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