Annexe7 Recycle Pneus Minumar 14.06.2023

Download as pdf or txt
Download as pdf or txt
You are on page 1of 2

ANNEX VII

INFORMATION ACCOMPANYING SHIPMENTS OF WASTE


AS REFERRED TO IN ARTICLE 3 (2) AND (4)
Consignment information (1)
1. Person who arranges the shipment 2. Importer/consignee
Name: RECYCLE PNEUS Name: S.C. INTERNATIONAL TYRES S.R.L

Address: ZA LA GRAND COLLE, 11BD DE Address: 727296 Slobozia Sucevei, Suceava, Romania
L’ENGRENIER, 13110 PORT DE BOUC
Contact person: Petru Sbiera
Contact person: AURELIE RATTALINO Tel.: +40-749.147.598 Fax:
Tel.: +33 684 620 830 Fax: E-mail [email protected]
E-mail [email protected]
3. Actual quantity :1700pneus Tonnes (Mg):14.58 t m3: 90 4. Actual date of shipment: 14.06.2023

5.(a) 1st carrier (2) 5.(b) 2nd carrier 5.(c) 3rd carrier
Name: MINUMAR SRL Name: Name:
Address: str.Plevnei 10, Baia Mare, MM,
RO Address: Address:
C.I.F.: RO15212346 / J24/156/2003
Contact person: Pop Cosmin Ioan Contact person: Contact person:
Tel: +40262211683 Tel.: Tel.:
E-mail: [email protected] Fax: Fax:
Means of transport: E-mail: E-mail:
MM30LCF/MM31LCF Means of transport: Means of transport:
Date of transfer: 14.06.2023 Date of transfer: Date of transfer:
Signature: Signature: Signature:
6. Waste generator (3) 8. Recovery operation (or if appropriate disposal operation in the
Original producer(s), new producer(s) or collector: case of waste referred to in Article 3(4)):
Name: RECYCLE PNEUS R-code/D-code: R3
Address: ZA LA GRAND COLLE, 11BD DE
L’ENGRENIER, 13110 PORT DE BOUC 9. Usual description of the waste:
Contact person: AURELIE RATTALINO Pneumatiques usages destines au rechapage – des carcasses
Tel.: +33 684 620 830 Fax:
E-mail: [email protected]
7. Recovery facility X Laboratory  10. Waste identification (fill in relevant codes):
Name: S.C. INTERNATIONAL TYRES S.R.L (i) Basel Annex IX: B3140
Address: 727296 Slobozia Sucevei, Suceava, Romania (ii) OECD (if different from (i)):
(iii) Annex IIIA (4):
Contact person: Petru Sbiera (iv) Annex IIIB (5):
Tel.: +40-749.147.598 Fax: (v) EC list of wastes: 160103
E-mail: [email protected] (vi) National code: 160103
11. Countries/states concerned:
Export/dispatch Transit Import/destination
FRANCE Italie Slovenie Hongrie ROUMANIE

12. Declaration of the person who arranges the shipment: I certify that the above information is complete and correct to my best
knowledge. I also certify that effective written contractual obligations have been entered into with the consignee (not required in the case of
waste referred to in Article 3(4)):

Name: Aurelie Rattalino Date: 14.06.2023 Signature

13. Signature upon receipt of the waste by the consignee:


Name: Date: Signature:
TO BE COMPLETED BY THE RECOVERY FACILITY OR BY THE LABORATORY:
14. Shipment received at recovery facility or laboratory  Quantity received: Tonnes (Mg): m3:

Name: Date: Signature:


(1) Information accompanying shipments of green listed waste and destined for recovery or waste destined for laboratory analysis
pursuant to Regulation (EC) No 1013/2006. For completing this document, see also the corresponding specific instructions as
contained in Annex IC of Regulation (EC) No 1013/2006 on shipments of waste
(2) If more than 3 carriers, attach information as required in blocks 5 (a, b, c).
(3) When the person who arranges the shipment is not the producer or collector, information about the producer or collector shall
be provided.
(4) The relevant code(s) as indicated in Annex IIIA to Regulation (EC) No 1013/2006 are to be used, as appropriate in sequence.
Certain Basel entries such as B1100, B3010 and B3020 are restricted to particular waste streams only, as indicated in Annex
IIIA.
(5) The BEU codes listed in Annex IIIB to Regulation (EC) No 1013/2006 are to be used.’

You might also like