Waste Profile Form & Instructions LDR & UHC Forms Chain Of Custody Form	All forms requiring a signature must be faxed or mailed to: Perma-Fix of Dayton, Inc. Att: Customer Service 300 Cherokee Drive Dayton OH 45427 Fax: 937-268-5734 See the Help Pages for technical assistance. Questions? Perma-Fix of Dayton, 1-800-543-3670 (For problems with operation of Web site ONLY: )
Right click File Name and choose "Save As" to download to your computer. See the Help Pages for assistance. Form Name/Description File Name Right click to download Format Size Posted Waste Material Profile Fill out electronically & email. Important: you must DOWNLOAD first; see the Help page. Send completed form as an attachment to Dayton Customer Service, . If you email, you MUST also print, sign, and fax the signature page to the number above. PermaFixProfile.xls Microsoft Excel Worksheet 465 KB 6/15/04 Land Disposal Restriction & Related Contents: LDR Certification, Subpart CC & LDR Notification, Univ Treatment Stds/Underlying Haz Constituents Form LDR-UHC.xls Microsoft Excel Worksheet 89 KB 4/12/04 Chain of Custody Form PFDChainofCustody.xls Microsoft Excel Worksheet 50 KB 7/01