ANNEX IIU.K.

Statement of Conformity with the end-of-waste criteria referred to in Article 4(1)

1.

Producer/importer of the copper scrap:

Name:

Address:

Contact person:

Tel.

Fax

E-mail:

2.
(a)

Name or code of the scrap metal category, in accordance with an industry specification or standard:

(b)

Where relevant, main technical provisions of a customer specification, such as composition, size, type and properties:

3.The scrap metal consignment complies with the industry specification or standard referred to in point 2(a) or with the customer specification to in point 2(b).
4.Quantity of the consignment in kg:
5.A radioactivity test certificate has been established in accordance with national or international rules on monitoring and response procedures for radioactive scrap metal.
6.The producer of scrap metal applies a management system complying with the requiremets of Commission Regulation (EU) No 715/2013, which has been verified by an accredited conformity assessment body or by an environmental verifier or, where scrap metal which has ceased to be waste is imported into the [F1United Kingdom], by an independent external verifier.
7.The scrap metal consignment meets the criteria referred to in paragraphs 1 to 3 of Article 3 of Regulation (EU) No 715/2013.
8.

Declaration of the producer/importer of scrap metal: I certify that the above information is complete and correct to the best of my knowledge:

Name:

Date:

Signature: