Hazardous Wastes (Management and Handling) Rules, 1989

FORM 4: FORMAT FOR SUBMISSION OF RETURNS REGARDING DISPOSAL OF HAZARDOUS WASTE

[Rule 9(2)]

(To be submitted to the ²[State Pollution Control Board or Committee])

1. Name and address of the institution

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2. Details of waste disposal operation:

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Sl . No.	Date of issuance of authorization for the disposal of hazardous waste and its reference number	Description of hazardous waste			Mode of transportation to the site of disposal	Site of disposal (Attach a sketch showing the location (s) of disposal	Brief description of the method of disposal )	Date of disposal	Remarks (if any)
		Physical form and contents	Chemical form	Total volume of the hazardous waste disposed of with No. of packages

3. Details of environmental surveillance:

Date of measurement	Analysis of ground water			Analysis of soil samples			Analysis of air sampling		Analysis of any other samples (give details)
	Location of sampling	Depth of sampling	Date	Location of sampling	Depth of sampling	Date	Location of sampling	Date

Name and signature of the head of the facility