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Jul. 10. 2008 10: 32AM West Star Environmental, Inc. No. 8964 P. 5 <br /> SYSTEM RETROFIT OR R"R <br /> (Submit minimum of 2 sets of pians&applications as originals will be retained by END) <br /> 1. Site map enclosed YES[] NO ki <br /> 2. Manufacturer's spec sheets attached for all equipment to be installed YES[] NO 01 <br /> 3. Description of work to be completed (if add in piping, UDC's, or other UST equipment, or performing tank top upgrade, <br /> use the USTt Ilation Application pa e 4-8 assnneceessary for a timely plan review): <br /> .S et S <br /> 4. Description of equipment to be used(Attach drawings/blueprints as necessary): <br /> 5. All equipment is State certified or approved. YES-,NO[] <br /> 6. Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? YES[] NO[] <br /> b. Identify contractor performing decontamination: Phone(_ <br /> Name City Zip <br /> Address <br /> c. Describe method to be used for decontamination: <br /> --------------- <br /> d. Describe how rinsate material will be stored onsite prior to manifests offsite: <br /> e. RI to Hauler and permMed Treatment, Storage&Dis I Facility: Hauler R <br /> Hauler Name Phon <br /> Address City Zp- <br /> Permitted Disposal Site <br /> 7. a. Describe the method that will be utilized to purg and/or inert the piping: <br /> b. PipingHauler. Phone( _) <br /> Name City Zip <br /> Address <br /> Hauler Reglstration#(if hauled a azardous) <br /> c. Piping Disposal Site: phone(_� <br /> Name City Zip <br /> Address <br /> EPA ID#(if transported a permitted TSD facility) <br /> 8. Is the sampling fir n independent third party from the contractor? YES[] NO [I <br /> g. Describe, in de I, how the soil and/or water sample(s) beneath the piping or dispenser will be obtained: <br /> 10. Handli of excavated soil(Contaminated Soil Hazardous Waste Hauler): <br /> Na phone <br /> Hauler Registration# (^} <br /> A rens City Z'p <br /> b) if soil is not to be hauled, describe what will be done with it: <br /> 2 <br />