Hazardous Materials (Management, Handling and Transboundary ...

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* (attach details)Other [ ]UN shippingname:19. Concerned states, code number of competent authorities, and specific points ofentry and exit:State of exportStates of transit State of import20. Customs Aces of entry and/or departure 2 1. Exporter's/Generator's declaration:Entry:Departure22. Number of annexesattachedI certify that the information is completeandCorrect to my best knowledge. I alsocertify thatLegal y-enforceable written contractualobligationshave been entered into and that anyapplicableinsurance or other financial guarantees areor shall bein force covering the transboundarymovement.Name: Signature:Date:FOR USE BY COMPETENT AUTHORITIES23. To be completed by competent authorityof- importNotification received on: - transit (Basel) of(country):Acknowledgement senton:Name of competentauthority, stampAnd/or signature:24. Consent to the movement provided bythe competent authorityConsent given on: Consent expires on:Specific conditions (1): [ ] Yes, see block24 overleaf annex[ ] NoName of competent authority,Stamp and/or signature:(1) Enter X in appropriate box (2) Attach list if more than one (3) Attach detailedlist of multiple shipment (4) See codes on the reverse38
List of abbreviations used in the Movement DocumentRECOVERY OPERATIONS (Block 9)R I Use as a fuel (other than in direct incineration) or other means to generate energyR2 Solvent reclamation/regenerationR3 Recycling/reclamation of organic substanceswhich are not used as solventsR4 Recycling/reclamation of metals and metal compoundsR5 Recycling/reclamation of other inorganic materialsR6 Regeneration of acids or basesR7 Recovery of components used for pollution abatementR8 Recovery of components from catalystsR9 Used oil re-refining or other reuses of previously used oilRIO Land treatment resulting in benefit to agriculture or ecological improvementR11 Uses of residual materials obtained from any of the operations numbered R I to10R12 Exchange of wastes for submission to any of the operations numbered RI to R I IR13 Accumulation of material intended for any operation numbered RI to RI 2MEANS OFTRANSPORT(Block 8-10)PACKAGING TYPES(Block 16)H NUMBER AND LIN CLASS (Block17)R = Road 1. Drum LIN Class H No. Designation2. Wooden barrelT = Train/Rail 3. Jerrican I H I Explosive4. Box 3 H3 Inflammable liquidsS = Sea 5. Bag 4.1 H4.1 Inflammable solids6. Compositepackaging4.2 H4.2 Substances or wastes liableto Air39
Page 1 and 2: [To be published in the Gazette of
Page 3 and 4: (f)(g)(h)(i)(j)(k)(l)“exporter”
Page 5 and 6: (ze)(zf)(zg)“storage” means sto
Page 7 and 8: (2) Import of hazardous wastes shal
Page 9 and 10: (6) The Port and Custom authorities
Page 11 and 12: (4) The Central Pollution Control B
Page 13 and 14: obtain ‘No Objection certificate
Page 15 and 16: (1) The Hazardous Wastes (Managemen
Page 17 and 18: SCHEDULE - II[See rule 3(k) & (l)]L
Page 19 and 20: C4C5C6C7C8C9C10C11C12C13C14C15C16C1
Page 21: Basel No. Description of hazardous
Page 25 and 26: Basel No.B1110B1120Description of h
Page 27 and 28: Basel No. Description of hazardous
Page 29 and 30: Basel No. Description of hazardous
Page 31 and 32: UN Class 1 Code Characteristics5.2
Page 33 and 34: [See rule 6]Hazardous Wastes Prohib
Page 35 and 36: Schedule - VI[ See rule 12]LIST OF
Page 37: FORM - 1[See rules 8, 9 & 10 ]Trans
Page 41 and 42: Signature:26. COUNTRY OFIMPORT/DEST
Page 43 and 44: Signature of Carrier'srepresentativ
Page 45 and 46: R5 Recycling/reclamation of other i
Page 47 and 48: FORM - 3[See rule 10 ]Application f
Page 49 and 50: 6. Break-up of the imported materia
Page 51 and 52: FORM - 5[See rules 13 & 14 ]Form of
Page 53 and 54: FORM − 6[see rules 14]Form for Fi
Page 55 and 56: FORM-8[See rule 19]Transport Emerge
Page 57 and 58: FORM − 10[see rule 21]Form for Fi

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