Attachment_12_-_Certificate_of_Recycling.pdf
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SP4500-19-R-000X
Sagami HW
Attachment 12 Example of a Certificate of Recycling
CERTIFICATE OF RECYCLING
Contract Number:
Company Name:
EPA I.D. Number:
Delivery Order Number:
Date:
This document is to certify that (Company Name) has completed the recycling of your hazardous waste.
Under civil and criminal penalties of law for the making or submission of false or fraudulent statement or representations (18 U.S.C. 1001 and 15 U.S. C. 2615), I certify that the information contained in or accompanying this document is true, accurate, and complete.
I certify as the company official having supervisory responsibility for the persons who acting under my direct instruction made the verification that this information is true, accurate, and complete.
Company Officer’s Signature Date
Title
Generator:
CLIN:
Manifest Number(s):
Weight:
Approved by:
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