Attchmt_07_-_Facility_Profile_Sheet.doc

SP4530-14-R-0002, Korea HW

Attachment 07

FACILITY PROFILE SHEET

1. Facility Data:

Facility Name:

Address:

Facility Representative(s):

Telephone Number:

Fax Number:

Email:

Principle Owner(s):

2. Disposition Services Facility ID# ___________________________ . (Provide number if facility has been previously approved by Disposition Services.)

3. For all permits, authorizations, and licenses that authorize the facility to dispose/recycle hazardous waste, provide the following information:

4. For each waste that will be processed through the facility, identify the waste, treatment process and CLIN number.

FACILTY PROFILE SHEET 1

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