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{"sheet":"様式(PC用)","index":0,"n_rows":122,"n_cols":40,"rows_kept":122,"cut":false,"hidden":false,"merged":[[94,1,94,39],[84,8,84,39],[85,8,85,39],[86,8,86,39],[87,8,87,39],[88,8,88,39],[89,8,89,39],[67,8,67,39],[68,9,68,14],[68,16,68,39],[70,8,70,9],[71,1,89,7],[79,8,79,39],[80,8,80,39],[81,8,81,39],[82,8,82,39],[83,8,83,39],[62,11,62,15],[62,21,62,22],[63,8,63,39],[64,8,64,39],[65,8,65,39],[66,12,66,15],[66,21,66,25],[66,31,66,38],[60,11,60,15],[60,21,60,24],[60,29,60,30],[60,36,60,38],[61,12,61,15],[61,22,61,23],[61,30,61,31],[61,37,61,38],[54,12,54,13],[54,20,54,21],[54,26,54,38],[55,2,55,7],[55,12,55,13],[57,1,59,7],[52,12,52,13],[52,20,52,21],[52,29,52,30],[52,37,52,38],[53,12,53,13],[53,20,53,21],[53,29,53,30],[53,37,53,38],[40,8,40,39],[44,30,44,39],[51,12,51,13],[51,20,51,21],[51,29,51,30],[51,37,51,38],[10,33,10,39],[11,8,12,39],[21,12,21,38],[23,19,23,28],[38,8,38,39],[39,8,39,39],[7,8,8,10],[7,12,7,15],[7,16,8,39],[9,8,10,10],[9,11,10,20],[9,21,10,23],[9,24,10,30],[9,31,9,32],[9,33,9,39],[10,31,10,32],[4,6,4,7],[4,9,4,10],[4,12,4,13],[4,32,4,39],[5,8,6,10],[5,11,6,39]]}
["＜ 表　面 ＞",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"管理番号"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"廃棄物データシート（ＷＤＳ）"]
["※1 本データシートは廃棄物の成分等を明示するものであり、排出事業者の責任において作成して下さい。"]
["※2 記入については、「廃棄物データシートの記載方法」を参照ください。"]
["作成日　　　　　　　年　　　月　　　日",null,null,null,"令和",null,null,null,"年",null,null,"月",null,null,"日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"記入者"]
[1,"排出事業者",null,null,null,null,null,null,"名称"]
[]
[null,null,null,null,null,null,null,null,"所在地",null,null,"〒"]
[]
[null,null,null,null,null,null,null,null,"所属",null,null,null,null,null,null,null,null,null,null,null,null,"担当者",null,null,null,null,null,null,null,null,null,"ＴＥＬ"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ＦＡＸ"]
[2,"廃棄物の名称"]
[]
[3,"廃棄物の",null,null,null,null,null,null,"主成分",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　MSDSがある場合、CAS No."]
[null,"組成・成分情報",null,null,null,null,null,null,"他"]
[null,"　（比率が高いと"]
[null," 　思われる順に"]
[null,"   記載）"]
[null,null,"分析表添付",null,null,null,null,null,"・成分名と混合比率を書いて下さい。　ばらつきがある場合は範囲で構いません。"]
[null,null,null,"(組成）",null,null,null,null,"・商品名ではなく物質名を書いて下さい。重要と思われる微量物質も記入して下さい。"]
[4,"廃棄物の種類",null,null,null,null,null,null,null,"汚泥",null,null,null,"廃油",null,null,null,"廃酸",null,null,null,"廃アルカリ",null,null,null,null,null,"廃ﾌﾟﾗｽﾁｯｸ類"]
[null,null,"産業廃棄物",null,null,null,null,null,null,"その他（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,null,null,null,null,null,null,null,"※廃棄物が以下のいずれかに該当する場合"]
[null,null,null,null,null,null,null,null,null,"石綿含有産業廃棄物",null,null,null,null,null,null,null,null,null,"水銀使用製品産業廃棄物",null,null,null,null,null,null,null,null,null,null,"水銀含有ばいじん等"]
[null,null,"特別管理",null,null,null,null,null,null,"引火性廃油",null,null,null,null,null,null,null,"強アルカリ（有害",null,null,null,null,null,null,null,"指定下水汚泥",null,null,null,null,null,null,null,"廃酸（有害）"]
[null,null,"産業廃棄物",null,null,null,null,null,null,"引火性廃油（有害）",null,null,null,null,null,null,null,"感染性廃棄物",null,null,null,null,null,null,null,"鉱さい（有害）",null,null,null,null,null,null,null,"廃アルカリ（有害）"]
[null,null,null,null,null,null,null,null,null,"強酸",null,null,null,null,null,null,null,"PCB等",null,null,null,null,null,null,null,"燃えがら（有害）",null,null,null,null,null,null,null,"ばいじん（有害）"]
[null,null,null,null,null,null,null,null,null,"強酸（有害）",null,null,null,null,null,null,null,"廃水銀等",null,null,null,null,null,null,null,"廃油（有害）",null,null,null,null,null,null,null,"13号廃棄物(有害)"]
[null,null,null,null,null,null,null,null,null,"強アルカリ",null,null,null,null,null,null,null,"廃石綿等",null,null,null,null,null,null,null,"汚泥（有害）"]
[5,"特定有害廃棄物",null,null,null,null,null,null,"ｱﾙｷﾙ水銀",null,null,null,null,null,null,null,null,null,"(","　",")","ﾄﾘｸﾛﾛｴﾁﾚﾝ",null,null,null,null,null,null,"(","　",")","1,3-ｼﾞｸﾛﾛﾌﾟﾛﾍﾟﾝ",null,null,null,null,null,"(","　",")"]
[null,null,null,null,null,null,null,null,"水銀又はその化合物",null,null,null,null,null,null,null,null,null,"(","　",")","ﾃﾄﾗｸﾛﾛｴﾁﾚﾝ",null,null,null,null,null,null,"(","　",")","チウラム",null,null,null,null,null,"(","　",")"]
[null,"　（　）には",null,null,null,null,null,null,"カドミウム又はその化合物",null,null,null,null,null,null,null,null,null,"(","　",")","ｼﾞｸﾛﾛﾒﾀﾝ",null,null,null,null,null,null,"(","　",")","シマジン",null,null,null,null,null,"(","　",")"]
[null," 混入有りは○、",null,null,null,null,null,null,"鉛又はその化合物",null,null,null,null,null,null,null,null,null,"(","　",")","四塩化炭素",null,null,null,null,null,null,"(","　",")","ﾁｵﾍﾞﾝｶﾙﾌﾞ",null,null,null,null,null,"(","　",")"]
[null," 無しは×、混入の",null,null,null,null,null,null,"有機燐化合物",null,null,null,null,null,null,null,null,null,"(","　",")","1,2-ｼﾞｸﾛﾛｴﾀﾝ",null,null,null,null,null,null,"(","　",")","ベンゼン",null,null,null,null,null,"(","　",")"]
[null," 可能性があれば△",null,null,null,null,null,null,"六価ｸﾛﾑ化合物",null,null,null,null,null,null,null,null,null,"(","　",")","1,1-ｼﾞｸﾛﾛｴﾁﾚﾝ",null,null,null,null,null,null,"(","　",")","セレン",null,null,null,null,null,"(","　",")"]
[null,null,null,null,null,null,null,null,"砒素又はその化合物",null,null,null,null,null,null,null,null,null,"(","　",")","ｼｽ-1,2-ｼﾞｸﾛﾛｴﾁﾚﾝ",null,null,null,null,null,null,"(","　",")","ダイオキシン類",null,null,null,null,null,"(","　",")"]
[null,null,"分析表添付",null,null,null,null,null,"ｼｱﾝ化合物",null,null,null,null,null,null,null,null,null,"(","　",")","1,1,1-ﾄﾘｸﾛﾛｴﾀﾝ",null,null,null,null,null,null,"(","　",")","1,4-ジオキサン",null,null,null,null,null,"(","　",")"]
[null,null,"（廃棄物処理法）",null,null,null,null,null,"ＰＣＢ",null,null,null,null,null,null,null,null,null,"(","　",")","1,1,2-ﾄﾘｸﾛﾛｴﾀﾝ",null,null,null,null,null,null,"(","　",")"]
[6,"PRTR対象物質",null,null,null,null,null,null,"届出事業所　（該当 ・ 非該当）、　委託する廃棄物の該当・非該当　（該当 ・ 非該当）"]
[null,null,null,null,null,null,null,null,"※ 委託する廃棄物に第１種指定化学物質を含む場合、その物質名を書いて下さい。"]
[]
[7,"水道水源における",null,null,null,null,null,null,"生成物質：ホルムアルデヒド（塩素処理により生成）"]
[null,"消毒副生成物",null,null,null,null,null,null,null,"ヘキサメチレンテトラミン（HMT）　",null,null,null,null,null,null,null,null,null,null,"1,1-ジメチルヒドラジン（DMH）"]
[null,"前駆物質",null,null,null,null,null,null,null,"N,N-ジメチルアニリン（DMAN）",null,null,null,null,null,null,null,null,null,null,"トリメチルアミン（TMA）",null,null,null,null,null,null,null,null,"テトラメチルエチレンジアミン（TMED）"]
[null,null,null,null,null,null,null,null,null,"N,N-ジメチルエチルアミン（DMEA）",null,null,null,null,null,null,null,null,null,null,"ジメチルアミノエタノール（DMAE）"]
[null,null,null,null,null,null,null,null,"生成物質：クロロホルム（塩素処理により生成）"]
[null,null,null,null,null,null,null,null,null,"アセトンジカルボン酸",null,null,null,null,null,null,null,null,null,null,"1,3-ジハイドロキシルベンゼン（レゾルシノール）"]
[null,null,null,null,null,null,null,null,null,"1,3,5-トリヒドロキシベンゼン",null,null,null,null,null,null,null,null,null,null,"アセチルアセトン",null,null,null,null,null,null,null,null,"2'-アミノアセトフェノン"]
[null,null,null,null,null,null,null,null,null,"3'-アミノアセトフェノン"]
[null,null,null,null,null,null,null,null,"生成物質：臭素酸（オゾン処理により生成）、ジブロモクロロメタン、ブロモジクロロメタン、ブロモホルム（塩素処理により生成）"]
[null,null,null,null,null,null,null,null,null,"臭化物（臭化カリウム等）"]
[8,"その他含有物質",null,null,null,null,null,null,"硫黄",null,null,"(","　",null,")",null,"塩素",null,null,"(","　",null,")",null,"ニッケル",null,null,null,"(","　",null,")",null,"ホウ素",null,null,"(","　",null,")"]
[null," 混入有りは○、",null,null,null,null,null,null,"ヨウ素",null,null,"(","　",null,")",null,"フッ素",null,null,"(","　",null,")",null,"アンモニア",null,null,null,"(","　",null,")",null,"臭素",null,null,"(","　",null,")"]
[null," 無しは×、混入の",null,null,null,null,null,null,"硝酸",null,null,"(","　",null,")",null,"亜鉛",null,null,"(","　",null,")",null,"アルミ",null,null,null,"(","　",null,")",null,"炭酸",null,null,"(","　",null,")"]
[null," 可能性があれば△",null,null,null,null,null,null,"銅",null,null,"(","　",null,")",null,"その他",null,null,"(","　",null,null,"成分名：",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,")"]
[null,null,"分析表添付（組成）"]
[9,"有害特性",null,null,null,null,null,null,null,"爆発性",null,null,null,null,null,"引火性（",null,null,null,null,"℃）",null,"可燃性",null,null,null,null,"自然発火性（",null,null,null,null,null,null,"℃）",null,"禁水性"]
[null," ( 有 ・ 無 ・ 不明 )",null,null,null,null,null,null,null,"酸化性",null,null,null,null,null,"有機過酸化物",null,null,null,null,null,null,"急性毒性",null,null,null,null,"感染性",null,null,null,null,null,null,null,null,"腐食性"]
[null,null,null,null,null,null,null,null,null,"毒性ガス発生",null,null,null,null,null,"慢性毒性",null,null,null,null,null,null,"生態毒性",null,null,null,null,"重合反応性"]
[null,null,null,null,null,null,null,null,null,"その他（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,")"]
[10,"廃棄物の物理的",null,null,null,null,null,null,"形状",null,"(",null,null,null,null,null,")",null,"臭い",null,"(",null,null,null,null,")",null,"色","(",null,null,")",null,"比重",null,"(",null,null,null,")"]
[null,"性状・化学的性状",null,null,null,null,null,null,"発熱量",null,null,"(",null,null,null,null,null,")",null,"沸点",null,"(",null,null,null,"℃）",null,"融点",null,"(",null,null,null,"℃）",null,"pH","(",null,null,")"]
[null,null,null,null,null,null,null,null,"粘度",null,"(",null,null,null,null,null,")",null,"水分",null,"(",null,null,null,"％)"]
[11,"品質安定性",null,null,null,null,null,null,"経時変化（ 有 ・ 無 ）　　有る場合は具体的に記入"]
[]
[12,"関連法規",null,null,null,null,null,null,"危険物（消防法） ・特化則（特定化学物質障害予防規則） ・有機溶剤 ・毒劇物 ・悪臭　　なし"]
[13,"荷姿",null,null,null,null,null,null,null,"容器",null,"(",null,null,null,null,")",null,"車両",null,"(",null,null,null,null,null,")",null,"その他（",null,null,null,null,null,null,null,null,null,null,")"]
[14,"排出頻度",null,null,null,null,null,null,"頻度（ スポット ・ 継続予定 ）"]
[null,"数量",null,null,null,null,null,null,"(　",null,null,null,null,null,null,")","kg ･ ｔ ･ ㍑ ･ m3 ･ 本 ･ 缶 ･ 袋 ･ 個 　　　　　／ 年 ･ 月 ･ 週 ･ 日"]
[15,"特別注意事項",null,null,null,null,null,null," ※取り扱う際に必要と考えられる注意事項を記載"]
[null,null,null,null,null,null,null,null,"例"]
[null,"（ 有 ・ 無 ）",null,null,null,null,null,null,"・避けるべき処理方法、安全のため採用すべき処理方法"]
[null,null,null,null,null,null,null,null,"・他の廃棄物との混合禁止"]
[null,null,null,null,null,null,null,null,"・粉じん爆発の可能性"]
[null,null,null,null,null,null,null,null,"・容器腐食性の可能性／注意点"]
[null,null,null,null,null,null,null,null,"・廃棄物の性状変化などに起因する環境汚染の可能性"]
[null,null,null,null,null,null,null,null,"・環境中に放出された後の支障発生の可能性（消毒用塩素等との反応により"]
[null,null,null,null,null,null,null,null,"　他の物質を生成し、水道取水障害に至る可能性等）　　等"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"【参考】　その他の情報"]
[]
["・","サンプル等提供　　　（　均一ｻﾝﾌﾟﾙ有　・　不均一ｻﾝﾌﾟﾙ有　・　ｻﾝﾌﾟﾙの一部分有　・　ｻﾝﾌﾟﾙ無　・　写真有　）"]
[]
["・","産業廃棄物の発生工程等"]
[null,null,"「3廃棄物の組成・成分情報」を推定する根拠となる、使用原材料・有害物質・不純物の混入、排出場所"]
[null,null,"がわかる発生工程の説明を書いてください。　工程前からの持ち込み成分があれば書いてください。"]
[null,null,"工程図への記入でも可。"]
[null,null,"（処理業者においては、不純物混入の可能性や廃棄物成分のブレ幅の推定、分析頻度等の"]
[null,null,"判断材料となります。）"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"＜排出事業者及び処理業者内容確認欄＞"]
["No.",null,"内容確認日時",null,null,null,null,null,null,"排出事業者担当者",null,null,null,null,null,null,null,"処理業者担当者",null,null,null,null,null,null,"備考"]
[]
[]
[]
[]
[]
[]
[null,"＜変更履歴＞"]
["No.",null,"変更日時",null,null,null,null,null,null,"排出事業者担当者",null,null,null,null,null,null,null,"処理業者担当者",null,null,null,null,null,null,"変更内容"]