Republic of the Philippines

Department of Environment and Natural Resources

ENVIRONMENTAL MANAGEMENT BUREAU- Region ____
(Address of Regional Office)
Tel. No.:
E-mail:
Visit us at http://www.emb.gov.ph

HAZARDOUS WASTE MANIFEST SYSTEM

Hazardous Waste Generator’s Name:

DENR ID No.:
Generator’s Address:
Tel. No.:
Fax No:

PTT No.:
Manifest No.:

Waste Class and Waste Number

HW Number:
Quantity (MT):
Date of Transport:

HW Number:
Quantity (MT):
Date of Transport:

Packaging Information:

Special Handling Instructions:

Transport Type: Land Water

Land Transporter:
Water Transporter:
2nd Land Transporter:
Treater:

I hereby declare that the content are fully described above and are classified, packed, marked
and labeled and in all respect in proper condition to transport to approved TSD facility in
accordance with applicable national regulations.

Signed by Owner or Authorized Representative:

Signature over printed name:

Designation:
Date Signed:

HWM Manifest Form 2018

Transporter No. 1

Date of Transport:
Vehicle (Plate number and Type):
______________________________________________
___________________________________________________________________________
___________________________________________________________________________

Driver Name(s):
_____________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

Signed by Owner or Authorized Representative:

Signature over printed name:

Designation:
Date Signed:

Transporter No. 2

Date of Transport:
Vehicle (Plate number and Type):
______________________________________________
___________________________________________________________________________
___________________________________________________________________________

Driver Name(s):
_____________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

Signed by Owner or Authorized Representative:

Signature over printed name:

Designation:
Date Signed:

Generator: (Company Name)

Signature over printed name:

Designation:
Date Signed:

Transporter #1: (Company Name/DENR ID No.)

Signature over printed name:

Designation:
Date Waste Received:

Transporter #2: (Company Name/DENR ID No.)

HWM Manifest Form 2018

Signature over printed name:
Designation:
Date Waste Received:

TSD Premise/Operator: (Company Name/DENR ID No.)

Signature over printed name:

Designation:
Date Waste Received:

FOR DENR USE ONLY

HWM Manifest Form 2018