Laserfiche WebLink
H131465 ACACEPTABLE FrI 693 <br /> LAWRENCE LIVERMOc NATIONAL LABORATORY <br /> HAZARDOUS WASTE DISPOSAL REQUISITION go HWM Use Only Page 1 of 1 <br /> 1.Building No: 2. Room No: 3. RMMA: 10.Hazardous ou;ezConLain'eS/Ratention f�nk'Ip crarpack? h.duleay+ate Runoate VoidRequisition; a <br /> 2 B U Si ❑ Yes No PPeperties 3 .,., ]Yea ❑No / - <br /> "! l.T DATE— / — <br /> oxic <br /> 4.WAA No: 5.Workplace End Date: 6.Account No: 12.Outer Container 13.Outer Container Size: ❑ Initlal8/Dat + - <br /> Z _3 / / – _ ❑Corrosive Type; ❑ 1 gal ❑330 gal HwM;Waste,Runy <br /> l– ❑ Ignitable ❑Box ❑ 5 gal ❑660 gal Off-Site to LLNL RTO <br /> 7.Waste Minimization Efforts Practiced During Generation of this Waste? -IEQP ,�,/ <br /> ❑ Reactive ❑Can ❑ 7 9a1 ❑750 gal ' Commerclai Sh,iprnent WTO <br /> ❑Yes, Activity Codes(enter up to four): W W W W ❑30 gal ❑1000 gal <br /> 11.Waste Form: ❑Carboy ❑5000 gal <br /> Comments: ❑55 gal g ❑SalCtled Pfcup <br /> XSolid Drum ❑85 gal ❑1x1x15 ft r ra x <br /> ❑2x4x7 ft �H e d Pure Oyt .' <br /> Did this Waste Minimization effort begin in current calendar year? ❑Yes ❑No ❑liquid Tank-Fixed ? vqa <br /> 8.Profile No: 9.Directorate: ❑ Sludge ❑Tank-Portable ❑4x4❑x7ga ft ;❑ Generated Waste <br /> –� ❑ <br /> Gas Other: Other. 7— ❑Cu ft ❑�S9YV®� '�`' `� DATE:_�_�RSDR# " <br /> 14.ITEM 15.AQUEOUS ONLY 16.ANALYSIS 17.SOURCE 18.CHEMICAL/PHYSICAL DESCRIPTION 19.QUANTITY <br /> per Item <br /> NO. H Normality* SAMPLE NO. CODE <br /> Amount Units <br /> aJ ® v - <br /> HW SHI PING <br /> M R 7 1994 <br /> For RMMA Waste *Normality Required if pHs 2 or pH a 12.5 USE CONTINUATION FORM FOR ADDITIONAL ITEA- <br /> 20.Was the waste kept isolated from <br /> any operation that could have 22.Describe other controls used to prevent radioactive contamination: <br /> produced radioactive contamination 23.1 certify,to the best of my knowledge,that the information provided on.this requisition is correct.I understan I to 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.: InspectSd� HWK(P[int Name Last,First): Ext.: <br /> ' g73 3S,2�a . _ <br /> 21.Was the waste exposed to particle <br /> beams capable of inducing radioactivity Signature Employee No.: Date: Sign11 ature G . Employee No.: Date, <br /> by activation? Yes El No❑ 613719 <br /> O <br /> (If yes,full rad analysis required) !✓7/37,38 <br /> r a; 1 - r , q Handling Code: By: <br /> ITEM RCH RC P w Otigin Form EPA NO _ DISC NO.„= MSDSNO Hazardous Properties <br /> Prefix;' Code "Code <br /> T C I R <br /> Date: Loc: <br /> lORr <br /> ❑ El <br /> Compatibility Code: <br /> 01 <br /> El ❑ ❑ Department Gen rating Waste:' <br /> H qu k pproval ( ure)` 5=� <br /> x <br /> Employge (J �7 <br /> LL 5344-8(Rev.3/93) 7600-70302 Whit&—HWM CW <br />