Attachment_16_-Certificate_of_Destruction_Sample.pdf
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- Attached to
- Hazardous Waste Disposal Services - Hessen and Rheinland-pfalz, Germany Federal contract opportunity
- Solicitation number
- SP4520-18-R-0004
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Attachment 16 - Certificate of Destruction
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Text version
Attachment 16
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: _______________________________________________________________
Solicitation SP4520-18-R-0004
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