Los Alamos - Welcome to NewMexico.gov Alamos National Labs/FFCO/36042.pdfPage 1 r113. Emergency ~ Phone ratrs~397 1 s WASTE MANIFEST HJI08980!0515 1 505-667-6211 FLE 5. Ganerator's

Los Alamos NATIONAL LABORATORY

Waste Management Division P.O. Box 1663, Mail Stop K499 Los Alamos, New Mexico 87545 ( 505)667 -4873/Fax:( 505)-667 -9201

~ ENTER} 1/!J ···~~1 #/IV~"'-~~~~ Netlor111/ Nuc/Hr S.CUrlty Admlnlslrltlon

National Nuclear Security Administrations Los Alamos Field Office, A316 Los Alamos, New Mexico 87545 (505) 667-7203/FAX (505) 665-4504

Date: OCT 1 4 2013 Refer To: WM-D0-13-0072

LAUR: 13-27833

RETURN RECEIPT REQUESTED

Mr. Timothy Hall, STP Project Manager Hazardous Waste Bureau New Mexico Environment Department 2905 Rodeo Park Drive East Building 1 Santa Fe, New Mexico 87505-6303

Dear Mr. Hall:

RECEIVED

OCT 1 5 2013

NMED Hazardous Waste Bureau

SUBJECT: NOTICE OF COMPLETION OF OFF -SITE WASTE SHIPMENT ACTIVITY 3.3.4 (BAND C), COMPLIANCE PLAN, SITE TREATMENT PLAN, FEDERAL FACILITY COMPLIANCE ORDER, LOS ALAMOS NATIONAL LABORATORY

This letter notifies the New Mexico Environment Department (NMED) that Los Alamos National Laboratory (LANL) has completed required activities set forth in the Federal Facility Compliance Order (FFCO), Activity 3.3.4 (B) in the Compliance Plan (CP) of the Site Treatment Plan (STP). Activity 3.3.4 (C) requires that the Department of Energy (DOE) and Los Alamos National Security, LLC (LANS) notify the NMED of the shipment off site of waste included in the STP, and provide documentation of the receipt of the waste at an off-site treatment facility within 45 days of its receipt.

LANL made eight shipments with a total of eight containers of 10-100 nCi/g Waste (LA-W935), reclassified from MTRU to MLLW in FY13, to Waste Control Specialists LLC, Texas, on September 4, 2013, September 11, 2013, September 18, 2013, and September 25, 2013 for treatment. The shipments were received at Waste Control Specialists on September 5, 2013, September 12, 2013, September 19, 2013, and September 26, 2013. Shipment details are provided in Table 1. Documentation that waste was received at the aforementioned facility is provided in Enclosures 1-8.

An Equal Opportunity Employer I Operated by Los Alamos National Security, LLC for the U.S. Departr

III/II/IIIII ~~~~fmlll/ll/11111

Mr. Timothy Hall WM-D0-13-0072 - 2-

Tabl 1 STP C e . - overe dMLLWSh. 1pments

STP/ MW1R T~iljbt f i Manifest CP WasteiD ~ i Number Section r

'

.. ' ' 3.3.4

LA- 10-100 nCilg 006639776FLE

W935 Waste

3.3.4 LA- 10-100 nCi/g

006639796FLE W935 Waste

3.3.4 LA- 10-100 nCi/g

006639799FLE W935 Waste

3.3.4 LA- 10-100 nCi/g

006639801FLE W935 Waste

3.3.4 LA~ V ;110.:) (JO :n Ci/ g

006639802FLE W935 Waste

3.3.4 ~1}\~ ( 0-100 nCi/g J Waste 006639803FLE

3.3.4 LA- 10-100 nCilg

006639829FLE W935 '"1 'Mit! Waste . .,. _ .. "' . ""' "' t : ~. ,, ; v} 0! J'(}(J' h'Cffg

3.3.4 A-

006639837FLE W935 Waste

LAUR-13-27833

MTRU MILW Container ..

Volume Volume Number Removed

Ship~ i fromSTP (m) ' (m~t

L13226958 24.700 66.7143

L13226980 34.130 28.9442

L13226984 21.530 22.5062

L13226988 32.600 28.5452

L13226989 42.800 45.5342

L13226981 52.390 37.001 2

W94241 0.0004 1.9002

L13226975 34.130 27.0832

Total Volumes 242.280 258.227 I Removed STP volumes (based on contamer size) are giVen as reported m the MTRU volumes m the FY12

Annual Report. 2 Shipped MLLW volume is given using field measurement of containers size. 3The actual waste volume used is a sealand container. The sealand container is considered the waste

container by the offsite facility's WAC. The waste is overpacked into the sealand because of external contamination, fragility of and/or the age of the waste.

4 Volume removed from MTRU STP has been reported. In order to meet the Governor's 3706 campaign this was not the only container to be processed from the MTRU STP container.

Based on meeting the Governor's 3706 campaign, STP MTRU are processed into several different containers. These containers shipped at different times and/or to different offsite facilities. These shipped containers in this report have had the volume removed from MTRU STP already reported in the section or previous reports, therefore, these volumes have been zeroed so the volumes are not reported twice.

An Equal Opportunity Employer I Operated by Los Alamos National Security, LLC for the Department of Energy's NNSA

Mr. Timothy Hall WM-D0-13-0072 - 3 - LAUR-13-27833

In accordance with the requirements of Section XX of the FFCO, "Documents, Information, and Reporting Requirements," we certify, as the project managers responsible for overseeing the implementation of the Site Treatment Plan for the Los Alamos National Laboratory and for Los Alamos Site Office/National Nuclear Security Administration, that, to the best of our knowledge and belief, the information in this document is true, accurate, and complete. If you have any questions, please contact Monica Noll at (505) 667-5999, or by email at [email protected], or Andrew Worker at (505) 606-0787, or by email at [email protected].

Sincerely,

STP Project Manager Waste Management Programs (WM-PROG) Los Alamos National Security, LLC

MN:lm

Enclosures: 1. MLLW Shipment Manifest 006639776FLE 2. MLL W Shipment Manifest 006639796FLE 3. MLLW Shipment Manifest 006639799FLE 4. MLLW Shipment Manifest 006639801FLE 5. MLLW Shipment Manifest 006639802FLE 6. MLL W Shipment Manifest 006639803FLE 7. MLL W Shipment Manifest 006639829FLE 8. MLL W Shipment Manifest 006639837FLE

Sincerely,

Andrew Worker STP Project Manager Los Alamos Site Office National Nuclear Security Administration

Cy: John E. Kieling, NMED/HWB, Santa Fe, NM, w/enc., (E-File) George C. Henckel III, NA-00-LA, w/enc., (E-File) Andrew Worker, NSM-00-LA, w/enc., (E-File) Carl A. Beard, PADOPS, w/o enc., (E-File) Michael T. Brandt, ADESH, w/o enc., (E-File) Robert L. Dodge, WM-DO, w/o enc., (E-File) Tamer Amin, LTP-OCP, w/o enc., (E-File) Mark P. Haagenstad, WM-PROG, w/o enc., (E-File) Michelle L. Coriz, WM-PROG, w/o enc., (E-File) Monica D. Noll, WM-PROG, w/enc., (E-File) Margaret A. Powers, ENV-ES, w/enc., (E-File)


Mr. Timothy Hall WM-D0-13-0072

CY (continued)

- 4 -

Susan L. McMichael, LC-LESH, w/o enc., (E-File) LASOmailbox @nnsa.doe.gov, w/enc., (E-File) [email protected], w/enc., (E-File) WM-DO Correspondence File, w/enc. , K499

LAUR-13-27833


ENCLOSURE 1

MLLW Shipment Manifest 006639776FLE

WM-D0-13-0072

LAUR-13-27833

Date: OCT 1 4 2013

An Equal Opportunity Employer I Operated by Los Alamos National Security, LLC for the U.S. Department of Energy's NNSA

WM-D0-13-0072 ENCLOSURE 1 LAUR-13-27833

Please prill or type. (Form designed for use on elite 112-pitch) typewriter.) II. II ~Ill ~Ill jiiiiM 11~1111. I Form Approved. OMB No. 2050-0039

UNIFORM HAZARDOUS I 1 Genoralor 10- I z. Page 1 r113. Emergency ~ Phone ratrs~397 1 s WASTE MANIFEST HJI08980!0515 1 505-667-6211 FLE 5. Ganerator's Name and Mailing-· Gllnllrab"S SMM<nss (l<linoranl 11\an mailing IIXImS)

Loa Ala~ Rational S.Curiti LLC for USDO Loe !laaoa Rational Security LLC for USDO P. 0. Box 166~ llS J586, LOR A IIIJLLEH P. 0. Box 1663 TA-46 ~ Al!aoa, ;.,!7545 I

Los Alaaos, i& 87545

lb. ranopor1ef I -~""""' U.S. ~PAIO-

Caat Transportation I COR000M5389 7 Transpot1012 Company Name U.S. EPA l> Nllnbor

I 8 ~e~;nt~!-~iali8t& LLC TSD Facility

U.S.EPAl>-

9996 Highway 17 West Andren, TX 79714

I TID9B8088464 Faclll 5 Phone: 4325258500 9a. 9b U.S DOT Desalption (1ncludir1g l'lq>e< Slipping Name. Hazatd Cla.IO -· 10. Coritlinors 11 .Tolal 12. Unit 13. Wlls10 Codes HM and Paclci'lg Gloup (if ony)) , No. Typo Quantity WtMJ..

X 11 RQR ,!!?if-3 WASTE RADIOACTIVR .1ATER~~L, c•; 5J:~ ,• ,J ... .,.. Ill ., a:

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-and lobe~. and .. " alrespec~S"- . lormsport according lo~ illomalional and-~~- . export shipment lhe Prinoly E.xponer,l Clll1ily lhallhe COI11enls olhs a>nSignmonl ariorm 1o lhe 1erms rllhe aaached EPA~rl~ I c:riy llallhe W8Sio mininilalion stall!montldenliliod WI 40 CfR 262.27(1) (WI am a largo quanlily gene!*) tr (b) (~ I ant 1 smal quanlily gonoraDj is lnJO.

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~ 1.

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EPA Form 8700.22 (Rev. 3-llS) Previous edrtJons are obsolete. / DESIGNATED FACILITY TO GENERATOR

------------~------------~--~~--~~-------~--~----------------~-----------------.


ENCLOSURE2

MLL W Shipment Manifest 006639796FLE

WM-D0-13-0072

LAUR-13-27833

Date: OCT 1 4 2013


WM-D0-13-0072 ENCLOSURE2 LAUR-13-27833

Please print or type. (Form designed for uoe oo aile (12-pitch) ~-) FormAor>roYed. OM8 No. 2000-0039

IJHIFORM HAZARDOUS 1'-Gooaa 10 H....., WASTE IIIAHIFEST Rltl898810!i15

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Gonotab'al'lloo..'511l 8688

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ENCLOSURE3


WM-D0-13-0072

LAUR-13-27833

Date: OCT 1 4 2013

A I .:f C"J?5\ An Equal Opportunity Employer I Operated by Los Alamos National Security, LLC for the U.S. Department of Energy's NNSA I Y A ,.,;are~ - -


Los Ala.os National Security LLC for P.O. Box 166~ TA- 46 Los Ala.os, KA 87545

TXD988888464


/

ENCLOSURE4

MLLW Shipment Manifest 006639801FLE

WM-D0-13-0072

LAUR-13-27833

Date: OCT 1 4 2013

Al .,~1!8,o An Equal Opportunity Employer I Operated by Los Alamos National Security, LLC for the U.S. Department of Energy's NNSA I ~~it~


Please print or type. (Form designed for use on elite (12-pitc:h) lypewriler.) • • 1111111 Fill 11111 uu•MIII!IIII!IIIIttl Form Approved. OMS No. 205().0039

UNIFORM HAZARDOUS ,1 . Genetator 10 Number WASTE MANIFEST HK0890010515

12. Page 1 ol,3. Emergency Response Phone 1 505-667-6211 rafesoTsk63s a a 1 FLE

5. Genotato<'s Name and Mai!ng Address bOI10!lROnl Site Address(~ ddleronllhan mailing aOOil!SS)

Los Alamos National Securiti LLC for USDOf.: P.O. Box 1663M KS J586, LOR A KULLEN

Los Alaaos National Security LLC for USDOS P.O. Box 1663 TA-46

Los Alaaos, H 87545 1 Generator's .

Los Alaaos, NM 87545 1 o. ranspat1er 1 lAmpany Name U.S. EPA 10 Numbef

Cast Transportation I COR000005389 1. Transporter 2 Company Name U.S. EPAIDNumber

I 18. ~!'!!""led Fad~ Name and ~te £:<~dress U.S. EPA 10 Numbef

Waste ontrol S~ecialists LLC TSD Facility 9998 Highway 17 West Andrews TX 79714

Faciity's Phone: 4J25258500 I TXD988088464

9a. 9b. U.S. DOT Description (lndoding Pmper Shippilg Name, Hazard Class. I> Number; 10. Containers 11 . Total 12. Unit 13. Waste Cedes HM and Pad<lng Group fd any)) No. T_ypo Quantity wt.lllot

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111811<ed and labeledlplacanled, and are 11 all ., proper condilon for tranoport to aptjcable international ond nrionai g<M!tiiJIOf11at regulations. I export shipment and I am the Plinary Expor1ef, I cel1ily that the oontents of this consignment conform to the 101ms ollhe attached EPA~ al Coosa!t. I cel1ily that the waste minimization sta1omen1 identified i140 CFR 262.27(a) [dina large quantity~or(b) [tlan a smal quantitygenantlor) Is true.

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l......,..,')'pedfu:'~ l ~.11<l' I s;,..nn. lqJ fll (j EPA Form 8700-22 (Rev. 3-05) PrevioUs editions are obsolete. v DE SIG NATED FACILITY TO DESTINATION S ATE IF RE QU IRED

···~0~ An Equal Opportunity Employer I Operated by Los Alamos National Security, LLC for the U.S. Department of Energy's NNSA I~ A~~,

ENCLOSURES


WM-D0-13-0072

LAUR-13-27833

Date: OCT 1 4 2013


WM-D0-13-0072 ENCLOSURES LAUR-13-27833

Please print or type. (Fonn designed lor use on elite (12-pitch) typewriter.) Fonn Approved. OMB No. 20S0.0039

UNIFORM NK0890010515 HAZARDOUS 11. GenetRlr 10 Noo1ber WASTE MANIFEST

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I a~:~o!:r~f*~ialists LLC TSD Facility U.S. EPAIOtbnber

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3 TX 79714

Phone: 4 2525851110 I TXD988088464 F..-y's •

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ENCLOSURE6


WM-D0-13-0072

LAUR-13-27833

Date: OCT 1 4 2013

••·l~z8.(/ An Equal Opportunity Employer I Operated by Los Alamos National Security, LLC for the U.S. Department of Energy's NNSA I Y, ~ -~'-\


Please print or type. (Fonn designed lor use on eHte (12-pitch) typewriter.) • • onn Aooroved. OMB No. 2050-0039

UNIFORM HAZARDOUS 11. Generator 10

Number ,2. Page 1 ol,3. ~Response Phone rcnrs639ao3 FLE WASTE MANIFEST Nlf0890010515 1 505-667-6211 I 5. Genefakl(S Name 811<1 Maili1g- Genendor's Site Address (W -..nt than malting -ss)

Loa A1aaoa Hati ona1 SecuritJ LLC for USDO£ Los Ala• os Nati onal Securit y LLC for usooe. P.O. Box 1663h liS J586, LOR A MULLEN P. O. Box 1663 TA- 46 Los Ala110s, H 87545 1 Los Al a•os, HK 87545

Generalor's 6 Transpo!1er 1 COmpany""""" U.S. EPI'.IOI+.Inbet

Cast Transportation I COR000005389 7 Transpo!1er 2 COmpany N3ne U.S. EPAilf+.lnbet

I 8 ~. ~Name..S§Ie.Mdrass U.S. EPI'.tONumbef

Waste ontrol S~ecialists LLC TSD Facility 9998 Highway 17 West Andrevs32Tx 79714

I TXD988088464 Facllty's Phone: 4 5258500 . 9a. 9b. U.S. DOT~ fondudi>g Proper Shipping Name, Hazan! Closs. tO Numbef, 10. Conlarws 11 . Total 12. Untt 13. Waste Codes HM and PadcJ1g Groo4> (W any)) No. Type Qurity WINol.

0:: X 1 RQR UH2913k WASTE RADIOACTIVE IIATERIAL, 1 Cll 1313 K 0008 ~t.t11 IJ/911 0 SU FACE CO TAIIIKATED OBJECTS <SC0-11) ~ ~~~!~-~~~e~~tn~f:. <fU;~~ta.,A~;~41~ ~U-~40 w

~ 0.4, RAb10ACTIVE YELLOW II z w 1-Cl

3

4.

14. Speaal Handing lnstrudions ond Additionallnfonnatioo ER6 :tJ:: Ito~ WP- OIDJ71~ 1.1 37279, L13226981 , 162

J;..)<-I ... J :v t. u~(_ S~ t ... wtM.f- W-1-/ohf l'el'f~ch n """ ../ wA..Sh_ Wr'J•/ ~-15. GENERATOR'SIOFFEROR'SCERllFICATION: lhereby~..J!:;"tmtentsolttis~aro ..... ~~--bylie~shlpprlgname,..SIIIl!dassitled,~

marked ond labeledlplacanl, ond are in all respec1s in~ · · lor nnsport acaxding lo~ inlomalional ..S-... _,_tal~- W export slipment and I am the Pmay Elq>ol1er,lcerllfythellllaoontenls oltlis~axionnlothe tennsolllla allachedEPA~~eor-t. 1 C81ty lhal the- nrinlzatlon stalomonl- i140 CFR 262.21(.1) (t I am a ~ qurily gonara4or) ot (b) f'l .. a smal qurity geoeralor) is true.

IGm<nlo(LO'RI AillfLw ;;:!!'~ f()v oPa- lq llg IJ~ ~16. lnlemabonaiSiliprnonls D Import ID u.s. D~.s. Polld~..t: :z T. ,.,.,..,.only): Date teavina u.s.: 0:: 17. T"'""'JI'OerAdmowledgmenl~Recoip~Malorials

~ I Transpo!1er 1 Pm1ec11Typed Name ,~.t!?i~ ~A.J ti wu3 ~ p i£A ~C...t-IU J J:£.D M :i Transpo<10r 2 Prm!d/Typed Name ,~ t7 ~~Day I Year a< r-188. tlisaopancy lndicalion Space DQuarlrty 0Typo 0ResU.e D Pattial Rejection D Fit Rejedion

MirilestRelenn:e-. ~ 18b. AIIemateFac:ily(otGeneralor) U.S.EPAIDI+.Inbet -' 0

I ~ Fac:ily'sPhone: ffi 18c. SignaluleoiAI1emale Facitty (otGenem.) - Day Year

!;i I I I :z ~ 19. Hazardous Waste Report~ Method Codes ~-• , axles lor hazardous was1e troalmenl, disposal. and I1!C)ding syslems)

~ 1. 1-1 , 41 r· r· r·

! ~===~-~=·---·~~-;;;···· Monlh Day Year

I ~ I 11 11.3 EPA Fonn 8700-22 f!N. ~ Previous editions are obsolete. {R v DESIGNATED FACIUTY TO DESTINATION STATE (IF REQUIRED)


ENCLOSURE7


WM-D0-13-0072

LAUR-13-27833

Date: OCT 1 4 2013

. . . Al .l~S~() An Equal Opportunity Employer I Operated by Los Alamos National Secunty, LLC for the U.S. Department of Energy's NNSA I y ~ ~

WM-D0-1 3-0072 ENCLOSURE 7 LAUR-13-27833

Please print or type. (Fonn designed for use on elite (12-pitch) typewriter.) lllllllJIIII Ullllllllillll J11119111!11 Form Approved. OMB No. 20S0.0039

UNIFORM HAZARDOUS I'· Generator ID Number WASTE MANIFEST 10515

5. Genera101's Name and Mailng Address Genera101's Sl1e Address (f ddleran11han mailing addross)

Los A1a•os National Securiti LLC for USDO~ P. O. Box 1663~ KS J586, LOR A KULLEH I

~p~a•os, Hn 87545 . ti. ransporter

Cast Transoortation 7. Transporler 2 Company Name

8. ueslgnaled Facility Name and Sl1e Addfuss

Waste Control Special ists LLC TSD Facility 9998 Highway 176 West

F~~~vs, TX 79714

9a. 9b. U.S. DOT Oesaiption (lndudiog Proper Slippi1g Name, Hazan! Class, ID Number, HM and Pad<ing Group (d any))

1.

Los Ala• os Nati onal Security LLC f or USDOE P.O. Box 1663 TA- 46 Los Ala•os, HK 87545

U.S. EPA ID Number

I COR000005389 U.S. EPA 10 Nuni>or

I U.S. EPA 10 Number

I TXl 1988088464 10. Containors 11. Total 12. Utit 13. Waste Codes No. Type Ouanlity WINd.

~ x 1 RQ UN3321 WASTE RADIOACTIVE MATERIAL LOW ~ SPECIFIC ACTIVITY <LSA-II> FISSILE-EXCEPTED, ~ 7, <AK-241 PU-239, PU-240), SOLID OXIDE,

1 CK -t.a6o- K D008 "''~ m il-6fti'1

3.

4.

;~~;;~~:-:::~=- t~tJt/{;.J. E xJIIJJ'fl(t /Asc, sl.,flii"'Lvf-

15. GENERATOR'S/OFFEROR'S CERTlfiCAnON: I twrletrff*:Jtw t.IA the ccntents of this ~ent 11111 fully and acanlaly described a00ve by the- shippng name, and ant~ ped<aged, marl<ed and labe!edlptacarded, and araln al respedlln ~~lot transport acalldlng lO applicable International and national governmental regulations. «export slipment ond I om the Prinary Expo<lor, I certify that the oontents d this consi!Jvnent arionn t> the lOomS of the altached EPAAcl<nowlodgnent d Consent. I certify thai the waste- slalenlenl ilontillodln «< CFR 26227(a) (flam a 1111!10 quantity generate!) or (b) (W I am a smal quantity generator) Is trua.

1 Generalors/Oiferor's Pnntad/Typed Name . "'~ /'(\ 1 ll . ~ uay oar

LORI A !fULLER y-...{~ I I I~ I"'\ IJ'S 113 ~ 16. International Shipments 0 Import to U.S.

z Tran ""' lor exports only):

~ 17. Transpoller~dRecelptdMaterials ~ ransporter ll'lintea/ 1yped Nome

~ LJif? .4 u &H ,J Li£:7:> L::> :i I Transporter 2 PrintadiT yped Name

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18a. Oiscn>t><lflCY Indication Space 0 Ouanlity

118. Discrepancy

5 18b. Allemate Fac:iity (or Generator)

~ "' FacilitY's Phone:

O~.s.

0Type

Portolenllylexit ----------- --Dale teamg U.S.: '

MO!lOI uay "'"'

I <t I 2.-:11£.3 ~- I uay I Year

0Rasldue 0Pi1111a1Rejec:tion 0 F .. Rejection

Manifest Refe!ence Ntmber. U.S. EPA 10 Number

I fil 18c.SignatureofAitemateFaciity(orGeneraD) llrnh Day Year

~ I I I ~ ...,.19'"'. Hazanlou-- s"'"Wa_ste_R_eport_Mooagement ___ Me_thod--:-Codes--:(l.e:-.-mdes-,-.,...ft>f-halardou---:-,- -- -tre-atment,-....,disposa-.,.-1. a-rct- IOCYcllng--:-systems--) -----------L---L-....1....~

!!! '· 1-1 u-f ' 12. r· r· I ~:;;.;-;~;;;;~---·7:zl::z·_· ~ ""9 ~~~ a

EPA Form 871J0..22 (Rev. 3-{}5) Previous edilions are obsolete. [ DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED)


ENCLOSURES


WM-D0-13-0072

LAUR-13-27833

Date: OCT 1 4 2013

Al .l~a~~~ An Equal Opportunity Employer I Operated by Los Alamos National Security, LLC for the U.S. Department of Energy's NNSA ,., ~~~

WM-D0-13-0072 ENCLOSURES LAUR-13-27833

Please pmtortype. (Foon des~ned for use on eite (12-pildl) typewriter.) 1111111{1111 Dill DIU liiii!IIIIJIIIIfll FOIII\ Approved. OMB No. 2050-0039

UNIFORII HAZARDOUS 11· Generator 10 Ntm>or rP

1oge1ol 3. Emervon<Y ~Phone raoT6639s37 FLE WASTE MANIFEST 1 \£11515 o;DI"i-~~7-~?11

I"'_..,., Name anc1 MailngAddresS ..,.,.._. se AdiRss (t dollenlnlllan maililg adcnu)

Loa Ala•oa National Securiti LLC for USDO~ Los Ala•os Hational Security LLC for USDOf P.O. Box 1663K KS J586, LOR A KULLEH I P.O. Box 1663 TA-46

~~a•os, H 87545 Los Ala•os, Hk 87545 iti.J.._... US. EPAIOI'm1ber

Csud. TrsonAnnrt.:at. inn I 7. Transponor 2 Ccm!>anY Name U.S. EPAION\mber

I 8 DesqlllledFadlo!yNameanciSIIaAOOross U.S.EPAIO-

Waste Control S&ecialists LLC TSD Facility 9998 Highway 17 West

FadliA~~y~t.. ... !! .. z~n4 I 'PVI .. :UU>n.,ot> ... !:

9a. 9b. US DOT Desaiption (lnducl<lg Prop!l' Slipping Nome, Hazloll Class,IO - · 10. Conlah!rs 11. Tolol 12. lkil 13. W-Codes HU IIIII Packrlg Group (t any)) No. Type Clurity WtJYc:J..

1 i!tlo•{ Jl'f IJ rr: X 1 RQR UH2913N WASTE RADIOACTIVE KATERIAL, 1 CK "**"' K 0008 0

~ SU FACE CO TAftiHATED OBJECTS CSCO-IIJ 11"1D FISSILE- EXCEPTED 7 CPU-238 PU-239 w • '~6~4~Abiil~M¥v~Ai~tLo~· nz--VJ.J I tsw, •• J.. = z ~I": w ~;,,fiJ C)

3

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14. Special Handli1g lnsWclions and

ER~~1ftJ2. 6.<-/~vl f4S<.. sA f'"" ., .. r-1.1 37279, Ll3226975, 162

WIJ- IJJq 712 t.J efq/.t-1 rf. .PI o(,C -h 1'1 ~+ VA.J 1-e. w-eJ tf A -1--15. GEIIfiWOR'SIOFFEROR'S CERTlFICATIOH: I hef8by doc:lf"' ~ lho-olllis conoignmonln Uy IIIII .....-ely--by lho pocpet shipping name, and .. ~ pockaged,

.-11111 ~. andn inal ._a., · · lorlranspclf1iiCCilfdingloappllcal*inlornllicnlllllll-~ rego-.s. H_,shlpmentind lamlho Pnmaly ~.I~ llollhomnlonls ctlhll conoignmonl-ID lho lorms olllo-6¥.~ olc..-.l I~ llaC l1o wasle minimization statemenl icleniRd in 40 CFR 2ti2.27(8) fll lam I largo quanlily ~ jb) (K I am 1-quanlily gltiOfaiDr) Is lrue.

""""""''ypell""""' l?f~ (f~ IC(' ,;sl B LORI A .IIULLEN .... 16.- Shipmonls 0 OExport~S . Pall al nyluit !'z knpart ID U S.

l · · ~ r ._taonlyt. Oelo leaWig u.s.. ffi 17. T"""""""'~allloceipla1Malenall IX Transporler 1 Pmled/Typed Name

~ PE.A-Ut.&l-l,J 4::>1' I :;ignaln ~ /iH Cf ~.JI; ~ T"""""""' 2~yped Name

I~ I :;ignaln 1- I Day I y,.,

r-1111. !llsa_,cy- Space OQudy Or""' 0-. 0 Prill Rejection 0 F .. Rejedion

-Relnnca--5 1a..MemalaFacliy (or~) U.S. EPI\IDN\mber

u ~ : fdols Phone: I ~ 111c. So!Jllhn ct-.me Focildy (or Genonolof) - Doy Year

~ I I I ~ 19.-Wasil! Roport Maoagemenl Meflod Codes (i.e., codes lor hazardous wasta 1re1tnen1. 6sposal, lllld rocyding .,._,.,

~1. U14t r· r r J :_ffi£7~~=·----~~~* J'~ 113 EPA Form 8700-22 (Rev. J.05) Previous editions are obsolete. /~ DESIGNATED FACIUTY TO DESTINATION STATE (IFMQUIRED)

..,~~ An Equal Opportunity Employer I Operated by Los Alamos National Security, LLC for the U.S. Department of Energy's NNSA IV~ ~'

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