WAC 173-303-9906. Special waste bill of lading

special waste bill of lading example 1) Receiving Facility Name: phone: Address: fax: 2) Customer Name: phone: Address: fax: 3) Property Owner Name (where waste originated): phone: Address: fax: 4) Hauler Name: phone: Address: fax: 5) Consultant Name: phone: Address: fax: 6) Amount of waste: 7) Original Location of Special Waste: 8) Activity Which Generated Waste: 9) Description of Waste. Include any Applicable Dangerous Waste Code: 10) Does Waste Have Potential to Create Fugitive Dust? Yes_____ No_____ If Yes, What is your Plan to Mitigate Dust? 11) Amount of wastes in pounds or tons: special waste waste analysis Customer Must Initial the Appropriate Item. 1. Wastes were designated through testing 2. Wastes were designated by other means Customer Certifies That: 1. The Waste sampled and intended for disposal under this Certification is special waste as defined in WAC 173 303 040 2. The Waste has no free liquids per WAC 173-303-110 (3)(c)(i). Signature Date 1) Receiving Facility Name: phone: Address: fax: 2) Customer Name: phone: Address: fax: 3) Property Owner Name (where waste originated): phone: Address: fax: 4) Hauler Name: phone: Address: fax: 5) Consultant Name: phone: Address: fax: 6) Amount of waste: 7) Original Location of Special Waste: 8) Activity Which Generated Waste: 9) Description of Waste. Include any Applicable Dangerous Waste Code: 10) Does Waste Have Potential to Create Fugitive Dust? Yes_____ No_____ If Yes, What is your Plan to Mitigate Dust? 11) Amount of wastes in pounds or tons: special waste waste analysis Customer Must Initial the Appropriate Item. 1. Wastes were designated through testing 2. Wastes were designated by other means Customer Certifies That: 1. The Waste sampled and intended for disposal under this Certification is special waste as defined in WAC 173 303 040 2. The Waste has no free liquids per WAC 173-303-110 (3)(c)(i). Signature Date