Laserfiche WebLink
LIST SYSTEM RETROFIT OR REPAIR <br /> (Submit minimum of 2 sets of plans&applications as originals will be retained by EHD) <br /> 1. Site map enclosed YES[] NO[] <br /> 2. Manufacturer's spec sheets attached for all equipment to be installed YES[] NO[] <br /> 3. Description of work to be completed(if adding piping,UDC's,or other UST equipment, or performing tank top upgrade, <br /> use the UST Installationication pages 4-8 as necessary for m ty plan review): <br /> 4. Description of equipment to be used(Attach drawings/blueprints as necessary): <br /> 5. All equipment is State certified or approved. YES[j NO[j <br /> 6. Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? YES[] NO[] <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. Rirmte Hauler and permitted Treatment,Storage&Disposal Facility: <br /> Hauler Name Phone(_ Hauler Reg# <br /> Address City - zip <br /> Permitted Disposal Site <br /> 7. a. Describe the method that will be utilized to purge and/or inert the piping: <br /> b. Piping Hauler: <br /> Name Phone(, _ <br /> Address City Zip <br /> Mauler Registration#(if hauled as hazardous) <br /> c. Piping Disposal Site: <br /> Name Phone <br /> Address City Zip <br /> EPA ID#Cd transported to a permitted TSD facility) <br /> 8. Is the sampling firm an independent third party from the contractor'? YES[j NO[j <br /> 9. Describe,in detail,how the soil and/or water sample(s)beneath the piping or dispenser will be obtained: <br /> 90. Handling of excavated soil(Contaminated'Soil Hazardous Waste Harder): <br /> Name Haug Reg"rstratwn# Phone <br /> Address City Zip <br /> b) if soil is not to be hauled,describe what will be done with it: <br /> 2 <br />