Free 52388.pdf - Indiana

HAZARDOUS WASTE BIENNIAL REPORT
State Form 52388 (9-05) Indiana Department of Environmental Management

FORM GM

RCRA ID |_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _| NAME

REPORT YEAR

A. Waste Description

B. Waste Codes

|_ _|_ _|_ _|_ _|

|_ _|_ _|_ _|_ _| |_ _|_ _|_ _|_ _| |_ _|_ _|_ _|_ _|

|_ _|_ _|_ _|_ _|

C. Quantity Generated

|_ __|_ __|_ __|_ __|_ __|__ _|_ __|_ __|__ _| . |_ __|

_ _ pounds _ _ tons

_ _ kilograms _ _ metric tons

D. Form Code

W |_

__|_ __|_ __|

E. Source Code

G|_ __|_ __|
(If G25 enter a management code)

H |_ __|_ __|_ __| H. Management Code
H |_ _|_ _|_ _|

F. RCRA ID of Facility Shipped To
OFF SITE SHIPMENT Site #1 Site #2 Site #3 Site #4 |_ __|_ __|_ __|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _|

G. Quantity Shipped Off-site
|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _| . |_ _|

|_ __|_ __|_ __|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _|

|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _| . |_ _|

H |_ _|_ _|_ _|

|_ __|_ __|_ __|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _|

|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _| . |_ _|

H |_ _|_ _|_ _|

|_ __|_ __|_ __|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _|

|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _| . |_ _|

H |_ _|_ _|_ _|

I. Management Code
ON SITE MANAGEMENT System #1

J. Quantity Managed On-site |_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _| . |_ _|

H |_ _|_ _|_ _|

System #2

H |_ _|_ _|_ _|

|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _|_ _| . |_ _|

COMMENTS:
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