‘Movement document for transboundary movements/shipments of waste
1. Corresponding to notification No:
2. Serial/total number of shipments
/
3. Exporter — notifier
Registration No:
Name:
Address:
Contact person:
Tel.:
Fax:
E-mail:
4. Importer — consignee
Registration No:
Name:
Address:
Contact person:
Tel.:
Fax:
E-mail:
5. Actual quantity:
Tonnes (Mg):
m3:
6. Actual date of shipment:
7. Packaging
Type(s) (1):
Number of packages:
Special handling requirements: (2)
Yes:
No:
8.(a) 1st carrier (3):
Registration No:
Name:
Address:
Tel.:
Fax:
E-mail:
8.(b) 2nd carrier (3):
Registration No:
Name:
Address:
Tel.:
Fax:
E-mail:
8.(c) Last carrier (3):
Registration No:
Name:
Address:
Tel.:
Fax:
E-mail:
- - - - - - - To be completed by carrier’s representative - - - - - - -
More than three carriers (2)
Means of transport (1):
Date of transfer:
Signature:
Means of transport (1):
Date of transfer:
Signature:
Means of transport (1):
Date of transfer:
Signature:
9. Waste generator(s) — producer(s) (4) (5) (6):
Registration No:
Name:
Address:
Contact person:
Tel.:
Fax:
E-mail:
Site of generation (2):
12. Designation and composition of the waste (2):
13. Physical characteristics (1):
14. Waste identification (fill in relevant codes)
(i) Basel Annex VIII (or IX if applicable):
(ii) OECD code (if different from (i)):
(iii) EC list of wastes:
(iv) National code in country of export
(v) National code in country of import:
(vi) Other (specify):
(vii) Y-code:
(viii) H-code (1):
(ix) UN class (1):
(x) UN number:
(xi) UN shipping name:
(xii) Customs code(s) (HS):
10. Disposal facility
or recovery facility
Registration No:
Name:
Address:
Contact person:
Tel.:
Fax:
E-mail:
Actual site of disposal/recovery (2)
11. Disposal/recovery operation(s)
D-code/R-code (1):
15. Exporter's — notifier's/generator's — producer's (4) declaration:
I certify that the above information is complete and correct to my best knowledge. I also certify that legally enforceable written contractual obligations have been entered into, that any applicable insurance or other financial guarantee is in force covering the transboundary movement and that all necessary consents have been received from the competent authorities of the countries concerned.
Name:
Date:
Signature:
16. For use by any person involved in the transboundary movement in case additional information is required
17. Shipment received by importer — consignee (if not facility):
Name:
Date:
Signature:
TO BE COMPLETED BY DISPOSAL/RECOVERY FACILITY
18. Shipment received at disposal facility
or recovery facility
Date of reception:
Accepted:
Rejected (*):
Quantity received:
Tonnes (Mg):
m3:
(*) immediately contact competent authorities
Approximate date of disposal/recovery:
Disposal/recovery operation (1):
Name:
Date:
Signature:
19. I certify that the disposal/recovery of the waste described above has been completed
Name:
Date:
Signature and stamp:
(1) See list of abbreviations and codes on the next page.
(2) Attach details if necessary.
(3) If more than three carriers, attach information as required in blocks 8 (a, b, c).
(4) Required by the Basel Convention.
(5) Attach list if more than one.
(6) If required by national legislation.
FOR USE BY CUSTOMS OFFICES (if required by national legislation)
20. Country of export — dispatch or customs office of exit
The waste described in this movement document left the
country on:
Signature:
Stamp:
21. Country of import — destination or customs office of entry
The waste described in this movement document entered the
country on:
Signature:
Stamp:
22. Stamps of customs offices of transit countries
Name of country:
Name of country:
Entry:
Exit:
Entry:
Exit:
Name of country:
Name of country:
Entry:
Exit:
Entry:
Exit:
List of abbreviations and codes used in the movement document
DISPOSAL OPERATIONS (block 11)
D1 Deposit into or onto land (e.g. landfill, etc.)
D2 Land treatment (e.g. biodegradation of liquid or sludgy discards in soils, etc.)
D3 Deep injection (e.g., injection of pumpable discards into wells, salt domes or naturally occurring repositories, etc.)
D4 Surface impoundment (e.g., placement of liquid or sludge discards into pits, ponds or lagoons, etc.)
D5 Specially engineered landfill (e.g. placement into lined discrete cells which are capped and isolated from one another and the environment, etc.)
D6 Release into a water body except seas/oceans
D7 Release into seas/oceans including sea-bed insertion
D8 Biological treatment not specified elsewhere in this list which results in final compounds or mixtures which are discarded by means of any of the operations in this list
D9 Physico-chemical treatment not specified elsewhere in this list which results in final compounds or mixtures which are discarded by means of any of the operations in this list (e.g., evaporation, drying, calcination, etc.)
D10 Incineration on land
D11 Incineration at sea
D12 Permanent storage (e.g. emplacement of containers in a mine, etc.)
D13 Blending or mixing prior to submission to any of the operations in this list
D14 Repackaging prior to submission to any of the operations in this list
D15 Storage pending any of the operations in this list
RECOVERY OPERATIONS (block 11)
R1 Use as a fuel (other than in direct incineration) or other means to generate energy (Basel/OECD) — Use principally as a fuel or other means to generate energy (EU)
R2 Solvent reclamation/regeneration
R3 Recycling/reclamation of organic substances which are not used as solvents
R4 Recycling/reclamation of metals and metal compounds
R5 Recycling/reclamation of other inorganic materials
R6 Regeneration of acids or bases
R7 Recovery of components used for pollution abatement
R8 Recovery of components from catalysts
R9 Used oil re-refining or other reuses of previously used oil
R10 Land treatment resulting in benefit to agriculture or ecological improvement
R11 Uses of residual materials obtained from any of the operations numbered R1 to R10
R12 Exchange of wastes for submission to any of the operations numbered R1 to R11
R13 Accumulation of material intended for any operation in this list
PACKAGING TYPES (block 7)
1. Drum
2. Wooden barrel
3. Jerrican
4. Box
5. Bag
6. Composite packaging
7. Pressure receptacle
8. Bulk
9. Other (specify)
H-CODE AND UN CLASS (block 14)
UN Class
H-code
Characteristics
1
H1
Explosive
3
H3
Flammable liquids
4.1
H4.1
Flammable solids
4.2
H4.2
Substances or wastes liable to spontaneous combustion
4.3
H4.3
Substances or wastes which, in contact with water, emit flammable gases
5.1
H5.1
Oxidising
5.2
H5.2
Organic peroxides
6.1
H6.1
Poisonous (acute)
6.2
H6.2
Infectious substances
8
H8
Corrosives
9
H10
Liberation of toxic gases in contact with air or water
9
H11
Toxic (delayed or chronic)
9
H12
Ecotoxic
9
H13
Capable, by any means, after disposal of yielding another material, e.g., leachate, which possesses any of the characteristics listed above
MEANS OF TRANSPORT (block 8)
R = Road
T = Train/rail
S = Sea
A = Air
W = Inland waterways
PHYSICAL CHARACTERISTICS (block 13)
1. Powdery/powder
2. Solid
3. Viscous/paste
4. Sludgy
5. Liquid
6. Gaseous
7. Other (specify)
Further information, in particular related to waste identification (block 14), i.e. on Basel Annexes VIII and IX codes, OECD codes and Y-codes, can be found in a Guidance/Instruction Manual available from the OECD and the Secretariat of the Basel Convention.’