Waste Enquiry Form

Protective Marking: / NO MARKINGPROTECTRESTRICTEDCOMMERCIAL
LLWR Ref:
Introduction
The purpose of this form is for Customers to identify the scope and detailed service requirements they wish LLWR and its supply chain to provide. The information stipulated on this form will be used as the basis for returning a quotation for the required scope of work. It is therefore essential that this form is completed accurately and to a sufficient level of detail. Please contact the Customer Team on 01946770300 if you require assistance, Please return completed forms to
1. Customer Information
Company Name: / Customer Code:
Site Name:
Contact Name:
Contact E-mail Address:
Contact Telephone Number:
Contact Fax Number:
Customer Enquiry Reference:
Waste Services Contract Reference:
2. Pre-requisites
Please confirm that the following documents are in place and valid to support this Enquiry:
Environmental Permit/Authorisation / Waste Assurance Form Ref:
Waste Forecasting Form / Wastestream ID:
Other:
3. EnquiryInformation
Required Consignment Date:
Approximate Total Volume: / m3
Approximate Total Weight: / tonne
Enquiry Scope
(select all that apply) / Individual Items (i.e. a single large item or less than one container of waste)
Single Consignment (i.e. one container full of waste)
Project (i.e. a defined volume of various waste types from a single project)
Direct to Treatment Company (for treatment/onward disposal)
Building (i.e. routine arisings from a specific location on a site)
Single Wastestream (i.e. arisings of various waste types for a specific waste fingerprint)
Mixed Wastestreams (i.e. arisings of various waste types for multiple waste fingerprints)
Enquiry Duration
(select one) / One Off (i.e. this enquiry covers a defined volume of waste)
Single Year (i.e. this enquiry covers 12 months of waste arisings)
Multi Year (i.e. routine waste arisings over a number of years)
Service Required
(select all that apply) / Metallic Waste Treatment (including management of any Secondary Waste)
Combustible Waste Treatment (including disposal of any Secondary Waste)
Supercompactable Waste Treatment (including disposal of any Secondary Waste)
Very Low Level Waste Disposal
Low Level Waste Disposal
Transport / Please use e-Logistics or complete a Logistics Services Form (LSE)
Packaging
4. Waste Information
General Waste Description:(Provide a detailed description of the waste and complete the Waste Item Register and Radioactivity Table at the back of this Form. Where possible, please provide details of any relevant drawings or photographs of the waste included with this Form.)
Please confirm if any additional supporting information has been supplied: / Reference (additional files)
Drawings / Yes / No
Photographs / Yes / No
Other / Yes / No
Does the information within the Waste Characterisation Form (referenced in Section 2) suitably represent the waste described above: / Yes
No (Please state reason below)
5. Proposed Packaging
6. Further Information Please identify any constraints, risks, assumptions and key milestones associated with this enquiry

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Waste Enquiry Form

7. Customer Declaration
I declare that the information provided in this Form is accurate to the best of my knowledge and complete.
Name: / Position:
Signature: / Date:

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Waste Enquiry Form

Note. Electronic signatures may be used - Please send completed forms to

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Waste Enquiry Form

For LLWR use only

8. LLWR Requirements
Signature: / Date:
9. Service Provider Tender Submission
Service Providers are to use the information provided on this form to submit tenders via CTM.
NB. Any Technical Queries regarding the information stipulated on this form must be submitted to LLWR Ltd. at least 5 days prior to the proposal submission date.
Appendix 1:Radioactivity Information
Activity Infomation Table: (Refer to Notes below)
What form does the radioactivity take? (select all that apply) / Surface Contamination Activation
Can the Activity Information Table be completed? (see the table below) / Yes Partially No (to be developed)
Radionuclide / Activity (MBq)(1) / Radionuclide / Activity (MBq)(1)
Uranium nuclides / Uranium-232 / Specified non alpha emitting nuclides / Carbon-14
Uranium-233 / Cobalt-60
Uranium-234 / Iodine-129
Uranium-235 / Tritium
Uranium-236 / Group Total:
Uranium-238 / Other non alpha emitting nuclides of ½-life > 3 months plus Fe-55 / Plutonium-241
Uranium-
Group Total:
Ra-226 and
Th-232 / Radium-226
Thorium-232
Group Total:
Other alpha emitting nuclides of ½-life > 3 months / Thorium-228
Thorium-230
Protactinium-231
Neptunium-237
Plutonium-238
Plutonium-239
Plutonium-240
Plutonium-242
Americium-241
Americium-242m
Americium-243
Curium-243
Curium-244
Curium-245
Curium-246
Curium-247
Californium-249
Californium-250
Californium-251
Californium-252
Einsteinium-254
Group Total:
Other non alpha emitting nuclides of ½-life <3 months(2) / Protactinium-232
Group Total:
Other alpha emitting nuclides of ½-life < 3 months(2)
Group Total: / Group Total:
Total alpha activity:(3) / Total non alpha activity:(3)
Total alpha specific activity:(4) / Total non alpha specific activity:(4)
Notes:
(1)Values of activity should be quoted to not more than three decimal places.
(2)The activity of decay products with half lives of three months or less should only be included if they are present in amounts exceeding those which could be present through radioactive decay of the accounted radionuclides. Decay products are defined as those radionuclides succeeding another radionuclide in the radioactive series in which both, or all, occur.
(3)Total activity to include both short and long lived radionuclides.
(4)For Metallic, Combustible, Supercompactable and Very Low Level Waste Services: Specific Activity = Total Activity ÷ Weight of Waste
For Low Level Waste Service: Specific Activity = Total Activity ÷ Gross Weight of Consignment.

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Appendix 2: Waste Item Register (Refer to Notes below)
Item ID / Item Description / Quantity
(no.) / Weight (kg) / Length (mm) / Width (mm) / Height (mm) / External Diameter (mm) / Internal Diameter (mm) / Surface Dose Rate
(µSv/h) / Surface Contam.
(Bq/cm2)
γ/βγ
γ/βγ
γ/βγ
γ/βγ
γ/βγ
γ/βγ
γ/βγ
γ/βγ
γ/βγ
γ/βγ
γ/βγ
γ/βγ
γ/βγ
γ/βγ
γ/βγ
γ/βγ
γ/βγ
Notes:
(1)Complete the Waste Item Register as fully as possible. Enter “Not Applicable” where a field is not relevant. Enter “Not Known” if the information is not available at this time.
(2)For multiple similar items, enter a single description and detail the Quantity in the relevant field of the Register. Please provide the weight of an individual item in the Weight Field.
(3)Surface dose rates should be stated for pre-wrapped or pre-processed monitoring and the reading identified as either gamma (γ) or beta/gamma (β/γ).
(4)Where there is insufficient space to detail all the items in this Waste Enquiry, please use theWaste Item Register Continuation Sheet that can be found on our website:

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