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Page Title:
Sample Management of Change Form |
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|  Exhibit 2.10
DOE-HDBK-1101-96
Sample Management of Change Form
General Information
Urgency of Change
u Emergency
Date ______________
u Priority
Originator(s) _______________________
u Routine
Department _______________________
Basis for the Change (Check One)
Review of Change (Check One)
u Improved Safety/Reduced Risk
u Approved
u Improved Performance/Efficiency
u Not Approved
u Pollution Prevention/Waste Minimization
Reason: ____________________________
u Essential to the Operation
____________________________________
u Other
____________________________________
Name
Organization/Position
Reviewed by _________________________
__________________________
_________________________
__________________________
_________________________
__________________________
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