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LIN <br />F� <br />LM <br />0 <br />L <br />there a '= contradoes questionnaire of file or euclosW? <br />t) Is i Does <br />current certificate.. t ♦fi IS ) sf 1. 8 V li 1 •_ '1 <br />l i :,thecontractorPossess aj > f r i s Substance Rcmwal{Ia 1.'(t <br />Has a Wft Heaft & SWkq PhW for this job site been submitted? <br />Has aPPIkAnt Perfbnnluff removal In the City of Tracy <br />eda %rading and Mm'"+. f i 1 permit -9 <br />N/A IFES NO If YES, Permlt# <br />Is there laumdedge or evidenceof t ria the auws)piping?Plea" explain) <br />tankresidualexists, Identitytransporting hazardous hauler. <br />F <br />Address <br />�` <br />►� r <br />phoned <br />8. will tank(s) and pipes be decontaminated prier to removal:' YES [ l NO <br />b. Identify contractor performing decontaminatlow. <br />Name 01 <br />Address city i <br />Phoneo. <br />C. Describe unthod to be used for decontamination: <br />onsitedL Describe bow rinsate material will be stored o <br />e. Rinsate Hauler and Permitted Treatment, Storage & Disposal Fachty- <br />Hauler Name Hauler Reffish-stion <br />Address city Zip <br />Phone No. { } <br />Permitted is Site <br />