Dd Form 836 – Fill Out and Use This PDF

UN/ID

NUMBER

a.

PROPER SHIPPING NAME

(Include RQ, Technical Names, Additional

Information per 49 CFR172.203, as required.)

b.

HAZARD CLASS/ DIVISION c.

SUBSIDIARY

HAZARD

d.

PACKING GROUP (PG)

e.

PACKAGES

NUMBER KIND

f.g.

TOTAL NET QUANTITY h.

TOTAL AMMO (NEW)

i.

DOD

NON-EXPLOSIVE

HAZMAT:

1-800-851-8061

AT SEA: COLLECT:

1-804-279-3131

DOD HAZ CLASS 1

(EXPLOSIVES) ONLY:

(703)697-0218 or 0219

(COLLECT)

OR

DSN 227-0218

(WATCH OFFICER)

CHEMICAL/BIOLOGICAL

WARFARE MATERIAL

DUTY HOURS:

DSN 584-3044, 584-7211,

584-6455,

Comm. (410) 436-3044,

(410)436-7211,

(410)436-6455

AFTER DUTY HOURS:

DSN 584-2148,

Comm. (410) 436-2148

(Ask for TEU S3)

SECURE HOLDING:

Non-AA&E: 1-800-524-0331

AA&E: 1-800-826-0794

OIL AND CHEMICAL SPILLS:

NATIONAL RESPONSE

CENTER (NRC) AND

TERRORIST HOTLINE:

1-800-424-8802

AT SEA:

202-267-2675

(COLLECT)

DOD RADIOACTIVE

MATERIALS:

ARMY: (703) 697-0218

(COLLECT)

USAF: (202) 767-4011

(COLLECT)

USN/MC: Use 24-hour

emergency response phone number provided by USN/MC activity initiating shipment.

DLA: 1-800-851-8061

(AT SEA: (804) 279-3131)

a. TYPE OR PRINT NAME OF SHIPPER CERTIFIER

c. SIGNATURE(S) OF VEHICLE OPERATOR(S)

GENERAL

DDForm 836 will be completed by a qualified* individual from a transportation office, unit or other organization offering Hazardous Material (HAZMAT) for transportation in areas accessible to the general public.

*An individual is considered qualified to complete and sign (certify) DD Form 836, only after having satisfactorily completed either a DOD authorized HAZMAT Course from one of the DOD-approved schools listed in the Defense Transportation Regulation (DTR) or military technical specialist training in accordance with the DTR, Chapter 204, Paragraph D. This person will be appointed in writing by the activity or unit commander, to include scope of authority and expiration date of training.

Item 1. Fill in the nomenclature, model number, TCN, and bumper number/serial number of the vehicle/container. For containers carrying sensitive or classified items, the container security seal is required.

Item 2. Enter the shipper's address and telephone number of the HAZMAT origination and date of preparation. Telephone number is for NOTIFICATION PURPOSES ONLY. Emergency assistance will be obtained from the 24-HOUR EMERGENCY ASSISTANCE TELEPHONE NUMBER(S) in Item 7c. on the first page of this form.

Item 3. Self-explanatory.

Item 4a. Enter the identification numbers, e.g., NA, UN. The letters "UN" or "NA" must be noted. "NA" may not be used for OCONUS.

Item 4b. Enter the proper shipping name of the HAZMAT and if applicable include the technical name. (Enter additional information as required by 49 CFR, 172.203 - Example: RQ, Inhalation Hazard.) NOTE: In the case of multiple HAZMAT items on the same form with different emergency response telephone numbers, each phone number will be annotated below or adjacent to the HAZMAT item to which they apply.

Item 4c. Enter the Hazard class/division and, if applicable, the Compatibility Group.

Item 4d. Enter the subsidiary hazard of the material if applicable.

Item 4e. Enter the packing group (e.g. I, II, or III) of the HAZMAT.

Item 4f. Enter the total number of packages/items.

Item 4g. Enter the type of packaging (e.g., container, box, drum, pallet), the HAZMAT is packed in.

Item 4h. Enter the total net quantity for non-explosive material in metric measure. US measure may be added in parentheses underneath the metric measure. For ammunition, enter the total number of rounds/articles. Exception: Net total quantity is not required for bulk packages, empty packages, and cylinders of Class 2.

Item 4i. Enter total Net Explosive Weight (NEW) in kilograms for ammunition/ explosive (Class 1 items). NEW information is found in the Joint Hazard Classification System (JHCS) in the entry for the NEW (Transportation Quantity). Example: 27.231 kg.

Item 5. Enter the six digit Department of Defense Activity Address Codes (DODAAC) and/or the clear geographical location of the ultimate consignee of the HAZMAT shipment. If this is a unit move, the unit name will be the same as that for Item 2.) Additional information if needed can be annotated in Item 6.

Item 6. Additional handling instructions/information.

Item 7a. Enter Emergency Response Guide Number.

Item 7b. Self-explanatory. Call 24-hour Emergency Response number(s) circled in Item 7c first and then shipper.

Item 7c. Circle emergency response telephone number.

NOTE: For Radioactive Material Shipments only: Circle numbers and cross out those numbers that do not apply, e.g., Army shipments - cross out all but Army's radioactive response number.

Item 8. Certifying person must type or print name legibly in 8a. and must sign in writing (longhand) and add the date signed in 8b.

Item 8c. Self explanatory.

NOTES:

1.Units returning from firing range must have a certified or qualified person to ensure that all HAZMAT is properly repackaged and secured (i.e. braced, blocked, and tied down) prior to being transported back to base. See exception below.

2.Completion of a new DD Form 836 is not required. Original DD Form 836 may be used provided that:

a.Change Item 2 (Date Prepared).

b.Change Item 4. (Cargo):

(i)HAZMAT used will be deleted from form by crossing out or lining through.

(ii)HAZMAT that remains, but is in different quantities, will have the correct amounts entered in the section(s).

EXCEPTION:

c.Change Item 8b.:

(i)A qualified individual (if available) must sign in writing (longhand). If a qualified individual is not available, then the Officer-In-Charge (OIC) or Non-Commissioned Officer-In-Charge (NCOIC) must sign in writing (longhand) to verify that the above procedures have been performed for the return trip to base.

(ii)Cross out original signature if different certifier will be used.