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FORM <br /> '11772--ADMM TRATIVE REVIEW PROBLEM CHECKLIST �9� <br /> Facility Name: V L�, (� Q ,,�, �} ID #: C F� J 115 0 �Y Dods <br /> Check appropriate blocks for problems found (& explain if necessary) <br /> ❑ Second copy is missing <br /> Facility Specific Form: n� <br /> ❑ Revised box checked U <br /> ❑ I. Notification Categories - <br /> ❑ Tiers marked do not match type of forms filed <br /> ❑ Number of forms attached do not match total number of units }l <br /> ❑ Tier 'A' checked with other tiers. <br /> ❑ R. Generator Identification - Check all that apply <br /> ❑ EPA # incorrect/missing <br /> ❑ Name/Address incomplete <br /> ❑ Contact Person/Phone # missing <br /> ❑ III. Type of Company: Standard Industrial Classification Code - Code missing <br /> ❑ VI. Attachments - Missing (if there, mark boxes if necessary) <br /> Certifications <br /> ❑ No signature/title/date <br /> ❑ Questionable title <br /> ❑ No original signature on both copies <br /> Unit Specific Forms: Unit # <br /> ❑ Unit Name/Unit ID Number - Information missing <br /> Number of Treatment Devices - No number (x is unacceptable) <br /> I. Wastestreams and Treatment Processes <br /> ❑ Total Volume Treated - No quantity <br /> ❑ Wastestreams - None marked (circle marked ones, top form only) <br /> ❑ II. Narrative Descriptions - Blank 1 2 (Circle blank section.) <br /> ❑ III. Residual Management - #3 - letter not checked when Yes (others can be blank) <br /> ❑ IV. Basis For Not Needing A Federal Permit - Nothing Marked <br /> ❑ V. Transportable Treatment Unit - If marked, set aside for special handling <br /> Additional Comments/Problems: <br /> Reviewed by : u Date: 17 43 <br /> Problems handled by: Date: Rev. 4/17/93 <br />