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Get Editable Form 7710 53

5P) Office of Solid Waste U.S. Environmental Protection Agency 1200 Pennsylvania Ave., N.W. Washington, DC 20460-0001 1. Name of Facility Name of Owner Facility 2. EPA Identification Number (if already assigned under RCRA) 3. Facility Mailing Address (Street or PO Box, City, State, & Zip Code) 4. Location of Facility (No. Street, City, State, & Zip Code) 5. Installation Contact (Name and Title) 6. Type of PCB Activity (Mark X in appropriate box. See Instructions.) A. Generator w/onsi.

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