Form Amsa 250 - Multimodal Dangerous Goods Form Page 3

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MULTIMODAL DANGEROUS GOODS FORM
Page 3 of 3
DOCUMENTARY ASPECTS OF THE INTERNATIONAL TRANSPORT OF DANGEROUS GOODS
Note 1:
Description of Dangerous Goods: This information is provided as a guidance only, persons should refer to Chapter 5.4 of the Code
for specific requirements. The basic items of information necessary, in addition to the number and kind of packages, and the total
quantity (by volume or mass and, in the case of goods of Class 1, by the net explosive mass of the contents), in the description of
each dangerous substance, material or article offered for shipment are:
– the letters „UN‟ followed by the UN number shown for the goods in the IMDG Code;
– the proper shipping name;
– the class or, when assigned, the division of the goods, including the compatibility group letter for class 1. Any assigned
subsidiary hazard class or division number(s) shall be entered following the numerical class hazard or division and shall be
enclosed in parenthesis. The words “Class” or “Division” may be included preceding the primary or subsidiary hazard class or
division numbers;
– where assigned, the packing group for the substance or article which may be preceded by “PG” (e.g. “PG II”)
The dangerous goods description shall be shown in either the sequence above, which is the preferred sequence, or alternatively in
the sequence of proper shipping name, Class or Division, UN number and packing group. No information shall be interspersed,
except as provided for in the Code. Unless permitted or required by the Code additional information shall be placed after the
dangerous goods description. (see 5.4.1.4.2 of the Code)
The proper shipping name may be supplemented by:
– the words “EMPTY UNCLEANED” or “RESIDUE – LAST CONTAINED” before or after the proper shipping name for empty
packagings, including portable containers or bulk packagings, which contain the residues of dangerous goods, or the word
“WASTE” before the proper shipping name for waste dangerous goods (other than radioactive materials) being transported for
disposal or processing for disposal. Where salvage packaging has been used, the words “SALVAGE PACKAGING” shall be
included in the description of the goods;
– technical names for “n.o.s” and other generic descriptions. Proper shipping names that are assigned special provision 274 shall
be supplemented with their technical or chemical group names. If the goods to be transported are marine pollutants the goods
shall be identified as “Marine Pollutant”. (see 3.1.2.8 of the Code);
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– if applicable, the minimum flashpoint, if 61
C or below (in
C closed cup (c.c.));
– where applicable, dangerous goods being transported according to the exceptions for dangerous goods packed in limited
quantities, the words “limited quantity” or “LTD QTY” shall be included.
Examples of dangerous goods descriptions are provided at 5.4.1.4.4 of the Code
Extra information is needed for certain goods of Class 1, 4.1, 5.2, 6.2, 7. See 5.4.1 of the Code.
In certain circumstances special certificates are required. See 5.4.4 of the Code
Transport documents associated with the carriage of cargo transport units under fumigation must show the date of fumigation and
the type and amount of fumigant used, and give instructions for the disposal of residual fumigant, including fumigation devices, if
used. See 5.5.2 of the Code.
Note 2: Container/Vehicle Packing Certificate
The signature given overleaf in Box 20 must be that of the person controlling the container/vehicle operation, who certifies that:
– The container/vehicle was clean, dry and apparently fit to receive the goods.
– If the consignments include goods of Class 1, other than division 1.4, the container is structurally serviceable in conformity with
7.4.6. of the IMDG Code.
– No incompatible goods have been packed into the container/vehicle unless specially authorized by the Competent Authority.
– All packages have been externally inspected for damage and only sound packages packed.
– Drums have been stowed in an upright position, unless otherwise authorized by the Competent Authority.
– All packages have been properly packed and secured in the container/vehicle.
– When materials are transported in bulk packagings the cargo has been evenly distributed in the container/vehicle.
– The packages and the container/vehicle have been properly marked, labelled and placarded. Any irrelevant mark, labels and
placards have been removed.
– When solid Carbon Dioxide (CO2 - dry ice) is used for cooling purposes, the vehicle or freight container is externally marked or
labelled in a conspicuous place, e.g. at the door end, with the words: DANGEROUS CO2 GAS (DRY ICE) INSIDE -
VENTILATE THOROUGHLY BEFORE ENTERING.
– A dangerous goods transport document, as indicated in 5.4.1 of the Code, has been received for each dangerous goods
consignment loaded in the container/vehicle.
In accordance with Commonwealth Government policy, businesses employing fewer than 20 people are invited to provide information
on the time spent completing forms. If this applies to you, please indicate the time spent completing this form: ……………..mins
AMSA 250 (11/03)

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