Underground Petroleum Storage Tanks and Related Wastes - Code ...

APPENDIX 3B
WASTE DISPOSAL REGISTER: DISPOSAL CERTIFICATE
Form of certificate to be rendered to the principal by contractors removing liquid waste produced by tank disposal
operations from disposal contractors premises.
To:
(Principal)
Waste Disposal Certificate
WE certify that we have disposed of the wastes produced by tank disposal operations and listed below in a manner that
does not contravene any relevant Government Regulations or Territorial Authority Bylaw or requirement.
The wastes listed below were disposed of at (location) on ___ / ___ / ___
Waste treatment prior to disposal (details)
Chemical analysis of waste required prior to disposal? Yes/No
(If “Yes”, attach copy of certificate of analysis)
Signed:
On behalf of:
Quantity of wastes:
Drum or batch identification No:
(Signature)
(Name in block letters)
(Waste Disposal Contractor)
(Address)
Chemical Analysis Certificate attached:
Transport and Disposal of Petroleum Storage Tanks 37