ML12271A464

Enclosure 29 to ULNRC-05893 - 2011 Facility Summary Reports

ML12271A464
Person / Time
Site:	Callaway
Issue date:	05/09/2011
From:	Maschler D L State of MO, Dept of Natural Resources
To:	Office of Nuclear Reactor Regulation
References
ULNRC-05893
Download: ML12271A464 (6)

Text

-COPYING FORM. AlTACH SITE IDENTIFICAllON L.ABLE OR MISSOURI D!PARTMENT OF NATURAL RESOURCES HAZARDOUS WASTE PROGRAM P.O. BOX 178 JEFFERSON CITY, MISSOURI 85102 1573\751-3171 FACILITY

SUMMARY

REPORT PART I 8 eJ +--CHECK HERE IF NO WASTE WAS RECEIVED FROM OFF-siTE, AND NO WASTE WAS GENERATED AND MANAGED ON.SITE (DO NOT COMPLETE PART II) b STA-:"t::r:ENT I certify under penalty of law that I have personally examined and am famiHar with the Information submitted In this and all attached documents and that based on my inquiry of those individuals immediately responsible for obtaining the infonnatlon, I beKeve that the submitted information Is true, accurate, and complete.

I am aware that there are significant penalties for submitting false information, including the posslbHity of fine and imprisonment PRINT NAME Sl ATURE or AUTHORIZED PIN DATE Davkll.Maschler (12.()7)

. {-..>.1: . **Y I*--l MISSOURI DEPARTMENT OF NATURAL RESOURCES HAZARDOUS WASTE PROGRAM P.O. BOX 176 JEFFERSON CITY , MISSOURI 65102 15731 751-317& FACILITY

SUMMARY

REPORT PART I IMPORTANT:

ALL MISSOURI BASED FAC ILIT IES THAT RECLAIM , TREAT. STORE OF DISPOSE HAZARDOUS WA STE ON-SITE SHALL REPORT THE TYPE , QUANTITY A ND HANDLING METHOD USED FOR EACH WASTE RECEIVED FROM ALL SOURCES ALL FACILITIES MUST REPORT QUARTERLY. SECTION B *FACILITY IDENTIFICATION CHANGES FACILITY NAME * * , 1-AI,;ILII V I,; ON I AI,; I t'I:K:)ON

• COPY I NG F ORM , ATIACH SIT E IDENTIFICATION LABLE O R EPA ID AND MISSOURI FACILITY ID NUMBERS ARE ASSIGNED THE SITE WHERE WASTE IS HANDLED. YOU MUST NOTIFY THE IF THE ADDRESS FOR THE FACILITY SITE CHANGES. 1. FOR THE PERIOD ENDING (CHECK ONE AND F I LL -YYYY) 0 9-30-YYYY 0 3-31-YYYY o 12-31-vvvv C=:J 6-30-YYYY OF +---CHECK HERE IF NO WASTE WAS RECEIVED FROM OFF-SITE, AND NO WASTE WAS GENERATED AND MANAGED ON-SITE (DO NOT COMPLETE PART II)

...ouRS DEPAR,_...

0#' MTUIIIAL *e8QIIa(:FS P.O. IIOX t71 JEJ'RittON cnv. MaSOUN *toz (5nt 711-atla FACILITY

SUMMARY

REPORT PART I 1 - *, , T:M!r.i I certify under pen.ny of

• that I have persoNIIIy examined and -.n famUiar with the lnformallon Mbnltblclln this and all altiChld docwnents and thllt baed on my lnqtiry of thole lndlvickllls immediately reaponslble for obtaining lhtlnlonnation, I believe !hat thtllbnilted information Ia true. accurate.

and complete. I am aware that there areiiiJI'IIfieant penaliet for submitting false informetion, Including the P<<*ibbitY of fine and Imprisonment.

PIIIINT NAMf SIGNATURE or AUTHORIZED PIN David L M-** . .,..:.; 2 DATE 1/

WSIOUAI 01' NATURAL MSOUftCIES HIZAitOOU!I WMTE PROGRAM P.O.IIOX 171 Mfi!RSOM crrt, ..asouRIIS102 (P317114t75 FACUTY

SUMMARY

REPORT PART II MO 71C).4.401 (12.07) 2 G 1.0 H141 FOAM DNR-H\W-1 IUIOURI DUAitTIII!NT OF NATURAL RESOURCES HAZAitDOU8 WAITE PROGRAM P.O.BOX171 JEFFERSON CITY,IIISSOURI U102 (173)751*3171 FACILITY

SUMMARY

REPORT PART I {,4:

BEFORE COPYING FORM , ATT'ACH SITE I DENnFtCAnON LABLE I certify under penalty of law that I have personally examined and am familiar with the information submitted in this and all attached documents and that based on my inquiry of those individuals immediately responsible for obtaining the Information. I believe that the submitted information is true, accurate, and complete. I am aware that there are significant penalties for submitting falae information.

including the possibility of fine and imprisonment PRINT NAME SIGNAT RE or AUTHORIZED PIN DATE / David L Maachler MO 7110-0408 1 7)

IUSOUIU DEPARTMENT OF NATURAL RESOURCES HAZAJU)()US WAST£ PROGRAM P.0.80X171 JUI'MSON CITY , MISSOURIII102 (m) 711-3171 FACLITY

SUMMARY

REPORT PART II DUCIUI'TION OF WAST! Waste Lab Solvent wih Lirrited Quantity of Radioactive Material :::,ECTION I COMMt NT::-11 MO (12-07) M00000687392 003518 NOTE: THE FEDERAL EPA NO MISSOURI FAC I UTY 10 NUMBERS *-*1----1 ARE ASSIGNED EXCLUSIVELY TO THE SITE WHERE Wt.STE IS HANDLED. YOU MUST NOTIFY THE DEPARTMENT IF THE ADDRESS FOR THE FACIUTY SITE CHANGES. 12.Unttor G ,L<<Y 1 4. TOTAL AMOUNT Measu,. SP&CFIC Mngmnt OF WASTE GRAVITY CODE 1 G 1.0 H141 FORM DNR*H'M'*1