Workplace Hazardous Waste Disposal Compliance

Employee Information:

Employee Name:	[Your Name]
Department:	[Department]
Job Title:	[Job Title]
Date:	[Month Day, Year]

Description of Hazardous Waste:

Type of Waste:	Chemical solvent (Acetone)
Quantity:	5 gallons
Physical State:	Liquid
Chemical Composition:	Acetone (CAS No. 67-64-1)
Storage Container Type:	Sealed metal drum

Disposal Method:

Preferred Disposal Method:	Incineration
Reason for Disposal:	Waste accumulation from expired solvent batches.
Documentation of SDS:	Attached

Safety Measures Undertaken:

Personal Protective Equipment Used:
Handling Precautions Taken:
Training Received:

Certification:

I certify that the information provided above is accurate to the best of my knowledge. I understand the importance of proper hazardous waste disposal and have adhered to company policies and procedures in handling and disposing of the mentioned waste.

Employee Signature:

Date: [Month Day, Year]

Supervisor Approval:

I have reviewed the information provided by the employee and confirm compliance with company guidelines for hazardous waste disposal.

Supervisor Name: [Name]

Date: [Month Day, Year]

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