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I <br /> OENERAL INFORMATION: <br /> obtaof tical(h <br /> es <br /> 1. tdo s wn,a Fentoval Number <br /> ctivities essocinted withle tunderg underground storage9tank (USI)lremov la s <br /> hnznrporary <br /> 2. hispnsal Information: Public I lcatdt Services Tracking Sheet shall accompany each lank removed <br /> from site. 1 mnk(s) will lie Issued in, idenlification number which PHS-EIID's represenlalivewill "ole <br /> on Ihe 'I'nnk 'llncklnp, Sheet Gwtrncku will Affix some 'den 10 <br /> number onto tank end using <br /> fimorescent spiny paint. Contandnated looks and/or piping are to be transported under Hazardous <br /> Wnsle Manifest by A stole registered ha7Atdous waste hauler. <br /> 1. Commulor to I'tovide: Gnnbustlble/Igantmnble gas detector (it) verlfy the Lower Explosive Lind <br /> (1,171,)ntmosphcre And oxygen level of look prlor to filling from excovnlinn),adequate number(s)end <br /> npproprlate type(s)of file exdngnisbet(s), barrlers to secure the area as necessary to minimize traffic <br /> And patestrfan Inlerference, and lfmorescent spray paint l0 affix tank identification numbers. It shall <br /> be tine pmlect nrnnager's respoaelblllly for compliance with All health A safety regulatlons and <br /> tequltentents,which shall be slrlctly adhered to at old shoes during the course of the closure activities. <br /> 4 the 1'I IS-F.I II) pentdt shall be on site during mnk excavation and removal. <br /> 5. Any changes its lids document shall be approved by PHS-EI117 prior In Initialing work. <br /> fr. Closure-hr-1'Ince: If Closure-in-Place Is the suggested nnethod of abnmfonment, complete form <br /> .11 23 039 and subndt written opproval from the local Fire bepaflmenl. <br /> 1. 1'euparay i1osure: If'lcmporary Closure is the suggesled method of abnndonntenl, complete <br /> form E11 23 046 and subudl written nplit . I horn tine local Fire bepatt"tent. <br /> 9. The following docnnlentalion shall be Submitted within 30 days of (lie talk removal <br /> dole: <br /> n) Analytical resuhs, moiled directly hunt laboratory to PI IS-EMU,Incl uJhrg a chain of custody. <br /> b) 'Tank Trecking Record Shect(s) and/or Tank I lazardous Waste Manifcst(s). <br /> c) 11/7100115 Waste Manifests for piping, rhnsale, residual fuel, or waste oil receipt. <br /> d) Subndt the bnckliil excavation certificale as required by San Joaquin County and the <br /> Incorporated City Building Departments. 'iltis report will be referred to the appropriate <br /> agency for their review. <br /> A site which ling hall US T(s) removed,shnll not ire considered for fluid closure unlll the above Items <br /> ore submilled for review. <br /> I <br /> i <br /> B11 23 040 (Revised 7-10-92) page 2 <br />