Free ANNUAL MANIFEST SUMMARY - Indiana


File Size: 24.8 kB
Pages: 1
Date: July 26, 2006
File Format: PDF
State: Indiana
Category: Government
Author: mweddle
Word Count: 154 Words, 1,022 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.state.in.us/icpr/webfile/formsdiv/52718.pdf

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ANNUAL MANIFEST SUMMARY REPORT
State Form 52718 (7-06)

REPORT YEAR

Indiana Department of Environmental Management

FORM WG
WASTE RECEIVED FROM OFF-SITE Waste #1
Hazardous Waste Description: EPA Waste Codes: Generator RCRA ID# Generator Name and Location Address Quantity Received Unit of Measure Mgmt Code H

RCRA ID TSD FACILITY NAME

Waste #2
Hazardous Waste Description: EPA Waste Codes: Generator RCRA ID# Generator Name and Location Address Quantity Received Unit of Measure Mgmt Code H

Waste #3
Hazardous Waste Description: EPA Waste Codes: Generator RCRA ID# Generator Name and Location Address Quantity Received Unit of Measure Mgmt Code H

Waste #4
Hazardous Waste Description: EPA Waste Codes: Generator RCRA ID# Generator Name and Location Address Quantity Received Unit of Measure Mgmt Code H

Waste #5
Hazardous Waste Description: EPA Waste Codes: Generator RCRA ID# Generator Name and Location Address Quantity Received Unit of Measure Mgmt Code H

Copy this page for as many wastes as needed.

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