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UST SYMM RETRQFrr OR REPAIR <br /> Mubmit mWimun of 2 sob o1plans&al*katlim as wilik"VA be retained by EHD) <br /> 1. She map enclosed YES <br /> 2. MamdacWFWS SIM SIMMIS attached for 82 e* do be butdo'dYEPS[] NOU <br /> 3. Deem"on of work to be wu~(if MMM*kqh UDC's,or odw UST equipmeK or performing Unk top upgrade, <br /> use the UST kwWAMon Applcdon pages 4-8 as neCOWNY for 8 SMIY Plan rOwww)- <br /> ad <br /> 4. Desdow of equipmwt10 be used(AMach drawkWa1bluepilnis as necessary): <br /> S. AN equipinerd Is SUM cedilled or approved. YES NO <br /> 6. Decontamirialim Procedums: <br /> a. VW piping be decontwminsAad prior lo nmvmal? 11YES11 NO[] <br /> b. Identify contractor perkoning decontandnatim: <br /> --- <br /> Na <br /> Address city <br /> c. Describe method to be used for decontamination: <br /> d. DeSCOC hOW dnnft mejwW vA be skaW ONWOVdOrtO MGx'ffe8*Q 098ft: <br /> a. <br /> Rhmmft Hmkr and pwnm,"d Treatment Slorege,&Disposal FacpW <br /> Hauler Reg#____. <br /> Hauler Cft ZIP- <br /> Permitted Dhoossi <br /> 7. a.Deecdbe the melhodtiatvA be ullInd to Purge OKV(WtmtfhO P"9: <br /> b. Piping Hauler. Phone <br /> Cfty� Zip <br /> "aulgr Regishagop (of hauled as <br /> o. Piping Disposal SMO: Phone Address <br /> EPA W#(if trar"ported to a parnMed TSD <br /> a. is the sampling*M an kidelmulattlilrd party*m 2w COWIROW1 YES I NO[) <br /> 9. Desorlbe,in dqW,howthe wA andfar vmler samPIO(s)beneath If+Piping OF dwPensw vA be obtai'm"t <br /> 10- HwWtlnq;ofO=arv�aftd saO Wide <br /> a(contambasted Sol Hazardous <br /> Haider # phone <br /> Name <br /> 70 <br /> p_ <br /> b)if go is not to be hauled,describe vAnt will be done vdh it <br /> 2 <br />