Att_13_Certificate_of_Destruction_Sample.pdf

PDF 142 KB Posted

Attached to
Hazardous Waste Disposal Services - Qatar
Solicitation number
SP4520-17-R-0003
Issued by

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Attachment 13 - Sample Certificate of Destruction

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Text version

Attachment 13

Certificate of Destruction

Date:

From: Received by:

Date:

This is to certify that the waste identified on Shipping Document: ______________ ,Manifest # ____________

Line# ____________ was received by _________________________ on this Date:

The waste(s) were subsequently disposed of by the process bearing this Disposal or Recovery code __________ on this

Date: ______________ in accordance with all permits and laws regulating this process.

Reference number: Delivery Order XXXX, Line Item(s): XX –XX.

Material:

Number of containers:

Type of container:

Address of the Facility Disposing of the Waste:

Certifying Official Printed Name: ________________________________________________

Signature: ______________________________________________________________

Verifying Official Printed Name: _________________________________________________

Signature: _______________________________________________________________

File details come from the government source that posted it. Updated .