Waste Consignment Information Form

LLW Disposal and Supercompaction

Protective Marking: / NO MARKINGPROTECTRESTRICTEDCOMMERCIAL
LLWR Reference:
Version:
Introduction
This form is to be completed by Customers wishing to consign waste using LLW Repository Ltd’s Waste Treatment and / or Disposal Services through their existing Waste Services Contract. The information provided by the Customer will be used to establish if the consignment can be approved and meets the requirements of the relevant Waste Acceptance Criteria. The information provided will also provide the lifetime record of the consignment for inventory purposes.
Please answer each question as fully as possible. If there are insufficient lines in any of the tables, please enter details on a separate sheet and indicate on the appropriate table that you have done so.
If you need any assistance or have any questions regarding the completion of this form, please contact the Customer Team, by e-mail: or by telephone: (019467) 70300
Please return the completed form, at least 5 working days prior to the proposed delivery date, using one of the following routes (e-mail is the preferred option):
·  by e-mail to:
·  by post to: Customer Team, Pelham House, Pelham Drive, Calderbridge, Seascale, Cumbria, CA20 1DB
Following receipt of this form, LLW Repository Ltd will respond within 5 working days.
PLEASE NOTE: the final approved WCI must be sent with the Waste Consignment to the relevant Treatment or Disposal Facility.
1. Customer Information
Company Name:
Waste Services Contract Reference:
Site Name:
Customer Code:
Contact Name:
Contact E-mail Address:
Contact Telephone Number:
2. Consignment Information
Customer Consignment Reference:
Anticipated Volume:
Container Type and Serial Number: / /
Date Container Last Sealed:
Maximum Contact Surface Dose Rate: / µSv/h
Gross Weight of Consignment: / kg
Weight of Waste:
Weight of Waste: / kg
Gross Volume of Consignment: / m3
Weight of Waste:
Volume of Waste: / m3
Service Required: / Supercompactable Waste Treatment (including disposal of any Secondary Waste)
(select one) / Low Level Waste Disposal
Direct to Treatment Company (for treatment/onward disposal)
Waste Services Quotations:
Please state the relevant Waste Services Quotation References for all waste included within this Waste Consignment:
I confirm that this WCI aligns with the above referenced WSQ’s:
Purchase Order Number applicable to Waste Consignment:
3. Waste Information
Waste Description:
Description of Waste: (Provide a detailed description of the waste and complete the Waste Item Register at the back of this Form)
Does the consignment contain any waste that could be diverted/treated? / Yes No / Approximate % of treatable waste
If yes, please provide an explanation or reference to a justification (BAT Case):
Hazardous Waste:
Does the Consignment contain any of the following Hazardous Wastes?
Asbestos: / Yes No / Waste Form: / Volume: m3
Lead: / Yes No / Waste Form: / Surface Area: m2
Mercury: / Yes No / Waste Form: / Volume: m3
Others: / Yes No / Waste Form: Surface Area: m2 /Volume: m3
If Others, please provide a detailed description of all other Hazardous Waste: (Include the waste form and quantity / volume)
Environmental Permit or Disposal Authorisation Reference Number:
Waste Consignment Variation Forms:
Is the Waste covered by one or more approved Waste Consignment Variation Forms and does the Waste Consignment
align with the specified requirements of the referenced Waste Consignment Variation Forms? Yes No
If Yes, please state all relevant Variation Form References:
Waste Characterisation Forms:
Please state the relevant Wastestream Identification Codes and what % Weight of the Waste Consignment they cover:
% / % / % / % / % / % / % / %
Waste Assurance Forms:
Please state the relevant Waste Assurance Form References for all waste included within this Waste Consignment:
Waste Composition:
Approximate Overall % Composition By Weight of the Waste Consignment:
Metal / Concrete / Soil / Organics / Plastic / Rubber / Wood / Other
Supercompactable Waste Treatment: / Low Level Waste Disposal:
(select all that apply and state others) / (select all that apply and state others)
Loose Supercompactable Waste / m3 / Metal (not suitable / selected for treatment) / tonne
Loose Shreddable Waste / m3 / Concrete / Rubble / Bricks / tonne
Loose Filter Waste / no. / Soil / tonne
Drummed Supercompactable Waste / no. / Sealed Sources / no.
Drummed Reassertable Waste / no. / Supercompacted Waste Boxes / Drums / no.
Loose drums / no. / Secondary Waste (from a treatment service) / tonne
Others: / no. / Others: / tonne
4. Radioactivity Information (Refer to Notes below)
Radionuclide / Activity (MBq)(1) / de minimis (MBq) (8) / Maximum Specific Activity (MBq/t)(2) / Radionuclide / Activity (MBq)(1) / de minimis (MBq) / Maximum Specific Activity (MBq/t)(2)
Uranium nuclides / Uranium-232 / 0.30 / 1(3) / Specified non alpha emitting nuclides / Carbon-14
Uranium-233 / 0.30 / 1(3) / Cobalt-60
Uranium-234 / 0.30 / 0.01(3) / Iodine-129
Uranium-235 / 0.30 / Tritium
Uranium-236 / 0.30 / 0.0001(3) / Group Total: / 0.00
Uranium-238 / 0.30 / Other non alpha emitting nuclides of ½-life > 3 months plus Fe-55 / Plutonium-241 / 1.00
Uranium- / 0.30 / 1.00
Group Total: / 0.00 / 1.00
Ra-226 and
Th-232 / Radium-226 / 0.03 / 1.00
Thorium-232 / 0.03 / 1 / 1.00
Group Total: / 0.00 / 1.00
Other alpha emitting nuclides of ½-life > 3 months / Thorium-228 / 0.30 / 100 / 1.00
Thorium-230 / 0.30 / 1.00
Protactinium-231 / 0.30 / 0.1 / 1.00
Neptunium-237 / 0.30 / 1.00
Plutonium-238 / 0.30 / 1.00
Plutonium-239 / 0.30 / Total / 1.00
Plutonium-240 / 0.30 / 100 / 1.00
Plutonium-242 / 0.30 / 1.00
Americium-241 / 0.30 / 100 / 1.00
Americium-242m / 0.30 / 100 / 1.00
Americium-243 / 0.30 / 100 / 1.00
Curium-243 / 0.30 / 100 / 1.00
Curium-244 / 0.30 / 100 / 1.00
Curium-245 / 0.30 / 1 / 1.00
Curium-246 / 0.30 / 1 / 1.00
Curium-247(4) / 0.00 / 0 / 1.00
Californium-249 / 0.30 / 1 / 1.00
Californium-250 / 0.30 / 10 / 1.00
Californium-251 / 0.30 / 1 / 1.00
Californium-252 / 0.30 / 1 / 1.00
Einsteinium-254 / 0.30 / 10 / 1.00
0.30 / 1.00
0.30 / Group Total: / 0.00
0.30 / Other non alpha emitting nuclides of ½-life <3 months(5) / Protactinium-232 / 100
0.30
0.30
Group Total: / 0.00
Other alpha emitting nuclides of ½-life < 3 months(5)
Group Total: / 0.00 / Group Total: / 0.00
Total alpha activity:(6) / Total non alpha activity:(6)
Total alpha specific activity:(7) / 4,000 / Total non alpha specific activity:(7) / 12,000
Notes:
(1)  Values of activity should be quoted to not more than three decimal places.
(2)  Maximum values which, if more restrictive than 4,000 or 12,000MBq/t, must not be exceeded without agreement from LLW Repository Ltd using a Waste Consignment Variation Form. Please note, the Thorium-232 limit applies to the Supercompactable Waste Treatment Service only.
(3)  Maximum values only applicable if consigned uranium has been specifically enriched in this radionuclide.
(4)  Agreement must be obtained before consigning Curium-247 using a Waste Consignment Variation Form
(5)  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 natural 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. Please note, Protactinium-232 must always be declared if present.
(6)  Total activity to include both short and long lived radionuclides.
(7)  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
(8)  No de-minimis levels for treatment.
5. Packaging Information
Packaging Option Used: / Supercompactable Waste Treatment: / TC05 Multi Use ISO Skip Container
(select one) / 210 litre Drums in a Transport Container
Loose Drums
Other (complete box below)
Low Level Waste Disposal: / TC01 Half Height ISO Container
TC03 Third Height ISO Container
TC08 WAMAC Disposal Container
Other (complete box below)
If Loose Drums or Other, please state how the Waste is Packaged:
6. Service Specific Information (complete only those sections relevant to the service required)
Supercompactable Waste Treatment
Uranium Radionuclides:
If any uranium isotopes, natural or U-235 enriched, have been declared as being present in this Waste Consignment, please complete one line of this table for each enrichment band.
If any uranium has been specifically enriched in any of the following, please tick the relevant box: / % Enrichment / Total weight of uranium (kg) / Weight of
U-235 (kg) / Form of uranium (Metal or Oxide)
U-232
U-233
U-234
U-236
Other
Drum and Package Information:
Please list the serial numbers below of all drums or any other packages in this Waste Consignment. Identify all packages with a “p”, any drums or packages unsuitable for High Force Compaction with a “u” and any reassertable waste drums with an “r”. Please also record the quantity of drums below 300kg and the quantity of packages in this Waste Consignment. If any drums exceed 300kg, please specify the quantity and record the combined weight of these drums. (Note: Each drum must be physically labelled with the serial number and the Drum Suffix, i.e. the Site Code specified in the Waste Services Contract) Drum Suffix (Site Code):
Number of Drums < 300kg: / Number of Drums > 300kg: / Combined Weight > 300kg: / kg
Number of Packages:
Monitoring Information:
Record the surface gamma radiation levels on contact with drums and / or packages, within the following band limits:
Band (mSv/h) / Volume (m3) / Band (mSv/h) / Volume (m3) / Band (mSv/h) / Volume (m3) / Band (mSv/h) / Volume (m3)
<10 / 10 to <30 / 30 to <100 / 100 to <300
300 to <1,000 / 1,000 to <3,000 / 3,000 to <10,000 / >10,000
Low Level Waste Disposal
Uranium Radionuclides:
If any uranium isotopes, natural or U-235 enriched, have been declared as being present in this Waste Consignment, please complete one line of this table for each enrichment band.
If any uranium has been specifically enriched in any of the following, please tick the relevant box: / % Enrichment / Total weight of uranium (kg) / Weight of
U-235 (kg) / Form of uranium (Metal or Oxide)
U-232
U-233
U-234
U-236
Other
Photographic Records:
Please provide the file references for photographic records. (Copies are to be retained and made available on request)
Consignment @ 25% Full / File Reference:
Consignment @ 50% Full / File Reference:
Consignment @ 75% Full / File Reference:
Consignment @ 100% Full / File Reference:
7. Customer Declaration
This Waste Consignment Information Form must only be signed by a person authorised by the Customer as being responsible and competent to ensure that the Waste Consignment complies with the Waste Acceptance Criteria and will be consigned in accordance with the Waste Acceptance Procedure as detailed in the Waste Services Contract that exists between LLW Repository Ltd and the Customer.
Statements:
1.  Before waste can be consigned, Customers must have accepted the Waste Services Quotation(s) from LLW Repository Ltd and completed the Waste Acceptance Procedure including the submission and approval of a Waste Forecasting Form, Waste Assurance Form(s), Waste Characterisation Form(s) and Waste Enquiry Form(s).
2.  For the consignment of waste to LLW Repository Ltd for Treatment and / or Disposal Services, Customers must have a valid Environmental Permit or Disposal Authorisation in place, issued by either the Environment Agency or the Scottish Environmental Protection Agency.
3.  When consigned, the waste must comply in all respects with the Waste Acceptance Criteria, and / or any approved Variations, and the requirements specified in the Waste Services Quotation(s).
4.  As far as reasonably practicable waste should have been segregated in accordance with the Waste Hierarchy to minimise the volume of waste for disposal.
5.  Where waste is to be consigned for Low Level Waste Disposal, it must either be Secondary Waste from a Treatment Service or have been accepted by LLW Repository Ltd as being non-compactable low level waste and the inaccessible voidage within the Waste Consignment must be less than 10% after grouting.
6.  The Waste Consignment must be free from non-permitted external contamination.
7.  The Waste Consignment must be packaged in compliance with the relevant Regulations for Road, Rail and Sea Transportation and the relevant Certificate of Approval for the Package including the requirements of any Packing and Handling Instructions.
8.  With regard to Nuclear Material Accountancy considerations, where appropriate, Customers must declare the material “Not Subject to Safeguards Coverage” or Safeguards Coverage must be terminated by the Customer on delivery.

WSC-FOR-WCI – Version 3.2 – November 2013 Page 2 of 7

Waste Consignment Information Form

LLW Disposal and Supercompaction

Declaration:
By signing this Form, I declare that I have read and accept the Statements above, that the Waste Consignment complies with these requirements and that the information provided in this Form is accurate and complete.

WSC-FOR-WCI – Version 3.2 – November 2013 Page 2 of 7

Waste Consignment Information Form

LLW Disposal and Supercompaction

Name: (Please Print) / Company:
Signature: / Date:

WSC-FOR-WCI – Version 3.2 – November 2013 Page 2 of 7