Notification document for transboundary movements/shipments of waste
1. Exporter - notifier Registration No: 980948854
Name:
Rgs Nordic As
Address: Storemyra 295, 5954 Mongstad, Norge
Contact person: Morten Sognnes
Tel:
Fax:
95192822
E-mail:
2. Importer - consignee
Registration No:
15084790
Name:
RGS Nordic A/S
Address: Selinevej 4 2300 København S, DK
Contact person: Pernille Lyngsie Pedersen
Tel:
Fax:
+45 23 31 33 67
E-mail:
8. Intended carrier(s)
Registration No:
Name
(7):
See annex to box 8
Address:
Contact person:
Tel:
Fax:
E-mail:
Means of transport
(5):
Sea
9. Waste generator(s) - producer(s)
(1;7;8) Registration No: 980948854
Name:
Rgs Nordic As
Address: Storemyra 295
Contact person:
Morten Sognnes
Tel:
Fax:
95192822
E-mail:
Site and process of generation
(6):
RGS Nordic, Mongstad
Olie-/vandemulsioner fra norske producenter o
10. Disposal facility
(2):
or recovery facility (2):
Registration No:
15084790
Name:
RGS Nordic A/S
Address:
Askelunden 24 4230 Skelskør, Danmark
3. Notification No:
Notification concerning
NO 500491
A.(i) Individual shipment:
(ii) Multiple shipments:
✘
✘
B.(i) Disposal
(1):
(ii) Recovery:
C. Pre-consented recovery facility
(2;3)
Yes:
✘
No:
4. Total intended number of shipments: 500
5. Total intended quantity
(4)
Tonnes (Mg): 500000
m
3
:
6. Intended period of time for shipment(s)
(4)
First departure: 01.07.2021
Last departure: 30.06.2024
7. Packaging type(s)
(5):
8
Special handling requirements (6):
Yes:
No:
✘
11. Disposal / recovery operation(s)
(2)
D
-code / R-code
(5):
R12
Technology employed
(6): R12-R9.
Fraseparering af olie samt biologisk rensning
Reason for export
(1;6):
Ingen tilsvarende behandlingsmulighed i Norge
12. Designation and composition of the waste
(6):
Olie-/vandemulsioner fra norske producenter og oplagret hos RGS
Nordic i Mongstad. Se desuden bilag med nærmere beskrivelse og
analyser
13. Physical characteristics
(5):
Liquid
14. Waste identification
(fill in relevant codes)
(i) Basel Annex VIII (or IX if applicable): A4060
(ii) OECD code (if different from (i)):
(iii) EC list of wastes:
*130802
(iv) National code in country of export:
✘
(v) National code in country of import:
(vi) Other (specify):
(vii) Y-code:
Y9
(viii) H-code
(5):
H12
Contact person: Pernille Lyngsie Pedersen
(ix) UN class
(5):
9
Tel:
Fax:
(x) UN Number:
+45 23 31 33 67
E-mail:
(xi) UN Shipping name:
Actual site of disposal/recovery:
Det samme
(xii) Custom code(s) (HS):
15. (a) Countries/states concerned,
(b) Code No. of competent authorities where applicable, (c) specific points of exit or entry (border crossing or port)
State of export - dispatch
State(s) of transit (entry and exit)
State of import - destination
(a) Norge
Danmark
(b) NO-001
DK001
(c) Mongstad Harbour
EU Gulfhavn Harbou
16. Customs offices of entry and/or exit and/or export (European Community)
Entry:
Exit:
Export:
17. Exporter's - notifier's / generator's - producer's
(1)
declaration
I certify that the information is complete and correct to my best knowledge. I also certify that legally enforceable written contractual obligations have been entered into and that any applicable
insurance or other financial guarantee is or shall be in force covering the transboundary movement.
Digitally verified 18. Number of
Flemming Jesper Bendt
annexes attached
by the NEA,
Exporter's - notifier's name:
Flemming Jesper Bendt
Date:
27.5.2021
Signature:
Rgs Nordic As
08:56:01UTC+2
Generator's - producer's name:
Date:
Signature:
8
FOR USE BY COMPETENT AUTHORITIES
19. Acknowledgement from the relevant competent authority of
20. Written consent
(1;8)
to the movement provided by the
countries of import - destination / transit
(1)
/ export - dispatch
(9)
competent authority of (country):
Country:
Consent given on:
Notification received on:
Consent valid from:
until:
Acknowledgement sent on:
Specific conditions:
No:
If Yes, see block 21
(6):
Name of competent authority:
Name of competent authority:
Stamp and/or signature:
Stamp and/or signature:
21. Specific conditions on consenting to the movement document or reasons for objecting
(1) Required by the Basel Convention
(2) In the case of an R12/R13 or D13-D15 operation, also attach corresponding information on any
subsequent R12/R13 or D13-D15 facilities and on the subsequent R1-R11 or D1-D12 facilit(y)ies
when required
(3) To be completed for movements within the OECD area and only if B(ii) applies
(4) Attach detailed list if multiple shipments
(5) See list of abbreviations and codes on the next page
(6) Attach details if necessary
(7) Attach list if more than one
(8) If required by national legislation
(9) If applicable under the OECD Decision