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a <br /> Address City zip <br /> Phone No. ) <br /> Hauler Registration#(if hauled as hazardous) <br /> C. Tank/Piping Disposal Site: <br /> Name <br /> Address City zip <br /> Phone No. ) <br /> EPA ID#(if transported to a permitted TSD facility) <br /> 9. Is the sampling firm an independent third party from the contractor? YES [] NO[] <br /> 9a. Describe,in detail,how the soil and/or water sample(s)beneath the tank and piping will be obtained: <br /> 10. Describe how the excavation will be backfilled with suitable material upon removal: <br /> 11. Handling of excavated soil: <br /> a)What material will be used to line the tank pit and cover the stockpile? <br /> b)What will be the final destination of the excavated stockpile? <br /> c)Contaminated Soil Hazardous Waste Hauler: <br /> Name Hauler Registration# <br /> Address City zip <br /> Phone No.( ) <br /> 12. What is the depth to groundwater? <br /> Describe the source of information: <br /> EH 23 046 (Revised 12/31/07) $ <br />