ANNEX IBSupplementary provisions
ANNEX IB Text of image Movement document for transboundary movements/shipments of EU waste 1. Corresponding to notification No: 2. Serial/total number of shipments: 3. Exporter - notifier Registration No: 4. Importer - consignee Registration No: Name: Name: Address: Address: Contact person: Contact person: Tel.: Fax: Tel.: Fax: E-mail: E-mail: 5. Actual quantity: kg: litre: 6. Actual date of shipment: 7. Packaging type(s) (1) : Number of packages: Special handling requirements: (2) Yes No 8 a) 1 st carrier (3) : Registration No: Name: Address: Tel.: Fax: E-mail: 8 b) 2 nd carrier: Registration No: Name: Address: Tel.: Fax: E-mail: 8 c) Last carrier: 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) : 10. Disposal facility or recovery facility Registration No: Name: Address: Contact person: Tel.: Fax: E-mail: Actual site of disposal/recovery (2) : 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): 11. Disposal/recovery operation(s) D code/R code (1) : Text of image 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: Signature: Date: 16. For use by any person involved in the transboundary movement in case additional information is required: TO BE COMPLETED BY DISPOSAL/RECOVERY FACILITY 17. Shipment received at disposal facility or recovery facility Date of reception: Accepted: Rejected*: Quantity received: kg: litre: * immediately contact competent authorities Approximate date of disposal/recovery: Disposal/recovery operation (1): Date: Name: Signature: 18. I certify that the disposal/recovery of the waste described above has been completed. Date: Name: 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. Text of image FOR USE BY CUSTOMS OFFICES (if required by national legislation) 19. COUNTRY OF EXPORT - DISPATCH OR CUSTOMS OFFICE OF EXIT The waste described in this movement document left the country on: Signature: Stamp: 20. COUNTRY OF IMPORT - DESTINATION OR CUSTOMS OFFICE OF ENTRY The waste described in this movement document entered the country on: Signature: Stamp: 21. STAMPS OF CUSTOMS OFFICES OF TRANSIT COUNTRIES Name of country: Entry: Exit: Name of country: Entry: Exit: Name of country: Entry: Exit: Name of country: Entry: Exit: List of abbreviations and codes used in the movement document DISPOSAL OPERATIONS (block 11) D 1 Deposit into or onto land (e.g. landfill, etc.) D 2 Land treatment (e.g. biodegradation of liquid or sludgy discards in soils, etc.) D 3 Deep injection (e.g. injection of pumpable discards into wells, salt domes or naturally occurring repositories, etc.) D 4 Surface impoundment (e.g. placement of liquid or sludge discards into pits, ponds or lagoons, etc.) D 5 Specially engineered landfill (e.g. placement into lined discrete cells which are capped and isolated from one another and the environment) D 6 Release into a water body except seas/oceans D 7 Release into seas/oceans including sea-bed insertion D 8 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 D 9 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) D 10 Incineration on land D 11 Incineration at sea D 12 Permanent storage (e.g. emplacement of containers in a mine, etc.) D 13 Blending or mixing prior to submission to any of the operations in this list D 14 Repackaging prior to submission to any of the operations in this list D 15 Storage pending any of the operations in this list Recovery operations (block 11) R 1 Use as a fuel (other than in direct incineration) or other means to generate energy/Use principally as a fuel or other means to generate energy R 2 Solvent reclamation/regeneration R 3 Recycling/reclamation of organic substances which are not used as solvents R 4 Recycling/reclamation of metals and metal compounds R 5 Recycling/reclamation of other inorganic materials R 6 Regeneration of acids or bases R 7 Recovery of components used for pollution abatement R 8 Recovery of components from catalysts R 9 Used oil re-refining or other reuses of previously used oil R 10 Land treatment resulting in benefit to agriculture or ecological improvement R 11 Uses of residual materials obtained from any of the operations numbered R 1 to R 10 R 12 Exchange of wastes for submission to any of the operations numbered R 1 to R 11 R 13 Accumulation of material intended for any operation in this list Text of image 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.