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Hazardous waste consignment note Fill in parts A to E, each person signs their own part, then share the PDF. Free, for England and Wales.

  • Free, no account
  • Schedule 4 of the Hazardous Waste Regulations 2005

Fill in and sign the consignment note

Consignment note

What hazardous waste is going?

  • 16 01 13*

    brake fluids

About the load

Form

Hazardous waste consignment note template

A blank note to print and fill in by hand: Parts A to E in the order and wording of Schedule 4, for waste moved in England.

Hazardous waste consignment note

Part A Notification details

A1Consignment note code
Left blank to fill in
A2The waste described below is to be removed from (name, address, postcode, telephone, e-mail, facsimile)
Left blank to fill in
A3The waste will be taken to (name, address & postcode)
Left blank to fill in
A4The waste producer was (if different from 2) (name, address, postcode, telephone, e-mail, facsimile)
Left blank to fill in

Part B Description of the waste

B1The process giving rise to the waste(s) was
Left blank to fill in
B2SIC for the process giving rise to the waste
Left blank to fill in

B3The waste(s) is

Description of wasteList of Wastes (EWC) code (6 digits)Quantity (kg)Chemical/biological components and their concentrations (% or mg/kg)Physical formHazard code(s)Container type, number & size

The information given below is to be completed for each EWC identified

EWC codeUN identification number(s)Proper shipping name(s)UN class(es)Packing group(s)Special handling requirements

Part C Carrier’s certificate

Schedule of carriers attached
□ Yes □ No

I certify that I today collected the consignment and that the details in A2, A3 and B3 are correct and I have been advised of any specific handling requirements.

Where this consignment forms part of a multiple collection, the round number and collection number are
Left blank to fill in
C1Carrier name
Left blank to fill in
On behalf of (name, address, postcode, telephone, e-mail, facsimile)
Left blank to fill in
C2Carrier registration no./reason for exemption
Left blank to fill in
C3Vehicle registration no. (or mode of transport, if not road)
Left blank to fill in

Carrier’s signature

Part D Consignor’s certificate

I certify that the information in A, B and C above has been completed and is correct, that the carrier is registered or exempt and was advised of the appropriate precautionary measures. All of the waste is packaged and labelled correctly and the carrier has been advised of any special handling requirements. I confirm that I have fulfilled my duty to apply the waste hierarchy as required by regulation 12 of the Waste (England and Wales) Regulations 2011.

D1Consignor name
Left blank to fill in
On behalf of (name, address, postcode, telephone, e-mail, facsimile)
Left blank to fill in

Consignor’s signature

Part E Consignee’s certificate

Where more than one waste type is collected all of the information given below must be completed for each EWC

Individual EWC code(s) receivedQuantity of each EWC code received (kg)EWC accepted/rejectedWaste management operation (R or D code)
E1I received this waste at the address given in A3 on (date) at (hrs)
Left blank to fill in
E2Vehicle registration no. (or mode of transport, if not road)
Left blank to fill in
E3Where waste is rejected please provide details
Left blank to fill in
I certify that waste management licence/permit/authorised exemption no(s). … authorises the management of the waste described in B at the address given in A3.
Left blank to fill in
Where the consignment forms part of a multiple collection, as identified in Part C, I certify that the total number of consignments forming the collection are
Left blank to fill in
Name
Left blank to fill in
On behalf of (name, address, postcode, telephone, e-mail, facsimile)
Left blank to fill in

Consignee’s signature

Download the template PDF, 3 pages

Hazardous waste consignment note example

The same note filled in and signed for asbestos cement roof sheets taken to a landfill. The names and numbers are made up.

Hazardous waste consignment note

Example

Part A Notification details

A1Consignment note code
EXAMPL/A0001
A2The waste described below is to be removed from (name, address, postcode, telephone, e-mail, facsimile)
Example Roofing Ltd, 12 Sample Road, Exampletown, EX1 2AB, tel 01234 567890, email office@example.com, fax N/A
A3The waste will be taken to (name, address & postcode)
Example Landfill Ltd, Quarry Lane, Exampletown, EX9 8ZZ
A4The waste producer was (if different from 2) (name, address, postcode, telephone, e-mail, facsimile)
As A2

Part B Description of the waste

B1The process giving rise to the waste(s) was
Removing an asbestos cement garage roof
B2SIC for the process giving rise to the waste
43910 Roofing activities

B3The waste(s) is

Description of waste
Asbestos cement roof sheets, whole, wrapped
List of Wastes (EWC) code (6 digits)
17 06 05*
Quantity (kg)
1200
Chemical/biological components and their concentrations (% or mg/kg)
Chrysotile asbestos 12%; Cement 88%
Physical form
Solid
Hazard code(s)
HP5, HP7
Container type, number & size
1 x lockable 8-yard skip, sheets double-wrapped in polythene

The information given below is to be completed for each EWC identified

EWC code
17 06 05*
UN identification number(s)
N/A
Proper shipping name(s)
N/A
UN class(es)
N/A
Packing group(s)
N/A
Special handling requirements
Keep wrapped. Do not break sheets.

Part C Carrier’s certificate

Schedule of carriers attached
No

I certify that I today collected the consignment and that the details in A2, A3 and B3 are correct and I have been advised of any specific handling requirements.

Where this consignment forms part of a multiple collection, the round number and collection number are
N/A
C1Carrier name
Alex Morgan
On behalf of (name, address, postcode, telephone, e-mail, facsimile)
Example Haulage Ltd, Unit 4, Model Way, Exampletown, EX3 4CD, tel 01234 000000, email N/A, fax N/A
C2Carrier registration no./reason for exemption
CBDU000000
C3Vehicle registration no. (or mode of transport, if not road)
EX26 ABC

Carrier’s signature

Signed on the phone

Part D Consignor’s certificate

I certify that the information in A, B and C above has been completed and is correct, that the carrier is registered or exempt and was advised of the appropriate precautionary measures. All of the waste is packaged and labelled correctly and the carrier has been advised of any special handling requirements. I confirm that I have fulfilled my duty to apply the waste hierarchy as required by regulation 12 of the Waste (England and Wales) Regulations 2011.

D1Consignor name
Sam Carter
On behalf of (name, address, postcode, telephone, e-mail, facsimile)
As A2

Consignor’s signature

Signed on the phone

Part E Consignee’s certificate

Where more than one waste type is collected all of the information given below must be completed for each EWC

Individual EWC code(s) received
17 06 05*
Quantity of each EWC code received (kg)
1180
EWC accepted/rejected
Accepted
Waste management operation (R or D code)
D1
E1I received this waste at the address given in A3 on (date) at (hrs)
30/09/2026 at 14:20
E2Vehicle registration no. (or mode of transport, if not road)
EX26 ABC
E3Where waste is rejected please provide details
N/A
I certify that waste management licence/permit/authorised exemption no(s). … authorises the management of the waste described in B at the address given in A3.
EPR/AB1234CD
Where the consignment forms part of a multiple collection, as identified in Part C, I certify that the total number of consignments forming the collection are
N/A
Name
Jo Patel
On behalf of (name, address, postcode, telephone, e-mail, facsimile)
Example Landfill Ltd, Quarry Lane, Exampletown, EX9 8ZZ, tel 01234 111111, email N/A, fax N/A

Consignee’s signature

Signed on the phone
Download the example PDF, 2 pages

How to fill in a hazardous waste consignment note

What is a waste consignment note?

The note that goes with hazardous waste every time it moves, including between two sites of the same business. It is filled in before the waste leaves and stays with it until it reaches the site that takes it. Waste that isn’t hazardous goes on a transfer note instead.

Regulation 35, Schedule 4 and the Environment Agency’s guidance

Who fills in which part?

  1. A and B: the producer or holder, before the waste is moved. Where it is now, where it’s going, and what it is.
  2. C: the carrier checks A and B, adds their details and vehicle, and signs.
  3. D: the consignor checks A to C and signs. They must be there when the waste is collected.
  4. E: the receiving site weighs the waste, accepts or rejects each code, gives the R or D code and signs.

Source: regulation 36

How is the consignment note code made?

It reads XXXXXX/YYYYY. The first six are the first six letters or numbers of the company name in A2, with no spaces or symbols. A name with fewer than six is filled with Q. The last five are yours to choose, and change for every consignment from that address. CJ Tiles Ltd’s first note could be CJTILE/A0001.

Ships’ waste, fly-tipped waste, piped waste and consignee return derogations add a letter at the end. This page doesn’t make those.

Source: EA supplementary guidance, A1

Which hazard codes go on it?

Every hazardous property the waste has, and none it hasn’t. They come from classifying the waste, usually by lab results and the WM3 guidance, or from your waste contractor. Write POP for persistent organic pollutants.

HP1Explosive
HP2Oxidising
HP3Flammable
HP4Irritant
HP5Specific target organ toxicity or aspiration toxicity
HP6Acute toxicity
HP7Carcinogenic
HP8Corrosive
HP9Infectious
HP10Toxic for reproduction
HP11Mutagenic
HP12Release of an acute toxic gas
HP13Sensitising
HP14Ecotoxic
HP15Can show a hazardous property later
POPPersistent organic pollutant

Source: Annex III, Waste Framework Directive

How long do you keep a consignment note?

3 years for the producer, the holder and the consignor, kept in a register. Carriers keep their records for at least 12 months.

There is one copy each for the producer or holder (if not the consignor), the consignor, the carrier and the receiving site.

Source: regulation 36 and regulation 49

Does asbestos need a consignment note?

Yes, even from a house. Householders don’t need a note for other hazardous waste taken to a collection point, but asbestos always needs one. A contractor removing it fills in the note as the producer, with their business name and the home’s address in A2.

Source: EA supplementary guidance

Can a note be changed after signing?

No. Parts A to C can’t change once the carrier signs, and nothing in A to D once the consignor signs or the waste leaves. On this page, changing a part clears the signatures on it, so it is signed again before the waste goes. A receiving site that finds a mistake rejects the waste; it doesn’t correct the note.

Wales, Scotland and Northern Ireland

Wales still registers premises. Choose Wales beside the steps and the code starts with your premises code, as on the Natural Resources Wales form. Waste going from England to Wales uses the English note. Scotland calls it special waste and uses SEPA’s special waste consignment note. Northern Ireland has its own note, with a code from DAERA and at least 72 hours’ notice before the waste moves.

Not sure of the code? Find it in the EWC code finder, where codes with an asterisk (*) are hazardous.

Questions people ask

Is there a hazardous waste transfer note?
Not in England or Wales. Hazardous waste moves on a consignment note, the one on this page. A transfer note is only for waste that isn’t hazardous. Consignment notes on GOV.UK
Can a consignment note be signed on a phone?
The Regulations allow any form that asks for the same information in substantially the same format as Schedule 4. This note keeps its Parts, numbering and wording. Check the carrier and the receiving site accept an electronic note before the day. Regulation 35
Is there a premises code?
Not in England. Premises registration there ended on 1 April 2016, so the code is made from the company name. Wales still registers premises: choose Wales beside the steps and the code starts with your premises code. Natural Resources Wales
Does digital waste tracking replace consignment notes?
Not yet. Receiving sites record waste on the digital service from October 2026, and consignment notes carry on alongside it until further notice. Digital waste tracking on GOV.UK
Does ComplyOnSite keep my note?
No. Your notes stay in this browser on this device, and only you save or share the PDF. If someone signs on their own phone, the note is locked on your phone first, so our server holds a copy it can’t read, for 30 days. The page checks that every item is filled in, not that it’s right. It never decides whether your waste is hazardous or which HP codes apply.