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Fillable DRY CLEANER REGISTRATION – PERCHLOROETHYLENE AND ... - dnr mo

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MISSOURI DEPARTMENT OF NATURAL RESOURCES HAZARDOUS WASTE PROGRAM FOR OFFICE USE ONLY LOGGED IN BY DRY CLEANER REGISTRATION ­ PERCHLOROETHYLENE AND OTHER CHLORINATED SOLVENTS Complete this form and return it to: Missouri Department of Natural Resources Hazardous Waste Program/DERT Unit P.O. Box 176 Jefferson City, MO 65102-0176 YEAR OF DATA COUNTY NAME FIPS COUNTY NO. DATE LOGGED RECEIVED SURCHARGE CHECK AMOUNT...
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