SIXTH SCHEDULE

(Regulation 12)
ENVIRONMENTAL QUALITY ACT 1974
ENVIRONMENTAL QUALITY (SCHEDULED WASTES)
REGULATIONS 2005
CONSIGNMENT NOTE FOR SCHEDULED WASTES
I WASTE GENERATOR

For office use only

Fail Reference No:
Waste Generator Code:
State Code:

Name of Waste Generator: Ethylene Malaysia Sdn Bhd (Kertih Terengganu)

Address: Lot 3834, Kawasan Bukit Tengah, Km 105, Jalan Kuantan-Kuala Terengganu,
24300 Kertih, Kemaman, Terengganu, Malaysia

Name of Responsible Person: Abd Manaf Abd Hamid

Tel. No: 09 8272 040

Fax. No: 09 8273 940

Name of Waste: Ethylene glycol

Telex No: ....

Waste Category Code: SW327

Waste Component: Ethylene glycol

Waste Origin: heat exchanger

Waste Origin Code: M130

Type of Waste:
Solid
Waste
Packaging:

Sludge

Pallet
Container

Canister

Liquid
55 gallon
Drum

Other (Specify)
27

Quantity: 2 0

And If
Possible
3

Tonnes
Cost of Treatment and Disposal RM 1800/Metric Tonne
Name and Address of Final Destination:

PETRONAS CHEMICALS DERIVATIVES SDN. BHD. (OPTIMAL CHEMICALS (M) SB) : KM

106 JALAN KUALA TERENGGANU-KUANTAN, KAWASAN PERINDUSTRIAN KERTEH,
24300 KERTEH 24300

Delivery Date: 16 October 2016

Signature of Responsible Person:

Arshad

Delivery Time: 6.30 pm

II CONTRACTOR

For office use only

Contractor Code:

State Code:

Name of Contractor: PETRONAS CHEMICALS DERIVATIVES SDN. BHD. (OPTIMAL

CHEMICALS (M) SB)

Address: KM 106 JALAN KUALA TERENGGANU-KUANTAN, KAWASAN PERINDUSTRIAN

KERTEH, 24300 KERTEH 24300
Name of Responsible Person: Muhammad bin Abu
Tel. No: 0134234455

Fax. No: 09 8273 887

Telex

No:

Vehicle Registration No:

TWK 2190
Name of Driver: Samsul bin abu

Temporary
Storage:

No

/ Yes, Address: Km 16, Kampung Salak, 24300 Kerteh Terengganu

Date Received: 18 October 2016

Signature of Driver:

Samsul

Time Received : 2.45 pm

28

III STORAGE/TREATMENT/
RECOVERY/DISPOSAL/
FACILITY OPERATOR

For office use only

Facility Code:

State Code:
Name of Facility: EASTMAN CHEMICAL MALAYSIA SDN.BHD
Address of Facility: LOT 118 & 119, JALAN GEBENG 2/4 KAWASAN PERINDUSTRIAN
GEBENG 26080

Name of Responsible Person: En Azli bin Muhari (General Manager)

Tel. No: 09-5839696

Fax. No: 609 583 8600

Telex No: 09-5838605

Type of Operation:
Storage

Regrouping

Physical/Chemical Treatment
Quantity of Waste
Received:

2 0

Landfill

/ Incinerator

Secure Landfill

Others (specify) .
.

and If Possible

Tonnes

Date Received: 19 October 2015

Time Received: 11.00 am

Recovery

Signature:

Azli