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COMPANY NAME: _ .01l_ LOI I PPctJ ID No.: OPMCI51 Z(ol <br /> (See instructions on reverse) <br /> Ill. EFFLUENT WASTE AND/OR TREATMENT RESIDUAL INFORMATION: Complete chart below for each <br /> effluent waste and/or treatment residual produced at this site by this unit from each influent line <br /> reported above(see instructions for details). <br /> Influent Hazardous Unit <br /> Line Disposition Characteristics Waste of <br /> Number Code Code Quantity Measure <br /> Example D 8 1 T1 0 0 P <br /> T 8 9 N 1 2 0 01010 G <br /> Cl D l iv Z T <br /> N Z old Co <br /> DI N Z I I I 12000 <br /> � I N S f foo <br /> z <br /> 3 <br /> 4 <br /> 5 <br /> ❑ If additbnai space is needed, attach a separate piece of paper with the additional information, using <br /> the some format and place a check in this box. <br /> IV. STATUS OF ENVIRONMENTAL INVESTIGATION <br /> A. ❑ An environmental investigation has not been completed. <br /> B. ❑ An environmental investigation has been completed and no evidence of a release was <br /> found. <br /> C. ❑ An environmental investigation has been completed and evidence of a release was found. <br /> The cleanup,abatement,or remedial action has been completed. <br /> D. ❑ An environmental investigation has been completed and evidence of a release was found. <br /> The cleanup,abatement,or remedial action has not been completed. <br /> E. 2j An environmental investigation is not required because the TTU operator did not generate <br /> the waste. <br /> Distribution: DISC—While and Yellow; Nolinel—Pink and Instructions <br /> pW SMAcn/yq Page 4 of 5 <br />