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I. (a) Is thele A PI15-11th)fanlhacdrr's qucsllounaire on file or enclosed'f YDS IXI NO <br /> (Ir) Is Ilse cunenl ceflllicale of worker's conlpensaliou losmattce ou file? YDS IA NO <br /> (c) Does life confloclot Inrssess a "IlAxaldoos Solislan a iteoloval Cefl{Dctilltm?" YDS IXI NO <br /> 1. Ilas A "Site Ilealih A Safely flan" for flak Job site bceu sobwilled? YDS IN NO <br /> 1. 11ns At)III ICalll pet(mo Ililg feloovAI Ilt IIle Clly Ili TFA Ilhlp{IICII A "Golding Allo DACAVAthlll PCrn1It"? <br /> N/A IX I YI!S I I NO I I If YDS, I`emtil N <br /> d, 1W Cmlifacllrr tlblailled approval from rile lltcal life flellafflocill if, petrittol lAilk ctlnitlg? NA IXI YDS I I NO I I <br /> 5. Is Ihcte knowledge of evidence of leakage from Ike lank(s)and/or piping? (If yes, please explain) YDS I I NO YV <br /> (I. If lank fesidoal exists, identify fraospofliog harardoos waste Ilaoler: <br /> Nantc: Nor-Cal WFisle Oil hnolers Ilaoler Regisltallmt N: CAI) 981417155 <br /> Addlcss: 11.0. Box 645 City: Unfair, CA Zip: 95316 <br /> I'hone: (109) 331-8110 <br /> 7. Uecnnlatninalloul ntcedmes: <br /> n. Will 1340 .1) And piping Ire Acarnlaminatal plior Io rentovaff YDS IXI NO <br /> It. Identify eoolinclor perfmndng decontamination: <br /> Nance: Jhu 7 horpe OII Co , Inc <br /> Address: 351 N. Deckulnn Road/P.O. Uox 357 City: Lodi, CA Zip: 195 41-035 <br /> Phone No, J209)_"6 -4581 or (2 9 368-6175 <br /> C. Describe method to Ire used for dcconlandnalion: <br /> '1'Anks And piplog Will Ile fi Iple rinsed will, hot wnfer and blwlegrndable soap soloflon. <br /> it. Describe how f{nsale material will he slofed oo-site poor to tunoifeslhtg off-site: <br /> 1 he rinsnfe w11i be removed by.lint Thorpe 011, Inc., persofnfel And Ile placed In drums. The <br /> flillon 11-111111! Ialrletl "rill sloird oil dile nlvitillog Illck fill for dispostil Af A proper disltosal <br /> facllily, I <br /> C. Riosale Ilaoler and pnmilled "treatment, Slorage A Disposal Facility: <br /> Ilalllef NAme: Sallie As No. 6 Miller Regislrlillon N: <br /> Address: City: Zip: <br /> Phone No. <br /> Petndlied Disposal Site: Itclllimles Scrvkcs,lWicrsou, CA, or other opproved fndlll,y. <br /> rasa a <br />