WASTE DISPOSAL FORM

Department: Date of Disposal:

Department Head: Signature:
Instruction:
1. This form shall be used by all departments of Metro Clark Waste Management Corporation generating
wastes specifically hazardous wastes and recyclables that will be stored in the company’s hazardous
wastes storage facility located in the site.
2. Kindly check the corresponding hazardous wastes and/or recyclables as well as the corresponding
quantity of the waste materials generated.
3. This form shall be accomplished with the signatory of the Department Head and submitted to the
Pollution Control Officer (PCO) for approval and documentation.
Note: *If the department head is not around, the supervisor may sign instead.
Check Actual Weight
(Kindly specify the
Waste Number Description Item unit of
measurement: kg,
pcs, L, or etc.)
D407 Mercury Containing Busted Bulbs, Fluorescent/LED Lights,
Wastes or Flash Lights
F601 Solvent Based Paints (solvent/water based), Dyes, or
Thinners
Latex
Adhesives
F603 Ink Formulation Inks and Cartridges
I101 Used or Waste oils Used Engine and/or Hydraulic Oils
J201 Containers (Containers previously containing toxic
chemical substances)

-Aerosols
-Pesticides
-Fire Extinguishers

-Paint Containers
-Drums
-others (Kindly specify.)

M501 Miscellaneous Medical or Healthcare Wastes

Wastes
M506 Electrical and Electronic Equipment
Wastes
M507 Special Wastes/Household Hazardous
Wastes:

-Batteries
-Broken Home Appliances
-Mechanical/ Engine Scraps
RECYCLABLES Wastes that can be -Papers
re-used, recycled, -Cartons
and reprocessed.
-Plastics
- Metal Scraps
OTHERS
(Kindly specify.)

Approved by:
MCWMC Pollution Control Officer
(Print name and Signature)
Revision No: 00