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•��! Stericycle' <br /> Environmental Solutions <br /> Generator's <br /> Name: Work Order: <br /> EPA PROCESS CODE: PAGE of <br /> ID No: <br /> Drum <br /> DOT Shipping Description: <br /> No. <br /> DRUM SIZE DRUM TYPE CONTAINERWEIGHT <br /> Waste Codes: <br /> Manifest LineProfile <br /> No. I item: No. <br /> Unknown chemical identification form o <br /> t <br /> Catalog � � � <br /> No. d Description c v cc o a v v a °D EPA Code(s) <br /> Packing Certification-I authorize the material packed in this container,including all inventory sheets adhere to the following: <br /> 1 The material is exactly as identified above <br /> 2 The lab contents do not include materials not authorized or permitted by PSC Environmental,llc to ship or in violation of TSDF's facility permits <br /> 3 The lab pack has been completed in accordance with all Federal,State,and Local regulations <br /> Chemist Name(s) Date: <br /> ©Stericycle 2015.All rights reserved. Confidential Information:Copying,dissemination or distribution of this information is strictly prohibited. <br />