Attachment III

WASTE MANIFEST
Refer to GI 0430.001

Waste Originator:

P
I confirm that ________________________ (quantity) of __________________________________(type of waste; such
A
R as oily sludge, oily water, contaminated product,…) was loaded on _______________________________(date & time)
T from ___________________________________(originating location and DPC) and will be transported to
__________________________________ (location) as approved by EED or HMA.
1
_____________________________________________________________________________________
Name, ID No., Signature & Tel. No. of Saudi Aramco W aste Originator Representative

Waste Transporter:
P Contract No:
A
R I shall transport the aforementioned waste to __________________________________________ (location and DPC).
T

2 ____________________________________________
Name and Tel. No. of Company Transporting Waste
__________________________________________________
Name, ID/Iqamah No. and Signature of Driver
____________________________
Vehicle Plate No.

Waste Receiver:
Contract No:
P
A I confirm receipt of the stated waste____________________(quantity) on_____________________ (date & time) at the
R
T above location and will dispose of/treat the waste as approved by EED. Method of disposal/treatment is

3 _____________________________ (e.g., Landfarm, TEL weathering, Incineration, Class I Landfill, etc.)

__________________________________________________________________
Name, ID/Iqamah No. and Signature of Receiver

Notes:

1. For further assistance, please contact the General Supervisor of the Environmental Engineering Division (EED) at 874-6426, Fax 873-9331.
2. The W aste Originator shall fill in Part 1 of this form, retain one copy (yellow) for reference and follow up, and fax a copy to the General
Supervisor, EED and to the W aste Receiver.
3. The W aste Transporter shall complete Part 2 and deliver the original and the remaining 3 copies to the W aste Receiver.
4. W aste Receiver shall complete part 3 of this form; retain one copy (blue) and distribute the remaining copies as follows:
Original (white) to Waste Originator
nd
2 copy (pink) to General Supervisor, Environmental Engineering Division, E-2670, Dhahran
rd
3 copy (green) to W aste Transporter
5. If the signed original has not been received within 2 weeks, the W aste Originator shall contact the W aste Receiver and/or Waste
Transporter to determine the fate of the waste.