Industrial Waste Hazardous Declaration
Company Name
Address
Contact Person
Phone/Email
Waste Information
Waste Name
Type of Waste
Waste Code
Physical Form
Source/Process
Estimated Quantity (per month)
Hazardous Characteristics
Properties (e.g. toxic, flammable, corrosive, reactive)
Main Hazardous Components
Handling & Storage
Current Handling Practice
Storage Location
Disposal Method
Declaration
Name
Position
Date
Signature