Laserfiche WebLink
12/36/2818 17:15 1-289-36 - 851 JIM T OIL INC PAGE <br /> �- <br /> r <br /> t. (a) is them a low conosmesalt att6cantraetor's questionnaire on file or incl YES NO[] <br /> (b) Is the t ' se�te of s co Tori iti on Elle?. Y$S NO( <br /> (0) Does,the contractor possess a"Elasardous Substance Rtzmal C 'icnaun,,7 Yasw NO(j <br /> (d) Ka overyvite on site,including cranAackhoe operator,been certified to work on <br /> har,"dous waste Sita in accordance with CCR Title 8? mK NO[ <br /> 2. Has a"$IN HeaRb&Sdety]Pian"for this job site been lubmitted? YESX tJ0[) <br /> 3. Has applicant performing removal in ttw City of Tracy obtained a"Grading and$>tctvstlon le? <br /> NIA YES U NO U If YES, Permit# <br /> 4, Ku the contracw obtained approval tram the local fire department to perform tank cutting?NAV YES(, NO(j <br /> 5. Is them knowledge or evidence ofleakage from tho tank(sY sWor piping? (Hyc►please explain)YES[J NO)L <br /> 6. If tank residual exists.identify transporting hLurdous waste bautemr. <br /> Nam 4coelc ze ) utrrr Regfslratfon# <br /> Gam. EG city 1 . G 1 zip 15`.3 i 56 <br /> Address <br /> raw <br /> ® too 33.2,_ "7/67 <br /> 7. Deeontandution Protedarm: <br /> a Will tank(s)and piping be decoistaininated prier to removal? YESX <br /> NO() <br /> b. Ideaft contractor performing decontamination: <br /> Name :Y21 /zv��+.• Q4 F <br /> L a La X 2 City l Zap <br /> Phone No. `"' Z <br /> C. Describe m ad to fie used for dwotttamination: <br /> IKI <br /> 4914, <br /> d. Dwill bo goad onsite to manit8st' tc <br /> C/ S 2?"'0 lCtj <br /> e. Rinsatc Hauler and pereidtwd 71realment,�Sttorage&D t Facility: <br /> HmilerNme ter Reghlrafts# <br /> Addy 9a �^' , �e1;l f �, X 5`3 5' <br /> --,- <br /> Phone No.(_.. 0-0 „�� tis 710 <br /> Partnitted Disposal SirefA�1SF'�Lri'�G�- <br /> 1 s®v';P � IziIV--1 !2040 'w% C0• Cl Sr-e-5/. <br /> 8. a. 'bc the method chat will be utiGxod to a atidior inert thea s): <br /> j <br /> b. TankfPiping Hauler: <br /> Name <br /> Eli 23 046 (Revised 12131" 4 <br />