Registration Form For Hw Generator
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4DENR Hazardous Waste Registration
Form A : Registration form for HW Generator
Section A1. General Information of Generator
1. DENR ID:
*1
2. Date of issued (D/M/Y):
/
/
*1
3. Name of Firm:
4. Plant Address:
5. Date of Establishment:
6. Tel:
7. Fax:
8. Office Address:
9. Tel:
10. Fax:
10. Pollution Control Officer:
11. Tel:
12. Fax:
13. e-mail:
14. General Description of
Business/Operation
Philippine Standard Industrial Classifications
15. Primary:
16. Secondary:
16. Major Products:
1.
4.
2.
5.
3.
6.
17. Authorized Capitalization (Pesos/year)
18. Paid-up Capitalization (Pesos/year)
19. Approximate Annual Turn -over (Pesos/year)
20. Total No. of Employees:
21. Admi. Employees:
22. Plant Employees:
Please append the following:
¨
(1) Process flow diagram all waste streams
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(2) Mass balance of manufacturing process
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(3) Description of existing waste management plan
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(4) Analysis of waste(s)
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(5) Other relevant information e.g. planned changes in production processes or output, comparison
with related operations.
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(6) Copy of Environmental Compliance Certificate (ECC)
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(7) Copy of Valid Permits to Operate Pollution Control Facilities
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(8) If on-site treatment is present, submit the A4 form for every TSD facility.
I certify that the enclosed information is a true and accurate record as available.
Pollution Control Officer:
Signature:
Date (D/M/Y):
/
/
*1: to be filled up by EMB
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