Notification document for transboundary movements/shipments of waste
1. Exporter - notifier Registration No: 973152424
Name:
Equinor Asa Avd Raffineri Mongstad
Address: Postboks 8500 (JE), 4035 Stavanger, Norge
Contact person: Hanne Seljelid
Tel:
Fax:
+4799484859
E-mail:
2. Importer - consignee Registration No: 15084790
Name:
RGS Nordic AS
Address: Askelunden 24, DK-4230 Skælskør, DK
Contact person: Pernille Lyngsie Pedersen
Tel:
Fax:
+4588778939
E-mail:
8. Intended carrier(s) Registration No: SE 556772536001
Name (7): Sirius shipping AB
Address: Box 39, SE-430 82 Donsô, Sweden
Contact person: Daniel Backman
Tel:
Fax:
+4631973330
E-mail:
Means of transport (5): Sea
9. Waste generator(s) - producer(s)
(1;7;8)
Registration No: 973152424
Name:
Equinor Asa Avd Raffineri Mongstad
Address: Postboks 8500 (JE)
Contact person: Hanne Seljelid
Tel:
Fax:
+4799484859
E-mail:
Site and process of generation (6): Equinor Mongstad
Oljeforurenset vann segregert fra råolje
10. Disposal facility
(2):
or recovery facility
(2):
Registration No: 15084790
Name:
RGS Nordic AS
Address: Askelunden 24, DK-4230 Skælskør
3. Notification No:
Notification concerning
NO 500269
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: 45
5. Total intended quantity (4)
Tonnes (Mg):
m
3
:
450000
6. Intended period of time for shipment(s) (4)
First departure: 01.01.2021
Last departure: 31.12.2023
7. Packaging type(s)
(5):
9 Med skip
Special handling requirements (6):
Yes:
No:
11. Disposal / recovery operation(s)
(2)
D-code / R-code (5):
R12,R9
Technology employed (6): Seperasjon av olje fra vannholdige masser.
Se vedlegg 4 Prosessbeskrivelse av RGS Nordic
See annex to box 11
Reason for export (1;6):
12. Designation and composition of the waste (6):
Liquid chemical waste. Oil contaminated water segregated from different
crude oils at terminal caverns at Equinor Mongstad
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):
H11
Contact person: Pernille Lyngsie Pedersen
(ix) UN class (5):
9
Tel:
Fax:
(x) UN Number:
+4588778939
E-mail:
(xi) UN Shipping name:
Actual site of disposal/recovery: Skælskør
(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
(c) Mongstad
Skælskær
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
Hanne Seljelid
annexes attached
by the NEA,
Exporter's - notifier's name: Hanne Seljelid
Date: 17.12.2020 Signature: Equinor Asa
10:04:40UTC+1
Generator's - producer's name:
Date:
Signature:
6
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