-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, VRYiaU2QQ5WlXdah98MHlZJwC6rosU2A7QHwTT4PfgNRokgEN72L0/i5gUTMZsow 3EUZTc/zTDgb3BFZybMvRg== 0001181431-03-001269.txt : 20030130 0001181431-03-001269.hdr.sgml : 20030130 20030130172517 ACCESSION NUMBER: 0001181431-03-001269 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20021231 FILED AS OF DATE: 20030130 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: KOENECKE ROGER A CENTRAL INDEX KEY: 0001205219 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 5 MAIL ADDRESS: STREET 1: 29 FOXWOOD LANE CITY: KINGSTON STATE: MA ZIP: 02364 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: CLEAN HARBORS INC CENTRAL INDEX KEY: 0000822818 STANDARD INDUSTRIAL CLASSIFICATION: HAZARDOUS WASTE MANAGEMENT [4955] IRS NUMBER: 042997780 STATE OF INCORPORATION: MA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-16379 FILM NUMBER: 03532731 BUSINESS ADDRESS: STREET 1: 1501 WASHINGTON ST STREET 2: 325 WOOD RD CITY: BRAINTREE STATE: MA ZIP: 02184 BUSINESS PHONE: 6178491800 MAIL ADDRESS: STREET 1: PO BOX 327 STREET 2: 325 WOOD ROAD CITY: BRAINTREE STATE: MA ZIP: 02184 5 1 rrd3804.htm FORM 5 SEC Form 5
FORM 5

[  ] Check this box if no longer
subject to Section 16. Form 4 or Form 5 obligations may continue.
See Instruction 1(b).

[  ] Form 3 Holdings Reported

[X] Form 4 Transactions Reported
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C.  20549

ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility
Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Koenecke, Roger A.

(Last)                      (First)                      (Middle)
co Clean Harbors, Inc.
1501 Washington Street

(Street)
Braintree,    MA   02185-9048

(City)                      (State)                      (Zip)

2. Issuer Name
and Ticker or Trading Symbol

Clean Harbors, Inc.
clhb

3. I.R.S. Identification
    Number of Reporting
    Person, if an entity
    (voluntary)
4. Statement for
    Month/Year

12/2002


5. If Amendment,
    Date of Original
    (Month/Year)

6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

   Director      10% Owner
X Officer (give title below)        Other (specify below)

Description           Chief Financial Officer

7. Individual or Joint/Group
    Filing (Check Applicable Line)

X   Form filed by One Reporting Person
     Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security
    (Instr. 3)

2.Transaction
Date
(Month/Day/Year)
2A. Deemed Execution Date, if any
(Month/Day/Year)
3. Transaction
    Code
    (Instr. 8)
4. Securities Acquired (A) or Disposed Of (D)
    (Instr. 3, 4, and 5)





        Amount      /         A/D         /         Price          
5. Amount of
    Securities
    Beneficially
    Owned at end of
    Issuer's Fiscal Year

    (Instr. 3 and 4)
6. Owner-
    ship
    Form:
    Direct (D)
    or
    Indirect (I)

    (Instr. 4)
7. Nature of
     Indirect
     Beneficial
     Ownership

    (Instr. 4)
commom stock
01/16/2002
L
381.501354 / A / $2.0315
common stock
04/08/2002
L
261.257374 / A / $2.9665
7,861.734328
I
Employee Stock Purchase Pl

 
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)

1. Title of Derivative Security
    (Instr. 3)
2. Conver-
    sion or
    Exercise
    Price of
    Deri-
    vative
    Security
3. Transaction Date

(Month/
Day/
Year)
3A. Deemed Execution Date, if any

(Month/
Day/
Year)
4. Transaction Code
    (Instr.8)
5. Number of Derivative
    Securities Acquired (A)
    or Disposed Of (D)

    (Instr. 3, 4 and 5)





  A     or     D  
6. Date Exercisable(DE) and
    Expiration Date(ED)
    (Month/Day/Year)






  DE     /     ED  
7. Title and Amount of
    Underlying Securities
    (Instr. 3 and 4)






Title     /         Amount or Number of Shares
8. Price
    of
    Derivative
    Security
    (Instr.5)
9. Number of
    Derivative
    Securities
    Beneficially
    Owned
    at End of Year
    Reported
    Transaction(s)
    (Instr.4)
10. Owner-
ship
Form of
Deriv-
ative
Securities:
Direct (D)
or
Indirect (I)

(Instr.4)
11. Nature of
      Indirect
      Beneficial
      Ownership
      (Instr.4)
$
/
 / 
$
Explanation of Responses:
 
Shares purchased under employee stock purchase plan.
By: Date:
/s/ Roger Koenecke 01/21/2003
** Signature of Reporting Person
SEC 2270 (09-02)


Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.

* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Potential persons who are to respond to the collection of information contained in this form are not
required to respond unless the form displays a currently valid OMB Number.
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