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Fingerprint Verification Analysis Checklist <br />Date submitted 11/17/16 <br />WDR # W353384 Item # <br />COC # (if applicable) 206/—/ <br />IGD # (if applicable) 00909 <br />Generator Jon iJ2Ss <br />IGD annual verification ®Yes ❑ No <br />Bldg./Room 879 <br />Field Technician Alexander Blane-Zimberg <br />Complete applicable tests, as indicated <br />P F NIA (P = PASA F = Fail N/A = KIM Annlirnhlnl <br />® <br />Waste container label matches WDR and container contents ®Yes ❑No <br />❑ <br />Container contents match WDR: W353384 <br />Identity ®Yes ❑No Quantity/Weight/Volume ®Yes []No Container Size ®Yes ❑No <br />❑ <br />Waste Form ®Solid ❑Liquid (❑AQ (]NAL) ❑Sludge ❑Sediment (s 5% solids) <br />Additional info. (e.g., powder, granular, particle size?): <br />® <br />Odor: ®No ❑Yes, Explain- <br />1:10 <br />10 1 <br />If liquid, from top to bottom including non -liquid layers: <br />Laver Percentage <br />Color Turbiditv <br />Viscosi <br />S=Solid L=Li uid % volume <br />light, medium, dark clear, cloudy, opaque <br />ve It, It, med, heavy <br />1 ❑S El <br />2 El ❑L <br />3 ❑S ❑L <br />Packing or absorbant material present ®Yes ❑No (If yes, what type clay quantity 751bs) <br />® <br />pH ❑ Meter pH ❑ Paper (Possible interference: ) <br />0 <br />10 <br />10 <br />1 Alcohol Hydrometer test % Alcohol <br />® <br />Peroxide test _ppm Stabilized with Hydroquinone ❑Yes ❑No Final Peroxide ppm <br />Oxidizer test ❑Positive ❑Negative <br />LJ <br />IN <br />I Solubility test ❑Soluble []Insoluble <br />Comments: solid debris from 879 sump, contains petroleum hydrocarbons, soil, clay absorbant. <br />Verification Failure Description: <br />Verification Failure Resolution: <br />Field verification performed by: mp. #: 50E630 Date: 11/17116 <br />Field verification ® Pass []Fail (If failed ensure section above is completed) ' j� <br />FEB 0 9 Mt <br />V 'Lwt. <br />ENVIRONMENTAL H''ALTH <br />DEPARTMr-ENT <br />WCG 0006 Effective Date: 9/13/16 <br />See WIC 103 Expiration Date: 9113119 <br />