DATJ 116 - Non standard waste collection information form

• Site conducted

  Select

• Business unit

  Select

• Prepared on

  Date

• Prepared by

• Location
  Address

• Schenker Enquiry Number

• How many unique types of waste need to be disposed.

• This form is primarily aimed at the despatch of 1 or 2 "non normal waste lines" Definition can be found in QSHE SOP 016 Waste Management Process and is not suitable for disposal projects with varied/numerous lines of differing products. If your waste project has "multiple lines" due to the nature and complexity of requests such as this, it is recommended you contact our waste facility management company are able to "Project Manage" our waste disposal requirement. This will entail a site visit/inspection by a chemist, who will audit, label and prepare any documentation necessary for it's despatch. Arrangement can be made direct through your contact or via the facilities team.

Core Waste Information.

• Clear images of the waste, Including images of the front and back of labels are required together with images of the actual waste, to achieve this, you are required to open the box/container to obtain these (Images help our waste management provider to determine the correct disposal routes and costs involved).

  Media

• Waste type - (Different categories of waste should segregated and not listed together on the same waste disposal application).

  Select Hazardous Non-Hazardous Bio/Food/Animal matter based wastes

  • Hazardous
  • Non-Hazardous
  • Bio/Food/Animal matter based wastes

• What is the UN Code

• MSDS Document link

  Media

• Product Name

• Description

• Is there a DB Schenker/Customers (internal) Product Code

• Provide any relevant MSDS's for this product.

  Media

• Is this a single product and not complemented with secondary or more products E.g. paint with paint hardener etc.

  Single

  Two

• What is the additional waste type?

  Select Hazardous Non-Hazardous Bio/Food/Animal matter based wastes

  • Hazardous
  • Non-Hazardous
  • Bio/Food/Animal matter based wastes

• What is the UN Code

• Product Name

• Description

• MSDS Document Link

  Media

• Product Name

• Description

• Does this waste disposal request have secondary products that could be hazardous e.g. adhesive repair kits

  Yes

  No

• What is the UN Code

• MSDS Document Link

  Media

• Product Name

• Description

• Is this subject to decay and may become liquified or give off unpleasant odours.

  Yes

  No

• How is this waste Contained?

  Select 205 ltr Drum Boxed IBC Loose Palletised Other

  • 205 ltr Drum
  • Boxed
  • IBC
  • Loose
  • Palletised
  • Other

• Please describe container?

• Please describe fully. E.g. Pallet with bulk bag containing loose waste, how many boxes on a pallet how many boxes within boxes etc.

  Yes

  No

  N/A

• How much waste is in the container/bag/Vessel?

  Empty

  Full

  Part Full

  Residual

  Unopened

• Quantity of waste

• Unit of measure

  Kilograms

  Litres

• Date waste was generated or product was declared waste.

  Date

• Reason for disposal

  Select Contaminated Customer/Supplier/Authority Request Damaged End of Line Products/No Longer Required/Overproduction Out of Date Requires Secure Destruction Used - and no longer able to perform task due to wear and tear Waste generated following environmental spill response Unknown

  • Contaminated
  • Customer/Supplier/Authority Request
  • Damaged
  • End of Line Products/No Longer Required/Overproduction
  • Out of Date
  • Requires Secure Destruction
  • Used - and no longer able to perform task due to wear and tear
  • Waste generated following environmental spill response
  • Unknown

• Information regarding the contamination, additional information etc.

• Has the damage caused any internal leaks or created sharp edges?

  Internal leaks

  Sharp edges

  None

• What is leaking? You may be required to provide an MSDS.

• Is the leak contained

  Yes

  No

• How is the leak contained?

  UN Approved Container

  Other

• Please describe and if not evidenced in photographs previously provided, please provide.

• Please describe and if not evidenced in photographs previously provided, please provide additional evidence.

  Yes

  No

  N/A

• Please describe condition and provide photos

• Name of person and Position authorising the request.

• Where will the waste be stored whilst awaiting collection?

• Is this protected against contamination, damage, tampering, unathorised persons adding to and also if necessary, the weather.

  Yes

  No

• The waste should be moved to ensure it's protected. If there is a suspicion the waste has been contaminated, tampered etc. This initial information gathering process should be started again.

Agreements and signoffs.

• This completed form is for initial information gathering only and is not an agreement between either party for the collection of our waste. Our waste facility management providers can, if necessary, request further clarification on the information provided on this form or ask additional questions not yet captured as necessary to satisfy their requirements and make arrangements with a suitable waste carrier with specifically produced "Waste Transport Notes."

• The driver collecting the waste has the legal right to inspect the waste they'll be carrying and this can include opening packages.

• Disposal has been authorised on site by?

• Name of person completing this request.

• Signed

  Sign