Universal Waste Manifest
(Batteries & Bulbs)
Generator Name
Site Address
City
State
ZIP Code
Contact Person
Phone Number
Transporter
Transporter Name
Transporter Address
Waste Description
Type
Quantity
Unit (lbs/ea)
Container Type
Description
Destination Facility
Facility Name
Facility Address
Signature (Generator)
Date
Signature (Transporter)
Date
Signature (Facility)
Date