Spreadsheet: 24882d1215778647-how-to-print-only-selected-cells-on-a-worksheet-consignment-note-template-to-fill-in-
Sheet: Sheet1

PART A - Notification details
1 Consignment note code: |  |  |  |  |  |  |  |  |  |  |  |  |  | / |  |  |  |  |  | 4 The waste will be taken to (name, address, postcode):
2 The waste described below is to be removed from (name, address, postcode, telephone,fax):
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 5 The waste producer was (if different from 2) (name, address, postcode, telephone,fax):
3 Premises code (where applicable):
PART B - Description of the waste
1 Process giving rise to the waste(s) was: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 2 SIC for process giving rise to the waste: |  |  |  |  |  |  |  |  |  |  |  |  | . |  |  | /
3 WASTE DETAILS (when more than one waste type is collected all info given below must be completed for each EWC)
Description of waste |  |  |  |  |  |  |  |  |  | List of wastes           (EWC code) |  |  |  |  |  | Quantity (kg) |  |  | Component |  |  |  | Concentration |  |  |  | Physical Form |  |  |  |  | Hazard code |  |  | Container
As list |  |  |  |  |  |  |  |  |  | As list |  |  |  |  |  | As list |  |  | As list |  |  |  | As list |  |  |  | As list |  |  |  |  | As list |  |  | As list
As list |  |  |  |  |  |  |  |  |  | As list |  |  |  |  |  | As list |  |  | As list |  |  |  | As list |  |  |  | As list |  |  |  |  | As list |  |  | As list
The information given below is to be complete for each EWC identified
EWC code |  |  |  |  |  | Packing group(s) |  |  |  |  |  | UN identification number(s) |  |  |  |  |  |  | Proper shipping name(s) |  |  |  |  |  |  |  | UN class(es) |  |  | Special handling requirements
As list |  |  |  |  |  | As list |  |  |  |  |  | As list |  |  |  |  |  |  | As list |  |  |  |  |  |  |  | As list |  |  | As list
As list |  |  |  |  |  | As list |  |  |  |  |  | As list |  |  |  |  |  |  | As list |  |  |  |  |  |  |  | As list |  |  | As list
PART C - Carriers's certificate |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | PART D - Consignor's certificate
If more than one carrier is used, please attach schedule for |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | I certify that the information in A, B and C above is correct, that the carrier is registered or exempt and was advised of the appropriate precautionary measure.  All of the waste is packaged and labelled correctly and the carrier has been advised of any special handling requirements.
subsequent carriers & tick here.
I certify that I today collected the consignment and that the details in A2,
A4 & B3 are correct and I have been advised of any specific handling
requirements.
1 Carrier name:
On behalf of (name, address. Postcode, telephone, fax): |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 1 Consignor name:
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | On behalf of (name, address, postcode, telephone, fax)
2 Carrier registration no./reason for excemption:
3 [NAME] registration no. (or mode of transport, if not road):
Signature |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Signature
Date: |  |  |  |  |  |  |  |  |  | Time: |  |  |  |  |  |  |  |  | Date: |  |  |  |  |  |  |  |  | Time:
PART E - Consignee's certificate (all information below must be completed for each EWC if more than one waste type is collected)
Individual EWC code(s) received |  |  |  |  |  | Quantity of each EWC code received(kg) |  |  |  |  |  |  |  |  |  |  |  | EWC code accepted/rejected |  |  |  |  |  | Waste management operation (R or D code)
As list |  |  |  |  |  | As list |  |  |  |  |  |  |  |  |  |  |  | As list |  |  |  |  |  | As list
As list |  |  |  |  |  | As list |  |  |  |  |  |  |  |  |  |  |  | As list |  |  |  |  |  | As list
1 I received this waste at the address given in A4 on: |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Date: |  |  |  |  |  |  | Time:
2 Vehicle registration no. (or mode of transport, if not road): |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Name:
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | On behalf of (name, address, postcode, telephone, fax)
3 Where waste is rejected please provide details:
I certify that the waste management licence/permit/authorised exemption no(s)
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Signature
authories the management of the waste described in B at the address given in A4. |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Date: |  |  |  |  |  |  |  |  | Time: