Hazardous Material Packaging Compliance Form
Date
Prepared By
Reference Number
Shipper Name
Consignee Name
Material Information
Material Name
UN Number
Class/Division
Packing Group
I
II
III
Quantity
Unit
Package Type
Packaging Compliance Checklist
Packages are in proper condition and integrity
Packages are properly labeled and marked
Approved/Authorized Packaging used
Sufficient cushioning/absorbent used if required
Required documentation included
Additional Comments
Prepared By (Signature)
Date