REMOVAL_1996 - Laserfiche WebLink

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I. (a) Is there a ITIS-Elll)coullaclor's quesdomnaire on file or eoCIOsed? YES IXI NO I (M) Is the cmoenl certilicale of worker's compensAdoo fos"ClUce oo file? YES IXI NO I (c) Does the coolraclor possess a "Ilazanloos Substance Removal Celt!ficatioo?" YRS IXI NO I 2. lips a "Site 11CAllh de Safety flan" for Ibis job site been submitted? YRS 13q NO ( I 3. l las applicant peifooning icnmval in file City of Tracy ohlained a "Grading and Excavation Pemiil"7 N/A IX I YES I I NO I I If YES, Peooh p 4. 11as cominclor obtained Approval Coni the local lire deparmneoi io perform tank❑olfug? NA 1X1 YES I I NO I I 5. Is Illere knowledge or evidence of leakage from (lie lank(s)aodlor piping? (11 yes, please explain) YRS I I NOW 6. If lank residual exists, identify Iraospurtiog hazardous waste Iraoler: Name: NOF-011 WASIC OII llnulers Ilauler Registralion#: CAI) 982417155 Address: P.O. Box 645 City: Denair, CA Zip: 95316 Phone: (209) 331-8110 7. DecontaiuinaliowPlocedures: R. Will Iaoko s) and piping be deconlendoaled prior to removal? YRS IXI NO b. ldcotify couoacfor penfbnniog decontamination: Name: Jim I horpe Oil Co., loc. Address: 351 N. Ifeckoiml Road / P.O. Ifox 357 City: Lodl, CA Zip: 195 41-0357 Phone No. 3209) 462-4 81 or (2091368-6175 C. Describe method to be used for decontamination: 'I'moks "Oil p1plog will Ile Triple rinsed with hot water avid biodegradable soap solullorl. d. Describe how iinsate material will be sloped on-rile prior to niaoifesilog off-site: The rinsnie will be removed liy.IIm Thorpe 011, Inc., personnel and he placed hl drums. The nit loos will Ire Inhled grill st of ell oil she awnifirig lick Of)for disposal at a proper disposal fadlily, e. Ithisate Ilauler and penniffed Treaoneut, Slorage& Disposal Facility: I laoler Name: Saone as No.6 f hiller Registration N: Address: City: Zip: Phone No. I'ennifled Disposal Site: IteRnef les Services,PatIfersoo, CA, or other approved faclllly. Page 4