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# DLA Official Forms

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Form Information
| Form Number:       | DLA2543                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              |
|--------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Form Title:        | DLA DISPOSITION SERVICES RECEIPT IN PLACE HAZARDOUS WASTE                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            |
| Form Version:      | Dec 2021                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |
| Status:            | Active                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |
| Functional Area:   | Disposition Services                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |
| Opr:               | Disposition Services                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |
| Safeguards:        | None                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |
| Electronic:        | Yes                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  |
| Form Link:         | Documents/FormsSite/forms/DL2543.pdf                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |
| Type:              | Primary                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              |
| Prescribed:        | DoDM 4160.21                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         |
| Description:       | This DLA Form complies with requirements of DoDM 4160.21 to have a documented understanding with generators for Hazardous Waste  (HW) disposal services. A separate Receipt in Place (RIP) form is required for usable, scrap and hazardous material. Pursuant to DoDI 4000.19, a formal MOA/MOU is not required for services performed by a Defense Working Capital Fund (DWCF) activity for another DoD entity. A formal MOA/MOU is required for non-DoD entities doing business with DLA. RIP occurs at a physical location under the generator’s control, vice at a DLA Disposition Services location. RIP may be used when it is determined to be justified for economic reasons or when DLA Disposition Services is physically unable to accept property either by regulation or other restrictions. The provisions in this acknowledgement may not be changed or renegotiated, as all provisions are reflective of requirements in DoDM 4160.21. This DLA Form will be completed by DLA Disposition Services and signed by both DLA Disposition Services and the Generator.   |
| Records Retention: | 4700.24 Hazardous Waste Disposal Documents. Cutoff at end of Event. Destroy 50 years after regulatory approval for final site closure by the TSDF.  Pending NARA approval                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            |
| Form Audience:     | Disposition Services                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |

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