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44 <br />05/13/2008 TUE 14:10 PAX 2 3433 SSC EHD ®003/007 <br />WV 0 <br />UST SYSTEM RETROFIT OR REPAIR <br />( of 2 sets of plans & app8ntians as odgkWs will be vatained by EW <br />I Site map enckised YES I j NO 11 �*'1 <br />,,� f",( Man is spec tbraN to be insfaBedYES I j MU [ l <br />3. Description of tr o* to be <br />"e UST Installation I <br />v kO4. <br />(If aLcfing poft UWs, or other UST equiprneK or pe tardc tOp <br />mg s 4-8 as r=essary for a timely plan reviewp <br />k)� t, 0.�", C L Uedae, mss. ,-,. , ge.; t- <br />e, r-) <br />f) an of equiptrtent to be used {Attach drawing as <br />5- All equipment is State cedified or approval. YES t j NO [1 <br />6. Decantonobiation Pmcedurm <br />a• VM piping be deoontarnin ded prior to YES f X Moll <br />b_ Nerffy contractorpeftming decontaminaf n: <br />Nanw P <br />Address CRY An, <br />c. Descrbe method to be used far ' atian: <br />d. ho►v • trdt be onsite prier irs alis <br />e.litsatoNaukrandpermittedT ge&DWpasalFacW. <br />Haul®r'Narne (_,j HatderR <br />Address <br />Pb milted Disposal"Si* <br />7. a. ft meMW #W wrlf be to purge roes! 90 . - <br />b. Piping <br />Haufar- <br />lfiia&r Registratkm B Of hauled as <br />Q She: <br />Ij if <br />a. Is the sampling fm an independent thin party tram fire c nt ador? YES [I NO <br />9. De=be, im deK how Ithe soil andf" <br />Fir r <br />10. Handfingofe=avMedwg-(Cmtwo-mated-SDAHmwdmmWas*Hadles): <br />Name HaWw RegWkaGo* Phone <br />Zip - <br />b) N soif is rot to be hauled, desorbe what w1l be dam with it <br />2 <br />L -d 0*,69T91a602 DUI SJ040eJgU00 nI 9gTI3 d90:TO 20 06 unr <br />