Title Page

  • Site conducted

  • Date

  • Team Members

Byproduct Material Questionnaire

    Byproduct Material Identification
  • Generating process

  • Describe 'Other' process

  • Byproduct material name

  • Byproduct material physical state

  • Byproduct material collection/containment method

  • Describe 'Other'

  • Is this byproduct an unused/off-specification product?

  • Is a product Safety Data Sheet readily available onsite?

  • Has laboratory chemical analysis been conducted on a sample of the byproduct material?

  • Are copies of the analytical results on file at the facility?

  • Is this byproduct a jurisdictionally regulated material upon disposition?

  • Describe categorization

  • Has this byproduct material been sampled for characterization by CLR?

  • Date of last characterization

  • Are the analytical reports maintained on file?

  • Identify the vendor managing the material

  • Receiving facility name and location address

  • Is the facility permitted to receive the material?

  • Has the material been profiled by the vendor?

  • Does the facility have a copy of the vendor profile available the site?


  • Team Lead signature

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