Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Begin with Section A, where you will provide location information. Include details such as the release name (if applicable), street, city/town, state, and zip code. Specify the date period of generation, along with the U.S. EPA ID number and indicate if there is a 21E release.
3. In Section B, fill out the generator information. Provide the name of the organization, contact person's name and title, street address, city/town, state, zip code, and telephone number.
4. If necessary, complete Section C with the owner and/or operator's information, selecting whether the submitter is the owner or operator. Fill out similar details including organization name and contact information.
5. Proceed to Section D for transporter and common carrier information. Here, enter the transporter’s name, hazardous waste license number, licensing state, contact person's details, and address.
6. In Section E, input the receiving facility information. Include the operator/facility name, contact person, type of facility, and permit number if applicable.
7. For Section F, describe the materials being shipped. Check all applicable options for material type, provide a description, and classify the contamination. Also, include any analyses performed and constituents of concern.
8. Continue to Section G, where a qualified environmental professional must provide their opinion on the information submitted, including their name, organization, title, telephone number, signature, and license number.
9. In Section H, the generator must certify the accuracy of the information provided by including their signature, date, and printed name.
10. Section I requires acknowledgment of receipt by the receiving facility representative, including their title, signature, and date.
11. Section J contains load information where you will fill in load numbers, transporter signatures, dates and times related to the shipment, registration details, and load sizes.
12. Finally, save your changes, and you can download, print, or share the completed form as required.

Complete your Material Shipping Record & Log online today to ensure efficient and accurate documentation.