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S. <br />9. <br />10. <br />11. <br />a. JIescribe the method that will be utilized to puree and/or ineM the <br />t <br />b. Tank/Piping Hanle . <br />Names -.t <br />Address'/6,45 9o.yk-J,kr Ci ri (Qck— Zip VS—ZY&y <br />Phone ) 660 —93? R <br />Hauler Registration # (if hauled as hazardous)4A <br />C. Tank/Piping isposal Site: <br />Name�� — <br />AddressI/bo X(n_ C.t %s City fC Zip <br />Phone No.('Gy` ) CC <br />EPA ID# (if transported to a permitted TSD facility) /V� <br />Describe, in detail, how the soil and/or water sample(s) beneath the tank and piping will be obtained: <br />Describe how the excavation will be backfilled with suitable material upon removal: <br />Handling of excavated soil: <br />a) What material will be used to line the tank pit and cover the stockpile? <br />b) What will be the final destination of the excavated stockpile? <br />\d1L(, 16E cL- AuA <br />r(Tftr- rWV 214P°V14-1 <br />c) Contaminated Soil Hazardous Waste auler: <br />Name GtLl L' Hauler Registration # f, / <br />Address 2 /�T�` P" City ✓+ 4).D Zip <br />Phone No.( ) �/3gi3 <br />EH 23 046 (Revised 9/11/96) Page 5 <br />iJD <br />