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BLOCK TITLE INSTRUCTIONS FOR COMPLETION OF THE ENGINEERING DATA TRANSMITTAL,: ! (USE BLACK INK OR TYPE) (1) EDT 0 Pre-assigned EDT number. (2) To: (Receiving Organization) 0 Enter the individual's name, title of the organization, or entity (e.g., Distribution) that the EDT is being transmitted to. (3) From: (Originating Organization) 0 Enter the title of the organization originating and transmitting the EDT. (4) Related EDT No. 0, Enter EDT numbers which relate to the data being transmitted. (5) * Proj./Prog./Dept./Div. 0 Enter the Project/Program/Departrent/ivision tidle or Project/Program acronym or Project Number, Work Order Number or Organization Code. (6) * Cognizant Engineer * Enter the name of the individual identified as being responsible for coordinating disposition of the EDT. (7) Purchase Order No. * Enter related Purchase Order (P.O.) Number, if available. (8) * Originator Remarks * Enter special or additional comments concerning transmittal, or "Key" retrieval words may be entered. (9) Equipment/Component No. 0 Enter equipment/component number of affected item, if appropriate. (10) S ystem/Bldg. /Facility 0 Enter appropriate system, building or facility number, if appropriate. (11) Receiver Remarks 0 Enter special or additional comments concerning transmittal. (12) Major Assm. Dwg. No. 0 Enter applicable drawing number of major assembly, if appropriate. (13) Permit/Permit Application No. 0 Enter applicable permit or permit application number, if appropriate. (14) Required Response Data 0 Enter the date a response is required from individuals identified in Block 17 (1 5) Data Transmitted (Signature/Distribution). (A) Item Number * Enter sequential number, beginning with 1, of the information listed on EDT. (B)* Document/Drawing No. 0 Enter the unique identification number assigned to the document or drawing being transmitted. (C)* Sheet No. 0 Enter the sheet number of the information being transmitted. If no sheet number. leave blank. (D)* Rev. No. 0 Enter the revision number of the information being transmitted. If no revision number, leave blank. (E) Title or Description of 0 Enter the title of the document or drawing or a brief description of the subject if no title is Data Transmitted identified. (F)* Impact Level * Enter the appropriate Impact Level (Block 15). Also, indicate the appropriate approvals for each item listed, i.e., SQ, ESQ, etc. Use NA for non-engineering documents. (G) Reason for Transmittal 0 Enter the appropriate code to identify the purpose of the data transmittal (see Block 16). (H) Originator Disposition * Enter the appropriate disposition code (see Block 16). (1) Receiver Disposition 0 Enter the appropriate disposition code (see Block 16). (16) Key 0 Number codes used in completion of Blocks 15 (G), (H), and (1), and 17 (G), (H) (Signature/Distribution). (17) Signature/Distribution (G) Reason 0 Enter the code of the reason for transmittal (Block 16). (H) Disposition S Enter the code for the disposition (Block 16). QJ) Name 0 Enter the signature of the individual completing the Disposition 17 (H) and the Transmittal. (K) Signature 0 Obtain appropriate signature(s). WL* Date S Enter date signature is obtained. (M)* MSIN 0 Enter MSIN. Note: If Distribution Sheet is used, show entire distribution (including that indicated on Page 1 of the EDT) on the Distribution Sheet. (18) Signature of EDT Originator S Enter the signature and date of the individual originating the EDT (entered prior to transmittal to Receiving Organization). If the EDT originator is the cognizant engineer, sign both Blocks 17 and 18. (19) Authorized Representative * Enter the signature and date of the individual identified by the Receiving Organization as for Receiving Organization authorized to approve disposition of the EDT and acceptance of the data transmitted, as applicable. (20)" Cognizant Manager 0 Enter the signature and date of the cognizant manager. (This signature is authorization for release.) (21)" DOE Approval S Enter DOE approval (if required) by letter number and indicate DOE action. *Asterisk denote the required minimum items check by Configuration Documentation prior to release; these are the minimum release requirements. BD-7400-1 72R (07/91)
SUPPORTING DOCUMENT 1. Total Pages 350 2. Title 3. Number 4. Rev No. 100-N Area Underground Storage Tank Closures WHC-SD- EN-TI -136. _ 0 5. Key Words 6. Author 182-N-1-DT, 182-N-2-DT, 182-N-3-DT, 105-N-LFT M: .A. Rowley 100-N-SS-27, 100-N-SS-28, soil excavation,N sample collection APRO EDF0 PUB3LIC RE EASEjY organizati vCharge Code 1f/NA 7. Abstract This report describesthe em~ovadlcharacterization actions concerning underground storage tanks at the 100-N Area, 8. PUN D S OF DOCUMIENT -Thi as prepar use 10. RELEASE STAMP wihn S epartment of Ei its ractor is to be used to perform , or in t under U.S. Depart of Eneg s. This doc t approved PATENT STATUS . o a ument coy since edac , is madevil tr confi tted in piety U.S. D of Energ . is documen t to be publish r -its c otherwise diss ed or for purposes other thanRE aabove before patent Val such release or use has of ured, upon request, from Patent Counsel, U.S. Department ofEnergy Field Office, Richland, WA. DISCLAIMER - This report was prepared as an account of work sponsored byan agency of the United States Government. Neither the United States Government nor any agency thereof, nor any of their employees, nor any of their contractors, subcontractors or their employees, makes any warranty, express or implied, or asauimes any legal liability or responsibility for the accuracy, completeness, or any third party's use or the results of such use of any information, apparatus, product, or process disclosed, or represents that its use would not infringe privately owned rights. Reference herein to any specific commercial product, process, or service by trade nowe, trademark, mansuf acturer, or otherwise, does not necessarily constitute or imply its endorsement, recommendation, or favoring by the United States Government or any agency thereof or its contractors or subcontractors. The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States Governiment or any agency thereof. AS OFFICIALRE AS BY WHC@ DATE JUL 2 1 -1993 9. Impact Level 4 A-6400-073 (11/91) (EF) WEF124
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