Attachment_4b_-_Transporter_Profile_Sheet _Amendment_1.pdf

TRANSPORTER PROFILE SHEET

1. Transporter Name:________________________________________________________________

2. Address:

3. Telephone Number: __________________________ FAX:___________________________

4. Company Representative(s): __________________________________________________________

Telephone Number : _________________________________ EMAIL: _________________________

5. Principal Owner(s): __________________________________________________________

6. DRMS Transporter BOSS ID # _____________________ (Provide # if transporter has previously been approved by DRMS)

7. For all of the permits, authorizations, and licenses that authorize the transportation of hazardous waste the following information is required: the permitting authority’s name and address; the permit number, the permit expiration date; countries where transportation is authorized and wastes authorized by the permit using the European Waste Codes (EWCs).

Permiting Authority Permit Number Expiration Countries EWCs

8. Identify the waste, by CLIN, for each waste that will be transported.

Transported Waste (CLIN)

Solicitation SP4520-13-R-0020, Attachment 4b