DEQ-CFW_00046263

Hazardous Waste Section
File Room Document Transmittal Sheet
Identification:
Fill out form completely and accurately before sending it to File Room
Jenny TT. Lopp
Print Your Name Above fLast, First)
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Document Type:
Highlight, check oirc Document Type below
General (G)
Permit (P)
Corrective Action (CA)
11 Compliance Assistance Visit (CAV)
E Alternative to Post -Closure Permit (APC)
D Confirmatory Sampling (CS)
Fees/Invoices (F)
11 Emergency Permit (EMP)
Dr Corrective Action Information (CAI)
Ll Hazardous Waste Report (HWR)
11 Modification (MOD)
E Corrective Measure Plan/Design (CMPD)
11 Notification 8700 (8700)
U Notice of Deficiency (NOD)
[I Corrective Measures Study (CMS)
D Technical Assistance (TA)
­­ --- — ­­_.., .. ...... ... . . -....I...,_-..__
E Part A Application (PA)
0 Environmental Indicators (EI)
❑ Correspondence (C)
Ll Part B Application (PB)
E HSWA Remedy (HSWA)
0 Other (0)
D Permitting Information (PI)
­­­­ 1 ­1 - ­1 I_, ....... ........ . - 1.1.111 .I.I.I.I..
D Correspondence (C)
[I Interim Measures Study/Plan/Implemented (IM)
U Land Use Restriction, Institutional Controls (LUR)
Closure (C )
E Closure Information (CI)
D Other(0)
E RCRA Facility Assessment (RFA)
Groundwater (GW)
El Closure Plan (CP)
D RCRA Facility Investigation (RFI)
9 Closure Report/Certification (CR)
Fj Comprehensive Monitoring Event (CME)
Remediation System Effective Reports (RSER)
E Correspondence (C)
1-i Groundwater Monitoring Report (GMR)
Ej Correspondence (C)
J_ Other (0)
0 Correspondence (C)
El Other (0)
1] Other (0)
Inspection/ Investigation (1)
Enforcement (E)
Financial (F)
`1 Case Development Inspections (CDI)
11 Administrative Order on Consent (ACC)
IJ Complaint Investigation (CMP)
11 BaIjpj305bjegjLtB,�)_
[I Compliance Order (CO)
11 Compliance Evaluation Inspection (CEI)
Financial record review (FRR)
0 Enforcement Package (EP)
11 Compliance Schedule Evaluation (CSE)
0 Financial statements (FS)
IJ Immediate Action Notice of Violation (IANOV)
El Emergency Response (EMR)
E Insurances (1)
0 Notice of Violation (NOV)
I Focused Compliance Inspection (FCI)
11 Mechanisms and instruments (MI)
Cl Settlement Agreement (SA)
❑ Sampling Event (SPL)
0 Tax returns (TR)
EJ Ticket Notice of Violation (TNOV)
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U Correspondence (C)
R Correspondence (C)
LI Correspondence (C)
E Other (0)
El Other (0)
El Other (0)
Ill. Description:
Use up to 256 character's to describe the document. Every word below can be used as a searchable index to locate the document
..... .. .............
.......... ....... ......
IV. Date ofDocument: Date when the document generated, the date typed or printed on the front page of document
Date on Document 0
I I
V. File Room Use Only
Date Received
Date Scanned
Scanners Initials
Hazardous Waste Section Updated: 1110312010 File Room Document Transmittal Sheet (Form; LK-600)
DEQ-CFW-00046263

DEQ-CFW 00046264