DOT Shipping Name:
UN/NA ID No.:
NSSI Profile No. :
Generator Drum No. : sheet of per durm
Outer Container Type/Size:
UN/NA ID No. :
NOTE: Line item numbers on this sheetmust be entered on labels affixed to inner
containers holding materials/chemicals identified on the corresponding line.
Materials/Chemicals that appear in the "U" or "P" hazardous waste list must have the EPA
hazardous waste code; otherwise, enter "used", "spent" or "more than one active ingredient",
if it applies, to explain why the code is not assigned.
CERTIFICATION: The listing above is an accurate and complete description of the contents of this drum,
and they are packed in accordance to 49 CFR'173.12.
5711 Etheridge St Houston, Texas 77087
Mixed Waste: Kimberly Page
RSO/Sealed Sources: Gamaliel Torres
President: Gamaliel Torres