Wash. Admin. Code § 173-303-9906
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 | ||||||||
Wash. Admin. Code § 173-303-9906
Statutory Authority: Chapters 70.105 and 70.105D RCW. 95-22-008 (Order 94-30), § 173-303-9906, filed 10/19/95, effective 11/19/95; 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). 91-07-005 (Order 90-42), § 173-303-9906, filed 3/7/91, effective 4/7/91. Statutory Authority: Chapter 70.105 RCW. 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. 82-05-023 (Order DE 81-33), § 173-303-9906, filed 2/10/82.