Free 52391.pdf - Indiana

HAZARDOUS WASTE BIENNIAL REPORT
State Form 52391 (9-05) Indiana Department of Environmental Management

FORM WR
A. Waste #1 Description

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

REPORT YEAR

B. Waste Codes C. Generator ID number D. Quantity Received E. Form Code A. Waste #2 Description B. Waste Codes C. Generator ID number D. Quantity Received E. Form Code A. Waste #3 Description B. Waste Codes C. Generator ID number D. Quantity Received E. Form Code

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_ _ kilograms _ _ metric tons

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COMMENTS:
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