Waste Declaration Form
Industrial Production Waste - Fiberglass Waste Stream
About this form
Before Continuum ApS, CVR no: 42277843, can receive the waste, this declaration must be filled out. It is the responsibility of the waste producer/owner to ensure the accuracy of the information provided on the declaration. Similarly, the carrier is responsible for ensuring that the waste is accompanied by a properly completed declaration. We cannot receive contaminated waste, hazardous waste or waste contaminated with hazardous materials. For additional information, please reach out to Continuum at feedstock@continuum.earth.
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Contact Information
Company Name
*
Name of who is filling the form
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Corporate Address
*
Street Address
Street Address Line 2
City
Country
Postal / Zip Code
VAT No.
*
Continuum Contact
*
Peter Hoeg
Martin Graystone
Nicolas Derrien
Are you the waste owner
*
Yes
No
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Waste Owner Information
Company Name
*
Contact Person
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Address
*
Street Address
Street Address Line 2
City
Country
Postal / Zip Code
VAT No.
*
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Waste Information
Fiberglass Waste Stream
Location of the waste
*
Street Address
Street Address Line 2
City
Country
Postal / Zip Code
How is the waste stored
*
Open containers
Closed containers
Big bags
Plastic containers
Other
Has the waste been contaminated with other material such as soil, stones, standing water etc.?
Yes
No
Please describe the art of contamination.
How is the waste presented
*
Mixed waste fraction
Clean waste fraction
Other
Total quantity available now
*
How often are you expecting to deliver waste
*
Monthly
Quarterly
Yearly
Other
How much are you expecting to deliver in tones per delivery
*
Process by which the waste was generated
*
Date the waste is expected to be delivered
-
Month
-
Day
Year
Date
If you have any pictures of the waste make sure to upload them here
Browse Files
Drag and drop files here
Choose a file
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Composition of your composite waste
Please provide an estimated value in % next to the components that are part of your fiberglass waste stream. Only write numbers. Please note that all numbers must add up to 100%!
Plastic fraction
*
Rows
%
Epoxy
Unsaturated Polyester (thermoset)
Polyester (thermoplastic)
Polyurethane
Teflon (PTFE)
Phenolic resins
PVC
Polycarbonate
Rubber
Vinyl ester
Mixed plastic (type 1)
Mixed plastic (type 2)
Mixed plastic (type 3)
Mixed plastic (type 4)
Others
If you have selected others please describe the materials
Fiber fraction
*
Rows
%
Glass fibers
Carbon fibers
Aramid fibers
Natural fibers
Others
If you have selected others please describe the materials
Other fractions
*
Rows
%
Silicone
Oil
Dirt
Carbon black
Metals
Others
If you have selected others please describe the materials
Are there any Fire Retardant (FR) additives
*
Yes
No
What is the FR weight percentage (based on weight)
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Transport/Carrier Information
Company Name
Contact Person
First Name
Last Name
Email
example@example.com
Phone Number
VAT No.
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Thank you!
Other relevant information
Signature
*
Submit
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