Laserfiche WebLink
000082 <br /> J. a) Is there a PHS-EHD eewatr:kt uestit>Apnairc on file or enclosed? YES-Q NO[ J <br /> b) Is dw current cenifpccae of workees compo sation inwauoee at tele? YES�J NO[ j <br /> C) Depec die cexttraClOr 1x1.ees>a "Hazardous Substance Remoeal Certification"? YES (�(j NO( J <br /> 2. Has a "Site Health & Safety Man" faK this jut site been submitted? YES Py NO( J <br /> I Has applicant performing removal in die City of Tracy obtained a"Grading and Excavation Permit"? <br /> N/A[X j YES( ) NO[ ) if YES.Permit aE <br /> d. Has the cuntrxa,r okained:approval from the lot:al fire ak-partment to perform tank cutting? . <br /> NA[X j YES [ j NO[ j <br /> S. is there knowledge or evidence of kakage fn»t,the tank(s)and/or piping? YES [ j NO[ J <br /> (if yes.please explain) No. C <br /> 6. if tank residual exist-;.kk-ntity transporting h:avardua s w•aac Imuler: <br /> N;meLICK..Sc�N�S ' NL Hauler Registration tk�1q <br /> A"v,i 1�AtV1 tn,LVO City12L4M2,,3b Zip 9��®1 <br /> Pluxu No. I S) 1393 <br /> 7. Decontamination Procedures: <br /> a. Will tank(s)and piping he de-contaminated prix tU removal? YES [ j NO <br /> b. Identify contractor pt.:rforming decontantinatkm: <br /> Name <br /> A�klcess City Zip <br /> Phone No.t <br /> C. Describe method to be used for decontamination: <br /> d Describe how rinsate material will be Mored on-site ptirx It,manifesting off-site: <br /> •e. Rinsate Hauler and permitted Treatnx-m.Storage b Disp►na1 Facility: <br /> Hauler Nana � A Hauler Registration f <br /> Address City tip <br /> Phone No. i I <br /> Permitted Disposal Site <br /> e <br /> 4 <br />