Hazardous Waste Form- RPR Environmental

It is important to properly dispose of hazardous waste to protect our environment. Our services will properly transport and dispose of any hazardous waste from your location.

Please fill out this form if you would like RPR to manage hazardous waste disposal.

Hazardous Waste Profile

Submit original profiles only. Submit typed or printed profile with analytical and a one (1) liter representative sample of waste.

Generator Details

Generator NameMOE Generator Registration No.Type of Industry / BusinessSite AddressMailing Address (If different)Contact NameEmailPhonePhone ExtFaxAlternative Contact NameEmailPhonePhone ExtFax

Customer Details (For Billing Purposes)

Customer details are the same as generator detailsCustomer NameMailing AddressContact NameEmailPhonePhone ExtFax

Waste Composition / Characterization / Proof of Classification

Common Name of the WasteCurrent MOE Class Code (If registered under reg. 347)LDR Primary Hazardous Waste NumberAdditional LDR Haz. Waste Number(s) (If applicable)TDGA Shipping NameUN #Primary Hazard ClassSubsidiary Hazard ClassPacking Group (I, II, III)Generating Process (Detailed descriptionWaste is

Composition of Waste

List all chemicals/compounds. Provide MSDS’s or analytical data if available.Check box if MSDS providedPlease Include % and Chemical/Compound. List As many as you need separated by rows

Physical Properties Of Waste (21°c)

Physical StatePhases/LayersLiquid %Sludge %Solid %Powder %ViscosityPumpablePourableColourpHSpecific GravityBTU/lbDescribe OdourOdourFlash Point & Boiling Point

Reactivity / Hazardous Characteristics

Is this waste any of the following?Other (please describe)Shipping InformationShipping Volume (per shipment)FrequencyContainer TypeDo you require replacement containers?What Types?Please upload related documentation for this waste stream (ie Sample, MSDS, Analysis, TCLP, LEP, Elements by Atomic Spectroscopy, PCB Analysts)Please check documentation included as attachments for this waste streamAnalysis (please specify)Other (please specify): Elements by Atomic Spectroscopy (Water), PCB Analysts

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Hazardous Waste Form