Laserfiche WebLink
H131468 ACCEPTABLE FOR "93 <br /> LAWRENCE LIVERMOhE NATIONAL LABORATORY <br /> HAZARDOUS WASTE DISPOSAL REQUISITION ❑ HWM Use Only Page 1 of� <br /> 1.Bui.ding No: 2. Room No: 3. RMMA: 10.Hazardous Outer Contalner/Retention Tank ID:- Overpack? sch•dut•a West-Run Date: - Vold Requlsillori <br /> Properties: p <br /> 2 ®� ❑ Yes No P ❑va []NO �,'J_C._/ ❑DATEs�,_.J_,.—J <br /> 4.WAA No: F 5.Workplace End Date: Toxic <br /> 6.Account No 12.Outer Container 13.Outer Container Size: Initiala/D to <br /> Z 3 .3 S 3_? Q ❑Corrosive T e <br /> .HWM Waste Run <br /> —�/ L — —— 17 YP ❑ 1 gal ❑330 gal ar s�° ,i. 1 ,t <br /> 7.Waste Wniniization Efforts Practiced During Generation of this Waste? �pto �Ignitable ❑Box ❑ 5 gal ❑660 gal ❑��Off1$i;e to LLNI e` t Tt) <br /> -]Yes, Activity Codes(enter up to four): W W W W <br /> Reactive F-1 Can ❑ 7 gal ❑750 gal - r 1 <br /> El 30 al ❑1000 gal �tiC,pmmercla(Shipment �t'" WTD `. <br /> 11.Waste Form: ❑Carboy -155 gag ❑5000 gal <br /> Comments: <br /> ❑ Solid ❑Drum ❑85 gal ❑1x1x1.5 �r--yy <br /> Did this Waste Minimization effort begin in current calendar year? ❑Yes ❑NoLiquid Tank-Fixed El2x4x7 ft <br /> 8.Profile No: 9.Directorate: ❑Sludge ❑Tank-Portable ❑4x4x7 alftMveste <br /> f}i�r <br /> H P ❑ Gas Other: _ Other: O O "4g - , ,'',"v' <br /> —+- ❑cu ft ❑•S,eWer,: DATE:Lj_/ R8 <br /> 14.ITEM 15.AQUEOUS ONLY 16.ANALYSIS 17.SOURCE 18.CHEMICAL/PHYSICAL DESCRIPTION 19.QUANTITY <br /> NO. * SAMPLE NO. CODE per Item <br /> H Normality* Amount units <br /> sem( <br /> '---HYVP7 SHIPPING <br /> _ 4 1994 <br /> For RMMA Waste *Normality Required if pH s 2 or pHs 12.5 ECONiINUATION FORM FOR ADDITIONAL ITEMS <br /> 20.Was the waste kept isolated from _ <br /> any operation that could have 22.Describe other controls used to prevent radioactive contamination: JL <br /> produced radioactive contamination 23.1 certify,to the best of my knowledge,that the information provided on this requisition is correct.I understand that I may be liable to State and Federal prosecution by intentionally <br /> (using a glove box,vent hood,etc.)? providing false information. <br /> Yes❑ No ❑ <br /> (If no,full rad analysis required) Generator Name(Print-Last,First): L-Code: Ext.: InspectQd by NYVM(Pant Name ¢Last First):, Ext.: <br /> 21.Was the waste exposed to particle +e j-,e �t y- (S]�Q h T7 r3S,U to <br /> bein1s capable of inducing radioactivity Signature: Employee No.: at Signature, Employee No.: Date: <br /> by activation? Yes❑ No ❑ ,/ <br /> (it yes,full rad analysis required) `99r�T3 �T p , {/ <br /> ITEM RCH RCH P Origin Form EPA No. DTSC NO. MSDS NO. Hazardous Properties Handling Code: By: <br /> Prefix Code Code <br /> T C 1 R _ <br /> Date: Loc: <br /> l- <br /> Chemical Compatibility Code: <br /> ❑ ❑ ❑ ❑ ' ' <br /> ❑ ❑ El <br /> rt�lent Generating Waste: <br /> -_-----I—_— --_— — - ITWM Re ' IUon Approv .(SI uie), <br /> ❑ El E-1. <br /> ploy a No.: Date: <br /> LL:i344(3(knv.3i;ta) <br /> i600403(12 -- _- — <br /> White—HWM Copy <br />