Hazardous Waste Generator Registration Form

Important

This registration is required under Section 4(1) of the Hazardous Waste Regulation (M.R. 195/2015)

The generator is responsible for hazardous waste identification. If you need help with entering accurate information for your waste(s), please contact a qualified individual or refer to other resources for assistance. These can include:

  • Information from the Material Safety Data sheet
  • Your hazardous waste carrier or receiver company
  • Laboratory analytical results
  • The manufacturer or supplier of the raw materials that your waste comes from
  • In the case of infectious substances, a doctor, scientist, veterinarian, epidemiologist, microbiologist, pathologist, nurse, coroner or laboratory technician.

Select one of the following that applies to you:

Please enter your issued MBG number, current operation name, operation site location, and the type of amendment below:

(Name on the sign of the facility, common trade name, or name commonly known to the public. Example: Joe’s Automotive)

(This is the location where the waste is being generated. You are required to register each site that generates hazardous wastes in a separate form (P. O. Box is not acceptable))

Street Address
Legal Land description

(Eg. SW 24-12-20-W Southwest Quarter of Section 24, Township 012, Range 20, West)

Location GPS Coordinates

Enter the Latitude and Longitude

Latitude Longitude
Lot, Block, Plan
Lot or Parcel No: Block No: Plan No:
River Lot
Please check all of the following that applies to you:

Certification

The company’s contact person (an authorized employee of the generating company) must certify that the information provided below is correct and complete.

Primary Contact

Closed Operations

Important
Important

Note: This section does not apply to active operations. Click “Yes” and complete this section only if you have relocated and closed a previous location.



Street Address
Legal Land description

(Eg. SW 24-12-20-W Southwest Quarter of Section 24, Township 012, Range 20, West)

Location GPS Coordinates

Enter the Latitude and Longitude

Latitude Longitude
Lot, Block, Plan
Lot or Parcel No: Block No: Plan No:
River Lot
Amendment Description

Legal Company Name

Operation Name

Operation Site Location (This is the location where the waste is being generated. You are required to register each site that generates hazardous wastes in a separate form (P. O. Box is not acceptable))

Street Address

Legal Land description

(Eg. SW 24-12-20-W Southwest Quarter of Section 24, Township 012, Range 20, West)

Location GPS Coordinates

Enter the Latitude and Longitude

Latitude Longitude
Lot, Block, Plan
Lot or Parcel No: Block No: Plan No:
River Lot

Mailing Address (All correspondence will be sent to this address. This may be different than the address where the hazardous waste is actually generated)

Waste Management Information

Don’t know code

Waste Description

(Please click each of the blue headings A through J below to see a description of what needs to be entered in each field. Examples can be found here)

(A) Physical State (B) Transportation of Dangerous Goods (TDG) Shipping Name or Type of Hazardous Waste (C) UN Number or Provincial Waste Code (D) Transportation of Dangerous Goods (TDG) Class (if applicable) (E) Packing Group (if applicable) (F) Provincial Waste Class Code (G) Quantity of Waste Generated per month (H) Unit (I) How frequently is the waste generated? (J) Treatment or Disposal Code

Important

Important

Personal information is collected under the authority of the Dangerous Goods Handling and Transportation Act, Hazardous Waste Regulation M. R. 195/2015, and will be used to issue the Hazardous Waste Registration Number (Provincial ID number) and for administration and enforcement purposes. It is protected by the privacy provisions of The Freedom of Information and Protection of Privacy Act. If you have any questions, contact the Access & Privacy Co-ordinator, Box 90, 200, Saulteaux Crescent, Winnipeg MB R3J 3W3; 1 (204) 945-4170.

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