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I. (a) Is there a f IIS-BIID camractor's quesdoonaire oo file or enclosed? YES IXI NO 1 1 (b) Is the current certificate of worker's cgmpeusalioo insurance on rile? YBS 13Q NO I I (c) Does the contractor possess a "I lazardous Suirslance Removal Certification?" YBS 1111 NO 1 2. Ilas a "Site Ileallh & Safely flan" for Ilris.Iob site been submilted? YBS 11Q NO 1 I 3. Has applicant performing removal in the City of'fracy ohtained a "Grading and Excavation Pcmlil"? N/A IX I YES 11 NO I I If YES, Permit k 4. fins coulracior oblaioed approval from lire local lire department to perfoun lank tolling? NA (XI YES 1 I NO I I S. 1s there knowledge or evidence of leakage from the lauk(s)and/or piping? (If yes, please explain) YBS 1 1 NOA 6. If lank residual exists, identify Iranspooling hazardous waste hauler: Name: Nor-Cat Waste Oil haulers Ilauler Registration#: CAU 981417155 Address: P.O. Box 645 City: Mosier, CA Zip: 95316 I'hone: (109)331-8110 7. becomaminadon•Prceedures: A. Will tankQs) and piping be decontaminated prior to removal? YES 1XI NO I I b. Identify contractor perfouning decontamination: Name: Jin,?Lor rf a Oil Co., luc. Address: 351 N. Beckman Road/ P.O. Box 357 City: Lodi, CA Zip: 95141-0357 Phone No. 5209) 461-4581 or (109)368-6175 C. Describe melhod to he used for decoulamioadoo: 'tanks and piping will he It title rinsed with hot water and biodegradable Soap solution. d. Describe how dosate material will be sloped on-site prior to manifesting off-site: The rhcsale velli be venloved by.ihn'I'horpe (til, hue., personnel and he placed In drums. The drums IYIII Ile Ialdell atoll stared nil site nwolling trick tell for disposal at a proper dispersal facillly. C. Rinsale I lauler still permitted Ticalment, Storage& Disposal Facility: ?lauler Name: Smile as No. 6 Hauler Registration M: Address: City: Zip: Phone No. Permitted Disposal Site: Itefincrles See vices,Pallerson, CA, or other approved facility. Pegs 4