Laserfiche WebLink
1. is there a tyontractoi s questionnaire or, rile? NA (j YES®( ! <br />a) Is the questionnaire enclosed? YES (j ,a0 <br />b) Is the current certificate of ,VCr%:er'; compensation insurance on tile? YES NO ( J <br />C) Does contractor possess a "i-=rdous Substance Removal Action{ Cert."? NA (j YES (j NO ( � <br />2. Has a "Site Health & Sufety Plan" for :his jo.% site been sucirittrd? YES NO ( j <br />3, Has applicant performing remo••al in the Cita of Tracy obtai: ;d a 'Grading and Excavation Permit''. <br />NIA `rES [ J NO [ J if YES, Permit # ._ <br />Have tank(s) or piping pending removal leaked in the past? v YES (j '°O- ( j <br />S. What will be the disposition. Of;the wsk(s)fpiping? <br />•'�'n ... L .,._.nsrs i1 A� .�� s-7.�Y7 Ysi i C, }� f� i 1� 2i/�.. L S I b �.� �- • — <br />1 <br />61. Has the contractor obtained approVal from the local fire to perform tank cutting? NAN YES[ J NO <br />7. I. 7econtairtination Procedures: <br />3. Ide.ntifj, contr3ctnr perforniing decon nination <br />Address Zif''� F4 .r City j 4��c Zip5ldi <br />Phone NO -L)&_,_. 1 i . _—-..•.__ <br />b. Will tank(s) and pipir,.- be ontarninated? YES _ � NO � <br />+'.,) tdf�r r.; i^ - : if :: c in :ccn--E, s file): <br />C. Describe method us , to ::lean tank aT Pin, <br />d. 011 -scribe how rinsve material will be :tcred on i�:: tc ranifest.inU offsite: <br />3, Sate REgi•SCr:H322[vouS Wast-'itu'ers and p1ar:rittCd ���c<.1 cscilitieS. <br />- r - <br />a. ResidLal;i-i2:ardous ,V.aste 'H::uler <br />City -c>w-,Q State GA--- zip <br />Fhor.e L't,, t:� )_ • �3 �y3 _ Il.wler i�eg,str4ttion !,f GSD Cl 'Z5 Z <br />Page d <br />•� - - - _ 0 C -"I :;�:'•� <br />