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Small Quantity Generator - NH Department of Environmental Services
Waste Management
Small Quantity Generator Self-Certification Program
ONLINE REGISTRATION FORM
Contact Judy Small at
judy.small@des.nh.gov
if you have questions regarding registering for the workshops.
Name:
Facility Name:
EPA Identification Number:
Mailing Address
Street:
Town:
State:
Zip:
Phone:
E-mail:
Workshop you will be Scheduled to Attend:
Select One:
October 24, 2012: Portsmouth – NH DES, Registration 9:15 AM, Session 9:30 AM – 11:30 AM
October 25, 2012: Exeter - Exeter Public Library, Registration 9:15 AM, Session 9:30 AM – 11:30 AM
November 1, 2012: Rochester – Rochester Public Library, Registration 9:45 AM, Session 10:00 AM – 12:00 PM
November 6, 2012: Concord – NH DES, Registration 12:45 PM, Session 1:00 PM – 3:00 PM
November 7, 2012: Derry – Derry Public Library, Registration 9:45 AM, Session 10:00 AM – 12:00 PM
For No-JavaScript Browsers: The form will not be processed without your email address.
DES will notify you only if the workshop you would like to attend has been filled to capacity and it becomes necessary to assign you to another workshop.
NH Department of Environmental Services | 29 Hazen Drive | PO Box 95 | Concord, NH 03302-0095
603.271.3503 | TDD Access: Relay NH 1.800.735.2964 | Hours: M-F, 8am-4pm
