;;~, .."/.\ ....:;,./;:{:,. ·{,;L;;~;~/;C·< \c~~mber\ .~.:::' ;.~~ .~e;;~ce,U:.· .{
AVG, Abfall- Borgislrasse 2, D-22113 ~."",h ":;; 11/05/2005Verwertungs- Germany. IB2234/AVG-Gesellschaft mbH GENB-2
Indaver Relight NV Haven 1940 - Molenweg, B-9130 46003/44/A/1Doel-Beveren, Belqium.
lAG, Ihlenberg D-23923 Selmsdorf, Germany. M58SAD001
HC Starck GmbH & logistikzentrum, Lange Wanne 8 D- G/03/009-23128Co. 38644, Goslar, Mi/loDe Neff Chemical Molenweg 1, 9130 Kallo (Beveren), 6713/E~cessinlL- . Port No. 1948, BelQium.
Buhck GmbH & Co. I Rappenberg, 21502 Wiershop, lANU 630d-i Germany. 5270.40-72/53-i 129
Betrem I Sturnshof 20, 46238 Bottrop, 52,6.2 BOT 6Emscherbrennstoffe Germany.GmbHRemondis Industrie Niderlassund Bramsche, Am Kanal9, OHR003001Service GmbH 49565 Bramsche, Germany.(Bramsche)WC Heraeus GmbH Heraeusstrasse 12-14, 63450 Hanau, IV/HU43.3-0682-
Germany. GEN28/02Indaver NV Poldervlietweg, B-2030 Antwerpen, MLAV1/9800000
BelQium. 485/MV/bdP & R Disposal Unit 117 / 120 Clydesdale Place, AG8438Services Ltd. Moss Side Industrial Estate, leyland,
Lancashire PR5 30S, EnQland.Veolia Environmental Bridges Road, Ellesmere Port, I PPC BS51931EServices Pic Cheshire CH65 4EO, England. I~me!~__
Hendon Dock, Sunderland SR1 2ES,SRM (Sunderland) BV46731MLtd. England.SRM (Mor) Ltd. Middleton Road, Morecombe, Lancs BL73021D
LA3 3JN, EnQland.---.-
SRM (North Shields) Hayhole Road, North Shields, NE29 BV46651GLtd. 6D~J=.!lJlLand.
BASF Italia Sri - Via di Salone, 245-00131, Roma, Italy 8/2006Divisione Catalizzitori
_._.~_.
Pyros Environmental Charleston Road, Hardley, Hythe, HP3835UZLtd, Southampton Hants, S045 3ZA,
f-------.Enqland,
AHV Westring 360, 44579 Castrop-Rauxel, G62.093 00 08Aufbereitungszentrum Germany. 11 A2Hafen Victor GmbH,Indaver Relight NV Haven 1940 - Molenweg, B-9130 46003/44/A/1
Doel-Beveren, Belaium....-
BIP Organics Brooks Lane, Middlewich, Cheshire, 5828147CW10 OJG, UK
HeidelberaCempnt ,~ ILO-~~
AB 30 Slite, SwedenSUC GMBH CPA Freiberg, Gustav-Julius-Pilz- SC7730036
~._-_.._..........- ... Str8, D09599, freibera, GermanvSUC GMBH SUC Seelingstadt, Nl Meerane, EBS 602.103-8611-
Anla~07580 49/99
Waste Collection Permit No. WCP- DC-08-1139-01 43/46
For
insp
ectio
n pur
pose
s only
.
Conse
nt of
copy
right
owne
r req
uired
for a
ny ot
her u
se.
EPA Export 29-05-2012:04:44:02
Source Imaging Unit 3 Syngefield Industrial Estate, WFP-10-0Y- Offaly County iSupplies Ltd. Birr, Co. Offaly 0181-01 CouncilArch Chemicals Inc 100 McKee Road, Rochester, New NYD002220804 !
York, 14611 U.S.A.Eras Eco Ltd.
CRT Recycling Ltd.UK
Foxhole, Youghal, Co. Cork.
Unit 8a & 8b Antelope IndustrialEstate, Rhydymeyn, Flintshire CH75JH
W0211-01
5012116
EnvironmentalProtectionAqency
The Recycling VillageLtd.
Remondis IndustrieService GmBH(Herne
Unit 4, Tenure Business Park,Monasterboice, Drogheda, Co. Louth.
) Heerstrasse 29-43, 44653 HerneGermany
WP 2007/20
IE 312479
Louth CountyCouncil
PM Recovery Inc, 420 South Cascade Street. RearBuilding, New Castle, PA 16101
IE 312651
Indaver GevaarlijKAfval bv,
Haven 471, Wilemskerkeweg 5, 4542NN Hoek, Nederland
22064904
EAWL1000944Recycling Ltd. Beeley Wood Recycling Village,Clavwheels Lane, Sheffield S61 NF
I--Saye-r------t--:F=-'=a7'h'-'-rs-:.tr.:..::5:=1-'-'-=D==E:'-'·2::':5=--=5:'-:4-'-1'-::B:'-'ru:':"n:':"s-7-b~u-:-tte-'-:I'----t-A;-::51D 10521
MaterialScience AG,Henkel AG & CoKQaaA
, Henkelstrabe 67, 40191 DuesseldorfGermany,
100-00036701
Bilfinger BergerEntsorgung NordGmbH
Beim Industriehafen39, 28237I BermanI
0330300800
TWZ NV Durmakker 4 9940 Evergem, Belqium 0441198659Tredi Saint-Vulbas,Parc
! Industriel de la Plaine de I'Ain, AlleeI des Pins F-01150 Saint-Vulbas,
France
AP30/03/95,24/06/0826/02/98
Willacy GuinardHoldings Ltd.
Charles Road, Hardley, Southampton,SQ45 3NX UK
EPRlFP/39535KL
EnvironmentalAgency
Mr Binman Ltd. LUddenmore, Grange, Kilmallock,Limerick
W0061-02 EnvironmentalProtectionAgency
Electrical WasteManagement Ltd
Block 648 Jordanstown DriveGreenogue Business ParkRathcooleCo Dublin
WFP-DS-090012-01
Fingal CountyCouncil
W0129-02IA Murphy Environmental, HollywoodGreat, Nag's Head, Naul, Co. Dublin.
Murphy ConcreteManufacturing Ltd. T
EnvironmentalProtectionAqency
1-=-....,....-,.- _-_ ---..----.--.------..-.-- ..----+~=_=_=---+,:=:..:.:.::~~-_iRehab Enterprises Unit 77 Broomhill Road, Tallaght. WFP-DS-10- South Dublin
I-L~t:..::.d,-, +-=D:..:u-=b-'-lin...:,.-=.24_--::- =--,.-,.--c-:-__-+-=0:..:0~0=_8--'-0...,.1---_jI-C~o=-=.:untyCouncil
_l.1P~O~ly~m:e:r~R:e:c:o~ve:r~y==J~p~o~rt;a~rli~n~g~totniB~u~s~in~e~s~s~p~a~rk~,~W~as~t~=i3W~P~F~-L~S=-=09=-==tiL~a~oi~s~C~o~u~n'-'-~tv~j---_____~ Ltd r-.,~~ .... ~ . ,vI... "UI~. vulJ/-Ul Council
Indaver Ireland Ltd Carranstown,Dunleek,Co. Meath W0167·02 EnvironmentalProtection
c..._... -'- ._. . ....L-CA-:.IQ....Ee;c.:.n.;.;:cCL--y__--'
Waste Collection Permit No. WCP· DC-08-1139-01 44/46
For
insp
ectio
n pur
pose
s only
.
Conse
nt of
copy
right
owne
r req
uired
for a
ny ot
her u
se.
EPA Export 29-05-2012:04:44:02
APPENDIX C WASTE COLLECTION VEHICLES
The permit holder shall use the following vehicles for waste collection as authorised by this permit andno other vehicles whatsoever:
\'~'D~~'::'\:I";":" .~\0!;W8~;~':;;~~:~~ic~~\{,.".;<'~2~i'l
2. 99 D 83345 I3, 00D111571 I
I4,
5,
92 MN 1260
01 D 65350
6, 02 WX 637
7, 98 D 72913
8, 00 D 106033
9, 01LK1123
10, 04 CE 1622
11, 03 D 80879
12. 01 D 22142f--.
13, 03 C 22877
------------~-----~ ---~~--~----------~'
Waste Collection Permit No. WCP- DC-08-1139-01 45/46
For
insp
ectio
n pur
pose
s only
.
Conse
nt of
copy
right
owne
r req
uired
for a
ny ot
her u
se.
EPA Export 29-05-2012:04:44:02
For
insp
ectio
n pur
pose
s only
.
Conse
nt of
copy
right
owne
r req
uired
for a
ny ot
her u
se.
EPA Export 29-05-2012:04:44:02
WM CYRIL MC GUINNESS LTD.SUNRISE. WHITESTOWN RD. RUSH. CO DUBLIN.
PH: 0 I 8430771MOB: 087 2500775FAX: 0] 8071803E MAlL: CYRIL.MC.GUINNESSiQlIRELAND.COM
DATE: lito!07 /; Do .
FROM: 6:;£; I1/c f!;~d .ro r41 7J;JLl~4i"fi I v~"Y£eu41 ,PAGES - COVER NOTE: I
all SS3NNlm) :)lI\J ll<JA:) lI\JM
For
insp
ectio
n pur
pose
s only
.
Conse
nt of
copy
right
owne
r req
uired
for a
ny ot
her u
se.
EPA Export 29-05-2012:04:44:02
APPENDIX C WASTE COLLECTION VEHICLES
The permit holder shall use the following vehicles for waste collection as authorised by this permit andno other vehicles whatsoever:
98073505
I2. 99083345
--I 3. 000111571
4. 92 MN 1260
5. 01 065350
6. 02 WX 637
7. 98072913-
8. I 04 KK 3738
9. 000106033
L 10. 99072525
11. 01 LK1123
12. 04 CE 1622
13. 03080879--
14. 01 022142!
---~.
r=:J'--__.'--w_a_sl_e_C'--"'-'IJ-'eet~io_n_v_.e_hi_c __le_.s _1
• 1. I
Waste Collection Permit No. WCP- DC-08-1139-01j7/~!IFIDate
45/46
O1l SS3NNlm) 8~ lllJA8 ~M
For
insp
ectio
n pur
pose
s only
.
Conse
nt of
copy
right
owne
r req
uired
for a
ny ot
her u
se.
EPA Export 29-05-2012:04:44:02
CERTIFICATE OF DESTRUCTION
Eco-Safe Systems Ltd,Unit 1A,Allied Industrial Estate,Kylemore Road,Dublin 10
Tel: (01) 623 9135Fax: (01) 623 9136
Email: [email protected]: www.srcl.ie
Client Billing Address:Finisklin Business ParkSligoIreland
Client:C.1 Receipt No.:Job:Date of Acceptance:
Elanco Animal Health Ireland Ltd.B 651636J1068011/08/2011
Box ID Description Packaging Weight EWCIncoming
DispatchNo.
Destination TreatmentCode
TFS ShipmentNo.
DateDestroyed
10680-001
CLINICALWASTE,UNSPECIFIED,N.O.S.
Pallet 273 18 01 03* D964 SRCL Leeds Incineration IE 313760 22 19/08/2011
10680-002
CLINICALWASTE,UNSPECIFIED,N.O.S.
Pallet 347 18 01 03* D964 SRCL Leeds Incineration IE 313760 22 19/08/2011
10680-003
CLINICALWASTE,UNSPECIFIED,N.O.S.
Pallet 345 18 01 03* D964 SRCL Leeds Incineration IE 313760 22 19/08/2011
10680-004
CLINICALWASTE,UNSPECIFIED,N.O.S.
Pallet 422 18 01 03* D964 SRCL Leeds Incineration IE 313760 22 19/08/2011
Issued at:Issued by:Date Printed:
Eco Safe Systems
09/09/2011
Certificate of DestructionEco Safe Systems is a waste processing and disposal facility, licensed by the Environmental Protection Agency Of Irelandunder 54-2 and a body with whom the client identified in this document may contract with the terms on the Waste Act (Ireland)1996. In addition to the sterilisation of healthcare risk waste the facility is licensed to operate a hazardous waste transferstation and store waste for a perion not exceeding 6 months prior to ultimate disposal/recovery. Eco Safe Systems only sendwaste to disposal/recovery sites in agreement with the EPA through permitted contractors. Records of certificates ofdestruction are held on site for a minimum period of 5 years
For
insp
ectio
n pur
pose
s only
.
Conse
nt of
copy
right
owne
r req
uired
for a
ny ot
her u
se.
EPA Export 29-05-2012:04:44:02
ANNEX m: Movement document for transboundarv movelllen1slsbioments of wastePQrresPOndlng to notineation No: IE 313760 12. Serial/total Dumber or Ool 1150, . shbnaents:r3. F.~porter _ Dotifier Registration No: IREIAGlt3l11 4.lmportcr· cOllSipee RqpsIration No: CP 3930XiName: £Co-S.fe Systems ttd. Name: SRCL Ud.
Address: Unit la AJll<d In4uslrial Estate., Kylemor" Road, Dublin 10 Addtcss: Kno..5lboIpe Treal/DCI1l Wori<s. Leeds. West Yor\;shire. lS9 OPJ I
Contact person; Ms. Laura Tyson ~taet person: Mr.·Mario HiggillSfel: -353-1-6166900 Fa.'t: <-3S3-I-62."9136 Irel: 0044 1133918761 Fax: 00441133918762
~E::·-~m~aiil:'..,!I~ty~S<'~n~@~s~rc~l~c(\~m~_-;;-;'-'-~ ::T ~1F~'-maJ~~·I~:~~·~·~~~I.~com~.--::=~---;::::-.~:- .._5. Adual auantity: Tonnes (M2): --\ m': &. AdUl dareof~e8t: \\-0 'X - ~n\\7. Plickaging T)pe(s) (J): Numberofpacbges:~~ .fS~cilll hllndling requirements: ilj Yes: n No: I'iZI
l",
, r
t f.
"{" .'I .., ',·t l
8.(c) Last Carrier:Ikgistration No:Name:Address:
9. Waste-!enerator(5) - pl'Clduur($~.5:6): 12. Desipau'!.D a~eom~ oftbrwa5!C (1): .Registration No: lRUAG 1I3/11 See Annex 3 _ 1k. L ., '-/. ,'.' to '.? • "I. t'\-.. ~ ....,..:...., < ':> t ; '" ,.
INon~: Ee()-S"fcS)~temsltd. "'""'.,.,~ 't ".·.t; -h.J/;;> ,,,ro.l; :~-~ ·~·.I . .J--, C [of-~.'ddr~"' UmllaAlliodlndllSlrialEstate KvlcmorrR-.ADublmIO "i'f_ \"'v-- \1 ..... "._. ,1.-.'0(',1.)" ~ " , " ;.
.. \ l,:~. • ~ ~ 'I' " ..........Conlact person: M:;. UlW"4 T)"$OI1 lJ.PII)'Sic:aI ~"'racteris6cs (I): 2..soUD
II d: "353·1-6166900 Fax: +353-1-6239136.I.:-mail: l\).sonf;!jYcl.comISite of "eneration (}I: HAZARDOUS WASTE TRANSFER STATION (i) Basel Annex vm (or IX ifaPPlicable): A-4Q20i1O. Disposal facilit~· X or ~overy facility 0 (ii) OECD QX\c (ifdiffamt from (i)): NIA!Rc~i~lrdtion No: CP 3930X (iii) EC list of~astes; 180103', If. 0' co lr. \ 's '" - • f .iSa;n~: :>RCI. I.Id (iv) National code in country of export: 1801 03* I f. ,7: r;~, Ii ,.,
!Address: Knowslho.pe Trealment WOIb, Leeds. WestY~ lS90PJ (v) NaIioaaICXIlIein~ofimport: III Ol~: 180207'. \ ~ C': 0'
I ., ~~~~~
IConl:tet person: Mr. Marl: HIggins (vii) Y-code: YI,Tel: ()(l~4 113391~761 Fax: 00441133918762 (viii) "-code (/): H6.2iE-mail: [email protected] (ix) UN class (I): 6.2;Actual site of disDosallreoo"cn- (1) As Abo~ (x) UN number: PLEASE SEE ANNEX .'I!11. D!spo.<aVrecovery operatioa(s) (xi) UN shipping name: PLEASE SEE ANNEX 3iD-code I R-code (/); . DIO-Incineration 'xii) Customs a'idel:sHHSI: NtA
Date: ) 7-cTj -IISignature lIIId stamp:
II~. E'qlOrtn's - notir~r's I geaerator's· prodarer's (~) dedaratiGII:!I ,crtify mat the above information is oomplete and correct to my brst knowledge. I.also certify that legally c:nfun:eable wrinen cootmelual obligatiorn;ha"" heen entered into. that any appJicablr insurance or ctber financial guai1IDli:c is in rorce covering me 1ranSboondary movement and that all
;;.~:~"~;;: ......_~;;::;~~i16. For use by any penoa iDvolwd in the transboundary~ ill case addltioal iIIfermatio. is reqlliRd
~7.ShipmcnlRceiYrd lr\' iJpporter - COIISigiiff (if DOt farility): Date: Name: Signlltun:: .-- --··-----------,4
f TO BE COMPLETED BY DISPOSAL I RECOVERY FAClLfIY --'Ill. Shipment rec:rind lit dist-al fac:ility I3" or_-etyfacility D' 119. I eertify that tbe disposaJlrrc:overy of tm, . . "l __~ lwaste drseribed abo~·has beea rompleted'lbtc(,frcc<'l'tlOn: /.,c..-6?, -It Acceptt B"Kejcdcd·: 0
IQuantity reeei\"ed:6-~Cf. Toones :J:~. conroe Name' J ~ ~! {M~: com~Na~~a~ / .~!APrroximatc date ofdi~~ /"1-0'8-I (Dispu,alfrecO\'ery openll!!!!!.(I): ,/ _ _ _/_
Nume:c;Lc;..l- '-I'])~O"te: 19' -1'1Sig.nature
(2) Atll>ch dcraih if(.1) If,n"" than tl""" carriets. att:aeb infonnation as ~uinod in blocb II (a"b,c:).
For
insp
ectio
n pur
pose
s only
.
Conse
nt of
copy
right
owne
r req
uired
for a
ny ot
her u
se.
EPA Export 29-05-2012:04:44:03