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EAS Waste-Anaiysis Lequest Form- <br /> 13 <br /> or - <br /> lal� IIl�ll ��lll�a A RUSH <br /> EAS Sample# 9401922 3 '�c�WAA S <br /> t=Date <br /> HWMReq . ACCL.# S <br /> B =gog# R # R ?Yesd No-O u 1 0 <br /> #Bottles Submitged Field Tech <br /> `r � = <br /> SenCo;d is t0' i%7 > , , T 5. �. ti <br /> ru <br /> (Record volume of Uqnd wane is mk what NOTmmimm capacay of toW <br /> D Remndon T li Tank# D Tuff tank_li=s V miLm MQ <br /> Carboy,13 D 55 gal.Dmm, ACMer 7 7. ; , /� 5 <br /> Ptocess/Source generating the la <br /> A1 IMMMON(Ma aU MaPP 1 <br /> D Aqueous D Coolant- (specify below) -_ <br /> D Base- (specify below) D Solvents- (specify below) solid <br /> (specify below) D Oil- (specify below) D Phomhemicals <br /> Oth - (specify below) D Sili=flt'id G! UNKNOWN <br /> rCI-Zlqm phases <br /> 9fa(by volume) Top i B4^Lwn(circle one) <br /> Co Y f lcr ail odrr components mxh as heum,kWw dunner,alcohol) <br /> ANALVC=S;711-A nvIrO A yst Essig to the area) <br /> General Analyte GC Analyses GC-MS A „ <br /> ® pIVNormaiiry < ross Alpha and Beta* ®HaloMated and D VoLviles <br /> D Anions Aromatic Volatiles D Semi-Vobuiles <br /> D ppm oil S D Non-halogenatcd Vols TCLP <br /> D %oilif y adking for alphabets or ® PCBs D Volatiles <br /> D Cyanide K.fall our a Limited 07M D Semi-Voladles <br /> D Flashpoint Radioisotope Cen0kadon form <br /> es <br /> D T17LC Metals O TMC As D TPLC Se D TI-LC Hg <br /> D STLC Metals D STLC As D STLC Se D STLC Hg <br /> �D TpeCLP/Metals D TC12 ACr,Cu.Mn, ` D TCLPt Se �/ �g� D TCLP Hg <br /> l/L6�./J i C /m®emisa Ag.BB L�Be,Cd.Co.WCrC •®anMo.NL Pb.Sb.TL ,Za <br /> TCLP M s' Bas Cd.Cr.Pb <br /> Other Analyses <br /> 1 certify that the above ' o ' n is rrtct acid complete to the best of my knowledge <br /> Generator Si U 3 Date z <br /> Generator Name(print) _�,tJ ,/. Ext_ (Pager) <br /> EAS Approval l <br /> Date— <br /> EAS <br /> ate—EAS Approval 2(for RTs) Date <br /> Rev i 1. •7121191 nmfb cr A® 'T- a CCA r-AV feat„wne •1-" <br />