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1I. GENERAL I*NFGRMATICN: <br /> Obtain an EPA Sim Number iroet[he Degart-d5en.of Tex:: Subn=Cts COnsol X03 51-TOXIC for tecpe::r_. <br /> bazar aus warm <br /> .=oval activities associa ed with endo:gourd storge tank(UST) removals. <br /> Drspesal:nforrrstion: Public Haldl Services Undergroand Snraac Tank Disposi7On Trac_aag Rrerd;US- <br /> Tracking Record. page la, shat AccOmpanv each--mk removed from site. TMW3) will be issued an i ieaG.Iica:nr. <br /> narnber which PHS-EHD s r-_presentative will note on she UST T..acldng Rccord. Cont.-actor il^gzrx same <br /> ideatificauor.number onto tact end user$fluorescent spray paint. Contamran <br /> inated ks and'or P i i. are to be <br /> transported under Hazardous Waste Manifest by a state registered hazardous waste haute-. <br /> Contractor aro Provide: Combuat:ble/Flammabfe gas de-ecrcr (to verify the Lower Explosive Limit iEi) r Mr <br /> atmospiw and ox;gen level of tank prior to lifting from excavadoa). adequate mmsber(s) acid appreaa:e <br /> a <br /> of fire extigwisharfsj, barriers :o secure:he area as necessary to mfnfrrSxc uafflc and pedesman icorfe..e ace, are! <br /> ^ik7rGSceti spray Paint aro affix:ank idmuificadon 7mrieers. I: Shall i7s;h0 e.^^.mar:zser's :esponsibilic/ for <br /> compllaae^_with all health do safely regulations and —qui:emeras, which shall be Smcdy ad:=: d to at till tit-es <br /> during the"rsc Of the closure activitfes. <br /> a The PHS-EHD permit shall be or.site during=k excavetich and removal. <br /> 9. Any changes in this docu dd-It shall be approved by PAS-Eta prior m initialing warX. <br /> 6. Closure-in-Place: If Closure-in-?lana is thin suggested rrathed of abandonment, completc form <br /> EH 23 039 and submit wrtttea approval from the local Fre Department. <br /> 7 Temporary Closure: if Temporary Clesare is the sug;estad method of abacdcrtment, complete <br /> and submit this`,arm and a written approval from the lora: Fir_ DePa.=em- <br /> s. The following documentation shall be submitted within 30 days of the tank removal date: <br /> a) analytical results. mailed direcdy farm latoratery aro PHS-EHD. including a chain of cusrdy and qualiry <br /> assurance and guallty u:>z`ol(QA&QC). <br /> b) UST Tracdng Record Sheets) anedor Tank Hazardous Waste Manifest's). <br /> c; Tank Clcsux Cerlificaurn Form ;DTSC f_—rM 1249). <br /> dt Hazardous tVaste ldan esu for piping. rinsate, esidua fuel, car waste oil leeeipr. <br /> c1 Submit Lie backfill excavation ce-ificate as acquired by San Joaquin Cbarlty and*lie incorpor..ttc <br /> Building DePar.menn. Tiis report wit be refered to the appropriate agency for their re'Aeu. <br /> A site which has had t:ST(s) removed: shall not be crmidered for final closure until the above hetes are <br /> submitted for review• <br /> SITE'v MGATlO\: <br /> Lam. he event contamination is observed, ccr.f:rmed or swpected as a result of a leaking UST sys:em it is a r. <br /> responsibility of he Owner or operator tc submit a wcrb plan to PHS-BED Site Mitigation Unit and have:t <br /> sn?roved pricx arc inihati^ any assessment 0' e-Aediarion activities. To miatmize de:ays, the work plan 4ay bt <br /> n bmi:ted riot tcconcurori wid a'tk closutc or insta lntion pians. address one copy of the Work olan to the Six <br /> Mitigztion lint for review. If th she is not currently in ie=oea Cvetsight Program, a bruins tor, and t <br /> miniram fee mt:st be submitted sfth the work plan. Fo.trther assistance ccmam the Site MfUn trgatton i <br /> (209)468-N50- <br /> Eli 2.1 D46 (B.evised 0&'13199) <br /> ?aye 2 <br />