Notification document for transboundary movements/shipments of waste

1. Exporter - notifier
Registration No:
Name:
Addres
s:
Contact
person:
Tel:

Fax:

E-mail:
2. Importer - consignee
Registration No:
Name:
Addres
s:

3.
Notification
No:
Notification
concerning
Individual
Multiple
A.(i)
(ii)
shipment:
shipments:
B.(i) Disposal (1):
(ii) Recovery :
Pre-consented recovery facility
C.
Yes
(2;3)
4. Total intended number of
shipments:

No

5. Total intended quantity (4):

Tonnes (Mg):
m3:
6. Intended period of time for shipment(s) (4):
First departure:

Contact
person:
Tel:

Fax:

E-mail:
8. Intended carrier(s)
Registration No:
Name(
7):
Addres
s:
Contact
person:
Tel:
Fax:
E-mail:
Means of
transport (5):
9. Waste generator(s) - producer(s)
(1;7;8) Registration No:
Nam
e:
Addres
s:

7. Packaging type(s)
(5):
Special handling
requirements (6):
11. Disposal / recovery
operation(s) (2)
D-code / R-code
(5):
Technology
employed (6):

Last
departure:

Yes:

No:

Reason for export

(1;6):
12. Designation and composition of the waste (6):

13. Physical
characteristics (5):
Contact
person:
Tel:

Fax:

E-mail:
Site and process of
generation (6)
10. Disposal
facility (2):
Registration
No:

or recovery facility
(2):

Name:
Address:
Contact
person:
Tel:
E-mail:

14. Waste identification (fill in relevant codes)

(i) Basel Annex VIII (or IX if
applicable):
(ii) OECD code (if different
from (i)):
(iii) EC list of
wastes:
(iv) National code in country
of export:
(v) National code in country
of import:
(vi) Other
(specify):
(vii) Y-code:
(viii) H-code (5):
(ix) UN class (5):

Fax:

(x) UN Number:
(xi) UN Shipping
name:

Actual site of
(xii) Customs code(s)
disposal/recovery:
(HS):
15. (a) Countries/States concerned, (b) Code no. of competent authorities where applicable, (c) Specific points of
exit or entry (border crossing or port)
State of export State of import State(s) of transit (entry and exit)
dispatch
destination
(a)
(b)
(c)
16.Customs offices of entry and/or exit and/or export (European Community):
Entr
Exit
Expo
y:
:
rt:
17. Exporter's - notifier's / generator's - producer's (1) declaration:
I certify that the information is complete and correct to my best knowledge. I also certify that legally enforceable written
contractual obligations have been

entered into and that any applicable insurance or other financial guarantee is or shall be in force 18. Number
covering the transboundary movement.
of
Exporter's - notifier's
annexes
Date:
Signature:
name:
attached
Generator's - producer's
Date:
Signature:
name:
FOR USE BY COMPETENT AUTHORITIES
19. Acknowledgement from the relevant competent 20. Written consent (1;8) to the movement provided
authority of
by the
countries of import - destination / transit (1) /
competent authority of
export - dispatch (9):
(country):
Consent given
Country:
on:
Notification received
Consent valid
until:
on:
from:
Acknowledgement sent
Specific
If Yes, see block 21
No:
on:
conditions:
(6):

Name of competent
Name of competent
authority:
authority:
Stamp and/or
Stamp and/or
signature:
signature:

21. Specific conditions on consenting to the movement document or reasons for objecting
(1) Required by the Basel Convention
(2) In the case of an R12/R13 or D13-D15 operation, also attach corresponding information on
any subsequent
R12/R13 or D13-D15 facilities and on the subsequent R1-R11 or D1-D12 facilit(y)ies when
required
(3) To be completed for movements within the OECD area and only if B(ii) applies
(4) Attach detailed list if multiple shipments

(5) See list of abbreviations and codes on the next page

(7) Attach list if more than one
(8) If required by national legislation
(9) If applicable under the OECD Decision

List of abbreviations and codes used in the notification document

DISPOSAL OPERATIONS (block 11)
D1
D2
D3
D4
D5
D6
D7
D8
D9
D10
D11
D12
D13
D14
D15

Deposit into or onto land, (e.g., landfill, etc.)

Land treatment, (e.g., biodegradation of liquid or sludgy discards in soils, etc.)
Deep injection, (e.g., injection of pumpable discards into wells, salt domes or naturally occurring
repositories, etc.)
Surface impoundment, (e.g., placement of liquid or sludge discards into pits, ponds or lagoons, etc.)
Specially engineered landfill, (e.g., placement into lined discrete cells which are capped and isolated
from one another and the environment, etc.)
Release into a water body except seas/oceans
Release into seas/oceans including sea-bed insertion
Biological treatment not specified elsewhere in this list which results in final compounds or mixtures
which are discarded by means of any of the operations in this list
Physico-chemical treatment not specified elsewhere in this list which results in final compounds or
mixtures which are discarded by means of any of the operations in this list (e.g., evaporation, drying,
calcination, etc.)
Incineration on land
Incineration at sea
Permanent storage, (e.g., emplacement of containers in a mine, etc.)
Blending or mixing prior to submission to any of the operations in this list
Repackaging prior to submission to any of the operations in this list
Storage pending any of the operations in this list

RECOVERY OPERATIONS (block 11)

R1
R2
R3
R4
R5
R6
R7
R8
R9
R10
R11
R12
R13

Use as a fuel (other than in direct incineration) or other means to generate energy (Basel/OECD) - Use
principally as a fuel or other means to generate energy (EU)
Solvent reclamation/regeneration
Recycling/reclamation of organic substances which are not used as solvents
Recycling/reclamation of metals and metal compounds
Recycling/reclamation of other inorganic materials
Regeneration of acids or bases
Recovery of components used for pollution abatement
Recovery of components from catalysts
Used oil re-refining or other reuses of previously used oil
Land treatment resulting in benefit to agriculture or ecological improvement
Uses of residual materials obtained from any of the operations numbered R1-R10
Exchange of wastes for submission to any of the operations numbered R1-R11
Accumulation of material intended for any operation in this list.

PACKAGING TYPES (block 7)

1.
2.
3.
4.
5.
6.
7.
8.
9.

Drum
Wooden barrel
Jerrican
Box
Bag
Composite packaging
Pressure receptacle
Bulk
Other (specify)

MEANS OF TRANSPORT (block

8)
R = Road
T = Train/rail
S = Sea
A = Air
W = Inland waterways

H-CODE AND UN CLASS (block 14)

UN Class

H-code
Characteristics

1
3
4.1
4.2

H1
H3
H4.1
H4.2

4.3

H4.3

5.1
5.2
6.1
6.2
8
9

H5.1
H5.2
H6.1
H6.2
H8
H10

Explosive
Flammable liquids
Flammable solids
Substances or wastes liable to spontaneous
combustion
Substances or wastes which, in contact with
water, emit flammable gases
Oxidizing
Organic peroxides
Poisonous (acute)
Infectious substances
Corrosives
Liberation of toxic gases in contact with air or
water

PHYSICAL CHARACTERISTICS
(block 13)
1.
2.
3.
4.
5.
6.
7.

Powdery/powder
Solid
Viscous/paste
Sludgy
Liquid
Gaseous
Other (specify)

9
9
9

H11
H12
H13

Toxic (delayed or chronic)

Ecotoxic
Capable, by any means, after disposal of yielding
another material, e. g., leachate, which
possesses any of the characteristics listed above

Further information, in particular related to waste identification (block 14), i.e. on Basel Annexes VIII and IX
codes, OECD codes and Y-codes, can be found in a Guidance/Instruction Manual available from the OECD and
the Secretariat of the Basel Convention.

Movement document for transboundary movements/shipments of waste

2. Serial/total number of
shipments:
4. Importer - consignee
Registration No:
Nam
e:

1. Corresponding to
notification No:
3. Exporter - notifier
Registration No:
Name:
Address:

Addres
s:

Contact
person:
Tel:
Email:
5. Actual
quantity:
7. Packaging

Contact
person:
Tel:
Email:
6. Actual date of
shipment:

Fax:
Tonnes
(Mg):
Type(s) (1):

m3:

Fax:

Number of
packages:

Special handling
requirements: (2)
8.(a) 1st Carrier (3):
Registration
No:
Name:
Address:
Tel:
Fax:
E-mail:

Yes:

No:

8.(b) 2nd Carrier:

Registration
No:
Name:
Address:

8.(c) Last Carrier:

Registration
No:
Name:
Address
:

Tel:
Fax:
E-mail:
- - - - - - - To be completed by carriers representative - - - - -

Tel:
Fax:
E-mail:
--

More than 3
carriers (2)
Means of transport
Means of transport
Means of transport
(1):
(1):
(1):
Date of transfer:
Date of
Date of
transfer:
transfer:
Signature:
Signature:
Signature
:
9. Waste generator(s) - producer(s) (4;5;6):
12. Designation and composition of the waste (2):
Registration
No:
Name:
Address:
Contact
person:
Tel:
E-mail:
Site of generation
(2):
10. Disposal
facility
Registration No:

13.Physical characteristics
(1):
Fax:

or recovery
facility

Name:
Address:

Contact person:
Tel:

Fax:

E-mail:
Actual site of disposal/recovery
(2)
11. Disposal/recovery operation(s)

14.Waste identification (fill in relevant codes)

(i) Basel Annex VIII (or IX if
applicable):
(ii) OECD code (if different from
(i)):
(iii) EC list of
wastes:
(iv) National code in country of
export:
(v) National code in country of
import:
(vi) Other
(specify):
(vii) Y-code:
(viii) H-code
(1):
(ix) UN class
(1):
(x) UN
Number:
(xi) UN Shipping
name:

D-code / R-code
(xii) Customs code(s)
(1):
(HS):
15. Exporter's - notifier's / generator's - producer's (4) declaration:
I certify that the above information is complete and correct to my best knowledge. I also certify that legally
enforceable written contractual obligations have been entered into, that any applicable insurance or other financial
guarantee is in force covering the transboundary movement and that all necessary consents have been received from
the competent authorities of the countries concerned.
Name:
Date:
Signature:
16. For use by any person involved in the transboundary movement in case additional information is
required
17. Shipment received by importer - consignee
(if not facility):
TO BE COMPLETED BY
18. Shipment received at disposal facility

Date of reception:
Accepted
:
Quantity
Tonnes
m3:
received:
(Mg):
Approximate date of disposal/recovery:
Disposal/recovery operation (1):
Name:
Date:
Signature:

Date:

Signature:

DISPOSAL / RECOVERY FACILITY

or recovery
19. I certify that the
facility
disposal/recovery of the

Rejected*:
waste described above has

been completed.
*immediately
Name:
contact
competent
authorities
Date:
Signature and stamp:

(1) See list of abbreviations and codes on the next page

(2) Attach details if necessary
(3) If more than 3 carriers, attach information as required in blocks 8 (a,b,c).

Name:

(4) Required by the Basel

Convention
(5) Attach list if more than one
(6) If required by national
legislation

FOR USE BY CUSTOMS OFFICES (if required by national legislation)

20. Country of export - dispatch or customs office
of exit
The waste described in this movement document left the

21. Country of import - destination or customs

country on:
Signatur
e:
Stamp:

office of entry
The waste described in this movement document
entered the
country on:
Signatur
e:
Stamp:

22. Stamps of customs offices of transit countries

Name of country:
Entry:
Exit:

Name of country:
Entry:

Exit:

Name of country:
Entry:

Name of country:
Entry:

Exit:

Exit:

List of Abbreviations and Codes Used in the Movement Document

DISPOSAL OPERATIONS (block 11)

RECOVERY OPERATIONS (block 11)

D1 Deposit into or onto land, (e.g., landfill, etc.)

D2 Land treatment, (e.g. biodegradation of liquid or sludgy discards
in soils, etc.)
D3 Deep injection, (e.g., injection of pumpable discards into wells,
salt domes or
naturally occurring repositories, etc.)
D4 Surface impoundment, (e.g., placement of liquid or sludge
discards into pits,
ponds or lagoons, etc.)
D5 Specially engineered landfill, (e.g., placement into lined discrete
cells which
are capped and isolated from one another and the
environment), etc.
D6 Release into a water body except seas/oceans
D7 Release into seas/oceans including sea-bed insertion
D8 Biological treatment not specified elsewhere in this list which
results
in final compounds or mixtures which are discarded by means of
any of the
operations in this list
D9 Physico-chemical treatment not specified elsewhere in this list
which results in
final compounds or mixtures which are discarded by means of
any of the operations
in this list (e.g., evaporation, drying, calcination, etc.)
D10 Incineration on land
D11 Incineration at sea
D12 Permanent storage, (e.g., emplacement of containers in a mine,
etc.)
D13 Blending or mixing prior to submission to any of the operations
in this list
D14 Repackaging prior to submission to any of the operations in this
list
D15 Storage pending any of the operations in this list

R1

R2
R3
R4
R5
R6
R7
R8
R9
R10
R11
R12
R13

Use as a fuel (other than in direct

incineration) or other means to generate
energy (Basel/OECD) - Use principally as
a fuel or other means to generate energy
(EU)
Solvent reclamation/regeneration
Recycling/reclamation of organic
substances which are not used as
solvents
Recycling/reclamation of metals and
metal compounds
Recycling/reclamation of other inorganic
materials
Regeneration of acids or bases
Recovery of components used for
pollution abatement
Recovery of components from catalysts
Used oil re-refining or other reuses of
previously used oil
Land treatment resulting in benefit to
agriculture or ecological improvement
Uses of residual materials obtained from
any of the operations numbered R1-R10
Exchange of wastes for submission to any
of the operations numbered R1-R11
Accumulation of material intended for
any operation in this list

PACKAGING TYPES (block 7)

H-CODE AND UN CLASS (block 14)

1.
2.
3.
4.
5.
6.
7.
8.
9.

UN class H-code Characteristics

Drum
Wooden barrel
Jerrican
Box
Bag
Composite packaging
Pressure receptacle
Bulk
Other (specify)

MEANS OF TRANSPORT (block 8)

R = Road
T = Train/rail
waterways
S = Sea

A = Air
W = Inland

PHYSICAL CHARACTERISTICS (block

13)
1. Powdery / powder 5.
2. Solid
6.
3. Viscous / paste
7.
(specify)
4. Sludgy

Liquid
Gaseous
Other

1
3
4.1
4.2

H1
H3
H4.1
H4.2

4.3

H4.3

5.1
5.2
6.1
6.2
8
9
9
9
9

H5.1
H5.2
H6.1
H6.2
H8
H10
H11
H12
H13

Explosive
Flammable liquids
Flammable solids
Substances or wastes liable to spontaneous
combustion
Substances or wastes which, in contact with water,
emit flammable gases
Oxidizing
Organic peroxides
Poisonous (acute)
Infectious substances
Corrosives
Liberation of toxic gases in contact with air or water
Toxic (delayed or chronic)
Ecotoxic
Capable, by any means, after disposal of yielding
another material, e. g.,
leachate, which possesses any of the characteristics
listed above

Further information, in particular related to waste identification (block 14), i.e. on Basel Annexes VIII
and IX codes, OECD codes and Y-codes, can be found in a Guidance/Instruction Manual available from
the OECD and the Secretariat of the Basel Convention.