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EAS Waste- Request Form <br /> lIII�II�IIIII <br /> Approved RUSH <br /> I� 012 8 8 AA S <br /> SS Sample 94 D S '_ <br /> HWM Requisitiott Acct.# D S ux — z6--."f <br /> Building 4 Rooter# RMMA?Yes D No 13 DateIc <br /> Bottles Submitted Field Tech <br /> Send results to: L- <br /> Co ts: -0-- _ - <br /> ✓� 0 o -A <br /> SAMPLE-MM(Record volunw o;liquid in when NOT of MO <br /> D Retention Tank liters Tank# D Tufftank-liters(I gal.:3 ) <br /> ® Carboy, D 55er <br /> Process/S011MCg e le <br /> ( t WP ) <br /> 0 Aqueous D Coolant- (specify below) D Soil <br /> D Base (specify below) O Solvents- (specify below) D Sludge,solid <br /> D Acid- (specify below) D Oil- (specify below) D Ph r <br /> - (specify below) D Silicon D UNKNOWN <br /> li4uid p %(by volume) Top/Bottom(circle one) r <br /> Co sition(Llst all other components as hetane,laquer thUmer,alcohol) a <br /> A-s as -r— <br /> A iscuss wu nvtro A yst assigM to M area) <br /> General An lvscc84AMLY= GC Analyses GC-MS Anal <br /> ® pHINormality Toss Alpha Beta* D Volatues <br /> D Anions r.num* Vo D Semi-Volatiles <br /> D ppm oil ®C Spectroscopy D Non-halogenatedVols amudo <br /> - <br /> D %oil •!f only asidngfor alphalbeta or Q PCBs D Volatiles <br /> 0 Cyanide 3H.fill our a Limited D TTHS 0 Semi-Voladks <br /> 11 Flashpoint Radioisotope Cernfication form <br /> D nIC Metals D TMC As D TMC Se D TTLC Hg <br /> D STLC Metals D STLC As D STLC Se 0 STLC Hg <br /> �}Ds,.pT�+C LP Metals A®D TCLP A�se,� /ate Cu. '` D TCLP�+ S�}eg ® TCLP Hg <br /> TCLPpLCV�Jt C Ag,Ba.Be.Cd.Co.Cri CMo.Nie Pb,Sb, ,V,Za <br /> i CLP M s lig.Ba.Cd.Cr.Pb <br /> Other Analyses <br /> 1 certify that the above ' n is ea complete to the best of my knowle e <br /> Generator Si L- Date <br /> Generatm N (print) (pager) P 9/2.6 �3 <br /> EAS Approval 1 Date ` l <br /> FAS Approval 2 (for RTs) Date <br /> Rev 11.721/93 pme ELAP Cerdfi=on No. 1554 EAS(5I0)424-4127 <br />