Laserfiche WebLink
LPT SYSTEM RETROFIT OR REPqIR <br /> (Submit minimum of 2 sets of plans&applications as originals will be retained by EHD) <br /> 1. Site map enclosed YES NOS <br /> 2. Manufacturer's spec sheets attached for all equipment to be installed YES NO tw <br /> 3. Description of work to be completed (if gQ"in piping, LIDC's, or other UST equipment, or performing tank top upgrade, <br /> use the UST Installation Application pages 4-8 as necessary for a timely plan review)'�l) USA of Site. (2)Sawcut, <br /> Demo,Remove and dispose of 41W x 8'L x 6" thick cement pad. 3 Excavate 4'6" deep hole. <br /> (4)Fynnsp rrapd sprnnda-ry nining- (5) Makp rpnair to fjhPrq1.q---, ninj13R. .on ducL-ait <br /> test while repaired pipe is exposed. (6) Backfill and replace concrete 6" deep with #4 <br /> 4. Description of equipment to be used(Attach drawingsNueprints as necessary): <br /> rebar on 8" centers each way. (7) Conduct third party testing of lines and tank, and lake <br /> testing of sump. <br /> 5. All equipment is State certified or approved. YES K) NO <br /> 6. Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? YES NO)R <br /> b. Identify contractor performing decontamination: <br /> Name Phone(_)_ <br /> Address City Zip <br /> c. Describe method to be used for decontamination: <br /> d. Describe how rinsate material will be stored onsite prior to manifesting offsite: <br /> e. Rinsate Hauler and permitted Treatment, Storage&Disposal Facility: <br /> Hauler Name Phone(_ Hauler Re <br /> Address city Zip <br /> Permitted Disposal Site <br /> 7. a. Describe the method that will be utilized to purge and/or i iping: <br /> b. Piping Hauler: <br /> Name Phone <br /> Address City_ Zip <br /> Hauler Registration#(if hauled as hazardouff <br /> c. Piping Disposal Site: <br /> *P <br /> a 'm <br /> at <br /> Name Phone(_ <br /> Address Ci Zip <br /> EPA lD#(if transported to a pe fitted TSD facility) <br /> 8. Is the sampling firm ani <br /> endent third party from the contractor? YES NO[] <br /> ifsoil <br /> 9. Describe, in detail, the soil and/or water sample(s)beneath the piping or dispenser will be obtained.- <br /> 10. Handlin excavated soil(Contaminated Soil Hazardous Waste Hauler): <br /> Name Hauler Registration# Phone <br /> XAdss C" Zip <br /> If <br /> soil is not <br /> to <br /> If soil is not to be hauled, describe at will be done with it: <br /> 2 <br />