Industrial Waste Manifest Record
Manifest Number
Date
Generator Company Name
Generator Address
Contact Person
Phone Number
Email
Transporter Company Name
Transporter Address
Transporter Phone
Disposal Facility Name
Disposal Facility Address
Disposal Facility Phone
Waste Description
Waste Code
Quantity (kg/liters)
Container Type
Special Handling Instructions
Generator Signature
Date
Transporter Signature
Date
Disposal Facility Signature
Date
Remarks / Notes