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d. Rinsate Hauler_ <br />Corrrpany P�arne_�,Jv_►RC�I++��ri'a"�t_ A�ip�olik�.��r�:elr. _'C_ I'ieone::��y99-�Ti6 <br />Address `nao city r rd, �Mrip.945 _`r- w`lo <br />Transporter's ID# <br />e. Sandblast Waste Hauler. <br />Facility ID <br />Company Name 1 14 Phone ----- - <br />Address Clty , Zp <br />f. Treatment Storage Disposal Facility- State Facility ID <br />Company name__ <br />Address <br />Phone— <br />Confined space entry permit(s) in accordance with 29 CCR 1910.1 must be onsite at all fimes and <br />available to the PNS-EHID inspector, <br />9. Submit a complete third -part/ evaluation of the liming material and procedures as follmWs- <br />_a. A resume, including all applicable formal training experience, from personnel who conducted the <br />evaluation (not necessary for UncWwrders Laboratories) <br />_b_ An affidavit from the Company that received the third party evaluation confirming tfiat there ars; no <br />mutual financial interests between lining company and testing organization (not necessary for <br />Underwriters Laboratories) <br />_c_ A description of the testing organization's formal periodic inspections of the listed/certified materials <br />and processes. (The purpose of the forrrral periodic inspections is to ensure that the listedlcertified <br />mater fats and process continue to comply with the lininglcerttfic:ation ) <br />Td. A copy of the voluntary consensus standard that was used during the evaluation or description of <br />the equivalent test protocol, if a voluntary consensus standard was not used. <br />__e. The testing organization's raw field data- laboratory results, calculation, graphs, charts, etc <br />-- J. The conclusion of the testing organization's evaluation of the lining material. <br />_g. The conclusion of the testing organization's evaluation of tie lining process. <br />_h. Limitations on the iistingicertifteatiun, if any - <br />i. A statement from the testing organization confirmiixd that aU equipment at the test site(s) was <br />properly maintained and calibrated to the Level of accuracy necessary for a valid evaluation_ <br />L/9 'd H601ON 1991-z'('I-61); WdZ,j:Z 6661 ' l <br />Z <br />S <br />n <br />21 <br />C <br />a <br />Z <br />D <br />D <br />R <br />_d <br />M <br />H <br />Z <br />( <br />T <br />T <br />M <br />H <br />Z <br />S <br />n <br />