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9 0 <br />TT GENERAL INFORTMATION: <br />Obtain an EPA Site Number from <br />�� Departed ment ��el� and storage tank (UST) removals.ances Control (800) 61- 1 C for teulporary <br />hazardous waste removal activities <br />Disposal Information: SJC EHD's Underground Storage Tank Disposition Tracking Record (UST Tracking Record, <br />page 10) shall accompany each tank removed from site. Tank(s) will be issued an identification number which EHD's <br />representative will note on the UST Tracking Record. Contractor will affix same identification number onto tank end <br />using fluorescent spray paint. Contaminated tanks and/or piping are to be transported under Hazardous Waste <br />Manifest by a state registered hazardous waste hauler. <br />Contractor to Provide: Combustible/Flammable gas detector (to verify the Lower dExp=oosi e Limit �5) oL) atmosphere <br />and oxygen level of tank prior to lifting from excavation), adequate number(s) appropriate <br />extinguisher(s), barriers to secure the area as necessary to minimize traffic and pedestrian interference, and fluorescent <br />spray paint to affix tank identification numberwhicshall <br />skall bestrictly adhe �d to at alproject manager's ltimes daring they for rcoliance with urse of the all <br />health &safety regulations and requirements, <br />closure activities. <br />2. <br />4 The EHD permit shall be on site during tank excavation and removal. <br />5. Any changes in this document shall be approved by EHD prior to initiating work. <br />6. Closure -in -Place: if Closure -in -Place is the suggested method of abandonment, complete form. <br />EH 23 039 and submit written approval from the local Fire Department. <br />7. Temporary Closure: if Temporary Closure is the suggested method of abandonment, complete <br />and submit this form and a written approval from the local Fire Department. <br />g. The following documentation shall be submitted within 30 days of the tank removal date: <br />aboratory to EHD, including a chain of custody and quality assurance <br />a} Analytical results, mailed directly from l <br />and quality control (QA & QC). <br />b) UST Tracking Record Sheets) and/or Tank Hazardous Waste Manifest(s). <br />C) Tank Closure Certification Form. (DTSC form 1249). <br />d) Hazardous Waste Manifests for piping, rinsate, residual fuel, or waste oil receipt. <br />e} Submit the kackfill excavation certificate as required by Sari Joaquin County and the incorporated City <br />gency for their review. <br />Building Departments. This report will be referred to the appropriate a <br />A site which has had UST(s) removed, shall not be considered for final closure until the above items are <br />submitted for review. <br />III. <br />SITE MITIGATION: <br />1. In the event contamination is observed, confirmed or suspected as a result of a leaking UST system it is the <br />responsibility of the owner or otion nit and have it approved prior <br />perator to submit a work pian to EHD Sam theework plan may be submitted concurrent <br />to initiating any assessment or remediation activities. To minsmizfor review. If the <br />with tank closure or installation plans. Address one copy of tho work- Mitigation and a $267 minimumfee mus bei submitted with the <br />site is not currently in the Local Oversight Program a billing <br />work plan. For further assistance contact the Site Mitigation Unit at (209) 468-3450. <br />EH 23 046 (Revised 3/15102) <br />Page 2 <br />