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r <br /> S. a. De tribe the method that will be utilized to purge and/or inert the tank(s): <br /> NEE aA e i%.T Cl r)1 Vte wtov z k <br /> b. Tank/Piping Hauler: ' <br /> Name P—Q0I0 U�C0 hA-Q0' <br /> Address ��� Tc�Q'R 1� City \ zip I4 6 0 I <br /> Phone No.(12D _) 239 - G9 3 <br /> Hauler Registration# (if hauled as hazardous) CAD 9 S C. 030 1-73 <br /> C. Tank/Piping Disposal Site: <br /> Name I �—' , 7- 5 <br /> Address , P q 4 6 I <br /> 25� I\ <br /> Ci �� zi <br /> Phone No.(�) 22J " 13q-,3 <br /> EPA ID#(if transported to a permitted TSD facility)—CA-D 009 AbFj 3 q L <br /> 9. Is the sampling firm an independent third party from the contractor? YES[1l,-' NO[I <br /> 9a. Describe,in de ail,how the soil and/or water sample(s)beneath the tank and pi ing will be obtained: <br /> 1.0. Describe how the excavation will be backfilled with suitable material upon removal: <br /> S 2 ZLo O 2►'1 <br /> 11. Handling of excavated soil: <br /> a) What material will be used to line the tank pit and cover the stockpile? <br /> b)What will be the final destination of the excavated stockpile? <br /> A, --a�,e d la 41L <br /> c)Contaminated Soil Hazardous Waste Hauler: <br /> Name - 1 ley R intra ions �-- <br /> g <br /> Address �� City1n1-(-at1Zip <br /> L <br /> Phone No. ( (D!3(D ) - sa5�k <br /> T•H 23 046(Revised l0/16/03) Page 5 <br /> N D� <br /> to( (L-t ��� <br />