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09/28/99 TUE 09:56 FAX 503 229 6977 DEQ 9TH FLOOR <br />~ 003 <br />~ ~ Page 28 <br />P~EASE ENTER: <br />Facifity name: ' <br />I DEQ ID number: <br />12. Provide the following i~formation for each off-site shipment of waste. <br />1998 man'itest Manifest Ouantity shlpped How managed <br />DEQ ID ~ ol (eMer mgmt. Managed at <br />commercial <br />shipment date <br />(enter monthlday} document <br />number (use unit of <br />measwe from #10) receiving taciliry code) faciGty? (YMl <br />.. ~ ~.. . i. ._..__ __~ ~i'_'_'~_~. r_.~ c,.•.~ n~~~.,... c~...~a ll..nn...~.n, fAlIO <br />