FORM 6: Format for Notification and Movement Document
[Rule 11(2) and (4)]
A. Information to be provided on notification:
1.Reason for waste export:
2. Exporter of the waste4 :
3. Generator(s) of the waste and site of generation4 :
4. Importer of wastes4 :
5. Intended carrier(s) of the waste or their agents, if known4 :
6. Exporting countrys competent authority5 :
7. Expected countries of transit competent authority5 :
8. Importing countrys competent authority5 :
9. General or single notification:
10. Projected date(s) of shipment(s) and period of time over which waste is to be exported and proposed itinerary (including point of entry and exit)6 :
11. Means of transport envisaged (road, rail, sea, air, inland waters):
12 Information relating to insurance7 :
13. Designation and physical description of the waste and its composition8 and information on any special handling requirement including emergency provisions m case of accidents:
14. Type of packaging envisaged (e.g. bulk, drummed, tanker):
15. Estimated quantity in weight/volume6 :
16. Process by which the waste is generated9 :
17. Method of disposal:
18. Declaration by the generator and exporter that the information is correct:
19. Information transmitted (including technical description of the plant) to the exporter or generator from the importer of the waste upon which the latter has based his assessment that there was no reason to believe that the wastes will not be managed in an environmentally sound manner in accordance with the laws and regulations of the importing country:
B. Information to be provided on the movement document:
1. Exporter of the waste10 :
2. Generator (s) of the waste and site of generation10 :
3. Importer of the waste and actual site of disposal10 :
4. Carrier(s) of the waste or his agent(s):
5. Subject of general or single notification:
6. The date the Tran boundary movement started and date(s) and signature on receipt by each person who takes charge of the waste:
7. Means of transport (road, rail, inland waterway, sea, air) including countries of export transit and import, also point of entry and exit where these have been designated:
8. General description of the waste:
9. Information on special handling requirements including emergency provision in case of accidents:
10. Type and number of packages:
11. Quantity in weight/ volume:
12. Declaration by the exporter that the information is correct:
13. Declaration by the exporter indicating no objection from the competent authorities of all States concerned which are parties:
14. Certificate by importer of receipt at designated disposal facility and indication of method of disposal and of the approximate date of disposal:
