Fax: #193.th Pages: Dataj? V3) wwk?g? (304) 748?0014 Phone: CC: g3 Ujggent. For Review DPlease Comment DPlease Ram}: Radiuhgical Waste DispOSaI Form Form IW mam: 1-9 Generator's or Shipper?s Name and Mailing?igl?QIS a gma? 25.. HEM PhoneM ?5 La VB ?th?lci W?'rl?iqc #1 Colnpany Nam? kJ ?ieqm?k lag-?19 Phone 0 513,0 3. Transporter #2 Company Name Phonc Desigmated Waste Facility Name Phone 39% 7 L90 LHCG - IDchriptic-n of ?i Activity of Container 1 Tara! Uni! WWGI Time I :e (tug. tat-tic, sci], reading Concentmtion Containers Type Quantity LHUEBLFL ?4958"! 1 {an 3? Pb.? 44? 1 35,- {3 .135;- I Are than: any other saunas of radioactivitiy known to be in the vehicle? from driver, etc.) to Post-altum actions taken hy waste (6.3. medical source 91:1th Di {bark Lam a? Special Handling Instructions and Additional Page ULJ .jl'jo: jgg?g, 51 gJMELmerom: 19% any; 53g? Pages: 3\ Date: 1} Lo '22.on Phone: L304) 748-0014 Re: CC: Cl [gent Cl For'Review DPlease Comment CIPlease Reply Radiological Waste Di3posal Form Form 1W FoiEramr?s 01' Shippar?a Name and Mailing Addl'?SS uq'ri Phone .. Wm Slaw? a. Gad} hag] Coil n'i'IC Ph 3 ran p0 Bl omp'lny an: 391%?! on 39Late Transporter #2 COmpany Name Phone (Iorrunerciai Waste Facility Name Phone mu D??c?ptionol'ditf?f?w EidicroPJhr Activity Numbcr of Container i Total Unit WWOI Time I :c Sic-aim, soil, reading Concentration Containch Type Quantity -JEQ 'Bv' 19m?: F[m_h_ 1w) MLL Fe? ADP Lg' h_ -na? Arc there any othcr sources of radioactivitiy known to be in tho vehiclo? (3.3. medical source from driver, etc.) If) MNM Font-alarm actions takon by the waste {milky/transporter: Lam =54 F174 Special i-Imidling Insitmctions and Additional Information: Pa E19 milk To: [an jug-:55 rm ?mumow?u Pages: a lDatagw 3? 4-1 cl Phone: (304) 748?0014 Re: CC: QEELM ?1391? Review C]le Comment DPlease Reply Radiologicaj Waste Disposal Form lew Ciemvator?s or Shipper?s Name and Mailing Address DH Phone 19%) blxm?mk-I-w: I CO .. Company Name ?31 L15, a, I, Phone I ?2 c? #2 Company Name Phone Facility Name Phone 'DFicriplion ?EiicroFJhr Activity Numbcr of Container Total Unit Time . I 1: (mg. male, mil, wading; Concentration CDntuincm Type Quanlily pCir'gm F759 Arc: there any other sources ofradioactivitiy known to be in the vehicle? (6.3. medical murcc ?rom ddver, cm.) Gk :5:in F'osdaalann actions taken by the waste facilityr?tmmporter: J1 MP DP 31 Spuoia! Handling frzsi-r-ucnons and Additional Information: Page of Wy?g? If result <6,600 J- 745" Wm: County Land?ll Date; 7-43? Mist?lung; f: Drivg Note: IfAJarm caused by driver circle: YES. No further action necessary - Mid-height midpoint Front Mid-heightimidpoint Back Wit-height midpoint LHS RHS 1d Highm reading 3 . 1'801?61?2: ?ag M44 (29?3- ht) If highest reading 1011th above BKG..folIow RMP disposal pmcedln?es lnoli?ca?ons. If highest reading lOuR/hr above EKG-follow RMP procedures for reaming a load {lime-m Same! BKG Counts: (cps) *Surface Wipe Reading: .5 (cps) A) ?31.?in _me lat: :7 5 09? ate (dram/300w) . ro - om2 follow RMP disposal procedures I noti?cations. If result >6,600 dpm/300 om2 follow follow protocol for rejecting returning a load Wetul County Land?ll Iflsotope is on Disposal Approval List follow RMP disposal Iflsotope is NOT on Disposal Appmval List follow RMP noti?cation procedures Folldw Rm disposal procedmjes Farm Completed By (pn'nt): (vim): 5? 9:73 2-775? I I Radxolomcal Wm Diagram] Pam ?rm I. .. Name and Mailing Adm Phone ??r?r??nsf?ar?gg ?TZJE'rqmy .- #1 cm ?3 Phone (52:5; :14, 3M 925" 7 #2 Cornpm Mme 7 73 MEHMMWEJ Wm Facility Nam Pm 6,41% {543/ Jav~ 3am: gig]? I I Galactiva of 0mm Total Immox -hm Type If" A MCA :8:qu ?ag?om: 65 ?159! . 729,1 5 - vim my.? i Am than: any atria: my mm Permits: - ?(in act/3m Kazan Sig-groggy brim 1? 5'10 193/, muri?u?i?m a Handling Maw-Em and Additional Won: f?x Wetzel County Land?ll mm - 5 by Time: tNumber: ?msporter Name: 565 I2 Drive; um: Note: If Alarm caused by driver circle: YES. No further action necessary WASTE TYPE (CIRCLE): Drill Cuttings Medical dogs rate: 3, 3 VEHICLE GS: . 8mm?: 1. FOR DRILL QM Pen-?91m Surface Igotopic Dose Rate Sung! on vemclg cgntaine: ?nk/brig Mid-height midpoint Front I a Mid-height midpoint Back a . .f Mid-height/ midpoint LHS Mid-height midpoint RHS Highest reading 2 Isororx-z: ., Ifhighest reading lOuR/hr aioovo BKG, follow RMP disposal procedures lnoti?cations. If highest reading IOuR/hr above BKG follow RMP procedures for mining a load {mPe?orm Contamination BKG Counts: i (cps) *Sm'face Wipe Rending: 3? (cps) (3) ?nance Wipe Calculation (using 5 0% e?ciencg 0 (cptn): (mm: 0 .(cps) (C) 60 (dpm/BOOcm?) Surface We Read: If result <6,60.0 dpm/300 c.1112 follow RMP disposal procedures fno??ca?ons. Ifresult 3:6,600 dpm/300 cm2 follow RMP follow protocol for rejecting returning a load Wetzel County Land?ll ?e at Samoa 2. FOR MEDICAL WASTE ONLY Perform Surface Isotopic Dose ?ts. ?urvg 0; vehicle (mum; (alt/lad; Surface Dose Rate (highest reading on container) lsorors: If Isotope is on DiSpOSal Appmva] List follow RMP disposal procedures If Isotope is NOT on Disposal Approval List follow noti?cation procedures 3. F03 OTHER mam om Perform Surface Isotopic I Dose Rate Sung: on vehicle container (nit/lid: Surface Dose Rate (highest reading on canton-1mm Isorors: 2L4 Follow RMP disposal noti?cation procedures Form Completed By (mintyc (sip): A .r Radiological Waste Disposal- Form Fin-I11?! Gales-31063 01' ShisiName Mai! I I Mr? {ya (Z 'E/i Wilma Nam: l' - Phone 5M2 615: #25333; Gunman)! Name Dmigjnated (lemme-mild Waste Facility Name, Phone (dm? WA Vi?jnn WMRM Aca?tj' Mm of Container Uni! W01 (as. $5315.. sail, main? . Canning! Type . otherW/ur? ~r 3?63 am I i Are there any other salutes ofndioac?vitiy known to be in the which? (ex, Meal sum ?nm driven etc.) JJ . r; Post?111mm uniform than by the waste L?czd 00153.15: A par id (a L29, A - PM U) cu .lr-c g" Spa?al Handlith Instructions and Additional Information: a $0 bus-(dam Far EL-qlp?saah?m 1+9 p9; (1359014; Fowcf Wham: Wm 0:1qu4 ?ea CHEEAPEHIE o?t?ahq MW 0 595 ENERGY E?0n1 UTICA HANCHIN PRODUCED HAT ?9??annaazaow Chow?! onto Bo ROUTE 1, :5 L. UN Box 156A ER YARD TY SEN I?ll'?'ali?kr LANDFILL a? WTINBVILLE. WV 25155 REGEHIKBLE 51m- 569] [3 aims 5r;z.. Tb? 1/5} ?2 5% momma": 804 - Ei?hx' waswa i? E?qlupwae sm??f??gaau g??nth' HARE Eh 1 NUMBER aza?ig hu?nI-Ipn-u?I- hm In an I: ??lm ?mummuhm mgr: Ir- nuh??r. which IN or Minn-=4: mm mung?ma.? EHPHEH Hanna.? mar Wl?. luring? r-mwut um-n? mam?#? Jung y'ww?mwu'ahmr a-A- ?at-um: air-unn- mm mm: mm ?Jamil-uh -qhu:mnulmh tin-cg. aUq4366354 92-86-15 [18:55? Landfil 3344238394 F-232 MANAGEMENT Northwestern Land?ll. Inc. 510 E. Dry Run Road PARKERSBURG, W.V. 26104 (304) 865-3938 FAX (877)411-6497 or visit us at Fax Ta: From: Lisa Pages: :2 pawn; Inczuding cover Hate: Re: Rejected load - Urgent For Review Please Comment Please Reply E1 Please Recycle uu? 4U no.0; mum-Northwestern Landfil 3844288394 - Radiological Waste Disposal Form Paz/aaz F-232 Form 1W 1 . - Generator?s or Shipper's Name and Mailing Address Phone A IJ'l'cwo 9074?; Viz? Tramportcr #1 Company Name Phone . 51737-4322 51a 7/ 3% Transporter #2 Company Name PhOne Designated Commercial Waste Facility Name Phone - 3?0 (411 grew zen/? :cripiion of NORM Mi croRJhr Activity Number of Container Total Unit Time aste scale, soil. reading Concentration Containers Type Quantity other) . pCi/grL Dr72) Are there any other sources of radioactivity known to be in the vehicle? medical source from driver, etc.) Post alarm actions taken by the waste facility/tranSporter: Special Handling InstrUctions and Additional information: Page of ?r -- . 83:13 0401.5- new: an: i an 494: 4955 an: 593 4393 Wetzel County Land?ll . i FEB ?5 2015 Date- Time; 3?53 Tmnogg ?ame: ?2 E'm. Name-I "John 8891 Note: If Alarm caused by driver circle: YES. No further action necessary WASTE TYPE (omens),- Drill Outings Medical Other (specify) F146 We! LC ngkgom dose Leg: (um VEHICLE ?ames: SECTION 1. FOR DRILL (Ema/Assam!) DELM Wag; cum i Perform Surface soto 'c I Dose Ra vehicl container .- Mid~height I midpoint Front 2 i Mid-height midpoint Back 5 25 Mid-height midpoint LHS Mid-height I midpoint RHS I Le Highest reading HZ) Wm me If lughest reading lOuR/hr above BKG, follow RMP disposal procedures Inoti?cations. If highest reading IOuR/hr above BKG follow RMP procedures. for returnina a load {?lPerform Contamg? ration Survey BKG Counts: (cps) *Suiface Wipe Reading: 3. (cps) (A) (B) i aceW ion :25 ?ea (cuss-Lem); (D)lo.5 (dpnv3000m?) (C) . (D) Sumter: Ware Result If result <6,600 dpm/300 cm2 follow RMP disposal procedums noti?cations. result >6,600 dpm/BOO cm2 follow RMP follow protocol for rejecting retumirg a load Wetzel County Land?ll More; Sermon 2. Fox MEDICAL WASTE ONLY i Perform Surface Isotopic Dose Rate Sung 9n Ewe conm? e; mt): Surface Dose Rare (highest reading on container) ISOTOPE: IfIsotope is on Disposal Approval List follow RMP disposal procedures If Isotope is NOT on Disposal Approval List follow RMP noti?cation procedures Sgtmou 3. FOR 01mm WASTE ONLY 1: ace Is to 'c Dose te Surv on vehicle container uR/h 7%y?rr Surface Dose Rate (highest reading on container) Isorore: Rd Follow RMP disposal noti?cation prOCedures Form Completed By (minty?' we? [139/345 (Sign): Radiological Wm: Disposal me Para: Genaamr?s m- Shippcr?s Name and Mailth Plum "It {isjpm Compmy Nam: Phone ?157 ?i 2 #2 Company NJ Phone Waste Facility Nam: Phom: 1 I .33: r-h-F :3 pm; MicmR?xr Acti?ty Nmnbuof Container Total UnitWWol I Thu 10-3 milk. 501'1. wading COW Canning; Type Quantity palm 95-4: Ego/W 35? 1 Are were any Olha- min-ms ofmdioau?vitiy known to he in the vehicle? (0.5. medical some 1:111" i Wu: ?0444 ((45th?! P?r a WIN Ra 0516, vac. we go?! Swill Handling Instruc?mal?nd Aw? In??mnm baud Jrz) b0 D?Mz?l? Qag?a-Mon 4o land!qu ?Q?f {Wadi RXEA +0 DHHK actions taken by the Waste facil? Tu 3049260155? Hanath Fax:HaEtE HanagEIEnt boc?lo Paumooz . . ll. lk' u. a Ha. :2 Radiological Waste Disposal Form Huh?;? -. pliant? Wren) muse?) 4- 61%47757 ?SI-ammo: er #1 Company Name I I 1; 0m Generator or Sliippcr?s Nani: and Mailing A'dldIrcss . Phun?c- I Desi at: Commcwi Wast? i I I Phone I . . gamma 5am; m" Activity 1511;;ka uI? -- Coniajner reading Concentratian Type wmnawi? I waste scale. sail. Hellfing Quantity Total I Unit Time {1:37pm r? An: any other sources of radioactivity known to be in the vehicle? (mg. medical source from driver, etc.) No actions taken by the waste fa cility/transponcr: Mild Spit-2m! Handling, and Add ?ddled itional InIbrmation: a 3?3g:_ Framllastd Magma-.1: Fu:?a?ta Han gum ammo angoocs I WASTE MANAGEMENT TRUCK SURVEY FORM mom-?mmn?g?ml?zg We . marl-12m - 7 - mo .3 A near Matt-2m 7 r' 5? I . ?52773 r/me ?it/mm,? ?42mm WE WW #9 . READING ("Rm Larvae!? DESCRIBE ism My?? VEHICLE SURVEY snow RADETION MASUREMENTS m'nR/hr 33:42:39 - fins-:3 . I . REAR new; I . .. OO . Test Time 25"- - Truck Co. I, 139:} No. 7-7 3 Nate No. Background we um? Dose. My.) 12.? Typek RD L- Location he?, [Lam jg To: 5049250156 From: Haste I'lanageuent Fax: Haste ?mage-ent at 34 Doc: 210 Finals: 004 NON-HAZARDOUS MANIFEST 1. Generators US EPA ID No. Manlfest Doc No. 2. Page 1 at "3 ManEm? is H: Address;? - I Genaralor?s SMAddmulIl A. Number - ANTERO RESOURCES SITE NAME: Fag WMNA 29.06846 1525 lTl'H STREET PAD NAME: - SW . DENVER, CD coum- . . .. .. 'mp?x?l' 1 Cum-party 5. us EM ID Mulder - - E. State Trampon'er?s ID 335239 I WASTE MANAGEMENT OF - Phone 881-455-?9?1 7. Transporter 2 Company Name 3. US EPA ID Number Immr'si?huni :9 5 I- 5. Designated Facility Name and sm- Address us EPA Mamba? a LANDFILL E. State ID SWF1032 1438 DAWSON DR. STE 101 u. Facility p?m 531-456-6339 WV 26330 - -4, . ?535:1 w- I: 11. Dumlp?m of Waste Materials a. I. ., .. - . arm-m -. . - . .n mile a Owlmw?arl ?rfrle- (1.1 mm I I'ia1w, mr'mma - --..--. --.I . I '9 i' "I'?gg?r?x?mdw? Mm?i'lte- I'll: J. Ih-scrl?rztinnr. Mr Materials Listed Above K. DiSflni?l -. I. Cell I I Level I . . . Grid 15. Elna-cl"! Handling and Additional Information BOX NUMBER: 1 I Fun-chamovdeHDCKEE FREEMAN 504-629-5010__ 15 I hereby osrt'rl?v that the materials are nor hazardous waste: as de?ned by CFR Part 261 or any state law, haw been fully and accurately IiEitribted. class??rd and packaged and are In cundltion for 31m ?unk Printed - a Signatur behalf of' MII-llr 5-1! I .4901: - a z. 1 Acl.-nawledgenIe-nt ol' Rent-mt of Materials Printed I) rue Sig mm 'rI-Ir 1 I It.? 0 I -. f. . 13. Transpn er 2 Acknuwledgemunt of nemlpt of Mamrlals I . - I Prmtec Name Wufe Mann Dun, I I 15. Certi?cate? of Fina-1 Trent:th IDIsposcl leaning on rte-hall of the above Ilsled treatment mainly, that In the bar! of my knowledge, the waste was managed in compliance with all a pliable laws. ragulatlans, pen-nus and linings; an the dates listed above. . - 20. Facility mner or 0pc. a Certi?cation of receipt of Inn-hazardous materials mum-ed by this manifest. I Slgnatu n: Day Year wh?lId?R 311mm. STORAGE. DISPOSAL FACILITY BIG: - GENERATOR #2 COPY In r.an Fink- FACILITY us: Gnld- TRANSPORTER ?1 cow wasue rlanasement 10:3049260456 From: Hash: [image-mt Fax: Haste Images-ant 11 90?:483 Plano? of 004 R1237 Date: Tuesday, Feb-03-2015 Time: 01:11:18 PM i3? Company: div of water and waste management From: Sekela, Kelli EB 20? Subject: rejection load Number of pages including cover sheet: 4 Fran: Haste Hanna-ant Fax: Haste Mange-en 10:8049250456 FEB -3 2015 Radiological Waste Disposal Form .- . .?sl'I - Phone om Ima- 4'775 I -- norm-3.: mpg-erg mama: "mam - cxo Hz?mms . .. ?1 . #1 Company Name Phone ..- . . . I. I'll.1. our. #2 Company Name?: I .Eumm? Trampo? . t?dlr-mmomale; . . -. 7% Desi '12 Co Wag? i. . 5' mm mm Max Drive. 61.13am Bv?gtpo? ,wv M330 450-qu Dmcriptioz: MicroRIhr ng??vlty Total waste (eng. scale, soil, reading Concentration: ?1 ?Cwmimm my Unit otheQ a In? w?rfings ?Ll-?3 (033531 lbw) It . . I. -- Postalarm actimis taken by the waste facil' Scan Wi?rln hand held Special Handling Innovations and Additional Information: cd Page i of WASTE MANAGEMENT TRUCK SURVEY FORM - . a min H5115. MW 3n.- Ubod: Fran: ?at-ta Eugene-rut Fax: Haste ?ange-ant FEB-OS-ZOIS-IS: 11 Datum Paga:003 0* 004.MAIL 1mm gentl- (xi/44% my?? I . VEHICLE SURVEY snow RADIATION MEASUREMENTS mm, CO CO "gu' - 'ul II 0 Test Time .- 3 9? PM Truck Co. 1 Truck Nd. Plate No. 54c?. ?5997 . Background ?1 A Dose Type Locatioan-wr mr/J/C 51/ Tn: 304931601545 . . 1 i; Er - Fran: Haste management Fax Haste Manage-ant Dania-3 Pigm??'! Of 004 WASTE wrung? Ga?rglg? Phone: 6. Thy-a: 1 (hr:an Ngme limosmm 2 Name ?amm? ,l 1 . "3 719 ??m?iewa' {w Hmw?t 'agsenae anfbr- Br 3? 12 30.330 LLB. EPA ID Number U3. mm 1.3mm: It)th ?hagat'q' ammynampm ?arman 'd am I - Hay-wan? . Eliu?mmu?: Marne andr- ggf-Mmau m! asmrcE?s . - 31997 camp-99+ 6'0: wage: . 1} West E: Mm- .1.ml [Iv-Edption 10.6mm Hal . Woe 0mm - I. '2 . 13 3pm? Hm rmzm-Jm Z?nd Andi-mu .1 .12 . a. q. ?$01 Mag; Tran-5p Haw? 2 FW?n?i?nm'??me 14. smear-1mm: I. marked En 11! mm Gmm?v?s'c Harcr?a Pnni?'fl 15. Trir'iporl? ngzu Imam?:- .1 nanny: cl Mama: Maths: Moments-mm 1659* ?eskm I I gamma? 'Ih' mina?nnamumhw?. I "aft-:1. Eg?kl?? v3; b'fl?anrnpu'?m' ?.mucdmm. alums I Ya -3 I I [31.15. mm Ef- D?h burl-5A3; vfj??m I Him? .I - - I Emmi WC. Sbleiura cf MMIE Emmy for Generator] 10498 {Flt-2v. 9mg) Guam-?y TM am Mal-Mam 49?. . fi (f qql' . M53 ?rig?a .- tun-?15? mi?! 4' 1.5: .. I p- 5'4 if Cem?calhn a: many pm may: as Para-m Raj-chm 11.5. EPA H3 Hmtlar A i. . 1? 151%. J?ma?mj? . A, DFIW Ilbrm?l Day YearinGENERATOR .rx Wetzol County Land?ll ?imm -H .. . . 3 . ?gigign-..? Date: 9 i Jime: 7" 53am Emile}: Romantic: Name; ECS [2 Driva Note: If Alarm caused by driver circle: YES. No ?n?thcr action necessary WAS cm DrillCuuings Medical ?gcigmd dose Egg: . (M) Perform ?u?ce Isotopic 1 Ease git: Survey. 93 2: . Mid-height midpoint Front 5 Mid-height I midpoint Back Mid-height I midpoint LHS Mid-height I midpoint RHS i Highest reading 3 LP . IsoTorE: If highest reading lOuR/hr above EKG, follow disposal procedures lnoti?cations. If highest reading IOuR/hr above BKG follow RMP procedures for reaming a load {iiIPerfoz-m Contamination Survey EKG Counts: 3 (ops) *Surfaco Wipe Reading: (cps) (B) (A) Egg-?gs a! 0 a rat (cps): (C) (cpm); 0-5 (dmeOOm?) Samoa Wipe Result CB) - (A) If result <6,600 dpm/SOO cm: follow RMP disposal procedures lno??cations. If result >6,600 chm/300 cm: follow RMP follow protocol for rejecting lretuming a load r/7 ?j Wetzel County Land?ll Mir?Slug gamma 2. FOR MEDICAL Wg'm (i1 Perform Surface Isotopic I Dose Rate Sui-vex on vehicle container (HR/hr}: Surface Dose Rate (highest reading on container) ISOTOPE: If Isotope is on Disposal Approval List follow RMP disposal procedures If Isotope is NOT on Disposal Approval List follow RMP noti?cation procedures SECTION 3. FOR OTHER TE 0 Perform Surface Isotopic Doge Rate Sitng on vehicle container m: Surface Dose Rate (highest reading on container) Isomem?g: Follow RMP disposal noti?cation procedures Form Completed By (Sign)! - Radiological Waste Disposal Fm imam .. . . . .-. PM Su??mfg or Shipper?a Name and Mailing Address Phone T'th #1 Nam: Phone ?15:qu WM Name Phone Designated Commercial Waste Facility lune Phone thick 60v MM Jt 36 1 - [MIlehr Activity Numhu of Tour mwwa mm (mama, readinn 'on Gaming: Qnm?ty 1w mama ?39 i I Are there any ethn- ??om driver, eta) Pout-.3 [arm actions takun by the mate facility/hum ?Fm was 31mm Handling and Atkiiuonn! 7:111, ?Jada, ?15 bu; Page of (111/! 91? sources of mdimcti?tiy know to be in the Medical some QM (tight/K 15: M, 26(- if; W54 (1 - 1313 Thin-.1 6413115[gaze-94; $45-;m14 1; DEF Degmh? awe?: omFromr?nggm??mew Fax: (139% ?13x9 mksw?ike Pages; Date: 9a? 1% M175 Phone: (304) 748-0014 Re: CC: Urgent For Review DPlease Comment DPlease Reply Radiological Wrist: Disposal Form Form 1w Gcncin-Ior?s or Shipper?s Name and Mailing Addresx 9.51 33%? Phone (3 g?j flan-gr and Claw?? gm?vi?g 3 Cam crane: Transporter #1 Company Name I 5" Phone 3 7342:? q; 62 [q 939%} I can 1 155(49- Tramportcr #2 Company Name Phone Designated Commercial Waste Facility Name Phone D?wcription MioroRJhr 7" Activity Number of Container i Total Unit Time :e [jog scnto, soil, reading Concentration Containers Qu?nlily other] pCi/gm Cf?anwbg. qr FQU 2,?l 2W 3 :(Bk 1151* 52 '7 51.5:- Are there any other sources of fiom driver, etc.) 3?50 v} Post-31mm actions taken by the waste facilityfnansportor: Okk Cid-Q. (197%: Speriai Handling Instructions and Additional Infonnation: radioacti?tiy imown to be in the vehicle? (og. medical source Q2559 narrow vi our-+1. - Wetzel County Land?ll . - .: erfo ?rhea Mid-h?ight/ 3L Mid-height/mldpoint Back Md-height/midpointLI-IS Mia-height/midpohn RHS midpoint Front Highest reading 1961015: 2 4 Ifhighest readmg' lOuR/hr above BKG, follow RMP disposal procedures lno??ca?Ons. If highest reading lOuR/hr above BKG follow RMP procedures for returning?doad men-fog tion BKG Counts: (cps) *Surfacc Wipe (CPS) (A) I (C) 60 (0)105 (din-1500M) (C) (D) a Wine Rand: pm/3 Surface Dose Rate (highest reading on containedw I Wetzel County Land?ll I IfIsotope is on Disposal Approval Lisr follow RMP disposal procedmos IfIsotope is NOT on Disposal Approval List follow RMP noti?cation prooedmes 3I FOR Om ml: ONLY was cc 0 cl men: an: vehlcl on r: Follow RMZP disposal noti?cation procedures Form Completed By (print):Q - (siqu Magical WamDiapmal Farm Pam: 1W Gmm?sm?hppar?s NmamdelmgAddI-m mm Claw. wk: Hm (M17, 01W #1 Comm),ng mem? PM: 2-4 COM MW CHROME Miu'onfhr mor- "T?om mm?! r?W 5- ?Emma reading Comm Con:an mm mm ml? 3m with-f1 ROM 103% ?of L644 (Maggi ?wr (5MP WA 1m ?rm A i Muff/9 (5M 0w!) ?9 F20 @I?IC?t-xtj 13%. 5?a?1?ri~?04 {5194er dl?fg?os-i/ or? 11.1. 1: Wild bHUl?l-Northwestern Landfil 3344288394 Til-35 WASTE MANAGEMENT Northwestern Land?ll, Inc. 510 E. Dry Run Road PARKERSBURG, W.V. 26104 (304) 865-3938 FAX (877) 411 - 5497 or visit us at Fax To: From: Lisa Pages: 2 pages including cover Date: Re: Rejected load Urgent For Review Pleas: Comment El Please Reply El Please Recycle T-18b nun-I you-hub ll Radiological Waste Dispose] Form mel?! Generator's or Shipper?s Name and Mailing Address Phone A 9074;344/29 TranSporter #1 Company Name Phone 5? w:ch 6w. 864?737?43?22 Transporter #2 Company Name Phone Designated Commercial Waste Facility Name Phone N0 m1 fe/A/ [av-u] 3" ypg?rpj?s/ - :cription MicroR/hr Activity Number of Container Total Unit Time aste scale. soil. reading Concentration Containers Type Quantity ("it a! . I r? Pi?io 63.9% Pr Vac 3076/ . 75:3?! 3-06 fro Jc?lvf?32.vi" 30% I Are there any other sources of radioactivity known to be in the vehicle? medical source ?om driVer, etc.) Post-alarm actions taken by the waste facility/transporter: Special Handling Instructions and Additional lnfonnation: as 2% my? air-:25: antral: at Ta:304??50?36 Frau: Haste HanagElEnt Fax: Haste ?anagemt 003158 Page:001 of 0C - dopt-of-anviro protecton Date: Friday, Time: 03:11:5 AM To dept of enviro protocton Company: div of water and waste management From: Sokela, Kelli Subject: rejection of load Number of pages including cover sheet CiAn?k-?agrg ?ib?d?r?b 11318 Mailing Address Phon . . . Vi V0 . $091.47 .4770 . llama. Drawer- $0202 -. . . .. . -- - - Trans #.p?l-Aaut? Iiikibai?ohbr Susie- imymm;w . Transporter #2 Company Name . '1 - .IIDesi ted Wast?ngil?fNai??w. I - Phone me mid?ii (931.450.0486 Dascriplion MicmR/hrl A?ii'?'i?y ,1 mm 6:3. Scale. soil, reading . other) 1/ {Ntilnbe?of Total Unit Time .. Quantity I 1- ??og?wngPost-aim actions taken by the waste facility/transponer: 6am wiih hand had Special Handling Instructions and Additional Information: load "hm-rva Fran: Haste Han_ agent Fax: Haste anu?so-zols-oa: 11 Doc: 156 Panama: of 004 - . WASTE NIANAG MENT TRUCK SURVEY FORM SURVEY DATE TIME I I CALIBRATIONDAH ELM ?53er 6 mom I 01' K960141141 Mil-mm I a ?a If! @2233 ?93' . 35g 5915 33?: - 1 - REAR - 00 OO Truck Co. i? 9:55: 1'ka NO. I I 3 Plate - - Background . - Dose__ ?7 Th '1 ?Pew 2.1.0 . r, 1' Location from: Haste Hanageuent Fax: Haste [Image-ant 11 Doc: 158 Pagezooli D-F 004 NON-HAZARDOUS MANIFEST I. Generator's US EPA ID No. Manifest Doc No. 2. Page 1 of nom-mzutucius MANIFESI Jaws: I A. 3. Gentratnr?a Address: Generamr's Site Address {emu-an may a, Manifest Number ANTEHO nnsourmts SITE NAME;inch c2194?; 91}! 2.908357 1595 1 Til-I STHFET PAD NAME: B.$tate ?eneratar?sID i Dqu n.6merator's Phone . zr"- 5. Tran?mrmr 1 Company name 6. us EPA ID number . c.5tabu Transporwiun 335239 NTD IN . WAS MMAIGIEME WV DI Tanners Phone 816.5971 I 7. Trampomr 2 Camila?? Mane 3- Us EPA ID NumbState I'ramparrar's ilJ . - - Hf." -ir. n. . ?5 v'reF.Trans rter?s Phone .-. 9. DEIIW Facility Name and Site-Adams in. us cm In Iii-aha - I MEADDWFILL LANDFILL . E. State FaciIIthD SWF1032 -I. . Ir.- - - I . I 1433 DH. STE 101 I I II BRIDGEPORT, WV 26330 . 11. Dilatation of Waste Materials 9mmDRILLING RESIDUAL . I..- . 19/96 I . -- - WM Pm?le ?r.r'J -I I2val flu-J I I I II: WM Profile II trill-.- l2. -I .I. Additiona' Dani-mien: for Material: Liath Alum: i' Disposal Location can I Grid I - . 15. Special Halnudlinar Insmictions and Additional information BOX NUMBER: - I .mw??m . . Purchase Drder? - -- M1: FREEMAN 304432591110 115. CERTIFICATE: I mar-lily that the material: aria nnr'hamrdnut at mammal by CFR Part 261 Or any applicable state law. have been fulIy and accurately clam-lbw, classi?ed and packaged and are proper condition FurUansportatiun awarding to applicable reguiah'nns. Print Name I bignamreu I ?Hof- I . 4' (ah/Hf? I Acknowledgement of ReceipmeaterIaIs - ted Mame I maul-i Tea-r :?dm?f ?z Jar/f 13. Transporter! Acimnwierl enE'cIJFReceipt of Materials I: Printr'd Mame Signature I Mantl- I Year t? I .Ia 19. C?l??cate of Final TreatmenUDisposal I . I nor I In". on behalfol the abou- Ilsth Imatrnunl facility, that to the of my knowledga, the abnve-clac?b?d waste was managed in mmplian?? yirith all Ij?gllcablii Inw?gn ulauont, mpg; and Iicanws on the date; listed above. ll). Fat?ilitmemr or Operatcr: Certi?cation of receipt of nun-hazardous materials mated by this manifest. I [It'd Hume . II Signature Month Day Year Whito STORAGE. FACILITY Bluc GENERATOR #2 COPY. ?r'ellaw? GENERATQR #1 COPY F'Inlc-- FACILITY USE ?nldw owqudUUj?4 11:17 FROM-Northwestern Landfil 3844288394 T-JQB Fatal/I382 WASTE MANAGEMENT Northwestern Land?ll, Inc. 510 E. Dry Run Road PARKERSBURG, W.V. 26104 (304) 865-3938 FAX (877) 411 - 6497 or visit us at Fax 3?31? From Lisa Pagan 2 pages including cover Date: 1 lie: Rejected load Umant For Review [1 Please Comment [3 Please Reply CI Plum Recycle Ul?d?"lb 11:17 FROM-Northwestern Landfil 3344288394 Radiological Waste DiSposal Form Form 1W T498 F-217 Generator?s or Shipper?s Name and Mailing Address Phone PM 33? (6 7630A ?o?-asmmr Transporter #1 Company Name Phone 7V0?8?2?u7c 7/ . 6M Sari/fat. 2015 Transporter #2 Company Name Phone Designated Commercial Waste Facility Name Phone {-3738/ NP/?lmsfe/?l lWJ/gl/ '70 oription MicroR/hr Activity Number of . Container Total Unit Time aste scale. soil, reading Concentration Containers Type Quantity other} p?g? Dn'll op?: Mm we was?! a: Are there any other sources of radioact from driver, etc.) Post-alarm actions taken by the waste facility/transporter: Special Handling Instructions and Additional Information: Page of ivity known to be in the vehicle? medical source 0150:15 16:39-35 (Ri?e W. 9328 2'33 2% Mi ?14 m3 Pi". ?63 432% 41?34415 11:19 Landfil 34144288394 Peal/@132 9219 WASTE MANAGEMENT Northwestern Land?ll, Inc. 510 E. Dry Run Road PARKERSBURG, W.V. 26104 (304) 865-3938 FAX (877) 411 - 6497 or visit us at Fax In: From: Lisa Pages: 2 pages including cover Date: Illa: ReJected load Urgent El For Review CI Please Comment Cl Please Reply El Please Recycle Corfu-Erna! ?9507; f, 0.1. .w 44.? Lanuru 3M4288354 T-192 F-219 Radiological Waste Disposal Farm Form 1W Generawr?s or Shipper?s Name and Mailing Address Phone PM 53 '60 6'53 Vols/?r TranSporter #1 Company Name Phone 6? cKc-?le. wlef?f Sea/?Ufa; l? mil} 71/0 "326?)6 7y Transporter #2 Company Name Phone Designated Commercial Waste Facility Name Phone . . 551?373? No?wsfen/ laud/Q? 30?; .cription of NORM MicroR/hr Activity 1 Number of Container Total Unit Time aste (mg. scale, soil. reading Concentration Containers Type Quantity other] LCi/gm Dru/N Opt? loi?e?rzf de mpg?? H-wa Are there any other sources of radioactivity known to be in the vehicle? medical source from driver, etc.) 01.13315 9.033.359 Post- alarm actions taken by the waste facility/transporter: 9395.; mm 333 237$ 2385 Special Handling Instruotions and Additional Information: an m; 4783 Page of . ..- .. . Lita-u. ?21 ?x . .if'?Jsib i ?11:5; To: From: "E?gmyg?w?gmwa-AMQ (gym Heak{ ?3 (3:3 Pages: Date: (r :12; Mtg" Phone: (304) 748-0014 Re: CC: CJ Llrgent For Review DPlease Comment DPlease RE:pr 25 2015 Radiological Waste Disposal Form 9 Form 1W. Generators or Name and Mailin??ggress . 1 Phone Lg?d?N?? ?gny? - Transporter #1 Company Name 39:1,? us . ?a Phone 39% C. ?1 .. ?2 10 if!) - Transporter #2 Company Name Phone Designated Commiercial Waste Facility Name Phone chription Micron 1' Activity Number of Container 1 Total Unit mm: Tim: 32 (eg. scale, soil, reading Concentration Containers Type Quantity other) pCilgui r. a 8 "Lle (Q0 0? ?9 I aka-Ame? Are there any other sources of radioactivitiy known to be in the vehicle? medical source from driver, etc.) wow Page I a Mo . PO. A Post~alarm actions taken by the waste facility/nansponer: mg; ?4 ma Special Handling Instructions and Additional Information: 3844288394 Ell-Zfi-?15 11:36 FROM-Northwastern Landfil 3044288334 T-173 Peel/1382 17499 WASTE MANAGEMENT Northwestern Land?ll, Inc. 510 E. Dry Run Road PARKERSBURG, W.V. 26104 (304) 865-3938 FAX (877) 411 - 6497 or visit us at To: From: Lisa Pragus: 2 including cover sheet Date: 1f26!15 me: Load rejection RadiUm 226 El Urgont For Review Cl Please Comment El Please Reply 13 Please Recycle 11:66 FROM-Northwestern Landfil 3344288394 F-199 rs Radiological Waste Disposal Form Form 1W Generator-?5 or Shipper?s Name and Mailing Address Phone A 9o7?3.rs..rr27 Transporter #1 Company Name Phone . 514 A4 . 6N V- 7 Transporter #2 Company Name Phone Designated Commercial Waste Facility Name Phone 3 N0??hms?fe/A/ 39 '9 scription MicroR/ht Activity . Nuinber of Container Total Unit Time .151: (3.3. scale. soil, reading Concentration Containers Type Quantity other) pCilgm orm MmAre there any other sources of radioactivity knOWn to be in the vehicle? (eg. medical source from driver, etc.) [do . {ll/?lls 10:02:02 Post-alarm actions taken by the waste facility/transponer: mm a? Ll [4:5 32? 5405 . . . . . . FIJI Specm} Handling Instructions and Additional lnformatton: Page of - -- - - rl?rmaku . a; ?3 '4 (EU-J iT-lR-i'u'IJ-i {Gin?3. I - . .-.- .-. gap. To: $31.11;, 51 Mark?e. c1 week Fax: [390 ?imu? rat?16L, Pages: 9n Date:_ 1 Phone?; (304) 748?00135 Re: CC: Urgent For Review DPlease Comment DPlease ReplY 3.: 201% I Radiological Waste Disposal Form Form 1W WM .. Gemorator?s or Shipper?s Name and Mailing Address Cam Phone MW Trans nor #1 Com an Name om: p0 111,1 [m .. mi (19H) . f2 Came? E: Q3 ED .lLa'Bi?S Transporter #2 Company Name Phone Designated Commercial Waste Facility Name Micronmr '1 Antivin Nimberof Container 5 Total UnilWWol Time :e scale, soil, reading Concentra?on Containers Type . other) pCifgm 1:41:43?! Co? 5 1 cf: Chg-k- 595? \?kln-OIE Are there any other sources of radioactivitiy known to be in the Vehicle? (cg. medical source from driver, etc.) NO 5 drivEJ-l Post?alarm actions taken by the waste facilitym'an spotter: Page of__L eunuch-112.5 on Special Handling Instructions and Additional Information: M9. L.de n51..de Ewan-x1. DEED To: Q14 Lime From: wee Cam - a {kiwi Fax: 3.9% 63% Pages: 9, Date: may W5 Phone: (304) 748-0014 Re: CC: Urgent For Review DPlease Comment [Please Replji RadiOIOgical Waste Disposal Form Form 1w Gmerator's or Shipper?s Name and Mailing Address Phone (229 u' draw Vim??13} 3? Mam-Qanchr?r" (an ?sent-g ??11 TranSpoxter #2 Company Name Phone Designated Commercial Waste Facility Name Phone of NORM 3? Activity Number of Container Total Unit WWOI Time :e (e43. Scale, soil, reading Concentration Containers Type Quantity other) pCifgl Frmda, '53 ea,? th- WM . . - ?m3 Are there any other sources of ra'dioaetivitiy known to be in the vehicle? (on. medical 30m from driver, etc.) e; '00va Post-alann actions taken by the waste facility/transporter: Cane (?gm 0" LMQ Special Handling and Additional Information: Page of Lab-pt. AtsPW??g ?k Lillhil? - . :?Eh l; 7?134ij? 1?3-04: 1514141115 Dam, TO: QM Hm From: Fax: Pages: Date: 1? 3?3? "'39 Phone: (304) 748?0014 Re: CC: Urgent For Review DPlease Comment DPlease Re:pr Radiological Waste Disposal Form Faun lW - 31?. Phoneceki) Generator?s or Shipper?s Name and Mailing Address . - v-Px \V?tssm MW Emu? than? Mama-5.. ?lw?l (0?3 - ?1%1?1 ?QT-{ya Transporter #1 Company Name 3 Q?s. Phone E: Cone-Janu- Keg-?5" qq Transporter #2 Company Name Phone Designated Commercial Waste Facility Name Phone Me?p?on of NORM Microth Amivity Number of Container 1 Total Unit Time :e seaie, soil, reading Concentration Containers Type Quantity other) poi/gm mm? 998 53% Tans? \px-zw Are there any other sources afradioaetivitiy known to be in the vehicle? (eg. medical source from driver, etc.) No driver Post?alarm actions taken by the waste facilitylu?anworter: Queue?A Special Handling Instructions and Additional Information: Page 4 Lox? (ges? til->394 31 at page 3544552955 . PAGE 51/53 15:57 3544552955 WETZEL Wetzel County Land?We}; Note: If Alarm named by driver circle: YES. No further ac?onneoessary Drill Cuttings Medical on? A Mid-height lmidpoint Front '3 :l naught/midpoint Back 3 Mid-height [midpoint LHS 3 md-heigm/midpoim RHS :3 .E?ghestr?ad?mg 3a (1 150mm: 2 msk??i!? g: ?1cgi. Elm.?fo If highest reading IOuR/hr above BKG, follow RMP disposal procedms [noti?cation Ifhighest reading 59 IOuR/hr above BKG follow RMP procede for manning a load erfo ?onS BKG Counts: ?(Ly (cps) 'Surface WipeReading: 5 (B (cps(cps): (mm (am/300m?) (C) (D) may.? - '5 Ifresult<6.600 cum/30001112 fo?owRWdisposal procedures not?cahons. Ifresult _>6,600 dpm/soo m2 follow RMP follow protocol for rejecting returning a load my 61/22/2315 15:07 WETZEL 3644552955 Surface Dose Rate (highest reading 0n container) ISOTOPE: IfIsotope is on Disposal Approval List follow RMP disposal procedures If Isotope is NOT on Disposal Approval List follow RMP noti?cation procechn'es ecu N3.Fon 0 i erfo ?ceIsoto'c/Dose ms 0 r: Surface Dose Rate (highest reading on container) 0 Follow RMP disposal [noti?cation procedures Fonn Completed By (print): he, I. A: (sign): PAGE 02/63 15:5? 3544552555 NETZEL aaraa #22515" It . . Ru?alogim] Faun 19me 1? ., l. . I .. I?umwc Phuna J?gzz I E: I Wm?cammwm Hm, INN?snl?ll Vanal' Inna: Phone 14? afm?lani h? mu. mum: mug Wot Tau! mwwa -- .I?fa glut; {Ala-ff?? 23255?5' axf? dszz- NETZEL 83/83 [?0425 #3 Mom 5am L45 7gory??b?f337? Name Phone Plum: a] Jot/L tars-5,3500 I _l mun-um] Malibu-01' Comm will 1 Toni Tim: 2% wk? 1nmum lemma Com-um Tim: I ELL I ?73:1 I0 am I 1 ?ag-made? In?, midMImJ . rtuw c_ n? ym? Vt: ulw?m?w? gilt-th [Ba?<3 Kai-u Pageme . luv! 40:. J. 4: 34 PAGE 61 03 I Jae??5? MK lliiomm . my; Hag-Tuni- swig) Note: If Alarm caused by driver circle: YES. No further action necessary rrom ?3 Midshesight {midpoint ms LI 0 Highest reading 186mm: NOT lWow Ifhigheat readmg? IOaR/lu- above BKG, follow RMP disposal Procedures Ino??cmions. Ifhighest reading IOuR/hr above BKG follow RMP Prom-dues forreturning a load erfo Con MJcI-heighumidpoint Back 3 5? ma-mght/mmwha RHS 34?? a? sm *Surface Wipe Reading: (cps) (8) (dim/30M (D) Ifresu1t<6,600 dpm/soo c1112 noti? . Ifresult >6,6oo dpm1300 cm: follow Rm? follow proton for rejecting I rean a load NETZEL Wetzel County Land?ll PAGE 62/ 33 1. #2045 If Isotope is on Disposal Approval List follow RMP If Isotope is NOT on Dispo dxsposal Procedures 831 Appron List follow RMP no 3.1m ic/DoseRate me on Suf?ce Dose Rate (highest reading on container) contain ?31x2332m15 11:43 3844552955 38d4552955 NETZEL 81/83 #535: w/J/ Wm new 44,? 746,, Wa?omNm I '/42 r? 4: fwr'm 3 if Wu? 3051- 35% 3' Mm 0mm Wm Facility Nana A}!!de damaging}?! Kim may Numbu'of cm:- Tou (?mm mm 0mm Cunning; Type Quality W01 1 ,Raaba,cx?p I I 7231'); 7ng ?omdri .chc. O/quw ?LU/hf Lifhu'fL 45:04:: \3 Q?w? 491,0 - - Nob? - l?mdam (- ul I 26/ 2915 11:43 3644552955 WETZEL PAGE 32/ B3 Wetzel County Land?ll Reed/?2045 Time: USN 4m Monomer; - Twitter Name: A DriVer Name: 7? En 57h" Note: If Alarm caused by driver circle: YES. No fmther action necessary TE TYPE Medlcal Other )A?ev I A Backgomd dose gate: 7 (Mg) ECTION 1. FOR DRILL CUTTING 0ch ohm 0 Pol-gout; Surface Isotopic; 905: gm gt:ng on vegjgle container (?Mfr MCI-height midpoint Front 2 Mid-height I midpoint Back i Mid-height midpoint LHS 2 Mid-height midpoint RHS 9 Hi?lest reading 0/ If highest reading mull/hr above EKG, follow disposal procedures lnoti?cations. If highest reading lOuR/hr above BKG follow RMP procedures for row a load (i?Pegiom Congmination Survey BKG Counts: (cps) *Surface Wipe Reading: (cps) (A) (B) ace Ca! lotion min a 50% cie rare (B) (A) (C) 60 (cpm) (D) 10-5 (elm/300cm?) (C) Surface Wipe Rea-uh [fresult <6,600 cm? follow RMP disposal procedures I noti?cations. If result >6,600 de300 cm? follow RMP follow protocol for rejecting Mg a load 813644552955 WETZEL PAGE 03/3 /?30 do? Wetzel County Land?ll 8mg 2, For: WASTE (my a ce 130 1 Rate 11 Vehicle tainer .- Surface Dose (highest reading on container) ISOTOPE3M If Isotope is on Disposal Approval List follow RMP disposal procedures IfIsotOpe is NOT on Disposal Approval List follow RMP noti?cation procedures $353011 3. FOR OTHER WASTE ONLY Perform Surface Isotopic I Dose gate Sung! og vehige coping? er (HR/bu: Surface Dose Rate (highest reading on container)_ ISOTOPE: Follow RMP disposal noti?cation procedures Form Completed By (print): 6mm (sign): ow Tag?? 534 3 Elm-?lg 5 'L?lg? Tr) Fax. 3 Ct gm Pages: 2 Date: 1 a ?1 Q1 J?axolq Phone: 1304) 748-0014 Re: CC: QUI'gent For eview DPlease Comment DPlease Reply Radiological Waste Disposal Form Form IW Generator's or Shipper?s Name and Mailing Address}; . . Phone {Zr-mm luv? 0 #1 87 6? ransporter Company ame . Phone I 1955.?, Lu WW (3959 cm.? . Egg" Conckmu,RAlCn3 CHO Transponer #2 Company Name Phone Designated Commercial Waste Facility Name Phone Deccription of NORM MicroRJhr Activity Number of Container Total Unit Time .13 (e3. scale, soil, reading Concentmtion Containers Type Quantity 0919?} - i 3.915 w.m Are there any other sources of radioactivitiy known to he in the vehicle? medical sauna from driver, etc.) Ki 0 a \qu ?PQSt-alarm actions taken by the waste facility/unnworter: Special Handling Instructions and Additional Infoma?on: Page of_1_? 51:1"; {min . .. .- - DEF. - To: Sip LAW Hank From: Brw?? . Fax: 30% ?lm QWELO Pages: 'Datei 1 of 9-016? Phone: (304) 748-0014 Re: CC: Urgent For Review DPlease Comment DPlease R6:pr I Radiological Waste Disposal Form Form IW Generator?s or Shipper?s Name and Mailing Address Phone .h ?Wit? sen uH??i Poke n0ransporfer I Company Name ?59 ?51 us lkshua Phone ?68 Mam-Hire Conckm?b \G?Sl?o? Transporter-#2 Company Name Phone Designated Commercial Waste Facility Narne a Phone quoription MicroR/hr Activity Number of Container Total Unit WUVOI Tima :e (mg. scale, soil, reading Concentration Containers Type Quantity other) pCi/gm . u-o? roman mike. 9? I996 Tm WM Are there any other sources ofradioaotivitiy known to be in the vehicle? (6.3. medical source from driver. etc.) Nod)ch Post-alarm actions taken by the waste facility/transporter: Foam thurehom?cf at: 2:19 Label (156,035! 03; $de Special Handling Instructions and Additional lnfonnation; New. Page . Dye-?9, . T0: Diq.c51_ wows, From: (brunt; Fax: Pages: Date: I .4 ma fame Phone: (304) 748-0014 Re: CC: Uigth For Review CIPlease Comment CIPlease Reply Radiclosicnl Waste Dispose! Form Form 1W Generator?s or Shipper?s Name and Mailing Idol-cos Phone -) Car} Ll ?90 Emil 31nd} SE. -chgn when my?" Transporter #1 Company - Phone We?aw, . <9 Transporter #2 ?atly Name Phone Designated Commercial Waste Facility Name Phone De-ecription of NORM MicroRJhr 3? Activity Number of Container Tomi Unit Time (eg. scale, soil, reading Concentration Containers Type Quantity other) pCifgm Frau; [Anal-.3 33gb. RN: [La Are there any other sources ofrndioactivitiy lmown to be in the vehicle? (8.3. medical source from driver, etc.) No .. Post~alarm actions taken by the waste Special Handling Instructions and Additional Information: Page_ of? PAGE 34/07 14:56 3644552955 1? 4* . I 76-43 - Wetzel County Land?ll 1-514" 0 mm Ozark? 5-3 Note: IfAlarm caused by driver circle: YES. No further action necessary WASTE CLE Medical Other (specify) Mid-height midpoint Front Mid-height/midpoint Back I {a Mid-height lmidpointLI-IS RHS 16? Highest mung 186mm: as $333 If highest reading IOuR/hr above BKG, follow RMP disposal procedmcs lno??cutions. Ifhighedemg=>10uRmrabove BKG follome forretuming aload iiPeo taming? BKG Counts: (cps) *Surfacc Wipe Reading: 5' (cps) (3) on. note? (cpm); (In/0.5 --AZO mom (C) (D) 2? Ifrestnt<6soot1 m/soo 2?011 RMPdis . cm ow posal procedures no??cahons. Ifresult >6.600 dpm/300 cm? follow follow protocol for rejecting returning a load hr: PCPL L0 .UErmr?UdeH-U Eau?n? ?35 U382: HES was: . .u . . 333 7566? .9632 00:63?22:89 . Ea ag??gzg u??naoqanaa??o ?35235 was.? EFTE FUEL 3: mm- .9. ?28: 53 33.5% .0335 gain. dug AFN. ?an. gum Conan?g nonhuman. ASH noun?B . ago nkn?l $6315 an. . man?u tangy/20 meg/want; weaning. human: Era: Ex :5 #23? Egg Aymwugriafafumh . mama. Ewan hanging as 3 gm?, imam UL :3 4r 35F 9? EELSL . . an uuwwuuisnua WETZEL PAGE 35/37 Wetzel County Land?ll Sit ME to WASTE ONLY miner .- Sm'face Dose Rate (highest reading on container) IfIsotope is on posal Approval List follow RMP disposal procedures Iflsotope is NOT on Disposal Approval List follow RMP noti?cation procedures SEQON 3. F03 0mg WM ONLY Peg-[om Surface Isotopic I Dose Rag Song! 0; vemcle contain: (elk/hr): . Surface Dose Rate (highest reading on container) 150mm: Follow disposal noti?cation procedures Form Cornpleted By (print): Qc? pt [1 (Sign): 41'1- vu WI: . - r-?v BILL OF LADING-SHOFIT FORM-NOT NEGOTIABLE PAGE 30b n? ORIGINAL - NOT NEGOTIABLE NOBLE ENERGY =rom PEN-20 HELL mm . 0 4 1 .. WEI.- WILL . NE MME mm 1, an: 155; Qt?gk/ Ann NEH ILLE, 26155 ROUTE ne?vmuaawum ammo? 304-455-3130!) - - FF, minus I . CAROFIVEHEGLE I . INITIALMNOPackaging. of ANGIEE - 9 Special Marks and Exceptions mm - DRILL elm-muss #6094. 1 WELL: .347 pr APPROVAL commsogq-szn?w-m as a? ?9 - Mum: me: In: I M?W?I?nmlm Sam 90mm? Ian-um. ha din-and FREIGHT m- cande am sign ma mummy mm Shank Bax: Tmehrm?numlhm-yd?mm?m?m H. meght prnpaid {j Cullact i {Signature or Goa-answer) Em thud-u I'uu' aria-map: mute-um ?Irma-gmth Ichmul'llurlmm? and Mo! and hi: Margin}, 1. ?ne who HELL Dan I CARRIER sn I M. If? I E. ii mum/21s 14: 59 3644552956- mam-:1. PAGE 91/67 [a Wetzel County Land?ll 2535; ?0 ?ls, Timez' mm g/lg W5 BI (M 0? - Note: If Alarm caused by driver circle: YES. No ?n-ther action necessary 2 2015 Medical Other (specify) dose gm: 3 (My, VE IN Foul) cw erfor no [imitates rv vei ?ner r- Mid-height midpoint Front Mid-helght/midpoint Back 2 Mid-height lmidpoint LHS /0 Mid-height ImidpointRl-IS 40 Highest reading comm Ifhighest reading min/fir above EKG, follow RMP diSpoaal procedures Inori?carione. reading IOuR/hr above EKG follow RMP procedures for returning a load [IQPel-form Coirtaminatiog Sum BKG Counts: (cps) *Surface Wipe Reading: (cps) (Au as) . 1' '0 cl' (Dims a (wood) Sur?rae Wipe Raul: Ifresult <6,600 dpm/SOO cm2 follow RMP disposal procedures noti?cations. - If result >6.600 dpm/BOO em2 follow RMP follow protocol for rejecting I returning a load .. .. uu wnscuL. PAGE 32/37 [?lo-lo Wetzel CountyLand?ll on 2. Fan Surface Dose Rate reading on oontainer) motors: If Isotope is on Disposal Approval List follow disposal procedwes 111me is NOT on Disposal Approval List follow RMP noti?cation procedures ate-non 3. 393 WAsm my I urface [onto io rv on a container Surface Dose Rate (highest reading on container) ISOTOPE: Follow RMP disposal! noti?cotion procedures Form Completeo By (print): 2 2m a (myg ?tL PAGE 83/8? [4045' Radiological Wash: Diapoaal Farm Fem: 1W -. WamSl?ppu??s Hanan-at:delth Phone lo Log-.11 F31- b??mk? Mel/Mercia.) bus.) Tammi-term Compaumec Phone 301-1- 5&5 ?8&1 Mm?Cnmpanme Plum: Phone bah-.31 v-v- scale, m1, madang Conmm?m Containus Type Mt! E: Emormm Him Antiv?y Mmbuor Container Total UnitWWol Tim: .2 m} nCilgm I I dun/LP (02 I?kqm ?km +on mmqamyotham in?acvd?de? Mun] source big?Iv? ?dug-5? Post-alum actions taken by th: waste facilitin ?13 I?me RPM . Special Handling Instructions and Additional Informa?on: W. Page of 1r FEW LANE, FTOIDI Mk6. Fax?39H 934:1 Pages: Date: 8*1949? Phone: (304)748-0014 Re: CC: I ?3 Urgent For Review DPlease Comment ClPlease Reply Radiological Waste: Disposal Pom Foam Iw Gmemtor?s or Shippcr?s Name and Mailing Address 4 Phone 1 ?3 inn-39? at 0 .. 5 Ehroelcm om?mw? CM- 37 431% Transporter #1 Company Name Phone Term 3b? (Ts Transporter #2 Company Name Phone ?esignated Commercial W?sto Fao?ity Name Phone of NORM MicroR?u' *5 Amwin Number of Container? 5- Total Unit Tim: :3 ?ag. scale, soil. reading Concentration Containcrs Type Quantity o?w) poirgm - ?aked: Line? 0? [Soy- 2 Are om any other sources of radioacd?tiy known to be in the vei?cio? (6.3. modical source from drivor, etc.) Lhedud Arw??. I?osL-alarm actions taken by the waste facilityft?ransporter: ":0ka tebumw?g (3g OHM . 1 Special Handling Instructions and Additional Infomation: Genoa?31w *oo?xc. iooa? [Dock Ludk ?va?n. ml A'th 3344238394 9 - 13:45 FROM-Northwestern Landfil 3844288394 T-125 147 Radiological Waste Disposal Form Form 1W Generator?s or Shipper's Name and Mailing Address Phone A ?Taro Transporter #1 Company Name mi Phone summit? EMU Transporter #2 Company Name Phone Designated Commercial Waste Facility Name Phone N9 471? ?fe/J law/gr? $9555??th scription ofNORiVl MicroR/hr Activity Number of Container Total Unit Time .1818 (cg. scale, soil. reading Concentration Containers Type Quantity other) pCi/gm Mad?! . - a 71.377! U?e?ox 73A [237 Are there any other sources ofradiOactivity known to be in the vehicle? (cg. medical source from driver, etc. . . NO Post-alarm actions taken by the waste facility/transporter: 01/03/15 12:39:50 0405.0 Special Handling Instructions and Additional Information: 2m 2539 mt 5m $690 Page of 3044288394 1-7-'15 12:47 FROM-Northwestern Landfil 344288394 T-121 F-143 Radiological Waste Disposal Form thniVV Generator?s or Shippcr?s Name and Mailing Address A i'hone Transporter #1 Company Name en'- game Su en; ti, ff? 5956 ?2.3743241, Transporter #2 Company Name {a phone p?H? - -- Designated Commerciali?aste Facility Name .. . .. . Phonic. 3 3'0 $955," 73 3/ No ?ew-c grew [Owl/g mription of NORM MicroRIhr Activity Number of Container Total Unit Time me (mg. scale. soil. reading Concentration Containers Type Quantity other) pCi/?j; )r-H mad?, - I VHO 72W Iz'ddf?; #1058112 MN 37* 74? . 65x - Are there any other sources of radioactivity known to be in the vehic?c" from driver, etc.) . 0000.8 tum Post-alarm actions taken by the waste facility/transporter: 2325 Mv Am 4725 4750 Special Handling Instructions and Additionai Information: tax 5m 3354 Page of Wetzel County Land?ll EQILLMQEQ *6 2015 Dita: Time: Jr. ?e I2 WW Note: If Alarm caused by driver circle: YES. No ?rther action necessary KW Drill Cuttings Medical Mgound dose mg; (112,31) VEHICLE READINGS: Li) Perform rf ce lento i I Dose Rate Su co . . md-hoigm midpoint Back ,5 8 Mid-height midpoint LHS Mid-height midpoint RI-IS Highest reading ?an/r Ifhighest reading lOuR/hr above BKG, follow RMP disposal procedures Inoii?ootions. If highest reading IOuR/hr above BKG follow RMP procedures for ramming a load (iiIPerform Cogtann'nation BKG Counts: (cps) *Smface Wipe Reading: (cps) (A) (3) ace 8 Calculation usin a 50% cie ?rare: 0-5 - (A) a (C7__,tcps) so com/300cm Sherbet Wipe Res-alt If result <6,600 dpm/300 cm2 follow RMP disposal procedures I noti?cations. Ifresult om2 follow RMP follow protocol for rejecting manning a load Wetzel County Land?ll 2. FOR MEDICAL Wgt'n ONLY i Pa orm Sn ace Isoto ic I Dose Snrve ehicle con 1- .- Surface DOse Rate (highest reading on container) Iflsotope is on Disposal Approval List follow RMP disposal procedures If Isotope is NOT on Disposal Approval List follow RMP noti?cation procedmes {ignore 3. F03 OTHER EASE 0111.3 (i1 Perform Surface Isotopic I Dose Rate Sun-vex on vehicle nominat- (um/hr): Surface Dose Rate (highest reading on container) . 35:67 ESQTOPE: 1? ?n Hwy [Lf? Foilow RMP disposal noti?cation procedures I Form Completed By (print): :D?uq a ?x RadioIogical WamDinpoaal Foam E, Pom 1W -. .. Gumr?s m- am: and Mailing Address Plum .411. Hf; if {Ft} pun/?? {?26 .35 #1 Company Nina: mm mum #2 Cumufaany Name Deaigaamd :7mucial Waste Puffy}! Name Phone M?z (as J: 14' WP: 9453'- 357% p?on 01mm?: Mismth may Name: of We: Toua UnitWWol 1h? Wilt, mil, wading Cancellation Contains: Type Quantity Pc?im Am?me any other nources ofmdioami?tiy imam tube in the vehicle? (mg. madical driver, etc.) Post-alarm actions t?kan by the waste 31min! Handling Inshuc?ons and Additional Information: Page Oct.21.2014 05:43 pm Evans City 7244323056 pass. an a? Mi I ORIEINAL-NOT momma 1-. minim-amm man-nor ?gonna? CH MWVIEI I I mum STORAGE YARD i I Mirna?! mam Ln 1' 5? GETZEL COUNTY ROUTE 1, 301': 155A 13!? 26155 I k- Nu. mme. aim" warm? 301 - f'hm?nmmasmu 91109351173? NUMBER 92344 9 tun-manual unnawa?-cn aua' Tramwa?gqun-mm mun anhmn I'll-ml! mut?tw?wh . uni-Inhi- . lm?l: ?Wmuhhml??I?? an! nun . mama: tum Imam Hpul I 0 {Dem (:511 megaumfrom. Em. Qk? nggiuwmk ?31 an; - CH5 Lo Pages: 3 Date: 1 4} w- Phone: (304) 748?0014 Re: CC: Cl Urgent or Review DPIease Comment DPlease Reply (1 A I I Radiological Waste Disposal Form Form Iw 06153:?? 0" Shipper?s Name and Mailing Address .. Phone 229;; L4 I. ?100 3:4 EAch SE 0&4? a W319. bum [at Phone, mg . MOM TraHSpoItor'i??Z Company Na?io I Phone Designated Commercial Waste Facilityr Name Phone [)qun'ption of NORM MicroRJhr ?5 AcLivity of Containm- Total Unit WUVOI Time :3 (9g. Scale, soil, mading Concentration Containeis Type Quanlily - Ci! other(mg Are there. any other sources of?radioactivitiy known to be in the vehicle? (og. medical source from driver, etc.) NO: ?1 Post-31mm actions taken by the waste facilityfo'anSportcr; Special Handling Instructions and Additional Infomation: 1 gm Page I of To; From; Jrax{;30Hy oMSfp - w Re: Pages: ,Phone: ^ , (304^48-0014 CC: OJjrggBtO For Review OPlease Cninment DPleasft Rei RadioiogicaJ Waste Dbposal Fomi Form !W Phone Transporter#! Company Name S^riAci^OfN ^G-1MS-5S1^ CWH&iiW — Phone ^\A \/ Transporter #2 Company Name — Phone Desi^ated Commercial Phone Total ECi/eni ^ I fiom driver. barbi-U - oH-s^ Pages: _ ^ n^itp- -5^ -AX - T Phone: — C3Q4A 748-0014 CC; g;yrjLent[lFor Review OPIease Comment nPUa,.. p^pj. Radiological WasLe Disposal Fonii Fonn IW Qmerator's or Shipper's Mame and Mailing Address •T.;aniiiK,rtf!r#l Company ~ " Traji ,jK»r5jr #:» Company Name Phone D'csi griiite^J Ooinm.crciaj Wasie Facility Name D--mpl.o..of>ib)LV. (e.g. scat.soil. 9M'X ^ jeadiiig Aiuvhy Concentration _pCi/gm Phone Numbaof CoitameT Container Tvoe ^ Total Unit Wt/Vol P^kACu" C0^§J 4_o^y soiu-ces ofmdioactivitiy known to be in the vehicle? (e.g. medical source PosS-aJ;arm actions taken by die waste fedlity/transporter SpsciaJ Handling Instructions and Additional Information: i:i>_ i cfV Time Quantity ^ v.<, ^0 ' '>e«r {\HS^ Fax: #3 0049 @459, Pages: ax 153511255?! C1 - Phone: (304) 748-0014 1541-33 .. . CC: I. Il'r'ilf?l?uiql r~ —- . Radiological Waste Disposal Form Fiwn 1W Phone ^«^o< Irajisporter^rl Company Name TVarspoTt'w #2 Company Name Phone \m - 6 2015 Dei'gnated Coinmeniial Wjiste Facility Name Plwne D'"«cripiioa oi UO^M rMicioF.'hr feeder ^,^3 Are there any odicr sources of radioactivitiy known to be in the v^tcle? (e.g. medical source ftciji drv«. etc.) ^ jJO Post-alnnn actions taken by the waste fadlily/tiansporter; , LcaA Special HandlingIiisti-uctions and Additional Information: • Fax, ''bo^ Date; Re; Q? ~ i s Pages: Pages: ^ w —i-n ' Phonei_£304i748-0014 Phraif"" /"3rt/I\ lAO nm a CC: P Urgent • ForReview PPlease Comment DPlfiagP JUN 2 2 20!5 Radiological Waste Disposal Fonn FormlW Genaator's or Shipper's Name and Mailing Address _ . .i a _ , 7 _ IX.SI s4.^+.-7,U-<^A. touico WK CWafv;Ii\<;. geipK.oU Transporter#! company Name CavjuoTopV (i«*\ ^ Phone iSb-UP'i-O'iOl Phone tt,(SA M'514^ old Transporter#2 CompanyName Phone Designated Commercial Waste Facility Name Phone D''9CWVJ£V0RNII^ rao wcaaBigftitayiauiviiVMieaiKP CAX2BBA330NXUXQ' UWlBBSrilllft SaUBorXlQVSr ..a, wSwS" mm Sssgst 9- /WfArf \m ^•3^^ >.1 liJ S,cU HoUJL ^mAnrntsksmaeu^rffra WjiRflbr uihisuilL l(g'6a , Tryckco,^ : i.*T '"'W^ o oo Truck# gox-tf" /to^ Fa^tla^j©# Inbound wt. . ^ , •«' M r.r, Ffaa: Haste HonaeeMnt infA^Ai Fax: Haste Manapneent — NON-HAZARDOUS MANIFEST L Genetator's US EPAIDNo. Manifest Doe No. NOIMIAZAROOUS MAMFESr 3. <9«ii«iwa('»MalHns Addresc GMwraux^ SHaAiMnn CONSOL ENERGY PAD: 1000 CONSOL ENERGY DR WELU CANONSBURG, PA 15317 COUNTY: 4.OniaiMliu'a piiqtia W^ge-lSuUilAULIUILHl • •• INC {1*-^ :• • • loi - • . C State Tramportnf'B ID 33S239 P-TranaiwrtertPhone . 681-456«6971 US IPA10 Number e. State Traftaportef's IP • ... :. 10. US ERA ID Nunber K Tmnteerter^ Phone 0. State Padllty ID H.State Faculty Phone 1488 DAW50N DR STE101 BRIDaEFORT WV 26330 IL Dem^ilian ofWmm Materlab No E 315S573 a. Stata Qeneiator's ID' WVR000529289 ».DatteKM*dFadtity Name end site AtMnt* MEAOOWFIU LANDFILL 6 A. ManlfM Numlier ° us BPAID NumlMr 7.IhmtpertM 2 ODaqnmy Name • f miaal; 2.Pagelof WMNA Trantperter XCmnpany Nenw • HOFAX9 JIM-30-201S-10:03 Doc: 194 Page:004 of 007 a. v-'',ipe: PHA Energy Units: keV Start Time: 20154)6-30 16:03:12 Real Time: 60.02 see Live Ttme: 60 see Bias: 620 Coarse Gain: 1 Fine Gain; 1.1470 Group 8lx»:2S6 LLD: 0.80 ULO: 100.00 Zero: •»0.143S I -1 20 66 149 2fi2 469 741 1107 1594 energy (l«V> PHOTON DATA Geiecton gamma Real Time: 6a02eec Live Time: 60 sac Count Rate: 316.85 CPS Total: 19017 Ceunta Dose Rate: 0.22563 u8v/h (22.563 urem/h) ANALYSIS RESULT Threat Oescrlption: NurriWe Name: Co>B7 NucSde Type: Induatriai Niiciltle ID Confidence: 0.62482 NucMe ID Confldenca Oescrlption: Medium NucSde Dose Rale: 0 00035132 uSvlh (O.035132 unm/h) 2173 27BS « To:30492604S6 Froa: Haote Managaeent Fax: Maste Hanageaont Rtename: 8PEC0031.N42 instriment information JjJtftOTent TVoe; RadhmucUte htentlfiftr ^nufoctuier; Berkeley Nudsonics Coip. Instrvmeflt Model: SAM Eagis Instniment ID: Seiial 41464 Probe Type:Serial46737, Typo2x2 Nei SPECTRUM INFORMATION Spectrum Typo; PHA Energy Unite keV Start Time: 20164)6-3013:04:43 Real Time: 60.02 cec Live Time: 60 lec Bias: 620 Coarse OaJn: 1 Rne Gain: 1.1830 Group Siae: 206 LLO:0.80 ULO: 100.00 Zero: +0.1435 energy (keV) PHOTON DATA Detecton oamma Real Time: 60.02 eac LiveTTnte: 60eeo Count Rate; 286.3 CPS ToUd: 17116 Counte Doee Rate: O.21065 uSv/h (21.088 uromrii) ANALYSIS RESULT Threat Description: NuelldeName: Ra-SZS Nuclkte Type: NORM NticRde IDConflclence: 0.770428 Nucdide ID Confldenee Des^lon; High NueUde Dose Rate: 0.0318346 uSv/h ^.18346 utenVh) I nOFAX9 JtM-30-2019-10:nt F«c: Haste Hanagessnb Attn: 23 PM water and waste management To: water and waste management Company: dep From: Sekela, Kelli Subject: rejected load Number of pages including cover sheet: KDmX9 JUL-03-201S-13:S7 Doc:044 PagstOOl of 004 Date: Friday, Jul-03-2015 Time: 03:57: 4 •-•J ( -• Framz Maste Hanageoent To: 3049260436 Fa»: KOfVUCV JtUL-0a-201S-lS;Sr lloc:044 Paae:002 of 004 Haato Hani Rodiologtcal Waste Disposal Forn FMin I W i .Qenetator*s or-Shteper^s Name andMaffing Phone fo te w5 JiWt K*>i ^mn, (Xfipt Phoiie 3imm. 33£lWr.Of^/ TAGhapdzti^ if2 CdmpaiiylSIame Phone • ffStu'A Phone 1 1 ( De^ptidn ofNORM MiofoR/hr 'trasIie(e.g..scaIe,.soil,. reading oflierl Aetivi^ . Concemration.; 'pCi/kri 1»il Mly^ Numfsarof - " Container! Type Containers ; Total UflifWtArdl Quantity 1 • u 1 -— 1 ; 1 J 1 1 r 1 1 1 I I \ 1 I Atc-'theite any othersbinces ofradioactivity known to-be iiithe vehiicle?°(e:g^. medi°c&t source fioni driver, «Ci) I Pbst^alann. aot(«Ms t^en the V/aste -fadlityAransporter: ^Cdinned kcsJ)0os Special'I&nttling.Instruetions tma Additional Iqfqnnatton: I [% e. i_6f L Tim© To:304«60W Fra«: teateJtwageMnt Faxr Haste Hanaoewnt iroFAX9 'NON-HAZARDOUS l. .Gen»tQrl£liS EPA ID No. 31JL-03-201S-1S:S7 I>OC:044 Page:004 of 004 MANIFEST 1. Pass 1 of Manifest Doc Nb. NON-HAZARPOU$. MANIFEST I ^/ V j S.aMarstor'tMsUlneAclrfrmi QanMatftr"* Ut* ftddioss i---- ! CONSOL ENERGY PAO; lOOOGONSOL ENERGY.Oft CANONS8URS, PA 13317 - ,,1 / A ManW^«.Nuni6«f A? WMNA _ 3155568 '8. StateGeneratoYs lo COUNTY! .a..C*nerwter'e rhee* .S.TStirlClMKtar 1 US EPA ID NUmWr iiv;:5;;^^,T77^TidYT3SH5!®iT RssssrTMimiaiitir-slO: WVR0O0529289 >. Tnncpofter 2 Company Nwm D. Tunsnotier's Phone 335^9 €S1>456.*6971 USCPAIONumbar E.State Tranporter's.iO. P. TranNKner'sMtme 9. DesCshatad Ftit^ Name and SRe Adtkos MEADOWFIU. LANOntL i?',„ G. State Fadilcy ID 148S DAW50N OR STE IDl H.^maFadlltv Phona BRJDGEPOfTT WV Z6330 ; ..L--:;' S'V, r, e u. uascrlptiimof Wsm Meteriata I. M«c.co«vnena WM Proflle # Ca iv-"-; WMProfikff , j -'t , .1, .. - 0 ncHHiBnuHini '7'-.-.*ivvAv7.'-«.'«V'«^•••>;. .ips^wTwhI i AddMlofwrOeiolytipnf for M«»i<6l$Ustewi i v i t n ^ i ^ i i Manifest DocNo. r 2. Pace 1 of N0N4fAZAKDOUS MANIFEST 3. 6encr«te<» MaDlncAwraui Canacsto^c Sita AgU'*" ANTERP RESOURCES 1615 WYMKOOP ST srre NAfyiEt DENVER, CO 80202-S986 COUNTY, A, MantfestNamtor WMNA PADN^E: 3177743 '4./e«ncratbif'a Phwi* S. TmuFcrtet' 1 CbcnfUnV N»m< WASTE MANAGEMENT OF VVV INC. 7. THmspwrer 2 company Nanwr C.SeneTmisportpr'sID 335239 0. Transponer'iPhoftt 6B1-456-6971 us EPA iO Number F.TrsKporter's Wiooe •9.08slgnst84l FatRKy N»ma amt Sja Addma IVTEAOPWPia LANDnu C.StataraeURyiO' 14RS DAWSON OR, ST£ 101 H. State FaeffitV'Nwfie BRIDGEPORT, WV2633b 11. DMCfUKtonofWute Materials L"M)K.«nund#al.' lcerttfy;.on behat' ofthaabavu lbtKcl faUlU'y, iliaUw ltdi be»tpfn y lro(w46dit4, th« abt^dasCrlbad yilaite wet ma>>d8«b InHRtpHgni;? v< thAiia'ppl>eabCa lawt, regulatiofa. oamMtt and lieentesontttedaiesErad abova- ' 20_gdtity Owwer or Operator; Cerdflcafion ofmcalpfofoon-haiartdustnatertab covcreS bytfrts manifest. White-TREATM. , DisposAi. FAOiirrcoPY Pint- FACILITY USE ONLY Blua- GEMfWTOirifrc&l'Y Gold- TRANSPORTER #1 COPy Veltevy OEMeWATORflV'COPV Ulaste Manaoenent To:3049260496 Froa: MoBte HsnoBeaent Fax: Nasta HanagoMnt Attn: dep To: dep Company: water and waste management From: Sekela, Kelli Subject: rejected load KOmX9 IIJL-03-2019-13:48 ltae:046 Pa«a:001 of 004 Date: Friday, Jul-03-2015 Time: 03:48:51 PM Number of pages including cover sheet: LJU 4 To:30492M4S6 i=riia: Haste Hanaseaent Fox: Haste KOn^ JlJL-03-201S-lS:W Dac:OU Pa( e:0Q2 of 004 JRadipte^Sftl Waste Disposal Form •Fojin IW ot ShlKfti^ftNAfbe'and M^iiio'.Addiie5&- CO® • 1050 COnSQl • Phone Snvt. eim t • loifflipaM eft 3^ nSf 0S^f Transpo^#2 CcHnpony Name Dcsjgmp Phone Fanaity Name MOT(»}1 Phone Phone WkSbTV-. Swte lei 6r%f>nii. ww ibm )_ Dfisaaiptioh ofNORM •"- waste;(e.g. scaie, $oil, other) MIcrol<;9ir reeding j Activity . 1Cotteenliaddn .Number.of Contmner' Containers Type Total t Uhit Wt/Vdl Qiiaittity 1 1 Drftt KO fops^o I •l i i ofradibacttvhy Jcnovwi tobe inthe vehits e? (&:gi Medihal-soai^. fftilWrn r Post-alann tictioriB talcen by the wastefaciltfy/trmspofter; 6C4n .fefiy j>i 3 IO0hM€ 1 SpeciaiJHandringlnstnictionsand.Additionallnifat?^^ M Page ^ of f 1 ! i Tune To:30492&(MS6 .Haste Hanageeent . Haste Hanagemt KOMX9' aUL-03-2015-tS:4a Doc;046 MArazRiKcarGBaGity 003 of 004 7-^ / tZiX mmm ELim "pSmB PQBat 171*^ oKjOom;^ •f^St I41S!S?—L I ' «ilMr-«>6v 5Si06£2!^ TODOKdiftTCTgp fatii- mfjt k e4»Aiii> TSKiCK s3!B5aiH^0 ff 5ffir—- wmxsBAiiw •- • j 'rticlrCfl O On:^ ^*>Rear Wfif. OO o To^04ra604M Frua; Kacte Honagewnt VIiAM. Fax; Haste tianagnent JlJL-03-201S-lS:4a Doc; 046 Page: 004 of 004 NnN-HA7ADni NON-HAZARDOUSi MANIFEST »»a»Ts. iaaJ>>U«s laaw 1. uenetawr"su5 tPA ti> no. ManifKt Doc NO. 3. Page lot NON-HAZAROOU5 MANIFEST '1. Ceneratert MalNnc Addrtm Garicraloi^Site A*IA»xnfaifiw^t»i.t.inBniir) CONSGL ENERGY PAD; 1000 eONSOL ENERGYDR GANONSBURG, PA 15317 WELL; 4. fatof's Phone ¥ • ^ A/Maiiii«»i.Numbpr ' 315SS67 WMNA B. state GanBrator'i ID COUNTY; -i.- 5. TranmortA 1 7. Trentporter 2 Companv Name a. Stats Trsnaportar'i id F. Trawpcrw's Pttww fi. Designated FaeSitv Name and Site Address MEADOWna UNPFIU G. state Fadftty ID loaBoA'MfsaN dB stE 101 H: State reeUtty-Phena. BRIDGEPORT Wv 26330 ^1 I y;? • • I q[ U-DdbilptionefWasteMater<* s r.vt-ag^;at--gW78;&3A I Mac. CoffAcnb E WMProfSa* =t:;ySH WM Prone* IS^.lpadirHindllng InrthictiMii and.Addrtibnal Iniannaaon BOXNUMBEftn^^ j J ^ .— ! D.sPArcH.d/7 \m. .KtetftCh. Sav. ^'^•. TrenfponeflAcVoowlMgementofRecelptofMateri'als ifc Trgnsportef 2Aeknowledgsmeflt efftaca^of Materials ^ ~ ISignature 19. CrttflafofRnjiTrBatTn>m/DltpQ>il I 2Q. Mofttfi' j i "'*''' ' FOCl[ltyO>,r.tr.orppemtor: C.rt^fic.^onQ^racaiptef^o>v4^,.,,tlOiamata^blrr«:.ara0>w>f,i.^..,t...l " PrintsdName yL •, , Jammw ' T^aOire • W rTpr'^ MWBmi • " pgy 1 • I J' I 13:33 Northwestern Laj:dfii 304428839<3 ^ 213 P001/002 f,245 «5»TE IWAIUAGEMEWT Northwestern Landfill, inc. 510 E. Dry Run Road PARKERSBURg, W.V. 26104 (304) 865-3938 PAX (877)411-6497 From:'* Lisa Date; loaa ° OforR,^ ''^p'y o Please Recycle 1 04.u l. Radiological Wasm DiSpos?l FOrm Farm 1W Wh??br?s or Si?hipper?s Name-"and Mailing Phone: A a 1/ 2? ?i Adr??ro 90? 'E?rango?er #1 Company Namcu? Phone c" . . - 5437-4932 .31? (gs/N. 55:5 #2 Company Name Phone Co?uTnemial waste Facility Name Phone a, $95513 '33 3? grm/ 3 AEI?ivity I Number of Container Total Unit Tim: .1'It'3 (cg. acnlc. :mil, reading Containers Type Quantity 1 "Draw r?ml '3 II I, 1. (.115! I a Ios'smw JV. 5: 35?: I ?f Ewe" . 1 Art: than: any other sources of radioactivity knoum to be in the vehicle? (cg. medical source from driver, cm.) 0711?! :sc. 11:7;11! '4.de -u 4.4: FUSE-alarm aCLiUns taken by the wast: I it. .L . 3H5 3555' 265: II I. {a {:11 .sz Spatial Handling Instructions and Additional lnfOrmation: m: 53%: 533': Page 0L .. - -. 3044288394 09-16- 15 10:39 FROM-Northwestern Landfil 3044288394 T-442 P001/003 F-519 VUM WASTE MANAGEMENT Northwestern Landfill, Inc. 510 E. Dry Run Road PARKERSBURG. W.V. 26104 (304) 865-3938 FAX (877)411 -6497 or visit us at www.wmdisposaLcQm From; *^"9—« 3 Including cover Lisa / Judy jtetot Re'f<.c.'Ti arJ • llfgent •ForRevivw • Pl«aa« Commsitl • Please Reply • Please Recycle aa-ao- 13 ito:63 tHun-wortnwestern Landfil 3044288394 T-442 P002/003 F-519 Radiological Waste Disposal Perm FoimlW Generator's or Shipper's Name and MailingAddress Phone PreSSn/'e ~7eci\ Transporter#] Company Name Phone j2)>icKe.'/c. UJ^xTc./^ Shrift i c-Ke.yt' ^*2./"]/. iiir. Transporter #2 Company Name Phone Designated Commercial Waste Facility Name Phoiie Jo y /^/a/ I .cription ofNORM ..ste(e.g. scale,soil, MicroR/hr Activity reading Concentration other) Number of Containers Container Total Type Quantity 2^ UnitWt/Vol pCi/am "br.V/ joj ^2,$^ y/JJ 3^313^ ^/a soyJ 1 Tor/ • i Are there any other sources ofradioactivity known to be in the vehicle? (e. f medical cmirr? from driver, etc.) Post-alarm actions taken by the waste facilityAransporter: 0003.8 AL/»n EK6 3018 3066 Special Handling Instructions and Additforial IriforihatiCn: AB 5tM 5716. I1^60()dS33Z Page. Time of li:/^ io3-ao- ID ia:j8 fKun-Northwestern Landfil 3044288394 T-441 P002/002 F-518 WASTE MANAGEMENT TRUCK SURVEY FORM "'IKVEVORNAME SVJWey DATE & TIME h V.J'r eKfo. MANUFACTURER /MODEL /SERIAL NIIMBKR OFSURVEY ^fETEi^ IlloCb CALIBRATION DATE calibration ju>fi MANIFEST ID ft DESCRIPTION OF WASTE S0Ln5>-UQUID? a,Ke WASTE generator ADDRESS PHONE 91< S^L,rt.. Tecil 5*^ Aicru/.eJi WASTE GENERATOR CONTACT Of. TITLE TRUCK OWNER FAXorE'MAIL ADDRESS RuJ(W Aretiiere any otiiersoiirces of rsdioactivitiyknowntobe intbe vdiicle? (e.g. medical source fiom driver, etc.) • Post-elaim actioM taken by the waste facitityAren^orier: Spedsl Handling Instructions and Additional Information: Page pf_ • < J i i i •11 Radiological Wa^e Disposal Foim Fom iw Oenerator's or Shii^Kir's Name and Mailing^i^ldress Phone ^/7 ;;?7/ l/ih'c*. ^'V (S-A/Vey Transporter#! Company Name Phone {/)dl^crJ.j JfO ^3^ 3:200 Transporter #2 Company Name may [. Phone I 0 Ailb Designated Commercial Waste FacilityName Phone MicroR/hr Number of Container leading Containos Type /J,S/-77 Aie there any other sources of radioactivitiy known to be inthevehicle? (e.g. medical source from driver, etc.) /Jo Post-olaim actions taken by the waste fiwdlity/transporter ^%iy< h //• Additipnal Infonnation; Special Handling Instructions and Additipnallnfonnation; Page of j^/E 19Z. ^- ,, , . . /i • u D Radiological Waste Dispmi Ponn POBD 1W uneso^iecjice. 6ae^<^y UKc^ OiO m Conqany Name ntone , 53o-V/?Y:7 Ph(Kie ^•3o- T^»wporter#2 CompanyName" 3. Plione l.'A^' 2 9 2015 AJesigoated Ccaprntawa] Waste Facility Name" Phone ^-riptlonofNQKU --«to(o.g.ic«le,wl!, I ACBvtty ConeeitrMiou I Nmnbgrof I r.nrrt^ Contaiosr* Quantity fUnitWt/Von tST 2.^d Htpic. U^cCc»^-£/O^CJO ;3.V5 Ofr.di«caviBy tao« to be in th. veBlde? (e.g. medical P^-alanna«ions taken fey the waste fiwaKty/tranaport^ S^HamffinginstiuctioDSandAddi^l^^ recieuft:/ r ,, .'oGd (e-(uir\<2^^ i^Gfctd if\ reof ot \2ul,^:lo(k^ ,V Transp^^r^^;cmpadyNaine / Phone ^fo ' Transporter.#2 Company Name Phone •.1 ^ 'J «• Jlj 1Designated Commercuil Waste FacilityName iriptlonofNQRM .^te (e.g. scale, soil, Container Total Twe Quantity other' ^0 Are dimany other sourees ofradioacdvitiy known to bo in the vdiicle? (e.g. medical fiom driver,etc.) Spet^lMidling instructionsandAdditional Intaiati^ source t4^/^p~ afi in/'/a/i Radiological Waste Disposal Fona FomlW Qenerator's orShii9>er*s Name and Mailing Addres Phone ifcXrioiA-S Transporter#! Company Name ^002 / Phone wh/ ^^rra^-l-cpr imnaporter Wl Company Name Phone Desigoated Commercial Waste Facility Name Phone Number of CoutBtQer Total Containen T^pe Quantiiy Ai?e there any o&er souicea ofradioactivitiy known to be in the vehicle? (e.g. from driver, Poat^anh actioia^cn by the waste faciUtyAranaporter I. Special Handling Instructicms and Additional Page of UnllWt/Voi 1 source Tune Radiological Waste Disposal Fonn Fonn 1W Gfaerator's OT Shipper's Name and Mailing Addre» n . Phone i^JCicA (jiQLYxJljJ ZS 7"/ panyName Phone l3o550 ^2ado Transporter if2 Company Name Phone Designated Commercial Waste Facility Name Phone jnptionoiNOKM .^te (e.g. scale, soil, MicroR/hr Total reading Quantity Unit WtA'ol I (^er UJiKsV Are there any other sources ofradioactivitiy known tobeinthe vdiicle? (e.g. medical source from driver, etc.) f_V-* Post-alanh actiwis taken bythewaste fecUity/transporter: vtAov*. eO 5 ^ Special Handling InstnicSons and Additional Infbnnation: 'XV— V^r. 0[ ^ Page \ of__\ <>- s-/xi;,s Time Radiologioal WasteDiq»ssl Fosm FoottlW Oengat0l*a orShippa-'a Name and Mftfling AddTWS Fbone CVOw^O-i^^-etyj_ ^ ^-^4vajc 'nanqmter#! Con^anyName Gatve>H a5-ia-5 2)^D-4n-»a:iq Plume VOoV-W^^ 330- £2o-3aocJ i Pb»6 Traxispoiter.#2 Company Name Designated Conxmciual Werte PacOity Name Pbone CcMitiiiMr Type 13.»5 ' Are tiiere any ottier sourcesofxadioaetivit^Icnown to be in filevebide? (e.g.medical scwoe firaondriver, cto.) ' ^ WmJc, \V Time _ I Axe tiwe anyoflur souxeea ofradioactivitly known to be in&b vc^ole?(s.g. mediCBt sowoe fiom driver, eto>) . I 1 - Post-alanh aotiona taken by fte waste ftcUi^^tian^iorter y-* ^ -Ve. \e> m fi. sWSaJli^^ ^CiOoii W^rvV ITlnTrniBirril heiBht/midpoint Front NHd-hei^t/midpoint Bade It Mid-hdgjit/midpointLHS QC^ _ NBd-hta^/mi^ointRHS r l8 lowest radliig ISOTOFEI. IfW^tleafing lOuR/hr above BKG follow RMP procedures for letuining aload BKOCoMnta; 'j renci «SuiftcoW^!Uadiiig:__Jl^_fl. (B)-(A)=__SL_(q»);(C)x60»_2_(ct«i); (PVOJ = ^ 0) T) SuifitogWptSaiik (dprnOOOcm') Ifresult <6,600 dpm/300 cm^ follow RMP disposal proceduree / notificatioas. Ifresult >6,600 dpm/300 cm^ follow RMP follow protocol fijr i^ecting /letuming aload Wetzd Covaty Landfill SBCI10W 2. WOUMtelMCAL WAOTROWI.V fflFwfermSnrf«iftlM*« ^^^*pi^Snrvwimvaliictecwitri^ SnrfmBDomltatft (W^jhaa* w»««iigm csoitfamert imnoFs:. Isotope is onDi^Msal Appreval List Mow RMP disposal pxocedores if is NOT oo Dlsp^ Approval lift Mow RMP notificationprocedures Sgx?now3.BtoRftrimftlVA«T.s<»LV ffl Perform SurfacRUataaas / Pom Rate Stifvev yp TTk*^^ Svirfitoe Doso Rate (hig^wstreading on oontainer) ; ISQTOPSt. FoUow RMP disposal /notification procedures Form Completed ByfarintV^L^. fuMtOttl: (sign): Radiological Waste Disposal Fonn Formtw Oeaerator's or Upper's Name andMailing Addre% Phone 30H- iisS- (/•J'53 Transports #1 C^panyName Phone -ER OM^ Transporter #2 Company Name Phone Designated Commercial Waste Facility Name Phone niption ofNORM »te («.g. scale, sofl, MicroR/hr Number of ContiaQCT Total leading Contaiocn Type Quantity Unit Wt/Vol Time otherl Arethere anyother souieea of radioaetivitiy known to be in thevdiicle?(e.g. medical source from driver, etc.) j^ Post-alanh aotioiu taken by the waste fiBcllity/tiBD^ioTter: ..tT. ... and» AdditioQal A Spedal Handling Isstruotioas Infrnmation: Page of_ 4**' d 0^^ /' S)u{^R. ^Xrc\ Waste BOL BQT Production Company 625 LiberQr Avenue, Suite 1700 Bill'OfLading for Non-HazardousMaterials Pittsburgh, PA15222 , Q<2jaU(sd ICQO BOLNumber-079121 to/a .if. Clf'Thme /gi»f oty RigName: ' "Cjyt/ JciiackSeuic*1\nw:(ftWC) IpftrlllCuttings(810) AMms: Stati state Zip Ai,ca^-7J a Production Waste (807). • Frac Sand &Fiac Fluids (804) . DTiash(710) a Sewage • Pond Sludee (804) • Potable Water • other source. BDfnai^Mud/isti/Kaw»ttf(8<8) EsUmated BwrelsTToas Reinemd: oftacyciad water Date: n/ajJiS-^ well#: Time: / ^ m -A9 SeivceSupetvBon' j TSStABLwiSr 1 Supervisor Sgnaturei ZS P AtftffVKI ak /it cny 1state 1 i^«:0 TlC Ttenerdi Ueensft Plated: Field Ticket*: Bp Baiveli/roni Hauled: DrfwerNanw: y >P > CampenyNante: r Mdiasat Oty Truck#: Ttaitertf t Ucense Plate#: FleMTIdeat#: State BamlaTrona Hauled: PMiM#: Time: Date: AM / PM DifverS^pianire: BlteMeme: r i L . Ls&uP c DiSDOsal Site Gty • \• Recvdine Site Permit«: 1state Zip /A / AiC 3 LmUO ^ Well d: • Weiisite RiBNaiT.e:PAa*.eje>7j8— Qrde: or Tank Pit Pliaiie#:. , Barralf/Tem Received; Manifest th pacewmtstqienrtaor: Scalat: Date: Time: AM / PM SiipeivisDrSgrtatttre: wfiiR) - CV4I wnginai, teora - cm un-aite ^peoaiiST, PinK - primary Hauler, Blue - Receiving Site, Green - Secondary Hauler Completed forms mustbe submitted on a weekly basis to the EQT DrflUng Department. 1 Radiologicsl Waste Disposal F(his I^IW Oatoato's or ShippeT*s Name and Mailing Addrea ^tone T^fansporter #1 CompanyName Transportoti^ConqmnyName Phone ^^ •"• ' Phone ! ElesigOBted Crmmmoial Waste Fadlity Name Phone Cb^ L&j^Qif iriptlonofKORM (e.g. scale,soil, Total other fromdriw UnitWt/Vol I Time Quantity^ nidioactivitiytaunwa to be in flie vehicle? (e.g. source Post-alarm actions taka^ tbc waste fedBty/txanj^porter: Special Handling Instrucdoos idoos andAdditiraial and Addituaal Tnfammrinn' IiifiHmadm: »»«-7a c-e/!) PMe —/0« /of-/ /"/J'-ZC Wetzd County Landfill B«te Hmfl! towwmrNnmr V.^(^ r\A.,± Note IfAlaim CMBrfb)tWv«ohdo: m. ^to ftrtto Miion y WAgntTvwt/mfiin^, Biskeroi]iiddn«i»t«. -^i__ fnlMir) VBncucHnAm..^, SWim^Ti WPfiiH,Orrnwor^i.«nri^^ffy^jMnWA.iT,^,y l^li«iglit/ml«.««)^te^oo (W^ MowRMP iMIowlootoool Iterejeoliiig/teoTOtag, Wdzd CountyLandfill SKCnON^PtHtMRniTAryASTKflWI.V Sui&ceDose Rate (higflbwst reading on oontainerX ISOVofb: IfIsotope is on Disposal ^q;nioval list licdlow BMP disposal piocedates IfIsotope is NOTonDisposal ^pioval list Mow RMP iwlifioaticminocedures 8ycnow3.yoBOTw«BWAaTEfPn.v filfifiiJ^^Sqrliwnlsetonb/PaaayateSiirvayimirrfrf*^ Surftce Dose Rate QdS^iertiesdiiui onoontainert l80nK»E:_ /'^ 4^ FollowBMP diqiosalV notifictitioa pvooedures Fonn ConvletedBy(print): a /v (siaa): /-/S-Zf' fr? Wetzel County Land?ll D316: '15" Time: 54457-701) when Driver Home: Song .8692 Note: HAlann caused by driver circle: YES. No further action necessary Drill Cuttings . Medical omdspeoify) W: - 4m vm READINGS: . [12.0 Srfce otilee 'en or Iv?d-height I midpoint Front . i Mid-height 1. Back (E Mid-height I midpoint LHS Mid-height midpoint RHS Highest reading 3E - 150mm If highest reading lOuR/hr above BKG, follow RMP disposal procedures lnoti?cetions. If highest reading IOuR/hr above BKG follow RMP procedures for returning a load fg'll?egg' rm Cogtagiga?on Elli-Veg EKG Counts: (cps) *Surfoce Wipe Reading: (cps) (B) mg Qalgukgign (mug a 5 2/9 e?cigm rage): (clx60= ail/0.5 (dpm/SOO?m?) (Cl MMWW. ?If result ?5,600 dpm/SOO cm2 follow RMP disposal procedmes I noti?cations. Ifresu1t>6,600 dpm/3 oo om2 follow follow protocol for rejecting returning a load r?m? 4.x Wetzol County Land?ll Suf?ce Dose Rate (highesr reading on container) lflsotope is on Disposal Approval List follow RMP disposal procedures If Isotope is NOT on DisposalApproval List follow RMP noti?cation procedtm Surface Dose Rate {highest reading on container) . Follow disposal noti?c??on procedures Four: Completed By (prinQ?A only mom (sign): Radiological WamDiquasalFm'm lew Phone Water- #1 Name: Phone LS Jh?mqmter #2 Gohmpany Name Phonn 13553;.de Facility Name Phone 30 {5111. BQQO . 1'1? may Nmnburof 0mm Tohl? wwaf "Thu" "mustangsou, radius Containas Tm 031w) pCifgm F. I. moo; ?3 Aura than any Othm? aware-as afmdiouc?vi?y lumwa to be in tho vehicle? (mg. medical 0mm 15mm one.) Pam-mm: in?rm taken by the Wm ?aility/hmapm?h?r: a, {a a ?khx ?5 33mm Hmd?ng and Addititmal lumen: LIE 2L: Page (sf runner an Iguanas]: WATER mm: SANITARY memm. ROUTE 1. 30K 1569. NEH MIMINSVILLE, 2615-5 . IE . '3 L. "Hm 11?! m. Kind $339. mu ?assume aroma-a rm 1 qur?du .2 OWML-NUT ?In In"! VARIOUS 5:65 ?32 ?rst M- HATE EM - WASTE WHERE: :3 - {310411191434 7. 923MB :m?mu mu m: wmmamwm um saw-rm harm-Jrde Wln?ll?l-?l?ri mama-w lu- Weizmann-h I Mama I: a: awn-m: hullth ?m *mumr?wnmemh-uh mum?s-M mum-dunk? Ham-smnm'l Mum ?night-Illum- WF-?E?uuwwq 'mmr Luv: uurmu puma: can?. Imam my - n?vuup-F l- A .. . . Wetzel County Land?ll.- . me 12:19; Timey '45 her: 05 Momma? 5?003: Note: IfAlarm caused by driver No flu-the: action necessary Dn'll Cuttings Medical Othe?speci?r)m ?5 Md dose r?ez 3rL( VEHICLE READINGS: . 35mm! 1, Egg Dag; CUTTINGMIATED MG Wm 93;; Surface Isoto Dose Rate on tanner - - Md-height/midpoint Front l' Mid-height/midpoint Back Mid-height midpoint LHS 3% Mid-height/midpoint RHS 9.6- Highest reading Isoroma: Rd? Ifhighest reading mm: above BKG. follow RMP disposal procedures Noti?cations. If highest reading IOuR/hr above BKG follow RMP procedures for returning a load @1Perform Contaming?m sugg- BKG Counts; (cps) *Surface WipeReading: i (cps) (3) 532mm 1' (cps): (D5105 (C) (D) Mace WipcRnuIt 'Ifresult <6,600 dpm/aoo follow RMP disposal procedures noti?cations. 1f result >6,60'0 dpml3 00 cm2 follow RMP follow protocol for rejecting I rettn'ning a load Wetzel County Land?ll Sm'face Dose Rate (highesf reading on container) 1301093: Iflsotope is on Disposal Approval List follow disposal procedures IfIsotope is NOT on Disposal Approval List follow RMP noti?cation procedures Surface Dose Rate (highest reading on container) 186mm! 1'24 ?23 (I . - Follow RMP disposal noti?cetion procedmes Farm Completed. By 15) waifbe (sign): . c. a .5 ?g??immp?%i? ?1 Phone if :5 3 Warm?! Hm Phune Facility Name Phone v11 ombw mm Am War Callahan: Tom U?'?wvoz Tim. resde Cummings Type Qun?11,90 .m 41 ?045 I I Mu. Am any mam known to be the vehicle? (0.5. medical 1 cal-mar, an.) Poa?rzeimrm. ao?mi 1111mm by the warm ?zm?l' . a? QM?/de?aed Rat-1:994 Ma?a 6? Lima and Additional In?xmsu 1LMJ if? Hf ?l?l??m?om g? {fil?pw??ll ?w 1' amt-iniqu mug man?t?e?a? Jim CHEW-inure ENERGY .. me Wilmm: . nucm?w ma?a: WATER smmca YARD mazsgruza: an?: 05-31:: 1? ina?rzm. COUNTY gamma? mm. Hours 1, max 155:. mm minus I Eds/.52magma pf WEE and Emma: WASTE "ma?m mov?i?-rr 9234-1 9 7? 1 nu? unsaturatnmulzn mun n' ?hm nth-tummth ?Win: In.me mama-mm" . amutwn mama-1n . Wm Wetzel Cotinty LandfiiU iJa-^ Time; • ^^^MiuitfegtNumber ^ ik^m^Jl£SL l^IfA mcaai»dl>jufriveroirdc;YES.N^ Medicd Drill Cot ^ Driver Name! FEB - 2 2016 zt^^kwafy)—,^!2z^LCL Jsi&M VmcLKlteAiiiNGai SECQm gVMdlwu.CimwGs/iUsoaA™ torkSurface hotopie / Dww Rete Survey envehicle Mid-hei /"Mrf' 1/midpoint Front Mid'kd^/ini^tointBscic /midtxwntlHS Nfid-hd^/midpointRHS • Hfl^esCii^ IfmsiheK eadin^ < lOuR/hr above BKO» follow RMF disposal procedures AtotificatiQns. > lOuR/hr aboveBRO follow RMPprocedures forretumiog a load Cmrtamlnathm Survey (ops) *Surfoce WipeReading:. Xcps) 0} ^aJaaon rusinvaSm emdencv nOe): (cp8); (C)x<0 = (dpni/300cm') _^(cpm); (D)/0^» Suffiteelfilpe/lenUt c6,606 d^m/300 on^ follow RMP dtsposal procedures / notifications. »6,606 dpn)/300 cm* follow RMP follow protocol fornjecling/returning aload <2) F . Rsdidtogkti Weele tteposd Foim TamlW ¥ Gtantor*! or §9%wi's Kamftand MatKog Addicav PhooB ^!^vxm-oo^ PO ?0)^ l^gca ffrve.G)rajg..UXi3Lp7/9 Phone Ttuportor#) Con^tayNane Cen+ta £rajicarvnn0r\\a.l 5ertiQ-iiir,el&) ^/x> « PosHdna pctioniidwnbytheweitefteffiiy/tiBivortcr^'T^CH.o.A- siSdS^ of_ Wetzd County iiimf^6.600 dpm/SOO om2 follow RMP follow protocol for rejecting returning a load onus- Wetzel County Land?ll Sm'face Dose Rate (highest reading on container) Eamon: Iflsotope is on Disposal Approval List follow RMP disposal procedures If Isotope is NOT on Disposal Approval List follow RMP noti?cation procedures Surface Base Rate (highest reading on container) 3? Ra? (sign):@ (1W Follow RMP disposal noti?cation procedures Porto Completed (print): WETZEL COUNTY LANDFILL RT. 1, BOX 1S6A NEW MARTINSVILLE, WV 26153 (504) 455-3800 (304) 45 5-29 5 5 FAX FACSIMILE TRANSMITTAL SHEET TO- FROMt COMPANY: r«. Ig^dMl fax NOMilER; FKOKB NUMBRK: RE: TOTALNO. OF FACESINCLU0D4G COVER; ^ SENDER'S RBPBRENCB NUMBER; VOUR KEPBRENCB NUMBER: 13 URGENT •forrkvIEW • PLEASE COMMENT • PLEASE REPLY • PLEASE RECYCLE ssrtS'ssaHMusK ~€^jee/eClATED l^)aiTIJNG Wastb niCT V (li^gStollLgM'^ce laotoffiiaLLBose Rgie Snnrey np ^^ntainer ruS/^f): Mid~hf /mid-r'ofut Front, fe Mid-height/midpoint Back J S M:!a-.!ieight/mklpOintLHS —^ /^ h-Iid-height/midpointRHS // Highejrt readmg / h- It cat TeaoKg <-ftiRAt above BKG. foUow RMP disposal procedutes /riotificaiion, fchigh«tnaidmg=.-> lOu^above BKG folKv/RMP procedtwis forletimri^ ' fii)£.erfog]Qi CQatamii^y {on Survey BICG Counts: (^pg) ♦Surface Wipe Reading: (^ps) (B) &eMiJ&Re_Calcuiation (cp„„; (D),0.3-^ W If Ifresil.^6,600 djmi/J00cm ?!!"" follow (,t«a/30(tea=) Surface Wipe Result pt««pe Quotity twvwl I ....,4 ''Q'^oa] soutoe Si«iCi,3 ftoidiiag fetota P^«..i_of,.l__ A«im!3 Infoi:Hmaom tST ri oK K al I 7 © P" s° £z lit V 1t i0 lls I' III II ; 0-5 •g g I ~ CL .9-^ r a-c ; till i'-'sl • -jiT! i • r .o f W Iff h^nI iif -I Sfc r.. tv "1 ..- J , 5 ."i/a fi f, Hi rtf;? p H m i«J Ij •5 f.& P#=1 I s S ^ )F ® c yB V*» "C f: •iX if • jesgi llfll 1S i I.? * <8 5 r iPli ?-81^ S fsl tt 5 5 S ^ ^e 5 S • '<"< T> § T5 S C- Ss ^*? 't fP < •?o —•s o? I» 3 si i: S _ J I I I Sffl QffW 5b J 2 1» k iJ 111 ? F ' • . .O ;, '' -A I 3 V S » ; t: 2:1 i-i i" .•! • s.' fifllllf I l:lll P i I : i ililiimi 1% m^imi -3 ^ ill fir ; b? ^1 f 5 &!« mni p i iIslfiflfii Ji Wetzel Couniy Landfill •'A It 22iSe: -^fenifestKTiir,,^. Driver Note IfAlran can«d by driver circle: YEi A// irc er action necessary WaSTR Type (rmr-r Drill Cuttlflgs oa«(VMifr)Zlt„ 17/7 4— Lose rate' Mid-hwgfct/midpcint Front —(5 jChS^ ^^ Mid-httght/midpointBack 3^ \a-^ u • ,. "7^773^ Mid-height/midpoint RHS j$!n '— iVlid"hcig!it/aiiT Phone ^ •"''^ c^\i TbiiaiijxjJtir #i' CsMmjaoy Name , Fboae ?H&-'trCV-P13?' C^impsnyNsme Phone Dedjfnoied Conncetcial Waste Fee ilityName FhtHw Nusabact Container Conteinm I^fpe Arelti^in 91Q- othersoiBces of isdioedivitiy kccwc to be in tibe -vdiidis? (e.& medial eoume from drivar, «tc.) , i Poct-<)LTrm£:ci!ftasiai:aibywastefecility/h^natpoirtar; SponidlilaqrltogInsfrncaiaaaaadAdditicmiJlatbnmtion: Pa«e of„ -fo (p«r t rv A L, Wetzel County LaodfiU Date: Time: vrimifi«tNumber: Trfinf^PftrtijifNamg; C ?, f *!S DrivarName: Ajf'f/ C^lf\l\^i/ Note: K^Alann caused by driver circle: YES. No further action necessary WasteType r c m < — ^ DriUCuttings Medical t- —i / : fuR/brt VWMnn.v. READINGS! SeCHON 1. Fnw r yAssooATyifi npir.T. s^^ Wabtp. iwilv P) perform Sprfoce hotopic /Pom Rate Survey on vehiislc eantitU^m- Mid-heif^t/mirtyoint Front^'^g' Mid-height/xnidpoint Back Mid-height/midipointLHS Mid-height/mirtyointRHS EG^est reading ISOTora: highest leadifig IQuR/hr above BKG follow RMP procedures for returning aload fiftPcrfoypi Contamutatioii Sm-vev BKO Counts:^ (cps) ^Suifoce Reading:^ W (cps) (B) WftVt C/ifctdation (usin^a50%effidencv rate): —^^(cps); (C)x60« (cpm); (D)/0.5 (O) (dpnj^00cin») SmjauW^IUndt ^result <6,600 dpm/SOO cm^ follow RMP di^osal procedures tnotifications. Ifresult >6,600 (^un/SOO cm® follow RMP follow protocol for rejecting /returning aload Wcfcsdl CountyLaadfiU SgCTlON 2. Wastoonlv ffl Pfffwna SwflCT JhotOBiC /l>OgMteaiirvwr on irahleto fuPJlkri.' Sut&ce0086 lUite (hi^est readingon oontaiitet) bOTOPSi l^peison Disposd Ajqnoval List follow RMP disposal praceduros SIBCTTON 3.JpR Ofwen Wastt. nm.v (I) ^flfyrai Itotoplc/Dote Rate Sarvw m Surfoce 0088 Rate Od£ i6st readingon oontainerX. ISOTOPE: Follow RMP diiqiosal /notifioation procedures l^Q)ngl«ledBy6iiimirAfAsAM8«>i^3> fimV-mr ruJMkmh Rufiologial WostB Dlflpottl Fom FmiW Geii«lDr*Bora^per'B Nam® and NMing A*Mrew NUndMrctf CodlBiiKr Conuiiwn Type i^5^1Wr> 127^ "f known to be in «w Poat-alamactUMalakOTbythowaitolMKtyArBj^wta:"^^^^: Sp«±UH«KatogIh«n«tfioiu«rfAMitiood^^ p»w> of \ ^ . , RADIATION SUMMARY SHEET CORPORATE FILE 1 F DRIVE 1 - PUBLIC 2 - COMPANY FORMS 3 - COMPLIANCE DEPT. 4 - RADIATION PROGRAMS 5 - RADIATION FORMS 6 - WV RADIATION ALARMS 7 ~ RADIATION ALARM SUMMARY ( WETZEL) Wetzel County Landfill Tin,.. Ova" Tmmm!rNmm-\fi!>rib^ M YEmCLE y£ADINC.«ti Smmi f, fmj Psn,f OrmNrVAMnn.T... ti) faftrw NrtijwfnytTpic ^i)OTf lunSiin»»•• ytttei, Mid-h.igh./™dpomtFro«, MM^/midpointUIS rrr'^rf Mid-Mght/midpoiaB^Oc ^ Mid-height/aidpoiaRHS ISOTOPE: OilPerfrtpii CoiHnmiiia*^on Sn»T>..Y ^*Surfece Wipe Reading: Swfape Wipf Cqlqufmfm rufimra sno^ ''^"iehcv rnt^}

IOi' (dpn^ooem") Su/fiusa Herult Wetzd Cotnty t SBCTTOW 2. ForMp^^r^ Waotbnffl V foTiffi SmfyniItnmnic (poie Si SurfaceDose Rate (hi^est reading on oontainerX Isotope: gEQTIOW3. Itop On^i* ^astk V :readingon containcrt ISOTOPE: procedures Ivehicl* MHifainer Radiological Waats Diipaaal Fonn fmaiw Phooe a,^c^ ^r^.^^g-pAD ^ •nropoeter#! Con^aiqrNsi^ WclW'> Phone 33j ' Oo 1''*n^aiter#2 CoBpanyNanie Dodffiated Cocnmaraia] Waste Fadli^Name l/)^-(:Z^l "hoi-'<'^2^ naduig fitiradriver, etc.) Poateianxi aotlooi taken by the waste ftdlity/itiBnipQricr fe^iotvd Rl^^p foC du'i^O SpedalHaadlimInatmciiopM m»A AAtittnutfli PaM_^l of Pbone IAAWI/VqI in flievehicle?(e.g.medica] touice FOniM»rtJurmAnt b CHESAPEAKE ENERGY Rom UTICA DIVISION GASVey 25-12-5 PAD ^ ORkSML-Nor KEdqiuiBLe1 —B^mS^C, Ab HAASISON roUNTY OHIO QOHMMi )a^Kw •wwmtwft COONTY SANITARY LANDFILL 1/ fiOX 156A tiARTINSVILLE, WV 26155 VARIOUS ti I f ^ T CHARGES 1^4 - FRAC HA^TFi <—nnj— A^ttaidfan7tf«wcantfiinctnMinMkn(« *.a». «cn», a» »»iHi •— • • ^ tuwi»>»ggij»wgiBa I • PteSHTCHAflGEB Q RsfSfttpTBpBid .n'sbtora i_i - "nyB.' Nmn* hmty oMin Hnth>k «kT*r Fomrclo^ - easy to fill Fomw and Dooiments Hi liani, ' SHIPPER CHESAPEAKE EN s te'%. MMt^vr waaitntf ta- TTiank you for trying fbrms Formdocs -th« woricfs 6ji«I«st tpuse software/ - To purchasecan + l (97SJ 686-0020 OrvisitMfWW.fbnnrfoec.Tpp* i (Purchase removes this iarmer) STRAIGHT Bftl OF LAOU ^NEdOlUBLEI CHESAPEAKE ENERGY Ffwr UTICA DIVISION GRRVEY 25-12-5 PAD HARRISON COUNTY OHIO HfETZSL COUNTY SANITARY LANDFILL ,vu^.f-. route 1, BOX 156A NEW fdARTINSVlLLE, WV 26155 V IflffWltWl Cmhwim Iomafnift cH^ar VARIOUS j CfflOAveMCLE iMTMLSiNaTRKi: TL#; . O<>i«H0titvi or Artdea ^'soa Maria pid Brccob'arB WELL 3H CHARGES p/N - 65465 FreaSHTCHAfiGB Check'Appreproa eoR • SHPPER CHESAPEAKE EraRGY GABVEY 25-12-5 PAD . [CARRj^ Fm^prepoid o CtHtet Wetzel County T Field Sttrvev Slie«i* Pate:t^ 14 Time; Manifest TifflSPOrtfff Nftine: Driver ^ ^ Note: IfAlann caused by driver circle: YES. No ftmher action necessary Waste TvggfdRCLE^i DrillCuttings Medical ^^^p^^eci^) fiackgroimd dose rate: ^^R/hr) Vehicle KEAPiNGgs . SBffffQN tryORl>Rinf,I.Clin nprnriJ^^y^CTg (^V (i) Perfoyn Surface Isotopic / PoseRate Survey onvehicle coiifaiiMi.*' Mid-hei^/midpoint Front Mid-heifi^t/midpointLHS _ Mid-height/midpoint Bade Mid-height/midpointKHS Highest reading ' ISOTOPE; procedures Awtificatioi Ifhighestreading -> lOuR/hr above BKG follow RMPdi^sal procedures for retumiug aload ons. fiflPerfom^ Con*aniiiifl ^^^ BKG Counts: ^ (cps) ♦Surfoce Wipe Reading: (cps) (B) (SltfT/ftde WlP9 CQlcidation (ysinea 50% efi^eiencv rate).' CC)x60- (cpm); (D)/0.5 = fly Stafitet (dpm«00caA Ruidt w!!^I disposalprotocol procedures /notifications. Ifresult>6,600 j>m/300 cm follow RMP follow for rejecting /letumingaload Websd County Landfill Sgcnow 2. Eon MwiDicAt.Waste qwi.v SurlitfoD(weRale (In^esf rBadfng (vrfltaincf) IMnOFS: IfIsotope is onDiqjosal Approval List follow RMP disposal procedures Ifisotope18NOT on Disposal Approval List foUow RMP notificaticnprocedures ^gnO»3.WORClTHBI>yACTg (BOX ff) Surface ISOtoDK / Dose BrIb Snrw ph vehieiq COntBfagr AMrh SurfocoDoseRate(highestreadingoncontainer). ISOTOPE:_ hpyi^ Follow RMP disposal /notifioation procedures Form CompletedBy(prinOjCc). lA^ (rS 1\Su Rhr lUdidlogiGal Waite Dtiposa! Fonn PemtW pj^ -Ldl^aviv^lo^ jyn/'>-r.,+i^.-. c^f\Jf) ij No Post-olami aotioQa takcabyfiie waste ftcflity/tnnqpoiter. P^lbootA Ri/tlP for Spedal Handling Bntrucfions and Additiooil Tnthn^aitfa^; Paat ^ of 1 I nnm as aois lAiMyav. tsi^a^.Tsooooow WJora uaiK rrTT'rTr _ CHBSAPJaKE BMESGY MmM^Ns&nuiMEi ^ Rom •DTlCA DIVISION GARVBY 25-12-S PAD BASRieON COUNTY OHIO '^CTZEL COOSTY 9ABI1ART LWDmL oiaow 1, BOX 156& Ro f/ —6 raw MRWIfteVILLB, KV 26155 •!»< VARXODS "••"*B1'ig1^^TTr-'Trr TE 10 €54654 0 tfOCT" SH^^ER CHESAPEAKE fWjttr.priifihl D'cmk* tofill ffomtt and Dommertta Wi^wtMi^i^wwwur F^niMfQc«-tfiewDrid's«»9i^t0UB8 »» ftNiwioftixaie/ ^ opunhaMcall 4- l(97aj 6B6HM20 CSESAPEAKB ENSROYW ftwn OTICA, DTVIsrON . 6ARVEY 25-12-5 PAD ttAWtCBOH COOKTY OHIO #* (Puirfase femowss this fawng) MS00TMBL£1 M ••WWt rroWBL COONTY SANITARY LANDFILL ewwinaft I I route 1, BOX ISfiA aestjl^ »'8* MARTXMSVILlB, WV 26155 Mon VARIOns MSHprnd *££E?Z'55LI^!15"'* ' h• e» mSOHTCNARBBS Ow*'Afiprqpiri«i8oc • 3HTOl^ftPEAKS EHERSY flARVEY 23-12-s'pAD .1CftRRg [00/100'd HgS-OE5-OEE 'ON XVi > 1>- CDlacl ^ jpiiog spio^joH ^^EQuwm/n/m WeOelCoaitlyUiKlfin Pa,: r-ir-iC Time: tA'.SoA^rr^ Manifest>Ji»nT^er D-05'^y7l^ •nangporterName: fYWAt^V^ /YNqa DriverName: rlryrv^iV Note: IfAlatm caosed by drivo' drcle: YES. No fiiriheraction necessaiy Waste TvpgfcmcLE^: rill-Cutting Medical Other(specify). Backgrmimidoaerate! fuR/hrl Vehicle Readings; SECnONl.FORD»lLLCtriTINCfi/ASSOClAT^DRlLL«GWASTKO«LV m Perform Surface faotpple / Do» Rate Survav en vehicle btBd-heifdit/midpoint Front } ^ Afid-hdght/mic^ntLHS / ^ ^hcst reading hfid-hdght/nii^KdntBaok Nficl-bdl^t/mid^KdntRHS \C^ ^^ }^ IsoTOPEt:^ >i 4L ,i 4^' t: Ifhic^est reading < lOuS/hr above BKO, ftdlowRMP disposal procedures/notificatioDS. Ifhighestreading^ lOoR/hr aboveBK.G follow RMP procedures forreturning a load fiftPerform rentemimntoa Snrvev BKQ Counts:, (qw) *Surfoce Wipe Reading: W (cps) m SurfaoB Wise CalculaHon fusinwaSm emdeiKV rate): (B)-(A)= (q>9); (C)x«)= (Q (cpm); (D)/0.5 = (D) (dpinOOOcm*) SttditeeMpeSesult Ifresult <6,600 d^un/300 cm^ follow RMP di^sal procedures / notifications. Ifresult >6,600 djun/SOO ite;6i%iBrrj^^g^a ^ f^aili .,• 1- ••».;•, .-.•/Vj."-1. v/ Radiological Waste Disposal Fonn Foim IW Phone 1%-D Tr^rpj^^l Con^anyName Phone l/AY 2 0 201^; iransporter #2 Company Name Phone Designated Commercial Waste FacUity Name Phone uj^'d iriptlonofNORM .-..ste(e.g. scale, soil, MicroR/hr Number of Costaiiier reading Total Containers Tvpe Quantity other) Unit Wt/Vol I 1 Are tlwre any other sources ofradioactivitiy known to be in the v^cle? (e.g. medical from driver, etc.) ^ Post-alarm actions taken by thewaste!fMility/transporten Special Handling Instructions and Additional Infonnation*. Page of ^ii{fe«t>Jiimber:53ff7 TransporterName;/TVilM^LV\tSj^ 6^c >/r^hPCTverNoWlg? fi/l / ^>3 Note; IfAlarm caused by drivercircle: YES. Nofinrther actionnecessary Waste TwmrcmcuiV Drill Cuttings Medical Oilier (qped^) ^ OS&l (jj^y -52015 Vehicle Readings; SBcnoN 1- r> aw.i. riiTnNca/AfiSOCiATEP Washkonlv ffl Perfoi-m Surface Isotopk / IW Rate Survey on vehide container (umt): bfid<^i^ / midpoint Front. Mid-hei^/midpoint Back Mid-hei^t/midpointLHS / ^ Mid-heii^/midpointRHS .22 ffll^est reading ^•3 Isotope; •^^a..0C..:47jA Ifhi^estreading < lOuR/hr above BKG, fellow RMP disposal procedures Aiotifications. Ifbluest reading => lOuR/hr above BKG follow RMP procedures for returning aload fiilPerform CAntaminarinn Sarvev BKG Counts: Surface (B)-(A)= (A) ♦Surface Wipe Reading: (cps) fusing a ^ (cps); (C)x60- (cps) (B) pfflgteaev rate): (D) (cpm); (P)/0.5 Surfiua Wipe JIani/i (dpm/300cm^) Ifresult <6,600 dinn/300 an^ follow RMP disposal procedures / notifications. Ifresult >6,600 dpni/300 cm^ follow RMP follow protocol for rejcctmg / returning a load 6-S'i^ Wetzd CouQV Landfin TTii^^^iirviiV Sheet ;OX*)IWvrl. For MBPicALWAgra ONLY Perform Snrto Imtorie /Doiel^*** Snrvw on wWWa ffinntahiar (Mmr): SurftceDose Rale (hi^best reading oncontainer) .. ISOtOFE;. IfIsotope is on Disposal Apptoval List fbllow RMP disposal piooedures IfIsote^ is NOT on Disp^ Approval Last Mow RMP notificatiottprocedures Section 3. FaeOTHKa Waste owLV m Parfform Suriece imtmdc / Pom H«teSuiwy nn vrfiicle contatoer Sur&cepose Rate (bii^testreadingoncointaiiier)____22 ( Follow RMPdisposal / ootiiioation piocedures PonnConq^letedByfarmftTlN/-, •> ^ (ajgu): : RAdiolo^cal Waste Dl^oaal Fonn ?onnlW PhOftB 3e>/ ^ Tkan^wrtn:#! CenqittoyKame ^ Phone r<^¥ TrBn90cto#2 Conqiaay Name Fbcme Deagaated Ooounstcial We^ Fadlity Name Awoe onofNOSM Are 1 MicraRAr 1 teadiog any wciiCCT Activity 1 Numberof 1 rmthtrncr 1 l^pe Post^OanBWlioBitakoiibylhBwaatcftdUty/tiaMpoeta:: SpecUl Ha&dliog bntnictkna andAdditkittai lofonnation: of. XMi'Wt/Vdi 1 ffthfeTTi ifae vAicleg fe.a. medkal amme flom driver, etc.) Pef» Totd Qamfi^ Weitzel CountyLandfill FieMSnrvftV Sheet Date: Time: '7.^^ TTansiMrterName: ManifestNumber. ^ DriverName: M' Note: IfAlaxnx caused by driver circle: YES. Nofintfaer actioa necessary WAgiT.T«refciRCU^; Medical OfljerCsperafir) t2> (uR/hr^ VKmrf.Tc Headings; ^•LMK'K t y^Y .g . D»ff.¥• rnrrnNGs/Asso^ftTr" P^wwc Waste owly m Perform Surface laotopic/ Doae Rate Survey en vehicle cetttaincr fumrtf Nfid-hei^/midpointFront_/_l— Nfid-heigfat/midpoint Bade Md-heigbt/midpointLHS . 15 Mid-height/naidpoint RHS HighestreadiDg IfiOTQPB: Mo-r 4 1^ ibFUriHtet/^ Ifhighest reading < lOuR/hr d>ove BKG, follow RMP disposal procedures Aiotifications. Ifhighest reading => lOuR/br above BKO follow RMP procedures fbr returning aM Snrviiv BKG Counts: ♦Surfece Wipe Reading; (cps) (A) (cps) Surface Wipe Calculation (usinea 50% efficUmcv rffte):. (BI-CA)" (C) (cpa); (C)x60= (D) (cpn»); (D)/0.5 = -A.—---—.. (dpm/SOOan^ Ifresult <6,600 dpm/300 cm^ follow RMP disposal procedures / notifications. Ifrestit >6,600 <^pm/300 cm^ follow RMP follow protocol for rejecting / xetummg aload Weted County Landfill SECTiON 2. FDR MEDTCAI. WASTR OWLY m Perform Snrface Irotonk / Doaa Rate Snrvav on valikle cjaatainer ruSOw).' Surfiico DoseHtate (highest reading on containert ISOTOFB: If Isott^is Ofl Disposal Approval List follow RMP disposal piooedores IfIsob^ is NOT on DL^ioflal Approval List follow RMP notificatioii procedures SECTION 3. gtoftOnngaWASraoNLV ffl Perform Surface Iwrfnnig / Do«b Rate Survey on vaMete container fu»4tH! Surface DoseRaterbi^est reading on oQMtainfirt Isotope;. FonnC(Hiq)leted By (piint):_ 5-8-15" RadioU^pcd WasteDwpoatiPonn VormlW Gcaentor's orShipper*I NameendMtDtogA<)dies9 T^ensporter#! CoR^enyName Ol 5 Tnm9CKte#2 ConqMoyN Rioiie Ntnmrof Ccni^ner CoDtanun Type IbitWbrVol I CviAicui* Aretiun any odicr sonreea ofrsdioaotividy known tobe in fte Y^xtde? (e^ medioai Mwtoe fiom driver, etc.) PostHdaim actkns tdcraby thewaste ftctHiyAxanspocter ^o//auj^T^ /^/y^ 1^ ^ t^O SpeotalHandlinghainirtiniiw iwt AAtitifmal Tiii*iwi^itif«w Paae of Tiiefl Wetzel Connfy Landfill Pfc1?"'0-K Tlm« \UUI^ DriverMRWft; Q/jU '^{\)t}c j4 /ol Note; IfAlann caused by driver drdc: YES. No fiirther action necessary Waste Type rciRri.E): DriBCatang, Medical BadmomiilH^rate; vj ^(OdC t4a,<>lg. fan/hrt laElteAaiMCfti Sftnrow hFo^lHW.1.CinTTOGS/As^AiTOPMIJ.1WGWasteowlv ff) Pwfwm Surface liatoDtc / Dogft RateSutvpv miv«lttd'te amtalnw Mid-height/midpoint Ftont Mid-height/midpointBack Md-hd^/mii^ntLHS Hi^est reading " Mid-hd^/midpoint RHS • ISOTOPEt IfW^est re8ding< lOdR/hr above BKG. foUow BMP disposal procedures /notifications. Ithighest reading so 1OuR/hr above BKG follow RMP procedures for returning aload imperfonn Cmmrniiirtlim Smrvev BKG Counts: (^) *Surfiu;e Wipe Reading: 6,600 ^un/SCO cm^ follow RMP follow protocol for ngetdng /retomhigaload Wetzd County I,aiidfill Sirvgy • teCnON %BloaMtolCAl.WAgranMiy m p#yfo)rm Snrfwn I»oiotiir. / mwfP^ Sm-wwr on Surfece Dose Rate (hi^estreading on qontaine) isoron: Iflsotopeis on Disposal Approval list follow RMP disposal prooednes IfIfotope is NOT on IMsposal Approval list follow RI^ no^cationprocedoies SBcnaw3.Fane Quantity ^te (e.g. scale, soil, other) Unit WtA^ol PolUff ji^ Ate there anyothersources of radioacdvitiy known to be in thev^cle? (e.g. medical source from driver, etc.) Fost-elaim actions taken by the waste ftcility/transporter: PolloLOf^ Rivvp Special Handling Instructions and Additional Infrnmstion: Page of Time (610(»A(Vv f- ^ Weteel ComityLandfill ^ ... . FiridSnrvftvShiyi^ AU;:^' ?Z'2015 Date! TqdWPQrtefNaintt^^(^r/»l DriverKama? Qa^ OrtyA^l Not«IfAlanncaaaedbydrivcrcitolo:YES.NofefflMracfe>niiecc3«By { HAsmzBifiBsatii Drill'Cuttin^ Medical I ^ I Oflter^spedfir^ Backaroattddny^tate! fuR/hrt VEHICXJ^READINGS! SEcnoM i-inp»iDB^5;;ijTnwiM/AaBociAmPMUjNow ' o n VI Mid-hai^/midpoint Front _____ Mid-lidgbt/midpf^tBadc Ikfid-hdtftt/niidpdIntLHS NficWirii^/imd^RHS Isotoeb:^ Ifhi^readli^< lOuIWhr aSrove BKG, ftOlow RMP di^osal procedures /irotiiicatioiis. Iflu^ieBt reading lOnR/hr drove BKG fbllow RMP prooedorea for Tctuniiiigaload flftPcrfm-m r!nii#o n^mnB farvnv BKG Counts: _(ops) airferjt mtyg /iutHva 'Suriaoe Wipe Reading:..^ (eps); (C)xdO^ (opD); (D}/a5(D) (epr) (iSpmaiBOom') S!Heae»» p»itcftdlr Tfresnh <6.600 dpna/300 diwei? /notffiCBtfoiw, IfresuH>6,600 dmn/SQQ om* follow RMP fbttowprotyapl fer w^^iig /rahimiwg Wefzel Coun^ Landfill oniR r wl.' SBcnow 2. FttnMiafticAL Wampromly ffl Perform Sttrfacelioterie/Daaa Rate Sm-veyirnvditetecqntaincrr^ SmfeoeDoaa Rate fhiphaat rpadinp on ecmtainert ISOTOTE: IfIsotope is on DisposalAnnovai list follow KMP disposal pdrooednres IfIsotope is NOT a\^ 36H-H5"5-3lr'«> iriptioi of NORM —ate (e.g. scale, b<^ MicroR/hr reading UnitWt/Vol Nomberof Containefs Are thoe any odter souroeaofradloactivitiy Icnown to be in the vddde? (e.g. medical source from dri>w, ete.) ^ Post-alarm actimis taken by the waste fimHty/transporten special HaodUng Instructions and Additional Information: l„ . • - Page of_ follouki Tim STMaiwniILL QF LAIMNtS-i^HOtn- FORM-NOT phtfu.Mfw-WEQOTIABLE CHESAPEAKE ENERGY ORIGINAL-NOT NEGOTIABLE 1 " dm UriCA DIVISION HANCHIN PRODOCBD HATER STORAGE YARD HARRISON COONTY OHIO MweniA ''""'^TZEL CXiONTY SANITARY LANDFILL OMNttMB ROUTE 1, BOX 156A NEW MARTINSVILLB, WV 26155 noun ! VARIOUS ! I'oCUUMNSCMnS' Don of Artidea PROPERTY NUMBER 923449 «a m* M d^MdM «n mk, en—e m e •» k erting 6* igwd er deWreti FRBGKTCHARGES Oaejc Appm^iite Ba>! •M^ritacMwriabamitaiHftig 0 Hm'ERcRiAKMCB Exner urtcfc mitcB» mwowbd mTcn stoas vuo Fraigtie prepaid • ODtett CAHHIgt PER TRAISHT BILL OF LAtHNG^HORT FORMflOT NEQQTIABI.f ' CHESAPEAKE ENERGY n OTICA DIVISION OniGlNAL-NOT NEQOTtAai.E 1 ~ HANCHIN PRODUCED WATER STORAGE YARD MfwawL HARRISON COUNTY OHIO fwETZEL COUNTY SANITARY LANDFILL I--- route 1, BOX 156A NEK MARTINSVILLE, WV CAWIOI MooieHa 26155 IDOnmHacNvKR VARIOUS J Kind FRACK ^ORVgMOlS iNrmigANo; Packaging. Deeeriptnjn ofArtKtes Bpedw Marke and &ro^ons CHARGES WASTE PROPERTY NUMBER 923449 FBSGKrcjHAHis ^... M nrib n ritaam Uacuts e( Oia iQ FrnBiitpn^jsid naureorQinsIanorl — ("1 Cotect ^ itfWetzel Conn^ [.aiidfill Dag SO-I^ Tim« fm •faBSOOrterName; AAS "^nr^fr*"*'0^/1^4- Note: IfAlBnn oaosed by driver drote: YES. Noftotho-aotion neccsM^ WAOTBTvwrf^^gV DrittCuttingB Medical 1 Qfl»rfaoedfg\ Trr^" 1^ Background doaerate! d ftiR/hr^ VKmaLRREAMMGS; SBCraw l.I)ORDwM.QrriTiw«atfAMOciATm Dmia.iwo Waotbowi.v i ^^d-hdrfit/midpointFront Nfid-lidiiit/niidiMrintB^ } ^fid-hei dit/in^poiiitLHS ffil^beitreadiiq; bCd-bdc^/mi^oiiitRHS " ' ! IgorofPRt : Ifhigbe8txeading<10oR/lvabc)veBKQ,ftllowRMPdiqK>8alinoeedi]re8/tiiotiiicatioii8. ifbil^estreading=> lOnRdiriiboveBRGfblljOw RMP procedures f^retuniingaload mtParfiiHH erirtnmfaiifton anrrov BKG Counts: (^) *Smfece Wine Reading: W (qpa) m airfeee Wboe CnlnilatinnruaimaSMirfT?' (B)-(A)" (^); (Qx<0(0 fcem^: (D)/O.S " (K^n/SOOem') (P) Ifresoh <6,600 ^^nn/300 follow RMP disposal procedures / notifications. Ifresult >6,600 ^^m/30QGro^ follow RMP foltowpodoool for xtdecl^/returning aload ' r -fr iiaeaw—•• ••aas-iasT '~T¥ ~r*T— 2 0 2015 RadiologicalWaste Disposal Fonn FoimlW Oeneteto^s or Shipper's Name and Mailing Address Phoim Transpbrmr#! ConqianyName Phone 3%0X ^rAc-^ (?H, Tienspoiter #2 Company Name Phone Desigaated Cwnmocial Waste FadlityNam^ Phone 3(5H'HSS^^ Total UnitWtA'ol At Are tiiere any o&er sources ofradioaetiiidtly known to bein thevdicle? (e.g. medical source from driver, ete.) ^ Post-elaim actimis taken by the waste fsdlity/tnu^iorte]:: Spec^ Handling Instructions andAddidonal InibrmatioD: •• I Page of Time NON-HAZARDOUS 1.6«ne«BriONi«nbM itPigtlol a.EinargsicyniqxxiwPhcns 14. mm 7Mtag'fi )ittS^rr WASTE MANIFEST eiilMlngAd*eee Genenicr's stie Aserut (IT mmmthan noTng aUien] U-S.EPAIOMjiibar SCompenyNinie S.DMigniladFlciilyNamsaaaSitoAddiss U&P?AH> Number lO-ConUien 8.Wt$» Si^ng fbm and Oasolptlon r'a-V- sptcw Handing inibuehM tiMAdctkma) Wonnatian -mfc#47 QenentoiWlfergt^ Piintsdriyped Nm IsTitSrntfwiSaSpfneiS I—itmporttoUS. T>»wpontfSI««are»weniemonlrt: nE>ponftanU.S. MoMh Day Year Mcnh Day Year Mgnih Day Yaar Pcncrsaytatt M» Baring U.S-- 16. Treispoder Wnmrfedpnart efReoNpt (< UsMl Tiarmwte i Ttanspoiterg sistaure 17.ONcnmoney ITlLOiacnpeiuylndcaionSpKe —]^ JPtrURwAn iFdRajacSun 17b. AHtmale FMSly (or Generuer) U.8. EPA ID Number fteiiya Phong 17e. apwm elAbmil* Ftdltf (or Qmnto) Month Datlgnalta FacUy OMiar or Operator Cerlificsiion of raca eS-BLC-OS 11#77(H«v.»0») Day Yaar bythenenihtteevU# noted initem 17a DESIGNATBOFACILrrVTO GENERATOR' a OS or Phone if HC' — c.'^o\(({ tOa&e. b'^iOio^^ iPhon^ TnitUqK-ctTK.- ^'3 Pbome OSJSTwSiS^PaoilityNiS Phone ;jfian 0? W'jRhT raSS^Tnjoafcn 'co^SS Numberof <) ^ Ctme«itr«ioa Contaltaw . («.a.KaT4^joU, ;'ir>f-'^i Vy"5-~t 4 11j ^ qX ^— & Aro&er4imryo& from Jjfvw, aec.) i( ) I !.• aarf Additiowl teflon: lo/ yr '1- ¥- s= Y-i r^~ '•"N Wflbel County Landflll 1521 We(28l Co l-andRH Ra 01 New iWiarljpsvltle, VW 26155 Phojw; (304; 455-3800 Ticket; 20407a '2 March 2015 8:13 am 12 March 2016 O.-ia 003060 S.WS., INC. OFW/V PO 80X457 NEWMARTINSVJLLE.WV 26155 Contract: aiSTOMER Reforence; BOL; inbound. NONE Vehicle:SWS147 T^or/CfyMV SWS ofWest Vfi Blnia License; 00Gross Weigh! Tace Weight 02,740.00 tb 43,420.00 lb NetWeight Ouantily Ooscriplioh 10.320,00 fb Linil Rtao s.ee TN Waste. Residential Net Amoiml: Tendered; Weightma ::assl6 Mij Driver Date / Tiinei. Contract- Tux Tote! > I'M Wetzel Counly Landfill field SiirvAY 'QmL3'l3-L^ Time; —Manifest MinnKpy InimporterT^f^Kpy. >Driver Namo- •Note: IfAlonacaused by driv«drele; YES. Nofurther action necessary MAR i 2 2015 Drill Cuttings Medical Other (qjecifyX ^flcly^Ofund dose rate: VEHlCT,y. RjEAPWns? &££IS&S 1. CMTmvGsA ONLY OLgi Dose Rate Snrv^y M'd•-.ifcigiu / .midpoint Front vehicle , Mid-height / midpoint Back height / aiidpoint IJHS Mid-height / midpoint RHS lifist reading £Siv.vo.;-'S: fifiPeifforw Cantornfanit^im Snrvt^y BKG Counts: (cps) •Surface Wipe Reading: Sl'fface Wipe Cgl^atio„ rusint^n (B)--(A) = . ^f^-frrra rcrfrf- (qps); (C)x60' (Q m .(cpui); (D)/0.5 (l» Surfaet W^SesuU (^ni]/300cm^ WdzelCounty Landfill /"A ^-r>i[CALWastt. (11 PerfoFfw Snrfflga [fotawfa. / y pnh. i bi*J* .?uj'iaceDoseRate (highest readingon eontainerl \Ol^ HSOTOPEJ " iJ 1•flsotopc f Approval Ust follow RMP RMP disposal procedures IS\l WOT NOT on Disposal Approval List foUow notificationprocedures iiiasismaii^pK qthpr waste oot.v rS) Surface fsofanfa / hiii in ,;e Dose Rate (highest reading on contaioerl ISOTCfw,: I'ollow RMP disposal /notification procedures I'orm Completed By(priirtl.^J