INSTRUCTIONS FOR COMPLETING THE PCB WASTE NOTICE FORM

  1. Exporter : Indicate the name and address of the Canadian exporter. Provide the shipping address and, where applicable, the provincial exporter number

  2. Foreign Receiver (authorized facility: Indicate the name and address of the foreign receiver. Provide the receiving site address, the TSCA permit and, where applicable, the national operating licence or permit number.

  3. Carrier : Indicate the name, address, applicable licence or permit number, telephone number, fax number and mode of transport of the carrier of the PCB waste It more than one carrier is involved, for each additional carrier, provide the information on an attached list with the reference number of this notice

  4. Final Destination for PCB-D4 : Indicate the TSCA permit and the final destination where the disposal type PCB-D4 as set out in Schedule lll to the PCB Waste Export Regulations, 1996 (PCBWER) will take place after PCB-D-3 is completed.

  5. Number of Exports: If you are proposing under this notice, more than one export of PCB waste that meet the conditions set out in the Regulations, indicate the number of exports that are to occur within a 12-month period.

  6. Customs Offices : Specify all customs offices through which the PCB wastes are to be shipped. Attach a separate page, if necessary, quoting the reference number of this notice.

  7. First Export : Provide the dates of departure and arrival for the first export of a series, or for the only export.

  8. Countries of Transit : Identify any countries that the PCB Wastes will pass through before reaching their destination, and the amount of time that the PCB wastes will remain in each country. Attach a separate page, if necessary, quoting the reference number of this notice.

  9. PCB Waste Information : Provide the following for each of your PCB wastes:

    (a) the International Waste Identification code pursuant to Council Decision C(84)90 of the Organization of Economic Cooperation and Development. Use the identification number of the disposal operation code described in Schedule lll of the PCB Waste Export Regulations, 1996;

    (b) the identification number set out in Schedule ll to the PCB Waste Export Regulations, 1996;

    (c) the Product Identification Number (PIN) set out in List ll of Schedule ll to the Transportation of Dangerous Goods Regulations (TDGR);

    (d) the primary class set out in Part lll of TDGR or List ll of Schedule ll to TDG R ;

    (e) the total quantity of each waste to be shipped (specify kg or L);

    (f) the packing group set out in Part lll of TDGR or List ll of Schedule ll to TDGR; and (g) the packaging type, using one of the following codes: 01 Drum, 02 Tank, 03 Bulk, 04 Carton, 05 Bag, 06 Roll-off or Lugger, 07 Other

    IMPORTANT: If you are planning to export more than three wastes, you must complete another notice. Additional notices are available from the Regional Offices of the Department of the Environment listed below.

  10. Special Handling Instructions : Provide any special handling instructions in case of an emergency. Attach a separate page, if necessary, quoting the reference number of this notice.

  11. Undertaking of Exporter : If you are an exporter, sign the undertaking set out in this notice. For further details concerning the undertaking, refer to section 11 of the PCBWER.

  12. Certification of exporter : Print your name in capital letters and affix your signature. In the case of a corporation, the name and signature must be those of an individual who is authorized to act on behalf of the corporation. After completing this form, send it and all attachments to:
Chief, Transboundary Movement Division
Hazardous Waste Branch
Department of the Environment
Place Vincent Massey,12th Floor
351 St. Joseph Blvd.
Hull, Quebec K1 A OH3
Fax: (819) 953-0504

Department of the Environment Regional Offices
Atlantic: (902) 426-6141 (Nfld., N.S., N.B., P.E.I.)
Quebec: (514) 283-0248
Ontario: (416) 739-5865
Prairie and Northern: (403) 468-4020 (Man., Sask., Alta., N.W.T.)
Pacific and Yukon: (604) 666-6711 (B.C. and Yukon)