Food Processing Waste Manifest

1. Generator Information
Facility Name Date
Address
Contact Person Phone
2. Waste Description
Type of Waste Approximate Quantity
Packaging/Container Type Physical State
Special Handling Instructions
3. Transporter Information
Company Name Contact Person
Phone Vehicle ID
4. Receiving Facility Information
Facility Name Date Received
Address
Contact Person Phone
5. Certification and Signatures
Generator Signature
Date
Transporter Signature
Date
Receiver Signature
Date