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Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form Approved.OMB No.2050-0039 <br /> 1.Generates ID Number 2.Page 1 of 3.Emergency Response Phone 4.M if st Tracking�N�umbe <br /> UNIFORM HAZARDOUS r r r ,�, `tj 5 0 F L E <br /> WASTE MANIFEST CAL9212i16Q� i '"-moi Brr'v'?�,i � <br /> 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) <br /> ,i <br />