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008 09:52 FAX 510 614 8396 PARADISO MECHANICAL 4002 <br /> UST SYSTEM RETROFIT OR REPAIR <br /> (Submit minimum of 2 sets of plans&applications as originals will be retained by END) <br /> 1. Site map enclosed YES 54 NO [] <br /> 2. Manufacturer's spec sheets attached for all equipment to be installed YES m NO[J <br /> 3. Description of work to be completed (If a9l piping, UDC's, or other UST equipment, or performing tank top upgrade, <br /> use the UST Installation Application pages 48 as necessary for a timely plan review): <br /> A� SgST`lA G eALG oI.CP 2 - i <br /> s <br /> c <br /> SOAM11. '2 U04 1114 <br /> 4. Description of equipment to be used(Attach drawings blueprints as necessary): <br /> CZE AtrArjtjEb Fa, <br /> 5. Ail equipment is State certified or approved. YES IA NO[] <br /> 6. Decontamination Procedures: <br /> a Will piping be decontaminated prior to removal? yEg[] NO(] A114 <br /> b. Identify contractor performing decontamination: . Phone(_ <br /> Name city Zip <br /> Address <br /> C. Describe method to be used for decontamination: 4114 <br /> d. Describe how rinsate material will be stored onsite prior to man'rfesting offsite: A114 <br /> e. Rinsate Hauler and permitted Treatment, Storage&Disposal Facility <br /> Hauler Name PhoHauler Reg# <br /> Phone( <br /> Hauler <br /> City ZP <br /> Permitted Disposal Site <br /> 7. a. Describe the method that will be utilized to purge and/or inert the piping: A114 <br /> b. Piping Hauler: Phone(_� <br /> Name City <br /> Address /f <br /> Hauler Registration#(if hauled as hazardous) <br /> c. Piping Disposal Site: Phone(� <br /> Name Cityzip <br /> Address <br /> EPA ID#(if transported to a permitted TSD facility) NO[] /Y/" <br /> 8. Is the sampling firth an independent third party from the contractor? YES[] <br /> 9. Describe, in detail, how the soil and/or water sample(s)beneath the piping or dispenser will be obtained: <br /> 10. Handling of excavated sail (Contaminated Soil Hazardous Waste Hauler): phone (_� <br /> Name Hauler Registration# <br /> Address City Zip <br /> b) If soil is not to be hauled,describe what will be done with it: <br /> 2 <br />