Guidelines for reduction of dyes released from pulp and paper mills 2013: appendix 5
Appendix 5: Conformity Evaluation Form of the Guidelines for the Reduction of Dyes Released from Pulp and Paper Mills
This form may be used as a template to show conformance to the section 6 “Report” of the Guidelines.
Name and civic address of the mill:
_____________________________________________________________________
_____________________________________________________________________
Period covered by the report:
From ___________________ to ___________________
| Name of the substance | CAS # | Amount used (kg) | Retention in final paper product (1) | Solids removal efficiency by the wastewater primary treatment system | Containment plan in place (yes/no) | Environmental release (yes/no). If yes, specify the amount (kg of the substance) |
|---|---|---|---|---|---|---|
(1) If the method used to measure dye retention differs from the Appendix 3 method, include a copy of the method used with the report.
I declare this report to be accurate and complete.
_________________________________
_________________________________
Operator Name (print)
Operator Title
_________________________________
_________________________________
Telephone
Email
_________________________________
_________________________________
Operator Signature
Date of Signature
Please return this form to:
Director
Forest Products and Fisheries Act Division
Environment Canada
351 St. Joseph Blvd, Gatineau, Quebec, K1A 0H3
Email: mapbap@ec.gc.ca
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