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PAGE eta <br /> 09118eln-oo9 i4:�,3 2�1946&X43`3 EHD <br /> S. a, Desmibc the inethod that will�'e utilized to purge and/or inert the tank(s); <br /> JL.AA <br /> C� M M ct S <br /> b. Tank/Piping Haulei; <br /> Nlame_�4 A <br /> Address_—, __Y_._ —City Zip <br /> Phone <br /> Hauler Reostration#(if hauled as hazardous)._.__. <br /> C. Tart).c/Mping Disposal Site: <br /> Addxcsr,___C!tY Zip-- <br /> Phone No. ___ <br /> EPA ID#(i transported to a pormi:fted TSD fac4hty)__ <br /> 9. is the sampling firm an independent third party h-orr,the contractor? YE:S P40 <br /> 9a, Describe,in detail,how the sail and/or water SaMPle(s)beneath the tank and pipingwill be obtained- <br /> I-A <br /> 10. Describe how the excavati(>n will be backfilled with suitable material upon removal: <br /> JkLift <br /> 11- Handling of eAcavated soil: <br /> a)What material w-W be used to line the tank pit and cover the stockpile? <br /> b), What will be the final destinaticn of the excavated stockpile' <br /> c)Contaminated Seal Hazardous Was W_Hauler. <br /> Name Registration <br /> Phcme No. <br /> ri 3 04 (Revised 819/06) <br />