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FROM : TERRADYNE EtW IROtdMEt4TRL PHONE NO. : 919 4% WOE) PQl.FOR OFFICE USE ONLYTERRADYNE S 1 te TERRADYNE ,lnh Nn. ..oate--_Date-- Accepted Date &jecied Date ’Dote start Trcatmcnt Date End Treatment ndtp-I-._ __.EXHIBIT A AE’PLICATION FOR TREATHENT OFPIZTROLEUH CONTAHINATRD 90ItReceivedReturnGeneral ulrectlons: In order to ck~e~~air~t: whrLhr TERRADYNE ENVIRONWENT= CERVICES, INC.can properly and cafcly handle and treat your PCS, ve must nhtain Information about thechemical and physical properties of the vaatc. please Be complete in your d~iswrtti~; ifyuUL reayurlar is “aiuw” UL “~1 ~v~ll~l~le,~ so indicate. Answcrc must -be Printed in inkOL typevr itten and the completed form signed.1)2)3)4);-i-6)7)9)10)111Ocnerator/Owner tiame/Addrcaa Nawal Fac.i f i Si as nd/AS/S Environmentalnt kildirurr 00 . Czunu 1.?Re;43-W~1f%3 Site Complete Addr~ss/uesc~~p*t~~~~O 20. Box’).,~&&.-%?..., ,~&Kw&&&&!&?~~~.~_ MCB, Camp Lej,e_unGJ ‘NC .e-- -_I.Rnglnoar/Rnvironmon~al Firm- *- - ~...Se?vi rcct Tnr:. --.--Project Hanager Taylor Swril. C.P.G..-._-Company/Addrccc 12448 SEwcut~we FM.e&rd, Suite 106. Ch~sacc?ake.” VA 23320. .Telephone Number 1804) 436-1tl81.-. _-PCS SiLc D~vcriptiorl (tie uL~Ll&l, full service ok convenience store, cardaalership, number of tanks, age of .tanks, type of ‘fuel sold, tank or p!llrmhing leak,accident, etc. I_ Attach Engineering Report or Assessment.UST’ WAR 113e.d t.0 SI~OVF~ fue.t oi 1 at. t.he. 3-i t.e..Type of Contaminatiori (6asoline, Jet Fuel, Diesel,’ other-l FII~I ni.1Anticipated Volume (TONS )Soil Type (Sanrl, Clay, Unified Soil ClaFsifiration) Silty Sand ..8) Average Contamlnatlon 1,000 ppm Heasured by Lab TeslsIc thic coil a Wanardouc Vac4cfl ac defined by Regulatiots of the U.S. E.P.X.pursuant to Section 3001 of the Resource Conservation and Recovery Act (See 40 CE’K,ParL. 261 Lur defilliliqrl). ‘Yc?s . NomSoil Propartios (TCLP, ;Potal Patro~~ydrocarbon, t Moisture, eke.1 Attach~ngineerlng~Environmenta1 Report with Laboratory’ results.THE PROCEDURES ON’THE REVERSE SIDE SHALL BE FOLLOWED VITII 3PECIFICITY AND-ARE HADI APART OF THIS APPLICATION._.. -. . ..--_I hnrehy clerk; f.y that th e ihovs-attached description is cnmplc?te and acl~:c~rrtxa ta the bestof my knovledge and ability to .determine, that no dellberate 02 vlllful omishi.ons ofcomposition of properties exista and all known or auapactad hazards havo been disclosed.--In the event that any of the data is determined to be incomplete, inaccurate 02lalarrprusentation, the underslqned agrees to lndcmnlfy TERRADYNE from and against any andall lae~, coct or damogcs, includiny attorney fee3 which it lruy cuffcr.Upon ecccpldocc of This application by TERRADYNE, it shall LJ~~~~~~ rl wlerial park of LhcAqreaaont betveen tlie patties hereto and attached thcrcto ;IIZ Exhibit A.- Dote t;/,$3\7.? ticflueI -. onmen al F rm Authorized Signatory~~~~~~~~~~~ Date d-2& 9.7 NameReqlstratlon (P.E.,P.G. 1 .___- _____ -State._-__-ACCEPTED : TERRADYNE ENVIRONHENTAL SERVICE.S, INC.