COMPLIANCE INFO_2009-2018 - Laserfiche WebLink

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UAYST'EM RETROFIT OR REP41IR (Submit minimum of 2 sets of plans & applications as originals will be retained by EHD) 1. Site map enclosed YES [T, NO [ ] 2. Manufacturer's spec sheets attached for all equipment to be installed YES [-3 NO[] 3. Description of work to be completed (If adding piping, UDC's, or other UST equipment, or performing tank top upgrade, use the UST Installation Application pages 4-8 as necessary for a timely plan review): 4. Description of equipment to be used (Attach drawings/blueprints as ngcessary): Replace the ECPU Board and replace with a new ECPU board with noise R11i:)3ZPS-,i nn . 5. All equipment is State certified or approved. YES [4 NO [ ] 6. Decontamination Procedures: 7 E WS a. Will piping be decontaminated prior to removal? YES[] NO[] b. Identify contractor performing decontamination: Name Phone(_) Address City Zip c. Describe method to be used for decontamination: d. Describe how rinsate material will be stored onsite prior to manifesting offsite: e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: Hauler Name Phone() Hauler Reg# Address City Zip Permitted Disposal Site a. Describe the method that will be utilized to purge and/or inert the piping: b. Piping Hauler: Name Phone ( ) Address City Zip Hauler Registration # (if hauled as hazardous) c. Piping Disposal Site: Name Phone (_) Address City Zip EPA ID# (if transported to a permitted TSD facility) Is the sampling firm an independent third parry from the contractor? YES [ ] NO [ ] Describe, in detail, how the soil and/or water sample(s) beneath the piping or dispenser will be obtained: Handling of excavated soil (Contaminated Soil Hazardous Waste Hauler): Name Hauler Registration # Address City b) If soil is not to be hauled, describe what will be done with it: F