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1. Work site name and mailing address Asbestos Waste Shipment Record (See Completion Instructions on Reverse) Owner’s name 2. Operator’s name and address Owner’s telephone no. Operator’s telephone no. Authorized agent: 3. Waste disposal site (WDS) name, mailing address, physical site location: WDS phone no. GENERATOR Permit No. 4. Name and address of responsible agency: Tennessee Department of Environment & Conservation Division of Air Pollution Control William R. Snodgrass Te.

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How to fill out the TN CN-1054 online

The TN CN-1054 form is essential for documenting the transportation and disposal of asbestos waste in Tennessee. This guide provides clear, step-by-step instructions to help users efficiently complete the form online.

Follow the steps to accurately complete the form online.

  1. Click 'Get Form' button to obtain the TN CN-1054 and open it in the editor.
  2. In section 1, enter the work site name and mailing address. Include the owner's name and phone number.
  3. For section 2, provide the operator's name and address, along with their phone number and the authorized agent's information.
  4. In section 3, fill in the waste disposal site (WDS) name, mailing address, physical site location, and phone number. If applicable, include the WDS permit number.
  5. In section 4, enter the name and address of the responsible agency, which is the Tennessee Department of Environment and Conservation.
  6. Section 5 requires a description of the asbestos waste generated, including the types (e.g., friable, non-friable).
  7. In section 6, indicate the number of containers used and their type based on the provided codes.
  8. For section 7, specify the total quantity of asbestos material in either cubic yards or gallons.
  9. Use section 8 to include any special handling instructions or additional information necessary for transport.
  10. Section 9 requires the authorized agent to read, sign, and date the certification statement.
  11. For sections 10 and 11, provide the necessary details of the transporter(s), including names, signatures, and dates of receipt.
  12. In section 12, note any discrepancies between the waste information reported and what has actually been received.
  13. Complete section 13 with the waste disposal site owner's information, confirming receipt of materials.
  14. Once all fields are completed, you can save changes, download, print, or share the form as needed.

Complete the TN CN-1054 online to ensure proper handling of asbestos waste.

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TN CN-1054
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